There is, not surprisingly, a lot of discussion here about us taking statins and one of the points often made is that there has been little evidence of benefit for over 75s - mainly because they are more often than not excluded from clinical trials. This is a patient summary of a Chinese study which specifically looked at over 60s and their CVD history following initiation of statins. The conclusion reached was that statins did reduce the risk of CVD and there was no parallel increase in muscle-related adverse effects, That doen't mean there are NO muscle-related effects, it means all patient groups reported muscle symptoms, older patients could be expected to have them anyway and maybe the patients didn't associate muscle problems with the statins. Sometimes they start immediately, sometimes they don't and then it is very difficult to be sure it was the medication.
Statins in older patients and their benefits - PMRGCAuk
Statins in older patients and their benefits
Hi Pro I decided to take statins after a full fasting blood test because there is a family history of CVAs going back at least to the mid 1800s. A month in, I have piriformis syndrome. Again! I'm doing the exercises and have stopped the statins. I'll discuss with doc after next blood test due July. I have read reports that statins can be connected to piriformis syndrome.
Just had a look - and there is one case report linking piriformis syndrome and atorvastatin, to be fair it was pretty conclusive for that patient as atorvastatin = sciatica, no atorvastatin got rid of it repeatedly. I know that there are a couple of people on the forum who don't tolerate atorvastatin but are able to take another statin so perhaps worth trying a different one?
And piriformis is a common effect in PMR. I have it every so often if I don't do the stretches and I can't blame statins, their effect on me wasn't that specific! Atorvastatin nearly had me in a wheelchair I was so weak after 10 days at half dose! The local rehab rheumy says that these recurring hip-related problems do require consistent use of the stretches even when there is another treatment modality that is being used.
I really don't know why the NHS still keep giving Atorvastatin as the first statin option, it's only pennies cheaper yet it does seem to be the one that most people get side effects of some sort or another with.It's a real false economy.
I was given it first , even though I'd asked for Rosuvastatin like my OH. I didn't get the muscle issues , may be a bit more joint pain but that could have had many causes , but it doubled my IBS-C symptoms.
Not had any issues with Rosuvastatin.
Whereas I think it was rosuvastatin that coincided with a MAHOOSIVE PMR flare about 3 weeks in - just as I was thinking this is working OK!! Might have been coincidence but I wasn't risking it. The atorvastatin was the local hospital here - tried to smuggle it in, "Here's your tablet", just before I was discharged 12 years ago when the atrial fibrillation was first identified. Not just the NHS. "You'll be very carefully monitored" - was I hell, so I took the unilateral decision to stop it and then discussed it with the anaesthetist who was running the Pain Clinic at the time and she agreed with me.
A useful read and study, thank you. Although I guess it's results/conclusions aren't totally definitive. They have, once I found the right one, never been a problem for me.
Yes, I think a far more important conclusion is that a) some statins are a problem for some people and b) sometimes a different statin is better.
Mind you, I tried 2 and the results were enough to dissuade me from continuing the experiment!!
Three were dire for me but the last one has been fine. Doctors and patients need to be willing to try a different one and see if it is OK. If other ones don't work then at least you've tried. Having said that, the pain the first ones gave me, I can quite understand people saying enough is enough and no more. My doc did say that if the last one was no good then that would be be it.
Me too... tried 4 over the years.
In my 50s, statins prescribed... couldn't take Simvastatin and Atorvastatin, but Rosuvastatin was fine for a lot of years.
GP decided to stop statins and BP meds in 2018 when all levels went very low after knee replacement 2 years after GCA.
Both did creep back up - so restarted different BP meds [no problems] and tried Rosuvastatin on lowest dose in 2019. Couldn't tolerate - nor Pravastatin when tried in 2022.
Recently had another comment re Chol levels from random GP who viewed results [but obviously not my medical record as it states intolerance].
Retested after a couple of weeks, and they have reduced- with no change in anything -apart from the time between the time the blood was taken and then collected and transferred to lab for testing. Did notice a change in a couple of other readings as well.
Have decided to give plant sterols a whirl...
I'm taking plant sterols now. My cholesterol was only borderline so if it's gone down by next blood test ill put it down to the plant sterols which I was taking after first intimation my readings were high but stopped then when atorvastatinwas prescribed.
My friend's cholesterol blood test showed a reading of over 10. She changed her diet and started plant sterols and the reading reduced to 6.5!
Goodness the algorithms are quick! I just read your post, then immediately a you tube video flashed up about statins and muscle and tendon problems. Its a good little talk. I've tried to copy it. Hope it works: youtu.be/Njg7Aym6QQE?si=C-D...
journals.sagepub.com/doi/fu...
And the study the talk is based on.
Not a good mix with a disorder and its medication that can be associated with tendinopathy ...
And here is the link to be able to READ his soundtrack - always preferably I find
ok you are gong to wonder if I have gone off my trolley. BUT.. I have had high cholesterol since 2005 and every time tested it has been high. Good was always good but bad was bad. and the highest it was was 100 points (USA) over normal. I was told again and again to take statins which I refused repeatedly saying I would eat right. Anyway, this time it was BELOW NORMAL. I did NOT eat right. I have gained 10 lbs and couldnt figure it out why cholesterol normal! . A friend said, "could it be the ice baths and winter plunges?" ..which as some of you know, I insanely do 3x a week. and lo and behold I looked up a study which said: NASA studies found that repeated dips in chilled water over a 12-week period resulted in a series of changes known as 'cold adaptation. ' This brought down blood pressure and cholesterol as well as toning muscle. WOW! Seeing the doc today will see what he has to say. I realize for many going in an ice bath might be tougher than eating right! haha
After refusing to take statins since I reached the age of 70 (8 years ago), I finally agreed to do so and was taking 10 mg of Pravastatin. No problem to begin with but eventually I felt tremendous pain in my arms, was unable to move them or hold anything… such weakness., also started to feel pain in my calf muscles. Then I was losing body mass and losing weight while not trying to do so. After having a chat with my GP it was concluded I should stop taking statins. That was over 2 months ago and although the pain and weakness in my upper arm muscles have nearly disappeared, there is still some pain from time to time. I have regained a little weight without making any changes to my diet. I don’t want to take any statins again. Pravastatin is supposed to be one of the ‘kindest’ and gentle statin to use.
Made me dizzy amongst other things -not good when you live alone, have to drive and are mono-sighted!
Same here and also I could not remember things, that scared me! Not sure statins are actually necessary…
What are muscles please? I seem to have lost mine somewhere in the last couple of years, due to a mix of steroids, age and lack of exercise with all the illnesses going on like the MdDs and back problems. I'm not going to take statins, as the youngsters say I'm here for a good time not a long time and already on enough meds with all the comorbities going on. I'm sure I read somewhere (I think in an NHS article) that the medical advice for prescribing them has changed a year or so ago and women probably don't benefit as much as men from them? Are there any studies that show the difference in effectiveness by sex? One of my mates, same age as me (63) and absolutely fit as the proverbial fiddle, cycling mad and eats ultra healthy, has just had two heart attacks out of the blue, while cycling. He's had stents put in and is now on statins and docs are blaming it on familial high cholesterol I think he said. I don't have that.
Must have the odd one or three to be able to manage that walk the other week!!! I've just posted about their role in the older population.
The evidence remains mixed and not entirely clear - but this doesn't seem to think there is a significant difference, men and women whould be treated the same and wasn't funded by the manufacturers! They do have an effect on CVD irrrespective of age and sex but it seems to be a bit different mechanism,
ncbi.nlm.nih.gov/pmc/articl....
Actually, the legs are quite good, as long as I'm using the walker I can zoom along. And things like sit to stand are easy enough so you're right, there must be muscles there. Standing in one place more than a minute is impossible (with the broken lower back thing going on). My arms are skinny below the elbow and bingo wings flabby above 😀. i'm wonderinig if there's a bit of bone loss going on too as I can easily wrap my thumb and forefinger round my wrist which I couldn't do a few years ago, and I I've had to go up a hole on my watch strap.
Bones don't usually shrink though - the structure become more porous so lighter and less dense.
I explained recently where I suspect the 2 years came from - a relatively early paper about PMR found there were 2 distinct groups, a version that seemed to last maybe up to 3-4 years with a MEAN duration of pred of 23.7 months. The other group were what we see quite a bit, a longer need for pred. The number picked up on was that 2 year duration of pred because it suited someone.
The meeting last Friday was discussing the different phenotypes - really interesting and will be compelling to work on in the near future. There is one that fits me to a T.
I listened to most of that, a lot was a bit complex for me but I generally followed what they were saying and everybody was gettong very excited about the potentials of better scanning for diagnostics. Bringing power back to rheumies would be good if the rheumies get educated first, mine set me back years by not believing I had PMR. It gave me hope things are changing since the last guidelines were cobbled together in 2015. I wish more patients had been involved or at least invited to listen in, I think the invite was just sent to groups and bigwigs and I didn't hear about it until last minute. I will watch the recording if/when available. Very impressed to have the likes of Lorna and Dorothy Byrne fighting our corner
Mmm - the bad news is who is the lead author for the next Guidelines though my hope is that since it is a consensus document some of his daft ideas about 2 year PMR and rigid tapering may be challenged strongly and his mind changed, I was invited to be there in person - on the Wednesday!!!!
They stll all seemed a bit hung up about steroids = bad and getting off them asap when there still aren't any alternatives, and I got the impression most of them don't understand abiut flares and the volatiltiy of PMR and GCA, it's not a straight line progression to remission. My camera wasn't working for much of it so I still don't know what your man Christian looks like but I could hear other names mentoined like Sarah and Vanessa so I'm hopeful. Well slightly anyway
You must have been at a different meeting!!! The ones who were there certainly do,
There were a lot of complaints about patients and GPs putting up doses and that GPs are too generous with them, patients handled by GPs are on steroids longer. To me that seemed a good thng rather than bad. I may well have missed bits as I was listening on and off all day, I hope they do some kind of summary of it all
But the point there is that GPs are probably masking incorrect diagnoses and ending up skewing the situation. The main reason patients end up longer on pred is actually poor tapering technique - I'm no way saying that rheumies are better at it but there is no agreement about going about things logically, from criteria for diagnosis, starting dose, tapering, what to do with flares to what works to reduce steroid need. There has been no study looking at any of that. And a big point last week was that you can't even diagnose it properly. It is becoming clear that there is no single face of PMR and that has massive implications for management. Whoever does it. And Dasgupta admitted - they created a rod for their own backs by palming patients off to GPs years ago. Now there is such a shortage of both GPs AND rheumies worldwide they are in a real mess - or rather, we are.
After listening to so much information, to try and pull all the ideas together I started doing a kind of rough mind-map of what patients want and what doctors want. Although generally both sides want correct diagnosis and correct treatment there is so much missing info, misunderstanding, myths, attitudes etc. I feel strongly there should be more listening to patients and more learning from observational studies and patient feedback as well as all the learning from diagnostic scans, In all the anecdotes the speakers told it was patient's symptoms that led to the investigations that led to key discoveries.
This is one of the reasons Im dubious about many studies, they often don't differentiate between men and women or have equal numbers of both. Women's bodies are more complex with all the hormone stuff going on , weight and body mass differences etc.
I'm sure this is where some of the myths about PMR have derived from, the text books say it lasts 2 years because it was based on men, who tend, I know not all men, and there are a few longer timers on here, but generally they get through it quicker, and get diagnosed and treated sooner, and get it when older which I think may mean it's a less severe form than if you get it when younger. I appreciate we just don't know, but that's my theory. I know there is little research on this til now but I'm sure that now we have more diagnostic scanning it will tell us more about different phenotypes in years to come. I noticed from posts on here that the long termers like you and I had many things in common, delays to dx and starting steroids, severe inflammation in bursae especially the shoulders - quite often capsulitis or frozen shouldrs preceded PMR, age around 50 when started.
I am in a quandary as you can imagine after going to "older persons" clinic.....being told by a doctor, (not a Neurologist) that swollen blood vessels in my brain were cholesterol! my last reading was 6.1..... when I told Max he was amazed, and at the fact of being sent to the clinic, saying I wasn't old enough!....said it's normally 80 plus.....I am taking a statin every other day (just in case) the one often mentioned on here Ezetimebe. I am seeing GP in two weeks not happy being refused Neurology by an older persons doctor, when GP who referred me to them said I needed to go there. It bothers me whats going on....Cholesterol or not??
That woman needs a clip - but Max is wrong too, older persons clinics are quite useful even for under 80s!! It is more the clinical picture than the calendar.
I always remember many years ago when my husband was at work, he had yearly medical tests....his cholesterol was very high!....8.2....he weighed 10 st 7lbs.....a colleague he worked with weighed 19 half stone...cholesterol 4........husbands GP just told him cut the carbs.....Love .....here for a good time, not a long time!......but like you need muscles to enjoy myself!......especially in my legs which keep letting me down!....fatigue is unbelievable!......we crawl on!!
Go treat yourself to a rollator/walker and get out there, walking in nature does me good, even in the rain, you won't melt as me grandad used to say
Def inately will when my head can deal with it if that makes sense!...
Think of it as a more stable walking stick with a portable chair and shopping trolley ...
Do you wear specs?
Only wear specs to read
And you would only use the rollator to go down the road, not in the house. Same thing - your vision is not good enough to read without a bit of help. Your legs aren't good enough to take you down the road with a bit of help!
Would be difficult going down my road, I live with huge, old lime trees which have damaged the paths. I occasionally see people going past with rollators struggling, but will find the answer!
Before you agree to take a statin I recommend you read DrMalcolm Kemdrick's books "The clot thickens"and "Doctoring Data", or see his omline blog. He estimates that in otherwise healthy people (no previous history of CVD event) a statin taken for 5 years will possibly extend your life by about 3.2 days. And that's an overestimate for the over 70s.
I refuse to have my cholesterol measured by my GP practice, I don't want the argument that might ensue when I refuse a prescription for statins.
I can't remember my reading, I think it might have been about 8-ish. I got a message from my GP surgery saying book an appointment to discuss statins if I was concerned. I wasn't and nor was my rheumatologist so I left it. I remember when I tried the keto lifestyle people on forums often mentioed his first book The cholesterol myth. I haven't read it but picked up the gist.
I must stress these opinions are my own and I am certainly not saying what's right for me is right for everyone, or impose my thoughts on anyone, it's an individual decision
The opinions expressed in his books are based on a very sound grasp of statistics, they are not just my opinions. GPs are often just following NICE guidelines/making sure they meet targets for QoF to increase their income. We should be a lot more discerning about which treatments we agree to.
No sorry I didn't mean any criticism of you and we're on the same page, I was just defending myself as when I've gone on anti-statin rants before I've upset a few people with my opinions. I'm also cycnical that GPs get a bonus for putting people on them.
Dr Kendrick has upset a whole lot of people with his opinions - he is currently fighting a court case against the Daily Mail who accused him of being a "statin denier"! You couldn't make it up!
But things do change - and there is a lot of work that does show lowering cholesterol does also lower mortality. Discuss:
If his books are evidence-based surely he has nothing to worry about. The Daily Mail is a dreadful nusiness but has a major influence on what its (mainly elderly) readers beleive and do, and that as Dorothy Byrne says can be used as a channel for good as well as bad like raising awareness of GCA and all the articles by Michael Mosely advocating low carb eating for Type 2 diabetes. The current government reads it and panders to its readers with policies they'll vote for like bringing back National service and other political issues which are not appropriate to discusson here
Ah yes - but if you read my posts today, you will see that it depends on WHAT evidence you decide to cherry pick and cite in your book. And it is looking at the sources that suggests whether someone's opinion is really science-based or psuedoscience-based.
Yeah I understand that from a basic overview of books like Bad science and my own common sense from having taught report writing. I have a friend who is an editor within the NHS who refuses to take on board anything written in a Best-seller, particularly if the book is by an American author, she totally toes the official NHS lines. Will not consider any alternative medicine at all as they haven't been proven, even things like osteopathy, diet, etc. She thinks I'm a crank on a par with anti-vaxxers for reading these things.
It does lower mortality - most people get an extra 3 days of life! And then there's the fact that statins and "low fat" foods make a fortune for Big Pharma and Big Food. Discuss.....
I read recently that although we are living longer our potential Quality of Life in our later years has not improved much so I don't want to put things off for my old age, I want it all now 😆. Though if by some fluke I do live to be a ripe old age I'll be quite happy sitting reading all the books I've bought or picked up in little free libraries and not read. Buying books and reading books seems to be two different hobbies.
You are mixing up averages and means and distributions and all sorts there.
I'm not mixing up anything. You need to read Dr Kendrick's books. He has a better grasp of statistics than any of us.
Also when you look at any study you need to check who financed it or whom the authors received grants from. THEN you decide which studies are worth considering. Anything financed by Big Pharma is suspect. Again I would refer you to Doctoring Data. Studies which don't give the results Big Pharma wants are sidelined. We only get to see the ones that show what they want us to see. ie the ones that show their products "work".
I have. I do, I did science,
I would like your opinion. I was recently prescribed Crestor (40mg) because I have a 65% carotid artery stenosis (which seems to have occurred in a 6 month period) and the Dr. also referred to a recent PET Scan that I had LAD coronary calcification and Moderate Atheromatous disease abdominal aorta. My cholesterol levels are "perfect" and he said this statin would prevent a stroke. I don't like taking pills and I really wonder if this necessary. Will have another doppler in July which will be 6 months since the last to see how things are progressing.
Thank you PMR pro - guess I'm stuck with it.
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