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Statin neuropathy masquerading as diabetic autoimmune polyneuropathy

Statin neuropathy masquerading as diabetic autoimmune polyneuropathy -- Posted by Sharon Hope on 07-29-05 23:21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16043768&query_hl=1

Diabetes Care. 2005 Aug;28(8):2082.

Statin neuropathy masquerading as diabetic autoimmune polyneuropathy.

Vaughan TB, Bell DS.

Division of Endocrinology, University of Alabama School of Medicine,
Faculty Office Tower, Suite 758, 510 20th St. S., Birmingham, AL 35294.
brooks@uab.edu.

PMID: 16043768 [PubMed - in process]
Full text available via purchase or subscription from

http://www.ncbi.nlm.nih.gov/entrez/utils/lofref.fcgi?PrId=3051&uid=16043768&db=pubmed&url=http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=16043768All:This was a concern immediately upon FDA approval forstatins to be marketed to diabetics. It is well established that statinsCAUSEperipheral neuropathy and polyneuropathy, yet the FDA permitted thestatincompanies to market to diabetics, for whom neuropathy is an existingdanger.The Cholesterol-lowering Statin Drug Names: Lipitor, Crestor,Mevacor,Pravachol,Zocor, Lescol, and Baycol, aka atorvastatin, rosuvastatin,cerivastatin,fluvastatin,lovastatin, pravastatin, and simvastatin;This class of drugs is also knownas HMG-CoAReductase Inhibitors, short for3-Hydroxy-3-Methyl-Glutaryl Coenzyme AReductase.Now, there is also a combination drug, Vytorin, with both Zetia(Ezetimibe)and Zocor (simvistatin).The adverse effects of this class ofdrugs, specific to nerve damage isbelow. For a full FAQ of statin adverseeffects, including muscle,cognitive, ED, and other adverse effects ofstatins, see:http://www.freewebs.com/stopped_our_statins/StatinFAQ_031305wTOCv4.pdfStatin Adverse Effects FAQ: NERVE DAMAGE & STATINSTo my physician,I believe that my symptoms may be due to the adverse effectsassociated withcholesterol-lowering statin drugs. I need your help tounderstand the cause of my symptoms, treatment options, and the prognosisfor my recovery.Please review the references below, published medical studies thatshowsimilar problems associated with statin drugs. These are made availablevia the National Institutes of Health (NIH,http://www.ncbi.nlm.nih.gov/Entrez/)library of biomedical journal citationsand other major repositories of medical research.Also, I am respectfully requesting that you file an adverse effectsreportwith the FDA (http://www.fda.gov/medwatch/how.htm), and that youplease senda copy of the report to the to the NIH-funded Statin Study,attention: Dr.Beatrice Golomb, Principal Investigator.Statin Study website: http://medicine.ucsd.edu/statin/StatinStudy contact info: http://medicine.ucsd.edu/statin/contactinfo.htmlUCSDSTATIN STUDY E-MAIL ADDRESS: statinstudy@ucsd.eduMAILINGADDRESS: UCSD Statin Study 9500 Gilman Dr. La Jolla, CA 92093-0995PHONE NUMBER: (858) 558-4950Thank youReferences (updated as of January 7, 2005):NERVE DAMAGE & STATINSFrequently Asked Question: What medical research studies have been done onStatins and Nerve Damage that I can bring to my doctor's attention?Golomb BA, Yang E, Denenberg J, Criqui M (2003),Statin-associated adverse events. P95. Presented at the 43rd AnnualConference on Cardiovascular Disease Epidemiology and Prevention. Miami;March 5-8.Chong PH, Boskovich A, Stevkovic N, Bartt RE. Statin-associated peripheral neuropathy: review of the literature.Pharmacotherapy. 2004 Sep;24(9):1194-203. Review.PMID: 15460180 [PubMed - indexed for MEDLINE]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15460180"Based on epidemiologic studies as well as case reports, a risk ofperipheral neuropathy associated with statin use may exist; however, therisk appears to be minimal. On the other hand, the benefits of statins arefirmly established. These findings should alert prescribers to a potentialrisk of peripheral neuropathy in patients receiving any of the statins; thatis, statins should be considered the cause of peripheral neuropathy whenother etiologies have been excluded."Rajabally YA, Varakantam V, Abbott RJ. Disorder resembling Guillain-Barre syndrome on initiation of statintherapy.Muscle Nerve. 2004 Nov;30(5):663-6.PMID: 15389662 [PubMed - indexed for MEDLINE]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15389662"We report a disorder resembling Guillain-Barre syndrome, occurring oninitiation of simvastatin, in a 58-year-old man, who had experienced asimilar but milder episode after starting pravastatin 6 months earlier. Thiscase suggests that acute polyradiculoneuropathy may represent a rare butserious side-effect of statin treatment. It also raises the issue of thepathophysiology of acute neuropathy on statin exposure, with ahypersensitivity reaction resulting in an immune-mediated process beingpossible instead of the hypothesized mitochondrial dysfunction in chroniccases."Scola RH, Trentin AP, Germiniani FM, Piovesan EJ, Werneck LC. Simvastatin-induced mononeuropathy multiplex: case report.Arq Neuropsiquiatr. 2004 Jun;62(2B):540-2. Epub 2004 Jul 20.PMID: 15273860 [PubMed - in process]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15273860"The association between the use of statins and neuromuscular disease iscurrently being intensely discussed. We relate a 63 years old man withpossible case of statin-induced neuropathy in a patient with dislipidemia inuse of simvastatina at high doses. The electrophysiologic studies disclosedfindings compatible with mononeuropathy multiplex, suggested by clinicalprescutation of asymmetrical numbness and weakness. More common causes ofmononeuropathy multiplex were excluded and the patient improved after thediscontinuation of the drug."Statins and risk of polyneuropathy, A case-control studyD. Gaist, MD, PhD; U. Jeppesen, MD, PhD; M. Andersen, MD, PhD; L.A. GarcíaRodríguez, MD, MSc;J. Hallas, MD, PhD; and S.H. Sindrup, MD, PhDhttp://213.4.18.135/87.pdf full textFrom the abstract: "The authors verified a diagnosis of idiopathicpolyneuropathy in 166 cases. The cases were classified as definite (35),probable (54), or possible (77). The odds ratio linking idiopathicpolyneuropathy with statin use was 3.7 (95% CI 1.8 to 7.6) for all cases and14.2 (5.3 to 38.0) for definite cases. The corresponding odds ratios incurrent users were 4.6 (2.1 to 10.0) for all cases and 16.1 (5.7 to 45.4)for definite cases. For patients treated with statins for 2 or more yearsthe odds ratio of definite idiopathic polyneuropathy was 26.4 (7.8 to 45.4).CONCLUSIONS: Long-term exposure to statins may substantially increase therisk of polyneuropathy."Are users of lipid-lowering drugs at increased risk of peripheralneuropathy?David Gaist, Luis Alberto García Rodríguez . Consuelo Huerta . JesperHallas . Søren H. Sindruphttp://213.4.18.135/75.pdf full texthttp://213.4.18.135/76.2.pdf full texthttp://213.4.18.135/87.pdf full text textPharmacodynamics: Statins and peripheral neuropathyU. Jeppesen (2), D. Gaist (1)(2), T. Smith (1), S. H. Sindrup (1)(2)(1) Department of Neurology, Odense University Hospital, DK-5000 Odense C,Denmark Tel.: +45-6541-2474, Fax: +45-6541-3389(2) Department of Clinical Pharmacology Odense University, Odense, DenmarkReceived: 6 July 1998 / Accepted in revised form: 1 October 1998Abstract Volume 54 Issue 11 (1999) pp 835-838http://link.springer-ny.com/link/service/journals/00228/bibs/9054011/90540835.htmAssociation of HMG-CoA reductase inhibitors with neuropathy.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12549960&dopt=AbstractAnn Pharmacother. 2003 Feb;37(2):274-8.Backes JM, Howard PA.Department of Pharmacy Practice and Lipid, Atherosclerosis, Metabolic andLDL-Apheresis Clinic, University of Kansas Medical Center, Kansas City, KS66160-7231, USA. jbackes@kumc.edu"Epidemiologic studies and case reports suggest an increased risk ofperipheral neuropathy with statin drugs. The majority of cases were at leastpartially reversible with drug cessation." (emphasis added)Moosmann B, Behl C. Selenoprotein synthesis and side-effects of statins.Lancet. 2004 Mar 13;363(9412):892-4. Review.PMID: 15031036 [PubMed - indexed for MEDLINE]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15031036"We noted that the pattern of side-effects associated with statins resemblesthe pathology of selenium deficiency, and postulated that the mechanism layin a well established, but often overlooked, biochemical pathway--theisopentenylation of selenocysteine-tRNA([Ser]Sec). A negative effect ofstatins on selenoprotein synthesis does seem to explain many of theenigmatic effects and side-effects of statins, in particular, statin-inducedmyopathy."Statin therapy and small fibre neuropathy: a serial electrophysiologicalstudy.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12639733&dopt=AbstractLo YL, Leoh TH, Loh LM, Tan CE.J Neurol Sci. 2003 Apr 15;208(1-2):105-8.Department of Neurology, Singapore General Hospital, Outram Road, Singapore.gnrlyl@sgh.com.sgDescribes 3 patients who developed neuropathy after ONE MONTH of statintherapy. "One patient redeveloped small and large fibre neuropathy when thesimilar drug was readministered."Peripheral Neuropathy and Lipid-Lowering TherapyPaul E. Ziajka, MD, PhD, and Tammy Wehmeier, RN, Orlando, Fla.Abstract: We report a case of peripheral neuropathy induced and excerbatedby several commonly used HMG-CoA reductase inhibitors including lovastatin,simvastatin, pravastatin, and atorvastatin, and the vitamin niacin. A reviewof the literature shows similar cases with individual lipid-lowering drugs,but this case shows the cross-reactivity of the neuropathic process todifferent HMG-CoA reductase inhibitors, and is the first reported case of aperipheral neuropathy exacerbated by the use of niacin.http://www.sma.org/smj1998/julysmj98/ziajka.pdfPhan T, McLeod JG, Pollard JD, Peiris O, Rohan A, Halpern JP.Peripheral neuropathy associated with simvastatin.J Neurol Neurosurg Psychiatry. 1995 May;58(5):625-8.PMID: 7745415 [PubMed - indexed for MEDLINE]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7745415&dopt=AbstractAhmad S.Lovastatin and peripheral neuropathy.Am Heart J. 1995 Dec;130(6):1321. No abstract available.PMID: 7484806 [PubMed - indexed for MEDLINE]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7484806&dopt=AbstractJacobs MB.HMG-CoA reductase inhibitor therapy and peripheral neuropathy.Ann Intern Med. 1994 Jun 1;120(11):970. No abstract available.PMID: 8172444 [PubMed - indexed for MEDLINE]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8172444&dopt=AbstractMedication-induced peripheral neuropathy.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12507417&dopt=AbstractCurr Neurol Neurosci Rep. 2003 Jan;3(1):86-92. Review.Weimer LH.Neurological Institute of New York, 710 West 168th Street, Unit 55, NewYork, NY 10032, USA. Lhw1@columbia.eduPMID: 12507417 [PubMed - indexed for MEDLINE]"Although most cases demonstrate acute or subacute onset after exposure,recent experiences with statin drugs raise the possibility of occult toxiccauses of chronic idiopathic neuropathy."Le Quesne PM. Neuropathy due to drugs. In: Dyck PJ, Thomas PK, Griffin JW,et al, eds. Peripheral neuropathy. 3rd ed. Philadelphia: Saunders,1993:1571-1581.(Book, no link)Of interest:MacDonald BK, Cockerell OC, Sander WAS, Shorvon SD (2000) The incidence andlifetime prevalence of neurological disorders in a prospectivecommunity-based study in the UK. Brain123:665-676General background medical Info fromRelated, but also will appear in other FAQs:Neuromuscular Disease CenterWashington University School of Medicine, St. Louis, MOHome: http://www.neuro.wustl.edu/neuromuscular/index.htmlUnder Disorders & Syndromes:Select:Myopathy: http://www.neuro.wustl.edu/neuromuscular/maltbrain.htmlNeuropathy: http://www.neuro.wustl.edu/neuromuscular/naltbrain.htmlNeuromuscular: http://www.neuro.wustl.edu/neuromuscular/syaltbrain.htmlCNS (Central Nervous System):http://www.neuro.wustl.edu/neuromuscular/syaltbrain.html#cnsSpecifics,MYOGLOBINURIA - RHABDOMYOLYSIShttp://www.neuro.wustl.edu/neuromuscular/msys/myoglob.htmlThen see Lipid Lowering Agent Myopathieshttp://www.neuro.wustl.edu/neuromuscular/msys/myoglob.html#lipidNote that this connects to CARDIAC + MYOPATHYhttp://www.neuro.wustl.edu/neuromuscular/msys/cardiac.htmlAnd to TOXIC NEUROPATHIES:http://www.neuro.wustl.edu/neuromuscular/nother/toxic.htm#statinOR Locally supplied Search on "Statin" leads to:TOXIC MYOPATHIES http://www.neuro.wustl.edu/neuromuscular/mother/myotox.htmNote also tht under Mitochondrial Disorders, the list of problems associatedwith Coenzyme Q10 Deficiencyhttp://www.neuro.wustl.edu/neuromuscular/msys/myoglob.html#coq10MITOCHONDRIAL MYOPATHIESFacts About Mitochondrial Myopathies from the Muscular Dystrophy Associationhttp://www.mdausa.org/publications/mitochondrial_myopathies.html#whatcauses

Re: Statin neuropathy masquerading as diabetic autoimmune polyneuropathy -- Posted by Jenny on 07-30-05 08:30

Sharon Hope wrote:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16043768&query_hl=1
>
> Diabetes Care. 2005 Aug;28(8):2082.
>
> Statin neuropathy masquerading as diabetic autoimmune polyneuropathy.
>
> Vaughan TB, Bell DS.
>
> Division of Endocrinology, University of Alabama School of Medicine,
> Faculty Office Tower, Suite 758, 510 20th St. S., Birmingham, AL 35294.
> brooks@uab.edu.
>
> PMID: 16043768 [PubMed - in process]
> Full text available via purchase or subscription from

My board-certified endocrinologist told me she is seeing a lot of people
with diabetes in very BAD shape from statins, and that taking them off
the drugs makes a huge improvement in their pain and mental symptoms.
She quoted one patient in her 60s who was suffering intense symptoms
that turned out to be from statins as saying "you've given me my life
back."

My dad was put on statins in his 90s at a time when his mental abilities
were 100% and immediately went into a significant physical and cognitive
decline that ended in his death. The doctor insisted that the cause was
an underlying heart condition. However, I found it very difficult to
believe that the sudden mental deterioration that followed the statin
prescription within a week or two was not due to the drug. My father
also became very unsteady on his feet very soon after starting the
statin and he died after hitting his head in a fall, not from heart
disease.

http://www.geocities.com/lottadata4u/dangerousdrugs.htm has pointers to
several other medical studies pointing to the dangers of statins for
older patients.

Re: Statin neuropathy masquerading as diabetic autoimmune polyneuropathy -- Posted by Susan on 07-30-05 08:50

x-no-archive: yes

Jenny wrote:

>
> My board-certified endocrinologist told me she is seeing a lot of people
> with diabetes in very BAD shape from statins, and that taking them off
> the drugs makes a huge improvement in their pain and mental symptoms.

I know non-diabetic folks with similar stories.

>
> My dad was put on statins in his 90s at a time when his mental abilities
> were 100% and immediately went into a significant physical and cognitive
> decline that ended in his death.

My mother didn't die, but she suffered terrible pain, fatigue and muscle
damage from statin use given in her late 70s. She had no illnesses or
CVD and her ratios were great. Her only severe health problems in old
age were caused by statin use. She spent a year on steroids with all
their ill effects just to get out of pain and debilitating fatigue.

I believe her mental status was worsened, too, but I can't say for sure.

Susan

Re: Statin neuropathy masquerading as diabetic autoimmune polyneuropathy -- Posted by Sharon Hope on 07-30-05 09:23

"Susan" wrote in message
news:3l1lujF10lkhbU2@individual.net...
> x-no-archive: yes
>
> Jenny wrote:
>
>>
>> My board-certified endocrinologist told me she is seeing a lot of people
>> with diabetes in very BAD shape from statins, and that taking them off
>> the drugs makes a huge improvement in their pain and mental symptoms.
>
>
> I know non-diabetic folks with similar stories.
>
>>
>> My dad was put on statins in his 90s at a time when his mental abilities
>> were 100% and immediately went into a significant physical and cognitive
>> decline that ended in his death.
>
> My mother didn't die, but she suffered terrible pain, fatigue and muscle
> damage from statin use given in her late 70s. She had no illnesses or CVD
> and her ratios were great. Her only severe health problems in old age
> were caused by statin use. She spent a year on steroids with all their
> ill effects just to get out of pain and debilitating fatigue.
>
> I believe her mental status was worsened, too, but I can't say for sure.
>

Highly likely. My husband's statin damage at 56 years old, due to Lipitor
10mg for 4 years (muscle damage, nerve damage, and cognitive damage,
including short-term memory loss to below the 1 percentile, amnesia, and
aphasia) was written up by Smart Money Magazine in "The Lipitor Dilemma" by
Eleanor Laise.

A reprint of the article:
http://www.n3inc.com/SmartMoneyReprint_103003Web.pdf

> Susan

Re: Statin neuropathy masquerading as diabetic autoimmune polyneuropathy -- Posted by sechumlib on 07-30-05 09:52

Sharon Hope wrote:

> Highly likely. My husband's statin damage at 56 years old, due to Lipitor
> 10mg for 4 years (muscle damage, nerve damage, and cognitive damage,
> including short-term memory loss to below the 1 percentile, amnesia, and
> aphasia) was written up by Smart Money Magazine in "The Lipitor Dilemma" by
> Eleanor Laise.

It IS possible to contact your doctor if you have what might be adverse
reactions to statins, and switch to another one or off them entirely.
Did any of these afflicted people think of that?

My own experience: I took Zocor for a while and my cholesterol went way
down. When Lipitor came out, my doctor switched me to it and it never
worked as well. He increased my dose until it reached the maximum of 80
mg. Then I started getting muscle pains.

I called my doctor immediately and he took me off Lipitor. Ultimately, I
tried Pravachol but it was ineffective. I went back to Zocor (80 mg) and
it worked fine, but then it started giving me muscle pains. I'm now on
Vytorin 10/40 (10 mg Zetia, 40 mg Zocor) and at last analysis, it was
working better than anything I tried earlier.

Short synopsis: a person CAN, with medical help, quite often find a
statin regime that works & doesn't cause other problems.

Re: Statin neuropathy masquerading as diabetic autoimmune polyneuropathy -- Posted by Ray on 07-30-05 17:44

My priimary care giver had me on Zocor and tried to switch to Lipitor
because it helps control the triglyceride levels better. Now I have severe
neuropothy especially in feet to the point I can't feel anything on the skin
area but those nerves sure can hurt.

Since moving and locating a new doctor (Internal Medicines) he has taken my
off statins and prescribed 10mg of Zetia. Triglycerides still are a concern
but he suggest taking niacin to help with the battle. At present I have
abnormal liver tests which was probably due to high amounts of Zocor and
Ibuprophen. I tried and tried to lower the pain level by Ibuprophen (almost
eating them like candy) has absolutely no effect on neuropothy pain.

Ray O

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