So at a family birthday party on Monday, I found out something really quite obnoxious. My aunt went to get a certain soda, and her daughter's boyfriend informed her she shouldn't drink it because the grapefruit juice in the soda could interact with her statin cholesterol medication, and cause muscle damage. He's a pharmacist, and he's male, so naturally the sun shines out of his ass, so she put the soda back.

When I asked more about the interaction he rattled off a bunch of chemical names ... which I think he pulled out of his ass, because I've been doing some reading and none of the chemicals mentioned are familiar--and the names are pretty distinctive. Also? A chemical in grapefruit juice inhibits metabolism of statins, meaning levels can temporarily build up higher, and increase the risk of side effects. As in, a half a grapefruit can affect it for 24 hours. So basically, the .12 oz (I calculated!) of grapefruit juice in the can of soda wasn't going to hurt her. But whatever.

What shocked me is to find out that her daughter is on the same medication! She's 25! When I asked why, she said because she has high cholesterol on "both sides of her family" and then the boyfriend chimed in with "her LDL was 200!" Oh. Em. GEEEEEEEEE. I couldn't control my expression, which led Pharmacist Boy to snidely remark "I take it you don't believe in medication." I told him there were other ways to deal with and I don't believe in preventatively medicating people with potentially dangerous drugs. My cousin told me that she asked her doctor about dietary changes--but what she asked was "if I stopped eating completely would that even do any good?" Grr. Ahrg. Pharm Boy then started asking me if I believed in using red yeast rice for cholesterol, and then informed me that "herbal supplements are drugs too".

I don't have all the details, of course; I thought about asking for more info on her cholesterol readings, but a party isn't the best place--I couldn't hear some of what they were saying anyway. And, I admit, I didn't want to get into it with the pharmacist--he's got more formal education than I do, and it'd been a while since I'd read up on cholesterol. Add to that the fact that he's male, and therefore infalliable in their eyes, and it wasn't worth it.

There are just so many things wrong with this. For one thing, the girl is 25 freaking years old. Other than the one cholesterol reading, she's healthy. But she's on this potentially dangerous drug--which isn't actually proven to reduce heart attack risk or fatality, despite lowering cholesterol!--because ... umm ... her mom is? And her boyfriend told her she should be? Because it might be a problem later? Because ZOMG TEH FATZ AND KOLESTROL WILL KILLZ U?

It's just not as simple as "my LDL is 200!" What about HDL levels? What about the type of LDL--dense and prone to attaching to artery walls, or fluffy and not prone to that? What about triglycerides? What about triglyceride to HDL ratio? And LDL levels aren't even directly measured--they're calculated using other cholesterol types. Specifically, total - HDL - trigylceride/5. So maybe not always so accurate? That I'm not sure on.

And what about how statins work? They work by shutting down the activity of HMG-CoA reductase. You know what else limits the activity of that? Not eating carbs every fifteen minutes. Seriously. Insulin is a storage hormones--storage means fat cells--cells are built using cholesterol--so insulin tells your liver to manufacture some cholesterol to build those cells! So if your insulin is lower, your body produces less cholesterol. If you eat less carbs, your insulin is lower, and your glucagon is higher (glucagon is the opposite of insulin, so not a storage hormone). Best of all, if you do it that way, you don't run the risk of skeletal muscle wasting/death, renal failure, or liver problems. Of course that requires eating, say, chicken instead of pasta, but if I ever develop high cholesterol, I know which path I'll be taking.

But what do I know--I'm not a pharmacist.

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2 Responses
  1. vesta44 Says:

    People like that are just sure that if they take "preventive" measures they will get to live forever. Just because high cholesterol happens to be a problem for some family members, does not mean it's going to be a problem for everyone in the family.
    DH takes a statin, but he has type 2 diabetes and is 53 years old (it's a minimal dosage). His numbers are good, according to his doctor, so that's why she hasn't upped the amount he's been taking (he's been on it for 4 or 5 years now). It's also an older drug, since the VA is paying for it, and they don't always use the supposed "newest/best" drugs as soon as they come out (I don't know how long Lantus has been on the market, but the VA just added that to its formulary 6 months ago).
    I firmly believe in trying to handle things like cholesterol with dietary changes first, then meds if the dietary changes don't help (and minimal doses of meds whenever possible).

  2. purplegirl Says:

    Exactly -- if my cousin had tried a dietary approach, and found it didn't work, then okay. But basically what's happened is that her mother (who was a nurse in the 80s) spent years on a low fat diet, which of course didn't work, so her daughter didn't even try anything before starting to gulp down expensive drugs. Statins have their place; it sounds like it's working well for your husband, and that's great. But people who take the easy way, and have that "I'll never have to die!" mindset you mentioned just drive me up a friggin wall.