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Posted: 1/25/2006 11:55:59 AM EDT
I was reading on FalFiles of all places that several people claim that the cholesterol lowering drugs only damage the liver and alter lab results to show lower cholesterol readings. (I don't believe that) I know that they can cause liver problems hence the required testing while taking the drugs. They also claimed fish oil supplements did a better job with no side effects.


A few questions for discussion:

1) Are the side effects worth the lower cholesterol?

2) What are the long-term side effects to these drugs?

2) There are many factors that cause hearth disease. Is simply lowering cholesterol effective?
Link Posted: 1/25/2006 12:26:12 PM EDT
My doctor reccomended Fish Oil instead of prescriptions, and taking 1 in the morning, 1 in the afternoon I brought my count from dangerous to normal within 3 months. I don't have my medical records handy to tell you the count. Don't be cheap with the supplement, you do not want mercury in your fish oil. I also got "deodorized" capsules so you do not taste raw fish oil.

I also noticed the common effect of "calmness". I take creatine with my supplements for working out and before the fish oil I was very jumpy and aggitated, no more.
Link Posted: 1/25/2006 12:41:40 PM EDT
Hmmm


My total was 210-220. With Provacol it's 160. My liver enzymes were high before the Provacaol but seem to be lower now, one is still slightly elevated. The Dr. thought my liver was getting a lot of work because of the high cholesterol.

Link Posted: 1/25/2006 12:48:35 PM EDT
Link Posted: 1/25/2006 1:01:12 PM EDT

Originally Posted By mojo:

Originally Posted By JIMBEAM:
Hmmm


My total was 210-220. With Provacol it's 160. My liver enzymes were high before the Provacaol but seem to be lower now, one is still slightly elevated. The Dr. thought my liver was getting a lot of work because of the high cholesterol.




Also stay away from Tylenol...And JIMBEAM, stay away from yourself--Jim Beam -- or any other alcohol substance as they tend to work overtime on your liver.



True ture.


I don't drink much anymore.

Once or twice a month a go get beers with the guys 3 or 4 beers and I am done.

Link Posted: 1/25/2006 1:02:14 PM EDT
One to Three beers a day is supposed to lower Cholesterol.

I'm willing to try!
Link Posted: 1/25/2006 1:07:55 PM EDT
My father lowered his cholesterol from 240's to 160's in 7-8 months by changing his diet. For past 5+ years he has managed to keep his cholesterol level between 160-170's.

I'll have to do same in future.
Link Posted: 1/25/2006 1:35:06 PM EDT
Not a doc, but a pharmacist.

To answer some of your questions I'm ASSuming you are refering to HMG-CoA reductase inhibitors (or statins). (there are about 4 other prescriptions classes that can be used for cholesterol) These are the Zocors, Lipitors, Crestors and they target the cholesterol made by your body (yes, you make cholesterol) and they are very good at it. They reduce the bad (LDL) cholesterol very well (~20-50%) and have been proven to reduce cardiovascular disease (think heart attacks). This is a fact that no Dr. will deny and any one saying otherwise is full of crap. Statins are now a standard of care in hyperlipidemia (high cholesterol).

1) Compared to dying from a heart attack, yes the side effects are worth it
2) Most minor side affect are GI in nature like nausea, constipation, ab pain etc but major (though rare) can be liver damage (they'll do blood tests to catch this) and severe and pain muscle disorder ( very rare)
3) Lot of other things increase the risk of heart disease-smoking, diabetes (uncontrolled), age, being male, having low HDL (good cholesterol), and family history. Most of these you can't control, so control what you can.



Link Posted: 1/25/2006 2:04:47 PM EDT
Life is a side-effect of Sex.


There are side effects to all medications--INCLUDING placebos (fake medications for testing purposes). When research is done, they report the difference in side effects (Reported: 5% develop, say..headaches--that means 8% developed headaches, but the Placebo control had 3% headaches)

Cholesterol is a combination of body processes and diet. You can watch what you eat and lower it some...some people can probably lower their Cholesterol by diet just as much as by medication (diet including fish oil suppliments), however most aren't going to change the diet enough to matter, or have enough endogenous production of Cholesterol to need some help.

Starting any medication should be monitored--medication levels need adjusted or the medication changed in many instances.

And, as someone pointed out: Tylenol, Drinking, etc. can do significant liver damage.


AFARR
Link Posted: 1/25/2006 2:14:28 PM EDT
[Last Edit: 1/25/2006 2:17:42 PM EDT by California_Kid]
Excellent topic, JIMBEAM.

I quit Lipitor because it was hammering my liver enzymes and because it's incompatible with one of my favorite foods, grapefruit.

Every year for five years I got the same song and dance from doctors. I'd give a blood sample, then three days later the doctor's office would call because I had "abnormalities" on the test: Elevated liver enzymes.

Then came the same set of scripted questions about whether and how much alcohol I drink. Then the lecture about how I have to cut back. One year I got sent to an AA clone gastroenterologist who gave me a stern lecture about the effects of alcohol but could not find any evidence that I had liver damage, other than the elevated enzymes. The guy is a Marty Feldman lookalike, probably a total pervert. But he did do a good job on my colonoscopy.

Every year I cut back more and more on drinking, and laid off completely for an increasing amount of time before the test. On Year 4 I had nothing to drink for 8 full days before giving the blood sample, and my liver enzymes were still elevated.

On Year 5 I decided to try something different. I laid off alcohol for just TWO days, and also quit taking Lipitor for TWO days.

Lo and behold, no elevated liver enzymes. I have to conclude that the Lipitor itself was causing problems. It's been three months. I have less shortness of breath, I'm getting laid all the time after a hiatus of over two years, and some anomalies in my intestinal function have just about vanished (details withheld in the interest of decency).

I believe I got put on Lipitor on false pretenses in the first place. I had not properly fasted prior to the first test. Total cholesterol was around 220, high but not devastating. My numbers have consistently been good since I started on Lipitor (but I have been fasting per specifications before the blood test).

I'm going to lay off Lipitor for one year and see what happens to the cholesterol numbers.
Link Posted: 1/25/2006 3:34:07 PM EDT

Originally Posted By Hamel:
Not a doc, but a pharmacist.

To answer some of your questions I'm ASSuming you are refering to HMG-CoA reductase inhibitors (or statins). (there are about 4 other prescriptions classes that can be used for cholesterol) These are the Zocors, Lipitors, Crestors and they target the cholesterol made by your body (yes, you make cholesterol) and they are very good at it. They reduce the bad (LDL) cholesterol very well (~20-50%) and have been proven to reduce cardiovascular disease (think heart attacks). This is a fact that no Dr. will deny and any one saying otherwise is full of crap. Statins are now a standard of care in hyperlipidemia (high cholesterol).



Well then I am full of crap. They have not all been shown to reduce CAD to my knowledge and there are studies showing that they don't change the risk of 1st MI, but do a 2nd.
Big there as that just doesn't make a whole lot of sense. .
I think they do affect vascular risk and there is evidence but it is not a completely done deal so to speak. We are always learning more and it will be interesting to see what happens in the long run.


1) Compared to dying from a heart attack, yes the side effects are worth it


Depends on the side effects. If you are one of the unlucky ones with liver failure or rhabdomyloysis than it most definitely is not worth it.


2) Most minor side affect are GI in nature like nausea, constipation, ab pain etc but major (though rare) can be liver damage (they'll do blood tests to catch this) and severe and pain muscle disorder ( very rare)
3) Lot of other things increase the risk of heart disease-smoking, diabetes (uncontrolled), age, being male, having low HDL (good cholesterol), and family history. Most of these you can't control, so control what you can.






Yes, cardiovascular and cerebrovascular disease are complicated issues and lowering all of your risk factors is important.

Like many other drugs, some are released without proper study. Baycol would be a good example from the statin class. With that in mind I was surprised they released Crestor as fast as they did.

Other examples would be hormone replacement in elderly women. Turns out the data was faulty.
Zyprexa...now there's a great example of a drug that should be taken off the market. It should have never been released.
Accutane....never should have been released. I hammered that one in another thread the last couple of nights.
Proscar, Vioxx, Bextra, the list goes on. FWIW, I think Vioxx is worth it for some people but there are risks with ANY medication.


Now I don't think people should stop their statins but I have some reservations about some of the drugs and the class as a whole. The best thing Americans could do is take better care of themselves and make some serious lifestyle changes, regardless of all the rest. Taking a pill is just so much easier though but it sure as hell doesn't decrease the other risk factors and hyperlipidemia is just one.
Link Posted: 1/25/2006 3:43:19 PM EDT
What is the problem with Tylenol?

Thanks
Link Posted: 1/25/2006 3:48:14 PM EDT
I don't feel like typing a lengthy response, so I will say that I quit Statins(Lipitor, Altocor) because they made my shoulders and hands hurt. BAD , want to cry BAD. I'll take my chances with cholesterol.
Link Posted: 1/25/2006 3:54:09 PM EDT

Originally Posted By drjarhead:

Originally Posted By Hamel:
Not a doc, but a pharmacist.

To answer some of your questions I'm ASSuming you are refering to HMG-CoA reductase inhibitors (or statins). (there are about 4 other prescriptions classes that can be used for cholesterol) These are the Zocors, Lipitors, Crestors and they target the cholesterol made by your body (yes, you make cholesterol) and they are very good at it. They reduce the bad (LDL) cholesterol very well (~20-50%) and have been proven to reduce cardiovascular disease (think heart attacks). This is a fact that no Dr. will deny and any one saying otherwise is full of crap. Statins are now a standard of care in hyperlipidemia (high cholesterol).



Well then I am full of crap. They have not all been shown to reduce CAD to my knowledge and there are studies showing that they don't change the risk of 1st MI, but do a 2nd.
Big there as that just doesn't make a whole lot of sense. .
I think they do affect vascular risk and there is evidence but it is not a completely done deal so to speak. We are always learning more and it will be interesting to see what happens in the long run.


1) Compared to dying from a heart attack, yes the side effects are worth it


Depends on the side effects. If you are one of the unlucky ones with liver failure or rhabdomyloysis than it most definitely is not worth it.


2) Most minor side affect are GI in nature like nausea, constipation, ab pain etc but major (though rare) can be liver damage (they'll do blood tests to catch this) and severe and pain muscle disorder ( very rare)
3) Lot of other things increase the risk of heart disease-smoking, diabetes (uncontrolled), age, being male, having low HDL (good cholesterol), and family history. Most of these you can't control, so control what you can.






Yes, cardiovascular and cerebrovascular disease are complicated issues and lowering all of your risk factors is important.

Like many other drugs, some are released without proper study. Baycol would be a good example from the statin class. With that in mind I was surprised they released Crestor as fast as they did.

Other examples would be hormone replacement in elderly women. Turns out the data was faulty.
Zyprexa...now there's a great example of a drug that should be taken off the market. It should have never been released.
Accutane....never should have been released. I hammered that one in another thread the last couple of nights.
Proscar, Vioxx, Bextra, the list goes on. FWIW, I think Vioxx is worth it for some people but there are risks with ANY medication.


Now I don't think people should stop their statins but I have some reservations about some of the drugs and the class as a whole. The best thing Americans could do is take better care of themselves and make some serious lifestyle changes, regardless of all the rest. Taking a pill is just so much easier though but it sure as hell doesn't decrease the other risk factors and hyperlipidemia is just one.



Accutane was the ONLY thing that helped my acne in high school. I went from a face looking like the surface of the moon to almost completely clear in a matter of months. My dermatologist had me come in once a month for blood tests to make sure it wasn't causing any sort of liver damage.
Naturally, medication thats right for one person isn't necessarily right for another, but to write off a drug completely because a few people had problems with it is silly.
Link Posted: 1/25/2006 3:55:20 PM EDT
fish oil, garlic, flax seed oil....

try em and see if it works
Link Posted: 1/25/2006 3:56:21 PM EDT
For the last year I did Lipitor for the first 6 months and then Zocor for 6 months. I also have been eating better, such as granola bars or oatmeal for breakfast and either turkey sandwhiches or soups for lunch and then whatever we have for dinner. I have been riding bikes and jog/walking on and off a few miles 3 times a week and lifting some weights again. My Cholesterol was well over 300 and is now 145. My Tryglicerides were almost 400 and are now 109. My liver enzymes were all messed up and are all normal. I have went from about 230-230lbs down to 188-190lbs. Most of the exercise was only done the last 4 months. I have had no bad side effects from either of the meds I used. I have been off of them for 2 months now and everything is still looking very good.
Link Posted: 1/25/2006 4:53:11 PM EDT
DrJarhead,

Had a lecture about Vioxx once--it is my understanding from the lecture that Vioxx raised the BP by about 5 points. That accounted for the increased risk of Strokes/MI. Kind of a shame they pulled Vioxx and Bextra off the market (Bextra had some 'dermal' reactions--severe in a very few cases), as they seemed to work best for short term NSAID use for some patients. I would hesitate to put anyone on an NSAID for an extended period of time.

That being said, I have heard that if the FDA had to approve Acetylsalicylic Acid now, they would deny it due the the risk of bleeding, ulcers, etc.

I fully agree with you on the "Better care of themselves"--amazing how a person that is 100+ lbs overweight can come to the Dr and want HIM to figure out why their feet hurt all the time.

AFARR

Link Posted: 1/25/2006 6:11:16 PM EDT
[Last Edit: 1/25/2006 6:46:12 PM EDT by drjarhead]

Originally Posted By AFARR:
DrJarhead,

Had a lecture about Vioxx once--it is my understanding from the lecture that Vioxx raised the BP by about 5 points. That accounted for the increased risk of Strokes/MI. Kind of a shame they pulled Vioxx and Bextra off the market (Bextra had some 'dermal' reactions--severe in a very few cases), as they seemed to work best for short term NSAID use for some patients. I would hesitate to put anyone on an NSAID for an extended period of time.

That being said, I have heard that if the FDA had to approve Acetylsalicylic Acid now, they would deny it due the the risk of bleeding, ulcers, etc.

I fully agree with you on the "Better care of themselves"--amazing how a person that is 100+ lbs overweight can come to the Dr and want HIM to figure out why their feet hurt all the time.

AFARR




I totally agree on Vioxx and that was the point I was trying to get across in my post. For some, such as those with bad rheumatoid arthrits, it may be worth the risk and other management might alleviate some of the detrimental effects.

Different from drugs like Zyprexa and Accutane.


ETA: The NSAIDs as a class raise BP and all of the problems with Vioxx and Bextra have not been seen to anywhere near that degree. I am skeptical about the entire class however and people who are taking any of these on a daily basis are taking a risk.
Link Posted: 1/25/2006 6:16:30 PM EDT

Originally Posted By ZootTX:

Originally Posted By drjarhead:

Originally Posted By Hamel:
Not a doc, but a pharmacist.

To answer some of your questions I'm ASSuming you are refering to HMG-CoA reductase inhibitors (or statins). (there are about 4 other prescriptions classes that can be used for cholesterol) These are the Zocors, Lipitors, Crestors and they target the cholesterol made by your body (yes, you make cholesterol) and they are very good at it. They reduce the bad (LDL) cholesterol very well (~20-50%) and have been proven to reduce cardiovascular disease (think heart attacks). This is a fact that no Dr. will deny and any one saying otherwise is full of crap. Statins are now a standard of care in hyperlipidemia (high cholesterol).



Well then I am full of crap. They have not all been shown to reduce CAD to my knowledge and there are studies showing that they don't change the risk of 1st MI, but do a 2nd.
Big there as that just doesn't make a whole lot of sense. .
I think they do affect vascular risk and there is evidence but it is not a completely done deal so to speak. We are always learning more and it will be interesting to see what happens in the long run.


1) Compared to dying from a heart attack, yes the side effects are worth it


Depends on the side effects. If you are one of the unlucky ones with liver failure or rhabdomyloysis than it most definitely is not worth it.


2) Most minor side affect are GI in nature like nausea, constipation, ab pain etc but major (though rare) can be liver damage (they'll do blood tests to catch this) and severe and pain muscle disorder ( very rare)
3) Lot of other things increase the risk of heart disease-smoking, diabetes (uncontrolled), age, being male, having low HDL (good cholesterol), and family history. Most of these you can't control, so control what you can.






Yes, cardiovascular and cerebrovascular disease are complicated issues and lowering all of your risk factors is important.

Like many other drugs, some are released without proper study. Baycol would be a good example from the statin class. With that in mind I was surprised they released Crestor as fast as they did.

Other examples would be hormone replacement in elderly women. Turns out the data was faulty.
Zyprexa...now there's a great example of a drug that should be taken off the market. It should have never been released.
Accutane....never should have been released. I hammered that one in another thread the last couple of nights.
Proscar, Vioxx, Bextra, the list goes on. FWIW, I think Vioxx is worth it for some people but there are risks with ANY medication.


Now I don't think people should stop their statins but I have some reservations about some of the drugs and the class as a whole. The best thing Americans could do is take better care of themselves and make some serious lifestyle changes, regardless of all the rest. Taking a pill is just so much easier though but it sure as hell doesn't decrease the other risk factors and hyperlipidemia is just one.



Accutane was the ONLY thing that helped my acne in high school. I went from a face looking like the surface of the moon to almost completely clear in a matter of months. My dermatologist had me come in once a month for blood tests to make sure it wasn't causing any sort of liver damage.
Naturally, medication thats right for one person isn't necessarily right for another, but to write off a drug completely because a few people had problems with it is silly.



No, what's silly is prescribing a known toxic mutagen. Actually the word I would use for it is foolish, or maybe dangerous fits better. We take an oath to first do no harm and some of these meds are definitely harmful. Some of the long term effects aren't even known. Now you may have had great results for your acne and I am sure you think it was worht the risk if you are young. When you are older you may feel differently.

I've got a sense you really don't know much about the drug other than that it helped your acne.
Link Posted: 1/25/2006 6:20:36 PM EDT
Everything my esteemed collegue has pointed out. Instead of medications a change in diet and behavior is number one in preventing cardiovascular events.

Also the most PREDICTIVE symptom of a CV event is erectile dysfunction. If your pee pee no worky, you maybe pushing for an MI.

Link Posted: 1/25/2006 6:23:46 PM EDT
The HRT issue is a great to look at. All the study participants were over 60. Most also have pre-existing cardiovascular disease. So of course you are going to have more CV events on the drug. But the media took and ran. Also the drug in question was only PREMPRO. No other drug combinations were tested. Majority of women in the US taking HRT are under 60 and in good health. One other thing that needs to be pointed out is that prolonged use, we are talking 10-20 years were required before the CV events were noticed.
Link Posted: 1/26/2006 6:33:52 AM EDT
[Last Edit: 1/26/2006 6:39:04 AM EDT by JIMBEAM]

Originally Posted By ARDOC:
Everything my esteemed collegue has pointed out. Instead of medications a change in diet and behavior is number one in preventing cardiovascular events.

Also the most PREDICTIVE symptom of a CV event is erectile dysfunction. If your pee pee no worky, you maybe pushing for an MI.




The good news, my pee pee worky.

I have a follow-up appointment with the Doc in the morning. I have benn taking Provacol for about a year. No major side effects other than the slightly elevated liver stuff but that has been high before. I did have a very slightly elevated uric acid level on my last physical.

I had to stop taking Lipitor because of the muscle issues. I don't seem to have the same problem with Provacol. My family history isn't good both parent have high cholesterol. My Dad has had an MI and a stroke. He is currently 70 yo and smoked for 45 years.

Looks like I need to work on my diet.

Link Posted: 1/27/2006 3:39:31 PM EDT
My Dad and I went both went on Lipitor, with terrible side effects. We both lost our short-term memory within one month and very bad myalgia and myopathy in the leg muscles, and when we talked about it, we both decided to discontinue it. Started Crestor (40 mgs) after being off Lipitor one month, and no problems whatsoever. LDL-C #'s crashed (very good) and HDL #'s went way up (also very good). Also found three other people who's father's were on Lipitor with lots of memory loss. All three stopped Lipitor, got their memory back, and started Crestor with no ill side effects and great Cholesterol #'s. Just my experience. Good luck!

Michael
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