What is Statin and how it works?

First let’s understand what is Statin and how it’s work on your body. Statins are a class of medicines used to lower cholesterol. While some of the cholesterol in your blood comes from food, most is made by the liver. Statins work by reducing the amount of cholesterol made by the liver and helping the liver to remove cholesterol that is already in the blood which is done.

Statins may also reduce inflammation in the artery walls. This can lead to blockages that damage organs such as the heart and brain. Statin when used as directed, can dramatically reduce the risk of stroke or heart attack which can save millions of lives but some clinicians, intentionally or unintentionally miss that opportunity to prescribe the statin to their patients, and even if they prescribe, most people stop or do not start taking it to due to the concerns over the side effects.

Controversies

“Statins may lower cholesterol, but there is growing concerns among doctors about the side effect of such medication” – Dr. Sherif Sultan (Vascular Surgeon, Galway)

Sherif Sultan says such side effects may have been downplayed by manufacturers and he produced evidence at a recent conference hosted by the American academy of anti-aging in London. He’s not advocating people to quit the prescribed medication – statins are taken by an estimated 8 million people in in UK & Ireland and have many benefits. However, he says cardio-vascular patients who are prescribed the drug may require far more information than they are currently receiving from doctors.

In sultan’s view, a successful cardio-vascular anti-ageing diet involves reducing calorie intake by 30 percent, increasing green leafy vegetables by 60 percent, and cutting back on refined sugar intake by 90 percent. He’s also a firm believer of nutrigenomics.

This nutrient-led approach can improve health and longevity, and not just for those affected by age or medical factors or both, he says,

Nutrigenomics involves the study of the impact of foods and their constituents on ‘gene expression’. Certain nutrients can mimic natural recovery or self-repair through a “nutrient gene interaction”. 

L-Arginine helps to reduce blood pressure and lower low-density lipoprotein cholesterol (Bad Cholesterol). Sultan says these two agents have singularly led to cardiovascular cures, even in life threatening situations. They’ve been used to treat acute carotid dissection – a condition that can lead to stroke or even death if left untreated.  

“I was trying to understand why we hadn’t made further progress over several decades despite the fact that we give out statins like smarties when their benefits have been grossly exaggerated”

 – Dr. Aseem Malhotra (Cardiologist, London)

Dr. Aseem is a London based cardiologist and anti-obesity campaigner who co-founded Action on Sugar and the author of the book A Statin free life. In his words, Nobel Prize winners Joseph Goldstein and Michael Brown (whose discovery of the receptor in cells that takes in cholesterol became the basis for statins) promised a big miracle cure that’ll end the heart disease by early 21’st century which is statin. But we haven’t – it is still the single biggest killer of both and men and women worldwide with 18 million deaths a year.

From his research and the analysis of data from last three decades, he says, statins have not reduced death rates from heart disease at all. For those with heart disease, taking a statin every day for five years results in a 1 in 39 chance of preventing a non-fatal heart attack and a 1 in 83 chance of delaying death. I’m not saying statins don’t have any effect. I’m saying, ‘Be aware that their effects are marginal at best.’ And everybody – whether you choose to take statins or not – should be focusing on their lifestyle, he added.

Some History

Statins- a recommended as a first-line therapy for the management of lipid disorders, that reduce illness and mortality in those who are at high risk of cardio-vascular disease. They’re the most common, perhaps most famous cholesterol lowering drugs come to the clinical use in September 1 1987 in the United States of America.

According to the British heart foundation, over the years, statins cut the risk of heart attack and death from the heart disease by at least a quarter. The study from the University of Iowa, USA indicates that Cholesterol-lowering drugs are more likely to save thousands of additional lives when used in people with higher levels of LDL cholesterol, or “bad” cholesterol which is published in the journal of American medical association. Despite all of this statin is drug that often come to the discussion table and minds of people because of its side effects. Are they that bad or is it a super drug available at the moment to cure the heart disease? Let’s find out. 

What are the risks?

Please note If you think you’re experiencing side effects from statins, don’t just stop taking the pills. Talk to your doctor to see if a change of dosage or even a different type of medication might be helpful

The most common side effects include;

• Dizziness
• Sleep problems
• Headache
• Nausea
• Vomiting
• Diarrhoea
• Rashes
• Constipation
• Bloating or gas
• Low count of blood platelet
• Unusual tiredness
• Sick feeling
• Cough
• Weight loss

Uncommon side effects of Statin include;

• Inflammation of the pancreas and the stomach-ache
• Yellow skin or eyes
• Memory loss or memory problems
• Reduced sex drive
• Erectile dysfunction
• Pins and needles

Although serious side effects are rare, potentially serious side effects, includes

• Type 2 Diabetics

Statins can make your blood sugar level go high and cause decreased sensitivity of insulin, which may lead to type 2 diabetics. The increase generally occurs when blood sugar levels are already higher than normal and fall in the prediabetes or diabetes range when you begin taking a statin.

The research, which appears in the journal JAMA internal medicine found that people with type 2 diabetics who took statins were more likely to have greater disease progression.

• Myositis (Necrotizing Myopathy)

Myositis is kind of an inflammation in the muscles. Usually, the risk of muscle injury increases when statin is taking along with other medication like a cholesterol reducing drug. So, the risk of muscle damage is more for a patient who’s taking statin along with other medication than a patient taking statin alone.

Necrotizing myopathy does not resolve even after the statin is stopped, leaving patients with life-long challenges on doing simple things like climbing stairs, standing from a seated position, and even lifting their arms over their heads.

Moreover myositis patients are prone to other life threatening disorders like, Antisynthetase syndrome, interstitial lung disease and increased risk of cancer and other diseases. While there is no cure for this chronic, disabling condition, there are cases from all over the world that, many patients are successfully treated with anti-inflammatory medications.

• Rhabdomyolysis

More commonly known as Rhabdo is a serious condition that can be fatal and can cause a permanent disability. With this condition, muscles all over the body become painful and weak. The severely damaged muscles release proteins into the blood that collect in the kidneys. The kidneys can become damaged trying to eliminate a large amount of muscle breakdown caused by statin use. This can ultimately lead to kidney failure or even death. The main symptoms of rhabdo includes, muscle swelling, tender and sore muscles, red or dark drown urine etc.

Fortunately, rhabdo is extremely rare. It happens in less than one in 10,000 people taking statins.

• Increased levels of creatine kinase (CK)

A rare but worrisome side effect of taking a cholesterol-lowering statin is the breakdown of muscle tissue. Creatine kinase is a muscle enzyme when elevated it can cause weakness of muscles, inflammation and muscle pain. This condition usually takes long time to resolve.

Discomfort usually resolves with a lower dose or a different statin. If you have any unexplained joint or muscle pain, tenderness, or weakness while taking statins, you should call your doctor immediately. Do not take statin if you’re pregnant, there are research report which link statin to birth defects.

Risk Factors

You’d be having more chance of above-mentioned side effects if you are,

• Above 80
• Having a small body frame
• Alcoholic
• Woman
• Having Kidney or liver disease
• European or Chinese ethnicity
• Having/had diabetics
• Taking multiple medications for cholesterol
• Having Hypothyroidism or neuro-muscular disorders such as Amyotrophic lateral sclerosis (ALS)

How to get relief from such side effects?

Your doctor may be able to suggest ways to relieve the side effects. These changes may help, but talk to your doctor first;

• Taking a break from the statins or lowering the dosage or using a different statin
• Avoid heavy work out or exercise 
• Try other medications available to lower your cholesterol like Cholesterol Essentials

Approved Statins in Ireland

• Atorvastatin (also called Lipitor or Atorvas)
• Rosuvastatin (also called Crestor or Rosuva)
• Pravastatin (also called Pravitin or Pravame)
• Simvastatin (also called Zocor, Sivatin, Simator or Simtan)
• Fluvastatin (also called Lescol or Fluvastenol)

When to take Statins?

Usual statin dose is one per day. Zocor, Pravitin and Lescol is for night time. Because night is the time when body produces much of the cholesterol. However, Lipitor or Crestor can be taken at any time, but make sure you’re consuming the statin on the same time every day. You can take them with or without food.

If you’re suffering with a unexplained side effect please call on 112 or 999 or go to emergency department