Re: aggressive statin treatment may affect mitochondrial volume


"Bill" <xxx@xxxxx> wrote in message
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>
> "Sharon Hope" <shope@xxxxxxxx> wrote in message
> news:-oudnVB72v04sUTfRVn-vg@xxxxxxxxxxxxxx
>>
>> "Bill" <xxx@xxxxx> wrote in message
>> news:Ig2Ce.2866$8y1.2696@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>>>
>>> "Sharon Hope" <shope@xxxxxxxx> wrote in message
>>> news:ar-dnVmxJP2ODkXfRVn-1g@xxxxxxxxxxxxxx
>>>>
>>>> "Bill" <xxx@xxxxx> wrote in message
>>>> news:oQGBe.1439$8y1.742@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>>>>>
>>>>> "Sharon Hope" <shope@xxxxxxxx> wrote in message
>>>>> news:bb-dneKSFbuxrErfRVn-gA@xxxxxxxxxxxxxx
>>>>>>
>>>>>> "Bill" <xxx@xxxxx> wrote in message
>>>>>> news:whCBe.1369$8y1.2@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>>>>>>>
>>>>>>> "William Wagner" <Nonsence_here_B2wagner@xxxxxxxx> wrote in message
>>>>>>> news:Nonsence_here_B2wagner-93B457.18420614072005@xxxxxxxxxxxxxxxx
>>>>>>>> In article <YOABe.1530$dX5.897@xxxxxxxxxxxxxxxxxxxxxxxxxx>,
>>>>>>>> "Bill" <xxx@xxxxx> wrote:
>>>>>>>>
>>>>>>>>> "William Wagner" <Nonsence_here_B2wagner@xxxxxxxx> wrote in
>>>>>>>>> message
>>>>>>>>> news:Nonsence_here_B2wagner-460B02.15121814072005@xxxxxxxxxxxxxxxx
>>>>>>>>> > In article
>>>>>>>>> > <1121366219.295440.42590@xxxxxxxxxxxxxxxxxxxxxxxxxxxx>,
>>>>>>>>> > "zee" <outrider@xxxxxxxxxxxxx> wrote:
>>>>>>>>> >
>>>>>>>>> >> Just Ed wrote:
>>>>>>>>> >> > hj wrote:
>>>>>>>>> >> > > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&do
>>>>>>>>> >> > > pt=
>>>>>>>>> >> > > Abstract&list_uids=16003294&query_hl=1
>>>>>>>>> >> >
>>>>>>>>> >> > "The muscle ubiquinone concentration was reduced
>>>>>>>>> >> > significantly
>>>>>>>>> >> > from 39.7 +/- 13.6 nmol/g to 26.4 +/- 7.9 nmol/g (P = .031,
>>>>>>>>> >> > repeated-measurements ANOVA) in the simvastatin group, but no
>>>>>>>>> >> > reduction was observed in the atorvastatin or placebo group."
>>>>>>>>> >> >
>>>>>>>>> >> > no change with atorvastatin 40 mg, 8 wks!
>>>>>>>>> >> >
>>>>>>>>> >> >
>>>>>>>>> >> > other studies (all PMIDs) looking at this:
>>>>>>>>> >> >
>>>>>>>>> >> > reduction with atorvastatin:
>>>>>>>>> >> > 15942122 10 mg 8 wks hypercholesterolemic
>>>>>>>>> >> > 15721028 40 mg 6 wks CHF independent of LDL-cholesterol
>>>>>>>>> >> > alterations
>>>>>>>>> >> > 15210526 80 mg 4 wks, hypercholesterolemic
>>>>>>>>> >> > significant at 2 weeks
>>>>>>>>> >> > 14695926 10 mg 3 mo hypercholesterolemic
>>>>>>>>> >> > 11566168 10 mg 3 mo normal
>>>>>>>>> >> >
>>>>>>>>> >> >
>>>>>>>>> >> > no reduction:
>>>>>>>>> >> > 11479481 10 mg, 4 wk normal
>>>>>>>>> >> > 16003294 40 mg, 8 wks hypercholesterolemic
>>>>>>>>> >>
>>>>>>>>> >>
>>>>>>>>> >>
>>>>>>>>> >> Time.
>>>>>>>>> >>
>>>>>>>>> >> Statin adverse effects do not always show up within weeks, or
>>>>>>>>> >> even
>>>>>>>>> >> months. Some who have suffered life-altering and disabling side
>>>>>>>>> >> effects
>>>>>>>>> >> from statins did not notice symptoms until years after stopping
>>>>>>>>> >> statins.
>>>>>>>>> >>
>>>>>>>>> >> Many who post here about their lingering and life-altering side
>>>>>>>>> >> effects
>>>>>>>>> >> from statins will say this was their experience.
>>>>>>>>> >>
>>>>>>>>> >>
>>>>>>>>> >> Zee
>>>>>>>>> >
>>>>>>>>> > I lost 3 or 4 inches of calf muscle not the first year but in
>>>>>>>>> > the
>>>>>>>>> > second and third with higher dosages of statins. 20 Zorcor to
>>>>>>>>> > 80
>>>>>>>>> > lipitor over time with a few dosage tweaks . Had to quit as
>>>>>>>>> > pain and
>>>>>>>>> > aches looked like a walker was next. This is no exaggeration
>>>>>>>>> > but it
>>>>>>>>> > also aimed at folks like me who may respond differently to
>>>>>>>>> > statins.
>>>>>>>>> >
>>>>>>>>> > LDL flat anyway after the drug change was my fortune. Tore me
>>>>>>>>> > up alas.
>>>>>>>>> >
>>>>>>>>> > I'd measure calf and thigh and include that info with your
>>>>>>>>> > doctor visits
>>>>>>>>> > as it was of more import to me than body weight. Forearms too.
>>>>>>>>> >
>>>>>>>>> > Loss of muscle scares me big time albeit slow to recognize.
>>>>>>>>> > Which is
>>>>>>>>> > even scarier .
>>>>>>>>> >
>>>>>>>>> > I do not mean to scare you only an easy heads up when dealing
>>>>>>>>> > with the
>>>>>>>>> > modern pharmaceutical wonders.
>>>>>>>>> >
>>>>>>>>> > Bill
>>>>>>>>> >
>>>>>>>>> > P.S. The heart is a muscle too which scares me!
>>>>>>>>> >
>>>>>>>>>
>>>>>>>>>
>>>>>>>>> What happened when you discontinued the statin? Did you ever get a
>>>>>>>>> CK test,
>>>>>>>>> and, if so, do you know the readings?
>>>>>>>>>
>>>>>>>>> Thanks.
>>>>>>>>>
>>>>>>>>> Bill
>>>>>>>>> > --
>>>>>>>>> > Garden Shade Zone 5 in a Japanese Jungle manner.
>>>>>>>>> > FAIR USE NOTICE: This may contain copyrighted (© ) material the
>>>>>>>>> > use of
>>>>>>>>> > which has not always been specifically authorized by the
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>>>>>>>>> > constitutes a 'fair use' of any such copyrighted material as
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>>>>>>>>> > for in Title 17 U.S.C. section 107 of the US Copyright Law. This
>>>>>>>>> > material is distributed without profit.
>>>>>>>>
>>>>>>>> Chronic leg pain or large muscle pain faded in about a month.
>>>>>>>> Muscle
>>>>>>>> loss is my challenge to overcome. Please remember I was doing one
>>>>>>>> leg
>>>>>>>> deep knee bends and biked 20 mile every day.
>>>>>>>>
>>>>>>>> Seems so far way ...but I intend to get it back.
>>>>>>>>
>>>>>>>> Still can strike you in .02 seconds ;))) Tai Chi stuff;))
>>>>>>>>
>>>>>>>> Bill (Never Would)
>>>>>>>>
>>>>>>>> I'll ask my PCP about a CK test as I am ignorant about it. Aug 15
>>>>>>>> 05
>>>>>>>>
>>>>>>>>
>>>>>>>> William(bill)
>>>>>>>>
>>>>>>>
>>>>>>> Here is a link which tells a little about the CK test (also called
>>>>>>> the CPK test):
>>>>>>>
>>>>>>> http://www.mdausa.org/publications/Quest/q71ss-cktest.html
>>>>>>>
>>>>>>> It is sometimes used to help determine whether the pain you are
>>>>>>> feeling is caused by statin damage. I don't know how long the
>>>>>>> readings persist. Since you are feeling little pain now I suspect
>>>>>>> the readings would be low in Aug. If your Dr. had previously taken
>>>>>>> this test and they were high before and low now that, coupled with
>>>>>>> your improved condition, would SUGGEST to me that 1. This was
>>>>>>> probably due to the statin.
>>>>>>
>>>>>> Agree
>>>>>>
>>>>>>>2. You should be able to make a full recovery.
>>>>>>
>>>>>> There is a body of evidence beginning to accumulate that there can be
>>>>>> ongoing damage. (Heard in a discussion about current studies -
>>>>>> nothing I can point to that is published yet)
>>>>>>
>>>>>> Also, my own husband's experience (anecdotal, I know) is that the
>>>>>> OX-Phos respiration at the mitochondrial level is still not working
>>>>>> at 3 1/2 years off the statin. Once one unit of ATP is used up, if
>>>>>> the exercise continues the muscle cells suffer oxidative damage and
>>>>>> apoptosis begins, the body floods with Uric Acid to halt the
>>>>>> apoptosis, the uric acid precipitates into needle-like crystals and
>>>>>> settles into the joints causing gout/rheumatoid arthritis and
>>>>>> damaging the kidneys. Pain and fatigue and exhaustion are a given
>>>>>> throughout. BTW, "exercise" is at the level of walking from the
>>>>>> handicapped space to the back wall of Home Depot and back with a bad
>>>>>> knee - we are not talking marathon running here.
>>>>>>
>>>>>> Absolutely day and night different from his pre-statin athletic
>>>>>> abilities, lighting-quick reflexes, and stamina.
>>>>>>
>>>>>> Pre-statin muscles were bulky, calves had that squared-off blocky
>>>>>> muscle "played HS football" look, muscle tone maintained in upper
>>>>>> arms, chest, even with mid-life weight gain. On Lipitor the calves
>>>>>> melted away and looked like swimmer muscles. Arms and chest go into
>>>>>> a rigor every afternoon - like a body cast from wrist to wrist, neck
>>>>>> to waist - clenched like a stiff neck. (This was mentioned in the
>>>>>> Smart Money article, the journalist had an opportunity to observe it,
>>>>>> feel the hard contraction, see it continued for hours.)
>>>>>>
>>>>>> No fun.
>>>>>>
>>>>>> 4 years on Lipitor 10 mg, now 3 1/2 years off and the muscle damage
>>>>>> goes on and on.
>>>>>>
>>>>>> Improvement since off the Lipitor, however, includes the fact that he
>>>>>> isn't collapsing on the floor like a pile of dirty laundry when he
>>>>>> tries to stand for 4 minutes, as he did on the Lipitor.
>>>>>>
>>>>>>>
>>>>>>> I think Sharon and Zee know more about this test.
>>>>>>>
>>>>>>
>>>>>> Joint advisory from the AHA, ACC and NHLBI urges doctors to employ it
>>>>>> when there is any muscle pain on statins. Used as an early warning
>>>>>> to a condition that can escalate to rhabdomyolysis.
>>>>>>
>>>>>> Dr. Phillips has shown that statin myopathy and myositis can be
>>>>>> demonstrated on muscle biopsy even in the absence of elevated CK, but
>>>>>> elevated CK does indicate muscle damage.
>>>>>>
>>>>>> There are some finer distinctions that can be included, like
>>>>>> differentiating between heart muscle damage and skeletal muscle
>>>>>> damage.
>>>>>>
>>>>>
>>>>> I do not think that there has ever been a case in which 1. The effects
>>>>> of the statins continued long after the statins were stopped. 2. The
>>>>> pain subsided after the statin was stopped. 3. CK levels were normal.
>>>>>
>>>>> You can correct me if I am wrong on that.
>>>>
>>>> Were you intending those to be logical 'ands' or a sequence? Not sure
>>>> what you mean.
>>>>
>>>
>>>
>>> Yes those were intended to be "ands" Again I don't think there has been
>>> a documented case with those 3 together. Clearly there has been with
>>> each seperately. However, I am willing to admit that I might well be
>>> wrong if you know of such a case.
>>>
>>
>> Let's be careful here. The most reported statin adverse effects of
>> statins are, in this order (per Dr. Golomb's presentation at
>> International CoQ10 Assn conference, regarding her data collected in the
>> course of her study):
>>
>> 1- Muscle adverse effects (myopathy, myositis, muscle wasting,
>> mitochondrial damage, cellular mitochondrial respiratory damage,
>> apoptosis, sometimes accompanied by elevated CK)
>> 2 - Cognitive adverse effects (confusion, memory loss, aphasia, amnesia,
>> etc.)
>> 3) - Neuropathy (peripheral neuropathy, polyneuropathy)
>>
>> Some people, like my husband (who took Lipitor 10mg for 4 years), develop
>> all three categories of statin adverse effects - an entire constellation
>> of symptoms (which may someday be termed a statin syndrome).
>>
>> Some people develop only one category, most often muscle damage, of the
>> statin adverse effects. (Notwithstanding the Muldoon studies, showing
>> measurable cognitive damage in statin takers after only 6 months, which
>> makes me, at least, suspect that there may be some level of cognitive
>> damage in all statin takers, even though it may not be noticed by the
>> patient or diagnosed clinically.)
>>
>> If you intended to discuss and describe only the muscle damage adverse
>> effect of statins, and only those who develop only muscle damage (to
>> their knowledge), then the rarity of your proposed situation is likely
>> true in most cases, where (""=your words, [] = my clarification)
>>
>> "1. The [muscle damage] effects of the statins continued long after the
>> statins were stopped.
>> 2. The [muscle] pain subsided after the statin was stopped.
>> 3. CK levels were normal."
>>
>> In other words, IME it would be rare to see all 3 be true at the same
>> time in a post-statin patient.
>>
>> However, your #2 is what would make that true, as for most people #1 is
>> determined by #2, in other words, they experience the pain and then find
>> that it is due to muscle damage. If they have ongoing muscle damage,
>> they likely would have ongoing pain, and thereby be left out of your set
>> of 3 logical "ands".
>>
>> Thus, for 1 (lingering post-statin muscle damage) to be present, 2 (pain)
>> would likely also be present, and perhaps 3 (elevated CK).
>>
>
> I think you are agreeing that in William's case it is unlikely that muscle
> damage will continue. But what I wanted to focus on was CK levels. I said
> the following in my previous post in regard to Dr. Phillips study.
>
>> I know. But, if I recall correctly, none of those persisted - i.e. all
>> reversed when the statin was discontinued. (When there was no elevated CK
>> levels)
>>
>
> Do you know of an instance where muscle problems have continued after
> stopping the statins when CK levels were normal?

Good question. I have not asked that particular question of people, so I
cannot say with anything to base it on.

Certainly I wish everyone a speedy recovery from statin adverse effects.

It would seem logical that lasting muscle problems (particularly
mitochodrial respiratory dysfunction) would result in ongoing damage or
apoptosis, so it would be logical that there would be markers for that
expressed as an elevated CK or CPK, so I think your hypothesis is realistic.

You would need to keep in mind that elevated CK is simply a measure of
muscle cells damaged or dying (apoptosis). If the ongoing statin adverse
effects to muscles are in the area of mitochondrial respiration, with damage
whenever 1 unit of APT is exceeded, then a person could learn to live by
limiting all physical activity to 20 minutes or less per day. If they did
that (e.g., resign themselves to a battery-driven wheel chair), then they
could possibly avoid the dying and dead muscle cells (elevated CK), but
still have the lasting muscle damage due to statin adverse effects.

In other words, to call it a recovery there should be the ability to
function normally, not just the avoidance of pain and damage by lack of
physical exertion of any kind, should be part of the definition.


>
> Bill
>>>> #1 is well documented as occurring in many people.
>>>>
>>>> The sooner the problem is identified, related to the statin, and the
>>>> statin halted, the more likely 2 and 3 will occur sooner rather than
>>>> later.
>>>>
>>>>>
>>>>> However, in the absence of such information, I suspect William will
>>>>> make a full recovery.
>>>>
>>>> That is my fervent hope.
>>>>
>>>>>
>>>>> In Dr. Phillips studies the only patients who had persistent symptoms
>>>>> after discontinuing statins also had high CK levels.
>>>>
>>>> Actually, although Dr. Phillips does see patients with elevated CK, his
>>>> published "breakthrough" study demonstrated myopathy and myositis in
>>>> the ABSENCE of elevated CK.
>>>>
>>>
>>> I know. But, if I recall correctly, none of those persisted - i.e. all
>>> reversed when the statin was discontinued. (When there was no elevated
>>> CK levels)
>>>
>>> Bill
>>>
>>>> Muscle damage (and neuromuscular pain) can be the result of a statin
>>>> with or without elevated CK.
>>>>
>>>> Unfortunately, Dr. Phillips is finding that in some cases the myopathy
>>>> and myositis statin adverse effects continue and appear to be
>>>> permanent.
>>>>
>>>> Dr. Golomb reported at the International Coenzyme Q10 Assn conference
>>>> that 20% or more of the cognitive loss due to statin adverse effects is
>>>> permanent and unrecoverable.
>>>>
>>>> Ever the optimist (maybe because of my married last name?), I am hoping
>>>> and praying that "permanent" means more years to go before full
>>>> recovery, as this area of study has not been around for that long.
>>>>
>>>> Mevacor was first approved September 1, 1987. The studies tend to show
>>>> that adverse effects can be dosage related, and the higher
>>>> dose/stronger statins followed. We are under 20 years in our statin
>>>> era, and it takes about 7 1/2 years for adverse effects to be
>>>> recognized, for various reasons. Thus the studies into 'permanent'
>>>> damage are all under 20 years old. People in their 40s and younger
>>>> are taking statins (I have corresponded with one woman who had AEs
>>>> after 4 years of statins, first prescribed when she was age 24!). If
>>>> 'permanent' means 20 years so far (likely much less for any serious
>>>> study or anecdotal case workup with followup) we can always hope that
>>>> when a 40 year old
>>>> statin-taker-who-experienced-adverse-effects-from-the-statin might
>>>> possibly achieve full recovery by 60+ years of age. We can hope.
>>>>>
>>>>> Bill
>>>>>
>>>>>
>>>>>>> Bill
>>>>>>>
>>>>>>>
>>>>>>>
>>>>>>
>>>>>>
>>>>>
>>>>>
>>>>
>>>>
>>>
>>>
>>
>>
>
>


.

Relevant Pages

  • Re: Outcomes in 45 patients with statin-associated myopathy
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  • Re: CK blood test
    ... >> cause is a statin requires the false positive rate to be low. ... >>> In the case of statins, muscle pain and muscle damage with and without ... >>> adverse effects studies awaiting publication. ...
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  • Re: CK blood test
    ... >>> disabled from statin adverse effects. ... >>> taking is that drug. ... >> damage as identified by elevated CK? ... >>> as muscle damage, cognitive damage and nerve damage, many doctors ...
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  • Re: aggressive statin treatment may affect mitochondrial volume
    ... >>> mitochondrial damage, cellular mitochondrial respiratory damage, ... >>> of symptoms (which may someday be termed a statin syndrome). ... >>> Some people develop only one category, most often muscle damage, of the ... >>> statin adverse effects. ...
    (sci.med.cardiology)
  • Re: CK blood test
    ... > likely cause is a statin requires the false positive rate to be low. ... most common known adverse effects of the drug the patient is taking is that ... damage, cognitive damage and nerve damage, many doctors faced with that ... >> In the case of statins, muscle pain and muscle damage with and without ...
    (sci.med.cardiology)
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