I had my annual Medicare Wellness exam last month and got the full house of blood work. A couple of days ago Doc called and took me off simvastatin. I've been on it for 20 or so years and was under the impression once on it you never get off. I was taking it to lower high cholesterol. Doc said my numbers have been good last two years.
I have changed my diet, lost 20 pounds, and do regular exercise. Maybe that has helped the numbers. I still question the decision of stopping since I have been on it so long.
Nice work on the weight loss. I'm a bit surprised the doctor stopped the drug. Regardless of what your lab values are, the statin drugs reduce heart attacks and strokes. They can have their side effects. They're not perfect. But I'm personally a fan of them given their demonstrated benefit. Definitely curious what the doctor's reasoning was.
They are usually a long term thing, but I don't think there is any reason you can't stop taking them , apart from your :bad "cholesterol might start to creep up again?
Were you on a low dose, and the changes to diet / lifestyle made enough difference that you no longer actually need the med?
I'd expect another blood test in 3 months to check that you are still in "safe" zone.
Quote from: Ianab on October 20, 2021, 08:57:31 PM
I'd expect another blood test in 3 months to check that you are still in "safe" zone.
The thing is, the LDL "safe" zone turned out to be a bit of a myth. LDL isn't that good of a predictor of heart disease.
I was on 40mg. I don't know if that is low dose or high dose.
Quote from: Larry on October 20, 2021, 09:11:08 PM
I was on 40mg. I don't know if that is low dose or high dose.
It's right in the middle.
Dosage ranges from 10mg to 80mg.
Quote from: IndiLina on October 20, 2021, 09:00:57 PMThe thing is, the LDL "safe" zone turned out to be a bit of a myth. LDL isn't that good of a predictor of heart disease.
Yeah, that's another thing. Drs have put less emphasis on it over recent years. I suspect it could be a symptom of some other condition that increases the risk of heart disease? It's not actually causing the heart disease, it's caused by the same other underlying factors. So simply reducing LDL is merely treating a symptom, and the underlying problem / risk of heart disease is still there?
There is certainly some correlation between LDL and risk of heart disease, but that doesn't actually mean it's causing it. Lowering LDL with drugs doesn't seem to have a huge effect on the heart risk, possibly because it's not treating the underlying cause of the high LDL?
Lot of evidence out there that strongly suggests getting away from the soy and corn fed animal products (eggs, beef, poultry) will do wonders for your cholesterol levels.
You are what you eat and eat whatever you're eating ate.
Quote from: IndiLina on October 20, 2021, 09:00:57 PM
Quote from: Ianab on October 20, 2021, 08:57:31 PM
I'd expect another blood test in 3 months to check that you are still in "safe" zone.
The thing is, the LDL "safe" zone turned out to be a bit of a myth. LDL isn't that good of a predictor of heart disease.
IndiLina
Can you offer some backup to this "myth" ? A resource or your own expertise?
My Dr. has mentioned a similar "the thinking now is not as important". Just curious....
Quote from: beenthere on October 20, 2021, 09:38:36 PM
Quote from: IndiLina on October 20, 2021, 09:00:57 PM
Quote from: Ianab on October 20, 2021, 08:57:31 PM
I'd expect another blood test in 3 months to check that you are still in "safe" zone.
The thing is, the LDL "safe" zone turned out to be a bit of a myth. LDL isn't that good of a predictor of heart disease.
IndiLina
Can you offer some backup to this "myth" ? A resource or your own expertise?
My Dr. has mentioned a similar "the thinking now is not as important". Just curious....
I can try to link some sources if needed.
But we always thought that if a person had a high LDL level, their heart would benefit more if the LDL level was lowered the most.
But that hasn't played out that way. If a person has heart disease risk (LDL level being a marker for that) it doesn't matter how much the statin lowers their LDL. It just matters that they are on a statin. A statin lowers their heart disease risk, regardless of what the ensuing LDL level shows.
We spent years trying to get patients' LDL levels down to certain thresholds with statins, but that wasn't gaining us anything over just giving them the statin and not worrying about the level.
Sounds like you are a Doctor. Thank you for your dedication and service.
I am statin intolerant (most likely tied to a genetic "gift"). If you were part of the majority that tolerated it well that is great. Just realize more than a few folks had side effects that they didnt realize were statin related. I know of a couple of folks who improved their lifestyle and got off statins and then realized that some of their aches and pains were really statin side effects. A gerontologist for my parents was of the opinion that statins in older folks was a factor in old age mental decline. The assisted living and skilled nursing care places dont mind old people with dulled mental capacities as they are easier to manage. This doctor who was a contractor to the facility they were in did not agree and supported taking folks, including my 85 year old dad, off statins and he made it to 91 still quite sharp the day that he passed.
There is also an ultra precise CRP test which detects overall inflammation in the blood, if someone has high a CRP then their cholesterol needs to be tested aggressively, a low CRP means it does not. C-Reactive Protein (CRP) Testing for Heart Disease (webmd.com) (https://www.webmd.com/heart-disease/guide/heart-disease-c-reactive-protein-crp-testing). Might be worth discussing it with your doctor for confirmation of his decision.
I also had reactions to satains they tried on me. After about 30 days I started getting extreme muscle cramps in the groin area and constant extremely painful Charlie horses. I could hardly walk. Tried 3 different formulas all with the same reactions. Then my doctor tried me on Crestor and no reactions at all. Lowest dose is now keeping my cholesterol in line. High cholesterol runs in my genetics also. Only thing with Crestor is constant bloodwork to monitor liver damage and no grapefruit . My insurance company doesn't like paying for it but when my cardiologist told them the only other option was injections costing 25k a year they approved it.
I was taking Simvastatin for a while, and it messed with me pretty badly. Muscle pains, cramps and random sprains. Dr changed me to another type (Pravastatin), and that's been OK.
Way he explained it was that some people can have a bad reaction to them, but they start you with the "generic" Simvastatin because it's cheapest, and usually effective for ~90% of the population. If you can't tolerate it, then they are allowed to try the other more expensive types until you find one that works right. The more expensive ones are just as likely to cause side effects too, but you have to be really unlucky to not tolerate at least one of them. The more expensive ones aren't necessarily better, just work differently. Sounds like 21incher got well up the list.
But if you have a bad reaction, go back to your Dr, as there will be a plan B (and C and D)
I had a heart attack on Christmas eve, 2004. I was stabilized, got to know every nurse in the largest hospital in Lexington, KY, read lots of books, so on, then when all the docs came back from their Caribbean trips I got 3 stents in early Jan., 2005. I sustained zero heart damage and no further symptoms since then.
The original cardiologist I found over time to be more interested in young nurses than patients and I fired him this summer. After trying to ask for and be transferred within that large practice, I finally gave up and found me a new heart doc.
Now nearly 20 years later my new cardiologist told me at our first meeting that I should have had my statin changed given my age, etc. He took me off pravastatin and placed me on generic Liptior-same dosage of 40mg for both.
I have never had anywhere near high LDL, always very, very! low. My HDL has hovered around 38 as long as I've known the value #.
My old doc tried several statins some years back, hoping to raise my HDL but none did so. he also tried Niacin which I learned the hard way I was allergic to it-had all the bad symptoms quickly.
Diet wise I have always been a healthy eater and very active person.
The new doc also asked me (he has all of my old cardiology records already but hadn't read all of them) if I'd had a recent EKG, to which I replied it's been a good while-maybe 10 years or so. To my recollection I had only that one other than maybe when nearer the heart attack time. New doc says I should have been getting one each year and they did one right then plus he scheduled an Echocardiogram for a few weeks from now.
I remember Lipitor as being a very hot topic some years ago. I still have a freebie t-shirt I got at a 5K or 10K race I ran back a long time ago and when I wore it I'd often get asked "are you taking it?" but answered no, it's just free shirt.
Now I'm "that Lipitor guy" huh? ;D
Today's NYT's has a statin article- "How Many People Can't Tolerate Statins by Richard Klasco, MD.
The letters to the editor are interesting. So many people use their anecdotal experiences to decide more than they should IMO. One writer said she knows that flouride combined with her statin made her ill and so on & on. A few medical & non-medical people criticize the NYT's for allowing a non-cardio doc to write the article on statins.
My new statin Lipitor has a bad wrap for muscle issues-mine seem OK so far and I have zero idea of the effect on my HDL/LDL as no test yet.