Anxious About Dementia
Carol Bradley Bursack was a bit frustrated when she wrote the insightful column, “Aging Bodies Can House Strong, Agile Minds” in 2016. As a columnist, blogger and author of “Minding Our Elders: Caregivers Share Their Personal Stories,” Bradley Bursack receives a lot of mail and hears from many family caregivers.
Having spent 20 years as a caregiver for multiple elders, Bradley Bursack could relate to adult children’s concerns. However, from her perspective, many well-meaning children seemed to be overreacting to an aging parent’s increasing weakness or occasional memory lapses. Changes like these prompted some caring children to speculate about a parent’s possible dementia, making them feel they should immediately leap into a protective mode.
Online messaging and increased awareness of dementia – Alzheimer’s awareness in particular – can contribute to family members’ anxiety and overreaction, Bradley Bursack believes. They’re bombarded with advice like: “When your parents are 65, you have to check their refrigerator for old food,” she says. “And if they forget a word, you better get them in to a doctor.”
Although she doesn’t hear this from everyone, Bradley Bursack notes, some family members “want to kind of dive in and take over their parent’s lives once a birthday happens. They mean well – they’re worried about what they read.”
Alzheimer’s awareness is important, Bradley Bursack says. Yet, awareness of what older adults can accomplish and their value in society is equally important, she emphasizes.
“We all know that in this day and age, somebody 65 or 70 could still be working on the internet,” Bradley Bursack says. “They’re starting their own businesses. People are running; they’re going to the gym. They’re out there volunteering. Senior volunteers keep this country running. It’s amazing what people do.” Aging Happens
Aging is normal and acceptance is golden. “Just because we might walk slower or take longer to climb the subway stairs – well, you know, that’s life,” says Alice Fisher, founder of the Radical Age Movement, a national group based in New York City. Some people may deal with severe disabilities, she notes: “We’re not saying that getting old is this Pollyanna thing.”
Fisher is not a fan of phrases such as “aging well” or “healthy aging” and what they seem to imply. “‘Successful aging’ is the worst,” she says. “What does that mean: If I am just unfortunate and get sick, I failed? I didn’t succeed? I didn’t age successfully? That’s another way of looking at it.”
When older adults show outward signs of physical disabilities, like using a wheelchair, people around them may make assumptions that wouldn’t occur to them with younger adults, Fisher says. Complications from certain health conditions are often misconstrued.
Physical effects of stroke – from which many people recover – may cause family caregivers, friends or co-workers to assume the survivor’s mental capacity must also be affected. Not so, Fisher says. She describes an 80-year-old college professor, a fellow group member, who has had two strokes. Although these caused a speech impediment, Fisher says, “We could understand her just fine.”
Others around the professor were inspired as she moved ahead with her life, exercising daily, returning to teaching and writing books simultaneously. As for her stroke history, Fisher says, “It obviously had no effect on her brain.” Hearing loss can occur with age, but difficulty hearing is not the same as difficulty with comprehension. Consider whether somebody may have trouble hearing – not cognitive issues – if he or she doesn’t seem to understand you right away, Fisher advises. Memory Changes
Whether it’s a family member or health professional, determining how to account for memory loss and other cognitive changes in an older adult is challenging: Is it due to normal aging or potential dementia? Many factors are considered, such as specific language deficits or new behavioral patterns like increasing apathy.
Geriatricians use paper-and-pencil exercises and verbal testing of short-term recall to screen for cognitive problems as part of routine wellness visits. If Alzheimer’s or other dementia is suspected, more intensive testing could include brain imaging and possibly a spinal tap to reach a diagnosis.
Most of the time, however, gradual memory changes occur as part of the normal aging process, and people develop workarounds and continue to go about their lives. Certain types of memory may actually improve with age.
Researchers explored subtle differences in memory, intelligence and executive function related to age in the September 2013 issue of the journal Psychology and Aging. A study of age and economic decision-making found that younger adults had more “fluid intelligence,” whereas older adults had greater “crystallized intelligence” that influenced traits such as financial literacy, debt literacy and temporal discounting – a concept related to immediate reward-seeking versus self-control and delayed gratification.
Another study compared older and younger adults’ ability to use sentence context to memorize words. “Older and wiser” was the conclusion of researchers who found superior memory performance in seniors. Experience and earned wisdom matter.
Before making assumptions about mental capabilities, look around at what seniors are accomplishing. You’ll find older adults learning, adapting and contributing in myriad ways – even if they’re not in perfect health. It could be seniors earning a living in today’s gig economy, returning to college or volunteering their time and skill to help others in the community. Changing Your Mindset
You’re never too young to reset your attitude on aging. Keep these points in mind when you think about what aging means:
Your future self-image is at stake. In a youth-oriented culture, Bradley Bursack says, some 40-year-old adults say they feel old and “washed up,” when they’re actually just entering middle age. Start training yourself now to think about age in a more positive light.
‘Othering’ elders discounts their humanity. “People look at old people as the ‘other,'” Fisher says. “They don’t realize: Hey, excuse me, but I’m you. You just haven’t gotten here yet. We’re not another species. We are human beings, the same as you are.” Recognize the humanity of people at every stage of life and in every state of health, she urges.
Age-based stereotyping is a two-way street. Bradley Bursack is dismayed by social media stereotyping of all older adults being technology-averse. However, she adds, “The reverse is true and I also don’t like to see it: when older people have a stereotypical view of Gen Xers or millennials, where they just think they’re all about themselves, which is not true at all.” Workplaces where people of all ages work and interact with one another can help eliminate these outworn ideas, she says.
It’s natural to worry when a parent has health issues, Bradley Bursack says. It could be your father who’s had a stroke and some physical disabilities but no cognitive effects. Or it might be something gradual, like, “Mom’s getting so frail – her arthritis is making it difficult for her to take jar lids off,” she says. “Well, that isn’t Mom’s brain.”
Despite the massive impact dementia has on the economy and people’s livelihoods, there are still many misconceptions about it. There are also some facts that still surprise people.
1. Alzheimer’s disease and dementia are not the same thing
Dementia is a term used for symptoms like confusion, memory loss, mood changes and personality changes. There are a whole range of conditions that can cause dementia, not just Alzheimer’s. The most common are Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia and Frontotemporal dementia.
“Sometimes people will say to me, ‘Oh well, she has Alzheimer’s disease, but she doesn’t have dementia…’ But really, if you have Alzheimer’s disease and you’re showing symptoms, then you have dementia,” said Laura Phipps, the head of communications and engagement at Alzheimer’s Research UK. “Dementia is just a word for the symptoms.”
2. People react differently to the words
Although dementia and Alzheimer’s are often confused, people tend to have different reactions to hearing each word.
“When you ask them to think about Alzheimer’s disease, they will put that in with other physical health conditions, like heart disease, stroke, cancer, diabetes,” Phipps said. “And when you ask them to think about dementia, they don’t know what to do with it, and they tend to put it in with things like age and mental health.”
So even though dementia is caused by illnesses like Alzheimer’s, the word itself is conflated with being more of a mental disorder than something caused by a physical disease.
3. Dementia isn’t an inevitable part of getting older
A common misconception is that you get a bit forgetful as you get older, so dementia falls into that as an inevitability that just happens to most people.
“They’ll say, ‘Oh yeah, my grandma had dementia but she was very old,’ so it’s almost followed by an excuse that it was OK because they were old,” Phipps said. “And so I think that drives this kind of view in society that the diseases that cause dementia are not that important because there’s not much you can do about them.”
But this isn’t true. Dementia is caused by diseases. People understand cancer is a disease, that you shouldn’t have it and it’s unfair, Phipps said, but that’s not yet universally accepted by people when it comes to dementia.
4. At 90, more people don’t have dementia than do
By the time people get to 90 years old, they are more likely not to have any diseases that cause dementia than to have one.
Phipps said dementia research is behind a lot of other research because there is an extra mountain to climb. Because people think dementia is inevitable, they are less likely to want to support and fund research.
5. Almost half of adults don’t realize it causes death
A survey by Alzheimer’s Research UK found that 51% of adults recognize that dementia leads to death. That means almost half don’t realize, even though it’s the UK’s leading cause of death.
“These are physical diseases that ultimately are terminal — they will shorten your life,” Phipps said. “But people don’t recognize that, and again this just shows there is a lack of seriousness about it.
“You hear people joke about it, like, ‘Oh have you got Alzheimer’s?’ And actually, you wouldn’t joke about someone having another fatal illness. It’s not appropriate in society to do that. But people will still do that about dementia because they don’t recognize that diseases that cause dementia like Alzheimer’s are terminal. They will end your life too soon.”
6. There are more symptoms than memory loss
There is a slightly simplified view of dementia that it’s all about becoming forgetful when you get older. Memory loss is the most common symptom, Phipps said, but there are many more.
“As dementia progresses, people get more and more symptoms, including physical symptoms,” she said. “So they won’t be able to move around, they’ll have difficulty speaking, they’ll have trouble swallowing — and it’s ultimately those symptoms that make people immobile and much more frail and susceptible to things like falls or infections that they don’t recover from.”
7. A third of risk factors are within our control
People often understand the risk of dementia, Phipps said. About a third of cases of dementia could actually be down to risk factors that are in our control.
Age is the biggest risk factor because dementia mostly affects older people. Some people have a genetic predisposition to developing diseases like Alzheimer’s, which is out of their control.
“But there are also lifestyle factors that can influence your risk of dementia,” Phipps said. “And at a population level, these come out as things like smoking, like depression, physical inactivity, high blood pressure … so often it’s things that are likely to impact your heart.”
Only about a quarter of UK adults realize there is anything they can do to reduce their risk of dementia, according to Alzheimer’s Research UK surveys.
“If you were to address things like having more aggressive treatment of blood pressure, or stopping people becoming overweight, and if nobody smoked, then we would see a reduction in the number of people getting dementia,” said Phipps. “So there are things people can do that are within their control that can reduce their risk of dementia.”
8. Heart health and brain health are intrinsically linked
Many of the risk factors associated with dementia are the same as those associated with heart health. This is because your brain and heart are intrinsically linked.
“The majority of the blood that is pumped by your heart is used by your brain,” said Phipps. “So anything that damages how your heart is working will have a knock-on effect on your brain health. And so a lot of the risk factors for dementia at the moment with the best evidence are also heart health risk factors.”
So even though people may be unsure about the risk factors of dementia, if you tell them it’s the same as the ones for cardiovascular disease, stroke and heart attacks, they might have a better idea.
9. Midlife is the most important window for risk reduction
Many of the most important avoidable risk factors for dementia appear in midlife, between the ages of about 40 and 64, according to the Alzheimer’s Society, such as type 2 diabetes and high blood pressure.
People who have had periods of depression in mid or later life also have increased rates of dementia
10. It doesn’t just affect old people
Dementia doesn’t just affect older people. About 2-8% of all cases worldwide affect younger people. In the UK, there are about 40,000 people under the age of 65 living with dementia, but people tend to think it’s not something that strikes until later life.
“In 2015 we did some polling, and 46% of people think dementia mostly affects older people, 15% think it affects only older people, and 9% think it can also affect younger people,” Phipps said.
11. Sometimes, it only affects sight and perception
Sometimes memory loss isn’t a symptom of dementia until it is very advanced. The type of dementia author Terry Pratchett had, for example, affected how his brain interpreted vision from his eyes.
“So actually he didn’t have memory loss until the late stages, but he couldn’t really see at all,” Phipps said. “So he couldn’t type, and had big gaps in his vision where he couldn’t see things.”
Alzheimer’s Research UK has a virtual-reality dementia experience online called A Walk Through Dementia, which shows some of the visual perception tricks dementia can have.
“One thing people often tell us about is that puddles on the ground can look like holes because there are issues with perception and depth perception and color perception,” said Phipps. “You know when you go into a shop and they used to have those big black mats in front of the door … for some people with dementia that looks like a massive abyss.”
Imagine being faced with large holes in the ground. It would be confusing and alarming. Phipps said this means people with dementia won’t go into shops, or they won’t enter bathrooms because the shiny floors look like water.
“If your brain was working 100% you would probably be able to perceive the difference between shiny and wet,” she said. “But if there’s damage in your brain you just can’t quite make the judgment. Those things seem small but they can have a huge impact.”
12. Aggression and confusion may come from these small perception errors
Small changes can have big impacts on how people with dementia live. It may be something small that is confusing them with a simple fix, but the person with dementia may not be able to articulate the problem.
“There’s a big movement now for people who are showing signs of aggression or agitation, and rather than immediately giving them anti-psychotic drugs, is to try and look at their environment,” said Phipps. “Because it might be something really small like a change in routine or a change in the lamps or the way shadows are being cast around the room that could be having a massive impact on their level of anxiety, causing them to be agitated and aggressive.”
Small tweaks to their environment, like having more lights or keeping the curtains open, could have a big impact on their quality of life.
13. Disrupted sleep can be a factor
Research has shown that disrupted sleep may be associated with a higher risk of early signs of Alzheimer’s disease. This could mean that sleeping badly is an early warning sign of someone developing dementia.
Bad sleep could either be a symptom of dementia, or a cause — or it could be that both are true.
Other research supports the sleep theory, with one study finding that just one night of disrupted sleep could lead to a spike in Alzheimer’s-related proteins.
14. There is no cure or treatment for the progression of diseases that cause dementia
There is currently no cure for the diseases that cause dementia, and no treatments that will modify the progression.
Some drugs can help people to address certain symptoms, but they don’t stop the disease progressing in the brain.
This is why understanding that dementia may be preventable is so important, Phipps said, because increased awareness means more research.
“There seems to be less stigma, and people seem to be more open about talking about diagnosis with someone, or having a conversation with somebody with dementia,” she said. “I think awareness of dementia is better than it’s ever been, but understanding of dementia hasn’t quite caught up.”
Diabetic Drugs like Actos, Avandia, Metformin, Amaryl
Let’s write about each one…
Cancer Chemotherapy: Treating Disease with Chemicals
Understanding what chemotherapy does to the body will help you understand why detox is critical. Chemotherapy prevents all cells, malignant and normal, from further proliferating. This means that the healthy cells in the body are destroyed, leading to adverse chemotherapy side effects such as loss of hair, nausea, reduced immunity, male and female sterility, and mouth sores.
More serious and life threatening effects may include renal and liver failure, heart disease, and blood clots. According to the American Cancer Society, it is a combination of these damaging consequences to the body which often leads to the occurrence of a secondary cancer.
Whatever the dose of chemotherapy drugs may be, any dose is too high. Chemo drugs create a broad array of health problems. Unfortunately, the modern treatment for each symptom is another dose of drugs − each with more side effects to be treated. Take a look at a few drugs, their side effects, and the treatments prescribed:
Nitrogen Mustard: The injection site is most susceptible to pain and areas of blood clotting due to this metal-binding chemo compound.
Cis-platinum: Known to cause nausea and vomiting starting two hours following treatment. Cis platinum also hinders urination, compromising the removal of toxins. This drug leads to renal (kidney) toxicity.
Doxorubicin: This chemo agent leads to heart damage including cardiomyopathy (diseased heart) and is a primary trigger for hair loss.
Methotrexate: Known to cause serious, life-threatening side effects such as damage to the lungs, liver, and kidneys. Methotrexate can lower blood cell counts, decreasing the ability to fight infections and interferes with normal blood clotting.
Acyclovir: Prescribed to treat herpes, which is common in patients receiving cytotoxic therapies for cancer. This drug can trigger nausea, vomiting, diarrhea, and decreased urination, which may interfere with the effective removal of toxins. In rare cases acyclovir can cause life-threatening damage to the kidneys, resulting in renal failure.
Vincristine: Common effects are bone marrow suppression, gastrointestinal disorder, and neurotoxicity and can lead to renal failure. Infections which typically arise from loss of white blood cells are treated with antibiotics.
Bleomycin: Significantly associated with toxic accumulation in the lungs. Pulmonary toxicity can be life-threatening and progress to lung fibrosis, making it difficult for the lungs to work properly.
Phenothiazines: Relieves symptoms of nausea and vomiting, but causes drowsiness, restlessness, and involuntary movement. These symptoms are then treated with drugs like Benadryl and Cogentin, an anti-tremor medication used in the treatment of Parkinson’s disease.
Metoclopramide: Blocks the centers of the brain known as the medulla oblongata to treat nausea. This drug is given to help relieve GI contracts and improve blockage of chemicals from intestines. This drug can cause irreversible movement disorders.
Corticosteroids: Synthetic steroids which causes an imbalance in hormones and leads to drowsiness. Generally taken before the start of chemotherapy.
Nabilone: Prescribed for GI complications. Leads to disorientation, low blood pressure, and drowsiness. These symptoms are treated with repetitive rounds of multiple drugs causing mood swings, muscle weakness, easy bruising, and much more.
A side effect is an unwanted issue that is caused by a medicine. Some diabetes medication unfortunately includes common side effects such as nausea or an upset stomach.
Your doctor will be able to advise you about specific side effects and the best ways possible to avoid them.
No diabetic patients should suffer under the influence of side effects, and you should contact your doctor immediately if side effects are causing you pain.
Often in the case of diabetes drugs such as Metformin, side effects will only be temporary.
Potential side effects of common diabetes drugs*
Sulfonylureas: low blood sugar, upset stomach, skin rash or itching, weight gain
Biguanides/Metformin: sickness with alcohol, kidney complications, upset stomach, tiredness or dizziness, metal taste
Alpha-glucosidase inhibitors: gas, bloating and diarrhea
Thiazolidinedione’s: weight gain, risk of liver disease, anemia risk, swelling of legs or ankles,
Meglitinides: weight gain, low blood sugar
Side effect lists may be incomplete, please check with your doctor for more information about diabetes drug side effect
What are the side effects of the non-insulin diabetes medications?
Many people with type 2 diabetes will take a combination of medications to help control their diabetes. With combination therapy, there is increased risk for low blood sugar.
The sulfonylureas may cause hypoglycemia (low blood sugar), skin rash or itching, sensitivity to sunlight, upset stomach, and weight gain.
The meglitinides may cause hypoglycemia and weight gain.
People taking biguanides may develop lactic acidosis, a rare but severe side effect. Excessive alcohol intake while on metformin can contribute to development of lactic acidosis. Other side effects include metallic taste in the mouth and diarrhea.
Thiazolidinedione’s can increase risk of heart failure and should not be used in patients with symptoms of heart failure. Liver enzymes should be checked regularly with use. Other side effects include weight gain, fatigue, swelling of the legs or ankles, increased risk for fractures in female patients. Avandia may have a potential increased risk for heart attack.
Alpha-glucosidase inhibitors may cause gastrointestinal problems (nausea, gas, bloating), although they are usually fleeting.
The DPP-4 inhibitor sitagliptin (Januvia) may cause serious allergic reactions, sore throat, upper respiratory infection, and headache.
Pramlintide (with insulin) may cause gastrointestinal problems (nausea, vomiting, abdominal pain, anorexia), slight weight loss, headache, fatigue, dizziness, coughing, sore throat, and skin reactions at the injection site.
Side effects of exenatide may include slight weight loss, nausea, vomiting, and diarrhea.
What are the warnings and precautions for non-insulin diabetes medications?
Diabetes medications can have interactions with other medications or supplements being used. Use of more than one diabetes medication can increase the risk for hypoglycemia. Beta-blocker medications can mask the symptoms of hypoglycemia.
Sulfonylureas may increase the risk of death from cardiovascular disease. Prolonged exercise and alcohol intake increase the risk for hypoglycemia. Patients undergoing surgery or who have had recent trauma, stress, or infection may need to switch from a sulfonylurea to insulin to manage blood sugar levels. People with kidney or liver disease need to take precaution.
Because meglitinides may cause hypoglycemia, they should be taken right before meals to minimize the possibility of hypoglycemia. If a meal is to be skipped, the dose of the medication should also be skipped.
Thiazolidinedione’s may cause or exacerbate heart failure. Trouble breathing, rapid weight gain and fluid retention may indicate the onset of heart failure.
Avandia may potentially increase the risk of heart attack.
Alpha-glucosidase inhibitors should not be used in people with intestinal diseases such as inflammatory bowel disease or intestinal obstruction. People with kidney dysfunction may not be able to these medications.
Alpha-glucosidase inhibitors should be taken with the first bite of each meal.
Patients with kidney disease may require dosage adjustment if they are using a DPP-4 inhibitor.
People with a history of liver disease, heavy drinking, or kidney disease may not be able to take biguanides. Inform medical personnel of biguanide use prior to any radiological tests which require injection of dye.
Severe hypersensitivity reactions have occurred during use of sitagliptin.
Pramlintide is only appropriate for certain people with diabetes who use insulin and are having problems maintaining their blood sugar levels. Because of the potential for severe hypoglycemia with the use of pramlintide is with insulin, adjustments to insulin dosage and more frequent glucose monitoring may be necessary. Insulin and pramlintide should not be mixed in the same syringe.
Exenatide may increase the risk of severe even fatal pancreatitis.
Byetta should not be used in people with type 1 diabetes or to treat diabetic ketoacidosis.
Patients with severe kidney disease or gastrointestinal disease should not use exenatide.
Hypersensitivity reactions may occur following treatment with exenatide due to formation of antibodies.
Aricept, or Donepezil in its generic form, is a drug given to help with Alzheimer’s Disease and mild cognitive impairment. This post from Natural News discusses why it could have the exact opposite effect in some patients.
Donepezil is an acetylcholinesterase inhibitor approved by the Food and Drug Administration (FDA) in the United States to treat Alzheimer’s disease.
Since mild cognitive impairment (MCI), or the phase between normal age-related brain decline and dementia, displays similar symptoms to Alzheimer’s, many physicians also prescribe this drug off-label to patients with MCI.
Researchers from the University of California, Los Angeles (UCLA) School of Nursing, however, are urging doctors to stop prescribing Donepezil, also sold under the brand name Aricept, to people with MCI without first giving them a genetic test.
The scientists found that for individuals who carry a specific genetic variation of the butyryl cholinesterase (B.Ch.E.) gene, this drug may accelerate cognitive decline instead of stopping it.
The study, led by Sophie Socolow, an associate professor at the UCLA School of Nursing, was published in the Journal of Alzheimer’s Disease earlier this year. The co-authors included Ziaohui Li, Lucia Chen, Kent Taylor, and Jerome Rotter, who are all researchers connected to the UCLA. For their study, the team received funding from the National Institute on Aging.
Though donepezil was previously tested as a possible treatment for MCI in a federally funded study (the Alzheimer’s Disease Cooperative Study), it was never approved by the FDA. Nonetheless, many doctors prescribe it off-label to their patients, putting patients at greater risk of mental decline.
For this study, the UCLA scientists analyzed the data from the Alzheimer’s Disease Cooperative Study, which took place in 2005. To reach their conclusion, the team looked for a possible association between the B.Ch.E.-K gene variation and changes in brain health, reanalyzing the data from the 2005 study.
During the trial, researchers used two tests to measure cognitive impairment, the Mini-Mental State Examination and the Clinical Dementia Rating Sum of Boxes.
Socolow and her colleagues discovered that patients with the K-variant of the B.Ch.E. gene who took donepezil showed greater changes in their scores on both tests and had more rapid cognitive decline than those who received a placebo.
Previously, the BCHE gene has been identified as one of the few Alzheimer’s disease susceptibility genes with distinct pharmacogenomic properties, meaning drug activity and reactions to a certain drug can vary with the patient’s genes.
“Genetic heterogeneity in amnestic mild cognitively impaired (aMCI) subjects could lead to variations in progression rates and response to cholinomimetic agents.
Together with the apolipoprotein E4 (APOE-?4) gene, butyryl cholinesterase (BCHE) has become recently one of the few Alzheimer’s disease (AD) susceptibility genes with distinct pharmacogenomic properties,” the UCLA researchers pointed out.
The use of pharmacogenomic testing has the potential to improve the safety and effectiveness of many drug therapies.
Unfortunately, most physicians lack knowledge about the topic of pharmacogenomics and are not prepared to implement it in a clinical setting, a 2014 survey of primary care physicians, cardiologists, and psychiatrists reported.
Since doctors are increasingly prescribing this drug to people with MCI, the researchers hope that their study reinforces the importance of discussing the benefits and risks of every treatment option with their patients.
“These results clearly emphasize the necessity of monitoring potential pharmacogenomic effects in this population of subjects, and suggest enrichment strategies for secondary prevention trials involving prodromal AD [Alzheimer’s disease] subjects,” the UCLA research team concluded.
Statin side effects: Weigh the benefits and risks
Statin side effects can be uncomfortable, making it seem like the risks outweigh the benefits of these powerful cholesterol-lowering medications.
By Mayo Clinic Staff
Doctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. While statins are highly effective, they have been linked to muscle pain, digestive problems and mental fuzziness in some people and may rarely cause liver damage.
Statins include atorvastatin (Lipitor), flu vastatin (Lescol), lovastatin (Altoprev), pita vastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).
Having too much cholesterol in your blood increases your risk of heart attacks and strokes. Statins block a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood.
If you think you’re experiencing side effects from statins, don’t just stop taking the pills. Talk to your doctor to see if a change of dosage or even a different type of medication might be helpful.
What are statin side effects?
Muscle pain and damage
One of the most common complaints of people taking statins is muscle pain. You may feel this pain as a soreness, tiredness or weakness in your muscles. The pain can be a mild discomfort, or it can be severe enough to make your daily activities difficult.
Oddly enough, most randomized controlled studies of statins indicate that people taking statins develop muscle pain at the same rate as people taking placebo. But up to 29 percent of the people who start taking statins report muscle pain and many discontinue statins because of it. Many of these people do well when they are switched to a different variety of statin.
Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis (rab-doe-my-OL-ih-sis). Rhabdomyolysis can cause severe muscle pain, liver damage, kidney failure and death. The risk of very serious side effects is extremely low, and calculated in a few cases per million of patients taking statins. Rhabdomyolysis can occur when you take statins in combination with certain drugs or if you take a high dose of statins.
Occasionally, statin use could cause an increase in the level of enzymes that signal liver inflammation. If the increase is only mild, you can continue to take the drug. Rarely, if the increase is severe, you may need to try a different statin.
Although liver problems are rare, your doctor may order a liver enzyme test before or shortly after you begin to take a statin. You shouldn’t need any additional liver enzyme tests unless you begin to have signs or symptoms of trouble with your liver.
Contact your doctor immediately if you have unusual fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes.
Increased blood sugar or type 2 diabetes
It’s possible your blood sugar (blood glucose) level may increase when you take a statin, which may lead to developing type 2 diabetes. The risk is small but important enough that the Food and Drug Administration (FDA) has issued a warning on statin labels regarding blood glucose levels and diabetes.
Statins prevent heart attacks in patients with diabetes, so the relevance of the mild increase in sugar values with statins observed in some patients is unclear. The benefit of taking statins likely outweighs the small risk to have the blood sugar level go up. Talk to your doctor if you have concerns.
Neurological side effects
The FDA warns on statin labels that some people have developed memory loss or confusion while taking statins. These side effects reverse once you stop taking the medication. There is limited evidence to prove a cause-effect, but talk to your doctor if you experience memory loss or confusion while taking statins. There has also been evidence that statins may help with brain function — in patients with dementia, for example. This is still being studied. Don’t stop taking your statin medication before talking to your doctor.
Who’s at risk of developing statin side effects?
Not everyone who takes a statin will have side effects, but some people may be at a greater risk than are others. Risk factors include:
Taking multiple medications to lower your cholesterol
Having a smaller body frame
Being age 65 or older
Having kidney or liver disease
Drinking too much alcohol
Drugs and food that interact with statins
Grapefruit juice contains a chemical that can interfere with the enzymes that break down (metabolize) the statins in your digestive system. While you won’t need to eliminate grapefruit entirely from your diet, ask your doctor about how much grapefruit you can have.
Some drugs that may interact with statins and increase your risk of side effects include:
Amiodarone (Cordarone, Pacer one), a medication for irregular heart rhythms
Gemfibrozil (Lopid), another variety of cholesterol drug
Protease inhibitors, such as saquinavir (Invirase) and ritonavir (Novar)
Some antibiotic and antifungal medications, such as clarithromycin (Biaxin) and itraconazole (Onmel, Sporanox)
Some immunosuppressant medications, such as cyclosporine (Gengraf, NE oral, Sand immune)
There are many drugs that may interact with statins, so be sure your doctor is aware of all the medicines you take when being prescribed with statins.
Common side effects of prescription sleeping pills such as Lunesta, Sonata, Ambien, Rozerem, and Halcion may include:
Burning or tingling in the hands, arms, feet, or legs
Changes in appetite
Difficulty keeping balance
Dry mouth or throat
Impairment the next day
Mental slowing or problems with attention or memory
Stomach pain or tenderness
Uncontrollable shaking of a part of the body
It’s important to be aware of possible sleeping pill side effects so you can stop the drug and call your doctor immediately to avoid a more serious health problem.
Are There More Complex Sleeping Pill Side Effects?
Some sleeping pills have potentially harmful side effects, including parasomnias. Parasomnias are movements, behaviors and actions over which you have no control, like sleepwalking. During a parasomnia, you are asleep and unaware of what is happening.
Parasomnias with sleeping pills are complex sleep behaviors and may include sleep eating, making phone calls, or having sex while in a sleep state. Sleep driving, which is driving while not fully awake, is another serious sleeping pill side effect. Though rare, parasomnias are difficult to detect once the medication takes effect.
Product labels for sedative-hypnotic medicines include language about the potential risks of taking a sleeping pill. Because complex sleep behaviors are more likely to occur if you increase the dosage of a sleeping pill, take only what your doctor prescribes — no more.