Recently a neuroscientist, V. Meske, reported in the European Journal of Neuroscience a very relevant study about the ability of statin drugs to cause neuronal degeneration. To refresh your memory statin drugs are designed to inhibit cholesterol synthesis [in the liver] by their effect on the mevalonate pathway. It seems that a consequence of the inhibitory effect of statin drugs on the mevalonate pathway is the induction of abnormal tau protein phosphorylation. Tau protein phosphorylation goes on to form neurofibrillatory tangles, long known to be the prime suspect in causing the slowly progressive neuronal degeneration of Alzheimer’s disease. Sometimes this process is accompanied by Beta amyloid deposition but more commonly not. Research scientists are now finding that this mechanism appears to be true for ALS and many other forms of neurodegenerative diseases as well. They have even coined a new word for this, the taupathies.
Statin associated taupathies or tauopathies may well be additional gross evidence of collateral damage to existing cellular chemistry that our researchers were unable to predict when they originally created the statins. All this from a class of drugs originally designed simply to inhibit the biosynthesis of cholesterol, which is a vital substance now proven to be irrelevant to the atherosclerotic process.
Very few primary care physicians are familiar with the association of statin drug use with ALS and most are disinclined to use warnings from websites such as mine about statin drug side effects, saying they are anecdotal. These “anecdotes” are the patient’s histories! Doctor Ellsworth Amidon, my Vermont College of Medicine professor of medicine, used to say, “Heed well the words of your patients, my young doctors, they are telling you the diagnosis.”
Most physicians feel that the pharmaceutical industry is on guard for side effects such as this and if no black box warning is out, the drug is safe. This is terribly naïve. Nor is FDA’s Medwatch an effective monitor of drug safety. My personal experience with Medwatch is that it is an adequate repository only. As an example, primary care physicians were denied the existence of statin associated amnesias until Wagstaff et al reported in Pharmacotherapy their 60 cases gleaned from a Medwatch review in 2003. I can only hope that readers of this paper, especially those having relevant symptoms, will bring this subject to the attention of their doctors. Print out this paper for them and urge them to check their own literature.
My first case report will demonstrate how carefully guarded the drug industry is about this relationship. “Hundreds of folders” might be an exaggeration but, as a specialist in both family practice and preventive medicine, even [the existence of] ten folders frightens me.
Duane Graveline MD MPH
Author, Statin Drugs Side Effects: the misguided war on cholesterol
www.spacedoc.net
spacedoc@cfl.rr.com
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Recent ALS patient case reports
“My dad died on 6/1/06 at the age of 65 from a six-year battle with ALS. I said to my mom a million times that dad got ALS from taking Lipitor. When he was taking it he would wake up in the middle of the night from severe muscle pain and cramping. When he told his doctor about it, his doctor said, "Hey, I get aches and pains too, but that's life", then he doubled my father's dosage. My dad finally was diagnosed with the ALS and kept taking the Lipitor because no one told him of any connection of his aches and pains and the Lipitor. He went from stumbling, to falling down, to walking with arm braces, to a walker, to a wheelchair, to total paralysis except for his hands. I watched him die from a disease that took away every bit of his pride and dignity because he needed help eating and going to the bathroom to being completely paralyzed and helpless. He was a proud, strong hard working carpenter and this disease turned him into a sobbing, completely petrified paralyzed person. My dad worked for an "extremely" wealthy man who finally sent him to and paid for him to see one of the United States top neurologists after he was diagnosed. After seeing this doctor for a while I said to him that I thought my dad might have gotten ALS from taking Lipitor and the doctor said, “You see all of those folders behind me (there were hundreds)? He said, ”Those are all cases that pharmaceutical companies have sent me of people who are in law suits because they think they got ALS from their cholesterol-lowering medications and they want me to read them all over and decide if I think that is the case or not.” He said, “In your father's case, honestly I'm just not sure.” Well I know Lipitor gave my dad ALS no matter what anyone says. It took away my four small children's grandpa and memories they will never have with him. I just wish doctors would inform their patients before they prescribed them a medication of the side effects and risks of that medication so the patient could decide if they wanted to risk it or not. Maybe if someone told my dad this from the beginning he would have opted to lower his cholesterol in another way.”