Max Atorvastatin/Liver Health

[6357axbz]

My cardiologist just OKed 80 mg Atorvastin/day per my request (thanks doc). To date I’ve been taking 40 mg rosuvastatin/day for the last 7 months or so. Prior to that I had been taking 40 mg Atorvastatin/day for many years. My liver function always within normal, healthy range. I requested 80 mg as some hear are taking that dosage for PCa. Has anyone here had any liver problems after stepping up to 80 mg?

[Tall_Allen]

If you are taking a statin to bring down your cholesterol levels and that is what you need, all well and fine, but there is no credible evidence that statins help with PCa, and side effects, like myopathy get worse with higher doses (liver problems are rare). As with all drugs, you should take the minimum amount to achieve the desired effect - more is not better.

As for PCa, the highest level evidence we have so far is this mendelian randomization study that shows no effect:

nejm.org/doi/full/10.1056/N...

At lower levels of evidence, there are those observational studies that you have seen suggesting a positive effect, as well as these suggesting a negative effect:

onlinelibrary.wiley.com/doi...

ncbi.nlm.nih.gov/pubmed/235...

ncbi.nlm.nih.gov/pubmed/303...

The first of those suggests that any observed positive effect may be due to its masking of the true PSA.

[NOCanceros in reply to Tall_Allen]

Hello Tall_Allen

My family Dr. took Colosterol blod test and he recommended to take Rosuvastatin accord 20mg.I heard about this medecin that decrease the Testosterone level ,is it right or false.

Thanks for any answer

Nice to be here good people

[Tall_Allen in reply to NOCanceros]

I'm not aware of that, but it wouldn't surprise me because cholesterol is the starting point for the biosynthesis of steroids.

[6357axbz]

Thanks for the valuable info TA. Having gone on an ADT vacation (per my clinical trial at MDA) I have included certain supplements, off label meds to be doing “something” while I watch T and PSA start to increase from castration and undetectable levels respectively. As someone here said as “incurables” were all clinical trials of one. At least I’m doing something that, while unproved by trials, may help and not likely to cause damage if closely monitored. When I reported my latest, post adt vacation PSA and T numbers (both showing increases) to my MDA MO his comment was,

“When patients receive ADT on an intermittent schedule, the PSA tends to increase soon after the testosterone starts to recover. There is a chance that if we manage to control the tumor microenvironment with anti-stromal agents (such as statins), antimetabolic agents (metformin), anti-inflammatory products (curcumin), etc, we we delay progression...”

In my case yes, as a high risk cardio patient, I need statins for lowering cholesterol, so I’m just switching from a hydrophilic to a lipophilic statin, and increasing dosage. My cardiologist is supportive and we’ll be checking liver functions in a couple of months.

Does myopathy show up in blood tests or just as muscular pain?

[Tall_Allen in reply to 6357axbz]

Pain, at first - later, products of muscle breakdown may appear in the blood. I would love to hear your MO's reaction to this:

pcnrv.blogspot.com/2019/04/...

[6357axbz in reply to Tall_Allen]

Are u referring to something besides Curcumin? As for Curcumin I stop taking 4 to 5 days prior to testing. I believe it was you said stopping 3 days before should negate its effect on PSA. I also see where it had no or negative impact on length of iadt

[Tall_Allen in reply to 6357axbz]

Statins and curcumin may give false PSA results; in contrast to his quote, the best evidence is no benefit for prostate cancer. I think interest in metformin has waned since two randomized controlled trials showed no effect:

urotoday.com/conference-hig...

ascopubs.org/doi/10.1200/JC...

[6357axbz in reply to Tall_Allen]

Working on that

[hansjd]

Hi 6357axbz. I take 80mg / day atorvastatin, up from 40 mg a year ago, and have no side effects. Liver enzymes very normal. I take it together with a number of other meds and supplements because I believe it has a positive effect on helping to control PC. Cheers.

[6357axbz in reply to hansjd]

We can only hope. Thanks hans

[dentaltwin]

I was a little surprised to read that statins may protect against drug-induced nephrotoxicity. The major risk with muscle breakdown (the extreme case being rhabdomyolysis) is to the kidneys. I'm sure your docs will have that covered.

[Don_1213]

No problems. I went from 40 to 80 just to counter the effect that Lupron has on lipids.. mine sort of went off-scale thanks to Lupron. Taking 80mg lumps every day now at least has put them back on scale. And if statins DO help with PCa - more the better.

[FRTHBST]

There does seem to be some evidence on the positive effect of statins on Pca. Here's a brief review article referring to a presentation at a urology conference in 2018. As the author points out, evidence is not overwhelming. urotoday.com/conference-hig...

[6357axbz in reply to FRTHBST]

Also this from Patrick 11 days ago:



... statins reduced all-cause mortality by 27% & PCa-specific mortality by 36%

ncbi.nlm.nih.gov/pubmed/319...

[FRTHBST in reply to 6357axbz]

Thanks for the link!