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Statins and vitamin D

Apparently: Stains ==> less cholesterol ==> less pre-vitamin D ==> less vitamin D from sun


See also VitaminDWiki

Statin intolerance reduced as level of vitamin D is raised - July 2015

about 53% no longer statin intolerant if > 30ng of vitamin D
about 90% no longer statin intolerant if 54 ng of vitamin D
 Download a letter to the editor from VitaminDWiki

Statins and Vitamin D in PubMed 225 items July 2016: examples follow:

  • Is there really a relationship between serum vitamin D (25OHD) levels and the musculoskeletal pain associated with statin intake? A systematic review. April 2016 full free text
  • Safety of 50,000-100,000 Units of Vitamin D3/Week in Vitamin D-Deficient, Hypercholesterolemic Patients with Reversible Statin Intolerance. March 2016 full free text
  • Simvastatin and vitamin D for migraine prevention: A randomized, controlled trial. Dec 2015
  • Statin Intolerance Because of Myalgia, Myositis, Myopathy, or Myonecrosis Can in Most Cases be Safely Resolved by Vitamin D Supplementation. March 2015 full free text
  • Do women with statin-related myalgias have low vitamin D levels? Sept 2015 full free text
  • Low plasma vitamin D levels and muscle-related adverse effects in statin users.Jan 2014 full free text
  • The association between drugs frequently used by the elderly and vitamin D blood levels: a review of observational and experimental studies.Feb 2014
  • Vitamin D3 effects on lipids differ in statin and non-statin-treated humans: superiority of free 25-OH D levels in detecting relationships Sept 2013
  • Effect of simvastatin/ezetimibe 10/10 mg versus simvastatin 40 mg on serum vitamin D levels. May 2013
  • Cardiovascular disease, statins and vitamin D. Feb 2012
  • Possible mechanisms of interaction between statins and vitamin D May 2012
  • Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. - July 2011
  • Resolution of statin-induced myalgias by correcting vitamin D deficiency - May 2011

21% less vitamin D in those taking statins - 3 RCT Feb 2017

Statin Use and 25-Hydroxyvitamin D Blood Level Response to Vitamin D Treatment of Older Adults.
J Am Geriatr Soc. 2017 Feb 27. doi: 10.1111/jgs.14784. Epub ahead of print
Bischoff-Ferrari HA1,2, Fischer K1,2, Orav EJ3, Dawson-Hughes B4, Meyer U1,2, Chocano-Bedoya PO1,2, Meyer OW1,2, Ernst R1,2, Schietzel S1,2, Eberli F5, Staehelin HB6, Freystätter G1,2, Roas S1, Theiler R1,2, Egli A1,2, Wilson NM1,2.

OBJECTIVES: To determine whether statin use alters response of 25-hydroxyvitamin D (25(OH)D) level to vitamin D treatment.
DESIGN: Pooled analysis.
SETTING: Three double-blind randomized controlled trials that tested different doses of vitamin D.
PARTICIPANTS: Participants of three trials (N = 646; mean age 76.3 ± 8.4, 65% female).
MEASUREMENTS: In all three trials, 25(OH)D status and statin use were assessed repeatedly over time (baseline, 6 and 12 months). Repeated-measures analysis was used to compare 25(OH)D response to vitamin D treatment at baseline and 6 and 12 months of statin users and nonusers, controlling for age, sex, body mass index, Charlson Comorbidity Index, vitamin D dose, trial, and season.
RESULTS: At baseline, 17.5% were statin users, and 65% were vitamin D deficient (25(OH)D < 20 ng/mL). Baseline 25(OH)D levels did not differ significantly between groups at baseline (18.8 for statin users, 17.2 ng/mL for nonusers, P = .07), but according to the longitudinal analyses, the total increase over 12 months in 25(OH)D concentration was significantly lower in statin users (13.1 ng/L) than nonusers (15.9 ng/mL; 21.4% difference; P = .009).
CONCLUSION: Of persons aged 60 and older at high risk of vitamin D deficiency, statin users had a 21.4% smaller increase in 25(OH)D serum concentrations over time than nonusers, independent of vitamin D dose and other covariates.

PMID: 28240766 DOI: 10.1111/jgs.14784 Publisher will rent the PDF for $6


Do statins increase the level of vitamin D in the blood in the short term?

Question: Is this a direct effect, or is it due to statins reducing cholesterol, which is needed to produce vitamin D from the skin, but cholesterol is not needed if the vitamin D is taken as a supplement

Some people appear to think that vitamin D could serve the same function as statins at much lower cost and much lower risk

Note: one statin is the top selling US prescription drug - with more sales than the next two top-selling drugs
Image

See also Web

See also Vitamin D Council behind a paywall


VitaminDWiki expects that Vitamin K2 could decrease the above side effects of statins


Benefits of Chocolate on the heart and all cause mortality (vs statins) - 2012

Green Med Info April 2012
Great many health benefits of chocolate documented -
Regarding just the heart: Chocolate appears to be better than statins.


A New Women’s Issue: Statins NYT May 2014

  • If you’re going to tell a healthy person to take a medicine every day for the rest of their life, you should have really good data that it’s going to make them better off,
  • statins didn’t prevent healthy women from having their first heart attacks and didn’t save lives.
  • Women who are healthy derive no benefit from statins, and even those women who have established heart disease derive only half the benefit men do.
  • The drugs have long been known to cause muscle pain in some people and, more rarely, liver and kidney damage, as well as cognitive side effects like memory loss and confusion
  • postmenopausal women who took part in the Women’s Health Initiative were much more likely to develop diabetes if they took statins, and diabetes itself increases the risk of heart disease considerably.

    Summary by VitaminDWiki: No proof that statins helps healthy women, but there is proof that statins harms them

Statin Health problems - GreenMedInfo - 2015

nothing about vitamin D

Muscle damage 80 studiesNerve damage 54 studies+Liver damage 32 studies
Endocrine disruption: 16 studies Cancer-promoting: 9 studies Diabetes-promoting: 8 studies
Cardiovascular-damaging: 15 studiesBirth defect causing 11 studies
  • The JUPITER trial of Crestor vs placebo resulted in increased fatal heart attacks in the treatment group which were obscured by combing fatal and nonfatal infarctions.
  • The HPS study has 26% drop out rate prior to the beginning of the trial, so that those with significant side effects were functionally excluded from the study.
  • In at least four trials, statistically significant increases in cancer incidence was found, and handily dismissed by all authors as insignificant because they claimed "no known potential biological basis" is known.
  • A low serum cholesterol level has also been found to serve as a biological marker of major depression and suicidal behavior,
       suicidal ideation among adults with mood disorders was more than 2.5-times greater in those taking statins
  • "So, the next time you hear of a doctor recommending a cholesterol-lowering intervention, tell him you'll take that 1% risk and spare yourself cancer, cognitive dysfunction, myopathy, and diabetes"

__Aug 2016 Video Statin Drugs Linked to 300+ Adverse Effects


If you really must take statins and they cause pain, vitamin D will relieve the pain - 2015

Statin Intolerance Because of Myalgia, Myositis, Myopathy, or Myonecrosis Can in Most Cases be Safely Resolved by Vitamin D Supplementation March 2015
50,000 or 100,000 IU of vitamin D2 per week relieved statin pain
 Download the PDF from VitaminDWiki

  • ConsumerLabs has a nice summary of this as well as many other vitamin D studies behind a subscription paywall
    Their paywall is very much worth the price. They review a huge number of supplements
    I have subscribed for over a decade

80% of the people who should take statins have decided not to (TOO many side effects?) - 2015

Statins associated with low vitamin D - Dec 2015

Statin therapy and Vitamin D
Int J Basic Clin Pharmacol. 2015; 4(6): 1113-1117doi: 10.18203/2319-2003.ijbcp20151342
Arunkumar Radhakrishnan, A. Ruckmani, M. Abishek, S. Govindaraju.

Background: Statins are well-known drugs used in dyslipidemia and cardiac disorders since several years. Recently, it has been reported that long-term use of statins reduce serum vitamin D level. When statins are administered to patients with low vitamin D more muscular side effects have been reported. On the contrary, a few studies report that statins might increase vitamin D level competing with its metabolism. Hence, this study was conducted to evaluate the association between statins and vitamin D.

Methods: 125 participants who fulfilled the selection criteria were enrolled in the study. 65 subjects belonged to control group and 60, statin group. The blood sample was collected for Vitamin D estimation. The results were correlated with a demographic profile, nature of statin and the muscular side effects and compared with control group.

Results: The mean vitamin D level in statin group was 15.82 ng/ml±11.51 and 20.57 ng/ml±7.007 in the control group. The difference was found to be statistically significant. 13.85% in the control group and 10% in statin group had sufficient vitamin D level. 18.33% and 36.92 % had insufficient levels and 71.67% and 49.23% had a deficiency in the statin and control groups respectively. Myalgia was reported by 30 among 60 subjects (50%) in statin group and 5 among 65 subjects (7.69%) in the control group.

Conclusion: The present study has shown that statin therapy is associated with low vitamin D level and that this could contribute to the increased incidence of myalgia in the statin group.

 Download the PDF from VitaminDWiki


Statin intolerance ==> statin tolerance after add lots of vitamin D - March 2016

ID: 86: SAFETY OF 50,000-100,000 UNITS OF VITAMIN D3 PER WEEK IN VITAMIN D DEFICIENT, HYPERCHOLESTEROLEMIC PATIENTS, WITH STATIN INTOLERANCE
Journal of Investigative Medicine
V Jetty, G Duhon, P Shah, M Prince, K Lee, M Goldenberg, A Kumar, CJ Glueck, P Wang
DOI: 10.1136/jim-2016-000120.39 Published 22 March 2016

Background In ∼85–90% of statin intolerant patients, vitamin D deficiency (serum 25 (OH) D <32 ng/ml) is a reversible cause of statin intolerance, usually requiring 50,000 to 100,000 units of vitamin D/week continuously to normalize serum vitamin D, and thus successfully allow reinstitution of statins which previously could not be tolerated because of myalgia-myositis.

Specific Aim In 274 statin intolerant patients, all with low entry serum vitamin D (<32 ng/ml, median 21 ng/ml), we assessed safety and efficacy of vitamin D supplementation (50,000–100,000 units/week) over treatment periods of 3 months (n=274), 3 and 6 months (n=161), 3, 6, and 9 months (n=58), and 3, 6, 9, and 12 months (n=22).

Results In the 385 patients with 3 month follow-up, taking mean 61,000 and median 50,000 IU of vitamin D3/week, median serum vitamin D rose from 20 to 42 ng/ml (p<0.0001); vitamin D became high (>100 ng/ml) but not toxic-high (>150 ng/ml) in 4 patients (1.0%) (101, 102, 106, 138 ng/ml). Median serum calcium was unchanged from entry (9.6 mg/dl) to 9.6 at 3 months. On vitamin D supplementation, the trend of change in serum calcium from normal-to-high or from high-to-normal did not significantly differ (McNemar S=1.0, p=0.32), and there was no significant trend in change of the calculated glomerular filtration rate (eGFR) from entry to follow-up (McNemar S=2.6, p=0.11).

In the 161 patients with 3 and 6 month follow-up, taking mean 67,000 and median 50,000 IU of vitamin D3/week, median entry serum vitamin D rose from 21 to 42 to 44 ng/ml (p<0.0001), serum vitamin D was high (>100 but <150 ng/ml) in 2 patients at 3 months (1.2%, 101, 102 mg/ml) and in 3 (1.9%) at 6 months (101, 140, 140 ng/ml). Median serum calcium was unchanged from entry (9.7 mg/dl), at 3 and 6 months (9.7, 9.6 mg/dl, p>0.05). On vitamin D supplementation, the change in serum calcium from normal-to-high or high-to-normal was no significant trend (McNemar S=0.7, p=0.41), and no trend in change of eGFR (McNemar S=1.3, p=0.26).

In the 58 patients with 3, 6, and 9 month follow-up on mean and median 71,000 and 100,000 IU of D3/week, median entry vitamin D rose from 20 to 37, 41, and 44 ng/ml (p<0.0001), with 1 (1.7%, 102 ng/ml), 2 (3.5%, 140, 140 ng/ml), and 0 (0%) patients high. Median serum calcium was unchanged from entry, median 9.7, 9.8, 9.6, and 9.6 mg/dl. On vitamin D supplementation, the trend of change in serum calcium from normal-to-high or high-to-normal was not significant (McNemar S=1.8, p=0.18), and no trend in change of eGFR (McNemar S=2, p=0.16).

In the 22 patients with follow-up at 3, 6, 9, and 12 months on mean and median 70,000 and 75,000 IU of D3/week, median serum vitamin D rose from 20 to 37, to 41, to 44, and to 43 ng/ml (p<0.0001), with 1 (5%, 102 ng/ml) high, 2 (9%, 140, 140) high, 0 (0%) high, and 1 (5%, 126 ng/ml) high. Serum calcium was unchanged, median at entry 9.6, and then at 3, 6, 9, and 12 months 9.7, 9.7, 9.5, and 9.7 mg/ml. At entry serum calcium was normal in 21, none high, and one became high at 12 month follow-up. The trend of change in eGFR was insignificant, McNemar S=1.0, p=0.32.

When serum D rose above 100 ng/ml in the few cases, as above, it fell into the normal range within 2 weeks by reducing the vitamin D dose by 50%.

Conclusions When 50,000–100,000 units of vitamin D/week are given to reverse statin intolerance in statin intolerant patients with low entry vitamin D (<32 ng/ml), it appears to be safe over up to 1 year follow-up, without toxic high serum vitamin D levels >150 ng/ml, and levels rarely >100 ng/ml, and without changes in serum calcium or eGFR.
- - - -
A study has the same conclusion later in 2016
Rechallenging Statin Therapy in Veterans With Statin-Induced Myopathy Post Vitamin D Replenishment
41% tolerated their previously failed statins after taking vitamin D; free PDF is online


Atorvastatin decreases D levels via CPY3A4; parvastatin increases D levels vai CYP27A1 - 2016

The mechanism of statin-induced modulation of vitamin D metabolism Sept 2016
Behind $36 paywall http://dx.doi.org/10.1016/j.atherosclerosis.2016.07.224


Those with Statin pain were 3 times more likely to have levels of low vitamin D – Nov 2016

Impact of Vitamin D Status on Statin-Induced Myopathy
J of Clinical and Translational Endocrinology DOI: http://dx.doi.org/10.1016/j.jcte.2016.11.002
Krista D. Riche, Justin Arnall, Kristin Rieser, Honey E. East, Daniel M. Riche
 Download the PDF from VitaminDWiki
Image
Highlights
•Vitamin D status plays an important role in the consideration of statin-induced myopathy.
•Correction of vitamin D deficiency ( 20 ng/mL) can improve statin tolerance rates.


Nov 15 2016 - JAMA is finally questioning Statins

Four of the papers in that issue (Free online PDFs)

  • What to Believe and Do About Statin-Associated Adverse Effects
  • Statins for Primary Prevention in Older Adults - Uncertainty and the Need for More Evidence
  • Evolving Approaches for Statins in Primary Prevention- Progress, but Questions Remain
  • Statins for Primary Prevention - The Debate Is Intense, but the Data Are Weak
    "The evidence for treating asymptomatic persons with statins does not appear to merit a grade B or even a grade C recommendation.”
    “Benefits of any preventive therapy accrue according to risk of disease (greater benefit in higher-risk patients), the harms of therapy usually distribute equally overall risk levels. Thus, persons at low risk have little chance of benefit but equal chance of harms and thus are more likely to have a net harm.”
    “Other studies have estimated that closer to 20% of statin users have muscle problems.”
    “The decision aid [available from the Mayo Clinic website] shows that of 100 people who take a statin for 5 years, only 2 of 100 will avoid a myocardial infarction, and 98 of the 100 will not experience any benefit.”
    “At the same time, 5 to 20 of the 100 will experience muscle aches, weakness, fatigue, cognitive dysfunction, and increased risk of diabetes.”
    “The rate of statin use for primary prevention among persons older than 79 years had increased from 8.8% in 2000 to 34.1% in 2012.”
    The number needed to treat is 244 for the target group and is much worse for younger, women, and elderly

Dr. Grimes

  • Dr.Grime's blog post on the JAMA articles - he has been outspoken about Statins problems and the importance of Cholesterol for many years.
  • Comment by Dr. Grimes on BMJ 2016 study of Statins Jan 2017
    10 year study of statins in Europe concluded: “…. the apparent lack of association we observed between CHD mortality and statin utilisation ….”
  • Very small benefit to taking statins - and only to those who had heart problems - June 2017
    "Soon after the height of the epidemic in 1970–1980, there was a reduction of deaths in those who received statins, in WOSCOPS from 4% deaths at five years in controls to 3% in those treated. This means that just one man in 100 without a history of CHD who took (prava)statin for five years did not die.

_Statins are of no value in the elderly - Blog post Sept 2017
[http://www.drdavidgrimes.com/2017/09/statins-are-of-no-value-in-elderly.html|Dr. Grimes blog post
Image


Red yeast rice as good a statins (RCT May 2017) - without the side effects

Red yeast rice induces less muscle fatigue symptom than simvastatin in dyslipidemic patients: a single center randomized pilot trial.
 Download the PDF from VitaminDWiki

Good Review of Red Yeast Rice supplements by ConsumerLabs - June 2017
Consumer Labs found a 300 to 1 range in the active ingredient between the supplements
Nature's Plus and HPF Cholestene had good amounts

Attached files

ID Name Comment Uploaded Size Downloads
8446 Cholesterol vs survival.jpg admin 18 Sep, 2017 17:58 12.99 Kb 43
8035 Red yeast rice.pdf PDF 2017 admin 28 May, 2017 18:38 771.89 Kb 91
7402 Myophy 32 ng.jpg admin 26 Nov, 2016 20:06 40.84 Kb 2464
7401 Statins tolerated with Vitamin D.pdf PDF 2016 admin 26 Nov, 2016 20:05 290.13 Kb 375
6235 Statin and Vitamin D.pdf PDF 2015 admin 10 Dec, 2015 17:59 398.95 Kb 918
5725 Statin Intolerance July 2015.pdf PDF 2015 admin 28 Jul, 2015 03:09 336.10 Kb 1122
5306 Statin Intolerance.pdf PDF 2014 admin 14 Apr, 2015 14:23 4.79 Mb 1075
4806 Statin myalgia.jpg admin 01 Jan, 2015 23:30 31.95 Kb 8686
1172 Jupiter PMC3081676.pdf PDF admin 25 Mar, 2012 01:16 261.78 Kb 1695
152 List of best selling drugs wikipedia - 2006.gif best selling drugs admin 18 Aug, 2010 13:57 21.88 Kb 16497
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