Statins lower cholesterol, but there are side effects
Q. You have talked about cholesterol-lowering medication side effects several times. One of your more recent columns about this subject sparked a discussion in my household. A number of my friends who belong to a local running club have complained about muscle weakness after taking these medications. Their running performances were dramatically affected in a negative way. My friends and I don't believe that the pharmaceutical companies who manufacture these drugs are being candid about this issue. I know that they state that muscle weakness is rare.
Every runner in this club who takes these medications now has this so-called "rare disorder." It would be interesting to have a research study done about these medications' effects on runners.
A. I believe you are confusing two of the side effects of cholesterol-lowering statins.
First, the "rare disorder" that is mentioned as a side effect of these drugs is rhabdomyolysis. This condition occurs in only one of every 15 million prescriptions for statin medications and causes the muscle damage. When they break down, the chemicals and enzymes released can essentially poison the body. This can lead to muscle weakness and pain, kidney and/or liver damage and - if left untreated - death.
Muscle weakness and pain are other side effects that are more common, and some cases may be severe enough to interfere with activities such as running, climbing stairs or even walking. While these are also symptoms of rhabdomyolysis, it does not mean that the sufferer actually has the condition. However, a blood test will show whether muscle damage is the problem.
Another common side effect of statin therapy is liver damage. Because this usually does not present with symptoms until the late stages, regular blood work to monitor liver enzyme levels can determine whether any abnormalities are present. I generally recommend people get checked at least once or twice a year. Those with pre-existing liver conditions or who are on other medications that have the potential to cause liver damage may need to have their levels checked more frequently.
Some statin users have had positive results from adding coenzyme Q-10 supplements to their daily regimens. Others benefit from a change in medication. If side effects are present despite trying several different statins, these drugs may not be suitable.
Alternatives to statins include prescription bile acid sequestrant or bile acid-binding drugs and fibrates, niacin, plant stanols and sterols, and omega-3 oils.
Everyone with a high cholesterol level should be on a low-fat diet. It may be beneficial to reduce salt intake, since high blood pressure commonly accompanies high cholesterol.
If you and your friends are experiencing problems due to statins, I urge all of you to discuss the important issue with your respective physicians.
Q. I am interested in your colon cocktail, but don't know whether to use oat or wheat bran.
A. Bran is the outer coating of grains, including oats, wheat, rice, and barley. Oat and wheat brans are the most commonly available. Either can be used in the colon cocktail.
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