Questions about Statins

TideEngineer08

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I found a little on this topic in the obesity thread at the top of the board, but I'd like to hear anyone with any knowledge on this expound a bit further.

My story: I am 38, will be 39 in a couple months. In my mid-20s I began putting on weight which ultimately led to me being 300 lbs. I tried losing weight a couple of times which led to 50/60 lb losses, but I quickly gained it back both times. Fast forward to April of 2019. My dad has a sudden heart attack and passes away on the operating table. I do not recall specifics, but I believe his widow maker was nearly 100% blocked. He was probably 40 lbs or so overweight and had carried that weight for many years. He was 70. His dad passed away at 69 from congestive heart failure. One of his brothers died in his 40s on the operating table after a heart attack. Another brother had to have bypass surgery in his 40s. Pancreatic cancer ultimately claimed his life in his 60s.

Long story, but obviously family history is against me. In early 2020, as Covid madness was setting in, I began having chest pains. Called 911 once, and visited the ER on two other occasions. Stress test negative. Blood work and EKGs always negative. Turns out it was severe anxiety likely from Covid and dad's passing in combination, along with GERD. At this time, literally fearing for my life, I went on a low carb eating plan. Quit all forms of sugar. By this past December, I had lost 110 lbs. I was on anxiety meds, 2 blood pressure meds, acid reflux meds, and thyroid meds. I was able to come off the anxiety, reflux, and one bp med. I still take a beta blocker and the synthroid.

Now to the point. My LDL is high. I believe it was 165 the other day when I had bloodwork done. My doctor wanted me on statins last year and I refused. I've done a ton of studying on this since all of this began. It seems it has never been clearly proven that LDL is the bad actor in heart disease. Many cardiologists around the country have shifted away from the LDL paradigm. My doctor is absolutely against that line of thinking and wants my LDL under 100. This last go around, I've decided to listen to his advice due to my family history. Yet I still see and hear of people with low LDL still having heart attacks. See and hear plenty of stories of bad experiences for people taking statins.

I would love to hear anyone's thoughts on this, especially those of you with heart issues that you've dealt with and any medical professionals. I've been taking the statins for a week now. Actually 2 different meds, one of which actually stops the intestines from taking in cholesterol from food. No terrible side effects yet, that I can tell, except my sleep hasn't been great. However there are other factors at play there so I'm not willing to blame the meds just yet.
 

B1GTide

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So, I come from a family in which men rarely live past 65 due to heart issues. Because of that history, I have spent most of my adult life doing what I can to maintain my health and fitness. But, even eating a great diet and exercising more than any 5 people that I know combined, I still have to take a statin to control my cholesterol. I tried for 2 years to lower it on my own and it would not budge. Now, I take the lowest dose of Crestor available (5mg), and that does the job for me with absolutely no side effects. My numbers are in the ideal range.

But my genes are going to continue to present problems for me. I have gout, brought on by genetics. I have early state glaucoma, brought on by genetics. I have had colon cancer, brought on by genetics. And I have to take a statin to control my cholesterol - brought on by genetics.

My only advice - do everything in your power to avoid the statin, but if you cannot lower than number then you have to consider the many issues which are thought to be caused by high cholesterol and make a call.
 

Padreruf

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I found a little on this topic in the obesity thread at the top of the board, but I'd like to hear anyone with any knowledge on this expound a bit further.

My story: I am 38, will be 39 in a couple months. In my mid-20s I began putting on weight which ultimately led to me being 300 lbs. I tried losing weight a couple of times which led to 50/60 lb losses, but I quickly gained it back both times. Fast forward to April of 2019. My dad has a sudden heart attack and passes away on the operating table. I do not recall specifics, but I believe his widow maker was nearly 100% blocked. He was probably 40 lbs or so overweight and had carried that weight for many years. He was 70. His dad passed away at 69 from congestive heart failure. One of his brothers died in his 40s on the operating table after a heart attack. Another brother had to have bypass surgery in his 40s. Pancreatic cancer ultimately claimed his life in his 60s.

Long story, but obviously family history is against me. In early 2020, as Covid madness was setting in, I began having chest pains. Called 911 once, and visited the ER on two other occasions. Stress test negative. Blood work and EKGs always negative. Turns out it was severe anxiety likely from Covid and dad's passing in combination, along with GERD. At this time, literally fearing for my life, I went on a low carb eating plan. Quit all forms of sugar. By this past December, I had lost 110 lbs. I was on anxiety meds, 2 blood pressure meds, acid reflux meds, and thyroid meds. I was able to come off the anxiety, reflux, and one bp med. I still take a beta blocker and the synthroid.

Now to the point. My LDL is high. I believe it was 165 the other day when I had bloodwork done. My doctor wanted me on statins last year and I refused. I've done a ton of studying on this since all of this began. It seems it has never been clearly proven that LDL is the bad actor in heart disease. Many cardiologists around the country have shifted away from the LDL paradigm. My doctor is absolutely against that line of thinking and wants my LDL under 100. This last go around, I've decided to listen to his advice due to my family history. Yet I still see and hear of people with low LDL still having heart attacks. See and hear plenty of stories of bad experiences for people taking statins.

I would love to hear anyone's thoughts on this, especially those of you with heart issues that you've dealt with and any medical professionals. I've been taking the statins for a week now. Actually 2 different meds, one of which actually stops the intestines from taking in cholesterol from food. No terrible side effects yet, that I can tell, except my sleep hasn't been great. However there are other factors at play there so I'm not willing to blame the meds just yet.
I come from a family with high cholesterol...I have taken simvastatin for @30 years -- my LDL is about 75-80 and with exercise I have a high HDL. No problems or side affects...and yes, I can gain weight just looking at a donut. I swear by these and blood pressure meds.
 

TideEngineer08

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I come from a family with high cholesterol...I have taken simvastatin for @30 years -- my LDL is about 75-80 and with exercise I have a high HDL. No problems or side affects...and yes, I can gain weight just looking at a donut. I swear by these and blood pressure meds.
I was able to lower my BP through the dietary changes. Nowadays it runs in the 117/70 range most of the time. 130s/80s if I'm stressed. I still take a half pill of 25 mg Metoprolol. Resting HR stays in the 50s.

I need to exercise more. The family history angle, and the fear that maybe genetics plays a bigger role than lifestyle after all, are ultimately what led me to decide to take the statins.

My doctor says the statins lower inflammation, which I believe is actually what is damaging people's arteries. Do you believe that to be true? Seems research is mixed.
 

Padreruf

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I was able to lower my BP through the dietary changes. Nowadays it runs in the 117/70 range most of the time. 130s/80s if I'm stressed. I still take a half pill of 25 mg Metoprolol. Resting HR stays in the 50s.

I need to exercise more. The family history angle, and the fear that maybe genetics plays a bigger role than lifestyle after all, are ultimately what led me to decide to take the statins.

My doctor says the statins lower inflammation, which I believe is actually what is damaging people's arteries. Do you believe that to be true? Seems research is mixed.
Yes...my cardiologist for 20 years was also my golfing buddy and a good friend...also highly respected. He told me that 95% or so of cardiologists take statins.
 

TideEngineer08

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For some cases that is appropriate from what I know...but don't take medical advice from a minister!!
Well your brain absolutely requires cholesterol. Of course, my doc says any of the memory issues with statins is nonsense.

But like all things, it's risk/benefit analysis I guess. I'm happy to hear dtgreg's doctor worked with him and tailored treatment according to his unique case.
 
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PA Tide Fan

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I've been taking a statin for many years. My dad died when he was only 54 of a heart attack, but that was way back before much was known about cholesterol. He was a heavy smoker though so that may have had more to do with it than anything. I'm not a smoker. My total cholesterol was 210 when I was put on the statin. Since I've been on it my total cholesterol is consistently in the 120's and my LDL is always around 70. I take Rosuvastatin (generic Crestor) 10mg/day. One thing I've read about statins is that they can elevate glucose levels. My glucose level is always at the upper end of the "normal" range but I can't prove it's from the statin. I don't have any other side effects.
 

Toddrn

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I have a huge history of heart disease on my father's side of the family. Seven of nine of his siblings, including him, died from heart disease. My father died in 1992 at the age of 55. First heart attack at 40 with triple bypass. My father smoked up until his first heart attack and then never smoked again. He had at least 2 more heart attacks including the one that killed him and two more bypass surgeries. My brother, smoker, had triple bypass 11 years ago, then 2 stents 2 years ago. December 2020 I had 2 stents placed. I fought my weight my entire life, I'm 61 now, until I started running about 18 years ago.

My cholesterol has always been high. Total in 2018 was 262, LDL 167, HDL 84. HDL high from running. I have tried most of the Statins and could not tolerate them. I also tried Red Yeast Rice in combo with Zetia and saw no improvement. I gave up except for running. I always said I was running from heart disease and to eat. LOL. In November of 2020 I started having some chest tightness when running that went away with rest. I had a CT Calcium Score test about 10 years ago and my score was 288. I had another one done once I started having the chest tightness and it was 903. These are total numbers. When it is read they will also break it down by artery if your number is high enough. My Right Coronary Artery number was 504, Left Anterior Descending artery 293. That's where the 2 stents are now.

I used the Wellstar Health System and you do not need an order from a doctor for a CT Calcium Score. It is self pay not covered by insurance when you schedule it yourself. It cost me 99 dollars and if I had taken my wife we both could have gotten it done for 149 dollars. My wife had one when I did about 10 years ago and her score was 0. It is a easy way to find out if you MIGHT have heart disease. Not 100% foolproof of course. Once it is read they send you a report with CD copy for your records or to take to a Cardiologist.

After my stents my Cardiologist started me on Praluent, an injectable once every 2 weeks, with no side effects for me. Had my cholesterol checked about 2-3 months after starting it. June 2021 Total was 171, LDL 67 and HDL 91. I believe running helped me delay having the stents but family history caught up with me. You cannot run, no pun intended, from genetics. Everyone benefits from exercise, a little can go a long way. Running, walking, rucking, etc. Yes you sometimes have to make yourself do it but once it becomes habit it is much easier to do. Hope this helps you. Sorry this is so long.
 
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crimsonaudio

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The reality is that high cholesterol is not good for you.

My wife eats literally perfectly. She's an anomaly. No one can do what she does. On top of this she works out multiple times every day and is therefore in fantastic shape. But her cholesterol is consistently 50 points higher than mine (was even when I was 'fluffier' than I am).

Nowadays, my wife and I eat similarly, work out similarly, etc - yet my cholesterol consistently reads far lower than hers. The only answer is genetics.

In her case, she's still in the healthy range so nothing is needed, but at some point in the future some sort of medication will almost certainly be needed for her.

TLDR: sometimes it doesn't matter what you do, your genetics deem meds necessary.
 

crimsonaudio

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My doctor says the statins lower inflammation, which I believe is actually what is damaging people's arteries.
I think it's a complex issue we're just beginning to truly understand. By this I mean I don't believe it's just a matter of cholesterol - I think refined sugars play a role as well. And likely other things.

There's something to be said about the combination of diet and (lack of) overall exercise that is generally prevalent today. Our grandparents often lived long lives while eating 'bad' foods - but they actually worked all day. Our sedentary lifestyle combined with highly refined foods likely comes at a cost...
 

TideEngineer08

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I think it's a complex issue we're just beginning to truly understand. By this I mean I don't believe it's just a matter of cholesterol - I think refined sugars play a role as well.

There's something to be said about the combination of diet and (lack of) overall exercise that is generally prevalent today. Our grandparents often lived long lives while eating 'bad' foods - but they actually worked all day. Our sedentary lifestyle combined with highly refined foods likely comes at a cost...
I believe you are correct. People were not dying of heart disease 100 years ago when all they ate was animal fat. But yes, they were also not sedentary. They weren't staring at blue light screens all day either.
 

Padreruf

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I have a huge history of heart disease on my father's side of the family. Seven of nine of his siblings, including him, died from heart disease. My father died in 1992 at the age of 55. First heart attack at 40 with triple bypass. My father smoked up until his first heart attack and then never smoked again. He had at least 2 more heart attacks including the one that killed him and two more bypass surgeries. My brother, smoker, had triple bypass 11 years ago, then 2 stents 2 years ago. December 2020 I had 2 stents placed. I fought my weight my entire life, I'm 61 now, until I started running about 18 years ago.

My cholesterol has always been high. Total in 2018 was 262, LDL 167, HDL 84. HDL high from running. I have tried most of the Statins and could not tolerate them. I also tried Red Yeast Rice in combo with Zetia and saw no improvement. I gave up except for running. I always said I was running from heart disease and to eat. LOL. In November of 2020 I started having some chest tightness when running that went away with rest. I had a CT Calcium Score test about 10 years ago and my score was 288. I had another one done once I started having the chest tightness and it was 903. These are total numbers. When it is read they will also break it down by artery if your number is high enough. My Right Coronary Artery number was 504, Left Anterior Descending artery 293. That's where the 2 stents are now.

I used the Wellstar Health System and you do not need an order from a doctor for a CT Calcium Score. It is self pay not covered by insurance when you schedule it yourself. It cost me 99 dollars and if I had taken my wife we both could have gotten it done for 149 dollars. My wife had one when I did about 10 years ago and her score was 0. It is a easy way to find out if you MIGHT have heart disease. Not 100% foolproof of course. Once it is read they send you a report with CD copy for your records or to take to a Cardiologist.

After my stents my Cardiologist started me on Praluent, an injectable once every 2 weeks, with no side effects for me. Had my cholesterol checked about 2-3 months after starting it. June 2021 Total was 171, LDL 67 and HDL 91. I believe running helped me delay having the stents but family history caught up with me. You cannot run, no pun intended, from genetics. Everyone benefits from exercise, a little can go a long way. Running, walking, rucking, etc. Yes you sometimes have to make yourself do it but once it becomes habit it is much easier to do. Hope this helps you. Sorry this is so long.
Thanks...this is a really helpful narrative of how to combat genetics with lifestyle changes and meds.
 

B1GTide

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Where is the evidence for that?
Well, it wasn't a leading cause of death because people died from getting a scratch, or from any one of dozens of other ailments that no longer kill people because of modern medicine. But people have always died suddenly - most likely from stroke or heart attacks. We just didn't have the science to know what was killing them, or why.

Go back 100+ years and we are guessing. But the best guess is that heart disease first became the leading cause of death in America about 80 years ago based on a quick Google search.
 

UAH

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I was able to lower my BP through the dietary changes. Nowadays it runs in the 117/70 range most of the time. 130s/80s if I'm stressed. I still take a half pill of 25 mg Metoprolol. Resting HR stays in the 50s.

I need to exercise more. The family history angle, and the fear that maybe genetics plays a bigger role than lifestyle after all, are ultimately what led me to decide to take the statins.

My doctor says the statins lower inflammation, which I believe is actually what is damaging people's arteries. Do you believe that to be true? Seems research is mixed.
I accept it as fact that inflammation is a precursor to injury of the artery that leads to the build up of plaque and ultimately the rupture of plaque that is the principal cause of heart attack and stroke. That the primary cause of inflammation is high fat and refined sugars in our diet.
 
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selmaborntidefan

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Now to the point. My LDL is high. I believe it was 165 the other day when I had bloodwork done. My doctor wanted me on statins last year and I refused. I've done a ton of studying on this since all of this began. It seems it has never been clearly proven that LDL is the bad actor in heart disease. Many cardiologists around the country have shifted away from the LDL paradigm. My doctor is absolutely against that line of thinking and wants my LDL under 100. This last go around, I've decided to listen to his advice due to my family history. Yet I still see and hear of people with low LDL still having heart attacks. See and hear plenty of stories of bad experiences for people taking statins.
Apologies in advance for what is going to sound condescending on my part because I don't mean it that way, I promise.

Much of what you're saying here regarding the LDL cholesterol is very similar to what is being said about Covid-19 right now, not that I'm in any way accusing you of being any sort of an anti-vaxxer. We are PLAYING ODDS is all we're doing. There is a plethora of stuff we do not know for 100% certainty, but we know it with 80-85% certainty, too. We can find PATTERNS OF PREDICTABILITY where things happen. I believe - IIRC - that when David Letterman had his heart issue, his cholesterol was something like 170, which is below the 200 threshold. When General Schwarzkopf had prostate cancer his PSA result was 1.4 - far below the threshold of serious fear regarding prostate cancer.

Part of the problem is us as humans: we all want it to be very easy and built like an "if/then" hypothesis, but life doesn't work that way. (I include myself in this reluctant acceptance). We want a simple lab test to say, "You have disease X," but in all honesty it doesn't really work that way. False positives and negatives do occur sometimes through the fault of humans and sometimes because even the most accurate test is only 95% accurate.

Just because we don't know everything doesn't mean we know nothing. I can "know math" in that I know the four basic operations even if calculus would kick my behind. (I assume it would, I never took it - and I did pretty good in the higher maths, I'm just saying).

I think what grinds my gears so much is this very argument you're making here is the very same argument my former in-laws claimed about smoking cigarettes. Both quit when they were about my age, the FIL when he had a heart attack sitting in the doctor's office and the MIL when she had to have surgery for full carotid blockages at about the same age (54-55). They would INSIST over and over again that there was no conclusive evidence that smoking caused all those problems - and the ex-FIL would go with, "My father smoked every day of his life and died of cancer. My brother smoked and died of the same cancer. Both were 67 when they died." Unfortunately for him, he decided he was going to die at 67...and he turned 77 last week, but his retirement planning was largely based on not living very long past 65. To his credit and hers - both DID STOP smoking but only after severe issues.

Wanna know what that guy said? "Everybody said I'd die of lung cancer, nobody said I'd have a heart attack." Uh....yes they did, you just didn't pay attention.


I would love to hear anyone's thoughts on this, especially those of you with heart issues that you've dealt with and any medical professionals. I've been taking the statins for a week now. Actually 2 different meds, one of which actually stops the intestines from taking in cholesterol from food. No terrible side effects yet, that I can tell, except my sleep hasn't been great. However there are other factors at play there so I'm not willing to blame the meds just yet.
Issues You Can Control:
Your weight and fitness (up to a point anyway)
Whether you smoke or not
Whether you take your medicines or not
Whether you go to the doctor and/or listen to him/her or not

Issues You Cannot Control:
Genetics
Accidents

I'm sure there's more, but my advice would be to listen to your doctor.