Drugs Found in Puget Sound Salmon from Tainted Wastewater


Puget Sound salmon are on drugs — Prozac, Advil, Benadryl, Lipitor, even cocaine.

Those drugs and dozens of others are showing up in the tissues of juvenile chinook, researchers have found, thanks to tainted wastewater discharge.

The estuary waters near the outfalls of sewage-treatment plants, and effluent sampled at the plants, were cocktails of 81 drugs and personal-care products, with levels detected among the highest in the nation.

The medicine chest of common drugs also included Flonase, Aleve and Tylenol. Paxil, Valium and Zoloft. Tagamet, OxyContin and Darvon. Nicotine and caffeine. Fungicides, antiseptics and anticoagulants. And Cipro and other antibiotics galore.

Why are the levels so high? It could be because people here use more of the drugs detected, or it could be related to wastewater-treatment plants’ processes, said Jim Meador, an environmental toxicologist at NOAA’s Northwest Fisheries Science Center in Seattle and lead author on a paper published this week in the journal Environmental Pollution.

“The concentrations in effluent were higher than we expected,” Meador said. “We analyzed samples for 150 compounds and we had 61 percent of them detected in effluent. So we know these are going into the estuaries.”

The samples were gathered over two days in September 2014 from Sinclair Inlet off Bremerton and near the mouth of Blair Waterway in Tacoma’s Commencement Bay.

The chemicals turned up in both the water and the tissues of migratory juvenile chinook salmon and resident staghorn sculpin. If anything, the study probably underreports the amount of drugs in the water closer to outfall pipes, or in deeper water, researchers found.

Even fish tested in the intended control waters in the Nisqually estuary, which receives no direct municipal treatment-plant discharge, tested positive for an alphabet soup of chemicals in supposedly pristine waters.

“That was supposed to be our clean reference area,” Meador said. He also was surprised that levels in many cases were higher than in many of the 50 largest wastewater-treatment plants around the nation. Those plants were sampled in another study by the EPA.

The findings are of concern because most of the chemicals detected are not monitored or regulated in wastewater, and there is little or no established science on the environmental toxicity for the vast majority of the compounds detected.

Meador said he doubted there would be effects from the chemicals on human health, because people don’t eat sculpin or juvenile chinook, and levels are probably too low in the water to be active in humans. But one of the reasons the wastewater pollutants studied as a class are called “chemicals of emerging concern” is because so little is known about them.

Turmeric As Effective As Aspirin, Prozac, Lipitor, Metformin And 10 Other Drugs


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Turmeric is one the most altogether explored plants in presence today. Its restorative properties and parts (essentially curcumin) have been the subject of more than 5600 companion looked into and distributed biomedical studies. Actually, our five-year long research venture on this sacarosanct planthas uncovered more than 600 potential preventive and helpful applications, and also 175 unmistakable valuable physiological impacts. This whole database of 1,585 ncbi-hyperlinked turmeric edited compositions can be downloaded as a PDF at our Downloadable Turmeric Document page, and procured either as a retail thing or with 200 GMI-tokens, for those of you who are as of now are individuals and receive the automatically each month. naturally every month

Given the sheer thickness of exploration performed on this astounding zest, it is no big surprise that a developing number of studies have inferred that it looks at positively to a mixed bag of ordinary pharmaceuticals, including:

Lipitor/Atorvastatin(cholesterol medication): A 2008 study published in the journal Drugs in R & D found that a standardized preparation of curcuminoids from Turmeric compared favorably to the drug atorvastatin (trade name Lipitor) on endothelial dysfunction, the underlying pathology of the blood vessels that drives atherosclerosis, in association with reductions in inflammation and oxidative stress in type 2 diabetic patients. [i] [For additioncurcumin and ‘high cholesterol’ research

Corticosteroids (steroid medications): A 1999 study published in the journal Phytotherapy Research found that the primary polyphenol in turmeric, the saffron colored pigment known as curcumin, compared favorably to steroids in the management of chronic anterior uveitis, an inflammatory eye disease.[ii] A 2008 study published in Critical Care Medicine found that curcumin compared favorably to the corticosteroid drug dexamethasone in the animal model as an alternative therapy for protecting lung transplantation-associated injury by down-regulating inflammatory genes.[iii] An earlier 2003 study published in Cancer Letters found the same drug also compared favorably to dexamethasone in a lung ischaemia-repurfusion injury model [for additional curcumin and inflammation research

Prozac/Fluoxetine & Imipramine (antidepressants): A 2011 study published in the journal Acta Poloniae Pharmaceutica found that curcumin compared favorably to both drugs in reducing depressive behavior in an animal model.[v] [for additional curcumin and depressionresearch

Headache medicine (blood more slender): A 1986 in vitro and ex vivo study distributed in the journalArzneimittelforschung found that curcumin has hostile to platelet and prostacyclin balancing impacts contrasted with ibuprofen, showing it may have esteem in patients inclined to vascular thrombosis and obliging against joint pain therapy.[vi] [for extra curcumin and against platelet

Anti-inflammatory Drugs: A 2004 study published in the journal Oncogene found that curcumin (as well as resveratrol) were effective alternatives to the drugs aspirin, ibuprofen, sulindac, phenylbutazone, naproxen, indomethacin, diclofenac, dexamethasone, celecoxib, and tamoxifen in exerting anti-inflammatory and anti-proliferative activity against tumor cells.[vii] [for additional curcumin and anti-proliferative research

Oxaliplatin (chemotherapy drug)

Metformin (diabetes drug): A 2009 study published in the journal Biochemitry and Biophysical Research Community explored how curcumin might be valuable in treating diabetes, finding that it activates AMPK (which increases glucose uptake) and suppresses gluconeogenic gene expression

Another route in which turmeric and its parts uncover their astounding remedial properties is in examination on medication safe and multi-drug safe tumors. We have two segments on our site committed to inquiring about common and integrative treatments on these subjects, keeping in mind there are many substances with obvious viability against these chemotherapy-and radiation-safe growths, curcumin tops both records:

Tumors: Drug Resistant

Tumors: Multi-Drug Resistant

We have recognized 27 contemplates on curcumin’s capacity to either impel cell passing or sharpen multi-drug safe growth cell lines to routine treatment.

Considering how solid a reputation turmeric (curcumin) has, having been utilized as both sustenance and prescription in an extensive variety of societies, for a great many years, an in number contention can be made for utilizing curcumin as a medication option or adjuvant in tumor treatment

Lipitor Without a Rx? Pfizer Pushes Ahead With OTC Plans.


Pfizer, the maker of Lipitor, is pushing forward with efforts to sell its drug to patients without a doctor’s prescription, according to the Wall Street Journal.

The company recently launched a 1200-patient study to investigate whether patients could successfully take over-the-counter (OTC)atorvastatin to lower their LDL-cholesterol levels. Patients in the trial, which is currently recruiting at 35 US pharmacies, would get their own blood tests and would make decisions based on those results.

A positive study would determine whether Pfizer will file for regulatory approval of its OTC medication, according to the Journal.

Simvastatin has been available OTC at the 10-mg dose in the UK for nearly 10 years. Merck has gone before the US Food and Drug Administration three times since 2000, but the agency has turned away its drug, lovastatin (Mevacor) 20 mg, each and every time. Merck sought approval of OTC lovastatin in moderate-risk patients and aimed to market its drug to the “motivated health-conscious consumer.”

Like Merck, Pfizer says an OTC Lipitor would close the gap for people at risk of cardiovascular disease but who are not currently taking the lipid-lowering therapy.

Dr Neil Stone (Northwestern University Feinberg School of Medicine, Chicago, IL), the chair of the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for the treatment of cholesterol, told the Journal the new guidelines do not support OTC use of statins. In fact, the new guidelines don’t recommend treating to LDL targets any longer but instead recommend a moderate- or high-potency statin based on patient’s 10-year risk of cardiovascular disease.

Given that Pfizer is investigating the feasibility of just a 10-mg dose of Lipitor, undertreatment is a concern. “There’s a chance that a lot of people would take less than needed,” Dr Steven Nissen (Cleveland Clinic, OH) told the Journal.

At one stage, Lipitor was the world’s biggest-selling drug, with sales peaking at $13 billion in 2006, but since the patent expired sales have declined to $2.3 billion in 2012, reports the Journal.

The Common Drug that Destroys Your Memory.


Story at-a-glance

  • Dr. Graveline shares his powerful story about how the drug Lipitor caused him severe global transient amnesia, which is what brought him out of retirement to investigate statins
  • There have been thousands of cases of transient global amnesia and other types of cognitive damage associated with statin use, reported to the FDA’s MedWatch site
  • It is believed that statin drugs damage your brain by creating a cholesterol deficiency; insufficient cholesterol results in your brain not having the raw materials it needs to make biochemicals critical for memory and cognitive function, including coenzyme Q10 and dolichols
  • It is believed that statin drugs damage your brain by creating a cholesterol deficiency; insufficient cholesterol results in your brain not having the raw materials it needs to make biochemicals critical for memory and cognitive function, including coenzyme Q10 and dolichols
  • Dolichols carry the genetic instructions from your DNA to help create specific proteins in your body, which are crucial for cognitive function, emotions and moods—a shortage of dolichols can have disastrous results, including depression, aggression, and suicide

Dr. Graveline has an interesting background that makes him particularly suited to speak on the topic of statin drugs. He’s a medical doctor with 23 years of experience whose health was seriously damaged by a statin drug. His personal questions brought him out of retirement to investigate statins, which he’s been doing for the past 10 years.

As a former astronaut, he would get annual physicals at the Johnson Space Center in Houston. In 1999 his cholesterol hit 280 and he was given a prescription for Lipitor.

“When they suggested Lipitor (10 mg), I went along with it because I had no reason to be particularly worried about statin drugs,” he says. “I had used it a year or so before my retirement, but I wasn’t a big user.”

However, it quickly became apparent that something was seriously wrong.

“It was six weeks later when I experienced my first episode of what was later diagnosed as transient global amnesia,” Dr. Graveline says.

“This is an unusual form of amnesia wherein you immediately, without the slightest warning, are unable to formulate new memory and you can no longer communicate. Not because you cannot talk, but you can’t remember the last syllable that was spoken to you. So nothing you say is relevant anymore. In addition, you have a retrograde loss of memory, sometimes decades into the past.”

He “woke up” about six hours later in the office of a neurologist, who gave him the diagnosis: transient global amnesia. He quit taking the Lipitor despite the reassurances from his doctors that the drug was not of concern, and that it was just a coincidence.

He had no relapses during the remainder of the year, but his cholesterol was still around 280 at his next physical. He was again urged to take Lipitor, and he relented.

“I admit I was concerned, but I had talked to maybe 30 doctors and a few pharmacologists during the interval,” Dr. Graveline says. “They all said “statins don’t do that.” So I allowed myself to go back on statins but this time I took just 5 mg.

…[E]ight weeks later, I had my second, and my worst episode. In this one, I was a 13-year-old high school student for 12 hours… This is what convinced me, when I finally woke up, that something was wrong with the statin drugs. And yet, the doctors were, for years after that, still saying that this was just a remarkable coincidence.

This took me out of retirement and I’ve been actively involved in researching statin drugs ever since.”

Statin Drugs: Not Nearly as Safe as You’re Told

Dr. Graveline has since published a book about his discoveries called Lipitor: Thief of Memory.

“In trying to reach an explanation, I called Joe Graedon and asked him if he had ever heard of any unusual reactions associated with statins,” Dr. Graveline says of his initial investigations.

He was directed to the statin effects study by Beatrice Golomb in San Diego, California, and his story was also published in a syndicated newspaper column. Within weeks, the web site he had created received reports of 22 cases of transient global amnesia, along with hundreds of cases of cognitive damage. At present, over 2,000 cases of transient global amnesia associated with the use of statins have been reported to FDA’s MedWatch.

But cognitive problems are not the only harmful aspect of these drugs. Other serious adverse reactions include:

Personality changes / mood disorders

Pancreas or liver dysfunction, including a potential increase in liver enzymes

Memory loss

Impaired function of the heart muscle and heart failure

Muscle problems (rhabdomyolysis), polyneuropathy (nerve damage in the hands and feet), and rhabdomyolysis (a serious degenerative muscle tissue condition)

Increased risk for diabetes, Lou Gehrig’s disease, cancer, stroke, and heart attack

Sexual dysfunction

Cataracts

Immune suppression

Anemia

 

According to Dr. Graveline, a form of Lou Gehrig’s disease or ALS may also be a side effect, although the US FDA is resistant to accept the link found by their Swedish counterpart, and has so far refused to issue a warning.

“The World Health Organization (WHO) reported on this in July 2007 when Ralph Edwards, who directs the Vigibase in Sweden (the equivalent of the US MedWatch), reported ALS-like conditions in statin users worldwide,” Dr. Graveline says.

He has since forwarded hundreds of cases to MedWatch, but the FDA still has not been moved to act, and doctors are therefore unaware of the connection between this deadly disease and statin use.

“[W]e have anecdotal evidence that if you stop the statin drug early enough, some of these cases regress. That’s why we thought it was important that FDA issue a warning, but they haven’t,” Dr. Graveline says.

Today, all of these adverse effects, including the cognitive problems Dr. Graveline warned about 10 years ago, are supported by published research. At the time of this interview (February 2011), MedWatch had received about 80,000 reports of adverse events related to statin drugs, and remember, only an estimated one to 10 percent of side effects are ever reported, so the true scope of statins’ adverse effects are still greatly underestimated.

For a more in-depth explanation of how statins damage your mitochondria and DNA, resulting in a variety of health problems, please listen to the interview in its entirety or read through the transcript as he discusses far more than I can include here.

How Statins Harm Your Brain Function

As is often the case with pharmaceutical drugs, the side effects end up teaching us new things about how the human body works. When statins first hit the market, conventional medicine was unaware of the importance of cholesterol for proper brain function. Now, researchers believe that statins’ adverse effects on cognition are due to cholesterol insufficiency.

Research also began to emerge in 2001 showing the importance of cholesterol in the formation of memories.

“Then we have… dolichols,” Dr. Graveline says. “[W]hen a statin is used, it blocks the mevalonate pathway to get at cholesterol inhibition. It works very beautifully. But in so doing, it blocks CoQ10, dolichols, as well as other major biochemicals…

[D]olichol is one that most doctors have never even heard of before, but it just so happens that dolichols are almost as important as CoQ10 and cholesterol in cell processing.”

Dolichols carry your genetic instructions from your DNA to help create specific proteins in your body. If you develop a shortage of them, the messages are intermittent and chaotic. Some experts compare it to a computer virus that blocks specific paths to your files1 Dolichols are vital to a number of cellular processes, including:

  • Glycoprotein synthesis
  • Cell identification
  • Cell communication
  • Immunodefense
  • Neurohormone formation

Dr. Graveline goes on to explain that dolichols influence all the hormones involved with your mental condition, including your emotions and moods. And if you do not have sufficient dolichol, your entire process of neurohormone production will be altered-with potentially devastating results.

“[T]here are thousands of reports of aggressiveness and hostility, increased sensitivity, paranoia, depression and homicidal ideation,” Dr. Graveline says.

There are also numerous reports of suicide.

“This whole range of what I call personality- or emotion and behavioral responses have to do with the dolichol deficiency brought on by the mevalonate blockade,” Dr. Graveline explains.

“It’s not just something that occurs in an occasional person… You know we’re all the same and yet we’re all different… You give one medicine to 10 people and if you’re really lucky, in six of them it will do what it’s supposed to do. That’s the way it is with this. I expect there are some people that won’t get any effects of dolichol suppression because they have alternative pathways. The same thing probably holds for CoQ10.”

That said, it’s important to realize that your brain also requires cholesterol in order for memory formation to function normally. In essence, statins suppress a number of vital elements for proper brain functioning, including cholesterol, antioxidants and co-factors like CoQ10, and dolichol.

At the same time, statins also create mitochondrial DNA and cellular damage, including in your brain.

Your brain uses glial cells as factories for producing its own cholesterol on demand. Unfortunately, glial cells are affected by statins in the same way as your liver cells, or any other cell in our body. So if you take a statin, you’re also harming your glial cells and when they cease to function normally, that on-demand cholesterol capability also ceases and your brain can no longer function properly.

The Importance of CoQ10 or, if You’re Over 40, Ubiquinol

It’s now clear that if you take statin drugs without taking CoQ10, your health is at serious risk as statin drugs deplete your body of this essential co-enzyme. As your body gets more and more depleted of CoQ10, you may suffer from fatigue, muscle weakness and soreness, and eventually heart failure. Coenzyme Q10 is also very important in the process of neutralizing free radicals.

So when your CoQ10 is depleted, you enter a vicious cycle of increased free radicals, loss of cellular energy, and damaged mitochondrial DNA.

Unfortunately, the majority of people who take statins are unaware of their need for CoQ10, and physicians rarely advise their patients to take this supplement along with their statin-at least in the United States. It’s also important to supplement right from the start. According to Dr. Graveline, once the mitochondrial damage and mutations are formed they cannot be reversed-no matter how much CoQ10 you take.

So early intervention is key. (Dr. Graveline goes into further detail of how CoQ10 offers protection against mitochondrial DNA damage in this interview, so for more information, please listen to it in its entirety.) If you decide to take a CoQ10 supplement and are over the age of 40, it’s important to choose the reduced version, called ubiquinol.

Ubiquinol is a FAR more effective form-I personally take 1-3 a day as it has far-ranging health benefits. Dr. Graveline concurs with this recommendation.

As for dosage, Dr. Graveline makes the following recommendation:

  • If you have symptoms of statin damage such as muscle pain, take anywhere from 200 to 500 mg
  • If you just want to use it preventively, 200 mg or less should be sufficient

There’s also evidence that CoQ10/ubiquinol is beneficial for Parkinson’s disease and Alzheimer’s disease, and even cancer, and that large doses may be justified in those cases as well.

In addition, CoQ10 is believed to play an important role in preventing premature aging in general by preventing telomere shortening, which can slow or potentially even reverse the aging process. This is just one of the additional benefits of CoQ10, and one of the reasons why I take ubiquinol daily even though I’ve never been on a statin drug.

There are no reported side effects of CoQ10 supplementation, and neither I nor Dr. Graveline has ever heard of anyone overdosing on it. The only drawback is cost.

However, if you’re taking ubiquinol, here’s some cost-saving information for you.

Certified reduced ubiquinol is only manufactured by one company in the entire world, a Japanese company called Kaneca. They own the patent. So, as long as it’s certified ubiquinol, you can buy the cheapest brand you can find, because they’re all the same.

Other Valuable Antioxidants for Optimal Health-Especially if You’re Taking a Statin

CoQ10, or preferably the reduced version, ubiquinol, is at the top of the list of important supplements when you’re taking a statin drug. But there are also other antioxidants and nutrients that can be helpful. For example, selenium is also seriously inhibited by statin drugs, and selenium, along with magnesium, are commonly involved as co-factors in a variety of biological functions.

Other important nutrients include:

  • Vitamin C
  • Vitamin D
  • Vitamin E-An emerging form of vitamin E called tocotrienol is 50 times more powerful than tocopherol, which has been used for the past 60 years. It also helps produce cholesterol and has other biochemical advantages
  • Alpha-lipoic acid
  • L-carnitine-which helps metabolize fats properly. Since about 70 percent of your muscles’ energy comes from fats, it’s important to have the ability to metabolize them. According to Dr. Graveline:

“If you take L-carnitine and find that you suddenly feel much better, then you’ve just proven you need it for the rest of your life because you’re one of those people who have a dysfunction in this capability; you don’t have the means to properly burn fats at our muscle level… naturally you would then get weak when exercising. So it’s useful for making a diagnosis. If nothing happens after three months of a good dose, then I would say you can forget about L-carnitine.”

The Sad Truth: Even Your Doctor has Been Mislead About Cholesterol

That said, aside from taking CoQ10 if you’re on a statin, your diet really should be your primary source of nutrients. (For vitamin D, you’d ideally get it from sun exposure.) Supplements are just that; supplemental to an otherwise healthy diet.

“I think that when you have a statin associated muscle or nerve or even brain dysfunction, this is where you’ve got to go because that’s where the trouble is,” Dr. Graveline agrees.

“[I]f it’s cholesterol inhibition, you just eat more eggs… I can’t believe I went 17 years and never ate an egg. I can’t believe how gullible I was. I was this young medical doctor; I marched to that band of the cholesterol-causation people… I did everything I was supposed to do, and it was all wrong. I can’t believe that I was led astray, maybe for 25 years of my practice! It’s so bad to have to look back and realize you’ve been treating cardiovascular disease erroneously because you were doing what you were asked to do. The sad truth is that cholesterol, our supposed enemy for 35 years, has nothing to do with cardiovascular disease. It is the most important biochemical in your body.

…We all listened to what amounts to brainwashing. The brainwashing that we got from 1955 on, to just recently… They have liberalized the diet stuff recently though, so people are back to eating eggs and drinking whole milk and eating butter. I went around recommending margarine for so long, and margarine is what’s causing disease-butter is what’s helping to cure it. It’s incredible!”

This is true for the majority of our conventional medical professionals. They simply do not know better… which is all the more reason to arm yourself with the information you need to take control of your own health. Shunning statin drugs and addressing your lifestyle is the way to go if you have high cholesterol. For more information, please see my statin index page, which includes a plethora of free guidance and clear advice.

Source: mercola.com

Five Things You Need To Know When Deciding On A Cholesterol-Lowering Drug.


Recent news has caused millions of Americans to question whether they should be taking statin drugs, used for lowering cholesterol and preventing heart disease. TheFood and Drug Administration (FDA)recently announced safety labeling changes for statins and a prominent cardiologist warned in the New York Times that too many people are taking statin drugs.

The concerns affect many people since these blockbuster drugs are practically ubiquitous. Government studies indicate that there is a one in four chance that you are taking these medications if you are 45 years and older. About half of American men and a third of American women in the 65 to 74 years age range are taking statins.

Available products include single ingredient products ((atorvastatin), Lescol (fluvastatin), Mevacor (lovastatin), Altoprev (lovastatin extended-release), Livalo (pitavastatin), Pravachol (pravastatin), Crestor (rosuvastatin), and Zocor (simvastatin) and combination products (Advicor (lovastatin/niacin extended-release), Simcor (simvastatin/niacin extended-release), and Vytorin (simvastatin/ezetimibe)). Together they account for $14 billion in U.S. sales.

If you are taking statins, what should you do about this new information? Here are five key things to consider.

1. It is your decision.

First and foremost, this is your decision. Medicine is often defined by decisions with trade-offs and uncertainty. Choices about medications can be particularly challenging when they concern prevention. When you choose to take a drug for prevention, you have decided that the risks of the drug are more than offset by its future benefit.

Your doctors and health care professionals can guide you, but you deserve to be informed about the decision and make the choice that feels most comfortable to you. You do not know if you will be the person who avoids a heart attack or will suffer a side effect. You should have the information about what you are likely to gain by taking the medication – and what risks you are incurring. The decision to take the drug should mean that you believe that you are more likely to benefit from the drug than to be harmed by it. And even if a drug has a benefit for you, you have a right to decide whether it is right for you.

 

Moreover, in decisions about drugs for prevention, it is important to remember that lifestyle choices (e.g., not smoking, being active, eating healthy, and keeping your weight under control) should be a part of any strategy to lower risk of heart disease.

2. Statins reduce risk.

Among all prevention drugs, statins are among the most effective in lowering risk. These drugs have been shown, with quite a lot of evidence, to reduce the risk of heart attacks and deaths in a wide range of patients. Those taking statins have about a 20% lower risk of a heart attack and 10% lower risk of death. Higher dose and higher potency statins tend to reduce risk of heart disease a bit more.

The drugs with the strongest evidence of benefit are atorvastatin, lovastatin, pravastatin, simvastatin, and rosuvastatin.

This benefit is important because not all drugs that lower cholesterol or improve risk factors actually reduce the risk of heart disease. And some drugs even paradoxically increase risk. Questions remain about the effects on risk of many other lipid lowering drugs, such as niacin, fibrates, and ezetimibe.

3. Statins have risks.

Statins, like all drugs, have potential side effects. That is, although they are generally safe, they can cause harm in some people. Some of these side effects are well documented. In some people statins can cause muscle aches, soreness and weakness. This side effect is not uncommon and may occur in as many as one in ten people taking these medications. These symptoms usually resolve after discontinuing the drug – and they may not occur with another type of statin.

The new FDA announcement stated that there are rare reports of reversible memory loss and confusion, side effects that were considered not serious and went away when the drug was stopped. The reports about these side effects were submitted to the FDA by doctors and their relationship to statins is not certain.

The FDA also reported that blood sugar levels sometimes rise with statin therapy, but the importance of the finding is not known. For perspective, a recent study found that increases in blood sugar by a blood pressure drug, chlorthalidone, did not increase risk as much as would have been expected. Statins can very rarely also have more dramatic side effects such as life-threatening muscle damage or liver disease.

Finally, statins are generally drugs that are prescribed for a lifetime. Their effect over decades of use has yet to be determined.

Despite these risks, the trials showed a substantial benefit to these drugs – which is what has led them to be widely prescribed. But the drugs do cause harm for some even as they confer benefit for others.

4. Your risk matters.

Although the guidelines tend to focus on cholesterol levels in the decision to take statins, your overall risk of heart disease may be a more important factor in your decision. Since statins lower risk for people regardless of their cholesterol level, your benefit from the drug will depend on your risk of heart disease. If you have a low risk of heart disease, then you will have little to gain from treatment. A 20% reduction in a low risk of a heart attack may not mean much. The higher your risk, the more you have to gain.

Colleagues and I did a study and found that prescribing statins based on risk rather than cholesterol levels would lead to more lives being saved by treating fewer people. You can calculate your risk of heart disease from some online resources (http://www.reynoldsriskscore.org/ or http://www.framinghamheartstudy.org/risk/coronary.html). For many people a risk of less than 1% a year is considered low.

If you have heart disease, your risk of future events is higher and the benefit from statin therapy is generally considered substantial. In that case you do not even need to calculate your risk.

5. Minimize the statin risk.

If you do take statins, you have some choices that can minimize your risk.

First, you should be alert to symptoms that may signal a side effect. Talk to your doctor if you develop muscle aches, weakness or any new symptoms that concern you.

Second, lower doses are better. People with a higher risk of heart disease or with heart disease may benefit more from higher dose or higher potency statins (such as atorvastatin) but others may do better with a lower dose or less potent statin. These drugs tend to have fewer side effects.

Third, be aware that some other drugs you are taking may increase the risk of statins. Some drugs can markedly raise the risk of side effects of statins and you should ask your doctor about possible interactions if you are taking other medications. Also, for some statins, grapefruit juice can make the statin drugs more potent – though it is not clear if this raises the risk of side effects.

Finally, pravastatin appears not to increase blood sugar levels – so if this is a concern of yours, then you might want to try this medication. This statin is also less affected by other medications.

Bottom line: Statins are capable of remarkable reductions in the risk of heart disease and death. During the increase in their use there has been a marked decline in heart attacks and deaths from heart disease. The people with the most to gain are those with an increased risk of heart disease. If you are one such individual, and if your risk cannot be lowered by lifestyle changes, then statins are an excellent option. But it is your choice – and if you do take them, then be alert for side effects and minimize your risk.

The new information from the FDA or the admonitions from some experts does not fundamentally change the decision you have to make. Side effects are rare – but you should only take any drug if you are convinced that the benefits substantially outweigh the potential harms.

Harlan M. Krumholz MD, SM is the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University School of Medicine.

Source:Forbes Medicine

Generic Lipitor Makes Its Debut


The first generic versions of atorvastatin (brand name, Lipitor) are hitting the shelves. Watson Pharmaceuticals said it began shipping its generic version Wednesday, while the FDA approved Ranbaxy’s version of atorvastatin the same day.

A New York Times story outlines the steps Lipitor’s manufacturer, Pfizer, has taken to help maintain sales of the brand name version.

source: FDA

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