Statin resistant?

[fairgo45]

After a couple of stents I was put on 80mg of Statins but it failed to lower my LDL or overall cholesterol levels

Has anyone else had this and if so what did you do to lower it?

[Mart25]

Good morning. I had exactly this. My total cholesterol has always been at the high end of "normal" ie. around 4.5 - 5.5. My GP refused to put me on statins and no matter how hard I tried, I found that diet made little difference. Then last year I had angina (suddenly) and an angiogram showed that I needed a bypass. I was started on 20mg atorvastatin, which dropped my total cholesterol and LDL somewhat - but it was not enough to meet NICE guidelines for someone with cardiovascular disease. After my bypass op I was put on 40mg and my cholesterol levels didn't change - so I persuaded my GP to try 80mg but (again) nothing changed.

Then I encouraged my GP to try me on 40mg atorvastatin and 10mg ezetimibe. Ezetimibe works in a different way from statins. This combinaton worked! I now take this combo every day and my total cholesterol and LDL meet the NICE target levels.

Bottom line : If diet and statins don't do enough for you, it's worth trying a statin + 10mg ezetimibe combination. You will need liver function tests before and from time to time because ezetimibe can stress your liver.

I hope this helps.

[fairgo45 in reply to Mart25]

Thanks so much for that information it was totally frustrating being on 80mg statin and nothing changing I'm so willing to try your Statins/Ezetimide. Are there any side affects to be aware of as I had none with Statins alone.

Thanks again for the suggestion

[Mart25 in reply to fairgo45]

Here's a link for more info about ezetimibe : nhs.uk/medicines/ezetimibe/

I just got mild indigestion and gas for a couple of weeks...then it all settled down. Now I have no side effects. It works best as a combination with a statin so it's great you have no side effects with statins.

[fairgo45 in reply to Mart25]

Again thank you you're most helpful I'm presuming you and I are unusual having statin resistance ?I'm presently on atorvastatin 40mg is it ok to take this with the ezetimibe as a different statin was mentioned in the link you gave. All very interesting though

[Mart25]

Yes. Ezetimibe should work OK with any statin - they just make a combination tablet with simvastatin (mentioned in the link) to make life simple because you don't have to swallow two tablets. I'm taking 40mg atorvastatin daily too and about 6 months ago I started 10mg ezetimibe every day as well, so you should be just fine sticking with the statin you are on. Equally, your GP might prefer the simvastatin/ezetimibe combo tablet.

Your question about resistance to statins is interesting. It puzzles me too. I'm a biochemist so I'm quite happy trawling through scientific papers and one day I'll see what I can find out about this. My hypothesis (without any evidence at the moment) is that you and I are actually sensitive to statins, but our bodies are working very hard to counteract the effect of the statin. I'll be interested to see if your post gets any other responses from hearties who find statins don't work too well.

[fairgo45 in reply to Mart25]

Yes seems odd maybe you and I are unique as no one else has commented annoyingly my husband was only on 20mg and his lipids are great LDL of 1.4 and he doesn't even have heart problems just has a GP who is cautious. I'm going to try the same as your on and retest in a month I will let you know if it improves.

Thanks so much for your advice

Janet

[Mart25 in reply to fairgo45]

Yes, please let me know how you get on. I did a bit of internet research last night and I find that we are not unique. Patient responses to statins are variable and there are various ideas on the reasons why - some people metabolise and excrete the statin quickly so it doesn't do its job, other people have slightly different types of the target enzyme which are more resistant...and there are other possible explanations too. It's all to do with our genes!

Interestingly, I also found a report of a big study of 22,063 people in different countries who all take statins. They all had targets for their cholesterol levels. BUT 48.2% of the patients did not achieve their target for LDL-cholesterol. So many people are taking statins and don't actually know that they are not hitting their target levels!

Interesting.

[Mart25 in reply to Mart25]

PS. Are you in NZ?

[fairgo45 in reply to Mart25]

Yes very interesting my cardiologist told me it happens to about 4% of people but maybe because I live in New Zealand it's a smaller population different percentages.It's 11.09 pm at night here on Wednesday are you in the UK or USA or somewhere else?

[Mart25 in reply to fairgo45]

I'm in the UK.