You Docs: What you should know about statins and muscle pain

12/30/2013 12:00 AM

08/08/2014 10:20 AM

During the 1992 Olympics, when track star Derek Redmond hobbled across the finish line of the 400-meter semi-finals, 65,000 spectators cheered. And though his torn hamstring ended his track career, he rebounded and went on to play basketball and rugby.

If you are taking a statin and have symptoms of myopathy, or statin-related muscle problems such as hamstring or tendon pain, muscle soreness, cramping or weakness, alert your doctor. (Around 1.5 million people a year, a small percentage of those taking statins, have such problems.) These symptoms can make it uncomfortable to move, but you can bounce back, just like Redmond.

Stopping the statin, reducing the dose or taking a different LDL-cholesterol-lowering medication usually can resolve symptoms. Rarely, statins trigger rhabdomyolysis – the breakdown of muscle fibers – and hospitalization is required to prevent serious kidney damage.

Atorvastatin and simvastatin are the statins most likely to cause symptoms, and the Food and Drug Administration advises against taking high-dose (80 mg) simvastatin.

Fluvastatin extended release, low-dose or twice-weekly rosuvastatin, or every-other-day dosing of atorvastatin or rosuvastatin (off-label regimens) may avoid myopathy.

Other ways include:

• Talking to your doc about your risk of muscle problems if you have diabetes, hypertension, untreated hypothyroidism, kidney or liver disease, drink heavily, are a super-exerciser or drink a lot of grapefruit juice.
• Asking your doc about taking 200 mg a day of Co-Q10.
• Avoiding drug interactions. Various statins interact with: cyclosporine; anti-fungal or anti-yeast medications; the antibiotics erythromycin, clarithromycin and telithromycin; protease inhibitors; the antidepressant nefazodone; and/or other lipid-lowering meds such as fibrates and niacin.

Good health that’s skin deep

This winter, you can still hear Dean Martin in TV commercials crooning “Oh, the weather outside is frightful, but the fire is so delightful,” which pretty much describes why you’re extra susceptible to sinus woes and your skin is so itchy and flaky. Going back and forth from cold and wind into hot, dry air is not good for your skin or your mucous membranes in your sinuses and nose.

So how can you keep your skin (inside and out) healthy this winter? The first thing Deano should have done – you still have the chance: Quit smoking and go easy on the alcohol. Then

Humidify your house. Indoor humidity can hit 10 percent to 15 percent in the winter, causing dry sinuses, bloody noses, breathing problems and skin irritation. Super-alert: Fill your humidifier with clean water daily and keep filters mildew-free. Aim for around 40 percent humidity.

Seal in moisture. Use a thick moisturizer within three minutes of getting out of the shower or bath. That’s particularly important if you have eczema (red, flaky skin triggered by allergy, irritation or a genetic predisposition). Also, use moisturizing UVA/B sunscreen (SPF of 15 plus) daily to avoid snowburn (all that reflected sunlight).

Feed your skin. Vitamin A-rich greens and orange and yellow veggies help your skin’s elasticity (so wrinkles don’t stick). And consider taking 1,000 IU of vitamin D-3 daily. Turns out this mood- and immune system-booster also helps renew skin cells.

Then, you can join Mr. Martin, singing, “Let it snow, let it snow, let it snow.”

New treatment for Peyronie’s disease

If you’re a guy with Peyronie’s disease, you know you’ve been thrown a curve. This condition, which affects more than 3 percent of men, arises when scar tissue forms along the inner wall of the penis. This happens because of problems with how broken blood vessels in the lining of the shaft heal from injury, perhaps due to athletic activity, even sex. If scar tissue becomes extensive, it can cause the surrounding tissue to contract. The erect penis then develops a curve of 30 degrees or more, triggering pain and making intercourse more difficult.

Until now, there’s been no solution except for surgery, which could cause problems, too. But the U.S. Food and Drug Administration recently approved injections of Xiaflex (collagenase clostridium histolyticum) to treat the disorder. It’s the same medication used to treat a thickening of tissue in the palm of the hand and fingers called Dupuytren’s contracture. In a pre-approval study, penile curvature was reduced in 34 percent of those receiving the injections.

The treatment does have potential side effects, including hypersensitivity reactions and tissue and nerve damage. In the study, trauma (corporeal rupture) to the spongy tissue in the penis affected three of about 400 men; surgery repaired the damage. And the treatment falls under the FDA’s Risk Evaluation and Mitigation Strategy program that alerts doctors to the potential risks associated with a medication.

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