I was on Zocor for high cholesterol and constantly complained to my doctor of sore muscles. He switched me from Zocor to Crestor a year and a half ago. After a year on Crestor I was really miserable with sore muscles and fatigue. For the prior six months, I had not been able to raise my right arm due to a sore shoulder that still keeps me awake at night. I stopped taking the Crestor for 30 days at the end of 2007 and felt much better, except for my sore shoulder. When I notified my doctor, he then put me back on the Zocor.

From what I have read previously in your column that if a person is over 60 and has a cholesterol level under 200, he or she shouldn’t need drugs. Do I have to take medication that makes me miserable?

DEAR READER:
The purpose of these drugs is to reduce the risk of heart disease because of high cholesterol. As I have reported in the past, some medications for this purpose do cause muscle pain, leg cramps, fatigue, and a number of other symptoms. What’s more, they can affect the liver once taken, even in appropriate doses. For this reason, simple periodic lab testing should be done to assure levels remain within normal limits.

Unfortunately, you did not indicate in your letter if you have other medical conditions, particularly cardiac in nature, that would suggest your physician might want you to have total cholesterol levels below the 180 reported. If this is not the case, I personally feel you do not need any drugs. I should also add that there are considerations such as niacin and flax seed oil that could be taken without prescription that have been reported to reduce levels. Still, lab testing should be done periodically.

In any event, I strongly urge you to return to your physician for an explanation and guidance. If he or she has a strong basis for wanting you to have lower readings, find out what they are. Ask for a trial without medication while on a restricted diet. Make sure you get your questions answered to your satisfaction.

I would also like to comment on your doctor’s prescription decision. You claim to have had side effects from Zocor. At that time your doctor appropriately switched you to another medication. However, you also had adverse reactions. Now comes the problem. Your physician put you back on the medication that caused symptoms and the reason for the switch in the first place. In my opinion, this is down-right dumb. You have a prior history of side effects and should not have been put back on that medication. There are several choices available to lower cholesterol and there is no need to put a patient back on a medication that has caused problems. If you truly need statin medications, you need to try a new non-statin, not one that will invariably cause you ill effects.

To give you 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, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Statin drugs are effective in lowering cholesterol levels and reducing the risk of heart attack and death in patients with known coronary artery disease. Lipitor (atorvastatin), Lescol (fluvastatin), Mevacor (lovastatin), Pravachol (pravastatin), Zocor (simvastatin), and Crestor (rosuvastatin) fall into the statin category. If you are on any of these medications, you are taking a statin.

The most common side effects are elevated liver enzymes and leg cramping. If you are on a statin, your doctor should schedule periodic laboratory testing to determine if your levels are within normal limits. If the cholesterol level remains high despite the medication or the liver enzymes start to rise to dangerous levels, he or she will likely make a determination to change to another drug that will be more effective.

I don’t wish to be offensive but it is just plain foolish to be taking any drug without knowing what it is, why you’re taking it and how long. It is also important to know if it should be taken with food or on an empty stomach, if there is an equally effective yet cheaper generic brand and what the consequences might be if you miss a dose. Because statin drugs can have serious side effects, it is often necessary to undergo a trial period of two or three weeks to determine if you can tolerate it. Diet modifications must be made before any cholesterol-lowering medication is prescribed. A low fat, low salt diet may even eliminate the need for statins and should be continued once you have been diagnosed with elevated cholesterol levels.

I urge you return to your primary care physician with a list of questions. Take a spouse, relative or friend with you if you wish. Two heads are often better than one when it comes to remembering important information. You owe it to yourself to be an informed consumer and your doctor owes it to you to explain why he or she is recommending you subject your body to medication.

To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicines”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.