Cycling UK Forum

Hi

I found this interesting study by Drs Sinzinger and O’Grady last year and am sharing it.

https://www.ncbi.nlm.nih.gov/pmc/articl ... 5/citedby/

It was found that only 20% of Athletes could tolerate a statin, without muscle problems, compared to 80% of the general population.

That makes perfect sense, because -
- The Number 1 side effect of statins is Muscle Aches
(90% of statin side effects are muscle aches
- Which is the cohort that use their muscles the most?

After finding the above study, I researched and found 50 more that showed that exercisers are more at risk of muscle aches on statins.

Statins and exercise are not indicated.

Keep cycling!

Coldesarenne

That paper was specifically about elite athletes with familial hypercholesterolaemia. (In the Discussion they describe them as having severe FH, although it isn't clear why.)

The study does not mention blinding so I'd conclude that there wasn't any.

The subject of muscle symptoms and statins is highly contentious. The last few posts in this thread discuss what I think is the latest study on this in the general population:
viewtopic.php?t=97373

Jonathan

coldesarenne wrote: ↑3 Nov 2022, 4:46am Hi

I found this interesting study by Drs Sinzinger and O’Grady last year and am sharing it.

https://www.ncbi.nlm.nih.gov/pmc/articl ... 5/citedby/

It was found that only 20% of Athletes could tolerate a statin, without muscle problems, compared to 80% of the general population.

That makes perfect sense, because -
- The Number 1 side effect of statins is Muscle Aches
(90% of statin side effects are muscle aches
- Which is the cohort that use their muscles the most?

After finding the above study, I researched and found 50 more that showed that exercisers are more at risk of muscle aches on statins.

Statins and exercise are not indicated.

Keep cycling!

Coldesarenne

That was my experience after the quack suggested that because I was 60 years old and me mam had angina, I should take statins. These soon induced a severe joint ache - strangely, in only one joint at a time - thumb, hip, shoulder ..... These things appeared after doing some particularly heavy-duty exercise. The thumb was after a long hand planing session of a large plank. The hip ache appeared during some vigorous circuit training part of a weight loss programme. The shoulder after a long sea swim. Each one didn't go away for weeks. But I didn't get a different one until it had.

Supposedly statins reduce the chance of various heart, stroke and similar things in later years. Perhaps they do. However, the process of deciding who would benefit from statins seemed driven more by the marketing of the pharmaceutical companies than it was by proper medical risk assessments.

I stopped taking them and the joint pain thing disappeared never to return.

Cugel

Jdsk wrote: ↑3 Nov 2022, 8:40am That paper was specifically about elite athletes with familial hypercholesterolaemia. (In the Discussion they describe them as having severe FH, although it isn't clear why.)

The study does not mention blinding so I'd conclude that there wasn't any.

Do you normally interpret an absence of evidence as evidence of absence?

Jdsk wrote: ↑3 Nov 2022, 8:40am The subject of muscle symptoms and statins is highly contentious. The last few posts in this thread discuss what I think is the latest study on this in the general population:
viewtopic.php?t=97373

They seem to be discussing a meta analysis recycling earlier studies, many flawed, working on the theory that you can find gold if you sift toxic waste in a specific way.

mjr wrote: ↑3 Nov 2022, 10:00am

Jdsk wrote: ↑3 Nov 2022, 8:40am That paper was specifically about elite athletes with familial hypercholesterolaemia. (In the Discussion they describe them as having severe FH, although it isn't clear why.)

The study does not mention blinding so I'd conclude that there wasn't any.

Do you normally interpret an absence of evidence as evidence of absence?

In a study of this type if blinding isn't mentioned as part of the study design (in the Methods or elsewhere) then I'd conclude that it wasn't performed.

Jonathan

Has this been discussed here?

https://evidence.nihr.ac.uk/alert/stati ... stiffness/

Like Cugel I got ‘instructed’ to take (a very low dose) statin when I had my 60yo MOT because one of my parents suffered first angina and then other heart problems, so despite having perfectly fine cholesterol etc levels myself I was deemed at enhanced risk of heart/stroke problems. So far no noticeable side-affects.

Nearholmer wrote: ↑3 Nov 2022, 1:32pm Has this been discussed here?

https://evidence.nihr.ac.uk/alert/stati ... stiffness/

Like Cugel I got ‘instructed’ to take (a very low dose) statin when I had my 60yo MOT because one of my parents suffered first angina and then other heart problems, so despite having perfectly fine cholesterol etc levels myself I was deemed at enhanced risk of heart/stroke problems. So far no noticeable side-affects.

I'm glad if they work for you, but yes, that's the one discussed over on the main thread and not limited to athletes. viewtopic.php?t=97373&start=585

I said for a long time that I had "no noticeable side-effects" too because I did not realise how much my memory had been ruined by them, to the point of being unable to notice that various other health problems correlated with the time taking them.

What do you call "a very low dose"? 5mg Atorvastatin or equivalent?

I'm glad if they work for you,

Well, I have no idea whether they are doing anything useful or not, TBH. How would anyone, myself included, know?

And, if they are having a negative affect likewise, how would anyone, myself included, know, because it may be too subtle an affect to pick out from background issues like the onward march of time, subtle changes in diet, exercise, or sleep patterns, or subtle lagging affects from covid, or, or, or….?

I had a chat with the local pharmacist about it when I collected the most recent batch, and he made me chuckle, because he’s the same age, has the same sort of family history, has also been ‘instructed’ to take them, and freely confessed that he has no idea whether they are doing him any harm or good either!

My nagging minor concern is that they may be a medicine that has a positive affect population wide, but that the understanding of detailed affect, positive or negative, on any given individual may be poor.

PS: is it ‘side effect’ or ‘side affect’? I think I spelled t wrongly throughout!

It may be a somewhat naive question. But given that the reason for taking Statins was to reduce the incidence of heart attack and stroke is there any published data showing how effective they have been at achieving those outcomes? Given the apparent increase in use amongst the population, should that not have lowered those numbers hugely.
As far as I can see the number of deaths from heart attacks continues to increase yearly.

Nearholmer wrote: ↑3 Nov 2022, 2:15pm

I'm glad if they work for you,

Well, I have no idea whether they are doing anything useful or not, TBH. How would anyone, myself included, know?

Direct outcomes, as Bsteel seeks, are pretty difficult to determine at a personal level. We don't get two of you to try different approaches and compare. And at the population level, as with the negative effects you mention, it's all tangled up in "the onward march of time, subtle changes in diet, exercise, or sleep patterns" too... we can hope that those cancel out, but then the statin effect seems very modest indeed.

Indirect markers, such as cholesterol levels, we can measure. Then we have to rely on the lipid hypothesis, or some other theory for why statins should improve outcomes.

And, if they are having a negative affect likewise, how would anyone, myself included, know, because it may be too subtle an affect to pick out from background issues like the onward march of time, subtle changes in diet, exercise, or sleep patterns, or subtle lagging affects from covid, or, or, or….?

Yes, it took me years of testing (including retrying lots of statins, some several times) and recording many of these other factors to try to eliminate them, before I reached my current conclusion that statins do not work for me. I do wonder if they have a negative effect on any FH sufferer who exercises, not only elite athletes. But we have more data on elite athletes, so they are a good place to start.

PS: is it ‘side effect’ or ‘side affect’? I think I spelled t wrongly throughout!

Effect is the noun (what you have), affect is the verb (what you do), so it's "side effect".

Indirect markers, such as cholesterol levels, we can measure.

Even measuring cholesterol levels is prone to oodles of confounding factors, notably changes in diet, and I struggle to understand how thnhgs work for someone like myself who started out with cholesterol levels that were “optimal”. Do my cholesterol levels become “super optimal”?

If GPs weren’t run off their feet, I’d try to pin mine down to have a proper conversation about all this.

Another interesting paper looking at the other pathways, such as Coenzyne Q, affected by Statins whilst reducing LDL production. Also discusses the reduction of brain LDL. (Although I'm not sure that all Statins make it past the blood brain barrier? )
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341496/

mjr wrote: ↑3 Nov 2022, 2:46pm

Nearholmer wrote: ↑3 Nov 2022, 2:15pm

I'm glad if they work for you,

Well, I have no idea whether they are doing anything useful or not, TBH. How would anyone, myself included, know?

Direct outcomes, as Bsteel seeks, are pretty difficult to determine at a personal level. We don't get two of you to try different approaches and compare. And at the population level, as with the negative affects you mention, it's all tangled up in "the onward march of time, subtle changes in diet, exercise, or sleep patterns" too... we can hope that those cancel out, but then the statin effect seems very modest indeed.

Indirect markers, such as cholesterol levels, we can measure. Then we have to rely on the lipid hypothesis, or some other theory for why statins should improve outcomes.

Unfortunately, only a meta-analysis and the full text is behind a paywall. But at least someone is looking to confirm the efficacy.
https://jamanetwork.com/journals/jamain ... ct/2790055

A friend of mine who is a medical professor said that research shows that taking statins has a beneficial affect in only 0.3% of patients. Meaning in theory for the other 99.7% they do not reduce the risk of heart attack or stroke.
He actually started taking statins but stopped after having bad muscle pain. He had his blood tested for an enzyme created by statins which causes muscle inflammation.
His reading was high so he stopped the tablets. It took approx 10 weeks for it to get out of his system and he could resume exercise with no muscle pain.
A friend in the cycling club who's father in law is 101 was prescribed statins ! Doctors "encouraged " to prescribe whatever the circumstance ?

joeegg wrote: ↑8 Nov 2022, 6:06pm He actually started taking statins but stopped after having bad muscle pain. He had his blood tested for an enzyme created by statins which causes muscle inflammation.
His reading was high so he stopped the tablets. It took approx 10 weeks for it to get out of his system and he could resume exercise with no muscle pain.
A friend in the cycling club who's father in law is 101 was prescribed statins ! Doctors "encouraged " to prescribe whatever the circumstance ?

Not encouraged so much as advised, and with plenty of caveats not whatever the circumstance. I've never known a GP order a test for enzyme levels either. Only hospital clinicians. You're lucky if GPs even follow the dosage advice fully or order any follow-up tests.