Atorvastatin 2: Who Should Take It and Why

[@bartrobinson2103]

Hi Doc.. I Came Upon Your Channel a few months ago and subscribed please do some more videos and could you please discuss the coronary calcium scoring and give me your opinion of it please? My standard lipid panel has been perfect all my life and I have a slight family history of heart disease I'm very fit and healthy but I had a 490 coronary calcium score a couple years ago. Have been on 20mg of atorvastatin but really not getting any follow-up kind of feel left in the dark any comments much appreciated thank you sir! It's also my understanding that much smaller doses of rosuvastatin are far better for inflammation which I feel is the key driver heart disease not cholesterol

[@CardioGauge]

Hi Bart, thanks for Subscribing. I really do need to do some more videos. I use calcium scoring in people who have a family history of coronary artery disease and have a normal lipid panel. I also use it in people who are worried about having heart and blood vessel disease and want to know as much as possible about their risk before considering medication. The average age of a person with a calcium score of 490 is about 80 years old. The average age of a person with a calcium score of 30 is 60 years old. Because I do not know your age, I do not know what to say about your calcium score of 490. This is a calculator where you can plug in your age, gender, and race, and see what the average calcium score would be for someone in your shoes. www.mesa-nhlbi.org/Calcium/input.aspx I have patients who are in their 60s, with normal cholesterol levels, but family history of coronary artery disease. I check their calcium score, and if it is elevated, I recommend statin medication. I have a couple of patients and your shoes, with calcium scores around 500. I gave them atorvastatin. Rosuvastatin is not proven to be better than atorvastatin. I do not know which one is better. They both appear to be good medications. They are both generic. It seems like people have less muscle aches with rosuvastatin, as compared to atorvastatin. But as far as rosuvastatin actually being better than atorvastatin, I would not consider that a factual true statement. In terms of which is worse, LDL cholesterol, or inflammation, nobody knows the answer. They both appear to be a problem, in general. We are getting to understand inflammation more, and there is ongoing study of anti-inflammation medication for preventing heart disease. clinicaltrials.gov/ct2/show/NCT01594333 If I had a patient who wanted to switch from atorvastatin 20 mg per day to rosuvastatin 10 or 20 mg per day, I would switch them without thinking about it. I consider both medications good for patients with elevated calcium score. I also usually give my patients with elevated calcium score aspirin 81 mg per day. This can prevent a sudden blood clot in a coronary blood vessel (heart attack). Best Wishes!

[@bartrobinson2103]

CardioGauge .. thank you so much for your response sir. Yes I forgot to say that I am 58 years old so obviously my score isn't good at my age as I said I'm very active and in great shape but that always doesn't do the trick. Going to try to convince my doctor to do some more advanced blood work like I initially had three years ago such as NMR profile and inflammation panel possibly? All they want to do is standard blood work and put me on a treadmill once a year for a stress test which of course I passed with flying colors. Thanks again for taking the time to respond I look forward to see more from you on your Channel! And oh yes I also take 81 mg aspirin

[@CardioGauge]

The NMR panel mostly would serve curiosity rather than affecting your treatment. The high calcium score indicates the presence of atherosclerosis. While it is true that the test could show a high risk profile that was not picked up with the standard lipids test, you already know you are in a higher risk category because of the calcium score. If you have biological children, you could look at your NMR profile (it would have to be off atorvastatin), and compare with their NMR profile, to get a better idea of their risk situation. However, for my patient like you, I don't pursue the NMR profile as a rule, because I already know what I need to tell the patient: take atorvastatin or rosuvastatin, take aspirin, exercise routinely, eat a healthy diet that works for him or her, ie Vegan Diet, or Mediterranean Diet for those who can't go Vegan. Thanks for your questions and comments!

[@bartrobinson2103]

CardioGauge .. thank you again for your prompt response much appreciated! And hope to see some new videos when you have the time

[@rosalindasiapuatco5920]

Bart Robinson x

[@BeatlesFanSonia]

When I read the side effects of taking this group of drugs, I’ve come to the conclusion that it depends on what diseases you think you can withstand to try and survive! The side effects are almost scarier than the original reason for taking them! There has to be a better answer!

[@suadkacar3017]

i dont know why so many people are calling this guy a drug pusher, very unbiased and objective info. great doctor.

[@e-pharma9293]

www.pharmashrub.com/product-page/atorvastatin-20-mg-lipitor

[@josephdennison4890]

Here's a fact that statins only increase life by by an average of 4 days in person who never had a heart attack . Those who had a heart attack have an increase in life 3.5 days.

[@josephdennison4890]

Here's another fun fact , only 1 in 600,000 benefit from a statin but everyone will have negative effects.

[@josephdennison4890]

I don't know why people call Al Capone a criminal . He was just an unbiased entrepreneur. Come on give me a break Suad Kacar .

[@josephdennison4890]

Here's another fun fact for the Doc. Statins will double your risk is dementia.

[@irmadennington2773]

No! I suffered too much from the side effects! Kidneys and liver damage! I stopped taking and now recovering and no more aches and pains!

[@IndyDog-ns8ws]

Was on it 3 months back in 2017. It destroyed my leg muscles. It took 6 months to get somewhat back to normal.

[@vicster9401]

Thank you for a balanced and very informative video !

[@barrydobrin1135]

I had a heart attack in March of 2018. Three days after I turned 40. I had one stent put in. It was a mild attack, though nothing mild about how it felt at the time. The doctor who did my procedure said all my other arteries were clean and that one artery branch on the LAD was 100% blocked. He told me he removed as much plaque during the angio as he could before stenting it. My widow maker artery according to him he said was bigger than normal and that's what helped save me. I was put on 80mg of astrovastatin. Bad reaction in the first week. Doc put me on 40mg. Later that year I was bumped down to 20mg. Bad aches, joint and muscle issues along with foggy memory. Got bumped down to 10mg 6 months ago. I had bad tendonitis in my knees, ankle, and arm, muscle soreness and weakness. Stopped for 5 days in November, my doctor told me to try that. By day 3 felt much better. Day 5 felt back to normal. He switched me to simvastatin 10mg beginning of this month. Was on it 3 weeks and had bad reaction to that. I've been off the simvastatin for 6 days now and feel better. I'm on plavix with low dose aspirin. I can tolerate that although I don't want to be on plavix my whole life. March of 2021 will be 3 years since I had the stent put in. I eat much healthier, walk alot and do cardio. I don't want a second heart attack obviously, but the statins were ripping my body apart. I felt horrible physically and my moods and memory changed alot on the astrovastatin and felt worse in another way on simvastatin. There are natural ways to reduce imflamation and lower LDLs. I was on the statins for 33 months post heart attack. I can't live like that with tendonitis, muscle aches and cramps, foggy headed. That's a crappy quality of life. I dunno what else to do other than take my blood thinners and eat better and stay active.

[@doeidahousa3041]

I appreciate that you answer all good as well as bad comments.

[@CardioGauge]

Thanks for noticing that Doe/Idaho! I try to answer the questions.

[@pacopeso8474]

Thank you Doctor, I had two stents put in four years ago. I have been on Atorvastatin and plan on for the rest of my life.

[@umayaswellcallmejesus1489]

Paco Peso please please do some more research and try to find out who funds the studies for these drugs. Generally the studies are funded by the drug manufacturers. Please research how food destroys your body especially carbs and sugar. There are far more doctors on KZbin stating eliminating a poor diet will eliminate your risk for diseases. Check out Dr. Ford Brewer , Dr. Sanjay Gupta.. Family history only means everyone ate the same. I know far too many people suffering from severe cognitive issues from atorvastatin. Please check out Dr. Sam Robbins and Dr. Maryanne Demasi’s “statin wars video . Sorry for the long reply. I am passionate about people not being believing that pills heal, diet heals first and foremost. Be safe ! I wish you nothing but good health!

[@yulloveyullove326]

Excelent!! Go and take it until you get diabetes, dimentia, heart disease, athritis and other tons of health problems. LOL.

[@pacopeso8474]

ceti syg I have managed my diabetes for over 23 years with medication and diet. All checks by my doctors show that I am in excellent health

[@colinl9018]

Yes. I had 5 stents fitted 2.5 years ago, have been on Atorvastatin and other meds ever since. No side effects. A lot of changes in lifestyle too. No smoking, a lot less alcohol, more exercise, better diet. Early 60's male. Will be taking the drug for life and hope to live to a ripe old age..

[@pacopeso8474]

@@colinl9018 In November I had angioplasty done and the doctor said my arteries were clear and did not need anymore stents. He said stay on the Atorvastatin and aspirin

[@mariaq1328]

Atorvastatin gave me muscle weakness. I was hospitalized for 4 month, couldn’t walk and now getting therapy for my condition and still having therapy at home.

[@dieyoung8259]

@libtards suck Hope you feel better, these drugs are deadly

[@irmadennington2773]

Rubbish, statin is so dangerous!

[@CardioGauge]

Thank you for comment. It is important for people to know that Statins can be bad for some people. But they can be life saving for others! If a person has a heart attack or stroke, the medicine can decrease chance of having another one by 1/2! I don't want to discount your comment, Statins are poison for you, but that does not mean they are bad for everyone. Best wishes...

[@garrybinnema6291]

@@CardioGauge Thankfully i am refusing statins. There are much better ways of dealing with this.

[@truthsayer9847]

@@CardioGauge I have had heart surgery, but I think that I developed my problem by taking steroids.I no longer take steroids and have stopped taking statins as of three days ago as I have become very scared of taking them, after seeing lots of videos saying how bad they are. Yours is the only one saying that they are useful. Please help.

[@CardioGauge]

Truth sayer hi I just saw your comment now. If you had Coronary Artery Bypass surgery then atorvastatin would be a very standard medication for you. It decreases chance of new blockage. While anabolic steroids can make a person more likely to get blocked up, it is rarely the only factor. The main problem with atorvastatin is muscle aches, if this occurs, you could be tried on rosuvastatin. The best treatments for heart disease: exercise daily doing something you enjoy, eating a healthy diet with lots of fruits and vegetable and minimal meat (fish probably better than other meats), take atorvastatin and aspirin. Best book about diet and heart health “prevent and reverse heart disease” by Caldwell esselstyn. Best wishes

[@richardbailey2718]

I take 40 mg ,, I've had sents , 71 yrs old ,, why would my doctor prescribe 40 mg ?

[@kenrach9875]

A calcium score is not a fancy test, it's a 5 minute test that actually sees the disease, no guessing using lipids

[@CardioGauge]

A calcium score costs 100 - 700 dollars depending where you get it done, and you can get a year’s worth of radiation in 5 seconds. The machine that does the test costs a million dollars. Insurance generally does not cover the test you have to pay out of pocket.

[@kenrach9875]

@@CardioGauge you have to get with the times

[@EmilyTienne]

Very well explained. Loved your simple, but effective graphics!

[@CapWalks1]

I am 63, active and in good health. I've been taking Lipitor for over 20 years. Sorry but I don't believe the conspiracy theories about this drug. I've never had any side effects and the drug cost is negligible. I don't see any reason not to take this drug and I expect to live well into my 90s, maybe beyond.

[@e-pharma9293]

www.pharmashrub.com/product-page/atorvastatin-20-mg-lipitor

[@jerryboggs3474]

not conspiracies, sir! Broken hip, put on atorva, then two more statins. All caused horrid muscle aches,zero sleep,violent expulsion of ALL food. 182 to 160 lbs. in 6 weeks. Poisons for some people...

[@janekinzig3847]

Why don’t you recommend K2 (m7) ????

[@RCTarot]

Statins are poison

[@jeffj318]

Can you say conspiracy theory?

[@robarmstrong3408]

@Semper Fi Sure can

[@txdave2]

After 2 heart attacks and 3 stents my doctor put me on 80mg of Atorvastatin. It worked so well at improving my terrible cholesterol and triglyceride numbers that we were able to reduce the dose to 40mg. I haven't noticed any negative side effects, but based on all of the dire warnings on youtube about the dangers associated with statins , I had contemplated discontinuing the medication. Glad I found your video. Thanks!

[@CardioGauge]

Thanks for watching, David. Most people tolerate atorvastatin well, like you do. But because a lot of people do not tolerate it, there is a lot of negative information. This leads to an unbalanced perception of the med, because people who have side effects are understandably quite upset and vocal. Sine the point of atorvastatin is to cause "nothing" to happen (prevent strokes and heart attacks), when it is working, nothing is happening, and people are generally not vocal if nothing is happening. Anyway, I made the video to address this exact issue, and I really appreciate hearing it was informative for you!

[@AviPlot]

When comparing a group of people taking statins vs. a control group taking a placebo, the numbers presented show a 25% vs 50% risk of hearth atack/stroke/stent. Now, what about other parameters, like dietary habits, obesity, etc? I assume that most of the data comes from the US, where dietary habits are poor, and obesity and metabolic syndrome are very common. How would the numbers look like if all people involved were eating a healthy diet and/or not obese and/or free from metabolic syndrome? The presentation claims that lifestyle changes (diet, exercise) are beneficial, but there are a bonus that do not replace the need for the drug. Is that so? What if the comparative advantages of the drug become marginal once the lifestyle has been adjusted? Are there any numbers regarding this?

[@darlenepaul2934]

I agree with your questions.These are also MY questions I am only eating about 20 carbs a day and eating a cryogenic diet since I was diagnosed diabetic in June of last year.My a1c went from 11.7 down to 6.2.I've lost 15.5 lbs.I feel my health is getting better every day since I've stopped consuming carbs.Since I've been doing so well I feel that a statin might have very limited benefit for someone in my shoes and also could do more harm than good.There are no stats for me to look at since there would have to be a large group of people tested who are eating keto, losing weight and being way more active.I truly don't know what to do.

[@ozziebar]

I really appreciated this video. I was just prescribed this medication. A 20 milligram dose today. Your video was easy to understand and informative. Thank you. Your stick people scare me more than the medication :)

[@CardioGauge]

Thanks for the positive comment, I appreciate it!! I should get my kids to do the drawings, they have a lot more skillz than me...

[@nothingfree3524]

just like everything else everybody IS different ! because something doesn't work for you don't mean it don't work. everybody has to make choices in life and live or die with those choices. Everything got price good or bad! ☺

[@SkiNett]

Going by this video, everyone on this planet has to take a Atorvastatin and if possible give it the aliens on other planets as well.

[@EmilyTienne]

I don’t understand your humor.

[@mcfrdmn]

Very informative video !

[@lindahoganson8721]

Hello Dr., thank you for this/these two presentations and your frankness. I have been taking statins for over 10 years, and am not in either of your two groups. The long-continuing pain and weakness in my thighs and hips and ankles give me reason to step away from atorvastatin, 40mg for the next month preceding my next annual doctor visit, with hope for beneficial outcomes. Thank you.

[@CardioGauge]

You’re welcome, Linda!

[@DavidRodriguez-og4bm]

You are so awesome. I love your calm approach.

[@Praphonn]

This clip is quite a long time, I'm not sure doc you still watch. I have a question that I heard that Statin would block production of CoQ10 which is benefit to body. Is it true? Regarding this, I take 40 mg Atorvastatin prescribed by doctor and for myself I take 200 mg CoQ10 a day to supplement. Is it Ok?

[@bartrobinson2103]

You're doing the right thing by taking Co Q 10. It's absolutely safe

[@followthelaw8722]

Doctor thank you for the information. My question is something that didn't seem to be covered in your video. I understand the muscle pains that people get can be solved by typically stopping the Statin and the pain is reversed. However on all the other side effects you talk about that are clearly very serious can those be prevented by taking blood work every month for example and watch to see and stop the Statin before the damage happens? Or does the patient all of a sudden one day have kidney failure for example and the other problems they won't go away ever even if you stop the Statin. Thank you

[@CardioGauge]

Hi FollowTheLaw. The blood test (in USA, the standard is to do once a year) can help prevent the occurrence of liver damage, because the medicine can be stopped when there is an abnormality seen, before major damage has occurred. Kidney failure happens when there is severe muscle damage, so statins don't specifically mess up the kidneys. So testing kidney function on the blood test doesn't help with avoiding major ill effects. Muscle damage can happen without warning, and would not necessarily be prevented by blood testing. The patient knows muscle damage is happening if they have severe soreness and muscle weakness and brown urine. In my experience, the people who have had severe muscle damage (two patients total in my 15 year career in cardiology) were having a lot of muscle aching first, but their doctors ignored the patients' symptoms and told them to keep taking their medication (UGH!). The "diabetes" side effect is really a misnomer. Statins increase the blood sugar on average. This is a more accurate description of this side effect. Blood tests can show the average blood sugar increasing, and the patient and doctor can decide together whether or not to continue the medication. Checking average blood sugar (a test called the Hemoglobin A1c) is not routinely done in patients on statins because the change in sugar level is actually small, and not felt to be significantly bad enough to warrant changes in statin therapy. However, it is totally reasonable to check blood sugar annually for patients on statin to measure how much it is going up. Bottom line is checking the blood test routinely doesn't make the test a lot safer. In fact, there are plenty of doctors out there who don't believe in checking blood work annually for statin-treated patients. In spite of this, statins are in general safe medications and dangerous side effects are rare. For my patients who need a statin (people with prior heart attack or stroke), and are very worried about side effects, I will use an intermediate dose of atorvastatin, typically 20 mg per day, as this is much less likely to give side effects, and still quite helpful in reducing events. Hope this helps and thanks for your excellent question.

[@dieyoung8259]

@@CardioGauge Please don't believe the doctor. If you are taking drugs that can do serious organ damage. YOU NEED TO MONITOR THIS ON YOUR OWN. Find a place where you can have the blood work done without a prescription. Test as often as you deem appropriate. My mother died because they scheduled her cancer test to far apart. By the time they discovered the cancer it was too late. She died within 30 days. Doctors are out to make moneY, PERIOD!

[@dieyoung8259]

@@CardioGauge Please don't believe the doctor. If you are taking drugs that can do serious organ damage. YOU NEED TO MONITOR THIS ON YOUR OWN. Find a place where you can have the blood work done without a prescription. Test as often as you deem appropriate. My mother died because they scheduled her cancer test to far apart. By the time they discovered the cancer it was too late. She died within 30 days. Doctors are out to make moneY, PERIOD!

[@Bibi-vn1jw]

Respect to you Doc but I don't believe in those drugs...I think you are trying to push it here...as expected...your job though...my mom never got better with meds by incompetent or careless doctors...

[@CardioGauge]

Bibi Shakira Jameel thanks for your comment. I believe statins help some people, but unfortunately they do not help most people. Statins are not “The Answer” they are made out to be. So many cases where people were not helped like your mom. I find atorvastatin to be a useful but frankly mediocre medication in the fight against heart disease. Best wishes...

[@MR..181]

Bibi .who got rich from drug company kickbacks..800 times 100 $ a month...

[@JohnSmith-eg3nb]

CardioGauge “

[@MrDavidh37]

Hi Doc, I'm from the uk and 54 YO male. Last January I had a heart attack and had 1 stent fitted. I am an ex police officer retired after 30 years and always ate well kept fit and never smoked! The heart attack was the last thing I had expected. However 11 months on I feel as good as ever. I stopped eating any sugars and dropped 14ibs. I am now on aspirin, ticagrelor for the stent ramipril and bisoprololand of course 80mg atorvastatin. I had a recent blood test and here in the uk if your6 its high mine has gone down to 2. I have started to see all the hype on KZbin about how bad statins are so this started to concern me until I saw your video. Also in my last blood test they said I may be prediabetic. This is news to me and I think it may be that I had a good prime breakfast not long before the test. Anyway like most people in my situation you feel a little confused what to do for the best diet wise. Is it best cutting right down on carbs even whole food carbs? I have had no side effects from the statins just at the start felt a bit of discomfort in my chest muscles. Just to round off I was looking at the alternatives to statins but after seeing your video I am reassured again that they are right for me thank you Dave😁👍

[@CardioGauge]

Thanks for watching the video and your important comments, Dave. A big reason I started making these videos is that I felt that a lot of the KZbin info is not science-based, but rather rather ideology-based. The statin research has limitations, but overall I observe the medicines to be useful and safe. Diet-wise, you have made the most important adjustment which is eliminate processed simple sugars. Your medications are the standard ones for a person who has had a heart attack. Generally, the more optional ones are bisoprolol and ramipril, but that can depend some on the specifics of your situation. The aspirin and atorvastatin are pretty much indicated forever, although dose of atorva could be adjusted down, depending on what happens with your LDL (sometimes here in USA if below 1 mmol/L, we will adjust dose down). On average, high dose statin will raise the blood sugar 3 mg/dl. So it doesn't boost the sugar much. It could have pushed you from just below prediabetic up into the prediabetic range. Or, you may have been in prediabetic range before heart attack, and only were discovered to have high sugar because of the frequent testing done after an event like that. My opinion is a Whole Food Plant Based diet is the best diet for people in your shoes. This is an opinion, though, because plant based diet has not been pitted head to head against the Mediterranean Diet, for example. Dr Caldwell Esselstyn's book "Prevent and Reverse Heart Disease" details this approach. The diet is strict and not the easiest undertaking. But the closer a person eats like this, probably the lower the risk. I think the Mediterranean Diet is a good middle ground for folks unwilling to go the plant based route. Best wishes!

[@CJ-hc9ud]

I have leaking heart valves. I've had two strokes. I'm 65. I take atorvastantin. I take meds everyday. My legs and elbows hands knees feet ache hurt everyday. I wonder if there is another medication i can suggest to my nurse practitioner. My cholesterol is good. But the side affects are painful. Thank you

[@tommycockles2947]

I was taking 80mg of Astorvastin for about 3 years with no problems,last week the doctor changed the prescription to 40 mg plus, 5mg of korandil. i will be 79 in september except for slight chest pain when walking uphill i feel great.

[@gavinlangley8411]

Thanks for the video. I like that you focus on the statistics of the outcomes. But are the statistics relevant for me? I just went down to 40mg after nearly a year at 80mg after my MI and stent. My ldl was low enough for my doctor to lower the dose. Luckily I only suffer mild muscular discomfort. What worries me, even at the lower dose, is the insulin resistance. I refused the diabetes treatments offered to me after the MI and focused on my lifestyle & diet. That has been very effective for me and my blood sugars are now under control and stable. It was only recently that I became aware the statin could be working against me in that battle. Having cut out the causes of the diabetes, which I'm sure was the primary cause of the MI, do the statistics change for me? That is, does the balance of risk of the statin relative to the benefit change given other methods of controlling cholesterol?

[@CardioGauge]

Great question. The short answer is yes. Because you had MI, regardless of whether you cure your diabetes with diet and exercise changes, I would still recommend a statin for you, if you were my patient. Diabetes is one of many many factors that cause blockage to happen. Resolving that one factor does not protect you from all the others. Examples of other factors include “sticky” LDL due to genetics, the geometry of your blood vessels, blood pressure, inflammation, and the absolute cholesterol level, and other factors we don’t understand. The atorvastatin decreases risk in patients with and without diabetes, by about 40% at a dose of 40 mg. You have helped yourself a lot by controlling sugar, the atorvastatin provides you with further risk reduction. See “prevent and reverse heart disease” by Caldwell esselstyn, it’s a great book on diet for people who have had heart attack / stent. Atorvastatin does increase blood sugar some, maybe 10 points on average. But even though it does this it decreases risk of stroke and heart attack. Hope that helps

[@dieyoung8259]

Doc should have focused on lifestyle before stint. But you, like most of us wouldn't have listened.

[@markcognetti4875]

In sum: Everybody. Take a statin. No exceptions. be AFRAID

[@patrickbowen5398]

I'm not seeing any current videos on your Channel --- is your Channel still active ?

[@Bibi-vn1jw]

Thanks for responding so kindly..at least you are honest..Best wishes to you...

[@sharkair2839]

thanks doc..much appreciated.

[@CardioGauge]

Thanks for watching!

[@patrickwelch3274]

Tough group. I have not had any heart issues. I do take 20 mg daily with some soreness. My LDL twenty years ago was marginal high . Last twenty LDL around 150. My blood pressure also was high. My blood pressure for last twenty years on 40 mg of losartin. has been 120-80 for those twenty years. I haven’t worked for twenty years. My brother is / was Chairman of Radiology at Mayo Clinic in Rochester. He says I am in category of people having high cholesterol and high blood pressure even though I haven’t had it for 20 Years he said you still have it. Tim is kind of of no bs guy . I didn’t argue with him but he did say: 1. Control your weight to desired weight( I weight 190 6ft 1 age 72 2. Exercise daily to get heart rate up( walking three miles not enough) Any thoughts? I have had stress tests every 5 years - normal

[@CardioGauge]

Hi Patrick, I agree with your brother. According to our current guidelines, which are based on the type of research I talked about in the video, you have intermediate risk for a vascular event (stroke / heart attack / stent). Something on the order of 20% over the next 10 years. Based on that, I would generally recommend a statin for someone in your shoes. Atorvastatin 20 mg is a good choice. Since your LDL is 150, some docs might increase the atorvastatin dose to 40 mg or 80 mg. However, i personally like the atorvastatin 20 mg dose for folks in their 70's +. In addition, you have been doing ok with atorva 20 mg per day for a while, if it ain't broke don't fix it. Your 10 year risk goes down with the atorvastatin 20 from about 20% to 15%. So it makes for a modest change in risk. What you eat and do for exercise are probably more important than the atorvastatin overall, but the medication is an important part of decreasing chance of heart attack. As far as your blood pressure goes, i agree with your brother, once you are diagnosed with it, it generally doesn't go away. If you stop the Losartan, your pressure will go up. Same goes for the atorvastatin. Some people can fix their pressure with healthy diet (ie whole food plant based) / exercise / weight loss, but most can't. I also agree with his advice to avoid obesity and exercise daily, doing something you enjoy that gets you sweaty and tired. I personally think the concept of "cardio" like treadmill / elliptical / cycling / etc is overrated. Any exercise that makes a person tired and doesn't cause injury is a good bet. I like to do push ups, crunches, leg lifts, pull ups, wall sits and a ton of other bodyweight exercises. Best wishes!

[@aquamanhawaii]

Thank you for the important information..

[@CardioGauge]

thanks for watching aquamanhawaii!!

[@bigdaddeo76]

Because of being diagnosed prediabetic, my doctor at the time, put me on a statin I think started with pro. Can't remember what it was. Anyway, bloodwork 3 months later and liver function was horrible. Stopped immediately. A few months later I moved 1/2 way across the country. New doctor. He puts me on Avorastatin, even though my ldl by this time is down to 55 thanks to diet. No problems after 6+ months, but wondering if that is common. I have no other risk factors. Don't dink for over 10 years. Smoked 4 years teens/twenties. Now in 60's. Only history of coronary problems in family, paternal grandmother: stroke in her 60's with ldl in the 300's. Died of heart failure about 10 years later. No other family history.

[@truthsayer9847]

OMG I don't know what to do now. I have seen loads of videos telling me how bad statins were and that they did very little to help but caused so many serious problems, and now this video tells me that they are very useful. Shitting myself now. The other videos also say that cholesterol isn't a factor in heart disease either.

[@CardioGauge]

Hi TS, I totally understand why you would be confused. The most popular statin videos hate on the medication. That is why I made the statin videos myself. The biggest points to take away are: 1. If a person has a history of coronary artery disease, or stroke, he or she should take a statin, IF POSSIBLE. This is proven to decrease chance of further blood vessel problem. The people that say it doesn’t work at all are making that up. I have patients who have had heart attack and either decline to take or can’t tolerate statins. This is not the end of the world for them. I recommend vegan diet for them. 2. If a person has a strong family history for heart attack or stroke at a a young age, or a wildly abnormal cholesterol (ldl over 190), I usually recommend statin treatment, to decrease chance of heart attack stroke. It’s important to understand that nobody absolutely has to take a statin to live. I have moderately elevated cholesterol, and I don’t take a statin. If my patients are very worried about their risk for heart attack, I will do a calcium score test (I did a video on that test I can watch), and if the score is zero, we don’t have to worry about the statin, if the score is more than 100, we start the statin. Hope this helps. Best wishes!

[@CardioGauge]

Also, with regard to whether or not cholesterol causes heart disease, the very clear scientific answer is YES. The thing is, it is not THE ONLY cause of blood vessel disease. Inflammation, blood pressure, tobacco toxins, blood sugar, insulin resistance all can play a role as well. People who say “cholesterol is not the problem” are overstating the actual situation. What is true is “cholesterol is not always the problem.” Another true statement is ”high cholesterol often does not lead to heart disease.” Many people with high cholesterol never get any blockage at all. The reason you are confused is that we are all confused about how to predict who is going to have a problem with blockage and who isn’t. My opinion is the best way to clear things up is the calcium score

[@CardioGauge]

Lastly, people who eat a vegan diet from an early age are very unlikely to get heart disease. If we all are that way, we wouldn’t need statins. The problem is, most people can’t eat that way. They feel poorly

[@truthsayer9847]

@@CardioGauge Thank you for replying. How do I get my calcium tested please?

[@truthsayer9847]

@@CardioGauge Again thank you, but how do I get a calcium score please?

[@donnieshepperson126]

All you need is B3 vitamin(niacin)and cut your sugar intake to around 30 grams!

[@CardioGauge]

Thanks for your comment Donnie. While Niacin decreases LDL cholesterol and raises the HDL cholesterol, it doesn't do a great job of preventing heart attacks and strokes. This is a link to a study of that subject. www.ncbi.nlm.nih.gov/pubmed/28616955 So niacin as a supplement makes numbers better, but probably does not make health better. Statins, especially atorvastatin, are proven to decrease chance of heart attack and stroke, most importantly in people who have already had a stroke or heart attack: www.ncbi.nlm.nih.gov/pubmed/14692706 Thanks for putting in a plug for low sugar diet, if everybody did that we would be a lot healthier country and spend way less of health care!! However, a low sugar diet is probably not enough to maximally decrease risk in people who have already had a heart attack or stroke, so for those people I usually recommend low sugar diet and a statin. Best wishes...

[@donnieshepperson126]

I have a friend that had to have a bypass(I know he has to stay on medication)But I was talking about healthy people just staying healthy,also walk a mile per day!

[@CardioGauge]

Donnie Shepperson I’m with you on that!

[@theresag1969]

The problem with side effects of drugs many doctors don't listen to you if you have a problem and patients suffer too long. Doctors a notorious at saying lets watch it then forgetting about it. It seem watching it starts every time you come to see them. Let's not forget doctors assuming your complaints are all in your heard.

[@abc_cba]

There are really nasty comments against the doctor who's simply putting up an informative video to educate us. If you don't take his suggestion,then the best you can do is ignore or downvote the video ,there's no need to be this vicious and insulting. Ofcourse, he clearly stated there are side effects of the drug, yet, some are simply attacking him for no reason. My mom did have benefits from Atorvastatin and we stopped it and within a year she passed away with a heart attack , that was the worst thing that we've ever done and I feel sorry for that. That's why don't assume yourselves to a doctor when you're actually not !

[@CardioGauge]

You have no guilt in that, you do not know if the medicine would have prevented the heart attack. You were doing the best you could with the situation, and rarely in a situation like that do you know for a fact what the right thing to do is. Thanks for the supportive comment, I appreciate it!

[@abc_cba]

@@CardioGauge Thank you. Actually , I wrongly mentioned it in the video , we didn't actually stop it. We found out mom had hyperthyroidism and that was causing her throbbing in the chest and making her faint. So, when we started with the pills(levothyrox) and the beta blocker (propananlol) we thought it was the reason for everything and she stopped taking her pills for her heart. She was on risperidone as well which her psychologist didn't inform us about that it would keep her cholesterol and triglycerides elevated no matter what , and since her hyperthyroidism was getting better her lipid levels were elevating (since Hypothyroidism depletes the cholesterol and triglyceride levels naturally). She passed away and I thought she was having the same hyperthyroidism issues (heartbeat irregularity) of throbbing and it was my lack of knowledge, we couldn't save her.

[@pneulab]

This guy must have a financial interest in Statins.

[@abetteridea9841]

Doc, thanks for the concise information...what should also be noted irrespective of the numbers is the stabilizing and possible regression of plaques already present. I've resisted my PCP's recommendation to a low-dose statin for years based on my cholesterol numbers but he keeps pointing out that they " ...keep the arteries clean.." but now I will get a calcium score test.

[@robertobeltran9987]

What's the main difference between atorvastatin, simvastatin, pravastatin, fluvastatin, rusovastatin and lovastatin?

[@CardioGauge]

Great question Roberto. Atorvastatin: High potency for decreasing LDL cholesterol, very well tested. Beat Pravastatin in a head to head trial called PROVE IT. The preferred Statin by Cardiology Organizations. Inexpensive. Simvastatin: Medium Potency, not as strong as atorvastatin or rosuvastatin at decreasing cholesterol. maximum recommended dose 40 mg. It used to be 80 mg, but a lot of people had trouble with muscle aches and rhabdomyolysis, and simvastatin has more medication interactions than the other statins. I rarely use simvatatin. I basically only use it in people who have done well with it for many years and I don't want to switch them off it. Pravastatin: Low Potency, not as strong as simvastatin or atorvastatin or rosuvastatin. It's main selling point is the fact that people seem to tolerate it better than the other statins. Less muscle aches. It is more hydrophilic than atorva, simva and lovastatin, which some people think might be better for avoiding mental side effects, however, in my experience that doesn't play out at all. Pravastatin is my last ditch statin when people have failed atorvastatin, rosuvastatin. Fluvastatin: low potency. I have hardly any patients on it. If people fail atorva, rosuva, and prava, they almost always fail the rest of the statins, so I generally don't bother with fluvastatin. Rosuvastatin: high potency. Well tested and proven. It is the second most used statin nowadays. 40 mg of rosuvastatin = 80 mg of atorvastatin. If person fails atorva, i give them rosuvastatin. If they have trouble with rosuvastatin, I drop the dose of rosuvastatin down to as low as 2.5 mg twice a week. Rosuvastatin is hydrophilic. I think people are less likely to have muscle aches with rosuva compared to atorvastatin. Rosuvastatin became gerenic a few years ago and as a result, use is increasing. Lovastatin: low potency. This is what is in Red Yeast Rice, naturally occurring. I have Hardly any patients on it. No reason to use this when we can use low dose rosuvastatin instead. These are all Generic. Only the fluvastatin is expensive. The rest are reasonable. Simva and Lovastatin are the cheapest. Hope this helps, if any other questions / concerns, please let me know!

[@michaell3711]

@@CardioGauge ,, ONLY a good doctor would have spent the time to explain. Thanks much from Jamaica

[@karenm3710]

I have chronic migraines, which have gotten a lot worse since I've been on Atorvastatin.

[@onthetrailwithbart523]

Which study was this you're talking about?

[@CardioGauge]

Hi On the Trail with Bart, I think you are asking about the first study I mention in the video where risk for recurrent heart event was decreased from 25% to 12% over a period of 3 years, that was the GREACE trial which came out in 2002. Here is a link to the abstract, unfortunately the whole article is not available online for free. www.ncbi.nlm.nih.gov/pubmed/12201623

[@onthetrailwithbart523]

@@CardioGauge Hey, thanks for that link. It worries me when papers don't put the Absolute percentages. I was just looking at the Jupiter Study. They reported a 54% benefit over placebo (relative %). When I looked at the actual data it was 0.4% (absolute %) over placebo. That's quite a bit lower than 54%. Combined CAD: 0.45 for rosuvastatin group, 0.85 for placebo group (per 100 person years) = 0.4 absolute change Since you probably have access to the GREACE trial, maybe you could tell me what the absolute benefit was over placebo? Thanks, Bart.

[@daleweller5193]

I don’t even remember how many statins that I have taken and I have had bad side affects on all of them.

[@CardioGauge]

Me too. Options for you now are: Supplements: Berberine, Bergamot and other less proven supplements. Meds: Ezetimibe, Repatha, Praluent, Leqvio. Best wishes

[@georgittesingbiel219]

I'm 70. Lipid profile is great! However, I have a family history of heart attack. I have type 2 diabetes. My blood pressure is controlled by medication, as is my diabetes. So I am going to take my statins as my doctor has recommended. Per my risk factors. Just makes sense!

[@mohanshivamusicfactory]

Try keto diet reverse everything

[@carleenturner1348]

Has the patient changed eating habits? Have these patients started D3 K2 to get calcium in bones, not floating around vessels? Hope your patients on CoQ 10, cause stations wipe out CoQ 10 which is heart protective....

[@kristiedaughenbaugh69]

I'm on a lot of medications as I had two heart attacks in one stroke and my daughter got my doctor gets me on all heart medication

[@sabyasachisen5351]

U ARE DELETING COMMENTS THAT CRITICIZE U. LOVELY

[@NaturalNeuron]

Do you know the difference between absolute and relative risk? Statins are not worth the trouble. In some of the trials, more people died in the statin arm of the trial.

[@asvirgil1984]

Good morning, doctor. Anything on the effect of Atorvastatin on blood sugar?

[@CardioGauge]

Hi A's Virgil. On average, atorvastatin 80 mg per day would increase the blood sugar by about three points. In terms of hemoglobin A-1 C, for example, a person with a hemoglobin A-1 C of 5.6 who starts atorvastatin 80 mg per day Would then a couple of months later have a hemoglobin A-1 C of 5.7. So while atorvastatin does increase the blood sugar, it typically doesn't increase it a lot.

[@asvirgil1984]

CardioGauge . Thank you, doctor. Appreciate you taking the time to answer my question.

[@KristianVinales]

how long does it take for side effects to go? i only took for a month but felt very strange .Been off them for two weeks now

[@kayleen9110]

my husband has nueropathy so bad he cant feel the bottom of his feet

[@CardioGauge]

neuropathy usually not caused by statin, i believe it happens in less than 1%. But there are definitely reports of it happening. If there is no other apparent cause of neuropathy, I stop the statin. I have only done that a couple times in my career.

[@elizabethcochrane9229]

This is possibly caused by diabetes..!!

[@tanyapelep9726]

i have a question. can the right amount of water intake help in lowering bad cholesterol? along with taking statins

[@CardioGauge]

Water does not significantly change cholesterol levels

[@dianeshelley6439]

I took lipetor and I suffered from pain so bad I tried to commit suicide 3 times. I'll let you take that pill every day. Our bodies make cholesterol because we need it to live.

[@CardioGauge]

Thanks for your comment Diane. It is so important for people to know that statins can cause pain, because if you don't know you just suffer like you unfortunately did. Also, the doctors have to listen to people and make adjustments when things are going wrong. I'm sorry you suffered so badly.

[@leifd731]

Dr. I am on a vegan whole foods plant based diet. Ive had cholesterol readings in the 225 range and 125 ldl range in the past. My latest readings were 127 overall cholesterol, 56 ldl, 54 hdl and 83 triglycerides. My lipitor dose is 10mg daily which my Dr agreed to lower to 10 mg every other day. My question is should i be on lipitor at all ? 127 seems awfully low, should i be medicated at this point? (Ive never had a cardiac event).

[@CardioGauge]

Hi Leif, for my patients who have never had a cardiac event, and do not have a strong family history for vascular disease (mother, father, sister or brother with heart attack or stroke at young age, ie less than 60 yrs old) and have cholesterol numbers like you do now on your current diet, I would not use statin. The proof that the medicine will help someone in your situation is weak. The chance that it would help you is low. Stopping the atorvastatin 10 mg per day would probably put your LDL at around 75 - 80, which is excellent. Your numbers are not dangerously low now. Many people who eat a very healthy diet will walk around with numbers like you have, without apparent consequence. In studies of cholesterol medicines, there was no ill effect of LDLs in the 40 - 60 range. How low is too low? No one knows! I consider LDL less than 30 to be too low, but that is arbitrary on my part. Your doc may be using the "textbook" to decide whether or not to treat you, which I consider to be ok. Doc is supposed to calculate your risk for cardiac events over the next 10 years (you could google "pooled risk calculator" to calculate yours). You use the cholesterol numbers off of treatment to make the calculation. If the risk is more than 7.5%, doc is supposed to give you statin. Several parameters are used to decide your risk level: age, gender, blood pressure, presence or absence of diabetes, and cholesterol numbers. I hope this is helpful! Please feel free to ask follow up questions...

[@leifd731]

CardioGauge Thank you for your response. At my next appt,if all is still well, I will discontinue the statin. This will be very satisfying because previously I'd been told that I was on these drugs for life. I hope that the WFPB diet will do for others what it has done for me, Drs should actually prescribe it! Thank you again.

[@davidsalman8362]

Hey doc, what about the hot & cold shivers and sweats? i feel like i've taken a huge dose of caffeine although i never take any caffeinated products

[@CardioGauge]

I haven’t seen that but if you feel that only after you take the medication, it’s definitely possible

[@haroldbelcher2834]

I have read an article in JAMA that does not agree with you. They say no help comes from Statins.

[@debrabarkley866]

Thank you doctor for your informative video. My question has to do with diabetic patients. I read that this medication causes insulin resistance and elevated fasting glucose levels. I’m diabetic, have had two strokes ten years apart and had a stent put in this past October. My doctor changed me from Simvastatin to Atorvastatin. I am trying so hard to get my glucose levels down, how much of an increased risk is this medication to me. Both my Cardiologist and Neurologist think this last stroke was caused by the diabetes. Please advise.

[@4evaavfc]

Can Atorvastatin cause lethargy. I am only on 40mgs a day.

[@CardioGauge]

Hi Rangatiratumeke, it doesn’t usually do that. Often people who are on Atorvastatin are on Beta blocker medications, and these can definitely cause Lethargy. An example of this would be metoprolol. However, I have had a few people over the years say they feel tired with atorvastatin. I hope this helps.

[@chucksdesk]

I went to cardiogauge.com and could not find the calculator you spoke of, only 3 offers of courses.

[@CardioGauge]

Thanks for pointing that out. I revamped my website and the calculator is being cosmetically revised. It can be accessed at Cardiogauge.com/summary2 Sorry about that!

[@lidialidia4150]

Show me where you get thin numbers from , where is the science behind it?

[@jamesrossell6482]

I took it for six months. I had an issue with heartburn. I have stopped taking it and feel fine now.

[@neil2449]

Hello Dr. I have a question: I had a bypass 12 years ago due to Angina. Have been taking 20 mg Atorstatin ever since along with 40mg Aspirin. Now I am experiencing muscle pain in my right elbow joint. Had an x-ray so I know its not broken. I recently had a blood test which came out at 5.6 in the Cholesterol range. Thing is I only take Lipitor 4 nights every week as I work nights the other 4 so only taking 4 statins every 8 days for about 2 years now. I am 59. I also suffer from indigestion and flatulence and EDF. Should I stop taking these statins?

[@gmcenroe]

I tried your cardiogauge calculator on your web page. After entering all of my information the final button did not give me a result, just this page isn't working. Is this a temporary problem? Thanks, enjoy your web site and youtube channel. My blood pressure in left arm is 149/95 pulse 72, in my right arm it is 133/85. Is it safe for me to take lisinopril/hydrchlorothiazide? My doctor wants me to take Lipitor but I am hesitant, no history of heart disease and my lab tests are in high range but normal.

[@lisamorada2263]

Hi doc, Had aoerta dissection 2018, AFib, hi cholesterol. I stopped my all prescriptions but not atorvastatin 40mg. My BP is always high and heart rate is always crazy jogging and out breath. Replaced it with Vit12, D3, CoQ10, probiotic 10 billion, multivitamin, once a week collagen, once a week Vit C powder 1000mg. My BP is now low sometimes it is low once time only 86/62/56--dizzy, lightheaded I took a pinch of salt. Question- what will happen if too low BP? Will I call 911? What will happen to my hear? Thanks doc.

[@sherpitre6837]

I have been taking lipitor for high cholesterol a number of years (started at 10mg then upped to 20mg) with no known side effects. In 2014 I had a small stroke and saw a neurologist that wanted to raise the dosage to 40mg. I was concerned about this due the possible side effects that could possibly come up. In talking with my GP at the time he said he did not agree with the neurologist and to leave the dosage as is. In watching this video I am concerned with that now more than ever. Can you comment on this please? Thank-you!

[@SPEAKEASYAZ4895]

Never had stroke or heart attack, do have left branch bundle block.had icd implant4 yrs ago . Going ok, LDL is 85 take 80mg of astorventin daily, total cholesterol 140 I guess my dr. Is doing the right thing...I am in 70,s

[@ppg19782]

A quick question....has your ICD ever shocked you? I recently had an ICD installed due to arythmia and the ICD shocked me for the first time and felt like somebody was beating my heart with a baseball bat... I didn't passed out, but really scare the heck out of me...I take entresto y various meds for hb pressure. Any advice regarding the ICD and how did you adapt to your ICD during the 4 years that you have it? Thank you appreciate the input. Be safe and much blessings

[@waynesmith6417]

Well doc, you seem to be a basically good person. I am not a number. I have found through personal experience that if I do what my doctor says I am doomed to having a miserable life....it may be longer....but miserable. I don't want to live forever, I just want to live with a lot less pain than my father and grandfather. I am 68, over the last 2 years I lost 70lbs and erased my type2 diabetes and I am feeling better than I have in decades by eating low carb (25g/d). I didn't exercise, I didn't go hungry, I didn't get this from my doctor. Medicine in America is a statistical failure. We are fatter and sicker, and we keep getting fatter and sicker. We, patients, are blamed for our condition because we won't stop eating and won't exercise. Carbs are addicting and addicts have a hard time stopping. Exercise makes you hungry, so you eat, and causes you to injure yourself, causing more trouble. I lost my weight slowly and I am just now, after 2 years, ready to exercise. My risk of injury is much lower because I'm not fat. I'm 6'2" 189lbs. You are relatively young, and you are going to see the revolution in health the Internet is bringing. If you start now, you can avoid a lot of regret. Educate yourself, I did.

[@CardioGauge]

Thanks for your post Wayne. You make the important point that there is no one specific plan that is going to work for every person. You have made great progress, and I would never argue with success! I know for myself I require daily vigorous exercise or I go bananas...

[@waynesmith6417]

@@CardioGauge Thank you for responding to my comment Dr. Ritter. First let me apologize for being a smart ass. I didn't think you would read my comment, much less reply to it. This being a two year old video. Your explanation of the use of Atorvastatin is a compelling defense of the use of statins. I'm not one of those “no statins EVER!” people but I do think they are over prescribed. I also watched your video about how you don't tolerate statins well. This is an issue in my family right now. My wife has an over all cholesterol of 280. Our doctor recommended a statin and she said no. Our doctor is very progressive and suggested that she try Red Rice Yeast and my wife agreed to try it. It worked and lowered the number to 157. Then she started a Ketogenic diet and stopped the Red Rice Yeast hoping that the diet alone would fix the problem. We got a cholesterol meter so we could monitor the progress and her number went right back up without the RRY but the mix of HDL, LDL, triglycerides changed a lot. The Triglycerides dropped from 450 to 45 and the HDLs went up but the LDLs are more than before. So we got a better cholesterol meter that would tell us HDL, LDL, and Triglycerides. We are getting our first Coronary Calcium Scan on Monday. I had to figure out what test would tell us if her high LDL was a problem or not. For right now the CCS will be our truth teller. If she has an appropriate number for her age, she is 68 as well, and in a year the number has not progressed more than 2 or 3 % we have decided that the high LDL is not a problem and not treat it. High LDL is fairly common in people on a Ketogenic diet. We both have a family history of artery disease, heart disease, diabetes, and obesity. The one common thread in our families is they all listened to the doctor and did what he said and had a poor outcomes. I am glad you get a lot out of vigorous exercise. My wife and I SCUBA dive and skin dive, so we meditate on lowering our heart rate in order to stay under water longer on one breath. We don't do any cardio other than sex. Now let me encourage you. There are thousands of doctors in the US and not many take the time to make KZbins so normal people like us can understand complex issues. That makes you one of the good guys. Not many people, not many doctors can be a Cardiologist. What 17years of school and training just to get started? And then subject yourself to the stones and arrows of cyberspace in order to help people. Good on you Dr. Ritter, good on you.

[@markdavies8585]

Does it make sense to take CoQ10 to help with muscle pain when taking Artovastatin?

[@ngushaterlumun6114]

Can it's be used for stroke patients

[@richardwalsh1536]

Thank you for the information. I’m on 10mg daily. And I have not had side affects. I’m trying to maintain my daily calories intake below 1300 and exercise (walking) a minimum of two times a week.

[@REDDAWN2010]

I'm on 100mg metoprolol twice a day. Amlodipine 5mg per day. 25mg hydrochlorothiazide. And 10 mg atorvastatin daily. Age 43 male. Was 180/120 relaxed and 250-300/128 in the gym doing mild exercise. Now I'm 127/70-80 relaxed 3 months later.

[@leticiacabbigat1101]

HI DOCTOR A NEW SUBSCRIBER HERE I HAD A HIGH CHOLESTEROL BEFORE OF 140 AND SO THE DOCTOR PUT ME IN TAKING SIMVASTATIN OF 20MG,NOW MY LDL IS 75 . I WANTED TO STOP NOW TAKING STATIN ...SO I CHANGE MY LIFESTYLE MORE ON VEGETABLES SINCE I HAVE ALSO A TERRIBLE GI INFLAMATION KIDNEY FAILURE ETC.NO FAMILY HISTORY OF HEART ATTACK NOW DO I HAVE THE RIGHT TO STOP TAKING THE STATIN?

[@CardioGauge]

Hi Leticia, I can’t tell you directly what to do because this is KZbin. However, I will say what I do with my patients who are in the same boat as you. Statins are optional medications. Simvastatin 20 mg per day decreases chance of stroke, heart attack or stent by around 25%. It does not decrease the chance by 100%! To get this benefit, you have to stay on the medication. When you come off it, the LDL goes up, and the risk returns to what it would be without the medicine. I have many patients who do not want to take medicine like statin to decrease their risks. If person eats healthy Whole Food Plant Based Diet, they can VERY LIKELY get much greater benefit than taking statin. So for my patients with high cholesterol without blood vessel disease I encourage this diet. If you stop simvastatin 20 mg, your LDL will probably go up to 110 or so, after a month. Whole food plant based (or as close to this as you can get) is a great way to eat, and improves many parameters of health. Potassium level can increase in people with kidney failure, so that would have to be watched by your doc.

[@leticiacabbigat1101]

@@CardioGauge Thank you Doc.... atlleast i have an idea on what to do and what to talk about with my doctor

[@kenmarriott5772]

Trying to fix life style and SAD with a medication is difficult. You can only improve situation, but not fix.

[@HammersnBlades]

The Public have moved on to more Natural and Holistic Remediation. Understanding why, and subsequently correcting their diet to accomplish a more Longevity focused approach. Fasting and Plant based Nutrition for instance, cutting out Sugar and Pharmaceuticals Longterm....

[@Spark-Hole]

If you start by asking this Doctor, Who had fund the researches, then you will not want to ask any more question.

[@iwazzabadboy1982]

I’m 60...physically fit,about 30 pounds overweight..Went in for physical and chol was 241,BP great..Put me on this drug but I also changed my diet drastically and lost 23 pounds..Recheck and I dropped chol to 137..Doc says I need to keep taking this drug....How about I recheck in 2 months with my new diet and weight loss? Doc says NO...keep taking meds...I dont get it...Thinking about stopping taking these and new blood test in 2 months on my own..No family history of heart problems...

[@CardioGauge]

Hi Iwazza, docs are taught to prescribe meds. You don’t know how much of the drop in the cholesterol is due to your diet and how Much was due to the pill. I understand why you would want to see what you were getting with the diet alone. Eating healthy and exercising routinely beat statins for decreasing risk. But you have to be consistent and committed to healthy lifestyle for years to reap the long term benefits. Doc is concerned about your risk if you go off statin, however, in numerical terms that risk is quite small. If your calculated risk (using your age, cholesterol, blood pressure, etc) is 10% for 10 years, then with the medication your risk might be approximately 5% over 10 years. So that would be 0.5% per year, or 0.04 percent per month. So your risk for stopping the med a couple of months would be an extra 0.04% chance of stroke or heart attack each month you were off the med. that is a tiny amount of risk. Anyway, because this is KZbin, I can’t tell you what to do with your meds. But I will say, if one of my patients was in your shoes, I would say go ahead and see what you get off the statin for a couple months. Run the risk calculation with the new numbers and see if it’s worth it to take med. another alternative is to get calcium score, if zero or close to it, statin significantly less likely to be helpful. I did a video on calcium score if you are interested. Bottom line is eating healthy decreases risk a lot: avoiding sugars, avoiding processed carbs, avoiding high glycemic index foods, eating more fruits, veggies, berries, Nuts, greens, beans, varied whole grains. I am a fan of Whole Food Plant Based diet, it likely lowers risk the most of any diet, however, it certainly doesn’t work for everyone and keto has benefitted a lot of people. Thanks for your comment and best wishes!

[@iwazzabadboy1982]

Thanks

[@ramshambo2001]

Thank you for posting this! I have ldl over 220, and have started taking Statins and so far I feel fine, but was worried about the side effects.

[@CardioGauge]

ramshambo2001 you’re welcome! Thanks for your comment...

[@urbanimage]

Are these quoted percentages absolute or relative ? A ten year risk of 7.5% or more will only be reduced, at best, by 25%. So a 7.5% risk would drop to 5.7% on a statin.

[@CardioGauge]

urbanimage that’s right, if some one has a 7.5% ten year risk, and they take atorvastatin 80 mg per day, they decrease by about 50% relative risk so they decrease by 3.75% absolute risk. I tried to be clear about that in the video, because like you indicate, it is a critical concept to understand. The relative risk reduction percentage is a useless number if you don’t know the absolute risk. For decades Lipitor was marketed based on relative risk reduction with no mention absolute risk. A 20 mg dose of atorva decreases relative risk by about 25-33%. So for a person who has already had a heart attack, their absolute risk without meds (and without major lifestyle improvement) over ten years is something like 50%. Atorvastatin 80 mg per day would reduce risk to 25%, so that is a big difference, and in my opinion worth it. But for the average person with risk of 8%, to go to 4% with maximum dose atorvastatin, I don’t know that it is worth it. It’s certainly not worth it to me, i don’t take atorvastatin. Thanks a lot for your comment, I hope I answered your question!

[@urbanimage]

@@CardioGauge Yes, thanks for the response.

[@kenrach9875]

I've need taking a statin for 9 years and my calcium score as gone though the roof. Cholesterol does not cause heart disease, rather insulin resistance is the real culprit

[@bartrobinson2103]

Hey Ken we've both learned quite a bit from Doctor Brewer

[@kenrach9875]

@@bartrobinson2103 yes but gave you checked Dr . David Diamond or Ivor Cummins

[@bartrobinson2103]

@@kenrach9875 .. yes I'm also subscribed to Ivor Cummings channel. And I've heard a couple interviews with diamond. Thanks for the heads up!

[@mannyradzky493]

Ken Rach EXACTLY!!!!!

[@auntagatha2509]

What makes the muscles ache please?

[@TheArby13]

Atorvastatin OR a similar medication...what is the similar med that is as effective? I have aches and pains that are nearly debilitating. If it is the atorvastatin causing the pains, what can I use to replace that med?

[@josephdennison4890]

Hey doc , how much statin drugs are you taking

[@bartrobinson2103]

I'm sorry sir I did see you discuss the coronary calcium score in this video it's been awhile since I watched your videos again and I'd forgotten. I appreciate how you explain things very clearly and easy to understand

[@normahammer5566]

im taking 40 mg atorvastian and my liver enzymes have evelavated is this a concern

[@annmcnamee2991]

I have RLS I am taking 10mg off atorvastatin should I cut the pill in faif

[@joem5639]

Very informative presentation. I recently found myself in group 2, category 3, (304 score). My blood panel is considered normal) although total cholesterol, LDL & glucose are a few points high), normal blood pressure & not overweight. My primary physician put me on this very statin. When I explained this to my aviation medical examiner he said he would not have done this unless I was experiencing symptoms. Seems like doctors are prescribing statins to protect themselves from liability.

[@CardioGauge]

Thanks for your comment Joe M, yes there is some liability for docs who don’t aggressively push statins, because our guidelines tell us to do it, and if we don’t and bad things happen to patient, we could be held accountable legally. Docs have to have honest discussion with people about what statin does for risk. In my experience most docs don’t know the numbers I describe in the video. They just say the med is indicated to decrease chance for stroke and heart attack and leave it at that. Depending on your age, a score of 300 may warrant treatment. For someone in 40s -60s I would treat most people. If in 70s I would consider it. If person in 80s I would not use statin. You can put all your numbers (including your calcium score) in this calculator to gauge your risk, and the potential benefit of atorvastatin (decrease risk by 50% for 80 mg dose, approx 40% for 40 mg, approx 33% for 20 mg): www.mesa-nhlbi.org/MESACHDRisk/MesaRiskScore/RiskScore.aspx Many docs are not familiar with calcium score. I find it very useful. Best woshes

[@joem5639]

CardioGauge, Thank you for your response. I’m currently 55 and my risk on the calculator it 7.2% vs 3%. I’ve been prescribed the 40mg dose. I ate the standard American diet until 2016 when I started the keto diet and now just no highly refined carbs & no sugars. I dropped over 40lbs and kept it off and was briefly in Losartan for high blood pressure but no longer need it since losing the extra weight. There are 2 camps when it comes to reversing heart disease. 1 is the whole food plant based diet which assumes all animal products and oils are inflammatory. 2 is the low carb, no sugar, high fat (keto type) diets that assumes insulin & insulin resistance is what’s inflammatory. Thoughts on these two approaches? Also, what’s your opinion on supplementing vitamins C, D3 & K2 to reverse calcification?

[@outlander271]

My stroke was due to atrial fibrillation rather than plaque displacement. Do these studies distinguish between the causes of stroke?

[@CardioGauge]

Great question. The studies I refer to do not distinguish between causes of stroke. There is no good study I know of addressing the idea of using atorvastatin after stroke from atrial fibrillation. Probably your doc prescribed warfarin or Eliquis, or similar, to decrease your chance of another stroke from the atrial fibrillation. This decreases chance of stroke by about half, compared to being without the medication. The atorvastatin, as you indicate, does not address the atrial fibrillation aspect of your problem. With stroke, the neurologists take a shotgun approach. They don’t want you to have another stroke of any sort, so they hope to decrease your risk any way they can. It’s hard to know what your chance of benefiting from atorvastatin is. If, in the course of your stroke evaluation, you were shown to have atherosclerosis of any sort in the arteries of your neck or brain, the atorvastatin makes more sense. Atherosclerosis would be evident on CT scans and carotid ultrasound, and MRI. For my patients with stroke and atrial fibrillation, I emphasize the anticoagulant treatment, because it is so important. Hope this helps.

[@outlander271]

CardioGauge Thank you for your thoughtful reply. I am on anticoagulant meds and I will enquire regarding the condition of my arteries. I had a scan when I was hospitalised and will review the report. Best wishes from the U.K. by the way.

[@karenowen1744]

Have lots of pain, in the arms, legs chest and the contractures come back in my limbs. Muscle relaxes don’t work. Not allow to take inflammatory drugs as I have stage 3 kidney disease.

[@KarenHighcastle]

I love your drawings. It is more interesting and I pay more attention than other videos! I have been listening to your videos since I have been on lipitor . My LDH is 154, 65 yo, female. I feel achey since I have been on it. My liver function is normal. Thanks for doing these important videos.

[@CardioGauge]

Thanks for watching Karen K! talk to your doc about the aching, maybe they can help you by decreasing the dose or trying rosuvastatin. Best wishes!!

[@KarenHighcastle]

@@CardioGauge Thank you for your feedback! I will talk to my PCP soon when I get my annual physical. Take care, stay safe! By the way, are you also an artist?

[@Jeffotos]

My 85-yo mom takes this and she’s never had a cardio issue. But recently I hear fat soluble statins can cause dementia, and she’s been more confused and forgetful lately. I myself (58-yo) take a water soluble Pravastatin. Should my mom switch to that?

[@Corkfish1]

Despite having decent cholesterol levels I went on low dose atorvastatin because my brother had a cardiac issue. After two years I decided to go off it. I heard that it is not a good idea to go off once you've been on. Is that the case? I had a calcium score of 91

[@CardioGauge]

Hello again, Corkfish1! Stopping atorvastatin is not in acutely dangerous issue for someone who has been taking it for primary prevention. It will not suddenly cause a heart attack to occur. The bigger question for you is what is your risk for having a cardiovascular event, and should you take atorvastatin to decrease that. Your age is an important factor here. If, for example, you are In the age range of 40 to 60, a calcium score of 91 is pretty high, and implies that you could have the same genetics as your brother, which caused him to have the heart Attack. The absolute cholesterol level unfortunately is not in accurate predictor of risk. The calcium score is more accurate. For people in your shoes, I will often use the calcium score to direct whether or not I recommend a statin. Therefore, the fact that you had decent cholesterol levels before going on atorvastatin is not necessarily reassuring. For most of my patients in your shoes, I recommend healthy diet, such as whole food plant-based diet, or Mediterranean diet, routine exercise, and atorvastatin 20 to 40 mg per day. You can put your cholesterol numbers, age, blood pressure, and calcium score in the following calculator to get a numerical assessment of your risk. You could estimate that with atorvastatin 20 mg per day, your risk would decrease by about one third. For example, if the calculator gave you a risk over 10 years of 12% for stroke heart attack or stent, with atorvastatin 20 mg per day, the risk would be about 8%. Of course what you eat and how Active you are can make a big difference, Probably a bigger difference than taking the medication. But doing everything together is probably the best approach for most people!

[@CardioGauge]

Oops, I forgot to include the link to the Calculator: here it is www.mesa-nhlbi.org/MESACHDRisk/MesaRiskScore/RiskScore.aspx

[@Corkfish1]

@@CardioGauge thanks so much for your input! Your analysis seems to be spot on. I'm 60 and in excellent health as far as I know. The calcium score and my brother's experience is why my physician put me on statins. I run a couple of miles every day and lift weights 5 days a week so I look and feel great. Still, I think I will ask my doctor about going back on the statins for the reasons you cite. Again, thanks very much, I appreciate it.

[@Ken-rk3by]

I call bush-t on Atorvaston I had 2 strokes, carotid artery surgery, and then was put on the Staton and it almost killed me.

[@jimdandy8996]

Why isn't Co-Q10 supplementation with statins discussed typically?

[@vigilanterocco381]

Because in other studies, it shows it can actually give you more clogged arteries .... I take K2/K7/ flaxseeds, apple cider vinegar and eat lots of garlic cloves; and these doctors want me on a statin with an LdL of only 115. I nearly died 3 times on a statin from pancreatitus; depending on your calcium score doesn't necessarily mean your arteries are clogged; although with age, we all acquire atherosclerosis. But U can reduce it and even reverse it with diet changes; and it doesn't mean to stay clear away with fattening foods. Because most of us don't get Vitamin K2/Mk7. Garlic is a wonder in cleansing your arteries and it lowers blood pressure. And the less calories you eat, the less atherosclerosis and the longer you live. An apple a day shows it's equivalent to a statin; look it up. Google it. There are people out there walking around with a cholesterol of 3000; and a calcium score of 3,100----yet have no signs of heart disease; although it most cases there aren't any signs of a heart attack until the last second. I am baffled as much as the next person..... And zinc: it' s been put on the shelve for the past 40 years when studies have shown that zinc may be a cure for atherosclerosis.... Look it up if U don't believe me....

[@diptipateljena5372]

Hi Dr, is it ok to take vitamin k2 with atorvastatin. Should be together or separated?

[@DurinRhohan]

you better do lots of your owns research,, many new studies so different and when you see number look harder because some times they use number that are a percent of a percent EXAMPLE,, lets say the number is 2 but with statins it is 3, that is 33 percent longer , when it is really only 1 percent , So do hard research ,

[@zombiewanderer]

36 years old, obese, diabetic. LDL is 80 and doc is putting me on this medicine. I dont think I should take it, is it worth the risk? He says he wants me at 70 since im diabetic.

[@CardioGauge]

Hello. I can’t directly answer your question, because you are not my patient, but I will try to explain the situation. Your doc is following guidelines put out by Cardiology trade organizations, the ACC and AHA. This is a link to a summary of the guideline. www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/2018/Guidelines-Made-Simple-Tool-2018-Cholesterol.pdf The guideline is typically treated as dogma by health insurance companies, physician review boards, and the government. A “good” doctor follows guidelines. A “bad” doctor does not. So basically doctors are forced to follow guidelines. You are borderline, according to guideline, for the statin. I don’t know what your risk for having heart attack is over the next ten years, this number is used by the doc to decide whether or not you should take the med. you can find that out at my website cardiogauge.com, you click on the option to get your health summary. If you calculated risk is more than 20% for heart attack or stroke over 10 years, doc is supposed to give you the medication. If your risk is less than 20%, doc is supposed to give the med when you turn 40. Your head is probably spinning from all the blah blah blah right now. But let me break it down for you. Heart attack is very common in people with type 2 diabetes. On average somewhere around 25% over 10 years. If person takes the statin, the risk goes down to about 15%. The risk of a bad problem with statin is very small. One in thousands. The risk for muscle aches with statin is high, 1 in 5. The best way to treat risk is weight loss, daily exercise, eating super healthy. If you are unable to get your blood sugar near normal with diet and exercise, basically you will be stuck trying statin and seeing if you tolerate it. It is not an emergency to start a statin. You are young and you have significant potential to change your trajectory by attacking the diabetes. It means eating differently, and being satisfied with it. It means getting basically addicted to routine exercise that you actually enjoy.

[@CardioGauge]

Trying a vegan diet works for some people. You can check out Prevent and Reverse Heart Disease by Caldwell Esselstyn. Also, you could read Joel Fuhrman’s book The End of Diabetes for some ideas. Exercise is critical. Almost everyone has physical things they like to do. Find something you really enjoy, and get “into” it. For me it’s basketball. I went for 15 years doing no exercise, I hate treadmills and stationary bikes and ellipticals. But I do love basketball, and my wife got me going to the gym a few years ago, and now all my exercise is centered around that activity. Anyway I hope this answer is helpful to you.

[@alexanderdyk]

Doctor. Since 2013 i have had total cholesterol about 250, triglycerides around 290 and LDL around 160. I am 34 years old with high blood pressure and take enalapril 10mg on morning and night....do you recommend me take atorvastatine? My doctor in Mexico prescribed me atorvastatine 10mg and vytorin 10/20 time ago and my blood test after 2 month came very good total cholesterol 132 triglycerides 90 and LDL 76 and he suggest me to stop it. Hope you can answer

[@CardioGauge]

Hi Cesar, I can’t tell u what to do because I am not your doctor. None of what say here is medical advice. Only your doctor can give that to you. I have patients in your shoes and generally I would recommend atorvastatin to them, because the LDL is high at 160. It becomes more important to treat with atorvastatin if there is a family history of coronary artery disease, stroke, or other vascular disease. Also, because your triglycerides were high, that suggests you could have weight to lose, and may need to eat less. Eating a healthy diet (such as Mediterranean diet) with fewer calories than you are currently eating, and exercising daily for 30 minutes or more, your numbers could improve a lot and you might not need the atorvastatin.

[@alexanderdyk]

@@CardioGauge Thank you very much for you advice....just an other question about my case......as you see my LDL was 160 and tryglycerides 290 and after 2 or 3 months of taking atorvastatine levels reduced to LDL 76 and tryglicerides 90.....it is ok to stop taking atorvastatine when levels reduced to optimal or need to be taken forever like blood pressure pills? and i ask this because i know that even my blood pressure is low for a period of time i can not stop taking enalapril (or at least that was my doctor said) but it is normal to a person stop taking atorvastatine when lipids went down? it is not like withdraw symptoms or a spike on lipids?

[@CardioGauge]

Cholesterol medicines like atorvastatin are like blood pressure medicines that way. When you stop atorvastatin the cholesterol will go up in a few weeks. So unless the person makes major change to diet, they end up staying on atorvastatin “forever.” That is why it is better to try to eat really well and exercise daily to try to manage your cholesterol that way before starting the medication. For my patients (who do NOT have a history of cardiovascular disease) who get themselves down to ldl 130, I generally don’t end up recommending atorvastatin.