CoQ10

[Mr_Tomahawk]

Should I take it?

And I need a multivitamin to offset my frozen burrito diet. Recommendations?

[Hog's Gone Fishin]

Originally Posted by SupDock

I'd be interested to hear what he has to say. Keep in mind, CoQ10 has data (mixed) for its use in patients with heart failure with a reduced ejection fraction. I see it more commonly recommended for this indication.

I'm specifically referring to its use to alleviate statin associated muscle symptoms

a simple Google search will show you a lot of literature (American college of cardiology, American heart association)

I took pravastatin years ago and started having chest pain every morning when I first wake up and then my muscles in my forearms became 80% useless. I was then informed that statins could cause those symptoms so I quit them, that was ummm 18 years ago. Took about 2 months for the chest pain to go away and around 10 years to get my arms back to 90%.

So currently my cholesterol always runs 270-280 and my current heart doctor keeps trying to get me to take a statin and he just says take a CoQ10 with it. I refuse it all.

PS... I was able to get on Praulent injectible for some time and it literally cut my cholesterol 50% but BCBS quit covering it and I'm not paying $1300 month for the med

[DaneMcCloud]

Originally Posted by SupDock

You had a bad experience, so you would not advise anyone to ever take it?

My parents have had the same issues, although their doctors didn't push Statins on them until their late 60's.

Otherwise healthy people that take Statins develop Type II Diabetes in 20% of patients who take a statin, so to answer your question, the answer is a hard "Yes".

There are other options out there as well to reduce cholesterol, such as Cholestyramine, which does not affect the liver or other internal organs.

Originally Posted by SupDock

Millions of people take statins daily, and reduce their risk of heart attack and stroke.

95% of people prescribed Statins are done so because it's "Preventive Medicine" and only 5% actually benefit from the cholesterol reduction.

Originally Posted by SupDock

Do some people have side effects and have to stop them? Absolutely.

It's more than just "some".

Originally Posted by SupDock

Pretty much every diabetic is recommended to take a statin, regardless of their family history

That may be true but those people have health issues that extend beyond an otherwise healthy person.

[BIG_DADDY]

Originally Posted by Hog's Gone Fishin

I took pravastatin years ago and started having chest pain every morning when I first wake up and then my muscles in my forearms became 80% useless. I was then informed that statins could cause those symptoms so I quit them, that was ummm 18 years ago. Took about 2 months for the chest pain to go away and around 10 years to get my arms back to 90%.

So currently my cholesterol always runs 270-280 and my current heart doctor keeps trying to get me to take a statin and he just says take a CoQ10 with it. I refuse it all.

I was taking CoQ10 injectable. It was awesome but last year the Feds banned the sale. Your tax dollars hard at work. Everything that is not a vaccine they would love to ban. The most awesome thing I have ever done to feel better is hyperbaric IV ozone therapy with an NAD add on. I am sure they will ban that soon as well. 9ers are in there all the time getting that before a game.

[SupDock]

Originally Posted by Hog's Gone Fishin

I took pravastatin years ago and started having chest pain every morning when I first wake up and then my muscles in my forearms became 80% useless. I was then informed that statins could cause those symptoms so I quit them, that was ummm 18 years ago. Took about 2 months for the chest pain to go away and around 10 years to get my arms back to 90%.

So currently my cholesterol always runs 270-280 and my current heart doctor keeps trying to get me to take a statin and he just says take a CoQ10 with it. I refuse it all.

PS... I was able to get on Praulent injectible for some time and it literally cut my cholesterol 50% but BCBS quit covering it and I'm not paying $1300 month for the med

I have encountered several patients like you, and always hate hearing those stories. Some people cannot tolerate statins no matter how low the dose.

Praluent and Repatha are great options if you can get insurance to cover it.

[SupDock]

Originally Posted by DaneMcCloud

My parents have had the same issues, although their doctors didn't push Statins on them until their late 60's.

Otherwise healthy people that take Statins develop Type II Diabetes in 20% of patients who take a statin, so to answer your question, the answer is a hard "Yes".

There are other options out there as well to reduce cholesterol, such as Cholestyramine, which does not affect the liver or other internal organs.



95% of people prescribed Statins are done so because it's "Preventive Medicine" and only 5% actually benefit from the cholesterol reduction.



It's more than just "some".



That may be true but those people have health issues that extend beyond an otherwise healthy person.

I'll try to address some of these things

For preventative prescription, I am guessing you are talking about primary prevention, ie preventing the first heart attack. with statins, you generally look at someone's 10-year risk to having a heart attack. there is some disagreement, but generally if your risk is greater than 7.5%, it's recommended that you are on statin therapy. This is calculated based on your age, blood pressure, cholesterol, smoking status, etc. (ASCVD risk). While the percentage may vary (some say 10%) there is a consensus for prescription of a statin when your risk reaches a certain level.

http://tools.acc.org/ASCVD-Risk-Esti...late/estimate/


https://www.uspreventiveservicestask...ive-medication



In regards to prescribing statins to people in their late 60s, this is actually the time where I the data is less clear for prescribing. Especially at age 75, lowering cholesterol is associated with worse outcomes for primary prevention. So someone in their late 60s, likely will not be on a statin very long.

https://www.choosingwisely.org/patie...-75-and-older/


There are certain conditions where people are almost universally recommended to be on a statin. people with diabetes, people with prior heart attacks, people with prior strokes, people with other forms of heart disease

In regards to cholestyramine, this is generally thought of as a third line agent for reaching LDL goals. by that I mean, if a patient is on a maximum dose statin, and also on ezetemibe, And is still not at goal you would consider cholestyramine unless they had high triglycerides

I'm aware of the increased risk of type 2 diabetes with statin therapy, unfortunately there is not a good answer for this. Even if a patient develops type 2 diabetes, they still retain the cardiovascular benefit of statin therapy. education is important when starting the medication, but I have yet to hear a recommendation to stop prescribing statins for people who meet criteria. Education for weight loss, exercise, healthy food choices is very important.

In regards to how many people cannot tolerate statins, I will continue to say some. I don't really want to get into a debate about what "some" means, the data I have seen shows 5 to 10%

[DaneMcCloud]

Originally Posted by SupDock

I'll try to address some of these things

For preventative prescription, I am guessing you are talking about primary prevention, ie preventing the first heart attack. with statins, you generally look at someone's 10-year risk to having a heart attack. there is some disagreement, but generally if your risk is greater than 7.5%, it's recommended that you are on statin therapy. This is calculated based on your age, blood pressure, cholesterol, smoking status, etc. (ASCVD risk). While the percentage may vary (some say 10%) there is a consensus for prescription of a statin when your risk reaches a certain level.

I never smoked in my life, there was zero history of heart disease in my family, yet one UCLA doctor pushed me to take statins for 2 full years, despite the liver enzyme levels and despite the muscle and joint pain that it caused.

6 years later, another doctor tried to push statins on me and just to humor him, I took them every other day for 1 month but the pain was so bad, I could barely get out of bed in the morning. I discontinued use and had pain for the following 6 months.

Before I started statins, I was walking 25 miles a week in the hills, biking 60 miles a week and lifting heavily at the gym. Three years later, I could barely walk around my house.

You may be different but my experience with doctors is that they do not listen to the patient and instead, just push the AMA guidelines, which pisses me off to no end. There is absolutely no reason why a physically fit, healthy 40 year old male should be forced to take a "Preventative" medicine.

My 12 year old is 5'3 and weighs 85 pounds and after a blood panel that was ordered last summer to check her vitamin levels, found the cholesterol level to be 20 points higher than normal.

For many people, genetic high cholesterol is just that: High cholesterol that doesn't lead to stroke or heart attacks but these doctors just push and push and push, so hell yeah, I'm saying NO.

[SupDock]

Originally Posted by DaneMcCloud

I never smoked in my life, there was zero history of heart disease in my family, yet one UCLA doctor pushed me to take statins for 2 full years, despite the liver enzyme levels and despite the muscle and joint pain that it caused.

6 years later, another doctor tried to push statins on me and just to humor him, I took them every other day for 1 month but the pain was so bad, I could barely get out of bed in the morning. I discontinued use and had pain for the following 6 months.

Before I started statins, I was walking 25 miles a week in the hills, biking 60 miles a week and lifting heavily at the gym. Three years later, I could barely walk around my house.

You may be different but my experience with doctors is that they do not listen to the patient and instead, just push the AMA guidelines, which pisses me off to no end. There is absolutely no reason why a physically fit, healthy 40 year old male should be forced to take a "Preventative" medicine.

My 12 year old is 5'3 and weighs 85 pounds and after a blood panel that was ordered last summer to check her vitamin levels, found the cholesterol level to be 20 points higher than normal.

For many people, genetic high cholesterol is just that: High cholesterol that doesn't lead to stroke or heart attacks but these doctors just push and push and push, so hell yeah, I'm saying NO.

You are absolutely entitled to say no. you have complete autonomy over your health and your own medical decisions. No one should be forced to comply, or felt forced to comply with any medical recommendation.

As a healthcare provider, toeing the line between making recommendations and allowing for patient autonomy is important. However, you also cannot let bad outcomes skew your recommendations. for instance, you will run into people who have developed statin-induced myopathies, some get very sick from it. You cannot allow that experience to prevent you from appropriately recommending statins in the future. that being said, if a patient has not tolerated statins, and had significant side effects, it's hard to imagine a scenario where you would want to compel them to take it again in the future

The only reason I entered this thread was due to people saying that everyone on a statin should take CoQ10, or that no one should take a statin for preventative measures.

[DaneMcCloud]

Originally Posted by SupDock

You are absolutely entitled to say no. you have complete autonomy over your health and your own medical decisions. No one should be forced to comply, or felt forced to comply with any medical recommendation.

You know, that's thing, man: Who am I to tell a doctor "No"? That had always been my philosophy with doctors but now, I'm the only person that will decide whether or not I take a pharmaceutical, not the doctor.

Again, it sounds like you're a different kind of doctor than most I've seen and that's totally awesome. But I think that so many people, myself included, just take the recommendation of a doctor's pharma prescription with no question asked, unknown consequences be damned.

Since that time, I've researched each and every drug that's been prescribed to me, my wife and children, then weigh the positives and negatives before just filling the prescription and picking it up at CVS.

[SupDock]

Originally Posted by DaneMcCloud

Since that time, I've researched each and every drug that's been prescribed to me, my wife and children, then weigh the positives and negatives before just filling the prescription and picking it up at CVS.

Your healthcare provider really should help you with that, and I'm sorry that responsibility has fallen on you. I applaud you for putting in the work, though, and realizing that ultimately it is your health and your body.

This conversation is an interesting one, and a very complicated one

One of the issues is time, talking about these things takes time, and a lot of providers don't have enough time.

Next, some people just want to be told what to do with their healthcare. They don't want recommendations or options. In medicine you have to be a bit of a chameleon, taking different approaches with different patients depending on their expectations. It's also important to keep in mind that not all patients and providers are a good fit for each other, and that's ok.

Previously, a lot of physician were trained this way as well. Healthcare was prescriptive and not patient centered. Decision making was not shared. Some providers also take pride in telling patients what to do and being authoritative ("don't give options, man up and tell them what to do")

Another thing to keep in mind, is that when we are looking at medical therapies, it's based on treating populations, not individuals.
I'm going to make up some numbers to give an example.

******

Let's say that a group of people has a 10 percent risk of a heart attack, and a medicine reduces that risk to 5 percent. You could tell a patient "this medicine reduces your risk of a heart attack by 50 percent (relative risk reduction, 10 percent to 5 percent, most meds are advertised this way).
You would also be correct saying it reduces you risk by 5 percent (absolute risk reduction 10 percent to 5 percent)

Based on this data, you would need to give 20 people this medicine to prevent one heart attack.
I could take this information and say, I have 500 patients on this medicine, I've prevented 25 heart attacks.
As a patient, you are wondering if you are 1 of the 25 people in my practice getting a benefit.

***********

I've probably left more questions than answers, but that happens a lot with me. I have absolutely enjoyed this conversation, though.

I think that if you keep looking, you will find providers that are good fit for you, but continue to be your own advocate, especially when it comes to your own health.

[Chiefshrink]

Red Yeast Rice, Co-Q10 and odorless garlic if want to go the natural way. But don't use Red Yeast Rice with a drug statin. Your Co-Q10 level goes down when using a drug statin or natural statin(Red Yeast Rice) and why you take additional Co-Q10 supplement to assist your natural process of producing Co-Q10 keeping the CoQ10 at a healthy level in your body of which the majority of it is produced in your heart.

https://www.livestrong.com/article/4...ed-yeast-rice/

https://www.superfoodly.com/red-yeast-rice-with-coq10/

[Mr_Tomahawk]

Soooooo...is that a no?

[cooper barrett]

it's a NO unless your doc says take it or amend your will.