Lowering blood cholesterol- do statins have side effects?

I was asked to comment about the safety and side effect of statins– Lipitor, Pravacol, Zocor and others– drugs that are very effective at lowering blood cholesterol and preventing death from heart attacks. I’m not an M.D., but my impression is that these are pretty good drugs as far as safety and efficacy goes.

However, they can occasionally be toxic to the liver and to muscles, and if you are taking a statin your doctor is probably checking for liver toxicity (ALT/AST) and should be checking for muscle toxicity (creatine kinase). Your job is to note any muscle weakness or pain that might indicate dangerous muscle breakdown, which might eventually be fatal.

If you are concerned, there are two things you can do– one is to take supplements of coenzyme Q and vitamin D along with your statin. I can’t say that the evidence for benefits of these supplements is unequivocal, but I would take them if it were me.

The other thing you can do is to work with me to lower your cholesterol without statins. I’ve had great success with nutritional strategies that go far beyond the pretty useless low-fat recommendations you’ve probably given up on. Look on the testimonials page of my website (healthyfat.com) or search my name on Yelp for clients bragging about their low cholesterol numbers.

Tamoxifen in the news

In the Science Times today, Tara Parker-Pope tries to make the case that women are being illogical in not taking tamoxifen to prevent breast cancer.

I'm a scientist and the conclusion I draw from Ms. Parker-Pope's data differs from hers. Is it really logical to take a drug that when given to 100 high risk women, will lower the number of breast cancer cases from 1.9 to 1.0, but cause 8.5 additional cases of endometrial cancer, blood clots, cataracts, and sexual problems and 12 additional cases of hot flashes and irregular periods?

Are women really being illogical when they are willing to take birth control pills, but not tamoxifen? If the same 100 women were sexually active and not using birth control, 85 of them would become pregnant. Birth control pills would reduce this number to 1 to 8. If the pill were as ineffective as tamoxifen, women would be in big trouble.