FDA Limits Highest Dose of Zocor

http://www.webmd.com/cholesterol-management/news/20110608/fda-zocor-simvastatin-dose-limit?ecd=wnl_nal_chl_060811 ^

[chessplayer]

No New Patients Should Get Highest Dose Due to Muscle Injury Risk

[jerry639]

My doctor prescribed Zocor for me. Two weeks after I started taking it my hair started to fall out.

[muawiyah]

20% is not a small number ~ it's 1 out of 5 patients, on average.

It's kind of high.

If you were selling automobiles and every fifth one that rolled out the door ended up crashing and burning in a ditch within a day or two, you wouldn't shrug that off.

[Kellis91789]

When I was 25 I had a body fat percentage under 15%, and was in the best shape of my life, at 180lbs and 6’ 2” doing 5 hours of weight lifting and cardio a week. My total cholesterol was still about 215. By 45 the job had edged out exercise almost completely and cholesterol had climbed to 260 — with simvastatin it is now 160. Remember that blood serum cholesterol is produced by the body to repair arterial walls, nerve cells, create bile for digestion, etc. It has very little to do with what you eat, except in that a high fat diet causes the body to under produce bile which leaves more cholesterol lying around. This is why adding fiber to your diet is the first thing doctors recommend — it carries bile out of your digestive tract and more cholesterol is used up replacing the lost bile. Statins reduce the amount your body produces, but unfortunately also reduces some enzymes whose reduction results in muscle pain as this article says.

[LadyDoc]

20 percent of people on the high dose is “high” but since most folks are on smaller doses, the actual number is a lot lower.

And if you already had a heart attack, if it means you will live a couple years longer, the risk is worth it.

[PA Engineer]

Since the advent of statin drugs the number of deaths due to heart attack and stroke have not decreased.

Agreed. I have come to the conclusion that taking statins to reduce cholesterol LDL levels is like sending the fire department out to put out the smoke. Cholesterol levels, types and subtypes are markers. The evidence is becoming overwhelming that TAG-HDL ratios offer the greatest predictor of CHD. This ratio is the easiest to change with niacin and a low carb or paleo diet. The diets work and control the ratios independent of weight loss.

[PA Engineer]

About a year ago, my LDL was a little over 100 and my HDL was 58. Since I am in the very highest risk category for heart disease, my doctor immediately prescribed Zocor for me.

What! I would kill for those HDL levels.

[WaterBoard]

I am a big fan of low carb paleo diets myself. Most adults get into trouble health wise when they develop Metabolic Syndrome from their poor lifestyle.

Medication is not going to fix that, it just treats the symptoms.

[muawiyah]

Maybe. What else is that 20% associated with? Do these folks already have reasonably low cholesterol levels perhaps ~

What you have is someone who has just had a heart attack and you are giving him an 80 mg dose when he may have little tolerance to even a 2 mg dose.

Frankly, once you find out your favorite drug is causing intense intramuscular pain and can actually damage the heart muscle, don't you think it's time to totally reconsider what's going on here?

[muawiyah]

I think maybe I wasn't clear enough about that 20%. That's 20% of EVERYBODY, not just folks on a high dose. 20% of the population (broad masses in Comspeak) fail to produce enough of the enzyme that normally metablizes statins to avoid PAIN.

It just sticks around and sticks around and if you keep on taking your low dose you will end up with a really serious OVERDOSE.

[muawiyah]

Going back to ground zero, 20% of the population starts out without a serious enzyme that helps metabolizes statins. The discovery of an additional effect that lowers the amount of yet another enzyme that helps metabolize statins makes things even more serious.

Here's another source of statins you may not have expected ~ milk and other dairy byproducts.

[PA Engineer]

I am a big fan of low carb paleo diets myself. Most adults get into trouble health wise when they develop Metabolic Syndrome from their poor lifestyle.

Medication is not going to fix that, it just treats the symptoms.

Agreed. Soft plaque bursts are the killers. Platelet aggregation and factor 7 cascades are well associated with MetS. A low TAG-HDL ratio of 2 or less dramatically reduces the risk of of both inflammatory soft plaque and the clotting cascades. This has been known since 1992.

I was born with a congenital clotting disorder. I followed medical advice and achieved target lipid levels and therapeutic IR levels. Continued to have plaque bursts and a couple of visits to the cath lab. Triglyceride levels were never controlled. With the understanding of a new Hematologist, I went on a very low carbohydrate diet and attained a TAG-HDL level below 2. The "soft" plaque issue went away. Lab clotting tests also showed "clinical" improvement.

I have almost been problem free except for an Adenovirus. I did not know about the endothelial related inflammation risk from the virus. I do now.

The most important point about very low carb diet is the dramatic lowering of Triglyceride levels and modest increase in HDLs independent of weight loss. I am not a doctor and am only offering my conclusions from medical and familial history, plus many years of investigation. I am also blessed to be married to one of the best Neurologists in the world. Just my 2 cents.

[LadyDoc]

some folks who need it take coenzyme q10 that counteracts this side effect. Mayo Clinic article

[muawiyah]

That's only when the enzyme deficiency is a consequence of taking Zocor. The 20% category is mostly folks who just don't produce that or some other enzymes.

Mine is not resolved with supplements ~ besides, I don't need an anticholesterol drug anyway.

Another deficiency out there involves the lgE type antibody. If you don't make them your lgG type antibodies take on most of the burden of dealing with whatever it was got the lgE types churned up by the T-Cells.

Recently some clever scientists were playing around with their mice and discovered they had a breed who didn't produce lgE antibodies. This stirred them to determine what biological processes might be perturbed/changed/eliminated as a conseuence. Lo and behold they all concerned the liver ~ including some reduction in the ability to metabolize triglycerides.

I anxiously await the rest of their findings ~ and will send a small token of my respect to the local mouse god.