Lovastatin replacement suggestion please

#1

Currently on Lovastatin but I really don’t like statins in general, but am having some symptoms like leg cramps and lack of energy that I took myself off of it.

Tomorrow (Friday) I meet with me primary care doctor who is not my diabetes doc but prescribes everything else.

Any suggestions of what I can discus with him for alternatives?

I’m currently eating much better (lower carb) and exercising 30 min per day cardio, so that’s improved.

I just don’t like statins.

1 Like
#2

Definitely tell your doc about side effects you are having! Not everyone can take statins for a variety of reasons, and, unfortunately, diet education often doesn’t come along with the prescription—pills aren’t “magical”. Ask for a referral to a registered dietitian when you talk to the doc.

1 Like
#3

Neither alirocumab (Praluent) or evolocumab (Repatha) are statins and they can be used in addition to but also in some cases in place of statins.

#4

I took statins for years without any problems, but once I started having muscle spasms, I couldn’t take any statins at all. My overall cholesterol is good, but my LDL is a bit too high, and while I’ve had both a heart attack and a stroke in the past, I’ve elected not to take anything for the LDL and just watch my diet and try to get more exercise.

1 Like
#5

Atorvastatin and Rosuvastatin are the most effective at LDL reduction at lower doses. They also have less contraindications with other medications. Some of the statins are not recommended to be mixed with some of the blood pressure medications (at least not past certain dosages).

#6

I’d like to know more about this. Do you have any sources you can point me toward?

#7

I don’t like statins either and have reacted badly to all of them. Since I have heart stents and didn’t want to take the injectable alternatives, someone on this board suggested taking rosuvastatin at a very low dose. I started at 10mgs twice a week and my LDL came down. Now I am taking 10mgs 3 times a week in order to get my LDL down to 70. So far, I have no side effects and my liver enzymes are fine. I am very pleased to be taking such a very low dose.

#8

@MOOBM Do you have any sources you can point me too, showing where a lower dose is more effective at LDL reduction?

#9

Sorry…I didn’t go on this forum this weekend.

http://www.mqic.org/pdf/UMHS_Statin_Dose_Intensity_and_Equivalency_Chart.pdf

(The prices listed here may not be accurate because it was done in 2014.)

https://www.ncbi.nlm.nih.gov/books/NBK396417/table/ch1.t1/

The sources are really endless as it is a pretty well established fact about the various LDL reduction capabilities of the different statins.

This information may also be of interest to you:


and

This is about how the LDL Particle Number can be a more significant indicator of cardiovascular events. It is a scientific study so it may be challenging to understand it totally but if you read the conclusion at the end, that is the most important part. Essentially, they have found that the LDL Particle Number is more closely related to cardiovascular events. Some people have a “good” LDL level but their LDL Particle Number will still be high. These people have a higher risk of cardiovascular events. The first study was in 2007 and the second study is in 2014.

Hopefully this helps.

1 Like
#10

@MOOBM Thank you for the links; I do appreciate them! Unfortunately, I misunderstood your comment, “Atorvastatin and Rosuvastatin are the most effective at LDL reduction at lower doses.” I thought you were saying that a dose of 10mg was more effective than a dose of 20mg or greater. I thought it was interesting and I wanted to read more about it. Odder things have happened. I know from experience, more isn’t always better - there’s a mantra (with topical rx) … less is more (meaning the less you use, the better the outcome). Again, thank you very much for sharing the links and explaining them too!

1 Like
#11

Sorry…I can see where you got the other meaning from my sentence. I should have been more specific: Atorvastatin and rosuvastatin are more effective at lower doses than OTHER statins.

1 Like
#12

@MOOBM Thank you! That helps me understand what you were saying initially; I see it now. I can even relate, as my husband had gone from a higher dose of simvastatin to a lower dose of lipitor; I didn’t realize the connection with LDL levels. Thank you again!

#13

I have had my cholesterol particles looked at twice. My numbers are excellent, but my cardiologist won’t pay any attention to them. He said that he used to place some value in the test, but now he doesn’t. I really don’t understand why. I had a naturopathic doctor look at my results and say that I will have no more heart problems in the future and not to take statins, but my cardiologist wants my 117 LDL number down to 70 which requires a statin.

I have two heart stents which I received in 2010. My LDL was very high at the time.

#14

That is really interesting. There are quite a few studies behind it and the one thing they seem to conclusively state is that the LDL particle number is a better indicator. In your case, since they are excellent, I wouldn’t think it would be a big concern.
I personally don’t see how the naturopathic doctor could say that you will have no heart problems in the future.
I understand where your cardiologist is coming from with the LDL less than 70. The clinical guidelines (at the the endocrine ones) recommend the LDL target be less than 70 for those that are “very high risk”.

https://www.aace.com/files/lipid-guidelines.pdf Page 8
(Guidelines are just that guidelines. After reviewing all the available data, a general rule of thumb.)

#15

The naturopathic doctor was very impressed with my almost imperceptible amount of small, dense particles.

I am finding that although I felt no reaction to the statin at 20 mgs a week, I am reacting to 30 mgs a week much to my disappointment. It makes me feel hypoglycemic because of a bit of dizziness and fatigue. My liver enzymes are fine though.

I had one cardiologist who said he would be satisfied if I could get my LDL down to 100, so I may have to go with that.