Hey folks, good thread. If I had read it before, I had forgotten it -- not a good sign, I guess
The following cut & paste is a small section of a very long conversation found here:
[http://yarchive.net/med/statins.html]
And I previously cited it here:
http://www.spacedoc.net/board/viewtopic.php?p=2924#2924
But forget about all that because I have distilled all the pertinent stuff right here. Yes, even so, I know it is still very long, but I think at lease some of us will benefit. I hope so. This guy is just good. He's as smart and clear thinking as they come. (Which is encouraging, as you will see.) Every bit a match for the good doctors he's debating. He can speak for me any time.
Later on in this thread I will likely post some comments on Dr. Rind's suggestion for trying a "hydrophilic statin." In short, I sure disagree with the idea of trying ANY other statin regardless of blood brain barrier issues. However, he brings up an interesting thought. Specifically I will be commenting on my theory of additional problems associated with "onsite" (i.e., within the brain) suppression of *neurotransmitters* via (non-systemic) lowered cholesterol levels in the brain and how this may contribute to mood and/or memory issues -- beyond what has been discussed so far in this thread. (Well discussed, I might add.)
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>> >> Something bothers me about the general theme of most of these
>> >> discussion, or maybe simply confuses me: why the focused attacks on
>> >> statins, and seemingly only statins? Yes, they make drug companies
>> >> obscene amounts of money. Yes they can lead to life-altering side
>> >> effects, and often health care providers refuse to accept these side
>> >> effects. But at the least they have shown clear cut benefits to a
>> >> wide range of patients.
>>
>> > That's correct. And more intransigent. There are people who will not
>> > concede that it is likely that statins will benefit any subgroup of
>> > people - e.g. 50+ males with diabetes and previous MIs. But believe
>> > they are all about hidden side effects and Pharma out to make big $s.
>> > In other words, you can not discuss where the balance is.
>>
>> I'm a 60+ male with diabetes who's had a heart attack. I'm convinced
>> that statins would benefit me. I'm also convinced that for me,
>> personally, they're not worth the disbenefit. When I was taking a
>> statin I lost the ability to write research papers. In other respects
>> I was still performing mentally way ahead of the average for any age,
>> and I doubt if any psychological tests could have shown a loss of that
>> kind of ability. It's an ability I've only ever had on good days. All
>> my life I've had more bad days than good days with respect to that
>> kind of mental athleticism but I've always had enough good days to do
>> the job.
>>
>> After I started taking simvastatin I had no more good days. No matter
>> how I struggled I just couldn't complete something I'd been working on
>> and half finished.
>>
>> My doc and cardiologist insisted the problem was simply age. But the
>> ability started slowly returning after I stopped the statin. It took
>> more than a year to recover to where I'd been before the statin.
>>
>> I'm sure a statin would reduce my heart attack risk. But personally
>> I'd prefer another ten years with a good brain to another twenty with
>> a once-good brain.
>>
>> I doubt if most folk would even have noticed the mental deficit I'm
>> talking about. It was roughly around the level of effect a half pint
>> of beer has on me. But for me personally it was a disbenefit that
>> wasn't worth the benefits.
>>
>> This isn't the first drug I've stopped because of what to me were
>> unacceptable side effects. A long time ago I was supposed to stay on
>> 6mg prednisolone a day for the rest of my life. At that time I
>> completely believed all the medical assurances that that dosage
>> wouldn't have the slightest cognitive effects. I sincerely believed
>> that my failing mental powers were age. I stopped the pred by tapering
>> it off very slowly for other reasons, and was amazed and delighted to
>> find my mental powers returning as the dose decreased.
>>
>> Very rare cases of extreme damage will always be controversial. I'm
>> sure that there are lots of old people taking prescription drugs who
>> quite happily accept their doctor's confident claims that the fatigue,
>> joint pains, or episodes of confusion they suffer from are just a
>> natural part of aging rather than the side effects of the drugs.
>>
>> This is *bound* to happen with drugs which are mostly prescribed to
>> old people and whose side effects mimic the common concomitants of
>> age. There's no need to do studies to find out if this *is*
>> happening. It's bound to happen unless special efforts are made to
>> stop it happening. As it happens instead of special efforts to stop it
>> happening there are extremely powerful financial incentives to deny
>> that it's happening. The aging population is a gold mine for drug
>> manufacturers.
>>
>> I'm not a statin hater. Or indeed a prednisolone hater. I just decided
>> that for me personally the disbenefits outweighed the benefits, and
>> have been rather disappointed to find how readily doctors diagnosed me
>> as suffering from age rather than their prescriptions. I don't think
>> I'm a special case with respect to that. It's a rare funeral I go to
>> where the relatives haven't stories to tell of dismissive doctoring of
>> the old fool.
>>
>> I don't think there's anything special about the statin case. It's
>> just one of at least several drugs prescribed to the elderly whose
>> side effects get swept under the carpet of age. As increasing numbers
>> of old people are put on permanent medical research is running a
>> serious risk of ending up adding to the natural symptomatology of
>> aging the natural characteristics of an over-medicated population.
>>
> I understand your point and many of us actually pretty much react the same
> way. If we start a new drug and something happens then we blame it on the
> drug whether it's the drug or not.
That's not what I did. The coincidence of the cognitive problems
starting after I started taking a drug raised the possibility that the
drug might be to blame.
> The only way to find out is through studies and some science.
As it happens I am a scientist, though not a medical one. However,
you're not right that the only way to find out things like that is
through studies or science. Science is a formalisation of methods of
investigation that human beings were using successfully long before we
invented science. If science were the only way to find out things law
courts would never be able to come to a decision.
In this case, wondering if the statin might be to blame, I stopped
taking it. The cognitive problems started going away at much the same
rate as they had developed while taking the statin. I know this
doesn't *prove* that the statin caused them, but it does substantially
increase the likelihood.
> You say no
> studies have been done but they have.
You may be confusing me with someone else. I don't think I've ever
said no studies have been done. I know they have. When I first
wondered about the possibility that I was suffering from side effects
of the statin I searched Pubmed and found several relevant studies,
which I consulted. Apart from what is available on the web, as a a
university academic I have free access to medical journals. I wanted
to see whether the kind of problems I had noticed in myself had been
mentioned as possible side effects by any researchers. As I'm sure you
are aware, they have. The rate of development of the problems was also
consonant with those reported in the studies. And when I stopped
taking the statin the rate of recovery was consonant with it.
Did I have an objective way of measuring my cognitive problems? Yes,
it was very simple. My job as a university academic involves a great
deal of critical reading of difficult material, and writing some. I
found it incrasingly difficult to write research papers, and finally
doing so became impossible. Writing lecture notes, which used to be
very easy, took longer and longer, and the results were of worse
quality.
A few months after stopping the stain I found I was able to finish
some papers that I had become stuck in the middle of, unable to make
any progress. A year later I was once again writing fluently and well.
> I think you react to a new drug in a bad way no matter what that drug is.
Not at all. I'm always very pleased if my doc tells me that there's a
drug which will fix a problem he's identified. Mostly they do. And in
the case of prednisolone, I was a very enthusiastic taker of it,
because not only did it fix my problem like magic, but it actually
made me feel much better than I had done for years. I stopped it
reluctantly only because of the warnings about the risks of
osteoporosis in long term use. Discovering that minor cognitive
problems I'd been suffering from while taking it, and which both I and
my doctor had quite happily attributed to age, then ceased as soon as
I stopped it was a complete surprise.
It also didn't stop me taking it again when I had another problem for
which it was prescribed, because the problem was far more serious and
disabling than this mild cognitive impairment, and I had discovered
that that side effect completely vanished very quickly indeed as soon
as the drug was stopped.
I also get mild cognitive impairments with most pain killers, which
disappear as soon as I stop them, and which don't worry me in the
least, nor do I worry about the more serious cognitive impairments I
suffer temporarily as a result of drinking alcohol.
> I think if a placebo would have been given like a sugar pill then
> somebody might get the same results.
Of course they might. What makes you think I might doubt that?
> It is really a mind set that you have to keep in check.
What mind set do you think I have? I think you're confusing me with
someone who is suspicious of all drugs, and thinks they ought to be
side effect free. I expect all drugs to have side effects, and I hope
that the benefits of the drug outweigh the side effects. I know they
usually do, which is the reason why they've been licensed in the first
place.
> Medications
> obviously impact your body. When I first started taking blood pressure pills
> I felt like somebody hit me with a hammer. It takes time to adjust. There
> are always side effects to meds and it's the ration of benefit that one
> looks at.
Exactly.
> It is the quality of life issue that is important. If the quality
> of life bothers someone then that person should pursue his own happiness.
What are you trying to tell me? I started taking a statin. In the
succeeding months I started developing cognitive problems which
affected my work. I discovered that these kinds of problems had been
reported in medical journals as side effects of statins. I
experimentally stopped the statin. The problems started fading at
about the same rate at which they had developed. The rates of
development and recovery were consonant with those reported by medical
researchers. If the problems had continued I would have had to retire
from my job. I would also have had to give up my plan of writing a
couple of books when I retired.
I consulted three doctors and a cardiologist, and Pubmed, about the
levels of risk I was personally running, and the reduction in risk I
likely to be getting from the statin. They all agreed that the
reduction of risk was about the same as I could get by taking exercise
and changing my diet. The doctors all warned me that very few people
were capable of making the requisite changes of lifestyle. I told them
to look at my medical history, in which they would find the details of
similar successful changes of diet and exercise I had made in order to
recover from injuries. They agreed that it looked as though I might be
one of the few people who could accomplish the necessary changes of
diet and lifestyle to realise these desired cardiovascular benefits.
I also discovered that if I took more exercise and changed my diet not
only would I reduce my risk of a heart attack by about the same as
taking a statin, I was also likely to suffer the side effect of a
healhier brain with at least a slower rate of age-related
degeneration, and possibly even a temporary cognitive improvement.
I decided it was worth making the effort. As I write this my breakfast
mackerel is baking in the oven, and after eating it I'm going to cycle
a few miles up some pretty serious hills. My searches in Pubmed, and
reading sci.med.* newsgroups, have led me to believe that doing these
kinds of things carry around the same cardiovascular benefit levels as
taking a statin.
Do you think I'm being unreasonable or unscientific about this?
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>>I decided it was worth making the effort. As I write this my breakfast
>>mackerel is baking in the oven, and after eating it I'm going to cycle
>>a few miles up some pretty serious hills. My searches in Pubmed, and
>>reading sci.med.* newsgroups, have led me to believe that doing these
>>kinds of things carry around the same cardiovascular benefit levels as
>>taking a statin.
>>
>>Do you think I'm being unreasonable or unscientific about this?
>
>
> I don't, FWIW.
I agree.
I think it's very hard in any individual to know whether a side effect
that comes on slowly and resolves slowly is due to a particular
medication, so I would keep an open mind about whether in this
particular case the statin was responsible for the change in mental
ability. People are wonderful at seeing cause and effect where there
isn't any, which is why blinded trials are so helpful.
But not being able to be sure that the statin was the cause doesn't make
it unreasonable for someone who seems to have had such a side effect to
decide that statins aren't worth the risk. Someone else might choose to
see whether a hydrophilic statin was better tolerated, and this would be
reasonable as well.
