Interesting Article on Statins.

[Sparklingsunshine]

theguardian.com/society/202...

Interesting read.

[helvella]

Maybe I missed it, but I didn't see a single mention of thyroid either in the article or in the linked BHF document.

Despite hypothyroidism being recognized as an issue even in the documentation for statins.

[WhyAmISoTired in reply to helvella]

Could you tell me how they are an issue? My mom has had high cholesterol for decades and periodically she is told she should be on statins. I am worried her cholesterol is related to a t4 conversion problem, even though her tsh is perfect.

[helvella in reply to WhyAmISoTired]

The Patient Information Leaflet for an Atorvastatin product says:

Skeletal muscle effects

Atorvastatin, like other HMG-CoA reductase inhibitors, may in rare occasions affect the skeletal muscle and cause myalgia, myositis, and myopathy that may progress to rhabdomyolysis, a potentially life-threatening condition characterised by markedly elevated creatine kinase (CK) levels (> 10 times ULN), myoglobinaemia and myoglobinuria which may lead to renal failure.

There have been very rare reports of an immune mediated necrotizing myopathy (IMNM) during or after treatment with some statins. IMNM is clinically characterised by persistent proximal muscle weakness and elevated serum creatine kinase, which persist despite discontinuation of statin treatment.

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:

- Renal impairment

- Hypothyroidism

- Personal or familial history of hereditary muscular disorders

- Previous history of muscular toxicity with a statin or fibrate

- Previous history of liver disease and/or where substantial quantities of alcohol are consumed

- In elderly (age > 70 years), the necessity of such measurement should be considered, according to the presence of other predisposing factors for rhabdomyolysis

- Situations where an increase in plasma levels may occur, such as interactions (see section 4.5) and special populations including genetic subpopulations (see section 5.2)

In such situations, the risk of treatment should be considered in relation to possible benefit, and clinical monitoring is recommended.

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

It is usually recommended to ensure hypothyroidism is fully resolved before starting statins - if they are still required.

But certainly, as it says, a CK test should be run.

TSH, I think we almost all agree, is an inadequate approach to determining thyroid hormone status.

[Marz in reply to WhyAmISoTired]

Do they test her Ft3 ?

[WhyAmISoTired in reply to Marz]

No, of course not. I have been trying to get her to get some private tests, but because her TSH is literally perfect, it's hard to convince her there may be something there worth looking into. She thinks the cholesterol is unrelated.

[Marz in reply to WhyAmISoTired]

Oh dear ! Does she realise the TSH is NOT a thyroid hormone ?

Everything in our bodies is connected isn't it ? 🌻

[SlowDragon Administrator in reply to WhyAmISoTired]

Show her this

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.

[userotc]

What I found interesting when I read the article yesterday was that they seemed delighted if the side effect rate is only 10%! I think most drugs are indicated to be ~2% (though I don't believe it). And I think the study was skewed anyhow to reduce the rate to "only" 10%.