Statins & hypothyroidism

[tcpace]

For those on statins:

Hypothyroidism as a risk factor for statin intolerance

sciencedirect.com/science/a...

Be aware that some of your symptoms, especially muscle symptoms, may be due to taking statins rather than the hypothyroidism itself.

[SlowDragon Administrator]

NHS guidelines clearly state if hypothyroid statins should probably not be started

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[Judithdalston in reply to SlowDragon]

Well I never...wonder how many dr.s know that? I was prescribed statins for decades including while diagnosed with hypothyroidism and it was only my personal attempts to get rid of muscle pain (including dramatic stabbing like pain in legs/feet) that I told the Gp I was stopping them. 2 years later was still trying to treat hypothyroidism, though stabbing went.

[helvella Administrator in reply to Judithdalston]

Any doctor who has read the official prescribing information for statins should know there are issues with prescribing statins to those who are hypothyroid.

(I don't believe the documentation is strongly enough worded. But that is opinion - the fact is that information both exists and is readily accessible.)

A few examples:

Simvastatin

Before the treatment

Caution should be exercised in patients with pre-disposing factors for rhabdomyolysis. In order to establish a reference baseline value, a CK level should be measured before starting treatment in the following situations:

• Uncontrolled hypothyroidism

medicines.org.uk/emc/produc...

Atorvastatin

Before the treatment

Atorvastatin should be prescribed with caution in patients with pre-disposing factors for rhabdomyolysis. A CK level should be measured before starting statin treatment in the following situations:

- Hypothyroidism

medicines.org.uk/emc/produc...

Rosuvastatin

Before Treatment

Crestor, as with other HMG-CoA reductase inhibitors, should be prescribed with caution in patients with pre-disposing factors for myopathy/rhabdomyolysis. Such factors include:

• hypothyroidism

medicines.org.uk/emc/produc...

[tcpace in reply to helvella]

Yes but how many GPs check out whether the patient is hypothyroid? Even if they do, given that the TSH range is so wide, how would they know whether someone with a TSH of say 3.5 has a perfectly functioning thyroid or an impaired function. They wouldn't because most GPs believe TSH is the gold standard marker for hypothyroidism, which we know isn't the case. So someone with a TSH of 3.5 may well have an impaired thyroid function and be susceptible to statin damage. You have to wonder just how many people on statins are experiencing statin-induced problems through having sub-optimal but in-range TSH that GPs assume means the patient is euthyroid.

[helvella Administrator in reply to tcpace]

Agree with you about the fundamentals of diagnosis.

For Judithdalston it was despite actually being diagnosed.

[Judithdalston in reply to helvella]

I like the ‘uncontrolled hypothyroidism’ bit on Simvastatin...how many of us forum members are told our hypo is ok just cosTSH is in range, but in reality we are uncontrolled as our untested T3 is lingering below or at the bottom of the range and we still have symptoms? Perhaps accounts for why a locum GP didn’t argue with me after 20 years on Simvastatin and years of leg problems on my medical notes when I said I was stopping them!

[DippyDame]

Just goes to show....

I refused to take statins!

I was embarking on T-3 only mid 2018 when a test result of 7.5 returned. From advice here I said to my then GP that it would now start to fall, she wasn't convinced.

Result last week ....cholesterol 4.1.

Without reading posts and responses here I would probably have followed that GP's advice...she knew I was hypo

[humanbean]

My GP tried to get me on statins a few years ago on the recommendation of a cardiologist. I'd been seeing the cardiologist for frequent bouts of chest pain for which no cause could be found.

I told my GP that I wouldn't take statins. It was only after I refused to take them that she admitted that the dose the cardiologist had recommended was a really high one.

I fixed my own chest pain in the end. It was caused by low iron.