Should I take statins?

Hi guys and gals,

Some recent blood work came back with “Consider statins” printed across the top and my subsequent conversation with a physician had him trying to convince me of the merits of taking them. He says I should think of them like driving a car while wearing two safety belts rather than just one.

My cholesterol results were all well within range (total: 170, HDL: 81, LDL: 85, triglycerides: 54) and there’s no family history of CVD.

I’m a 53-year old male and have had type 1 for 39 years. I’m fit and healthy, don’t drink, have eaten a plant-based diet for 30 years and exercise 7 days a week. My HbA1c, which is normally 6.5% or below, was higher than usual (6.9%) but I moved on to using the Ypsopump back in June and have had a bumpy start with the CamAps FX algorithm, so it wasn’t unexpected.

I’m reluctant to take a drug if it’s not necessary and, to me, the figures don’t seem to put me in a situation where it is but some might disagree.

What would you do in my situation? I welcome all thoughts and opinions on this.

Thanks in advance.

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With those numbers, I would definitely not take them.

The recommendation is simply because you have diabetes. That’s how doctors roll. They don’t look at you as an individual, they just put you in the category with every other diabetic.



One other comment, just for clarification.

Does that help? It depends.

If you are lifting weights or doing pushups and sit-ups everyday, that’s good and everything. Keep doing it!

But it does not do much for the topic here.

How much benefit your heart gets from exercise depends on the type of exercise. So just make sure that your exercise includes cardio.

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@Eric, thanks for the reply.

That was my thought, too, regarding the doctor and his blanket recommendation.

Yes, I totally get that about the exercise. I keep it as varied as possible: jump rope, rebounding, cycling, power yoga, HIIT sessions etc. Plenty of heart-friendly activity.

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My 2c fwiw - if it’s not looking too bad in terms of your labs and you don’t have a family history, why start now? Have there been changes in your blood work aside from the increase A1C?

Personally, I love statins because they allow me to eat a pretty wide range of diet. But I had high cholesterol before going on the statins. And a family history of heart disease. Pretty different from your situation.

Let us know what you end up doing … and how it goes.

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I’d take them. They can provide a level of protection from vascular issues at any cholesterol level. Diabetes poses risk factors regardless of one’s lipid panel. I’m all for using every tool in the box to tip the scales in my favor. All of my docs (and I got several opinions) wanted me to start taking a low dose statin at age 40 even with perfect range lipids. Haven’t regretted it.

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Statins can help lower cholesterol levels. However, this only makes sense if they reduce the particles that can lead to calcification in your blood vessels.

  • There are two different types of LDL cholesterol: small dense and large buoyant.
  • Large buoyant particles are considered neutral in terms of health.
  • What you want to lower are the small dense particles.
  • Unfortunately, blood tests do not differentiate between the two types of LDL cholesterol, so you don’t know the proportion of each.
  • Still, looking at your triglycerides can provide insight, since small dense particles are formed from triglycerides. High triglyceride levels are often caused by a diet rich in carbohydrates and sugar.
  • However, your triglycerides don’t seem to be high.
  • According to Robert Lustig, an important health marker is as follows:
    Lustig suggests that a triglyceride to HDL ratio below 1.5 is optimal for overall health, while a ratio above 2.5 significantly increases the risk of heart disease by up to 80%.
  • Your ratio appears to be below 1, which is very good.

If you want to learn more about this, look up Robert Lustig and cholesterol on YouTube or watch the huberman interview under the title " How Sugar & Processed Foods Impact Your Health" on Youtube

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I’m almost at 30 years of type 1 so my NP recommended putting me on atorvastatin and lisinopril, despite my cholesterol levels and general bloodwork being good too.

My numbers were way worse with the statin - I had some nasty insulin resistance :frowning: so if it’s supposed to help prevent complications, it won’t do that if my numbers are worse. She gave me her blessing to stop taking it.

I do still take the lisinopril, though!

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Hi
No, nothing else of concern. BP is fine, thyroid, kidney and liver function are all fine. Other than diabetes, nothing that would put me in a higher risk bracket where heart disease is concerned. I think it’s just standard policy here in the UK to prescribe statins to someone of my age with diabetes without any consideration of the individual’s health and lifestyle. The quoted driving with 2 seat belts analogy is the same in that it doesn’t take into consideration whether you’re a careful driver or not.

I haven’t had out of range results for cholesterol in the 3 decades they’ve been testing me for them. If anything, I’ve often erred on the low side for total cholesterol, which I understand can cause problems, too, if it’s long term.

I’m not anti-drugs but at the same time, am not comfortable with taking them unless there’s a genuine need.

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I take statins as my cholesterol was high. My type 1 dad died very young from heart disease, so thought it was best. I have no side effects from the statins. Hard to believe I’ve taken them for 20+ years.

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Hello bananaman (love name). For years my doctors tried to get me on statins. My LDL was 108 and they wanted below 100. Cardio gave me 20 mg atorvastatin. Had awful muscle cramps so stopped. Last year I consented to try rosuvastatin 5 mg. No side effects. My last LDL was 72. Doctors are all happy. As a cardio nurse I felt that statins were a big money maker. Saw plenty of patients with LDL of 40 coming back in for stents. Need to change lifestyle along with meds. That’s my take for what it’s worth. Good luck.

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Me too - actually I was more anti-drugs before I became diabetic. We were trying to control my high cholesterol w/diet. (Given all my food posts, perhaps you can appreciate my suffering - I went without cheese for 3 years!)
When I got the diabetes diagnosis, the set of acceptable foods shifted again. So rather than further restrict my diet, I went on the statin and really enjoy my cheeses.
I don’t think there have been any side effects, although joint pain is a common one reported that I haven’t experienced.
I am taking so many meds at this point (cholesterol, 2 high blood pressure, insulin, duloxetine, tamsulosin) that I wonder if I could attribute one particular side effect to one medication.
I feel pretty good, but how about that slight dizziness when I stand up? Is that me or the meds?

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Thanks for all replies.

Those advocating for statins thus far seem to be doing so because they’ve had a genuine need to take them, i.e. because their cholesterol is/was elevated. I’m totally fine with that and given the same circumstances, I’d likely do the same.

However, my numbers, whilst not perfect, are what would be considered quite acceptable for non-diabetics. Within that category will be individuals who smoke, eat all the wrong foods, never exercise etc. but those values established for lipids are still applied to them without any consideration of their individual circumstances and there’d be no suggestion of a need for statins until those values were errant.

My point is that for my doctor to declare that simply by virtue of my age and having type 1 diabetes, I am in need of medication, seems quite blinkered. As does ignoring the fact that I’ve spent the better part of my adult life avoiding pretty much every food associated with high cholesterol (not difficult when eating a whole foods, plant-based diet) and exercising with a passion that could almost be considered religious (I am one of those fortunate people who gets a major endorphin rush from doing so). Absolutely no trumpet blowing here - I’m not some holier-than-thou health freak - I just enjoy life more that way.

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Hi @Bananaman – you and I have much in common: around the same age, similar duration of T1 and vegetarianism and fitness! My a1c is also around the same. I went through the same statin conundrum a few years ago – mine had been creeping up and topped 200 and I do have a family history with high cholesterol, but my bloodwork also showed low triglycerides and good HDL.

There is specialized bloodwork that can suss out levels of small dense LDL particles vs. large and I convinced my dr to run it for me. Mine tipped the scale to small (which are the ones that can create the basis for heart attack/stroke) and I decided to try a low dose of statin. (I also was nervous about taking statins b/c my dad had issues with severe muscle cramping/aching when he started statins.)

I am currently taking 10mg atorvastatin every other day and am back to the mid-100s for overall cholesterol with great ratios of the three components. Thankfully zero side effects and I am consuming moderate amounts of cheese without compunction. Good luck with your decision and welcome to the group! Jessica

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Statins are a cash cow for pharma.

My MD tried to get me on them despite A1Cs below 5.0. I swatted her down and haven’t heard anything since.

Industry will move away from cholesterol and LDL. But it’s a slow moving ship with plenty of money still on the deck.

Lp(a), Triglyceride to HDL ratio pretty good tests from what I’ve heard/read.

I’m skeptical on stains:

https://www.tandfonline.com/doi/full/10.1586/17512433.2015.1011125

https://onlinelibrary.wiley.com/doi/abs/10.1002/dmrr.3189

https://onlinelibrary.wiley.com/doi/10.1002/kjm2.12373

Read a statin study which did show that benefits of statins likely are independent of cholesterol lowering effects due to lowering inflammation which can probably be achieved through other lifestyle mods.

But in the end I think it comes down to what makes one feel comfortable/covered and there’s probably a quasi placebo effect to this.

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I’m not in disagreement.

I’ve followed the work of Malcolm Kendrick over the years and he makes a pretty compelling case.