PT Barnum Once Said ……
Before I get to the six percent rule I wish to voice the truth about the statin drugs many of us take to lower our bad cholesterol – the Low Density Lipoprotein ( LDL) component. They are saving lives, they are preventing heart attacks and strokes, and they should not be stopped unless there is a real good reason to.
There are the bottom dwelling types, the snake-oil salesmen, and the foolish out there who are attempting to scare many of us into stopping their lifesaving medication because they have potential side-effects, as every single drug, vitamin and food can have. And there are plenty of patients who should not be taking statins and who can have serious adverse effects from them. Recently the FDA did site a small but definite increase in diabetes in patients who take statins and yet, in spite of this, issued the following statements:
“Statins have been shown to significantly reduce the risk of heart attack and heart disease.”
“The new information should not scare people into stopping taking the drugs.”
"The value of statins in preventing heart disease has been clearly established."
"Their benefit is indisputable, but they need to be taken with care and knowledge of their side effects."
Since this latest warning, some patients have called me to let me know that they will no longer be taking their statin medication. Of these patients, many claim they listened to other “experts” on television and the radio and have found better alternatives to lowering their cholesterol. In my opinion, if you go out and purchase some crap talked up by some TV doc, some supposed wizard, or some clown hawking their natural and safer product, you are going to pay for it, with increased risk of stroke, heart attack, and death, not to mention the cost of the junk you just bought. I'm not a big fan of Big Pharma but at least they are regulated and do invent drugs that can be very helpful, like statins. The OTC stuff, sold on TV and the radio, by some snake-oil salesmen, is hardly regulated and meant to steal as much money from you as possible.
The Six Percent Rule:
Doubling the dose of your statin drug will not double it's effect. Doubling your dose of 20 mg of Zocor (simvastatin) will not lower your LDL from 140 to 70. The general, and quite accurate, rule is that doubling any dose of any statin will get you another 6% reduction in your LDL cholesterol.
If your are visiting your physician, and he raises your Zocor from 10mg to 20mg, because he wants your LDL reduced from 100 to 70 then, he ain't going to get you to that goal. More, likely, your LDL cholesterol will lower to (you do that math) around 94, or well short of your goal of below 70. In cases like this, it is often best to switch the statin to a more potent one, like Lipitor ( artorvastatin) or Crestor ( rosuvastatin). Lipitor is twice as potent as Zocor and is now a generic drug ; the retail price for it will be falling significantly this year. Crestor is twice as potent as Lipitor and is still a brand drug so be prepared to pay more for it.
In the patient I discussed, I suggested he change his medication to Lipitor 40 mg or Crestor 20 mg since that would lower his LDL ( you can do the math) by about 48 percent or down to below 70. Some physicians may suggest that you add a drug like Zetia or Niaspan, since they will also help you get your LDL numbers to goal, but these combinations don’t seem to protect you from stroke and heart attack as well as just using a statin by itself.