I’ve been taking statins for over 30 years. I’m now on my fourth sort, as each causes me unhealthy side-effects. How essential is it that I take them?
Name and handle provided.
This query will probably be of curiosity to most of the eight million individuals within the UK who take statins to decrease their ldl cholesterol.
Cholesterol, a pure fatty substance in your blood, is essential for the functioning of many processes within the physique (for instance, it’s utilized by pores and skin cells to make vitamin D from daylight). However, excessive ranges enhance the chance of coronary heart illness and stroke by contributing to fatty deposits in artery partitions.
Despite the advantage of statins, as many as one in two individuals scale back their dose or cease taking them due to the side-effects, reminiscent of muscle ache and constipation.
I’ve been taking statins for over 30 years. I’m now on my fourth sort, as each causes me unhealthy side-effects. How essential is it that I take them? (inventory picture)
The truth that you just eat healthily is useful, however it’s unlikely that this lowers your ldl cholesterol sufficient (inventory picture)
However, a research of 4 million sufferers, revealed within the European Heart Journal final 12 months, steered the true prevalence of side-effects is probably going nearer to 10 per cent. Other analysis suggests muscle ache, for instance, could also be a results of ageing quite than the remedy.
It is troublesome for me to advise whether or not statins are important for you with out understanding all of your threat components for coronary heart illness (reminiscent of age, ethnicity, blood stress and household historical past, as an illustration). You say in your longer letter that your ldl cholesterol is 7mmol/l, which is above the advisable restrict of 5, and you’re additionally pre-diabetic.
The truth that you just eat healthily is useful, however it’s unlikely that this lowers your ldl cholesterol sufficient. That’s as a result of most ldl cholesterol is made within the liver and a number of things, together with genes, decide how a lot the physique makes.
There are different drugs that decrease ldl cholesterol. One potential possibility for you is the drug ezetimibe, which may be prescribed alone or together with a statin. While statins work by suppressing ldl cholesterol manufacturing within the liver, ezetimibe lowers ldl cholesterol absorption within the gut. But it, too, has potential side-effects, reminiscent of abdomen ache.
Another possibility is a brand new class of medicine referred to as PCSK9 inhibitors — these work by inhibiting a protein (PCSK9) within the liver that breaks down receptors that ‘unhealthy’ LDL ldl cholesterol latch on to. The extra of those receptors that you’ve got, the decrease your LDL.
The two PCSK9 inhibitors at the moment accessible are solely prescribed for sufferers unable to take a statin or to regulate their ldl cholesterol with ezetimibe. They’re given by injection each two to 4 weeks, however they, too, have potential side-effects: 1-10 per cent of sufferers get flu-like signs for a day or two after the injection.
PCSK9 inhibitors need to be prescribed by a heart specialist or in a lipid therapy clinic, and so that you would want to request a referral through your GP. But do stick with discovering a therapy that works for you, because the well being advantages of decrease ldl cholesterol could possibly be important.
My father experiences ache in his toes when the climate is chilly, and they are often purple, swollen and sore to the touch. What do you assume is the issue?
Hayden Wan, Glasgow.
I consider your father has chilblains, a criticism that impacts 10 per cent of individuals sooner or later.
They’re triggered by publicity to chilly or damp air: because the pores and skin warms up, small, itchy, crimson or purple swellings can develop. These swellings may be painful and blister.
They happen when the small arteries close to the floor of the pores and skin turn into slim when it’s chilly; they then widen as heat returns however in some individuals, if the pores and skin warms too shortly the blood vessels can’t deal with the elevated blood move. The blood leaks into close by tissue, inflicting the signs related to chilblains.
While the toes are the commonest website, actually any of the physique’s extremities — fingers, heels, ears, nostril — may be affected.
Chilblains can final for months, particularly within the UK, because of our damp, chilly climate. While they usually clear presently of 12 months, they will persist by way of summer season as any sudden cooling or heating can set off them. Even strolling barefoot on chilly flooring could be a set off, so I’d suggest carrying socks and heat slippers at house.
Smoking and vaping considerably enhance the chance as they constrict blood vessels, so in case your father is a tobacco consumer, stopping will assist.
Soothing lotions based mostly on witchhazel may help with itching, however it might be price asking his GP concerning the drug, nifedipine. Taken as a each day pill, it really works by enjoyable the blood vessels, bettering circulation. But it does convey a threat of side-effects reminiscent of dizziness (because it lowers blood stress), so I’d urge your father to deal with prevention.
- Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or electronic mail: [email protected]. Dr Scurr can’t enter into private correspondence. Replies must be taken in a common context. Consult your personal GP with any well being worries.
In my view: Setting the bar excessive for fellow docs
Every from time to time I hear of one thing that reaffirms my religion in my career.
The affected person was seen the next day by a heart specialist and full investigations are beneath manner (inventory picture)
Last Saturday, an previous buddy was getting back from a live performance together with his spouse on a darkish wet night time. As they walked again to their automobile, his spouse — more and more breathless — mentioned that she was unable to proceed and needed to relaxation. Coming the opposite manner was their GP.
He sat her on a close-by bench, carried out a short examination (at midnight and rain) and suggested she see a heart specialist, stating that he would organize it.
On the Monday, he visited her at house and spent an hour conducting a bodily examination. The affected person was seen the next day by a heart specialist and full investigations are beneath manner.
The pity is it occurred in Toulouse, France, the place the couple have not too long ago retired. Nevertheless, that is the type of normal of care that we must always aspire to.
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