Even though managing cholesterol can be a very important task, one when doctors likely step in by prescribing statins like Lipitor, there are side effect risks (like with any drug). The trouble is determining how likely those side effects are, and proactive patients don’t always know how to assess that without some serious direction.
Some statin risks include Type 2 diabetes and muscle and liver damage. For writer Wendy Wolfson, both heart disease and diabetes run in her family – so when she needed to address her high cholesterol, it seemed like an unfortunate toss up.
As Wolfson details in a piece for NPR, she didn’t fit in with the risk guidelines put out by the American Heart Association, but her dad died before age 55 from a heart attack and population margins can be tricky to interpret, which “dumped me right back into the slush pile of uncertainty.”
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She pointed to Lipitor’s recent track record, which indicates some issues. “It had $631 million in U.S. sales in 2013, down from a peak of $7 billion in 2006.” But she also figured her risk wasn’t dangerously high after looking at different statistics and having email correspondence withDr. Naveed Sattar, a professor of metabolic medicine at the University of Glasgow who writes for Diabetes Update. “He tactfully confirmed that my diabetes fears were overblown.”
“After four months on statins, my blood glucose still tested normal, but I was feeling increasingly seedy, wobbly-kneed and weak, she wrote. “Maybe reading all those studies had fanned my incipient hypochondria, but going for a walk was like slogging through mud. Forget running. And my liver was squawking. My liver enzyme level was only a few points above normal, but it had almost tripled since last year.”
Wolfson eventually dropped the Lipitor after even further investigation of her real risks on either the heart disease side or diabetes and considering her resulting weakness. But she said she was left feeling like all of this work to really determine if taking a drug was worth it was in someways brushed over by her doctor who initially prescribed it.
I finally got in to see my doctor last week. She didn’t remember repeatedly insisting that I take the highest dosage of Lipitor, but after I briefly reviewed with her my risks and side effects, based on real research and experience this time, she agreed I could drop the statin.
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Doctors are busy, see many patients each day and can’t reasonably go to all of the measures Wolfson did for each case. But what they can do is insist that patients themselves do some investigation and ask the right questions.
I’m still shaken because she had prescribed to formula but not to me as an individual. We both missed things in the risk conversations we should have had. Next time I hope to do better at asking questions like “Why?” and “What happens in people like me?” and “What are the alternatives?”
And of course, “Where can I look this up?”
