Statins: No Easy Decision Here

A reader asked me to write about this topic.  Like me, she is a woman in her middle sixties who takes statins.  Unlike me, she has had adverse side effects.  Who even remembered about these?

Of course, I read the information handout the pharmacy attaches to the bag containing your prescription.  Of course, I researched this drug on the internet when it was first prescribed for me. But that was years ago and, while I periodically re-read the pharmacy’s handout, the dangers of this drug never quite resonated with me.

Dangers?  With statins?  That’s most people’s reaction.

Let’s go back to the beginning with an explanation of what statins are and what they do. According to MedicineNet.com at http://www.medicinenet.com/statins/article.htm,

“’Statins’ is a class of drugs that lowers the level of cholesterol in the blood by reducing the production of cholesterol by the liver. (The other source of cholesterol in the blood is dietary cholesterol.) Statins block the enzyme in the liver that is responsible for making cholesterol.”

Makes sense.  But what’s cholesterol? Medical News Today at http://www.medicalnewstoday.com/articles/9152.php tells us,

“Cholesterol is a lipid (fat) which is produced by the liver. Cholesterol is vital for normal body function. Every cell in our body has cholesterol in its outer layer.”

Okay, so we need this particular lipid but sometimes – between the foods we eat and our body’s functioning – we produce too much of it. Then it may stick to our arteries as plaque, possibly narrowing or even blocking them.  This could lead to CAD or coronary artery disease (heart problems).

Here’s the important part for Chronic Kidney Disease sufferers: it’s the liver – the organ that produces cholesterol – that is affected by the statins. That’s the only other filtering system your body has and your kidneys are already compromised.  TWO compromised filtering systems seems like a really poor idea to me.  Yet, sometimes, we need to take statins.

I went to my favorite, The Mayo Clinic, at http://www.mayoclinic.com/health/statins/CL00010 for information about when you need to be on a statin:

“If you have high cholesterol, meaning your total cholesterol level is 240 milligrams per deciliter (mg/dL) (6.22 millimoles per liter, or mmol/L) or higher, or your low-density lipoprotein cholesterol (LDL, or “bad” cholesterol) level is 130 mg/dL (3.37 mmol/L) or higher, your doctor may recommend you begin to take a statin. But the numbers alone won’t tell you or your doctor the whole story.

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 is only one of a number of risk factors for heart attack and stroke. “

As CKD patients, we already have another risk factor.  If, like me, those numbers mystify you, you can find them on your quarterly blood test reports which will usually have an “H” to indicate high or “L” to indicate low (You won’t find that if you’re on statins.) next to the numbers for your total cholesterol and your low-density lipoprotein levels.

As for how hyperlipidemia (high cholesterol) can affect your body and why statins are prescribed, I took a look at a non-technical explanation at  http://heartdisease.about.com/cs/cholesterol/a/statins.htm:

“Clinical studies have shown that statins significantly reduce the risk of heart attack and death in patients with proven coronary artery disease (CAD), and can also reduce cardiac events in patients with high cholesterol levels who are at increased risk for heart disease. While best known as drugs that lower cholesterol, statins have several other beneficial effects that may also improve cardiac risk, and that may turn out to be even more important than their cholesterol-reducing properties.”

Well, that all sounds good so what’s the problem?  It’s the side effects, ladies and gentlemen.  It’s all the ‘may cause’ that you find on the websites and in your pharmacy handout information.

I went to a new site for me, http://statinseffects.org/, and was staggered by the side effects:

“The risk of liver & kidney damage, muscle damage, increased risk of cancer & other side effects of cholesterol lowering drugs are good reason why exercise & diet should be patient’s first resort for controlling cholesterol levels. For people who must take cholesterol lowering medications, the dose needs to be reduced to minimum by again exercise & diet. The main concern seems to be the overuse or underuse of the medication, despite of the evidence that high cholesterol level itself is not the most important factor of heart disease. It is, however, the ratio between total & HDL cholesterol levels.”

You KNOW what popped out at me: kidney damage.  We already have kidney damage.  Each of these side effects deserves a blog of its own.  But, it is important to remember that these are possible, not definite, side effects.

Am I endorsing statin use for hyperlipidemia? No, I’m not.  I’m not a doctor.  You need to discuss this with your doctor. Mine at the time of my diagnose with hyperlipidemia was amenable to my desire not to take the drugs for a while.

Dr. Susan Bennett, agreed to this in an attempt to demonstrate to me that I needed the medication.  This was about six years before I was diagnosed with CKD.  For three months – the acknowledged honeymoon period – my numbers were great.  And then they started to climb… and climb, despite the dietary changes and exercise.  I am just one of those unlucky ones with naturally high cholesterol. Try this for yourself if your doctor agrees, but keep your health foremost in your mind.

Talking about that, SlowItDown held our first of ten monthly Chronic Kidney Disease education classes on The Salt River Pima – Maricopa Indian Community last Thursday. Talk about a gratifying experience!  In addition, the book is now being used by a spiritual healing and medical care group in the community.

Many thanks to Annette Folmer of DaVita for the ever higher quality of her teaching and to MaryAnn Bennett, the brand new Clinical Services Manager at Salt River Pima-Maricopa Indian Community. Our classroom was even more electronically modern than the ones I’ve taught in here in Arizona’s community colleges!

Until next week,

Keep living your life!