Blaming cholesterol med for achy muscles

BY MICHAEL ROIZEN AND MEHMET OZ Jan 31, 2011 06:02PM

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Q. I take the minimum dose of the statin drug simvastatin once a day for my cholesterol. I used to take Crestor. Simvastatin doesn’t do as good a job ­­­— my LDL is still a little high and my HDL is a little low — but Crestor made my muscles ache. is there a way to avoid taking a bigger dose of simvastatin? a. At the Cleveland Clinic, where Dr. Mike works, a novel regimen is being used to help people like you, who get achy from powerful statins (Crestor’s one) but who aren’t helped enough by milder statins.

The new Cleveland approach is a spin on combination therapy: You continue your usual daily low dose of simvastatin, then twice a week (say on Tuesday and Saturday) add a low dose (5 mg) of rosuvastatin (Crestor).

This regimen gives your heart-healthy HDL cholesterol a major boost while lowering lousy, artery-clogging LDL by 80 percent — all without causing muscle aches.

(You may be able to stop the simvastatin if the low dose of Crestor is enough.) Talk to your doc about this.

Most docs in our Wellness Institute also advise coenzyme Q10, 200 mg a day, every day, to help decrease the risk of muscle pain.

Q. I’ve been on a statin drug for a couple of years, and my cholesterol is still going up, even though I’ve become a vegetarian. My doctor just upped my statin dose. I’m “of a certain age,” so could perimenopause have anything to do with it?

a. Maybe. Starting to go through “the change” changes more than just your periods and your internal thermostat.

On average, lousy cholesterol jumps 10.5 points, or about 9 percent, as women journey through menopause, found the Study of Women’s Health across the Nation.

But it also could be a number of other things. First, get your thyroid checked.

Some menopausal symptoms (hot flashes, dry skin, mood swings, weight gain) also are signs of an over- or underactive thyroid. plus, an impaired thyroid can make your cholesterol wacky.

A sluggish thyroid, for example, may raise lousy LDL cholesterol as well as triglycerides, and may put you in the queue for heart disease and high blood pressure. New studies suggest that this can happen even if your thyroid is only a bit off.

Ironically, your cholesterol troubles also could be from your vegetarian diet. if you replaced meat with a lot of full-fat cheese, milk, yogurt and baked goods, you’re still eating a lot of saturated fat, which sends cholesterol soaring.

Q. I recently had a thyroid test that came back abnormal. My doctor says it may be a false positive because I’m on a statin drug. what does one have to do with the other?

a. a couple of years ago, a group of Texas researchers played a hunch and took a second look at more than 300 people with low thyroid stimulating hormone, a sign of an overactive thyroid gland. When they ran a more specialized test (a radioactive iodine scan), about half of those taking a statin drug turned out to have normal thyroids.

Most of those not taking statins really did have overactive thyroids, which can cause heart palpitations, anxiety, muscle weakness and sleep problems.

Statins may lower TSH without actually affecting thyroid function, and that could be what your doc suspects happened to you.

It’s worth asking your doc for a more specialized test.

To submit questions, go to RealAge.com.

King Features Syndicate

I have a friend who has been diagnosed with Hepatitis C. She is having a lot of pain in the area of her liver as well as having "lumps" on the back of her neck. She has been waiting for three weeks for the viral load panel (?) to come back before they discuss treatments. what type of treatment is available and do these symptoms sounds like the disease has progressed?

To clear up what a viral load is, it's the amount of virus found in one milliliter of blood. But viral loads vary from one person to the next so they're not always a good indicator of the severity of the disease but this will give your friend's doctor a baseline number to work with. This is something that will be rechecked during her treatment and the results will be compared to previous tests to see if the viral load goes down. This tells the doctor (and your friend) the current treatment, whatever it turns out to be, is working… or not.

If viral loads warrant, her doctor will likely start her on a combination of two drugs. This is called combination therapy ans this approach has shown better results than using one drug alone (monotherapy). There are a number of antiviral drugs used but I have no way to know if your friend needs them and, if she does, which ones her doctor will prescribe. You can run a search for this if you really need to know.

I'm guessing your friend's hepatitis C is acute rather than chronic. her symptoms sound like the early phase of acute hepatitis but only a small number of people have symptoms during the early phase. Symptoms when present generally appear 5-12 weeks after exposure. 80% don't have symptoms and sometimes symptoms don't show up for 10, 15 or even 20 years later and by the time they do, serious damage may already have been done to the liver.

"do these symptoms sounds like the disease has progressed?" — I can't tell you what you want to know. I'd need to see multiple diagnostic test results.

My answer is about the viral particle, as the term Hepatitis refers to the disease itself and you are not. The Hepatitis C virus (HCV) is a small (55-65 nm) in size, enveloped, positive single strand RNA virus in the family flavivinande. Although Hepatitis a,B,and C all have similar names, they do all cause different Hepatitis and liver inflammation disease. they are all both distinctly different genetically and clinically.
Unlike both types a and B, type C doesn't have a life saving vaccination either. not until 2007 was a potential World Wide Distribution of a preventative vaccine with the only animal HCV study involved being the Chimpanzee. hopefully sometime soon a vaccine for humans will be found and approved that works too. good luck and God Bless.