Are statins to lower cholesterol right for you?    
   
Two of the most reliable sources of medical information — Mayo Clinic and WebMD — have definite ideas about statins and cholesterol.
Americans are spending billions of dollars for such statins such as Lipitor, Zocor, and Crestor. But there are dangers as well as benefits.

First, Mayo: Statins can lower cholesterol. They may have other beneficial effects. “But doctors don’t know everything about statins yet.”

Whether you need to be on a statin depends on your cholesterol level along with your other risk factors for cardiovascular disease. If your cholesterol level is 240 milligrams per deciliter, or higher or your LDL, or “bad” cholesterol level is 130 mg.dl or higher, your doctor may recommend that you take a statin.

If the only risk factor you have is high cholesterol, you may not need medication because your risk of heart attack and stroke could otherwise be low. High cholesterol, after all, is only one of many risk factors for heart attack and stroke. Before being prescribed a statin, “other risk factors should be considered” including family history of cardiovascular disease, high blood pressure, sedentary lifestyle, obesity, smoking, narrowing of your arteries.

If your doctor advises a statin, the dose will depend on whether you need to cut your bad cholesterol significantly. Your lifestyle is still the key for lowering cholesterol. Exercising 30 minutes a day on most days of the week and managing stress are important.

Although statins are tolerated by most people, they do have side effects. Common side effects are muscle and joint aches, nausea, constipation, and diarrhea.

More serious side effects, however, include liver damage. Although not common, your doctor will likely order a liver enzyme test before you take a statin. “You should call your doctor if you have unusual fatigue, pain in your upper abdomen, dark-color urine, or yellowing of your skin or eyes.”

Another side effect is muscle pain so severe that muscle cells can break down and release a protein into your bloodstream. This can damage your kidneys. Certain other drugs taken with statins also can raise the risk.

It also is possible that “your blood sugar (blood glucose) could increase when you take a statin. This could lead to your developing Type 2 diabetes.” The risk is small. But the FDA requires a warning on statin labels regarding diabetes.

Some researchers have looked into whether statins could be linked to memory loss or Lou Gehrig’s disease. The FDA has warned of possible memory loss or confusion while taking statins. But these side effects seem to disappear if the dose is decreased.

Mayo doctors say your doctor may recommend another medication. And, if you have “bad” cholesterol (LDL) and high triglycerides, you may benefit by combining the statin with prescription niacin.

Can exercise and diet lower you cholesterol enough? Eating a heart-healthy diet can lower LDL “bad” cholesterol at least 10 percent. If you lose 5 to 10 percent of your body weight you can cut LDL cholesterol by 15 percent and reduce triglycerides 20 percent. (Triglycerides are the chemical form of fat in the body.)

If you exercise at a moderate rate — meaning you have enough breath to talk but not sing — for a minimum of 2 and 1/2 hours a week, you cut triglycerides by 20 to 30 percent. At the same time your “good” cholesterol—HDL—increases.

According to WebMD, if your doctor says you should take a statin to lower your cholesterol, “maybe you don’t think your cholesterol levels are that bad, or that you can try harder to eat right and exercise.” Probably you don’t want to take another medicine every day.

High cholesterol levels “have a direct impact on your risk of heart attack and stroke. So, you don’t want to make a hasty decision. Make sure the concerns are valid before you reject a statin.”

There are many reasons to reject statins. In addition to all the risks noted above, clinical nutritionist, Byron Richards, also points out to statin users that they can weaken the lenses of the eye and increase the risk of developing cataracts, according to a large study in the Ophthalmology journal of the American Medical Association. With all the risks to the heart muscle itself, he wonders how a doctor can know when the benefits outweigh the risks.

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

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