Statin use

[Vince]

There's no good evidence that statins cause or trigger ALS , also known as Lou Gehrig's disease. However, there have been reports of people who have developed ALS while taking statins. Other studies have shown a decreased risk of ALS in people who take statins.

Statins: Do they cause ALS?

These medicines for high cholesterol can cause muscle injury in some people. But can they also trigger amyotrophic lateral sclerosis, also known as ALS?

www.mayoclinic.org

 

[DJXS]

I wanted to see if anyone has tried very low dose statins long term with no side effects. My doctor keeps trying to push them on me but the potential side effects scare me. My total cholesterol is 240, LDL 162, HDL 55 and triglycerides are 98. All my other labs are good but diet doesn’t budge any of these no matter what I try. I am not overweight I have never smoked and have a few drinks on the weekend. I’m also very active. I’m just not even sure if I need them because I have no other health issues. I have tried to get the doctor to call in an order for a calcium scan but he refuses to so I might try to do that on my own somehow. He is trying to get me to take 10 mg per day of pravastatin and tells me that one has the least side effects but I’m just not sure I want to go that route.

Your lipid numbers actually look quite good, with normal triglyceride level and a notably good HDL number; LDL is a bit elevated, but with those numbers and being in otherwise good health it's interesting that your doctor is pushing you towards taking a statin. It's also strange that your doctor won't refer you for Cardiac Calcium Scoring. This test provides helpful insights, insurance typically doesn't cover it, but it's only about $150USD out of pocket. Maybe tell your doctor that you are considering her recommendation, and you'll go on a low dose statin if your cardiac calcium score is moderate-high or higher, such as being over 250 or 300, especially since diet doesn't seem to budge your lipid numbers. I will add that if you are to begin a statin, low dose pravastatin is the way to go. This is a hydrophilic statin, as opposed to the lipophilic statins, while also being a lighter statin, so the risk of sides is lowest of all statins with this one. If your cardiac calcium score is below 200, along with your solid HDL, normal triglycerides, and only somewhat elevated LDL, you might want to postpone starting a statin though. As an alternative to statins, you might look into berberine supplementation.

 

[NoVa Biker]

Take the statins. Your LDL is too high. (But your HDL is good.) I take statins and have no side effects that I am aware of. If you have side effects that bother you, you can just stop the statins. You’ll never know until you try.

 

[xcpatr922]

Your lipid numbers actually look quite good, with normal triglyceride level and a notably good HDL number; LDL is a bit elevated, but with those numbers and being in otherwise good health it's interesting that your doctor is pushing you towards taking a statin. It's also strange that your doctor won't refer you for Cardiac Calcium Scoring. This test provides helpful insights, insurance typically doesn't cover it, but it's only about $150USD out of pocket. Maybe tell your doctor that you are considering her recommendation, and you'll go on a low dose statin if your cardiac calcium score is moderate-high or higher, such as being over 250 or 300, especially since diet doesn't seem to budge your lipid numbers. I will add that if you are to begin a statin, low dose pravastatin is the way to go. This is a hydrophilic statin, as opposed to the lipophilic statins, while also being a lighter statin, so the risk of sides is lowest of all statins with this one. If your cardiac calcium score is below 200, along with your solid HDL, normal triglycerides, and only somewhat elevated LDL, you might want to postpone starting a statin though. As an alternative to statins, you might look into berberine supplementation.

I agree with CAC suggestion. If the score is above 50 and if the plaque is in the LAD or multivessel,better hurry with statin and aspirin. But if CAC is zero then you can skip the statin.

In case CAC is higher than 100, ask doc. if they're willing to do more stronger anti-platelet agent or event possible stenting before an event happened.

Statin is actually like long-term prevention but it will not affect the actual MI event. The one that really reduces the MACE/MI event is only anti-platelet/anti-coag agent.

Also, it's actually more important to know what to do you have MI as people usually deny it at the very first few minutes. If you have any "knocks" in the chest that are not from muscle or GERD, better call an ambulance soon.

 

[ed031561]

I wanted to see if anyone has tried very low dose statins long term with no side effects. My doctor keeps trying to push them on me but the potential side effects scare me. My total cholesterol is 240, LDL 162, HDL 55 and triglycerides are 98. All my other labs are good but diet doesn’t budge any of these no matter what I try. I am not overweight I have never smoked and have a few drinks on the weekend. I’m also very active. I’m just not even sure if I need them because I have no other health issues. I have tried to get the doctor to call in an order for a calcium scan but he refuses to so I might try to do that on my own somehow. He is trying to get me to take 10 mg per day of pravastatin and tells me that one has the least side effects but I’m just not sure I want to go that route.

I'm 60yo. At 58 I got a calcium scan and the doctor did not like it. I am not over weight, workout 4x/wk, have been on TRT since my early 40's but have a family history of high cholesterol which diet does not correct. Inflammation is low. Well went in for the scope procedure and walked out with a couple of stents! Doc put me on lowest dose (10mg) of Crestor which seems to be the only cholesterol med I could tolerate. My cholesterol is now great, blood pressure came down and I have noticed improvement in the erection department! In any event get a calcium scan, they are known to produce false positives but it could serve as a marker.

 

[xcpatr922]

I'm 60yo. At 58 I got a calcium scan and the doctor did not like it. I am not over weight, workout 4x/wk, have been on TRT since my early 40's but have a family history of high cholesterol which diet does not correct. Inflammation is low. Well went in for the scope procedure and walked out with a couple of stents! Doc put me on lowest dose (10mg) of Crestor which seems to be the only cholesterol med I could tolerate. My cholesterol is now great, blood pressure came down and I have noticed improvement in the erection department! In any event get a calcium scan, they are known to produce false positives but it could serve as a marker.

You're very lucky you got stent prior to the event. I have same experience with you. The libido increase after stenting as blood flow nicely. I just need to watch this hematocrit and TRT not to get too naughty.

The only thing that I regret is I wish I can control my dietary routine when I was 30 years old.

 

[Vince]

Once you have a stent. You can never have a true heart scan again. The stent will show a complete blockage and you would not get a true reading.

 

[sh1973]

I would definitely like to get a cac score even if on my own at this point but I did start pravastatin 3 days ago and so far no issues but I’ll wait a month or so to see how it’s affecting my cholesterol. One good thing about statins is the ability to lower inflammation which is certainly a good thing. Diet in my case is a no go. There’s nothing I haven’t tried as far as diet. I’ve even taking fiber capsules after every meal for months on end to no avail. I do cardio 6-7 days a week as well. In my case as well as many others it’s just hereditary I suppose.

 

[xcpatr922]

The way I understand it, lets say you have the following in the CAC report:
LAD-20
RCA-200
LCX-0

Now lets say you have stent in the RCA, you can still do the CAC but the number in RCA will be meaningless ; while the value for LAD and LCX can still be counted and useful. However good cardiologist will use more advanced Echo/nuclear scan test and EF to understand the heart rather than the CAC value alone.

 

[MarcoFL]

I would definitely like to get a cac score even if on my own at this point but I did start pravastatin 3 days ago and so far no issues but I’ll wait a month or so to see how it’s affecting my cholesterol. One good thing about statins is the ability to lower inflammation which is certainly a good thing. Diet in my case is a no go. There’s nothing I haven’t tried as far as diet. I’ve even taking fiber capsules after every meal for months on end to no avail. I do cardio 6-7 days a week as well. In my case as well as many others it’s just hereditary I suppose.

Will a CAC score measure any soft build up or just the hardened buildup? I just went on a statin at 59 because of a very negative Boston Heart Lab test. I am just not sure about soft plaque buildup that I may have and no longer willing to roll the dice!

 

[sh1973]

Will a CAC score measure any soft build up or just the hardened buildup? I just went on a statin at 59 because of a very negative Boston Heart Lab test. I am just not sure about soft plaque buildup that I may have and no longer willing to roll the dice!

I am honestly not sure. For some reason I can’t get my doctor to order one but I’m just gonna get my own. My ldl has been as high as 190 and the lowest I can get it is in the 160 range. The higher I take my testosterone the higher it goes. Luckily I feel the best with lower t levels. I only do 60-70mg per week. That puts my 7 day trough in the 600-700ng range.

 

[MarcoFL]

I am honestly not sure. For some reason I can’t get my doctor to order one but I’m just gonna get my own. My ldl has been as high as 190 and the lowest I can get it is in the 160 range. The higher I take my testosterone the higher it goes. Luckily I feel the best with lower t levels. I only do 60-70mg per week. That puts my 7 day trough in the 600-700ng range.

I am NOT a doctor but I assume a stroke does not care if you have hard or soft blockage! I would listen to your doctor.

 

[xcpatr922]

Most research is showing soft plaque is more dangerous than hardened-calcium plaque. CAC is counting the calcium in the plaque. Basically, these differences don't really matter because if it ruptures it might cause an MI.

Again statin is only one long-term prevention to slow down the plaque development but whatever plaque is in there if it ruptures, it may cause blockage and then clots forming from platelet stickiness. This is where it's tricky because we can't control whether that plaque will rupture or not.

The thing is if the blockage area is lesser than 70%, the cardiologist will not do preventative stenting.

I am NOT a doctor but I assume a stroke does not care if you have hard or soft blockage! I would listen to your doctor.

Also for stroke better to do a carotid scan in the neck.

 

[MarcoFL]

Most research is showing soft plaque is more dangerous than hardened-calcium plaque. CAC is counting the calcium in the plaque. Basically, these differences don't really matter because if it ruptures it might cause an MI.

Again statin is only one long-term prevention to slow down the plaque development but whatever plaque is in there if it ruptures, it may cause blockage and then clots forming from platelet stickiness. This is where it's tricky because we can't control whether that plaque will rupture or not.

The thing is if the blockage area is lesser than 70%, the cardiologist will not do preventative stenting.



Also for stroke better to do a carotid scan in the neck.

Thank you. Yes, I just had a scan last week and carotid was clean.

 

[Vince]

Will a CAC score measure any soft build up or just the hardened buildup? I just went on a statin at 59 because of a very negative Boston Heart Lab test. I am just not sure about soft plaque buildup that I may have and no longer willing to roll the dice!

It takes one year for soft plaque to calcify and become stable plaque. Plaque is made up of 20% calcium, that's what the scan sees. The calcium.