First, I take both lipitor (10 mg at night) and niacin (3,000 mg daily, in three doses of 1,000 mg each). Both are designed to lower my cholesterol, which was high (>250) at the time I had a heart attack seven years ago.

I have taken another statin (zocor) and my doc switched me to lipitor because (he claims) it produces comparable results to zocor at lower doses.

Four years ago, I put myself on niacin and then told my doc. He said, "Great!" He says niacin is a wonderful drug, but that he rarely recommends it because of the flushing side-effects which make most of his patients go off it. I did not have the flushing effects. He recommended both niacin and lipitor together. We have found that the combo does a much better job on me than either of them alone (and, yes, we have tried each of them alone for six months at a time to see what results). My last total cholesterol was 146, with an HDL of 45, and an LDL of 100.

A word of warning about things mentioned above in this thread -- I do not know what folks are meaning by "flush-free" niacin. There is a version of timed-release niacin that is supposed to avoid the flushing of mega-doses. This form of niacin (according to my doc and a number of places on the net which you can check easily with Google) has a high incidence of liver damage. My doc is candid about no one knowing why a blast of niacin seems safe, while timed-release niacin harms the liver. But, he says, once the correlation is demonstrable, it's silly (and harmful) to risk liver damage just to avoid the flushing!

Otherwise, no side-effects on me from either niacin or lipitor, after using it for three years now.

For what it's worth ,

Homesar

Rose, you said something very important, I think. You refered to you doctor as 'my careful doctor'. That's huge. I do not believe mine IS careful at all. He's so quick with that prescription pad - when in doubt, write it out. Heck, he's given me antibiotics for a skin infection he didn't even look at (I don't mean looked at quickly. I mean it was under clothing and he didn't see it).



I'm going to look up Zetia, Catherine. Thanks.



Homesar, sheesh, you've had cardic problems and are on 1/4 the dosage I was on. I find that significant.

Rainne - How is the Metformin working for you?

My DH used to be on Zocor, but now that he has acheived goal weight loss, all lipid levels are normal. If he ever had to go on them again, he would choose Zetia.

Sherrilee - it's working ok. I take 500 mg twice a day. I think I could use more the week before my period, but I need some time to see the pattern. My fasting glucose is usually between 6-7, which is still higher than I'd like, but getting better. (It seemed to be improving to between 5-6, but then I became premenstrual and now I'll have to wait to see what happens next. Damned cycles.)

Afternoon and evening readings are usually in the 5-6 range. I get the occasional spike that I haven't figured out.

Thanks for asking. It feels nice to be cared about :-)




This has been a great thread for me, by the way. If nothing else, I realize I just have to get a doctor I can work with. Even if I wind up in the same place, I deserve to feel good about my choices. That won't happen with this guy.

There's got to be a misprint or lab error in there somewhere. Since Total = HDL + LDL + Triglycerides/5, your triglycerides would have to be 0.2 with the above cholesterol numbers.

My physician would do the test over with such numbers.

Sorry to sort of come in late with this thread but I have only just read it and wondered if my experience may help.

I was prescribed an ACE Inhibitor for High Blood Pressure (which wasn't too elevated) and a Statin for cholesterol levels that were only marginally elevated 6 I believe. These were prescribed as a routine precaution because of my diabetes. I had a geat deal of trouble finding the right tablets because of side effects and eventually they found ones that I could live with. I can't say that I feel particularly different after taking them for quite some time now but my bp is now 125/60 and my cholesterol is down to 3 so they do work. I have regular blood checks to make sure that they are not doing me any harm.

On the subject of Kidney damage. I too was diagnosed with the start of kidney damage but since being on low carb my latest tests came back normal and the doctor was absolutely delighted (no more so than I was ). I wish you well in your course of action but please don't be afraid of taking the medication. Also hope that I have put your mind at rest about kidney damage. Dr Bernstein was right (isn't he always), in that low carb DOES cure it.

This story ran on the front page of several Canadian papers yesterday.

http://www.canada.com/health/story....38-FC47AE9B4AAE

Here it is without the annoying popup ad.


Cholesterol pills carry a risk, UBC group says Preventive use only

Margaret Munro CanWest News Service


Tuesday, September 16, 2003

Drugs taken daily by millions of Canadians to lower their cholesterol at a cost of more than $1.3-billion a year may be doing as much harm as good for many users, according to a group of University of British Columbia drug specialists.

The drugs, called statins, "have not been shown to provide an overall health benefit" when prescribed to people who have not already had a stroke or heart attack and do not have cardiovascular disease, say researchers at the UBC-based Therapeutics Initiative, which assesses the effectiveness of drugs.

The group has sent a bulletin to 12,000 B.C. doctors and pharmacists outlining concern about statins. Last year, Canadian doctors wrote 14 million prescriptions for the drugs. Often, the pills are prescribed to patients who do not have clogged arteries but are considered at risk for a heart attack or stroke because they have such risk factors as high cholesterol, hypertension or obesity.

Large international studies have found using statins for such "primary prevention" does lead to a 1% to 2% decline in heart attacks and strokes over three to five years. But that benefit appears to be negated by serious adverse effects, said Dr. Jim Wright, head of the UBC group.

He said the studies mention "in the fine print" that the total number of serious adverse events occurred at the same rate in people taking statins and those swallowing dummy pills. "This indicates that the magnitude of the harm caused by taking statins for primary prevention is about the same as the benefit," he said.

Putting it another way, he says the number of heart attacks and strokes was lower for people taking statins, but the incidence of other serious health problems increased.

The studies, which involved close to 40,000 people in North America, Europe and Britain, do not elaborate on what the serious adverse events were. But Dr. Wright says they would include all life-threatening events -- such as cancer, mental problems and car accidents -- that land people in hospital.

"They are the kind of thing nobody wants to have happen," says Dr. Wright, who also works with Cochrane Collaborative, an international group that assesses the value of medical inventions and drugs.

Dr. Wright says researchers are required to collect data on serious adverse events as part of drug trials, but do not have to release details. His team at UBC has asked for such information from drug researchers and government regulators in the past and has been told it is proprietary.

"We are challenging them to start releasing the data," Dr. Wright says. Serious adverse event data should be posted on the Web whenever drug trials are published in medical journals, he says.

Statins are racking up multi- billion-dollar sales worldwide. Use of the pills has more than doubled in Canada in the past five years.

The drugs are frequently described as lifesavers with few side effects. But it is known that statins can cause muscle aches and weakness. In rare cases they can lead to muscle breakdown, known as rhabdomyolysis, which can cause kidney failure and death. One potent statin, called Baycol, was pulled from the market in 2001 after 31 rhabdomyolysis deaths in the United States.

There have been suggestions that long-term use of statins might increase cancer rates and trigger mental and cognitive problems.

Other research has indicated statins may help prevent Alzheimer's disease and treat multiple sclerosis.

"Drugs are all double-edged swords," Dr. Wright says. "They all have some downside and we need to look at adverse effects more carefully than we do."

Starting today, our expanded health coverage moves to the front section and will run every Tuesday and Thursday. Discovery will run Monday and Friday. A new feature, an Education page, will appear every Wednesday.

© Copyright 2003 National Post

Well I just looked up this post because my doc wants me back on statins and I don't want to go back on them.

OK...some background. I'm 49 yrs old, with no family history of heart disease. My dad and his sister both had strokes due to untreated, extremely high blood pressure. My sister and mom both have high BP, both since their early 30's. (my sister is my half sister). About 80% of my mom's family over 50 have diabetes. My dad's side it's cancer. Both my parents passed away at 69 and 76 due to cancer.

I have gastric problems....GERD, hiatal hernia, esophageal motility problems (sometimes can't swallow my food). I have arthritis in my spine (top to bottom) and left shoulder. I also have restless legs and severe cramps, day and night. I take Nexium twice a day, double the maximum dose. I also take Pletal for the cramps. And, until I started LC I took 800mg Motrin 4 times a day! I was also taking HRT until the end of the summer. I also took a baby asprin each day.

I have normal to low BP. I've lost 24#, and still have 55+ to go. Until I had a hysterectomy 3 yrs ago I had normal lipids....they were all well within the range of normal. Since the hysterectomy, which also lead to a 20# weight gain, my cholesterol and everything else has been going up. The "good" was very low and dropping....I think the lowest was 30. The other numbers were all up....way up. My total cholesterol was over 325, everything. I tried LF, lost 18 pounds and they went up higher. I tried LC, lost another 24# and they still went up!

1 year ago the doc put me on Lipitor. Since I'd seen the numbers go up, even with LC, I decided to take it and see what happened. Well, I took it and had no problems, except about a week after I started it my stomach started acting up. I March my stomach doc told me to stop the Lipitor and see what happened. The nausea went away and when I restarted the Lipitor it didn't seem to bother me.....for about 4 months....then the nausea started again. I stopped the Lipitor the end of August, but by now I think my belly's gone past the point of no return and I'm going to have a GI procedure to get it fixed!

When I was on the Lipitor my numbers all dropped dramatically. My total cholesterol went down to 154....the "good" was still low, but the ratio, of course, was better.....but still not good. I also started having crying jags....and my hot flashes increased. I ended up going on an anti-depressant because it was starting to interfere with work. the hot flashes were horrible!

A month ago I went to my GI doc and he said to NOT go back on the Lipitor. About 4 weeks before I went to the doc I'd had a fairly bad flare-up and was told to stop all meds except my stomach med. I did and have inproved a lot, but still not back to 100%. I have kept up the Pletal for the leg cramps because they are the only way I can get any sleep.

Well....2 days ago I went to my regular doc and she's insisting that I go back on a statin, only this time she's ordered Zocor. She also wants me back on the baby asprin. AND wellbutrin for depression and smoking cessation. She ordered repeat blood work in 6 weeks.....and I insisted on getting it done that day also. I'm waiting on the results.

Now, I do smoke, and I know it's bad, and I have to quit....but I am hooked and I can only deal with 1 addiction at a time! I don't drink, I cook all my own meals, I'm exercising and loosing weight again.

I took the prescriptions, but I think I'm going to try the niacin. Maybe with flax seed also? The Wellbutrin I'll get....especially if it helps me cut down on or quit the smokes. But I think I'm going to hold off on the Zocor.

I've had MRIs done for ? of mild stroke and the results were negative. I've had vascular studies done of my legs....again negative. With my family history of NOT heart disease and 2 strokes, my dad being one, I am more concerned with the LOW cholesterol reading than I am with the high!

Also, for the first time in my life I've been diagnosed with depression? I've buried a brother and both my parents. I've raised 2 children on my own, since they were 5 months and 2 1/2 yrs old...they're 19 & 21 now. I've had days, weeks, months where I didn't know how we were going to survive. I've been injured several times at work and in auto accidents (none my fault)....I've had periods of months where I was in pain so severe that I couldn't function.....but I NEVER got depressed! Not to this degree anyway....we all have our blue periods....but never depression!

Well, this ended up sort of a rant. I think I'm going to give this a shot....heck if it doesn't work I can always go back on the statin!

You might also want to consider policosanol, I read some studies which showed it was effective at lowering ldl, leaving hdl unchanged or in some cases raising it. Here on this forum a member named Ira said back in Oct that he tried it, it lowered his total cholesterol 20% and his ldl 15%.He said he was pleased and recommended it. Bill

Any drug requiring blood work every 3 mos is DANGEROUS. The LIPID Theory has never been proven thats why its still called a theory. I would only take a statin and they are all the same if I had FH or CHD. There's no benefit for healthy people only with high cholesterol. You all need to go to the web sites of "second opinions" and "The International Network of Cholesterol Skeptics" . Do a search on google for it. I didnt believ what i read until i got the statistics from the Lipid Clinic on the WOSCOPS trial which was a cholesterol lowering trial of healthy (Primary Prevention) 55 year olds. Gues what they quote relative risk reduction of 31% CHD but I looked for the ARR or absolute RR which is what is truthful and guess what people it was 1.9 % which is statistically insignificant. You can do better by taking omega 3 & aspirin.

This is for Cindy Sue 48. I'd go low carb becasue the low carb diet is great for diabetics. You may see a decrease in TC. I don't know how overweight you are but weight is bad for reflux, a all bone & muscle pain. Statins I'd show the doctor the statistics and ask is a 1.9% reduction of CHD worth the side effects? I might get another doctor, one who understands statistics or one who isn't bought by Pfizer

My kidneys are failing and I've been on Lipitor for quite a few years - I haven't noticed any side effects, but I totally agree with your right not to take it. My family physician is a total nit-wit, but I can't switch doctors as none of the other doctors in my town or in the surrounding towns will take new patients if they already have a doctor. I've been trying to change doctors for years and I just can't get a new doctor. Luckily, I have a great Renal team of doctors and nurses at the hospital. I basically don't go to my doctor and just rely on them. Do you have problems being able to switch doctors in Ontario?

I too was afraid of statins and resisted my endocrinologist for a year. I decided that until I can get my weight down to a level below "obese" that we would go his way. Unfortunately I have only been able to drop 10-15 lbs. from the time I was diagnosed with diabetes. Same with cholestrol. YOU have to be the one to decide but personally having done a lot of research on the statins, I believe that the risks for us diabetes are too great not to implement these medicines.

Please do the research. Here is a couple of starter articles to consider:

http://www.veritasmedicine.com/arch...m_id=2747&cid=0

http://www.chfpatients.com/ace.htm

The truth is that diabetes produces such risks for heart disease that one can almost say that diabetes = heart disease.

There is now some suggestion that statins may reduce the risk of cancer and alzheimer's disease. My mom died and dad both had alzheimer's so any hope of avoiding that from these medicines is a definate good reason to consider them.

Diabetic D, we all have to do what we think is best for us and I've seen that quote myself. The thing is, I believe that assumption is based on the typical poorly controlled diabetic, not one that maintains normal blood sugars nearly constantly.
I'm also not convinced of the protection against Alzheimers and cancer since some reports I've read suggest that statins actually increase risk for certain cancers and may also cause problems with memory loss.
Keep in mind also that the high cholesterol = heart disease theory has by no means been proven at this point, either. Quite the opposite, in fact, since over half those that suffer heart attacks have normal cholesterol levels (hence the reasoning that the "normal" levels set now must still be too high) and that any protection offered by statins against heart disease seems to come from the anti-inflammatory effect and not through their lipid lowering abilities. Interestingly enough, low carbing also seems to have an anti-inflammatory effect caused by altering the type of eicosanoids being produced by your body (insulin levels play a large part in that with higher levels driving the production of more inflammatory type eicosanoids and lower levels driving the production of more anti-inflammatory eicosanoids). That, I think, is one of the reasons that a lot of people seem to see a reduction in inflammatory type diseases (arthritis, irritable bowel syndrome, asthma, etc...) when they switch to low carb.

In the first place, high cholesterol has nothing to do with your health, or how many if any heart arracks you will have. It's much worse to have low cholesterol. Statins are associated with cancer, memory loss, and deplete CoQ10. The study I read stated that if you took statins for five years, one in 71 people would benefit from heart related problems. I would rather play the lottery; at least I have a chance of getting something good in return.