Advice needed on Statins/Repatha

I had an angioplasty in July last year. I was put on a low dose (5mg) of Rosuvastatin along with blood thinners. Recently, about two months ago, I started developing muscular pain in the left arm. My doctor then suggested I do a CKMB test which indicates whether muscular degeneration has taken place. It turned out to be positive with 6+ as my reading. She stopped my rosuvastatin thereafter and has put me on atvorstatin 5mg every alternate day. She said we will try this for a month and see if symptoms remain and if the lipid profile is fine. It’s just about 10 days into this treatment. My arm pain has not subsided much. She has suggested that I take Repatha if need be after 1 month. I would love to know how you are managing without statins and Repatha to keep your LDL in the low range. I have also bought the book “Mastering Diabetes”. Thanks if you can respond. I am a Type 2 Diabetic of 30 years duration.

Jaybee, I have been taking 4 mgs Omega-3-acid Ethyl Esters daily and CholestOff Plus. I couldn’t take statins or Repatha. I am thrilled that I can take Praluent 75 mgs without any side effects so far.

I am trying to avoid leg bypass surgery, so I am doing a lot of walking. I see the vascular surgeon in early June. I am not familiar with what is going on with you, but I will educate myself. Best of luck to you. I hope that you find Mastering Diabetes helpful.

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I was on atvorstatin for some time, then started developing intense pain in the hips. Asked endo to change, but she gave me rosuvastatin, which changed nothing. I researched it myself, asked her to prescribe one of 2, she selected pravastatin.

Incidence of myalgia among statin drugs

Lowest

  • Lovastatin 1.8% to 3%
  • Pravastatin 0.6% to 1.4%

Higher

  • Pitavastatin 3.1%
  • Atorvastatin ≤5.6%
  • Fluvastatin 3.8% to 5%
  • Rosuvastatin 2.8% to 12.7%
  • Simvastatin 3.7%

Source: statins and myalgia_v2_9.29.15-fin (suny.edu)

T1D person here, but my experience with oral statins might help. I had intense, sometimes full body, muscle cramps with the statins. I just had my first injection a week ago. Esay pen injector (I haven’t used pens in decades!) quite the sting during the injection, but it wasn’t horrid. I also had muscle proteins in a urinalysis, so that was the reason insurance covered the Repatha. Overall, I don’t really have much of a cholestrerol issue - it’s mostly prophylactic use.

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Marilyn6, thanks for your response . I have noted down the meds you are taking . Will ask my cardiologist if these can be suitable for me . I haven’t started Repatha because of all the horrible side effects listed
I will have to take a decision once the month of alternative 5mg atvorstatin treatment gets over
Strange ., but I have leg issues just like you . The arterial Doppler confirmed the thin trickle of blood in my leg arteries
Have been advised to see a vascular surgeon also . Have been postponing this . The foot doc said that the thinners I have been taking for my heart , is enabling me to continue walking ! Anyway I am walking a lot !
The Mastering Diabetes book is advocating the opposite of a keto diet but will give it a try ! Do let me know about your leg issues Thanks

Thanks for your response . Has the Pravastatin reduced / eliminated your hip pain ? Any muscular pain ?

Thanks for the link describing the degree of myalgia caused by each statin .
Will ask my Cardiologist to change my statin . Didn’t know Rosuvastatin was banned in the UK
It sure is the worst one for muscle pain
So onwards !

Though prophylactic , has Repatha brought down your LDL further ? Because that seems to be its purpose .
No side reactions ? Been taking it for some time ?
Grateful for your inputs
Thanks

@jaybee I’d urge you to see the vascular surgeon if your Dopplers are abnormal. It’s likely showing you have monophasic pulse waveforms, which are often seen downstream of stenosis.

I had this issue last year following major heart surgery - wounds on my lower legs wouldn’t heal. My arteries are so severely calcified that they couldn’t reopen them with stents, they could only widen some of them with balloon angioplasty.

My cholesterol numbers are and have always been low. Is the calcification a result of a lifetime of T1D, or a combination of that plus renal failure? :thinking:

Please do not put off seeing a vascular surgeon ASAP. You need to find out how bad your circulation is. Meanwhile walking is the best thing that you can do. Look up PAD on YouTube where you will find lots of good advice about walking, and what procedures are available if walking is not enough. I imagine my calcification started years ago when my diabetic control was not good. If I had been able to take a statin decades ago, I might be in better shape now.

The pain is definitely gone, but I do have some ache in my thighs, but I do so much fitness/thigh work on the rowing machine, it is hard to say why.

But thanks for bringing this up. I might have to revisit my statins.

Isn’t balloon angioplasty done before putting in stents ?
Was walking an issue before the procedure ?
I will see the vascular surgeon soon I am first trying to get rid of the muscles pain in my arm
Thanks for your inputs

Yes I have also seen the YouTube videos . I am also doing leg exercises once in a while . Am planning to see the vascular surgeon soon
Thanks

Great about pain gone . I will also try the pravastatin
Thanks

Yes, but stents can’t be inserted in vessels that are severely blocked. Other options are percutaneous laser coronary angioplasty or percutaneous transluminal coronary rotational atherectomy (a rotating device cuts out the blockages)

Months? Years?
I’m curious because I’ve been on Atorvastatin for about a year with no side effects. I think I figured that meant I tolerated the drug at my current dose. How long into using Atorvastatin did you notice the pain?

My artery was too blocked for a stent, although there are PAD surgeons who can get around blockages, but I haven’t been able to talk with my surgeon to see what he thinks we should do. He did mention walking so I am certainly doing that. We may have to travel to get an expert who does some of the newer techniques. The hospitals in the large city which is 2 hrs away, are overwhelmed with patients. I know that getting a second opinion is really encouraged by the people on YouTube so I would like to find a very competent surgeon somewhere else.

@Marilyn6 There’s only so much they can do with highly calcified arteries. If laser angioplasty or rotary atherectomy aren’t viable, there’s always the option of doing a bypass (graft), the downside is the surgery carries a significant risks including heart attack, blood clots, infection and even death.

Usually grafts are only done in cases of critical leg ischemia.

I definitely don’t want to have bypass surgery!
By walking I want to create a natural bypass.
My left leg is ok, and I don’t have complete closure in my right leg. If my leg hurt without exercise, I would be more concerned, not that I am not really concerned now. What is really weird to me, is that shortly before I found out that I have PAD, I had a glowing report of
my heart arteries. Better than I have had since I received 2 stents 14 yrs ago. I have many
questions for my surgeon about my options now.

It certainly sounds like you had an excellent vascular surgeon.

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Since my cholesterol was boarder line high a few years ago, my Endo started me on Simvastatin. I started to get muscle pain, and as the year progressed, I became more tired and the pain became intense. Additionally, I started to lose all muscle strength. After three doctor visits, I was diagnosed with polymyositis, but since that diagnosis came from a General Practitioner based on a couple of blood test results, I decided to go to Mayo Clinic in Rochester, MN, before I went on the prescribed drug. After $32,000 worth of tests in one week, I was diagnosed with Dermatomyositis and prescribed a different drug. I could have died had the Dermatomyositis decided to attack my heart first. That’s when I learned that statins were a POSSIBLE (not proven) cause for developing myositis. That was enough for me. I dropped all statins and NEVER would recommend them to anyone.

My doctor suggested I try Ezetimibe (Zetia) since it is NOT a statin and works differently in the body. She cautioned that Ezetimibe alone may do nothing for me, which is why it many times is combined with Simvastatin. I tried the Ezetimibe alone and discovered that I am one of the fortunate people for whom the drug alone works well. My triglycerides are 42, my cholesterol is 152, my HDL is 63, and my LDL is 81. I am pleased with those results. I will NEVER take a statin again, and I would caution others to be very careful with them. Will the Ezetimibe work for you? Who knows; however, it certainly is worth a try. Good luck!

One statin was not good for my liver, Crestor and Zetia both caused neuropathy for me. My husband takes a statin and has no side effects. I am not taking a statin, and was able to reduce my LDL down to 80. Now my cardiologist and vascular surgeon want to see it at 30, so I am taking Praluent with no side effects so far.