All drugs have beneficial effects and also negative effects. Everyone should research carefully the "Numbers Need to Treat" vs the "Numbers Needed to Harm" prior to starting any drug.
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"But, she said, those at high risk for osteoporosis — women and older people, for example — should take particular care to monitor their bone health."
How does one monitor bone health?
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@Rex Nimbus by having yearly bone density scans
I took 50 mg Simvastatin for 20 years with no problems until 3 months after my cardiologist doubled my existing blood pressure meds. Then my legs began aching badly.
Stopped the simvastatin, and the pains went away, started it again, pains came back. luckily no long term effects. Next test 90 days later test showed triglycerides doubled.
I researched the literature for another statin, one that would not increase my pre-diabetes A1C. Doctor agreed to trial, went on 6 mg Lovastatin. No pains, triglycerides went down by 48% to 93, LDL decreased 30%.
Sometimes you have to be your own advocate. Doctors are overloaded, probably just use what they generally have had good experience with in the past, but there may be something better out there.
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simvastatin doesn’t come in 50 mg and prediabetes refers to risk of eye disease not cardiac disease. . since June 8,2011 FDA health advisory on simvastatin, most physicians don’t or should not use it as safer and more effective statins are available..however Beware of the statin-osteoporosis connection. Most people on high dose are for secondary prevention meaning they have established cardiovascular disease. They have had either a cardiac event or a cerebrovascular event. They are sicker and less active. Low dose statins are not recommended for those with established cardiovascular disease ( see American Heart Association 2013 cholesterol guidelines). Lower dose statin users are therefore only for primary prevention and those patients have the absence of clinical cardiovascular disease. This group on whole is healthier and this can account for the difference in bone density. Beware of reading medical studies and conclusions in articles not designed in the proper context...an example is saying senior citizens have a lower percentage of death rates in car accidents than younger drivers ..the difference may not be age but that older drivers tend to drive on neighborhood roads at lower speeds avoiding the high speed of highways when compared to younger drivers. Therefore speed not age is the variable...Besides, statins, especially high dose, have been proven over and over again to be safe and extremely effective in reducing CV deaths. Beware when only bones are left.
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@PeteinOC Your legs were hurting because the Statins were killing off your Mitochondria.
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@PeteinOC The new drug Bempedoic Acid (don't know what the brand name will be) coming out next year from Esperion Therapeutics will be a Godsend for statin users everywhere.
If you have elevated LDL and are being urged to take a statin, ask your physician about a coronary calcium scoring scan test, which is non-invasive and is increasingly regarded as a more accurate predictor of coronary disease than LDL.
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I had severe osteoporosis at age 35 because of a tumour which also caused high cholesterol. A 2nd parathyroid tumour 20 yrs later elevated my cholesterol even more and gave me high BP. (I take drugs for that)
I tried 5 statins over a 10 yr period; all gave me terrible complaints, the worst caused us to spend $A8000 on altering our house because I could hardly walk despite 18 months physio and was in great pain all the time.
So no drugs for high cholesterol ever again for me.
I have been mostly vegetarian for 30+ years and my triglycerides are good as is my HDL level. I took fish oil & then krill for years which helped until I developed an allergy to seafood!
As for my osteoporosis - it went from extremely severe to barely there because of 15 yrs of the drug Fosamax.
So some drugs are for our betterment and others are not.
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Notice you don't see round-the-clock ads for calcium supplement anymore? Too much calcium, which is but one component of bone health but which is integral to multiple physiological processes, resulted in a range of debilitating problems.
Likewise, cholesterol is integral to multitudes of body functions; it also comes in many forms, some of which are essential. Bringing total cholesterol down is an incredibly simplistic and dangerous mode of treatment.
Load-bearing exercise will not just strengthen bone but also change LDL/HDL ratios, but our reliance on drug-focused therapies is making big pharma rich and the putting population under a false sense of security- not to mention at risk, in this case of rhabdomyelosis, liver damage, kidney failure, neuropathy, and let's not forget- memory loss.
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@SYK94904 Having osteoporosis because of a parathyroid tumour I was not allowed calcium supplements because of the drug I was on but had to drink milk daily. Once off the drug my Endo recommended 1 calcium tablet per day plus my daily milk (lactose free low fat).
My calcium levels (along with other tests on my blood) have been monitored 3-6 monthly for 30 years and my calcium levels are generally good with no problems with my kidneys or other organs.
Calcium supplements are still regularly advertised in Australia.
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“Reaching the LDL target is the most important thing,” she said. Nope, reaching the triglyceride target is the most important thing because the small, dense LDL particles, caused by triglycerides (VLDLs), are the dominant cause of arterial plaque.
Want to reduce your triglycerides? Cut fructose (sugar) and carbs.
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If one just changes his diet and becomes a vegan, cholesterol will drop precipitously without medicine
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@EmmettC
Unless you have liver dysfunction, which can cause elevated cholesterol despite an excellent diet.
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@EmmettC
I have been vegetarian my whole adult life (50 years now). I have also been vegan, though I am not now: what I am is ‘close to vegan.’
I had quite low cholesterol levels until I had a child. Ever since, I have had higher-than-desirable cholesterol levels.
I took statins: that was a nightmare. I am lucky that I was not permanently crippled. I won’t take again; the increased incidence of diabetes is women over 50 is a problem that doesn’t get enough attention.
I am active. I wondered what would happen if I lost a sizable amount of weight, and so I did. My cholesterol levels went down for a short time and then came back up.
I don’t have scarily high cholesterol. I wish I had lower levels. But I am healthy even though I don’t. And I don’t see the value in taking poorly tolerated statins or in increasing diabetes or osteoporosis risks.
And I have come around to thinking what so many other professionals are coming around to thinking: genetic contributions to cholesterol levels are the principal players.
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@nann Dave There are several forms of recognized genetic high cholesterol, and it stands to reason that genes may play a role even in moderate elevations. There are tests for certain genetic factors, and a preventive cardiology specialist can help if the problem is serious, there is an elevated calcium score, and a person cannot tolerate statins.
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I just completed 5 days taking the lowest dose available of crestor, and it gave me terrible nerve pain in my fingers and legs. Dying of a heart attack would not be as bad as living taking that pill, so I stopped. I swim half a mile every day, eat Mediterranean, and not only tolerate all that but enjoy it. So you can take my bottle of crestor and......
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@John Mardinly Both of my parents died after what were called mild heart attacks. Neither death was easy or quick. They were in a lot of pain. Pretty awful.
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@John Mardinly
I also get aches particularly in my fingers that make even low-dose statins pretty unbearable. My doctor is switching me to ezetimibe (generic name), which is not a statin but results are similar to statins on cholesterol. He said it does not cause pain. I start it this week so we will see. Just letting you know there might be an alternative out there for you.
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““Reaching the LDL target is the most important thing,” she said. “You should never stop or switch statins because of the risk of osteoporosis.”
This is nonsense - you can die from a broken hip within a year - and, for primary prevention, looking at your cardiac calcium levels could well mean that you don’t need to take a statin.
Remember: LDL is a surrogate marker correlated with CVD. It does not cause CVD. And there’s plenty of questions about taking them if you haven’t had a heart attack, etc.
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Eating plant based whole foods may decrease your cholesterol levels sufficiently to avoid all statins. Since this way of eating has so many other benefits, for both your health and the health of the planet, it seems worth trying.
And exercising may help with bone density. Again, there are few downsides to exercise, and mostly benefits.
Taking drugs, on the other hand, benefit only a proportion of the patients taking them, and they all have adverse side effects. Check out https://www.thennt.com/thennt-explained/ (Numbers Needed To Treat). So why take them if you can avoid them?
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Not if you have familial hypercholesterolemia. No amount of diet and exercise has lowered my cholesterol levels to safe levels. Also note that I am not overweight.
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@Someone- familial hypercholesterolemia is the exception.
A plant-based diet however dropped my cholesterol over 90 points within 3 months
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@Someone,
Diet and exercise may reduce risk of high cholesterol, but sadly, it never goes to zero. Or 100%. That is why, for some folks, medications are a potential lifesaver: the benefits outweigh the risks. And it sounds as though you are in that group.
But many to most of us don’t need them, and we’d be better off if we could avoid them.
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This finding is not a surprise: Statins reduce the liver's secretion of cholesterol, which is the substrate for vitamin D. Vitamin D is a key player in in calcium absorption and bone mineralization. It's another reason to use these drugs with caution.
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The risks of taking statins are much less discussed by prescribing physicians and in media articles than the touting of their benefits. This article seems to be an exception.
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“Reaching the LDL target is the most important thing,” she said. “You should never stop or switch statins because of the risk of osteoporosis.”
Agreed. So... what was the point of this article?
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@KxS: ... especially given that the article doesn't tell us which one (of six) statins is not bad for osteoporosis.
"Yet for five of the six types of statins tested, the risk of osteoporosis increased with the size of the dosage."
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Still waiting for the followup to statins.
Such pain in my hip from any/all statins beyond words.
That pain always makes me think the future is full of lawsuits and regulations (like the miracle drugs of yesterday/nightmare drugs of today).
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@Robert Hey Robert had same issue. Couple of studies show taking statin every other day almost as effective and less pain. Good Luck
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@Robert There are alternatives to statins. Consult a preventive cardiologist/lipid specialist!
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As a woman with osteoporosis who may need to go on statins soon, I would have appreciated knowing which statin produced the most protective effect against osteoporosis.
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@Maria Cate
Research niacin (slo-niacin) and cholesterol. The niacin can cause flushing but other than that there have been no side effects. Used to get at Costco in SF but now I have to order it from Costco on line.
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@Maria Cate New drugs with fewer side effects are coming out. You should look for instance into repatha (which is already on the market) or inclisiran (which is just getting approved). Only thing to keep in mind is that statins lower not only LDL, but also triglycerides, which these newer drugs don't lower. If you have high triglycerides, it's bad for you, too. Also, unfortunately, these drugs are very expensive.
@Maria Cate I have had really severe reactions to 5 statins so won't take any. My LDLs are my concern as my HDL & Triglycerides are fine probably because I don't eat meat, mainly eat vegies and no junk food.
I also take Vit E daily and used to take fish & krill oil which greatly helped my chol levels but I developed an allergy to them (I have multiple allergies)
I had severe osteo at age 35 because of a parathyroid tumour, was on the drug Fosamax for 15 yrs (over the recommended time) had a 2nd tumour 20 yrs later but I only have osteopenia now.
If you don't take any drugs for your osteoporosis, take one calcium tablet, 1 K2 and 2 Vit D3 daily and drink a glass of low fat milk daily.
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Regardless of the drug, patients need clear explanations from their doctors or pharmacists that all drugs, both Rx and OTC, can be harmful. The goal is to take the minimum effective dose and avoid the maximum tolerated dose but it is a gray zone that varies from one patient to another. I think many doctors fail to effectively communicate this well enough to their patients and it is up to your doctor to help you navigate this complex challenge.
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@A Goldstein See the study results. You may need to review with your doctor to make sense of it.
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