by Dr. Steven Garner, MD
Dear Dr. Garner,
I have slightly high cholesterol, and the bad type of cholesterol is high as well.
My doctor wants me to go on Lipitor, but I have read about some really nasty side effects from the drug.
I’ve tried changes in my daily routine, such as eating better and exercising, but the cholesterol does not move. I have mild diabetes and I’m a little overweight, but otherwise in good health.
I trust you and want your opinion.
Scared of Lipitor
In Sunset Park
Dear Scared of Lipitor,
There is an important thing I want you to remember. Every medication, whether by prescription or over the counter, has risks. The trick is to figure out if the benefits outweigh the risks.
Lipitor is a type of drug known as a statin. Zocor is another type of statin similar to Lipitor.
Statins are drugs that lower your cholesterol. They work by blocking the process through which cholesterol is made. They may even raise a person’s HDL (good cholesterol).
For people with high cholesterol, particularly the LDL (bad cholesterol), there is good reason to consider prescribing Lipitor (or any other statin), especially if the following risk factors are present: high blood pressure, diabetes, obesity, inactivity (the person does not exercise) and smoking tobacco.
As with any medication, there are side effects. There may be serious side effects of statins, such as liver damage and muscle destruction, as well as less serious ones, such as muscle and joint aches, nausea, diarrhea and bowel problems.
Statins reduce heart attacks and strokes and may even clean up plaque that is already in the blood vessels.
A review of some new studies finds that statins have benefits far beyond those involving the heart and blood vessels. They have been shown to:
• Protect against Alzheimer’s, cutting the risk by as much as 40%
• Lower the risk of cataracts
• Protect against prostate cancer
• Help protect diabetics against heart attacks
• Save the lives of people who were hospitalized with the flu
• Reduce the risk of arthritis and bone fracture
• Lower the risk of kidney disease
In a recent study, patients taking statins for up to five years reduced their risk of death from any cause by 45% compared with those not taking statins.
These added benefits seem to be related to the ability of statins to reduce inflammation or irritation and swelling.
Cancer, for example, has been traced in some cases to persistent inflammation and irritation. The statins somehow reduce this irritation and reduce the risk of developing certain types of cancer and other diseases as noted above.
The studies are not large in number and long-term effects have not been well studied, but the statin drugs appear to have the possibility of a remarkable future.
Review your situation with your doctor. Taking statins is a lifelong commitment. There are some blood tests you will need to have during your yearly physical to make sure you’re not developing liver problems.
If it’s possible to control cholesterol with diet and exercise and one does not have risk factors previously mentioned, then it may be possible to control the situation without a statin.
Statins are very effective in lowering cholesterol, even unclogging blood vessels and reducing the chance of heart attacks and strokes. For this reason, I suggest you strongly consider starting Lipitor after discussion with your doctor. Thank you for your question.
Before I sign off, I’d like to recognize two loyal Tablet and Ask the Doctor column readers, Eileen Halvatzis and Jennie Donovan. Eileen has almost a complete collection of Ask the Doctor past letters. Jennie is a loyal viewer of the Ask the Doctor TV show as well.Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.