Question: I have heard some things about cholesterol drugs in the news recently. I take one, and so does my husband. Are they safe?
I hear this question often. I asked about the use of cholesterol buster drugs, also known as statins, in my initial history for new patients. It is always important to know a patient's drug profile in a health history, but statin drugs have specific impact on what I do because they have musculoskeletal effects.
It is possible that because I am a chiropractor, I am predisposed to seeing the musculoskeletal side effects of these drugs because people come to me with aches and pains. It is also true, though, that Zocor and Lipitor, two of the most widely used statin drugs, are associated with muscle cramps, muscle weakness, and tendon conditions as side effects. A new study of nearly 14,000 active-duty and retired soldiers who take these drugs confirmed the association of these drugs with musculoskeletal complications. About three quarters of the patients in this study were taking Zocor, and about 20% were taking Lipitor. The rest of the participants were taking one of the other drugs in this class.
Before we paint with too wide a brush, while these drugs do produce musculoskeletal side effects, some are worse than others. Besides muscle aches and tendon problems, some are associated with joint pain as well. The market leader, Zocor (simvastatin), has a package insert that states it causes less arthralgia (joint pain). It does have an in frequent allergic response in some patients that may include fever, chills, shortness of breath, itching, a skin rash, swelling around the face, tongue, and lips, wheezing, and bruising. Obviously, if you are taking a statin drug and experience musculoskeletal or systemic side effects, call your prescribing physician immediately. Also talk with your pharmacist for advice, as they are the experts on drugs and their interactions with other drugs as well as foods.
There is are better alternatives to the statin drugs for many people. Omega-3 fatty acids found in fish oil are known to reduce inflammation, which is a common link and heart disease, cancer, and arthritis. Numerous studies have shown that the omega-3 fatty acids lower cholesterol and triglycerides. Not all omega-3 supplements are alike, however, and it takes a little bit of label reading to be sure you are getting the right quality product. Generally speaking, the more it is refined and purified, the higher the concentration of the fatty acids you need. I personally take about 1 g per day to keep my own cholesterol low.
Higher doses of omega-3s in the range of 3 or 4 g per day have been shown to lower blood pressure in people with untreated hypertension, which would be a very happy additional benefit. The anti-inflammatory effect of omega-3s may be responsible for reduction of morning pain and stiffness in patients with rheumatoid arthritis.
Another very safe alternative to help you with cholesterol and triglyceride problems is non-flushing niacin. Niacin is vitamin B 3. Taken in high doses by itself, it can be dangerous for the liver, but when it is bound to an inert sugar (inositol), you can take it safely on a daily basis without the familiar flushing side effect. It will reduce triglyceride levels significantly, especially when taken with omega-3. It will also increase the good cholesterol (high density) while reducing bad cholesterol (low density). It appears to have this effect even among people with genetically high cholesterol and triglyceride.
I could go on and on with the research about the positive effects of omega-3 fatty acids and niacin. The point I want to make, though, is that there are very good alternatives that may be far safer than statin drugs. While I have heard of and seen serious reactions to statin drugs, I have never seen or heard of a negative reaction to omega-3 or non-flushing niacin. Perhaps something as profound as anything else, I know of some pharmacists who use these more natural and very effective means to maintain health because they are very skeptical of the drugs.
I personally take omega-3 daily with non-flushing niacin to control my own cholesterol and triglycerides. Historically, my cholesterol levels have been in the moderate risk range (200 – 230), but I have cut that to a total cholesterol count of about 160 using omega-3. My primary care doctor was quite surprised to see my last triglyceride level at 70 (on the low side for a middle-aged guy), and she asked me what I was doing to make that happen.
If the side effect profile of the statin drugs is a concern to you, talk with your pharmacist about it. Ask about the side effects of the drug you are taking, potential interactions with other drugs, including over-the-counter drugs you may be taking, such as ibuprofen, aspirin or Tylenol. Ask about interactions with foods. Ask about long-term effects. Ask your pharmacist to compare the effectiveness of your statin drug to omega-3 and non-flushing niacin. Armed with information, make an appointment with the prescribing physician and explore your alternatives.