A comment from a viewer saying Statins kill; a few minutes later, I saw an
article by Mayo Clinic about weighing the benefits and risks. So, it got me
going and, again, I'm doing another series on Statin benefits and risks. This - I've
done a couple of them so far and I'll do several others. We'll talk about what
those are and just - well, actually - let me just go through the - the items real quick.
Yes, statins kill. Everybody - I think everybody that's used them would agree but
it's sort of like airplanes kill too - and cars and trucks and antibiotics and
water and oxygen; they all kill. The question is not whether they kill. The
question is - Do the benefits outweigh the risks?
I cover - just did a video on David Diamond's STEM talk 41, where he talks
about absolute versus relative risk and saying, "people are lying with statistics"
No, they're not; and I go in and do a rebuttal of this issue about absolute
versus relative risk. You know - again, I have at one time over half of my - between a
third and a half of my patients that needed that I would recommend Statins; for
I did not take Statins; and that's fine, in terms of making your own choices. A lot
of people choose not to fly; some people choose not to drive, etc. So, I'm ok with
people not doing it but I'm not ok with people not understanding the details and
that's what this survey - this series is about. I've done a couple of videos on
Rory Collins in the statin trial as grouped; they would - their position would
be similar to what mine and I think a lot of people's position. And that is - Yes
you can get - you do get side effects and you can get rare deaths with statins
but the benefit is huge compared to - for a low probability group
like David Diamond was talking about - No, you shouldn't take statins.
But, if your risk is 10%, 20%, 40% - which you can find with CIMT, this issue of
relative versus absolute risk becomes a non-issue. We covered in the last video
- the JACC (Journal of the American College of Cardiology) issue about
relative versus absolute risk. some of the lay press like David Diamond's video
and the profound impact it's had on public health with so many people
stopping their statins. Again, today's video is going to be about the Mayo
Clinic; very practical if you're taking a statin. If you're not taking a statin, you
probably should skip over this video entirely. Maybe not; you may be interested.
So here's the thing - Mayo Clinic. Statin side effects. What - before I do just one
other comment - I'll also be doing another video a little bit later on liver safety.
There is actually (believe it or not) a statin liver safety task force and, again,
the short version on that - a spoiler is: if you don't - if your liver enzymes don't
triple or go over three times the higher limit, then you're safe
- believe it or not. So, back to the Mayo Clinic article; and very practical lay
press article. Statins have been highly effective - safe for most people. They've
been linked to muscle pain - that rhabdomyolysis that I talked about -
digestive problems, mental fuzziness, etc. Researchers found a nocebo effect when
it comes to perceived muscle pain as statins. What is a nocebo? A nocebo
effect means people have negative expectations about a medication. They
report experiencing the potential side-effects at higher rates than the
drug actually causes. Now, I have a lot of disagreements with Mayo Clinic. For
example, they say I have disagreements with them about metformin but that's a
different issue for a different time, I agree with them 100% and
JACC talked about this as well. (the Journal of the American College of
Cardiology) this nocebo effect is killing - killing a lot of people. Very
rarely, statins can cause life-threatening muscle damage. It is
life-threatening and it is rare; and it's called rhabdomyolysis. Again, rhabdo-
is the medical term for muscle. It can cause severe muscle pain, liver damage,
kidney failure, and death. The very risks - the very serious side effects; risk is
extremely low and calculated in a few cases per million people taking statins.
Let me just say that again.
Risk of very serious side effects with statins is extremely low; a few cases per
million. So, again, it's - I'm fine with my patients that choose not to take statins.
But you need to know the facts. Okay. Liver damage - occasionally, it can
cause liver damage. if the increase in liver enzymes is mild,
continue to take the drug. As I said, we'll cover that in another video.
Basically, mild means anything less than three times the upper limit of normal
for liver functions. Liver enzymes (ALT and AST) but a practical component.
Contact your doctor immediately if you're taking statins and you have
unusual fatigue, weakness, loss of appetite, pain in your upper abdomen, dark
colored urine, or yellowing of your skin or eyes. Again, those are classic signs of
liver disease. Increased blood sugar or type 2 diabetes - some people think that
it causes diabetes. It doesn't cause diabetes. It does increase insulin
resistance and that's a major issue that I have in terms of statins because my
whole legacy goal right now is to get people to understand how many of us - as
in way over half of us sixty-year-olds have insulin resistance
now. And so, Statins make it worse. So, why
would you get them? A couple of points: number 1, 2 or 3 points; Number
1. The lower dose statins aren't as - don't cause as much - for example, low dose
crestor, generic rosuvastatin - doesn't cause so much.
Number 2. There is a statin now which actually helps to fight insulin
resistance. That statin is called lavalla or pitavastatin. Up until this
year though, we had - it was rare to write a script for it because it cost so much.
There are some ways to get pitavastatin now at better costs. It still costs a
lot though. The other statins tend to cause a little bit more problems in that
area and especially higher dose statins. So, back to the article
itself. Statins prevent heart attacks in people with diabetes. So the relevance of
mild increase in sugar values with statins observed in some people is
unclear. The benefit of taking statins likely outweighs the small risk to have
blood sugar level go up. Talk to your doctor if you have concerns. Neurological side
effects: Some people have talked about memory loss, brain fog, confusion. These
side effects reverse once you take the medication. There's limited
evidence to to prove a cause-effect relationship there. That's why it wasn't
even listed in some of the other groups - like Rory Collins's group. There's
also been evidence that they they may help with brain function. For example, in
people with dementia, this is still being studied.
Don't stop taking your statin before talking to your doctor. Here's a risk of
developing statin side effects. Here's some of the risks taking multiple lower
multiple medications to lower your cholesterol - being female, smaller body
frame, being eighty or older, having kidney or liver
disease already, drinking too much alcohol, (oops)
and having certain conditions such as hypothyroidism, or ALS. How to relieve
statin side-effects? Take a break from statins for a week or two; switch to
another statin drug; change your dose; lowering your dose may reduce some of
the side effects. Now, according to them it may reduce some of the
cholesterol-lowering benefits and, again, according to me and a whole bunch of
other people - it's not cholesterol-lowering anyway. It's the
cardiovascular inflammation lowering. Take it easy when exercising. And that's
just - unaccustomed vigorous exercise. I have a lot of folks (myself included) who
do very vigorous exercise on low-dose statins. I used to have - I had some
problems for a while with some calf cramping but, again, not that bad; and I
didn't stop my statin. I have vacillated between five milligrams per day of
rosuvastatin or Crestor down to two and a half milligrams twice a week. And I
watched my CIMT results to decide what level and what dose I take; consider
other cholesterol-lowering medications and try CoQ10 supplementation. I just had
a viewer comment about making sure you take your CoQ10. Other folks would also
say "Take vitamin D3" and weigh the risks and benefits. All those side effects
believed to be caused by statins can be annoying. Consider the benefits of taking
a statin before you decide to stop taking your medication. Remember, the
statin medications have reduced the risk of heart attack or stroke and the
life-threatening side effects are very low. As I would quote from the JACC
article of a couple of years ago, research estimates would indicate that
between two and six thousand added deaths have occurred in the UK alone
from P. hearing these videos and saying I'm
gonna stop my statins. There's just where there's smoke, there's fire.
If you've read about the potential side effects of statins, you may be more
likely to blame your symptoms on the medication, whether or not they're truly
caused by the drug. And, again, that's the "nocebo effect." Even if
your side effects are frustrating, don't stop taking your statin medication for a
period of time. Again, plenty of people have stopped statins safely but I've got
a series of 4 studies that I reviewed that looked at stopping statins.
All of them said, "You know, we could choose.." okay
But - and, again, this article would even recommend a week or two - but to stop them
entirely for six months - you - if you have cardiovascular inflammation, you're
increasing your risk. Again, even your doctor may be able to come up with an
alternative treatment plan that can help without these side-effects. So, again, I
hope this article is a little more practical for some of you who want to
know - just, okay, what would you recommend in terms of me looking at potential side
effects. What are some practical implications? If you made it this far,
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