Why don’t people talk about the problems with statins?

Dear people, PHARMACY: As a nurse, I have seen countless negative experiences with statin use over decades. Most often, the prescribing physician refuses to consider the possibility of statins as a cause, even though many patients become pain-free and return to normal activities when given a physician-approved “statin holiday.”

A patient with a total cholesterol level of 98 read your article about the dangers of extremely low cholesterol. The doctor replied, “The lower the better.” Shortly after, the patient died of a brain hemorrhage, as you warned in your article.

Reactions to statins can destroy lives, even though some doctors refuse to believe the reactions are serious.

A. You’ve raised one of the most controversial topics in cardiovascular medicine. Most experts agree that lowering LDL cholesterol reduces the risk of ischemic strokes (which are caused by blood clots in the brain). But they disagree about how using statins to lower LDL cholesterol affects the risk of hemorrhagic strokes (which are caused by bleeding in the brain).

The most recent meta-analysis reviewed 33 statin trials (Journal of the American Heart Association, February 20, 2024). The authors reported a small increased relative risk (17%) of bleeding in people taking statins to lower their LDL cholesterol. An accompanying editorial emphasizes that “… the fear of HS [hemorrhagic stroke] “The risk should not preclude the use of statins if clinically indicated.”

You can learn more about the pros and cons of statins and other ways to manage cardiovascular risk in our “eGuide to Cholesterol Control & Heart Health.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. I have sometimes suffered from irritation under the breast and in the groin area. Thanks to your website I have found a great remedy: topical milk of magnesia.

I use it as a deodorant and I think it works better than brand name deodorants. I just blow dry it after I apply it so it doesn’t run. I do the same for the area under my breasts every day. No more irritation!

A. A rash under the breast has a fancy medical name: inframammary intertrigo. It is usually associated with skin folds where sweat can collect and encourage yeast overgrowth.

Magnesium hydroxide (milk of magnesia) does not stop sweating like antiperspirants do. However, it does control odor when used on the armpits. We suspect that it may alter the balance of microbes on the skin. That could discourage the fungus that causes irritation.

Q. Reading your article about medications being risky in hot weather helped me understand my experience. I often feel too hot and have trouble sweating.

Because I have fibromyalgia, chronic pain syndrome and arthritis, I take gabapentin and amitriptyline and some other medications. Even in the middle of winter, I often have very little bedding on because I am too hot! My partner is going crazy because he feels the cold intensely. What do I need to know about these medications in the summer?

A. Antidepressants like amitriptyline are especially troublesome in hot weather because their anticholinergic activity reduces sweating, the body’s primary way of keeping cool, especially in hot and humid conditions. Reducing sweating makes hot weather riskier.

Do NOT stop taking your medication suddenly. This can cause unpleasant withdrawal symptoms. Your best strategy is to stay out of the sun and stay as cool as possible.

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In their column, Joe and Teresa Graedon answer letters from readers. Write to King Features, 628 Virginia Drive, Orlando, FL 32803, or e-mail them through their Web site: www.PeoplesPharmacy.com. Their latest book is “Top Screwups Doctors Make and How to Avoid Them.”

(c) 2024 King Features Syndicate, Inc.

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