Popular cholesterol drug may hurt, not help

I have serious genetic cholesterol issues, so diet and exercise isn't enough for me. I've been treating myself with niacin successfully for years. My brother, 2 years older, same genetic high cholesterol, took the prescription drugs, making fun of my preference for natural medicines.

He had a heart attack a few months ago and now has a stent, which will probably kill him eventually. Unless the blood thinners and anti-coagulants he has to take so the stent doesn't kill him causes him to have a stroke first.

In the meantime, his quite beautiful and young-looking wife has mentioned to me that since he started the meds, their sex life is history. I wonder if he will die before his marriage does.

It's sad, but he believes only those with an allopathic medical degree can possibly know anything.

Good for you..............some idiot doctor put our friend on one of these drugs and left him on it for years...............end result.......he has lost the nerves in his legs and can barely walk.

Don't you just love the TV drug commercials? Ask your doctor. Ask your doctor.

Disgusting!

Crone, are you female? If so, and you are under 55, your risk profile is much lower than your brother's. You cannot compare yourself to him.

Now, about that deprived wife of his..;-p

Is this better known as Genocide

Dave, I did the same thing. I took a cholestorol med for about a month and just didn't feel right for some reason. My body was telling me that it wasn't a good thing.

So, I ate more oatmeal, fruit, vegetables, and very little meat, and exercised more.

I lost weight and my blood pressure dropped significantly in the process!

And don't forget these drugs block the production of Coenzyme Q10 in the liver - something that helps keep your heart healthy!!!

Natural health is the way to go! Very little, if any, side effects!!

i take zetia due to genetic cholesterol level elevation. works fine. drug companies are just afraid zetia will soon be generic and they will lose millions a year. as a brand drug it costs minimum $4 per day. as a generic it will go for $4 per month. more money in drug company pockets.. more donations to doctors and american heart. people have had excellent luck with niacin for decades. why pay some drug company for natural substance. and how can they get a patent on natures creation.

what I find quite unbelievable is that no one is discussing the benefits of taking COQ10 200 mgs with vitamin E daily as a supplement. I have been taking both for 13 years - my good cholesteral keeps going up and bad is at an acceptable level. Just Google COQ10 and see for your self. My Mother was on Lipitor ( which is known to cause stomach side effects and just this past summer 4 months ago stopped using it entirely - she is more vibrant, no more pains in her abdomen, she eats well, excercises and feels better all around at 84

Bob B from Barrie Ontario, Canada

The data on vitamin E and CoQ10 for cholesterol is like Zetia's - no benefit. Cardiovascular causes of death are also not reduced. That's why we docs don't talk about it - it doesn't work. I wish it did. http://content.nejm.org/cgi/content/full/342/3/154

This won't work for many people for a variety of reasons, but good that you are able.

However, THESE are the same rapscallions that are raising drug prices in advance of the new drug regulations that are to be enacted and promised rebates on prices to help "reduce" drug costs to consumers. These bastards are no better than the crook bankers doing the same things with credit card rates and consumer loans. Crooks, Liars, and Thieves, the lot of them.

Merck's Zocor and Mevacor are statins that are off patent and available as generics now. However, these are the older, less effective brands, that have been replaced by the likes of Lipitor and Crestor, and more. The big difference between these medications and the generics is that the newer meds also control Triglicerides, which is just as important as controlling Cholesterol. The older meds are in the Statin drug class, whereas the newer ones are in a different drug class.

if you go generic, you don't really get the protection from both issues as you would with the newer brands. This is the problem with going generic. Zetia and Vytorin just plain dont work as advertised/promised. A waste of money, and an example of how big pharma lie, cheat and misrepresent just to make a faster buck.

Your goal LDL is less than 70. If generic simvastatin works, great. Don't forget diet and exercise. :)

I, too, am on Vytorin and have had astonishing results.  My beginning cholesterol was over 200 but is now 127 with LDL at 72, HDL at 37, and triglycerides at 99.  I also take Lovaza which is an ultra pure high potent Omega3 (fish oil) capsules.  My doctor is quite pleased with my results as I am.

He tried me on the Niaspan and I also had the same results as ZooCrew.  Untolerable burning, raw skin and I felt like the top of my head was going to blow like a volcano.  I tried to adjust to this drug but my body kept saying 'no way!'

Twice a year I go in for blood to be drawn to check my levels and my doctor is pleased as punch.  But I still have far too much weight to lose. 

One of the problems with the vytorin andzetia studiesis that the group of study participates used were men who where already on statins for 6 years, with what can be assumed significant buildup to begin with. Of course no buildup decrease was seen because the drugs don't work like that. They work to lower your overall cholesterol by blocking absorption and limiting your body's ability to make it's own cholesterol. They do not breakdown already formed cholesterol, nor do they increase the rate of breakdown. A proper study would have used people who have high cholesterol and who have not been on any cholesterol medication before. The study should then see if the drugs prevented any buildup and lowered cholesterol. This study would test the intended effects of the drugs, not effects that the drug was not designed for.

more of drug companies chosing who to study so they get the results they want. why does FDA allow this.

The problem with this study...it was paid for by the rival company Abbott Laboratories. What do you think the rival companies are going to do to each other??

The 2nd problem with this study, the researchers were paid by the drug companies. Don't you think they are going to be biased??

Joan, my head felt like a volcano was about to explode!! WOW, I thought I was the only one that this.

Is Lovaza a prescription?

"Joan, my head felt like a volcano was about to explode!! WOW, I thought I was the only one that this.

Is Lovaza a prescription?"

I never thought a medication that was supposed to help you could make me feel soooooo miserable!

Yes, the Lovaza is by prescription only. It is ultra pure, ultra refined, and ultra potent. It's 20 times more concentrated than otc fish oil capsules. It's been one of the reducers in my triglycerides and it's also good for the ol' ticker, too!

Eating fish in one study showed a reduction in cardiovascular death by half. Fish oil (either by rx or OTC), while making the triglycerides better, has not shown a similar benefit. That said, there is probably no harm in taking them. More studies are under way. I suspect people who eat fish (not processed fish patties that are deep fried) are more likely to eat healthier overall and thus have better health outcomes.

Isn't this Genocide

Yes, the vegetables never had a chance. I only have Beef every 2 or 3 week, because they are harder to catch.

sam, words to live by.

If we would all eat only what we can catch, we'd all be better off.

Good job. Unfortunately, only about 5% of my patients actually achieve what you did. You would be a dream patient, a joy to care for. I'm all for preventive health care. Unfortunately, most people do not take care of themselves, and expect a pill or pills to fix them.

Hey, folks, lef.org seems to be an online vitamin store with a few non sequitur abstracts quoted from various journals, nothing mor.

OK, ok, I spoke too soon...some interesting stuff here. Hey, everyone should support HR. 3396. Give the government back to the people!!

Yes the site offers LEF branded vitamins, minerals and nutritional supplements as well as bio-identical hormone sources. It also sells books by recognized authors with many letters after their name and who teach and do research at major universities around the country and world. They also offer lab test services anywhere in the U.S. with followup by an M.D.. This is only a small part of the site. There is free access to articles and publications that are not based on anecdotal testimony and include relevant citations of the latest research published by research teams in universities and private labs around the world. Investigate it a little more thoroughly before you trash it!

By the way, the study quoted in the article only has a relatively small number of patients and thus the study findings may not yet be conclusive. However, other studies have hinted at the same conclusions, so they do make sense to me.

well i was on lipitor and crestor and neither one lowered my cholesterol. changed to vytorin and cholesterol dropped by 50%. now i just take zetia because i had too much muscle pain from the vytorin to even sleep at night. and i have seen many heart attacks in people with normal lipid profiles. modern medecine does not know every thing about what causes this to happen. and levels of every thing change frequently to suit doctors and drug companies. some teaching hospitals are now telling any suspected heart patient thaty they have to take beta blocker and statin for ever before even seeing a lab study. all in the name of drug sales and money making. the docyor is no longer the family friend and trusted individual he once was. more of a business man out to make his fortune

Beta-blockers (generic), aspirin (generic), and statins (generic and brand-name) are "standard of care for myocardial infarction patients. In other words, if docs don't give these (unless there is a contraindication), and the patient has another myocardial infarction, the lawyers can sue us and win. There is no conspiracy theory here. Even if you believe the conspiracy, then why do you even take the Zetia?

NU Wildcat Fan: I agree with almost everything you say, but I am not sure of the Triglicerides comments. My insurance company recently took Lipitor to a non preferred med, and raised my cost from $50 to $120 for a three month supply. I searched the drug tier they would give me at the old price, and the only one I found that would reduce both Cholesterol (LDL) AND triglicerides was Crestor. I would not go for Vytorin or Zetia given the bad rap both had gotten in several articles i read about them. Like you said, Zocor was added to Zetia to make the expired Zocor find new life. It never worked as promised, regardless of who did the studies. After Merck's Cox 2 pain relief fiasco, and now this, I just don't trust them anymore.

One question, I always thought low dose, 81 MG aspirin was best, and not the 325MG, since the lower dose had less chance of stomach aggravation. The lower dose is what I am taking, after discussing with my Doc. Just curious.

The dose of aspirin depends on your particular medical history, and there is conflicting data. I'd say 81 mg is a nice standard dose, with higher doses of 162 or 325 mg for patients with cardiac issues.

The main complications from aspirin are a slight risk of brain hemorrage and GI bleeds. For these reasons, aspirin should not be recommended for patients at low risk for cardiovascular problems. Unfortunately, the tools we have to measure or estimate risk (e.g. Framingham score), are very imprecise, so it usually comes down to an educated guess on the part of the doctor.

You can save $ and just try the 20 mg simvastatin component of your Vytorin. Maybe the generic brand won't have the same side effects as Zocor. I don't understand how you had debilitating side effects with Zocor (simvastatin) yet tolerate Vytorin. The 10 mg in Vytorin 10/20 is Zetia, and the 20 mg is simvastatin. Alternatively, your doc can try lower than 20 mg doses of Lipitor or Crestor (whatever your insurance covers) because these statins are stronger than simvastatin, and you can save money by cutting pills in half. The ideal situation is getting the cholesterol numbers to goal on a generic statin at a dose you can tolerate.

You are quite young to have had myocardial infarctions. I hope you quit smoking and are taking your aspirin, assuming your docs have you on this.

Your LDL of 79 is close to the goal of less than 70, but your HDL stinks. Exercise can raise this maybe 10% if you do several hours of vigorous cardiovascular exercise. Niaspan (intermediate release niacin) can raise the HDL 20-30%, but has the flushing, which can be reduced by taking the aspirin 30 min prior, and the harmless yet awful side effects gradually wane over a period of several WEEKS.

Good luck.

If your liver enzymes are normal after 6 weeks of starting a statin or after increasing the dose of the statin, it is highly unlikely that they will affect the liver later. Of hundreds of patients in my career I've put on statins, fewer than 5 had to be taken off of them due to liver enzymes going up. Risk factors for high liver enzymes include alcoholism, hepatitis viruses, and excessive Tylenol or NSAID use.

Statins are not fads. Patients and docs are not sheep. Decisions are made with informed consent on a case-by-case basis. No meds are 100.0% safe. Docs recommend things to patients where the benefits exceed the risks. It is not always clear-cut.

Only your doc knows your medical history and lab results and can advise you.

Once at goal, cholesterol panel and chemistry panel (includes liver, kidney, glucose, electrolytes) can be done at the annual physical.

If your liver enzymes are normal after 6 weeks of starting a statin or after increasing the dose of the statin, it is highly unlikely that they will affect the liver later. Of hundreds of patients in my career I've put on statins, fewer than 5 had to be taken off of them due to liver enzymes going up. Risk factors for high liver enzymes include alcoholism, hepatitis viruses, and excessive Tylenol or NSAID use.

Statins are not fads. Patients and docs are not sheep. Decisions are made with informed consent on a case-by-case basis. No meds are 100.0% safe. Docs recommend things to patients where the benefits exceed the risks. It is not always clear-cut.

Only your doc knows your medical history and lab results and can advise you.

Once at goal, cholesterol panel and chemistry panel (includes liver, kidney, glucose, electrolytes) can be done at the annual physical.

The collusion between the pharmaceutical industry and the AMA have long been known.

As a doctor myself, I am well-aware of the risks vs. benefits of certain medications, but I find most well-meaning MD's miss the point.

You state that fewer than five of the patients you have given statins to have been taken off due to increased risks of liver problems. So how many did you take off because they got better and didn't need the meds anymore? How many other patients with increased cholesterol did you advise to eat healthy and exercise BEFORE you would ALLOW them to take the meds?

We have gotten so far off the path to health in this country that people think it's normal to take numerous medications indefinately, and expect to not have any repercussions.

Well, my friend, it IS the fault of Big Pharma and the MD's. Taking statins IS a fad in my opinion, and yes, many docs and patients ARE sheep when it comes to diagnosis and treatment. You're simply a victim of your own profession. Many docs are afraid to try any nutritional alternatives to dangerous statins because they do not want to be sued for treating outside the "standard of practice"- which is baloney.

This is a societal issue, that's why we are THE sickest developed nation in the world, despite all the money we spend on drugs.

Besides, if medications made us healthier, then the people taking the most drugs would be the healthiest. Instead, they're some of the sickest.

Indy,

As you know, only a small fraction of patients are actually able to follow diet & exercise advice, and get their numbers to healthy levels on their own. I tell patients that if they can demonstrate they can fix the problem without meds, then I won't rx them. The leeway I give depends on their individual cases. After starting meds, I encourage them to still try to fix their habits, and am more than happy to d/c meds when not needed. Sometimes cost and side effects are enough to motivate a patient, usually not. They want a pill to fix everything. And, we docs have a "standard of care" to follow, a medicolegal mess that society has created.

Your last sentence, though, is twisted logic. I'm sure there is a term for exactly what type. And I've never been a member of the AMA, but I belong to Sermo.

Yes, I am taking metoprolol twice a day and lisinopril one a day. I took plavix for the first year and then moved to vytorin. I run out of money and now take Simvastatin and also take 81 mg of aspirin.

The doctor explains to me that the medicine is to keep the blood thinned and to stop the production of cholesterol so the two stents do not get blocked. I went through cardiac distress when I was 38. One artery had two blockages, 98% and 50%.

Life goes on.

I was 100% in back, 40 in left front 30 in right front. Life does go on, for how long,...who knows??? But i'm not scared. I feel fine. Ride my horse, mow grass, move furniture, never giving up untill the big one! I take aspring religiously with my coffe in the AM. I feel great and hope to live another 20 years, but if not, i'm good with that too, I'm living my second life now. And enjoy every minute of it.

EXACTLY!!!! You said everything I wanted, but didn't have the time to write.

Modern allopathic medicine is in the business of managing sickness, not curing it.

There is almost no effort given to finding the root cause of one's ailment, much less attempt to do anything naturally about it. Nutrition anyone?

my first question is always "what do I need to do, NOT to have to take the drugs." Many ailments can be controlled by diet and exercise. That's where people need to look first. I'm 55 never had a flu shot, take no meds of any kind, just nutritional supplements and moderation on everything.

You are misleading. Both Lipitor and Crestor are statins. They work by the same mechanism of action. Crestor (rosuvastatin), Zocor (simvastatin), Lipitor (atorvastatin), Lescol (fluvastatin), and Pravachol (pravastatin) have all reduced cardiovascular events in clinical trials of their patient populations.

JUPITER trial: http://content.nejm.org/cgi/content/full/359/21/2195

The study discussed in the article: http://content.nejm.org/cgi/content/full/NEJMoa0907569

Not all the data is found in the "advertising" or "package insert." Lipitor does have more studies than Crestor, but has been out on the market for more years. By the way, did you know that Lipitor lowers good cholesterol (HDL) and Crestor raises HDL? To be honest, though, the clinical significance of this is unknown. This article is one of the few medical articles written by the lay press that actually are accurate and put the correct emphasis on what is important. As a doctor, I don't look at the advertising, I look at the data. I can't confirm what you say about the Crestor advertising but it is clearly incorrect.

Sorry, Wildcat, but after reading this post, I'm convinced you're simply a shill for the pharmaceutical industry.

Do you REALLY believe this stuff is good for people? Do you REALLY think people are healthier because you prescribed them these medications that only cover up their symptoms? Please correct me and write a post that shows you really understand human physiology and how nutrition relates to one's cholesterol problem.

Besides, people, half the cholesterol your body needs is made by your body itself! The allopathic doctors keep lowering the cholesterol range because everytime they do they add huge boons to the pharma companies' coffers.

The body actually can manufacture all the cholesterol it needs, as evidenced by vegetarians. Animals manufacture cholesterol, plants do not. Humans are animals. The liver synthesizes cholesterol and packages it. If people took better care of themselves and ate healthy and exercised and didn't smoke, a lot fewer medications and procedures would have to be done. Take some personal responsibility, and don't expect a pill to fix everything. Demonstrate to me that you can get your blood pressure, cholesterol, and glucose down to healthy levels, and you won't need my rx, and it will save me a lot of unreimbursed work.

Agree. If patients can tolerate the side effects (and I'd estimate that half of the patients can't, despite all the proper preventive measures), I'd use niacin 1st choice. As you know, many patients have all 3 parameters (LDL, HDL, TGs) out of whack, so niacin + a generic statin is often the way to go. Niaspan reduces side effects minimally, and is expensive; furthermore, the slower the niacin release, the greater the liver toxicity, which is opposite the effects on side effects (skin on fire sensation).

Try not to blame the government for the mistakes of the AMA, wanting to put patients on every drug they possibley can to keep you coming back, they love that money, they live really well off that money.

I agree with your statement, drugs seem to be the first option for Dr's, but it's up to the patient to say no "what are my other alternatives?" My point was/is, the government (FDA) approves of these drugs but are not held accountable when they have bad consequences. For that, they let the drug company take the hit.

True - I have been taking 3 drugs in combo for most of the last 10 years. Lipitor + Niaspan + Welchol. I can take a lower dose of the lipitor and Welchol because I'm taking multiple drugs. The key here is that I have kept and ideal lipid profile for most of these years and have raised my HDL from around 30 to 60 at last reading - that's the Niaspan.

HDL is the primary predictor of longevity in my book. Of course cholesterol is only part of the root cause of this disease. The treatment must include daily exercise, a better diet, weight control, and stress control as well as well managed blood pressure.

Bill - FYI, re: Welchol. It's probably harmless, but I don't rx it. It's expensive, inconvenient, and has no data that it improves outcomes (i.e. no reduction in cardiovascular risk). Of course, discuss with your doctor as I am not your doctor.

Gotta lose the smokes, if you can. If the enjoyment of them exceeds your fear of health problems, well, thats the way it is and I'll respect that.