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Statin - starting dose

H

helli

Well-Known Member
Relationship to Diabetes
Type 1
Despite some reticence on my part, I finally agreed to taking strains in the summer.
I was reluctant to take preventative drugs when I had no.problems - my cholesterol is not that high.
I didn't question the dose for 3 months. Then I found out it had more than halved my ldl which was only just on the cusp of the threshold when I started.
So I questioned my statin dose and discovered I could take half the dose.
Why, when I was on the cusp of needing a preventative medication was I prescribed twice as much as I need?

What are other people's experience regarding starting dose for stations?
(I think there are more than enough threads debating the pros and cons of stations so I don't think there is a need for another - this is just about dose size, please.)
 
helli said:
Despite some reticence on my part, I finally agreed to taking strains in the summer.
I was reluctant to take preventative drugs when I had no.problems - my cholesterol is not that high.
I didn't question the dose for 3 months. Then I found out it had more than halved my ldl which was only just on the cusp of the threshold when I started.
So I questioned my statin dose and discovered I could take half the dose.
Why, when I was on the cusp of needing a preventative medication was I prescribed twice as much as I need?

What are other people's experience regarding starting dose for stations?
(I think there are more than enough threads debating the pros and cons of stations so I don't think there is a need for another - this is just about dose size, please.)
Click to expand...
I was put on 10mg atorvastatin and it has been sufficient to keep the cholesterol at around 3.5 despite having not a low fat diet. That
does seem to be lower than many are prescribed.
 
Leadinglights said:
I was put on 10mg atorvastatin and it has been sufficient to keep the cholesterol at around 3.5 despite having not a low fat diet. That
does seem to be lower than many are prescribed.
Click to expand...
Yes, it is lower than what I was initially prescribed.
I needed to do a bit of pleading to get it reduced to 10mg and I don't know why.
 
Just out of curiosity, what dose were you started on @helli I am still resisting statins until I really feel I need them, but want to be fully informed for if/when that situation arises and I am due a full lipid panel next month. Currently upping my soluble fibre intake which I have been a bit lax about in recent months, in the hope that will keep things in the borderline region of risk and I won't have to have a change of heart this year.
 
Alan44 said:
I'm on 20mg and my last test was 3.8, but to be honest I only take one every other day
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Was that how you were prescribed them or just that you keep forgetting to take them every day?
 
TBH I resist any medication unless the doctor can prove I need it, just got my BP meds reduced.

I never had the flu jab and not had a cold, let alone flu for well over 20 years.

I will fix my own body until I can't
 
I was put on a statin at end of September. I have high blood pressure and in June was told cholestral had crept up. I discovered not been tested for diabetes, last test 2014 40 no test since! I asked for a test. When I went back was told hba1c was 69 and yes your diabetic. I had eaten fewer cholestral fuelled bits then reduced further. Next reading 64 and confirmation cholestral reduced but it was obvious hcp wanted me on statins. Metformin two weeks later hba1c 58. Then a SGLT2 but knew they would talk statins. End of September seen. By then diarrhea problems and cold. Just told I was now on a statin. Have never discussed it since but noticed I'm on 20 gms don't know why I wasn't started on 10. I have stiffness and aching hips but don't know if it is related to statin or just old bones. Very tempting to take every other day.
 
helli said:
Does soluble fibre make any difference to cholesterol?
Click to expand...
I feel it does help but it is an n=1 experiment, so purely my own opinion. As you probably know, I eat a lot more saturated fat than is recommended, so I feel the soluble fibre offsets that. Porridge is the most commonly recommended source of soluble fibre for reducing cholesterol, as it contains beta glucans, but being high in carbs I don't eat it. Psyllium and chia seeds are both also high in soluble fibre and low in carbs, so I use those instead. Obviously the soluble fibre is also good for gut health and I definitely feel a benefit in that respect.

I will be reporting my HbA1c and cholesterol results next month when I get them. I am currently carrying too much weight because I have over indulged in carbs of late, so I am getting back to my exercise and more strict low carb regime and that may mean that I am in weight loss mode when my test is done which will likely cause my LDL to be slightly raised when I get tested next month, but it was the same last year when I was tested in that I was in weight loss mode then too and LDL slightly higher, but not significant enough of an increase to warrant a change in my statin reluctance. TC was still just 4.5 and all parameters within the recommended guidelines apart from the TC being more than the 4 they like us PWD to be under, but I am happy to live with that.
 
I had a couple of false starts with Statins, as I felt they were causing side effects. My GP put me on one straight off at 20mg, which probably didn’t help! When I reluctantly agreed to give them another try, I was put on Rosuvastatin, at a 5mg dose, and the hospital consultant actually suggested I could try it every other day. As I didn’t seem to get S/Es on it, and my GP prescribed enough for one a day, I decided to aim for one a day, but not to worry if I forgot occasionally. That was enough to reduce my total cholesterol from 6.5 to 5. (my ratios were always very good, and my triglycerides low, but they seem to take less notice of that these days)
 
I’m still resisting statins. I keep vacillating, but even when I decide I might try them, I get nervous again. You don’t have to answer @helli but can I ask what your total cholesterol was, and what your LDL was? Was it the LDL you wanted to reduce, or was it your total cholesterol?

FWIW, I never understand them starting people on a high dose of anything (unless for an emergency or necessary, of course). Surely it’s better to start low and increase if needed?
 
I had huge problems with statins, Atorvastatin and Simvastatin, and gave up on them and refused them for about 15 years, I eventually agreed to try them again at a reduced dose and immediately had the same bad outcomes and stopped taking them, I eventually tried a low dose of Rosuvastatin that seems to work, sufficiently, without any of the horrors that the others give.

So I'm with Robin on this, a low dose of Rosuvastatin doesn't give the results the medics want but they do enough of a job to keep people off your back and have some beneficial effect. I would give them a try if you can, I take 5mg, and see if they work for you, if they don't , and in my case if they didn't, I would quit them without a second thought. My cholesterol was edging around 6-6.5 before I tried them and now it's around 5 and the good cholesterol levels make up the 2/3- 3/4 of that figure.
 
Inka said:
You don’t have to answer @helli but can I ask what your total cholesterol was, and what your LDL was? Was it the LDL you wanted to reduce, or was it your total cholesterol?
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The total had just nudged over 4 - but no more than 4.1.
This was mostly HDL ("good cholesterol ") but the LDL ("bad cholesterol ") was the kicker that had increased since my previous test.

It is all now well below target
 
No way would I take statins as a preventive. Don't see the reason for this massive push to put everyone over a certain age on them regardless of actual need.

My cholesterol is currently slightly on the high side but the DS reg is pretty convinced that's a byproduct of having such high BG for a while.

Even with that statins have been mentioned and refused. Remember, you can turn any medication down. Sometimes it's not sensible to refuse of course but don't feel pressured into taking something you really don't want or need to.
 
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I too was reluctant for quite a long time, but I could see my QRISK creeping up as I got older. My TC always used to be around high 4s-low 5s, with very low Trigs and lots of HDL, but LDL always above the 2 target (when they worried about the splits of such things).

I started on 20mg, which must have had better outcome data in the majority of people, with no significant difference in adverse events for NICE to have recommended it as the starting point.

My TC has now settled into the low-mid 3s, and I’ve had absolutely no negative effect whatever. From what I can tell, the benefits of cholesterol reduction appear to be cumulative over time, so earlier intervention has a greater preventative effect than waiting until things appear to be starting to ‘go wrong’.
 
helli said:
The total had just nudged over 4 - but no more than 4.1.
This was mostly HDL ("good cholesterol ") but the LDL ("bad cholesterol ") was the kicker that had increased since my previous test.

It is all now well below target
Click to expand...

Thank you @helli 🙂 I was interested because I know you’ve given this a lot of thought.

My LDL has always been below 2. The GP said the ratio was the most important thing, but is it actually the LDL? I’ve read so much about it, but different sites say different things, eg some say it’s the type of LDL.

The QRisk thing is scary @everydayupsanddowns My GP didn’t have me listed as having diabetes (!) so my QRisk was great. Of course, with the Type 1 added, it shot up.

Questions: if it’s the Type 1 that increases the risk, why does it do so? Is it inflammation? High blood sugar? Blood sugar moving in too large a range? Does changing any of those things reduce the risk? The QRisk thing seems such a blunt too: got Type 1? You’re @**##&! Surely logic suggests trying to modify the risk contributed by Type 1?
 
Alan44 said:
Quite often forget to take them, so decided just to take one every other day or when I remember
Click to expand...

Was only on them briefly, main reason being forgot to take them for few days then never bothered after that.

Cholesterol levels are all good though so I'm not concerned at moment but would happily try them again if need arises.
 
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