Friday, July 17, 2015

Taking statins or not: Dueling perspectives

I've written a lot of posts on here about the issue of diabetes, cholesterol, and taking statins.  I suppose it's a pet topic of mine.  So when I saw these two articles almost back to back (they were published a couple years apart, but I only just saw both of them the other day) I had to blog about it.

April 3, 2013: Side Effects Prompt Patients To Stop Cholesterol Drugs

July 15, 2015: When To Start Taking A Cholesterol Pill? The Decision Is Yours

The two articles provide two contrasting points of view.

The first article starts out fairly critical of people who choose not to take statins.

It's tough to get people to take medicine to reduce the odds of disease years from now, notes Dr. Scott Grundy, a cholesterol researcher at UT Southwestern Medical Center in Dallas. "The vast majority of people don't have side effects," he wrote in an editorial accompanying the study. "Not continuing the drug has a lot more to do with people just not wanting to take drugs for a lifetime."

"Statins are important drugs, especially for patients with known heart disease," says Dr. Alexander Turchin, an assistant professor of medicine at Harvard Medical School, who led the study. "These are not drugs you just want to throw away without a second thought."
 The article goes on to present a surprisingly well-supported contrasting opinion:

But patients should still proceed with caution when considering statins, says Dr. Barbara Roberts, director of the Women's Cardiac Center at Miriam Hospital in Rhode Island, and author of a book called The Truth About Statins.

Studies haven't shown that statins help women who don't already have heart disease, even if they have risk factors like obesity and family history, she says. That's compared to a recent study that found a 30 percent reduction in heart attacks in people who follow a Mediterranean diet. "You can get just as much benefit from following the Mediterranean diet as you can from statins," she says.

Last year the Food and Drug Administration warned that taking statins slightly increases the risk of diabetes, even in people at a healthy weight and with no other risk factors. No research has been done to see if the diabetes goes away when patients stop taking statins, she says.

And long-term statin use may cause nerve damage, Roberts says. That damage often reverses, she says, but the process can take months. "I have two patients who wound up bedridden from biopsy-proven neuropathy due to statins; both improved but never returned to normal strength."

The nerve damage is particularly interesting, since so many diabetics have problems with this issue.  It makes me wonder: Is it diabetes causing this, or the statins that so many diabetics end up taking?

The other article is even more interesting, and I think reveals a shift in the industry's thinking in the past two years.  Basically, the article discusses new guidelines, which say that people should be put on statins based on their risk for heart disease, rather than their cholesterol numbers regardless of how high their risk is.  This is pretty groundbreaking, considering not too long ago the industry wanted to put half of American adults over 40 on statins.

I'm holding firm: I'm still not taking anything for my "high" cholesterol.  It's not that high, my risk isn't that high, and I'm not going to spend the next 50 years taking drugs -- especially not now that I know that neuropathy is a risk!

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