HbA1c & Statins.

[Felinia]

I have said before that statins are like Marmite - either you can or can't take them. I tried 3 different sorts over 18 months, had very similar severe side effects to Drummer, and took 9 months to fully recover. But my friend has been taking them for years with no side effects.

 

[Anbemcc]

Good afternoon all.

Had some good news today, my HbA1c has fallen from 112 (on diagnosis) to 73 in two months.

On another note, my doctor has suggested statins, but I have heard they can be problematic, does anyone have any experience?

I’m on slow release metformin, statins also but had to come off them as they were causing pain in my bones and muscles. Everyone is different

 

[Maca44]

The only problem I had was very Vivid dreams some were horrible but DR changed to another type and they suit me well no more bad dreams.

 

[Deleted member 21371]

I have no problems at all with statins, and never had.

 

[Eddy Edson]

I have no problems at all with statins, and never had.

This is a little gem of a study, published recently: https://www.jacc.org/doi/10.1016/j.jacc.2021.07.022

The majority of symptoms caused by statin tablets were nocebo. Clinicians should not interpret symptom intensity or timing of symptom onset or offset (on starting or stopping statin tablets) as indicating pharmacological causation, because the pattern is identical for placebo.

 

[silentsquirrel]

Definitely NOT nocebo effect for me, pains in joints and muscles that I put down to arthritis for years. So bad it virtually stopped me bellringing, which was my passion for years, but just a few minutes was too painful in shoulders and upper arms.

I do still have pain from arthritis, but once I finally stopped the statins it was improved enough to also stop daily painkillers and PPIs to deal with the side effects of those. So 3 medications less.

As so many do not have side effects, it would seem wise given your risk to try them - but you will be aware that problems are possible.

 

[everydayupsanddowns]

This is misleading and you should delete or correct it. The vast weight of evidence points to 20% risk reduction per 1.0 mmol/L LDL reduction (or a corresponding reduction in apoB).

You might go 10% => 8% with a 1.0 mmol/L LDL reduction, but of course the LDL reduction would typically be greater than that (and the baseline risk very often much greater than 10%).

I was referring to Hope3, which mentioned a 20% - 25% reduction in relative risk for an intermediate/low risk population I think? It was a study that caught my eye some years ago because it involved people with diabetes, but who were still not at especially high risk. I’ll edit to clarify.

I was grateful that you mentioned other data which interpret it for mmol/L LDL.

Useful to have both I think?

 

[Eddy Edson]

I was referring to Hope3, which mentioned a 20% - 25% reduction in relative risk for an intermediate/low risk population I think?

I was grateful that you mentioned other data which interpret it for mmol/L LDL

Useful to have both I think?

In Hope3, with 10mg rosuvastatin, avg LDL reduction was ~40mg/dl, so ~1.0 mmol/L, with ~20% risk reduction. In other words, exactly the same LDL lowering => risk reduction relationship seen in a zillion other studies.

If you take a higher statin dose and reduce LDL by 2.0 mmol/L then yr risk will reduce by 40% on avg. Etc etc. Also as demonstrated in a zillion studies.

 

[everydayupsanddowns]

In Hope3, with 10mg rosuvastatin, avg LDL reduction was ~40mg/dl, so ~1.0 mmol/L, with ~20% risk reduction. In other words, exactly the same LDL lowering => risk reduction relationship seen in a zillion other studies.

Thanks Eddy.

This was what I was remembering (found it eventually)…

Primary prevention and intermediate risk fits with quite a few forum folks.

The evidence is clearest in the cholesterol-lowering arm of the trial. For the intermediate risk population tested in HOPE-3, the trial adds to the large amount of “clear evidence” showing the benefit of statins, said Yusuf. In sharp contrast, the blood pressure arm did not find any overall benefit for antihypertensive therapy, though there was a benefit in the prespecified subgroup with the highest blood pressure levels. The benefits of statins, on the other hand, did not vary by LDL level or level of risk.​

​

“Statins work beautifully, resulting in a high significant relative risk reduction of 25%,” said Yusuf. Further, statins were “relatively safe,” though there was a small excess in muscle pain, but not rhabdomyolysis, in the statin-treated group.​

How Does HOPE-3 Change Thinking About Primary Prevention?

www.cardiobrief.org

 

[mikeyB]

Severe reactions to statins are exceptionally rare. Unlike, for example, the common problem that bell ringers have, pain in the arms and shoulders. Drummer's experience I don't doubt was due to the statin she was taking, I've heard it every time this question comes up. That shows how rare such side effects are. Lots of people on the forum, millions round the world take statins without a problem. So the chances of getting significant side effects are actually minimal, or even microscopic.

I took Simvastatin for years until I got to the stage of a ridiculously low Cholesterol, so they were stopped. I'm still in the normal range without any. I did get the vivid dreams, which I quite enjoyed, no nightmares. That's because Simvastatin is one of the few statins that can cross the blood brain barrier, the molecules are too big in some other stains. That's how simple molecules like alcohol can get through, as can cocaine, caffeine, LSD, and opiates. Headache treatments don't need to, because it's your head that's aching, not your brain, which has no pain reception neurones.

 

[Leadinglights]

Definitely NOT nocebo effect for me, pains in joints and muscles that I put down to arthritis for years. So bad it virtually stopped me bellringing, which was my passion for years, but just a few minutes was too painful in shoulders and upper arms.

I do still have pain from arthritis, but once I finally stopped the statins it was improved enough to also stop daily painkillers and PPIs to deal with the side effects of those. So 3 medications less.

As so many do not have side effects, it would seem wise given your risk to try them - but you will be aware that problems are possible.

Another bell ringer in our midst, I have been ringing for 60 years. It is a shame when physical limitations make something you enjoyed impossible or difficult.
I just had a visit from a friend who said statins had made him depressed despite changing to different ones. He noticed a difference within 2 days of stopping them.

 

[Eddy Edson]

Thanks Eddy.

This was what I was remembering (found it eventually)…

Primary prevention and intermediate risk fits with quite a few forum folks.

The evidence is clearest in the cholesterol-lowering arm of the trial. For the intermediate risk population tested in HOPE-3, the trial adds to the large amount of “clear evidence” showing the benefit of statins, said Yusuf. In sharp contrast, the blood pressure arm did not find any overall benefit for antihypertensive therapy, though there was a benefit in the prespecified subgroup with the highest blood pressure levels. The benefits of statins, on the other hand, did not vary by LDL level or level of risk.​

​

“Statins work beautifully, resulting in a high significant relative risk reduction of 25%,” said Yusuf. Further, statins were “relatively safe,” though there was a small excess in muscle pain, but not rhabdomyolysis, in the statin-treated group.​

How Does HOPE-3 Change Thinking About Primary Prevention?

www.cardiobrief.org

FWIW, "intermediate risk" seems a bit optimistic to me. Certainly versus the non-diabetic & fairly healthy-looking Hope3 cohort.

Anyway, the ~1.0 mmol/L LDL lowering in Hope3, from ~3.2 mmol/L to ~2.2 mmol/L, probably goes with something less than the >40% non-HDL reduction called for in the NHS England guidelines. So by those guidelines, dosage would be increased from the 10mg rosu used in Hope3, delivering a further lowering of LDL and risk.

My original point remains: simply saying that statins might reduce yr risk from 10% to 8%, with the implication of "so what", is misleading.

The reduction depends on the dose. For dosages achieving the NHS England guidelines, for many people, the risk reduction will be substantially greater than 10% => 8%.

In addition, forum denizen baseline risk IMO is likely to be substantially greater than 10%.

I bet 20c that the avg baseline for people around here would be 20%+ & that achieving NHS guideline lipid improvements would get it down to something around 10% - 12%.

 

[Sharron1]

When I was asked if I had considered Statins( although all cholestrol at normal range but the good cholestrol HDL gives a higher ratio on the calculation). I did say I would wait until next blood test. Just a little worried about any side efects and the nurse said that's fine anyhow if you have problens you can always throw them away...never heard that advice before...

 

[Burylancs]

Thanks for the reply. My QRisk is 13.8%. I think a conversation needs to be had. All the doctors gave me was a return slip, very much like a school trip, tick yes or no and return.

Having been dxed with Type 2 Diabetes you are in a foot race with cardio vascular disease (cvd). The statin is a little helper intended to keep you in the race longer.

 

[adamtype2gout]

'No evidence' having bad cholesterol causes heart disease

High levels of LDL-C, known as bad cholesterol, has been considered a major cause of heart disease - the world's leading killer - for at least 50 years.

www.dailymail.co.uk

Maybe this is being suppressed now ,i think this should be about health not money.

 

[Deleted member 21371]

'No evidence' having bad cholesterol causes heart disease

High levels of LDL-C, known as bad cholesterol, has been considered a major cause of heart disease - the world's leading killer - for at least 50 years.

www.dailymail.co.uk

Maybe this is being suppressed now ,i think this should be about health not money.

Ah, that old team again?
Have you actually read that study?

It definitely makes me feel better about taking statins, and keeping my cholesterol within medically advised limits.
(And limits, not the new "ratios" although the advised numbers give you them anyway if you work it out)

 

[DaveB]

Good afternoon all.

Had some good news today, my HbA1c has fallen from 112 (on diagnosis) to 73 in two months.

On another note, my doctor has suggested statins, but I have heard they can be problematic, does anyone have any experience?

Do you know why your GP has suggested statins? They are not a diabetes med and should be prescribed when your lipids (LDL, HDL etc) ratios are not good or for another specific reason. Your Total cholesterol figure is not the best guide neither is guesswork. I do take statins but my wife had a severe liver reaction to them so they must not be treated like sweets. To the poster who said their cholesterol is now below 3 should be aware that the body needs cholesterol for repairs and may be their statin dose is too high?

 

[Drummer]

It was only on Twitter, but someone claiming to be working in a clinic wrote that over half the patients had below average cholesterol levels, but it could not be mentioned at work as it would mean losing their place and reputation.
Having to relearn over 300 songs was no joke - and now that my memory has improved I get clashes where the version I remember is not identical to the one I relearned.
I suspect that at least some of the effect declared to be 'placebo' was down to ongoing effects of the statin as it took years for me to begin to remember my original versions, and 18 months for the ache in my left leg to subside. My leg muscles are far weaker than they were not surprising as they aren't there any more. I now have skinny legs for the first time in my life.

 

[Terry-J]

There was an interesting article on Dr Kendrick's blog last year -

Cholesterol lowering has no impact

5th August 2020 This article was first published on RT.com on the 4th of August, and it can be seen here In the midst of the COVID-19 epidemic almost every other medical condition has been shoved o…

drmalcolmkendrick.org

 

[Eddy Edson]

There was an interesting article on Dr Kendrick's blog last year -

Cholesterol lowering has no impact

5th August 2020 This article was first published on RT.com on the 4th of August, and it can be seen here In the midst of the COVID-19 epidemic almost every other medical condition has been shoved o…

drmalcolmkendrick.org

Kendrick is a well-known fringe cholesterol denier. Experts think he's full of it.

Malcolm Kendrick

Malcolm Kendrick is a General Practitioner (GP), conspiracy theorist author, cholesterol denialist and low-carb diet advocate who has spent decades promoting the Atkins diet and more recently the carnivore diet.[2][3][4] He is best known for his unsupported claim that low-density lipoprotein...

rationalwiki.org