recommendations for high cholesterol med please

[RLSNona]

I stopped taking my cholesterol meds in November, just tested again and it's now 371. For RLS I'm now on gabapentin (100mg) and .5mg requip (need to transition off). My RLS is the best it's been in years! However, my doc wants me to continue to take the pravastatin (80mg) for the high cholesterol. Will the statin aggravate my RLS? Is there another drug to take for cholesterol? Thanks.....my research has fallen short!

[ChrisColumbus]

Statins do trigger RLS in some/many: atorvastatin was very bad for me; rosuvastatin also triggered my RLS but not quite as badly. Have no experience with pravastatin or other statins. Whether statins are essential for some is a matter for debate with your doctor.

It was only when I threatened to take myself off statins that my consultant eventually agreed to put me on ezetimibe (brand names Ezetrol, Zetia) instead. I later found that ezetimibe, which works differently from statins in that it inhibits the intestinal absorption of cholesterol, is recommended in the UK if a statin is “inappropriate or not tolerated”. It generally works more slowly than a statin, so may not be suitable for those with very high LDL.

There have also been reports that ezetimibe triggers/exacerbates RLS, but it doesn’t for me. And it certainly doesn’t cause the tiredness and weakness that the statins did, but it perhaps increased my tendency to diarrhoea (difficult to tell as I have radiation proctitis of the bowel after radiotherapy). It’s possible that the reports linking ezetimibe to RLS may be partly due to the fact that ezetimibe may – particularly in the US - be supplied in combination with other drugs including statins: ezetimibe and simvastatin (Inegy, Vytorin); ezetimibe and atorvastatin (Liptruzet, Atozet); ezetimibe and rosuvastatin (Ridutrin).

Other alternatives to statins include bempedoic acid which works by reducing the production of cholesterol in the liver. And Nustendi (Nexlizet in the US) which combines ezetimibe with bempedoic acid: this may be a good alternative for people who cannot tolerate statins, but it too has a long list of possible side effects - haven't seen reports re RLS for these.

UPDATE: another possibility, ref Sue Johnson, with no adverse RLS reports is fenofibrate (Lipantil/Supralip/Triglide)

Unfortunately, rather like ezetimibe, common or very common side effects of fenofibrate include abdominal pain, diarrhoea, flatulence, nausea, vomiting...

[RLSNona in reply to ChrisColumbus]

thank you Chris. Lots to study.

[Opie__]

I can only speak for myself but I have taken two different statins and neither effected RL. I am probably very unusual but I take Lexapro which seems to bother most but it hasn't made any difference in RL the last severals years I have taken. My RL are under control right now and pray that lasts. Good luck, maybe someone else has some suggetions.

[RLSNona in reply to Opie__]

thanks opie. I’m so worried to mess up my present good fortune!

[SleeplessinOR]

I am on Atorvastatin 10mg, which is a lot lower than what you said your doctor wants you to take. I find that if I take it in the morning rather at night I don’t have any increase in RLS. I only have symptoms at night, so if you have them during the day as well then this might not be a possible alternative for you. Like you, my RLS is currently pretty well managed so I was concerned about starting a statin but so far so good. I also only take it every other day.

[Eryl]

Cholesterol is essential to the correct functioning of the human body, it's the mechanism for trsnsporting essential fatty acids in the aqueous bloodstream so why on earth would anyone in their right mind want to lower it? Cholesterol can be divided in to HDL cholesterol and LDL cholesterol and LDL cholesterol can further be split into two types, large buoyant LDL and small dense LDL and only the small dense one is bad but the cholesterol test can't differentiate between the two types. The bad type comes from eating refined carbohydrate as found in processed foods like white flour and fruit juices. High levels of cholesterol is linked to a longer lifespan in older people. For a fuller explanation get hold of a copy of a book entitled 'A statin free life' by Dr Aseem Malhotra.

[Beater in reply to Eryl]

How refreshing to see your response. I was afraid to say anything for fear of being jumped upon. The Cholesterol Myth is a great book. I stopped taking statins after 30 years and open heart surgery. I actually realized that my health issues only started after I started taking statins in my 30s which I probably didn't even have high cholesterol at the time. You know, the prescribing bonus wink wink. My ldl is high but my triglycerides and hdl are perfect and I have a ratio of 1. Not to mention the pain in the bones, I never realized it was the statins.

[Eryl in reply to Beater]

I was put on statins after a stroke but stopped taking them after a couple of months because of excrutiating pains in my knees when walking up quite moderate hills which basically meant that I could hardly do any exersise. I decided that lack of exersise was probably going to do more harm than having high cholesterol.

You may like to watch this video: youtu.be/C3rsNCFNAw8(Not working as expected?)

[Beater in reply to Eryl]

Thank you, I will definitely watch it. With all the information that I have found is that if they do any good it may save 4 days of your life. 4 more days of misery and pain?

[Eryl in reply to Beater]

But if you implement the dietary changes you probably won't be in too much misery or pain.

[Beater in reply to Eryl]

Yes it eat so clean that I unintentionally went into keto. I had open heart surgery and I couldn't tolerate the meds I nobody's would listen and cardiologist would not return pcps calls and I collapsed in the street. Such a long and unbelievable story. I'm bedridden from all their meds with a damaged CNS and a frozen shoulder. Pain management wants me on antidepressants for pain? My file clearly states NO MEDS, REHAB ONLY. I waited for year for that appointment and they did a 1 hour intake and examination and said no problem, we are going to put a great program together for you and we will call. 3 months later I got the call and off I went to begin my long anticipated rehab program so I can get my life back. They gave me antidepressants and said follow up in 6 months. Needless to say I am still bedridden and in pain. Finally saw cardiologist after 18 months and the first thing she gives me is statins, takes zero responsibility for her actions, wants me to kiss her feet for saving her life. I told her that she killed her that day and put her feet to the fire. She then taunted me and said I was agitated and physically escorted out of her office. Gaslighting and manipulation. I took my script and they booked me for a follow up in October of 2024. I will not be taking the statins. Same crap with family Dr. and she wants me on Redpatha a monthly injection. So my diet is very very clean, no booze, sugar or bad carbs, no caffeine. Very low profile lifestyle. It was all the meds. They sit there and lie to your face. But they will get their bonuses.

[SueJohnson]

Nexlizet is a cholesterol lowering drug that is not a statin, but I don’t know if it exacerbates RLS symptoms. Ezetimibe (Zetia) - reduces cholesterol although It doesn't reduce cholesterol as fast as the statins, but as Chris Columbus said it didn't trigger his RLS although the FDA does show it increases RLS for some people and then there is Triglide which seems safe. You might want to discuss these with your doctor. A more difficult way to reduce cholesterol is to go vegan. My husband lowered his cholesterol from 221 to 131 this way.

[ChrisColumbus in reply to SueJohnson]

Thanks for the tip on Triglide. I can't find any RLS issues with fenofibrate (Lipantil/Supralip/Triglide), so might mention it to my doctor. Unfortunately, rather like ezetimibe which I've been on until recently, common or very common side effects of fenofibrate include abdominal pain, diarrhoea, flatulence, nausea, vomiting...