Ok, so my cholesterol was high when measured a few months back and since then Ive been really careful with my diet and subsequently lost 4-5 kilos (I appreciate the 2 aren’t necessarily related). I’ll need a retest soon and if it’s still high my doctor is likley to prescribe statins. There are known ‘uncommon’ side effects including lethargy, tiredness and muscle fatigue. These aren’t compatible with an active biking life so I’m wondering if any one out there is on statins and whether or not its affecting their biking, or other aspects of life.
(PS – not interested in psuedoscience-tabloid scare stories about increasing ageing, growing 2 heads or whatever :-)).
Cheers

Been on them for years (was slightly borderline, but being a Type 1 diabetic, they tend to chuck everything at you!) and can’t say I noticed any difference.

I recognise most of those symptoms…. IME they give you the cheapest ones 1st when you report the symptoms they progressively give you more expensive ones until you find something that you can live with.

Been on them for years (was slightly borderline, but being a Type 1 diabetic, they tend to chuck everything at you!) and can’t say I noticed any difference.

This, to the letter. Though my cholesterol dropped, came off them and it stayed dropped.

IME they give you the cheapest ones 1st when you report the symptoms they progressively give you more expensive ones until you find something that you can live with.

And with the NHS pretty cash strapped, this approach is a surprise to you because….?!

DrP

Simvastatin used to be what we gave first line, Atorvastatin is stronger and usually better tolerated and is now reallly cheap and what most of us use first-line. 90% of people seem fine on them.

Most of your cholsterol is not from eating, but made by your liver and is dependent on your genetics, but really a big well-done on the weight.

If in doubt, get your numbers and run them through the JBS3 Heart Risk calculator – available as an app.

isn’t it best to get HDL/LDL ratios checked? Do the NHS do this?

http://dietheartnews.com/2013/06/triglycerides-not-cholesterol-is-the-bona-fide-risk-factor-for-coronary-heart-disease/

Actually TC:HDL levels or non-HDL cholesterols if no vascular disease, and that is what JBS3 works on.

TC and LDL and Trigs if you have it already, but very little evdidence that any drugs actually alter outcomes by reducing trigs or increasing HDL. It may be that TC and LDL are substitute endpoints and that Statins work via otherways as well, but work they do…

Bollox. You have cat aids. Plain and simple. Man (or cat) up!

IME they give you the cheapest ones 1st when you report the symptoms they progressively give you more expensive ones until you find something that you can live with.

And with the NHS pretty cash strapped, this approach is a surprise to you because….?!

DrP]

I didn’t express any surprise?? and at no point did I criticise the NHS….

I got prescribed simvistatin after being diagnosed with a furred up artery in my left leg they will not operate because I,m to active and could wear the stent out if they put one in and could possibly lose my leg!!!!! Went on the statins and had all of the above tiredness lethargy and aches in muscles came off them after 6 months and felt a lot better, had a check up by the doc and they have prescribed me a different type.Heary disease runs in my healthy Scottish family so I should get back on them really!!

Rich

This doctor says it how it is:

http://drmalcolmkendrick.org/

I didn’t express any surprise?? and at no point did I criticise the NHS….

Fair enough, so you didn’t. Sorry – I (like many other health care professionals at present) are slightly on the ‘defence’…

DrP

Asked on here a while back. Took Simvastatin for the past 4 years, didn’t think I was getting side effects but had my share of exercise difficulties. Painful muscles, no energy or arsedness to get on the bike. At it’s worse I was struggling to even walk 2 miles.

Last discussion with diabetes nurse I was advised to stop the statin and give it three months without. Most of the aches have gone after a month or so, but it feels like starting from scratch again.

I’d suggest trying them but keep an eye on the symptoms and be aware they can creep up over time too. If you’ve got a decent GP they’ll be understanding.

Check your triglycerides figure. I recently had one of those checks and although my cholesterol was above the target the triglycerides shows how you process it / how likely fatty deposits are. The nurse put my figures (including weight) into an app and came up with a .81% risk of heart disease in the next 10 years. Felt immortal for a second then remembered lousy traffic sense and other risks.

If you can get weight off and exercise there are fewer risks of side effects (excluding bike purchases).

I was on a selection of statins and couldn’t get on with any of them, caused terrible muscle weakness so much so it was affecting biking big time……I was also getting memory problems which after the statins were out my system went.
At worst my total serum was 9.6, at lowest before I came off them it was 3.2!!!! The bad side of the 3.2 was that the good cholesterol was so low that it was not giving me any heart protection!
Anyway, hills that I could no longer ride up and even struggled to walk up are no longer a problem and the more I bike the stronger my legs are getting whereas on statins I was trying but getting nowhere.
My advice is to do eveything in your power, diet, weight loss etc etc etc to avoid going on them and if you do, read up in depth on them.
One year on from no statins total serum is 5.2 ( above what NICE recommend for type 2 diabetics) but I feel a damned sight healthier.

Am I right in thinking that cholesterol checks are generally taken when you reach a certain age. i.e. 50+ ?
As someone mentioned above, if you’re genetically predisposed to have a “high” cholesterol level, is it possible that you’ve had that level most of your adult life?

Is there enough evidence to say that a high cholesterol level is definitely a health risk?

I haven’t had mine measured and I’m sort of happy not knowing as I’d prefer to be able to compare my level at 20 to my level now I’m pushing 50.

Anyone with more than this laymans opinion?

Depends on if you’re happy just dropping down dead one day or having a stroke or heart attack…….I was diagnosed at the age of 39 as type 2 diabetic and prior to developing diabetes (had symptoms on and off for about 8 years prior of unstable blood sugar levels but always came back negative on blood tests) when all of a sudden my cholesterol as well as blood sugars were through the roof. Wouldn’t mind but never did sugary drinks (beer didn’t count of course) 😆
Had an average but healthy diet. Genetically it’s fair to say that I’m flawed with stuff from both parents. All my grandparents were dead at a youngish age so I’d rather try and look after myself as best as I can.
You can walk into most chemists these days and get a cholesterol test……..and I would add that there are plenty of really thin healthy looking individuals with time bomb cholesterol levels too.
Pays your money you takes your chance as my dead granny would say!

Thanks all for sharing your views and experience. Seems a mixed bag. (btw loddrik – I’m sero negative for cat AIDS but thanks anyway). I’m on a corporate health plan at the moment so getting regular checks. At the last one, the Doc said that my overall cholesterol (7.4 – upper normal limit 5.0) was mainly being driven by my high trigs (3.5 – upper normal limit 1.7) and looking through my food diary concluded that this was due to high sugar in my diet (I’ve a sweet tooth and could put away a couple of twix/kitkats/snickers a day, no problem, plus muffins etc!). Since July I’ve completely kicked the sugar habit (it was tough): I now have low sugar cereal (4%), no snacks mid morning/afternoon and eat only healthy fresh meals, I take omega 3 supplements and have replaced dairy with almond milk. The kilos have fallen off, Strava tells me I’m averaging 150km a week and desdpite being well ove 50, I’m feeling better than ever. Just hoping that at the retest this will be enough. Not sure I want to be taking a drug every day for life given that the long term safety (ie 15+ years of use and effects on liver function) for statins hasn’t really been established. Then of course there is the known short term effects on muscles, energy levels, as described by a few of you above.

and looking through my food diary concluded that this was due to high sugar in my diet

What you eat has no effect whatsoever on your cholesterol level

What you eat has no effect whatsoever on your cholesterol level

not sure that’s quite right, though it’s probably way truer in regard to dietary fats, including cholesterol, than it is for sugars

btw loddrik – I’m sero negative for cat AIDS but thanks anyway

You sure, have you been tested for both types (Good and Bad)?

you get about 25% of your cholesterol from your diet and the rest your body manufactures itself. if you take more in from food, your body produces less, and vice versa.This explains why well-designed cholesterol feeding studies (where they feed volunteers 2-4 eggs a day and measure their cholesterol) show that dietary cholesterol has very little impact on blood cholesterol levels in about 75% of the population. The remaining 25% of the population are referred to as “hyper-responders”. In this group, dietary cholesterol does modestly increase both LDL (“bad cholesterol” and HDL (“good cholesterol”), but it does not affect the ratio of LDL to HDL or increase the risk of heart disease.

This is well known science, not wackery…

Having said that, lowering the amount of sugar in your diet will have a good effect on your weight and health.

Someone already said this – IME you get started on the generic stuff. If you find problems they’ll move you on to something else. My problem was muscle aches, sometimes within minutes of starting an activity. The worst for this was using a pick & shovel. I didn’t know about the side effects at the time, so put up with it far too long, as with the cold hands from beta-blockers.

@nickc: Yes, hence my comment abovbe about dietary fats & dietary cholesterol

… and what do you get if you eat excess sugar ?

scaredypants, oh yes sugar!!…I think we’re on the same page to be honest, amazing that clinicians have had people on a low fat high carb diet, and they wonder why folk are fat and diabetic, and dying from CHD! the cure? (according to them) is to feed diabetic people more sugar!!

I know the world of health care is conservative, but turning this particular juggernaut around seems to be harder than most!!

The rates of heart disease deaths in the uk have fallen dramatically over the last decade (I read 45% somewhere).
This may or may not be due to statins which have been prescribed to more and more of the population in that time. (I’m pretty damn sure it is!)
There is no doubt about the efficacy. If you have diabetes or established heart disease a statin will reduce your risk of death by 30-40%
When used for primary prevention (ie people without overt cerebrovascular disease yet) the waters get muddier as the evidence for benefit varies according to calculated risk (jbs3 or qrisk2 numbers).
Nice used to tell us to recommend statins to people with a risk score greater than 20% but that has recently changed to 10%, on the basis that statins are now cheap enough that the cost per life saved is acceptable. The difficulty is deciding as an individual whether it is worth taking a tablet for 10 years with any associated side effects for the possibly quite small reduction in (theoretical) cardiovascular risk.
There are patient decision aids available from nice with pretty pictures to help explain this but basically a risk score of say 25% means that if we took 100 individuals with identical parameters (age smoking status sex lipids bp BMI family history other diseases eg rheumatoid arthritis even postcode) and did nothing at all for 10 years then 25 would develop heart disease- but we wouldn’t know which 25 it was.
If we give all 100 a statin at the proper dose for 10 years then about 9 of those 25 would be prevented from heart disease. This is pretty phenomenal compared to the efficacy of most preventative interventions, and makes absolute sense from a population perspective.
The difficulty for individual patients is that as a dr I can’t tell you whether you would have been one of the lucky 9 who will benefit from the statin, the lucky 75 who will be ok anyway, or the unlucky 16 who take a tablet for 10 years and still develop heart disease.
https://www.nice.org.uk/guidance/cg181/resources/cg181-lipid-modification-update-patient-decision-aid2
This decision making gets harder at lower risk figures as the numbers who benefit get smaller.
Recently I read that the cost per life saved by NHS health checks (the vehicle that public health England use to put this nice guidance into practice) is £450000. Not read much more than that but it shows the problem.
And the inverse care law applies too, people who are interested in their health and already addressing lifestyle factors are more likely to attend for these health checks than the overweight smokers who would benefit the most.

Re being offered cheaper generic drugs first- of course, the population benefit described above isn’t affordable if the drugs cost 10x more for a branded drug.
Nice guidance to gps is pretty clear- use the statin with the lowest acquisition cost.
The health of the nation will not be improved by as great a degree if the NHS prescribes branded drugs first line.
It doesn’t help that the daily fail likes to misinform its readers about the risks of statins (statins cause diabetes? Nope, try a slight increase in relative risk)

Recently I read that the cost per life saved by NHS health checks (the vehicle that public health England use to put this nice guidance into practice) is £450000. Not read much more than that but it shows the problem.

I was invited to one of these last Feb, but still haven’t got round to it. Having read that only the worried well turn up, I can see why they’re so ineffective.

Nice post docrobster, I’ve pretty much avoided the internet, having had good advice from my GP Practice Nurse that such ill informed sources will at best scare me and at worse end up killing me 🙂

Got a pretty good working relationship with the GP practice over managing my diabetes. Overall the NHS have been brilliant for me and I’m now getting my A1C around 5.2, eating a balanced diet and not having to do any faddy internet low carb high fat nonsense.

I do feel better off the statin, I guess I’ll see how the blood test looks in three months and see if trying a different one works.

The benefits vs risks of statins are debatable and is quite rightly being questioned more and more. As is the value of cholesterol levels as a risk for heart disease. More current thinking is that cholesterol is a marker of inflammation caused by factors such as stress and diet. You should read “The great cholesterol con” by Malcolm Kendrick for an alternative view from a practising GP. His blogs are also quite entertaining. This is also interesting don’t you think? http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/