DEAR DR. GOTT: I would appreciate your advice. I am a 72-year-old Caucasian female with treated high blood pressure and high cholesterol (362)/triglycerides (403). Using a statin drug, I am able to get them down to 231 and 288, respectively. My problem is that I react poorly to statins. My legs have become weak, I have a nightmare of leg cramps, my muscles hurt, and I cope with nausea and gas. The cramps have spread to my hands and chest muscles.
I formerly was walking two miles a day; now I can barely walk a half-mile, and that is with stops. I have tried niacin and red yeast rice. I am currently taking omega-3 and flaxseed-oil capsules.
I am 5 feet, 2 inches and weigh 168 pounds. I am careful about my diet. I feel good and energetic when not taking a statin; however, I’m lethargic when taking the drug. I’m afraid to quit but am truly miserable, so which is the lesser evil? I truly do not know what to do.
DEAR READER: Statin drugs work well, but for some people, the price is high. This poses the question of whether the benefits outweigh the risks. No one wants to suffer a heart attack or stroke, nor do they want unpleasant side effects such as those you have experienced. The answer should be a decision between a patient and his or her physician. That said, there might be alternatives. First, however, let’s hit some possibilities.
You can lower the dose of your medication. This may reduce or eliminate the leg cramps and fatigue but may also reduce the effectiveness of the statin. You can change to another label; however, this might not be successful. You have already cut back on your exercise routine, so I can’t endorse a further reduction. While some researchers question its effectiveness, you might consider ezetimibe, a prescription cholesterol-absorption inhibitor, or you might try an over-the-counter with natural plant stanols and sterols. You don’t indicate if the niacin was at all effective. Did you give it a try for a satisfactory length of time?
If you smoke, discontinue the habit. Eliminate fried foods, the skin on chicken and the fat on steak. Broil meats, and be sure to cut off any excess fat prior to cooking. Continue to exercise and modify your diet. Eat more fruits, vegetables, whole grains, fish and chicken. Limit the amount of cheese and eggs you consume, and switch to fat-free milk.
Ask your physician if he or she would consider an appropriate length of time so you can initiate a new diet and exercise plan. Perhaps a referral to a nutritionist and the physical-therapy department of your local hospital will be appropriate. Consider an OTC that doesn’t contain a statin component.
Ask your physician or specialist for advice on treating your leg cramps. If an underlying cause, such as iron deficiency or peripheral neuropathy, enters the equation, obtain appropriate treatment. Then consider ibuprofen, meditation, yoga and warm or cold packs. Avoid caffeine and alcohol. Place a bar of soap under your bed sheet to alleviate cramping. Exercise, but don’t overdo it, because fatigue will make your symptoms worse.
To provide related information, I am sending you a copy of my Health Report “Understanding Cholesterol.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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