Did statins mess up your conditioning?

[TexasGortex]

Yearly checkup shows I have high cholesterol. Didn't see that coming. I'm 31, hit the gym several times a week, am super active, eat well, don't smoke or drink, not carrying much extra weight (6'4" 180lbs), blood pressure is great, otherwise perfectly healthy.

I'm taking a crack at diet first, but my hopes for success aren't that high. My diet is already pretty locked down. I'll improve, but we are talking polishing edges not drastic changes.

My initial research on statins shows things like muscle fatigue, muscle wasting, getting mega sore from normal workouts, conditioning going to total shit, etc. It's apparently more frequent in fit people. Anyone on statins? Experiences? Side effects?

[drjoyous]

Don't even trust the cardiologist. For one thing, high because of what? Because of HDL (good!). LDL? Which one? Fluffy big LDL is not bad. Small LDL is the "bad" one (although there's limited evidence...). So unless they looked closer, don't listen to them. Google paleo or primal diet to see if your diet really is that clean, but otherwise, statins are really bad for you in so many f-u ways.

[prsboogie]

(1) 30 year olds have heart attacks (2) yes it is common for people with greater muscle mass to have issues with muscle pain taking stations. How high is your total and your LDL that they want to start you on meds?

[TexasGortex]

Why did I go? Short answer is a nagging wife. Longer answer is my previous doctor retired, I hadn't seen him in nearly a decade anyway, and part of getting a new doctor was a once over. Having a primary care doc and doing some preventative maintenance probably beats urgent cares and waiting for the shit to hit the fan.

Moderate family history. My dad had a heart attack in his 50s (20 years ago been fine since, but on BP meds, statins, etc). Brother has high BP. My diet, exercise and weight are not even in the same ballpark as theirs.

I don't eat fully paleo, but I am quite familiar with it. My wife is an Olympic lifter/gym rat and a medical professional. We got real science and bro science covered. I can set up a more formal consult with a nutritionist or dietician to help. We are basically 1 step short of being totally annoying pricks about diet as is.

TC 242
HDL 58
TRG 93
LDL 165
non-HDL 183
TC/HDL 4.1
GLU 92

[prsboogie]

Unfortunately you are most likely just producing the cholesterol on your own. Doubt your diet is contributing to it.

[powtario]

Did you get a good feel from the Doc or not? If not maybe shop around a bit.

You are 31, I would shy away for taking anything for now and watch it for a few years and see what happens with the #'s. Red meat vs lean meat might impact your CHL as well, but nutritional science is nearly impossible to synthesize well.

The biggest concern I have with statins is the risk of Type 2 Diabetes rather than the myopathy.

And I checked your ASCVD risk with a BP of 120 (apps are free, supposed to only be for >40 though) and your risk is almost nil, and this is for new guidelines that a lot of ppl thought/think are way too agro.

[TexasGortex]

I'm with you on that. I'm going to take it serious and do what I can with diet, I just don't expect drastic results. The end result has a good chance of a choice between having high cholesterol or taking statins. I want to make an educated decision. We all do similar activities here, figured I could get some valuable first hand input.

[TexasGortex]

Did you get a good feel from the Doc or not? If not maybe shop around a bit.

You are 31, I would shy away for taking anything for now and watch it for a few years and see what happens with the #'s. Red meat vs lean meat might impact your CHL as well, but nutritional science is nearly impossible to synthesize well.

The biggest concern I have with statins is the risk of Type 2 Diabetes rather than the myopathy.

And I checked your ASCVD risk with a BP of 120 (apps are free, supposed to only be for >40 though) and your risk is almost nil, and this is for new guidelines that a lot of ppl thought/think are way too agro.

I got a good feel from him overall. In fairness to him, he didn't suggest starting them today. He suggested starting with diet, keeping an eye on it, and considering statins if things didn't improve. He was just less optimistic after hearing about my diet. IE I don't have fried foods to cut out.

Not that it really matters either, but he was referred by my wife's trusted coworkers/fellow doctors at the hospital. Beats picking a random name out of a phonebook.

Avoiding diabetes would be a large priority. I don't beleive I am at high risk thankfully. I get how important it would be to avoid though, it can really mess you up.

Thanks for pointing out that app. I'll keep that in mind when as I assess risk.

[TexasGortex]

My BP is typically a few points below 120/80. I could probably lower it by dropping coffee, but fuck that. I'm pretty comfortable with black coffee as my vice.

I'm not worried about having a heart attack tomorrow. Or even 10 years from now. Id imagine my quality of life could be affected by how I spend the next several decades. I'd rather be skiing at 60 than trying to figure out how to avoid heart attack #2.

[grskier]

I cut red meat down to 1 x month for 2.5 months and dropped my LDL 38 points... Give diet a try... if not, then know that some sort of medication may be in your future... But I wouldn't just go on it at your age.

[Dantheman]

TC 242
HDL 58
TRG 93
LDL 165
non-HDL 183
TC/HDL 4.1
GLU 92

TC/HDL and TG/HDL are far, far stronger predictors of actual CVD risk than TC alone. Per the American Heart Association, ideal TC/HDL is <5 and you are well below that. The authors of this study http://circ.ahajournals.org/content/96/8/2520.long found TG/HDL was stronger predictor than TC/HDL and that the highest quartile of TG/HDL (mean 7.5) carried a 16x greater risk of MI than the lowest quartile (mean 1.4). Your ratio is 1.6, which is within the standard deviation for the lowest quartile.

Viewed in totality, there's nothing to be concerned about in those results. Sure, TC is a bit high but that's a weak predictor. And it's merely that, a (very imperfect) predictor, and a huge percentage of people who have heart attacks have TC <200. If you're really concerned, you can get a heart scan done which will empirically measure your level of atherosclerosis (i.e., what actually matters). I've read several posts from people here who had high-ish TC, doctors were pushing statins, did a heart scan, results came back squeaky clean, no more talk of statins.

Also, as others have noted, there is little if any evidence that statins prevent heart attacks when given to people who have not already had a heart attack. Even for people who have had a heart attack, the NNT is around 100. In other words, you have to give 100 people statins to prevent 1 heart attack (and 10 of those people will get diabetes).

[TexasGortex]

Thank you everyone. I asked here for help because I thought active outdoorsy types would have a more relevant perspective to my situation. I appreciate it.

1. Diet
2. Re test
3. Scan heart if bad
4. Revisit choice with the improved data
5. In all likelihood stay off statins.

[RCC55125]

I'm 67 and was on statins for over 15 years. I had risk factors on both sides of my family. Yes they dropped my cholesterol to "acceptable" levels. However, after that long I was experiencing muscle fatigue and joint pain. After my doc changed brands of statins 3 times with little affect, I finally did a little research and changed my diet to where it sounds like you are now. It helped. I finally decided to quit the statins because the joint pain was pretty bad. My doc was not happy.
I've increased my gym time and reduced carbs a lot. Pain and fatigue is greatly reduced. Cholesterol is OK.
When I was 57 I had an EBT heart scan. It showed zero blockage! I remained on statins for 8 more years.
It's anecdotal but I think one of the biggest contributors to my current health is reduced stress because I'm now retired.
At your age a heart scan will tell you where you are and give you a base line. If it shows no blockage don't go on statins. Then get a heart scan every 5 years. The price of these tests keep coming down which is a good thing because insurance won't pay for it. At least then you'll know where you are and will be better able to make a decision on statins.

[TexasGortex]

6. Retire immediately

[stuckathuntermtn]

Unfortunately, high cholesterol is a dominant trait. I will probably have to deal with it at some point (only a year younger than you).
Because of family history, I had it checked, and I don't think it was over 200 last time.
Also, isn't HDL that's the important one? Enlighten me.

[TexasGortex]

I bring my car in for oil changes and tire rotations all the time!

I get your point though, and it's noted. I'm gathering information and trying free things (diet) first.

[Dantheman]

expose him to CT radiation unnecessarily

I'm glad you brought this up, I meant to and then forgot. One CT is equivalent to at least several hundred X-rays. It's a fairly significant dose of radiation and you don't want to get one without a damn good reason.

[powtario]

Avoiding diabetes would be a large priority. I don't beleive I am at high risk thankfully. I get how important it would be to avoid though, it can really mess you up.
.

I'd rather have HIV than Type 2 Diabetes. I'm convinced that high fructose corn syrup was actually invented by Satan, but that's also me talking out of my ass.

Got a good feel from the Doc, great.

Risk of cancer due to a CT scan is somewhere in the neighborhood of 1/2000. It sounds like not much but it is.

The whole 'death panels' bullshit is fundamentally flawed because those assholes don't actually realize that diagnosis and treatment carries real risk of harm and death.

For random, unindicated PSA screening there is one life saved per thousand, lovely, after all just about everyone knows of someone who had an awful painful death because of it. But of that thousand people who get tested, during the process 3 people die from bleeding into their brain or blood clots caused by the tests and treatment. Plus you could be shooting blanks the rest of your life and that's not fun at all.

Switzerland decided last year to not do biannual mammograms for similar reasons.

Rant over.

[ByYoAw]

Risk of cancer due to a CT scan is somewhere in the neighborhood of 1/2000. It sounds like not much but it is.

The problem is that the cancer risk assessment in regard to radiation is dispensed by the BUSINESS of orthodox medicine (the American Cancer Society also belong to that cartel). The actual facts show a different story.


For like a half a century it had been known that low levels of xrays cause breast cancer, and a some years later it was found that the lowest dose of ionizing radiation can cause cancer and that medical xrays are the major cause of cancer, especially breast cancer (read: The Mammogram Myth by Rolf Hefti - more at TheMammogramMyth dot com). Because this knowledge inculpates the enormous profits of big medicine they, ever since, have been denying, minimizing, downplaying, and carefully hiding these profit-threatening facts.


Xrays have killed millions of people and the "advanced" medical business keeps killing millions more. Statins too have been found to increase mortality. Of course, that business keeps telling the public it does more good with these treatments but when you actually look you'll see these are mostly other false and misleading claims instead of the actual facts ....

[powtario]

I hope you don't fly anywhere.

[old goat]

Here's my advice about whether or not to take statins--don't decide based on the opinions in an internet forum.

I started taking them at 50, which was the first time I saw a doc who wasn't sewing me up (and I'm a doc). But my dad had his first heart attack at 40, die of his third at 51 and my younger brother had his only heart attack at 35 (but doing ok since). So I clearly have a much higher than average risk. I will answer your original question--no, statins have not adversely affected my ability to work out, hike, and ski or caused me any muscle problems. When the FDA recommended limiting the dose of simvastatin my doc cut mine from 80 to 40 and I noticed no improvement in my muscle pain, which I consider to be normal for my edge and physical condition. (I've had to cut back on exercise this year due to serious spine problems, which are a bitch, but as long as I can ski. . . ) As far as the heart scan, a strong vote against it.