Cirrhosis Support Group

For lowering cholesterol, specifically LDL? I have been trying to avoid them due to the ads and some articles I see saying they can cause liver problems, and not to take them if you have liver disease(on the commercials).

My bloodwork was all excellent at my physical in December, except my cholesterol is high, and doc wants my LDL below 100(it is 170). My HDL is excellent at 70(over 40 is the goal).

So, she has suggested starting simvistatin at 20 mg daily, but to talk to the hepatologist. I know he will say ok, as he glossed over the subject the day I met him. He said, as much as a small % have some negative side effects, many, many people take them safely, and some liver patients benefit from it wrt to the liver disease.

Any here take them? I am fearful of damaging my liver further. I do eat pretty well, have lost 60 pounds, and lowered all my lipds numbers(well increased my good chol.)from the beginning of all this, but not enough, and they have bounced up a bit this last time.

For folks who do not know me, I have fibrosis, not progressed to cirrhosis. I want to keep that from happening. NASH is my diagnosis wrt liver, and I have diabetes, controlled by diet.

Thanks and I hope everyone is hanging in there.

mimmi

Post edited by: mimmi, at: 12/13/2011 06:08 PM

MY personal beliefs for the statin drugs is stated on the commercial in small print at the bottom of the screen. It says something like, "Known to reduce overall cholesterol but has NO change on a person's risk to heart attack or stroke." (Emphasis mine.)

I copy and pasted this from the first site I came to. I did not try but about 3seconds...

http://www.tcolincampbell.org/courses-resources/article/the- statin-drug-deception/?tx_ttnews%5BbackPid%5D=76&cHash=6c62286950 Lipitor is advertised as reducing the risk of heart attack by 36%. However, look a little closer and you’ll see that even in newspaper ads for the drug, the small print says that 3% of patients taking sugar pills had heart attacks as compared to 2% of those taking Lipitor. In other words, the absolute benefit is about 1%, not 36%. The aggressive promotion of this drug is even more egregious when considering that 10-15% of those who take it experience significant side effects. All for a 1% advantage in terms of heart attack risk, and no reduction in the risk of mortality.

I was prescribed a statin last March when my cholesterol shot up again after dropping with diet and exercise for over a year. I also received my referral for the GI doc at the same time and that's when this all started to be diagnoised. Once I was told I have cirrhosis, I stopped the statin drug. My good cholesterol is high and the total cholesterol is a tad above normal but I know that PBC can cause the cholesterol to go up but it isn't the kind that causes heart attacks or strokes. I still exercise every day and watch what I eat so I don't want to take a drug that might cause more liver injury.

Thanks for your opinions. I feel the same wrt the degree of liver disease I have. and I know this is new territory for my primary doc. I was her first patient to have such severe NASH as to progress to fibrosis. At this physical, she said she has now had 3 more. One did not make the needed changes with weight loss and such and has now progressed to cirrhosis.

I think prescribing these meds to patients with known advanced liver issues is new territory, beyond the general use in other situations. She did ask me, "What do you think?" And did address my concerns but is still pushing for me to take them. She has said to discuss it with my hepatologist and I have asked her to get the latest numbers to him.

I know they are worse this time because I have slipped with the exercise and eating. My blood sugar is excellent and I am able to eat some sweets and carbs without any blood sugar issues. I am one of those people who clearly had the diabetes due to my obesity and that issue being resolved has controlled it.

And I just fell off the exerices routine with caregiver stress and depression surrounding the situation with my aunt, dad, selling their house and now catching up with my own life and home after neglecting it all. Just so challenging to do it all.

Sigh. My gut is telling me I do not need these drugs and I will do better to avoid them. And I am not a fearful person wrt meds. But there is nor proven health benefit I see, especially now with newer emerging evidence that they might lower cholesterol, but heart disease is still on the rise, overall. Something is amiss there.

Happy for any others to weigh in here. There is a big divide in the diabetic community where I post as well. Some take them, and others are very opposed and eat extremely low carb/higher fat diets and have amazing numbers.

I am trying to eat better. It is a hard time of year to do so! My 12 yo daighter is learning to bake with me. Ugh... Must resist tasting!

Mimmi (edited to fix typos)

Post edited by: mimmi, at: 12/14/2011 07:56 PM

Doctors tend to look at drugs with an optimistic risk/reward type methodology... With their patients!

They figure "all drugs have side effects" and if your GP wants you on a statin, and there is no PROOF it greatly harms fibrotic livers, then give it a go and see what happens.

Be sure and ask your hepatologist if his CHILD had a fibrotic liver, whether or not he would think going on statins was a smart thing to do, and this might change his advise.

I sleep better at night knowing I'm doing everything in my power to keep my liver as happy as possible. They've got a lot of fixes for heart disease, but nothing to fix a washed up liver except a transplant.

I just say NO to drugs! (but then, that's just me!)

Moonwatcher, you stated my thoughts very well wrt fixes for hearts but not a liver. That is the problem. If I try it and suffer liver damage that puts me over that edge to cirrhosis, what do we say then? Oops.

Not sure that is good enough for me.

And we all know liver enzymes do not alway elevate but sometimes there is still liver damage. Though my history was very high liver enzymes, so for me it likely would be a good indicator.

So far no-one here takes them. That was what I was wondering. While she says its ok, and a risk worth taking for the benefits, I read where this is new territory. And I just bet some big pharmacy compnay is behind reworking the data to say its ok for liver patients. I read one long paper that was from a reputable clinic, and it was exactly rewrking numbers for liver tests on subjects with no known liver disease. it just cannot be assumed that it will be the same for someone with a compromised liver.

Mimmi, I was in that situation when first diagnosed and chose to follow my hepatologist's advise and stop the statin. He said "the risks to the liver far outweight the benefits to the heart". Good enough for me. I have a new hep now, and better numbers than ever just from dietary changes, but the new guy agrees.-B-

P.S. Good to hear things are going well for you, keep up the good work!

Hi B! I was hoping you would weigh in, as I know you keep up with recommendations in the medical community.

I am pretty certain my liver guy will say its ok, as he did gloss over it at our first meeting. I had a initial gastro rabid to put me on statins, do a 1200 calorie a day diet, and drop weight as fast as I could. Period.

At that time, it was not the focus of my hepatologist visit, whether or not I had cirrhosis was. But he said, "Statins are widely used very safely by millions of people with very small % having any ill effects. They are very safe for most people." But, he did not suggest I go on them and my numbers then were about the same as now.

I am going to have to try to politely be non-compliant with my GP, whom I do really like and respect. She did not say I have to take them, but that she has to recommend it. She is careful withher language. I get that doc have to use what info they have at hand.

Thnaks, all.

B, how are *you*?

Mimmi, after seeing so many docs, I finally asked my hep who to listen to for what. In a nutshell, hepatologist first for ANYTHING affecting the liver, Gastro for procedures, GP/PCP for coughs, colds, etc. I NEVER took ANY medicine without consulting the hepatologist.