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  1. #1
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    Statin drugs?

    Are any of you on one and if so, how does it affect your training and/or racing? How about holistic alternatives? Some background: I'm nearing 60 and I'm a very fit XC racer, even better than 2015 when I was in best racing form ever but got sidelined with a shoulder injury. My BP is great, HDL is a tad over its range, LDL is at top of its range but the ratio of good to bad is excellent, triglycerides are good, yet doctor is suggesting I get on a statin. I'm thinking it's Pharma-driven. Thanks in advance.

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    Quote Originally Posted by fongster View Post
    Are any of you on one and if so, how does it affect your training and/or racing? How about holistic alternatives? Some background: I'm nearing 60 and I'm a very fit XC racer, even better than 2015 when I was in best racing form ever but got sidelined with a shoulder injury. My BP is great, HDL is a tad over its range, LDL is at top of its range but the ratio of good to bad is excellent, triglycerides are good, yet doctor is suggesting I get on a statin. I'm thinking it's Pharma-driven. Thanks in advance.
    Iím 55, am a very fit endurance XC racer (marathon+, 12/24-hour solo), and have been on Simvastatin 20mg for about 10 years now (along with CoQ10) with no ill effects that Iíve noticed. And I train hard (ride 5x per week) and lift 3x per week.

    I get my blood tested 2x per year, and my cholesterol numbers are OK, but towards the upper part of each range (with the meds), so my doc is keeping me on it. Thatís not pharma-driven, as he took me off Lisinopril for high blood pressure a year ago, after 9 years on it, because my BP numbers were low-ish (and theyíve stayed low). So his preference is to get off meds.

    Hope that helps. Itís a non-issue as far as Iím concerned.


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    How did your doctor sample your blood? Finger stick sampling and testing in the provider's office is far less accurate than an actual blood draw at a lab.
    There are potential adverse events associated with statins that may be undesirable to active persons, or anyone for that matter. Rhabdomyolysis being the most concerning.
    Have you discussed any other therapies with your doctor? Omega 3 Fish Oil with an adequate amount of EPA and DHA may be enough to bring your levels back into an acceptable range. Niacin is sometimes used in combination with Omega 3.
    There are options that could/should be evaluated before jumping right into life-long statin treatment, especially for mild cases such as yours.
    This should be discussed with your provider before taking any action on your own.

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    Whatís the benefit/reasoning behind CoQ10 when taking statinís. Iím interested as I take Lipitor. Thanks

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    Quote Originally Posted by Unbrockenchain View Post
    Whatís the benefit/reasoning behind CoQ10 when taking statinís. Iím interested as I take Lipitor. Thanks
    https://www.mayoclinic.org/diseases-...0/faq-20058176

    https://en.wikipedia.org/wiki/HMG-Co...te_pathway.svg

    When you inhibit HMG CoA Reductase, you block everything downstream, which includes not only cholesterol biosynthesis but also ubiquinone biosynthesis (CoQ10).
    In theory the CoQ10 supplementation makes sense, but it sounds as if the clinical experience is mixed.

    @fongster, if your HDL/LDL ratio is good, and you're a trained athlete, then I would suspect that the simple-minded "your LDL is too high" reaction could be wrong. I would do a lot of research before starting on a statin.
    (note: I am not a health professional)

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    Statins flat work. I am 56 and have been on one for 20+ years. Family has a strong history of heart attacks, so it especially makes sense for me.

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    Figures 3-5 are the most relevant. Statins work to reduce cardiovascular incidences. But on a population and not at the individual level - this is even true in those with familial hypercholesterolemia.

    Statins do have other benefits but may be equal to healthy diet and exercise.

    PIIS0140673618319421-2.pdf
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    In layman's terms, CQ10 benefits the cell components known as mitochondria, which produce ATP, the energy supply for the cells. The more active the cell, (like a muscle cell when the muscle is in use) the more the mitochondria work.Cells contain these organelles in a concentration directly associate with how much energy the cell puts out. So, which muscles in the body have the most mitts'? The heart muscles of course, as long as our heart is beating.
    When the heart does not beat as strongly due to fewer working mitt's in its' muscle, we get cardiac problems.

    Statins work, but a side effect of them working is that in many cases the mito's in the heart muscle cells are impaired in their production of ATP. So, you can guess the effect on the heart.
    That's why supplementation of CQ10 (also known as ubiquinol, the best , or ubiquinone, a cheaper form,) is a good idea when starting a statin regimen.

    One of my former students is a cardiologist, a very popular one in the San Diego area. He has most if not all of his patients taking CQ10.

    Some people also find other benefits from taking statins, and some people also feel multiple benefits from taking CQ10. But all statin- takers should supplement with CQ10.
    I hope that makes sense in everyday-speak!

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    Great info Radium. From your knowledge are all brands the same? Iím skeptical on some of these supplement companies. Thanks for explanation

  10. #10
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    Quote Originally Posted by Radium View Post
    In layman's terms, CQ10 benefits the cell components known as mitochondria, which produce ATP, the energy supply for the cells. The more active the cell, (like a muscle cell when the muscle is in use) the more the mitochondria work.Cells contain these organelles in a concentration directly associate with how much energy the cell puts out. So, which muscles in the body have the most mitts'? The heart muscles of course, as long as our heart is beating.
    When the heart does not beat as strongly due to fewer working mitt's in its' muscle, we get cardiac problems.

    Statins work, but a side effect of them working is that in many cases the mito's in the heart muscle cells are impaired in their production of ATP. So, you can guess the effect on the heart.
    That's why supplementation of CQ10 (also known as ubiquinol, the best , or ubiquinone, a cheaper form,) is a good idea when starting a statin regimen.

    One of my former students is a cardiologist, a very popular one in the San Diego area. He has most if not all of his patients taking CQ10.

    Some people also find other benefits from taking statins, and some people also feel multiple benefits from taking CQ10. But all statin- takers should supplement with CQ10.
    I hope that makes sense in everyday-speak!
    Great, informative post, Radium. Thank you!

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    Quote Originally Posted by Radium View Post
    In layman's terms, CQ10 benefits the cell components known as mitochondria, which produce ATP, the energy supply for the cells. The more active the cell, (like a muscle cell when the muscle is in use) the more the mitochondria work.Cells contain these organelles in a concentration directly associate with how much energy the cell puts out. So, which muscles in the body have the most mitts'? The heart muscles of course, as long as our heart is beating.
    When the heart does not beat as strongly due to fewer working mitt's in its' muscle, we get cardiac problems.

    Statins work, but a side effect of them working is that in many cases the mito's in the heart muscle cells are impaired in their production of ATP. So, you can guess the effect on the heart.
    That's why supplementation of CQ10 (also known as ubiquinol, the best , or ubiquinone, a cheaper form,) is a good idea when starting a statin regimen.

    One of my former students is a cardiologist, a very popular one in the San Diego area. He has most if not all of his patients taking CQ10.

    Some people also find other benefits from taking statins, and some people also feel multiple benefits from taking CQ10. But all statin- takers should supplement with CQ10.

    I hope that makes sense in everyday-speak!
    The data with CQ10 is mixed. Most docs recommend it as it appears to have no side effects but it may not actually be doing anything. Lots of people get myotoxicity with statins even when on CQ10.
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    Something that is not widely known is that there are actually two types of blockages in coronary arteries, though cholesterol is a significant component of each. The first type is a hard calcified plaque that shows up on coronary calcium scoring. These calcified lesions cause the arterial walls to lose elasticity and contribute to elevated blood pressure. Think of these as hard water deposits inside a pipe that gradually decrease the inner diameter and eventually impair flow. These lesions can grow to the point where the vessel becomes totally occluded and are the type of blockages that are generally found on stress tests (if they're large enough) and often cause anginal symptoms.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712374/

    The other type of blockage is referred to as a vulnerable, liquid, lipid rich plaque. In these, the center of the lesion never really solidifies and is covered by a fibrous cap. Think of these as a bit like having a pimple or zit inside the arterial wall. If the fibrous cap ruptures, all the crap inside is ejected into the coronary artery and the body's natural response is to form a clot (thrombus) at the site of the plaque rupture. A vessel can go from being minimally occluded (<50%), to completely blocked in minutes. Plaque rupture and thrombus formation is the major cause of most heart attacks.

    https://www.ahajournals.org/doi/full...AHA.114.302721

    What statins do, besides lowering serum cholesterol and preventing the formation of both types of lesions, is strengthen the fibrous cap on the vulnerable, liquid, lipid rich plaques making them less likely to rupture.

    https://bmcmedicine.biomedcentral.co...916-015-0459-4

    I've got a strong family history for premature coronary artery disease having lost my mom to a massive heart attack when she was just 54. Because of that, I have 2 to 3 times the risk for CAD right off the bat. My cholesterol numbers are OK - high 30's for the HDL (would prefer it over 45) and LDL under a 100. As someone else said, my low HDL is concerning, but my HDL/LDL ratio is pretty favorable. Still, I've been on low dose (10 mg) atorvastatin for 8 or 9 years solely for the effect it has on stabilizing the most dangerous plaques.

    If anyone is interested, you can actually use an online risk calculator from the American College of Cardiology and the American Heart Association to determine your 10 year risk of heart attack or stroke. We don't really treat to "goal" cholesterol numbers anymore, so this tool is what your physician should be using to determine if you would benefit from being on statin therapy, and at what dose.

    ACC/AHA ASCVD Risk Calculator

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    I take 20mg Crestor after having a heart attack at 41. Picked up a stint in the process. Not a big fan of the statins for several personal reasons. I bleed easier, skin just literally went from being tuff to old and easily torn in what felt like overnight. Skin infection now are a thing and I can bleed through the skin from simple carting a heavy bag on the shoulder. Bruise easier too. Also I get a bit of odd physical vibe from it. Canít explain it.

    If you can control it via diet, by all means do so. Iím working towards reducing this mg to something less damning.

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    Oh yeah, I'd heard that they can affect your mood. Bring up the symptoms with your physician and see about getting a different statin to see if you respond differently.

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    My Doctor told me to never take Statins.... Eat right and control your weight and you'll be better off. Cholesterol kills very few people. Don't listen to big pharma.....

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    Quote Originally Posted by Phillbo View Post
    My Doctor told me to never take Statins.... Eat right and control your weight and you'll be better off. Cholesterol kills very few people. Don't listen to big pharma.....
    Personally, I'd have a problem with almost anyone who makes an absolute pronouncement. Most any expert in a field, when asked a question, will respond with, "It depends," because they know enough that what they're dealing with isn't just black or white.

    I might not disagree with what your doctor is telling you to do, but I'd still be very skeptical about anything else they're similarly 100% confident about.

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    Statins are cheap, mostly safe and effective. A relatively small percentage of people donít tolerate them, and if youíre not monitoring your blood you can get serious complications, as a few posters have observed. I am one of those people, and I went into rabdo. For everyone else, statins are extremely effective. If youíre trying to lower your too high lab numbers by diet and excercise alone be prepared for a radical change in diet and lifestyle. I had to quit all dairy, only eat one serving of red meat a month, quit wheat and most sugar, and lose 20 pounds to get my numbers back to normal. I donít know how something so cheap can be a ďbig pharmacyĒ thing. A lot of doctors who donít even have high lab numbers take statins, as a shield against plaque that causes Alzheimerís.

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    ďPharma drivenĒ

    Do you think your provider gets a kickback for prescribing a generic statin?

    The reason your provider is suggesting a statin is because you have already done everything you can do lifestyle wise by being fit and eating right.

    If I were you, Iíd think less about how the statin will affect your performance and more about how a cardiac event will affect your life.

    Get a second opinion, see a cardiologist and get a full work up with stress test.

    There ainít nothing holistic thatís gonna drop that LDL as much as it needs to drop.

    Quote Originally Posted by fongster View Post
    Are any of you on one and if so, how does it affect your training and/or racing? How about holistic alternatives? Some background: I'm nearing 60 and I'm a very fit XC racer, even better than 2015 when I was in best racing form ever but got sidelined with a shoulder injury. My BP is great, HDL is a tad over its range, LDL is at top of its range but the ratio of good to bad is excellent, triglycerides are good, yet doctor is suggesting I get on a statin. I'm thinking it's Pharma-driven. Thanks in advance.
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    I went on a very low dose of Lipitor back in the early 2000s. It worked, at least as far as reducing the numbers. That was the good part, well maybe.

    After about ten years things weren't so swell.

    First problem: High blood sugar. My family has a strong history of diabetes. It comes on gradually in the late 40s to late 50s, even in those who have a good lifestyle. Due to this I have checked my blood sugar regularly since my mid 30s. Fasting glucose levels on good quality glucometers were in the 70-95 range when I started taking the Lipitor. After being on it about 10 years I noticed a troubling trend of my sugars heading towards the 100 range. Then I started to see a lot >100. Not good.

    Second problem: My family also seems to have a genetic predisposition to depression. It's never really held me back because I don't let it. Until it started to become very persistent and deep seated.

    Third problem: Concentration. I was finding it very difficult to concentrate like I used to. While I've always had a touch of ADD, this was far worse.

    Fourth problem: Falling athletic performance. That seemed to hit me rather fast and I just accepted it. At the time I was mostly trail running and had to start walking a lot on hills. Just age, right??? Well maybe not.

    I started doing some studying and found that Statins are well known to cause, or hasten, the onset of diabetes. Also, because our cells all have cholesterol and need cholesterol to function it has been implicated in things such as depression and cognitive decline.

    I went off the Statins without telling my Doctor. It's my body, not his. Within about 3 months my blood sugars were in the 70-85 range. My depression was starting to lift. That took about 6+ months to get back to a tolerable state. My concentration was a lot better.

    The thing that I had not anticipated was the gains that I made in my running. I was about 51-52 at the time and after about 6 months I found that I was running up the hills again. Before on the Lipitor my problem wasn't the cardio side but rather it was as if the legs just were dead and didn't have the power. I gained a lot of strength in my legs.

    I'm a Paramedic. Since I went off the Lipitor I have made it a point to delve into the history of my patients who are on Statins and also have known coronary artery disease. Guess what????? Almost all of them were on Statins BEFORE, their first cardiac event!!!!!!!

    There are two numbers that I look at when I take a medication. The Number Needed to Treat (NNT) and the Number Needed to Harm (NNH). Depending on the source Statins have a NNT in the 250-300 range. Some have placed it much higher. This means that only 1 person out of 250 will avoid a cardiac event by taking Statins. I've seen the NNH all over the place because it all depends on how the studies define "harm". I have read many comments from Cardiologists stating that about 20% of people will have life altering side effects from taking Statins. Muscle breakdown/myalgia is the most common. Liver problems are another one as is the diabetes component.

    There is a huge debate in the medical field over Statins. Whenever data is presented that shows problems with them, the presenters of such information are basically shouted down. But then it's that way with all medications. Sadly the only thing most prescribing providers are taught these days is now to write a prescription for another pill.


    That's my experience and opinion, Do with it what you wish.

  20. #20
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    Quote Originally Posted by Phillbo View Post
    My Doctor told me to never take Statins.... Eat right and control your weight and you'll be better off. Cholesterol kills very few people. Don't listen to big pharma.....
    "big pharma" is not making significant $ off statins. The patents have long run out. They are CHEAP.

    Eating right + exercise should control weight and certainly is beneficial, but for those of us with high cholesterol and a strong family history of heart disease, a statin, CoQ10 and baby aspirin cannot hurt.

    BTW, my dad's doctor told him at 54 his chest pains were heartburn. 5 days later he was dead. Sometimes doctors are too confident in their "intelligence".

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    Quote Originally Posted by Daydreamer View Post
    I went on a very low dose of Lipitor back in the early 2000s. It worked, at least as far as reducing the numbers. That was the good part, well maybe.

    After about ten years things weren't so swell.

    First problem: High blood sugar. My family has a strong history of diabetes. It comes on gradually in the late 40s to late 50s, even in those who have a good lifestyle. Due to this I have checked my blood sugar regularly since my mid 30s. Fasting glucose levels on good quality glucometers were in the 70-95 range when I started taking the Lipitor. After being on it about 10 years I noticed a troubling trend of my sugars heading towards the 100 range. Then I started to see a lot >100. Not good.

    Second problem: My family also seems to have a genetic predisposition to depression. It's never really held me back because I don't let it. Until it started to become very persistent and deep seated.

    Third problem: Concentration. I was finding it very difficult to concentrate like I used to. While I've always had a touch of ADD, this was far worse.

    Fourth problem: Falling athletic performance. That seemed to hit me rather fast and I just accepted it. At the time I was mostly trail running and had to start walking a lot on hills. Just age, right??? Well maybe not.

    I started doing some studying and found that Statins are well known to cause, or hasten, the onset of diabetes. Also, because our cells all have cholesterol and need cholesterol to function it has been implicated in things such as depression and cognitive decline.

    I went off the Statins without telling my Doctor. It's my body, not his. Within about 3 months my blood sugars were in the 70-85 range. My depression was starting to lift. That took about 6+ months to get back to a tolerable state. My concentration was a lot better.

    The thing that I had not anticipated was the gains that I made in my running. I was about 51-52 at the time and after about 6 months I found that I was running up the hills again. Before on the Lipitor my problem wasn't the cardio side but rather it was as if the legs just were dead and didn't have the power. I gained a lot of strength in my legs.

    I'm a Paramedic. Since I went off the Lipitor I have made it a point to delve into the history of my patients who are on Statins and also have known coronary artery disease. Guess what????? Almost all of them were on Statins BEFORE, their first cardiac event!!!!!!!

    There are two numbers that I look at when I take a medication. The Number Needed to Treat (NNT) and the Number Needed to Harm (NNH). Depending on the source Statins have a NNT in the 250-300 range. Some have placed it much higher. This means that only 1 person out of 250 will avoid a cardiac event by taking Statins. I've seen the NNH all over the place because it all depends on how the studies define "harm". I have read many comments from Cardiologists stating that about 20% of people will have life altering side effects from taking Statins. Muscle breakdown/myalgia is the most common. Liver problems are another one as is the diabetes component.

    There is a huge debate in the medical field over Statins. Whenever data is presented that shows problems with them, the presenters of such information are basically shouted down. But then it's that way with all medications. Sadly the only thing most prescribing providers are taught these days is now to write a prescription for another pill.


    That's my experience and opinion, Do with it what you wish.
    Sounds like all the things you attributed to being on statins for 10 years are things that happen with aging. 😉. Except for your ADD which was already there. Or you family history of diabetes. Which was already there. Just sayin .... 🤘

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    Quote Originally Posted by Daydreamer View Post
    ... Sadly the only thing most prescribing providers are taught these days is now to write a prescription for another pill.
    Fortunately, the majority of my patients don't think they know more than me.

    Can you imagine the conversations that providers have with their clients?

    Typical appt: We talk about what's working and what's not working. I make a suggestion, explaining why I think my suggestion is valid, then I ask the client what they think. The client is free to ask questions, refute my ideas, they can even seek another opinion.

    Quite honestly, there are so many people that need health care, if one chooses to take their own path, their space in line will be filled immediately.

    Going to a medical provider is sorta like bringing your car to a mechanic, the mechanic will fix your car and they'll offer helpful advice as to how to prevent future problems. When you bring your car back to be fixed again, the mechanic will fix your car and offer helpful advice as to how to prevent future problems ....

    Most of us are on a salary, some of us get some additional wages from seeing more clients, but we don't get any incentives for the number or types of medications we prescribe. If anything, prescribing less and treating less is the goal because it make our job easier.

    Big pharma doesn't exist in a medical office. Big pharma exists in politics, TV/social media, and in your head.
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    Quote Originally Posted by BlueCheesehead View Post
    "big pharma" is not making significant $ off statins. The patents have long run out. They are CHEAP.

    Eating right + exercise should control weight and certainly is beneficial, but for those of us with high cholesterol and a strong family history of heart disease, a statin, CoQ10 and baby aspirin cannot hurt.

    BTW, my dad's doctor told him at 54 his chest pains were heartburn. 5 days later he was dead. Sometimes doctors are too confident in their "intelligence".
    That's a real shame about your father. If hindsight were 20/20, he'd have been sent off for a cardiac assessment, but at 54 it's not something that comes to mind; hell, I'm 55 and I'd never think of a heart attack if I had something that felt like heartburn.

    I know it's probably unnecessary and wasteful for most folks, but if I had any family history of heart disease, I'd get a baseline full cardiac work up with stress test, imaging, etc...

    I had a full cardiac work up done in my early forties due to "exercise induced fatigue", turned out that I was just working out too hard in difficulty conditions (heat and humidity).

    Whenever these conversations come up, I'm reminded of Travis Bickle, he died while riding, had a heart attack, 60 yo, makes me wonder if he knew about his heart condition and was ignoring it, if there was something he could have done to prevent it or treat it. Sad.
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    Quote Originally Posted by BlueCheesehead View Post
    "big pharma" is not making significant $ off statins. The patents have long run out. They are CHEAP.

    Eating right + exercise should control weight and certainly is beneficial, but for those of us with high cholesterol and a strong family history of heart disease, a statin, CoQ10 and baby aspirin cannot hurt.

    BTW, my dad's doctor told him at 54 his chest pains were heartburn. 5 days later he was dead. Sometimes doctors are too confident in their "intelligence".
    Sorry to hear about your father. Physicians are human and 99/100 times, that chest pain was heartburn.

    Most statins are still huge money makers. Lipitor rakes in over 2 billions dollars annually. They are also not that difficult to synthesize either.
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    ^^^Thanks. Well, state of the art was a bit different in 1974 too. I can see how the mis-diagnosis was made and frankly I am not sure if they could have done anything. My dad and his 2 brothers all died before 60. Fortunately I have several older bros and one passed at 68 but he did not take care of himself.

    I discussed imaging with my doc and decided not to do it. Basically we decided I was doing all I could do based on the assumption I need to take care of my heart. I also told him that I am a cyclist and would regularly get my HR up over 170 and as high as 190. He did not seem to think that was an issue as long as my chest was not hurting.

    Last year I had a similar conversation with my oncologist about imaging after I was found to have a significant melanoma lesion. He was saying that while a PET scan can be beneficial to know what is going on, it can lead to a host of invasive surgeries that may, or may not, be helpful. I opted for the PET scan and against the odds it was clean.

    It certainly was sad to hear about Travis and I do my best to not take any day for granted.

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    Two things, (1) if you are quite fit, its probably not a lack of exercise that is creating the the results that are of concern to the doc, (2) you may find some leverage in a change in diet. I was am am also quite active and found my self at the border line with regard to my labs. Doc and I agreed to a 6 month test in which I maintained my level of activity but modified my diet. The diet changes were not particularly extreme, just things like cutting down (not completely eliminating) sugar, processed foods and swapping in foods with healthier fats in place of less healthy ones. On the last front, it meant eating more avocados and fish in place of red meat,cheese (man I love cheese) and pork. This seems to be working for me, for now. You might want to give that sort of exercise a try. If this still does not work, you probably have a choice between going all in on the diet changes, that is being really extreme for another 6 month trial or jumping on the pharma band wagon. Even after this second 6 month trial you may still find yourself on the pharma band wagon.

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    Quote Originally Posted by Unbrockenchain View Post
    Great info Radium. From your knowledge are all brands the same? Iím skeptical on some of these supplement companies. Thanks for explanation
    Whatever brand of ubiquinol they sell at TJ's is a good one. Also, there is no set dosage for CQ10, but starting at 200mg's a day is generally safe. After couple weeks, if no progress is felt, you can bump it up 100mg a week until you get to around 600mg's or so. CQ10 either works like dynamite ( in a good way) or it's just fairly benign.
    The Big Pharma companies don't promote it maybe because they have no patent on it.
    And you guys, just call me Ray.

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    Quote Originally Posted by Nurse Ben View Post

    Big pharma doesn't exist in a medical office. Big pharma exists in politics, TV/social media, and in your head.
    Well put, and thank you. Sometimes I think the whole purpose of the internet is to post so much false and misleading information, usually in line with the posters predefined narrative, so that no one believes anything anymore. Sort of a Putinís MO, if you will.

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    Quote Originally Posted by LanceWeaklegs View Post
    Well put, and thank you. Sometimes I think the whole purpose of the internet is to post so much false and misleading information, usually in line with the posters predefined narrative, so that no one believes anything anymore. Sort of a Putinís MO, if you will.
    Oh, you mean, sorta like our elections?
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    Quote Originally Posted by fongster View Post
    Are any of you on one and if so, how does it affect your training and/or racing? How about holistic alternatives? Some background: I'm nearing 60 and I'm a very fit XC racer, even better than 2015 when I was in best racing form ever but got sidelined with a shoulder injury. My BP is great, HDL is a tad over its range, LDL is at top of its range but the ratio of good to bad is excellent, triglycerides are good, yet doctor is suggesting I get on a statin. I'm thinking it's Pharma-driven. Thanks in advance.
    High HDL is generally beneficial.
    LDL at the top of the normal range is....well....normal.
    Doesn't seem like you need statins (I'm on them, they're fine) but it's something you should discuss in more detail with you doctor, even after digesting our impeccable advice.

    If it's easily available, you can get a calcium score. If it's low, you can probably do without statins. If it's high, it's just another diagnostic tool to help your doctor.

  31. #31
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    Quote Originally Posted by Nurse Ben View Post
    ďPharma drivenĒ

    Do you think your provider gets a kickback for prescribing a generic statin?

    The reason your provider is suggesting a statin is because you have already done everything you can do lifestyle wise by being fit and eating right.

    If I were you, Iíd think less about how the statin will affect your performance and more about how a cardiac event will affect your life.

    Get a second opinion, see a cardiologist and get a full work up with stress test.

    There ainít nothing holistic thatís gonna drop that LDL as much as it needs to drop.
    Hi Ben, I got a high calcium score and, based on a formula, he recommended a scan which showed plaque, to what degree I'm not sure. I get a Stress ECG next. Diet-wise, we eat pretty heathy, my wife really watches it, however, I do love full-fat cheese. I've already cut my intake of it. I cut my sugar intake 6 months ago. Carb-wise, I try to keep it to complex carbs--whole grains, veggies, etc. We never have red meat, just fish and chicken, even meatless nights. So, I'm not sure what much else I can do with diet. Exercise either--I train hard and frequently. Sleep? Could be a lot better. Just rambling now. Stress ECG will be interesting.

  32. #32
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    Quote Originally Posted by LanceWeaklegs View Post
    Well put, and thank you. Sometimes I think the whole purpose of the internet is to post so much false and misleading information, usually in line with the posters predefined narrative, so that no one believes anything anymore. Sort of a Putinís MO, if you will.
    Yeah, but it played a huge role until about 10 years ago (thanks Obama). And Pharma still plays a major role in prescriptions. It is the reason we have the opioid crisis now. And clinical trials are a huge business. My company pays $1000 per patient enrolled in a simple biomarker trial. A competitor (hint - SIB) pays 5-10X times that. Yes, much of it goes to the universities and hospitals but still, it is a money game.
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    Quote Originally Posted by fongster View Post
    Hi Ben, I got a high calcium score and, based on a formula, he recommended a scan which showed plaque, to what degree I'm not sure. I get a Stress ECG next. Diet-wise, we eat pretty heathy, my wife really watches it, however, I do love full-fat cheese. I've already cut my intake of it. I cut my sugar intake 6 months ago. Carb-wise, I try to keep it to complex carbs--whole grains, veggies, etc. We never have red meat, just fish and chicken, even meatless nights. So, I'm not sure what much else I can do with diet. Exercise either--I train hard and frequently. Sleep? Could be a lot better. Just rambling now. Stress ECG will be interesting.
    It sounds like you have already taken on the low hanging fruit associated with behavioral changes (Except for the cheese, I feel you on that one!) and the combination of your labs and scan results make taking a statin drug a good idea. At this point, the science associated with their safety and side effects is well settled. They are safe, and the side effects are minimal. I addition, many of them are no longer big money makers for drug companies so you can be a bit less concerned about the "big pharma" problem.

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    Quote Originally Posted by fongster View Post
    however, I do love full-fat cheese.
    If you are serious about all this, you gotta quit eating cheese. I did it, and it was very, very hard at first. But youíll get over your need for cheese. I donít even think twice about it now. Just envision the insides of your arteries when you think about cheese.

  35. #35
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    Statin drugs?

    Quote Originally Posted by fongster View Post
    Are any of you on one and if so, how does it affect your training and/or racing? How about holistic alternatives? Some background: I'm nearing 60 and I'm a very fit XC racer, even better than 2015 when I was in best racing form ever but got sidelined with a shoulder injury. My BP is great, HDL is a tad over its range, LDL is at top of its range but the ratio of good to bad is excellent, triglycerides are good, yet doctor is suggesting I get on a statin. I'm thinking it's Pharma-driven. Thanks in advance.
    Statins are one of the most widely studied drugs in the world. Trial after trial show positive results in terms of reducing MIs and strokes, compared to placebo. Nothing OTC will even come close to lowering bad cholesterol to the levels a statin can, even a low dose. Most statins are generic today and cost very little money. Furthermore 75% of your cholesterol derives from genetics, 25% from diet. If you have poor cholesterol numbers, itís mostly genetic and all the eating-right and exercise wonít do much to greatly alter your numbers.

    Lastly, if you ask most cardiologists, theyíll tell you that thereís also an unseen benefit to statin therapy thatís not directly related to lowering bad cholesterol. I, personally, have been taking them for almost 10 years (now 49) with no adverse side effects.


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  36. #36
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    I have been on a statin for a year and a half Ė Pravastatin 10mg Ė following a heart attack. My LDL cholesterol was pretty low (77, I think) at the time of the heart attack and the cardiologist said that it needed to be below 70 to reduce the risk of a future heart attack. I was on a different statin initially and I felt really (muscle) weak when mtbring. Changed to the current (weak?) one and I donít notice any negatives. I started a plant-based diet at the end of last year and am hoping it will bring my cholesterol down to below 70 without needing to take the statin Ė I would much rather handle it through diet than drugs if I can. My cardiologist is a Ďstatiní guy and doesnít believe I can do anything diet/exercise wise to eliminate statin. I eliminated cheese, dairy and meat from my diet about 7 weeks ago with a view to dropping off the statin 4-6 weeks prior to my next (GP based) annual check up and see where my cholesterol is at. I have read a ton of articles and books on the plant-based diet helping with cardio health but I suspect the results vary by individual. FWIW, I havenít really missed meat but like several of you, I am really missing cheese Ė veggie cheese is a poor taste substitute.

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    Quote Originally Posted by fongster View Post
    Hi Ben, I got a high calcium score and, based on a formula, he recommended a scan which showed plaque, to what degree I'm not sure. I get a Stress ECG next. Diet-wise, we eat pretty heathy, my wife really watches it, however, I do love full-fat cheese. I've already cut my intake of it. I cut my sugar intake 6 months ago. Carb-wise, I try to keep it to complex carbs--whole grains, veggies, etc. We never have red meat, just fish and chicken, even meatless nights. So, I'm not sure what much else I can do with diet. Exercise either--I train hard and frequently. Sleep? Could be a lot better. Just rambling now. Stress ECG will be interesting.
    Like you I eat well, exercise, maintain regular sleep, and try to keep my stress down.

    I'm fortunate to have not inherited familial hypercholesteremia, though my father and brother were not so fortunate. My father treats his and has been more or less healthy to his current age of 84, my brother was treating it but I'm not sure what he does now; ain't asking, gotta maintain those boundaries.

    There was a time when I was being treated for hypertension, it was discovered when I was in nursing school, so I started on Lisonopril, it worked, but it definitely messed with my exercise tolerance. However, I continued to take it because the last thing I wanted was a stroke.

    When I got to graduate school I was looking at research on hypertension and discovered a rare "allergic" reaction to antihistamines that can cause elevated blood pressure. I was taking Loratadine at the time. I stopped taking Loratadine and my blood pressure normalized.

    So yeah, treat it if you can't manage it with lifestyle changes.

    Fun fact: 75% of the cholesterol in your body is created by your body... and cholesterol is a building block for every cell.
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  38. #38
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    Quote Originally Posted by LanceWeaklegs View Post
    Sounds like all the things you attributed to being on statins for 10 years are things that happen with aging. 😉. Except for your ADD which was already there. Or you family history of diabetes. Which was already there. Just sayin .... 🤘

    Ahh yes, It's all just due to age. Guess your reading comprehension wasn't good enough to pick up on the fact that all those symptoms resolved once off the Lipitor. Just sayin.........

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    Quote Originally Posted by Nurse Ben View Post

    Big pharma doesn't exist in a medical office. Big pharma exists in politics, TV/social media, and in your head.

    Wow, Got your head buried in the sand much?????? A few years ago I worked with several nurses and paramedics who had full time jobs as drug reps. They loved working in critical care units and on the street, and mostly hated working as drug reps. It came down to the pay, often 3-4 times what they could make on the street or in direct patient care.

    I knew they got paid a lot and wondered what drugs there were marketing. I assumed that it was some of the newer ones. I was rather surprised to find that one of them was making well over 200k pushing Warfarin. At that time Warfarin had already been out for years and was rather cheap. The companies had him out there pushing the Doctors to prescribe more of it. It was really the same with all of them, just different cheap drugs.

    I could go on and on talking about the drugs that I've seen that were pushed by big pharma. Not because they worked but because of profits. Aspirin is actually one of those drugs.

    I have an acquaintance who is a very independent minded Physcian Assistant. She gets furious when the drug reps start pushing certain pills and then when management tells her to prescribe more of those.

    I have a feeling, Mr Nurse, that you prescribe far more based on what big pharma wants you to then you realize.

  40. #40
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    Quote Originally Posted by Daydreamer View Post
    Ahh yes, It's all just due to age. Guess your reading comprehension wasn't good enough to pick up on the fact that all those symptoms resolved once off the Lipitor. Just sayin.........
    most people, when they see the emojis, realize a post in meant in good humor. Maybe you should change you name to Peaches, since you bruise so easily. Good thing those emojis softened the blow ...

  41. #41
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    when my doc wanted to put me on statins I opted to go with Niacin, it is natural and not a statin. I have not checked my numbers in a while, but a little bit of cholesterol is better than the side effects of statins. I am on enough other meds that are required to keep me alive, so i am trying to keep my med intake as low as possible.
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    Quote Originally Posted by Klurejr View Post
    when my doc wanted to put me on statins I opted to go with Niacin, it is natural and not a statin. I have not checked my numbers in a while, but a little bit of cholesterol is better than the side effects of statins. I am on enough other meds that are required to keep me alive, so i am trying to keep my med intake as low as possible.
    Wut? No side effects? Niacin may be natural in small amounts but those Niacin capsules are brutal. 🤪 I tried that, took one before bed, and in minutes I was like a human firelog. My wife could literally feel the heat radiating off of me. 10 years later we still laugh about it. Beet red and felt like I was on fire. Who knew the human body could release so much heat almost instantaneously! I am surprised the bedding didnít catch fire. I canít describe it any other way. I know there are ways to try and mitigate the side effects, but for me it took so much planning to structure my life around the Niacin I quit them. Luckily, gave up all dairy and most red meat to get my numbers to normal. For anyone looking for a success story enough to motivate you to quit eating your favorite delicious foods, my ď badĒ cholesterol fell 85 points. If you can do the Niacin, thatís great. Hope it helps your blood numbers!

  43. #43
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    Quote Originally Posted by fongster View Post
    Are any of you on one and if so, how does it affect your training and/or racing? How about holistic alternatives? Some background: I'm nearing 60 and I'm a very fit XC racer, even better than 2015 when I was in best racing form ever but got sidelined with a shoulder injury. My BP is great, HDL is a tad over its range, LDL is at top of its range but the ratio of good to bad is excellent, triglycerides are good, yet doctor is suggesting I get on a statin. I'm thinking it's Pharma-driven. Thanks in advance.
    Genetics brought me a widowmaker at 38; Iím now 53 and have been on a statin (and other meds) ever since. I get annual physicals w/lab work. No issues. I also have no issues exerting and sustaining high levels of intensity.
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    Quote Originally Posted by MTBeing View Post
    Statins are one of the most widely studied drugs in the world. Trial after trial show positive results in terms of reducing MIs and strokes, compared to placebo. Nothing OTC will even come close to lowering bad cholesterol to the levels a statin can, even a low dose. Most statins are generic today and cost very little money. Furthermore 75% of your cholesterol derives from genetics, 25% from diet. If you have poor cholesterol numbers, itís mostly genetic and all the eating-right and exercise wonít do much to greatly alter your numbers.

    Lastly, if you ask most cardiologists, theyíll tell you that thereís also an unseen benefit to statin therapy thatís not directly related to lowering bad cholesterol. I, personally, have been taking them for almost 10 years (now 49) with no adverse side effects.


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    Yes, and the combined data has shown that for a population with a total cholesterol level of ~200 mg/dl, a HDL of ~ 48 mg/dl, a history of cardiovascular disease and with moderately high BMI, your risk of a cardiovascular event leading to death is about 1.4% off statins and 1.2% on statins.

    There is benefit, no doubt. But they are minor. There are generally 10X the number of people who die from a cardiovascular event when on statins then could be suggested to have benefited from the statin. This is also the reason all statin trials require huge numbers of patients -to reach statistical significance.

    Nothing in biology is absolute. There were many mothers who took Thalidomide and had no side effects (normal children) but I would not call it a safe drug! Ones person's experience is often not representative of the entire experience.
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  45. #45
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    ^^^ Heart disease accounts for 600,000+ deaths in the US annually. High cholesterol makes one twice as likely to have coronary heart disease.

    Using your numbers, the difference between 1.4% and 1.2% is 14%. 14% of 600,000 is 85,000 people. That is about 2.5x as many people as die in car accidents per year.

  46. #46
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    Re: the OPs original questions, statins for reduce VO2 Max but only in men. Go figure! It can be signifcant, meaning double digit decrease. Iíll find the study and post it when Iím in front of a computer.

    Iíve had two attacks, one flatline for 11 seconds while biking, lucky to have survived (paramedics had reached me just in time)....4 stents, 40mg Crestor. Trying to get approved for Repatha. Iíve gone to school on all this because cardiologists donít tell you everything.

    Bottom line: there is simply nothing good about LDL. If you can get it close to zero, do it. Under 70 and plaque buildup begins to reverse. Iím at 65 LDL with Crestor, but I want to get down to 10 or 15, and Repatha will do that.

    And you do not need high cholesterol for plaque buildup. There are other factors at play. My first attack happened at 51...no history of heart disease in my family anywhere, I was superfit with 7% body fat, eating clean under the care of a nutritionist for performance reasons with all cholesterol in normal ranges, and my widow maker was 98% blocked. Some bodies simply throw plaque...source is the liver obviously but the cause can be unknown.

    My lesson: Vanity metrics donít matter. And medication canít cure, only treat.
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  47. #47
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    Quote Originally Posted by BlueCheesehead View Post
    ^^^ Heart disease accounts for 600,000+ deaths in the US annually. High cholesterol makes one twice as likely to have coronary heart disease.

    Using your numbers, the difference between 1.4% and 1.2% is 14%. 14% of 600,000 is 85,000 people. That is about 2.5x as many people as die in car accidents per year.
    Yup. Agree 100%. And there are roughly 150K stroke deaths per year - which are statin related. On a population level, statins are very useful. And they have other benefits as well -reduce cancer rates, etc.

    What is important is that we don't understand who will respond to statins. We actually have a grant currently to try to identify serum biomarkers to identify those on statins who will predict poor outcome (I am a scientist if you did not figure it out).

    Also, the benefits of these drugs in specific populations, like individuals <50 and physically fit is not known. We do know that for the most part - the benefits of statins in those >70 is nil.

    Statins work, but things like exercise and diet can have an even greater impact. And there are lots of side effects with statins - like any drug. The use of baby aspirin is under debate as it is associated with certain toxicities.
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  48. #48
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    Article precis on statins and VO2 max.

    Statin drugs?-v02-statins-copy.jpg
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    I find it darkly humorous that in post #12 of 48 (to date) I posted links to peer reviewed research on the benefits of statin therapy. Since then, we've had no shortage of opinions on the subject (some I agree with, others not so much), but no actual evidence. Nicely done, y'all.

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    Quote Originally Posted by Fairbanks007 View Post
    I find it darkly humorous that in post #12 of 48 (to date) I posted links to peer reviewed research on the benefits of statin therapy. Since then, we've had no shortage of opinions on the subject (some I agree with, others not so much), but no actual evidence. Nicely done, y'all.
    That because internet. The whole goal is to post so much information, real or imagined, that no one believes anything anymore. Or that everyone believes your post. Then everyone wins. Or loses. It unfolds before us every day.

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