Diabetic drug pioglitazone mimics statin side effects

[saved from statins]

I have recently stopped taking the diabetic drug pioglitazone which lowers insulin resistance. My blood sugars lowered, but I experienced constant pain, most excruciating in my shoulders, arms and hands. In addition to the well known side effects of weight gain and shortness of breath, I had headaches, ice cold hands and feet, and a severe throbbing, unrelenting pain in one finger. I also had difficulty swallowing and several episodes of pharyngitis and an earache. Some of these symptoms seem similar to some of the symptoms my husband experienced while on statins. I recently read an article on the cholesterol-lowering effect of pioglitazone. I wonder, does this diabetic drug react in a fashion similar to statins? Of course, my doctor does not believe me, but I found many others on-line who have experienced the same effects--one person called it "the drug from hell."

[damaged]

I was very surprized to see this post.
Quite a coincidence!
I was recently diagnosed as "pre-diabetic". I've been dealing with skin infections related to high blood sugar, and the doctor prescribed metformin.
From what I'm reading it appears to share some side effects with pioglitazone.

I was taking the metformin (along with an antibiotic), and everything seemed fine. My blood suger came down as the infection cleared.

Then, for no apparent reason, I began to feel very dizzy and short of breath.

When I say "dizzy"....I mean dizzy enough to fall out of the chair. And I had to consciously will myself to breath.
Of course, this caused anxiety, and rapid heart rate - accompanied by thoughts that I'm turning into a freaking hypochondriac.

It was sever enough that I was leary of going to sleep until the dizziness subsided with time.
This happened 2 or 3 times until I suspected a connection to the metformin.

Recently, the infection has returned (and my blood sugar has risen to 125 - normally 102) and I've been contemplating (just this morning) taking the metformin.

That is - until I read this post and looked up the side effects of pioglitazone, and noticed a mention of metformin.

pioglitazone:
Side effects that you should report to your prescriber or health care professional as soon as possible:
• anxiety or nervousness, confusion, difficulty concentrating
• blurred vision
• breathing problems such as rapid, deep breathing or difficulty breathing with activity
• cold sweats, increased sweating
• cool, pale skin
• dark yellow or brown urine, or yellowing of the eyes or skin
• diarrhea
• drowsiness
• muscle pain
• nausea, vomiting
• skin rash or hives
• slow heartbeat
• tremors or shakiness
• unusual tiredness or weakness
• swelling of the hands, legs, and/or feet

metformin:
"Some people have developed a life-threatening condition called lactic acidosis while taking metformin. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting."

Considering the mess that the statins caused, I'm very nervous when a doctor prescribes drugs. I questioned the Dr. about metformin, and he insisted that it was very "safe". He went on to say that it has been in use for a long time with no worries. He said that it simply enabled the muscles to burn sugar more effectively.

I had taken the metformin for over a month with no apparent problem.....so I'm a little confused as to why all of a sudden I experienced side effects.
But, I'm really beginning to get very cynical and disillusioned with the whole hootenanny.
I doubt that the pioglitazone would cause anything permanent (as the statins did)...but please...continue to be careful.

[Ray Holder]

Damaged

Your symptoms and those shown for proglitazone are very similar to statin side effects, and I would suggest that carnitine supply damage is also occurring. The antibiotic is probably adding to your problems by further inhibiting carnitine supply and also carnitine transporters. Lactic acidosis is mentioned, often the reason for muscle pain in statin users and often respondent to L carnitine or to acetyl L carnitine.

It would appear that Q10 supply is being damaged, and the combined effect of that and the carnitine shortage is to reduce the energy the mitochondria are able to produce, affecting many parts of the body, including the heart. Now 88, and having had heart events last Christmas, I have found several antibiotics affect carnitine levels,mine has dropped so low thatI am having difficulty in keeping up an adequate level, so my energy level is overall very low.

More and more drugs are being found to affect Q10 production, and Q10 has been found in some cases to improve diabetic sugar levels, and this would apply even more for pre diabetes where permanent damage has not yet taken place and Q10 supplementation can restore some of the age related effects.

I know how difficult it is to get these points over to conventially trained medical personnel, with drug makers not even referring to Q10 and carnitine in their leaflets, and I have had to press my point that some drugs do me more harm than good quite firmly.

Ray

[Biologist]

To all,

I think the following should be read just to help get a person's "head right" regarding doctors and drugs. It's fundamental education in a way. It's a side of things we are not aware of. It shows that we have to be careful and as informed as possible, and that is not easy. I am not condemning all of "corporate medicine" by any means, it's just that we need to be aware of both sides of the coin. This is a primer I came upon last night:

*http://www.mnwelldir.org/docs/history/quackery.htm

For instance, as an example, it partly explains to me why a neighbor's friend (a former smoker, by the way), who was on lung cancer therapy of various types for half a decade was not also supplementing vitamin D over this time. Incredibly, I feel obliged to state the "obvious" even here, as it may still not be obvious to everyone (since its been kept quiet since there is no money in it) -- you are (to my knowledge) asking for cancer with low levels of vitamin D and you are begging to lower your odds of getting well if you have cancer if your vitamin D is very low; and most people are low. My neighbor asked me to speak with her friend this summer and I went over to visit when they were both at home one day sipping tea on the back porch (a covered porch). Long story, but Sheryl, about 50 or so, had not been tested for vitamin D to her knowledge (I'm rather sure she was not) and she had not seen any sun in many years. She was on pain medication, but was quit lucid at the time. I had months earlier advised my friend to get her friend to get her oncologist to test for vitamin D, but got nowhere -- I'm not even sure it was mentioned to the doctor (while the doctor should have been on top of that first thing). The "patient" certainly was not convinced by any means that a simple vitamin could help at all according to my neighbor -- after all, we all know how ridiculous "alternative medicine" is. At that visit I met her and I gave her a test kit for ZRT so that she could find out on her own and also a bottle of Vitamin D if she wanted it. Checking back, six weeks later, which was about two months ago, I got my test kit back and my unopened vitamin D bottle. She had been cremated the day before.

I think what Ray writes is important.

Also, this guy is big on truth in my book regarding metabolism and disease including diabetes. It may be way too much to understand for most people without an education in biology though. I wish I knew of a more appropriate website, and I am sure they are out there.

*http://high-fat-nutrition.blogspot.com/

Anyone who is diabetic or prediabetic and eating a lot of carbs just makes me want to throw my hands up in the air and give up. I would be eating as few as I could get by on. However, they may be doing that because they do not have enough carnatine to be able to use fats in their cells though. Diabetes is a very complicated disease; and I would not want to give much advise other than to try to educate yourself. However, Ray's message is important, I believe.

Good luck. Keep doing your research and keep vigilant about pharmaceuticals.

I will be staying away from them for now on as much as possible.

Biologist

[damaged]

I have CoQ10 200mg, and Acetyl L-carnitine 400mg with alpha lipoic acid 200mg here.
Is there absolutely no chance that any of this is causing the breathlessness/dizziness?
The reason I ask ... the last time that it happened, I hadn't taken anything other than CoQ10.
But it's quite possible that the metformin was still in my system at that point.

I'd like to re-start the CoQ10, because I also read that it can lower blood sugar. And I'm fairly certain that I'm through with the metformin.

[Ray Holder]

I would suggest that the metformin has probably damaged your carnitine supply chain, that certainly happened to me when I was taking a statin and heart energy insufficiency started to become apparent. This may not improve when the drug is discontinued, unfortunately.

I have looked up metformin in the UK prescribing book, it says that it may cause problems when kidney function is a bit low, and also mentions sepsis, but I would not have thought that your infection had progressed that far. Pioglitazone is said to be dangerous if taken with Metformin, it works by a different method.

What was the anti biotic ? some penicillins have been known for several years to cause carnitine deficiency, erythromycin and vancomycin were shown in fairly recent "in vitro" tests to inhibit carnitine transporters, making carnitine unavailable where it was needed.

I have not heard of any instances where Q10 has caused breathlessness/dizziness, the opposite is the most usual result. I have little or no experience with alpha lipoic acid. Carnitine is also usually beneficial, diarrhea, if too much is taken too soon, may occur. At my age and state of health, I am taking 1600 mg Q10 (some as QH) and 12.5 grams of L carnitine daily, but that is near the maximum possible.

Ray

[damaged]

Ray Holder
What was the anti biotic ?
…......

Augmentin.
I developed an abscess that required surgery. Just as the healing was almost complete, the infection returned. It was at this point that I asked how I could prevent the infection from again getting bad enough to require surgery. I was told “stop being a diabeticâ€Â

[Ray Holder]

damaged

Augmentin is a form of penicillin, and thus likely to cause carnitine deficiency. This kind of carnitine damage is not very well published in medical literature.
Google--Carnitine deficiency Fernando Scaglia , for an authoratitive paper on the subject, mainly from a pediatric point of view, but also applicable to older people.

Ray Holder

[Biologist]

An honest Oncologist. That sounds like a rare breed, damaged. I'm glad you found one. You needed it.

Interesting stuff, Ray. Thanks.

This could be one of the most important videos on the web:

*http://www.dhslides.org/mgr/mgr060509f/f.htm

No one should feel bad if they don't understand most or all of it. I read the 600 page book he wrote that it all comes from -- TWICE. So, I think I get it for the most part. But maybe that's cheating a little bit.

The presentation is like taking a college course in less than an hour -- on top of that, he's talking very fast. You can bet some, or most, or all, of the audience, all doctors, are thinking the same thing !

It is a MAJOR paradigm change in our understanding about obesity and diabetes and major western diseases (but really, about human physiology, period). If these doctors and others ever get it, much of the practice of medicine, and the quality of life around the planet, would change. He has a hell of a battle on his hands. I almost have to laugh. We know what its like. I like his comments on the matter at the end of the presentation.

I also like it that he chews tobacco. This guy's just alright all the way around!

Biologist

[cjbrooksjc]

Biologist: Excellent program. I have come to believe that statins have interfered with the very process covered here (the breakdown of glucose into energy or stored as fat). I had often in the past used a reduced carb load in my diet to lose weight. When doing so I would feel energized, sharp, and generally healthy, and I would lose weight at the same time. The last time I tried it following statin damage, I felt weak, dizzy, achy and a visiting of the flu-like symptoms I have come to associate with statin damage, and I did NOT lose the weight. I think our mitos have been damaged to the point they can't use glucose efficiently as fuel and turn to protein instead of stored fat to produce energy (hence - rhabdo). I don't know if there is a mending of this condition over time or if some of us are permanently damaged, but I remain firm in my beliefs -lay as they are.

Thanks for the link, and I'll get the book.

Best,

Brooks

[vipergg22]

Read this with interest. Within the last couple of weeks I started taking 2000-4000 IU's of vitamin D . Before meal testing or 3 hours after meal the readings have dropped into the 80's. They were never in the 80's before or used to be upper 90's or low 100's and this is after only like a week or 2 on those D levels. It will be interesting to see if it has any long term effect on the A1C levels when I get the levels done again.

[eml256]

(Am posting under "new topic" information about SLCO1B1 genetic mutation and statins.)
SLCO1B1 refers to a specific transporter protein responsible for movement of drugs and other substances into the liver so these substrates can be detoxified and metabolized, and thus eliminated from the blood stream.
PIglitazone is one of the "inhibitor drugs" for this transport protein. Some drugs bind to the enzyme and slow down its activity or block the activity needed for the metabolism of other drugs; these drugs are classified as "inhibitors". Piglitazone is classified as an inhibitor of SLCO1B1. THus, the drug inhibits the metabolization of any other drug (substrate) that should be transported by this protein into the liver. Most statins drugs are substrates dependent upon the SLCO1B1. Piglitazone is an inhibitor of SLCO1B1, thus potentially capable of causing greatly increased statin levels when administered together.


One reported study looking at this possibility:
Adverse events with concomitant use of simvastatin or atorvastatin and thiazolidinediones*

Alawi A. Alsheikh-Ali MDa and Richard H. Karas MD, PhD, , a

Abstract
On the basis of adverse events reported to the US Food and Drug Administration, it was observed that atorvastatin-associated adverse event reports were 3.1 times more likely to list rosiglitazone or pioglitazone as a concomitant medication compared with simvastatin-associated adverse event reports.

http://tinyurl.com/yapl9f3

Some drugs are both substrates and inhibitors of the enzyme proteins that move them into organs responsible for their ultimate detoxification.