Statin users(Lipitor, Vytorin, Crestor..etc) muscle or tendon problems--Doc's also

[Instrument 41]

I've been on Lipitor for about 4 years. Just recently in the hospital for very high blood pressure, 221/201. Never had had high bld psi. Right before I went in I had noticed than my groin/hip area on my left leg had started hurting. Now it's gotten to where I can't cross my left leg over my right, very painful. I can pull my knee up to my chest, left leg, and no pain, its just when I try to cross it. After reading this wonder if this is an issue due to Lipitor?? 47 yrs old, diabetic for 20.

[Z-man]

While on Lipitor, I had the following problems:
- Frozen shoulder (adhesive capsulitis) in both shoulders *
- Plantar fascia in both feet.
- General muscle aches and pains

I requested my doctor switch me off to something else, and since then, I've been on Crestor. Now:
- No aches
- A did stress my gastronimius (calf muscle) a couple of times while playing tennsi, but I attribue that to not warming up sufficiently.

When comparing the two, I believe Crestor has less ill side-effects.
-Z-man.

* I am a diabetic, and for some unknown reason, diabetics develop frozen shoulder more often than the general population.

[madmmac]

Almost forgot about this.....Update: After going to my Dr, he did an exam and did an x-ray. X-ray showed just a small compartment tilt so he was under the opinion that things were not too bad. He wanted to give me a shot of cortizone, but I said that I had never had any luck with it before in my shoulder and in my foot. So he prescribed Voltaren and it did help some with the pain and swelling.

I gave it about a month and the pain, ache and stiffness did not get any better. Called the Dr and asked if I should get an MRI. He kind of joked that I should have taken the shot but that he would schedule up the MRI.

Got the MRI yesterday and the Dr's nurse called with the results today. Small compartmental intrusion(that's good), complex tear of the medial meniscus, partial tear of the lateral meniscus and something else. I'm picking up the report and disk of the MRI to take to my Ortho Surgeon.

Freakin bummed......again.

[m110]

Originally Posted by aap1966

Muscle aches and pains are the commonest specific side effect of the statins, but the overall incidence is low. If it is an issue, it can usually be dealt with by adjusting the dose or type of statin used.
Musculoskeletal injuries (rotator cuff injuries, etc) are not related to the statins. Older people (sorry) tend to be on the statins, and the incidence of musculoskeletal degenerative conditions increase with age. If you don't blame your failing eyesight, greying hair or increasing girth on the statins, don't blame your rotator cuff issues or plantar fasciitis.
Statins can cause life threatening myositis (generalised skeletal muscle inflamation). In 17 years in general and cardiothoracic ICU I've seen one such case. Want to hear how many life threatening reactions to penicillin and acetaminophen (paracetamol) overdoses I've treated in that time?

This is entirely accurate. The benefits of statins, as measured by decreased MI, are not great. Therefore, going off for 4 months are fine to see if the myriad of elder complaints cease. As always, consult the prescribing physician.

[campbellcj]

I've been on simvastatin (Zocor) 40mg for several years now as well. No adverse side-effects that I can tell. I'm due to get my levels and liver enzymes checked again. I lost weight and changed my diet somewhat since I first started the Rx, so I bet my levels are much better 'naturally' although I do have a genetic predisposition to high LDL and doubt I will go off completely. Maybe I can drop the dose.

I took CoQ10 and chondroitin/glucosamine for a while but did not notice any benefit or change whatsoever, so I stopped. I still take Omega3 supplements.

[Rouxzy]

I was on Crestor for about 10 years and always had aches and pains that I associated with getting older. Doctor changed me over to Lipitor with no changes. I read about CoQ10 and gave it a try. All aches and pains are gone and my energy level is up. CoQ10 will not work the same on everyone, it all depends on what you are trying to take care of.

[LakeCleElum]

MadMac: PM me the name of the hosp you'd have the surgery in. My knee doc is in your area....A great guy and I've given him a lot of business. Last week I had surgeries #8 and #9. Replace one knee, rebuild the other.....

Hospital was the worst I'd ever experienced. Almost called an ambulance in the middle of the night to get me out...

I've been taking statin's for years. I always kinda blamed my joint isses on Football, Skiing, motorcycle racing/riding, rolling snowmobiles down the Mtn, falling off a ladder and 23 years of serious jogging.

[artplumber]

Originally Posted by m110

This is entirely accurate. The benefits of statins, as measured by decreased MI, are not great. Therefore, going off for 4 months are fine to see if the myriad of elder complaints cease. As always, consult the prescribing physician.

Really?

Example: Over the 5.4-year median follow-up period, simvastatin ..... The relative risks of main end points in simvastatin-treated patients compared with placebo-treated patients with the metabolic syndrome were as follows: total mortality 0.54 (95% CI 0.36–0.82), coronary mortality 0.39 (0.23–0.65), major CHD event 0.59 (0.45–0.77), and any atherosclerotic event 0.69 (0.56–0.84). The corresponding RRs in patients without the metabolic syndrome were 0.72 (0.56–0.91), 0.62 (0.45–0.84), 0.71 (0.61–0.82), and 0.76 (0.68–0.85). (This was the first abstract up for the 4S study, the last study for secondary prevention vs placebo)

So (approx numbers), all cause mortality cut in half, death due to heart attack down by 60%, any major event (includes stroke) down by 40%. Follow up period less than 5.5 years.

Maybe going off for a few months is not a big deal, but the belief that the cardiovascular benefits of statin use are inconsequential simply does not fit the data.

[m110]

Originally Posted by artplumber

Really?

Example: Over the 5.4-year median follow-up period, simvastatin ..... The relative risks of main end points in simvastatin-treated patients compared with placebo-treated patients with the metabolic syndrome were as follows: total mortality 0.54 (95% CI 0.36–0.82), coronary mortality 0.39 (0.23–0.65), major CHD event 0.59 (0.45–0.77), and any atherosclerotic event 0.69 (0.56–0.84). The corresponding RRs in patients without the metabolic syndrome were 0.72 (0.56–0.91), 0.62 (0.45–0.84), 0.71 (0.61–0.82), and 0.76 (0.68–0.85). (This was the first abstract up for the 4S study, the last study for secondary prevention vs placebo)

So (approx numbers), all cause mortality cut in half, death due to heart attack down by 60%, any major event (includes stroke) down by 40%. Follow up period less than 5.5 years.

Maybe going off for a few months is not a big deal, but the belief that the cardiovascular benefits of statin use are inconsequential simply does not fit the data.

I suppose it depends on what data you prefer and how much of a drop RR you think is significant. I would argue stopping for a few months in the setting of no previous CVD endpoint and a change in one's musculoskeletal complaints won't have a significant impact.

From the Cochrane review (inherently limited to design) but 34,272 patients:

Statins for the primary prevention of cardiovascular disease

Taylor F, Ward K, Moore THM, Burke M, Davey Smith G, Casas J-P, Ebrahim S

Main results
Fourteen randomised control trials (16 trial arms; 34,272 participants) were included. Eleven trials recruited patients with specific conditions (raised lipids, diabetes, hypertension, microalbuminuria). All-cause mortality was reduced by statins (RR 0.84, 95% CI 0.73 to 0.96) as was combined fatal and non-fatal CVD endpoints (RR 0.70, 95% CI 0.61 to 0.79). Benefits were also seen in the reduction of revascularisation rates (RR 0.66, 95% CI 0.53 to 0.83). Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects. There was no clear evidence of any significant harm caused by statin prescription or of effects on patient quality of life.

Statins for the primary prevention of cardiovascular disease

...several reviews of the effects of statins have been published highlighting their benefits particularly in people with a past history of CVD. However for people without a past history of CVD (primary prevention), the evidence is less clear. ...

can be found here:
Statins for the primary prevention of cardiovascular disease

[artplumber]

Originally Posted by m110

I suppose it depends on what data you prefer and how much of a drop RR you think is significant. I would argue stopping for a few months in the setting of no previous CVD endpoint and a change in one's musculoskeletal complaints won't have a significant impact.


Main results
Fourteen randomised control trials (16 trial arms; 34,272 participants) were included. Eleven trials recruited patients with specific conditions (raised lipids, diabetes, hypertension, microalbuminuria). All-cause mortality was reduced by statins (RR 0.84, 95% CI 0.73 to 0.96) as was combined fatal and non-fatal CVD endpoints (RR 0.70, 95% CI 0.61 to 0.79). Benefits were also seen in the reduction of revascularisation rates (RR 0.66, 95% CI 0.53 to 0.83). Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects.

So, your assumption is that all the use described on this thread is solely for primary prevention? Somewhat of a reach given that many of the members of this forum have experienced CV events. Some of them are diabetics or metabolic syndrome (the study I quoted). At the very least, appropriate service to the community would be to advise the individuals to discuss this in detail with their physician, rather than make the pronouncement that these risk reductions are minor.

As to the meta analysis you quote, someplace between a 15% reduction in all cause mortality and 30% reduction in specifically CV mortality is not inconsequential when discussing large populations at risk.

We may agree that temporary alteration of therapy may be warranted, without undue risk for a short period (and 4 months is longer than is necessary), but to suggest these risk reductions are not significant (in more than a statistical manner) is frankly irresponsible.

While we're quoting studies, it is instructive to note that JUPITER suggests even those with "normal" LDL levels and elevated hsCRP levels see (at least statistically) lower CV event rates on drug, which reinforces the robustness of the data in elevated lipid patients. For multiple risk patients (without established disease) I would not say the data is not clear, merely that the reduction is less. (Thanks I am quite aware of the data, as it is within the purview of my speciatly).

[m110]

I do not assume that all the use of statins on this forum is for primary prevention--I have no idea of the health of the forum's members nor does anyone.

You are certainly more in touch with the data than I am.

For a population, let's say anyone reading this forum, I think it's worthwhile to consider a drug holiday to see if they feel better, of course after consulting their physician. Those who are at higher risk will hopefully be able to have that guidance from their physician. Raising the issue for a dialogue I believe is worthwhile, not irresponsible. The increased relative risk of a several month holiday for the low risk population (in the setting of long term 15-30% RR reduction) would appear very low although I am unaware of any data for brief holidays from statins.

At no time did I suggest stopping a prescribed medication without consultation.

As always, most advice is worth what you payed for it.

[madmmac]

Update: Saw my Ortho Surgeon and he said that an arthroscopic clean up should do the trick.

I asked what the difference was between my 2 knees since they were both complex meniscus tears and he said, "About 100 years."

Moral of the story, if you have chronic pain, you should probably get it checked out before it is too late.

Yes, I am a guy and that is part of my problem.