Statins: "I heard cholesterol pills are bad for you!"

"Statins" are the most commonly prescribed cholesterol lowering medications, and have been around since the 1980's. The first four are now available generically, and were originally developed based on naturally occurring plant-based compounds. Lipitor was ground-breaking in the mid-1990's because it was more potent ("stronger") and mainly because it was completely synthetic in origin. Crestor followed in the same manner.

They are called "statins" because the chemical names all end in -statin: lovastatin, atorvostatin, pravastatin, etc., etc.

Concerns about rare but severe side-effects in news and magazines fail to make clear the extent of any risks and benefits in taking statins.

Downsides:

• Flatulence (passing gas) is actually the most common side-effect. Not harmful, not associated with diarrhea; just more passing gas. I have, so far, never had anyone stop taking a statin because of this.
• Liver injury. Turns out, increased liver function blood tests turn out to be from the effect that lowering your cholesterol has on allowing solidified fats in your liver to dissolve and return to normal. (so called "fatty liver") This is not a toxic effect on your liver. Unfortunately, warnings that go on drug labels rarely ever go off them.
• Muscle injury. Actual toxic injury to muscle is rare with statins. Rare as in 10-25 times per 10,000,000 (10 million) prescriptions written. That's 1-2.5 in a million. Your chances of being struck dead by lightning are about 1 in 5,000. Please, let's put that in perspective.
• Muscle aching. Here, were talking achiness that is not harmful, and goes away within a few days of stopping the medication. This occurs in about 4% of folks. Mind you, this comes from studies showing 21% of people taking a statin complain of achiness, but 17% of people taking a sugar pill (placebo) do, too. The human mind is a funny thing...

Upsides:

• Reduced risk of heart attack or cardiac arrest by about 31-34%.
• Similarly reduced risk of stroke.
• Reduced risk of Alzheimer's dementia.
• Reduced risk of colon cancer.
• Reduced risk of osteoporosis.

Short story:

• Statins can make you pass gas more often, but can't hurt your liver. Muscle aching is uncommon and actual muscle injury is extremely rare.
• They do reduce you risk of heart attack, stroke, Alzheimer's, colon cancer and osteoporosis.
  

Wal-Mart Pharmacy Changes

As you may know from prior postings on this subject or as a matter of common knowledge, last January Wal-Mart started offering deep discounts on hundreds of commonly used generic prescription medicines at $4/month or $8/3 months.

As of this January, the following changes have been made:

1. 3-month (90-day) prescriptions are $10.
2. New prescriptions have been added at $9/month or $24/90 days:

• Ventolin HFA, the asthma inhaler
• bupropion ER, the equivalent of Zyban for stopping smoking
• alendronate/Fosamax, the osteoporosis weekly pill
• tamoxifen, the breast cancer chemotherapy pill
• several birth control pills

Otherwise, the other medicines are still $4/month.

As previously mentioned, I'm not a big Wally World fan. However, I have to say these prices on hundreds of the most widely used medicines are probably saving lives in a time when lots of folks have to make food/medicines/housing/heating decisions all the time.

The increase from $8 to $10 for 90 days worth is still an unbelievably good deal; particularly with the addition of the aforementioned medicines!

I imagine the reason they continue to offer these discounts is that folks spend an average of $35 whenever they walk in. If you don't want to buy anything else, then don't. But that's a pretty unbeatable deal on medicines if you need them.

Economic Triage

I am borrowing this picture from a newspaper article that talked about something I haven't really seen in print as much as I would expect, which is patients having to not see a doctor because of cost or insurance problems.

Patients canceling, re-scheduling or failing to appear for appointments should not surprise anyone in a full year of the worst economic downturn since the Great Depression with no end in sight.

This article touches on some of the decision-making folks have to face, and also some approaches and resources to stay as healthy as possible.

Certainly, if cost is a problem with medications we are prescribing or tests that we order, do not hesitate to ask. (Believe me, you may find it slightly embarrassing, but you're far from alone.).

If you need to re-schedule a physical or visit due to financial problems, just give us a call in advance. If you are unsure whether this is prudent, it's okay to ask.

We want to see you as often as is in keeping with good preventive health care and treatment of emergencies or with chronic medical conditions. However, the world is presently far from perfect, so let us know if you are having difficulties.