Statin discontinued due to neuropathy. What are some alternatives?

My wife uses this Repatha and it cut her values almost in half with no side effects that she had with oral statins. An amazing drug but amazingly expensive if you do not have good insurance 😩

Welcome @rdeel55, There are a couple of discussions on Repatha that you might find helpful to learn what others have shared.

--- Repatha as a treatment for high HDL Cholesterol: https://connect.mayoclinic.org/discussion/repatha-as-a-treatment-for-high-hdl-cholesterol-1/
--- My goal is to get off statins (Atorvastin) and try Repatha. Advice?: https://connect.mayoclinic.org/discussion/my-goal-is-to-get-off-statins-atorvastin-and-try-repatha-advice/.

Is there a specific side effect that worries you?

Hi @jceop, I would like to add my welcome to Connect along with @mayoconnectuser1 and others. I too had that conversation with several of my primary care docs. I was concerned about taking a statin because I already had neuropathy and didn't want to make it worse. My cholesterol numbers were also borderline high similar to yours. I was able to lower my numbers through more regular exercise, losing some weight and eating healthier but it took me a couple of years. You might find the follow Mayo Clinic article helpful.

--- Mayo Clinic Q and A: Managing high cholesterol with lifestyle changes: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-managing-high-cholesterol-with-lifestyle-changes/

Have you discussed your concerns with your doctor along with your plan to lower your numbers?

My doctor has started me on Repatha Evolocumab. One injection twice a week. Has anyone else been on this? I would like to know how you were affected by the side effects. Thanks

jceop,

What is your technical/medical background?

Does your doctor believe you are more qualified to assess this, or has he offered his own educated opinion?

Sorry - tongue stuck in my cheek. 😇

After my annual checkup and blood work yesterday my doctor wants to put me on 20mg of Lipitor to reduce my cholesterol. My total cholesterol is 230, triglycerides are 71, HDL is 82 and LDL is 131. I am 68 years old and don't observe the best diet but I am changing that. I also do some cardio and a lot of strength training 3 days a week. My question is - with some dietary changes and a bergamot supplement instead of a statin will I possibly be able to lower my numbers? I just don't like what I've been reading about statins.

https://www.nejm.org/doi/full/10.1056/NEJMoa2215024

First, a good-news article from NPR:

Got muscle pain from statins? A cholesterol-lowering alternative might be for you

March 13, 20235:00 AM ET
Heard on Morning Edition

When the FDA approved bempedoic acid, marketed under the brand name Nexletol, back in 2020, it was clear that the drug helped lower LDL — "bad" cholesterol. The drug was intended for people who can't tolerate statin medications due to muscle pain, which is a side effect reported by up to 29% of people who take statins.

What was unknown until now, is whether bempedoic acid also reduced the risk of cardiovascular events. Now, the results of a randomized, controlled trial published in The New England Journal of Medicine point to significant benefit. The study included about 14,000 people, all of whom were statin intolerant. "The big effect was on heart attacks," says study author Dr. Steven Nissen of Cleveland Clinic.

People who took daily doses of bempedoic acid for more than three years had about a 23% lower risk of having a heart attack, in that period, compared to those taking a placebo. There was also a 19% reduction in coronary revascularizations, which are procedures that restore blood flow to the heart, such as a bypass operation or stenting to open arteries.

With these findings, the benefits of the medication are now clearer, says Dr. John Alexander, a cardiologist and professor at Duke University. "Bempedoic acid has now entered the list of evidence-based alternatives to statins,"

cgs,

Metformin is used to treat high sugar levels ...

Phenofibrate is not a statin - comparison - https://www.uclahealth.org/news/ask-the-doctors-which-are-better-for-cholesterol-statins-or-fibrates

You mention taking a statin or trying different ones, but don't say which ones.

One thing that my doctor told me was if you drink coffee for one cup of coffee you have to drink two cups of water be sure to drink plenty of water there's plenty of diet change that you can make that will improve your cholesterol that will improve your LDL and your HDL berries blueberries mixed berries avocados spinach go on a just tweak these things you don't have to change overnight little changes make big differences I have went from a 6.4 A1c to a 6.1 and I've also improved my cholest both of my cholesterols by just making small changes don't eat white bread make sure you're eating good whole grains I eat oatmeal every morning for breakfast I do have some bad habits of eating chocolate and drinking coffee then I'm battling coffee is not good for you if you're a diabetic with neuropathy it helps if you don't if you're not a diabetic but once you have diabetes and neuropathy is it's too acidic and it does it's a stimulant and it's not good for your nerves you can you can take Lifestyle Changes exercise is very big there's all kinds of things you can do besides taking the statins the doctors have tried to get me to take statins every every time I go in it seems like they want to try me on a different Statin I took metformin and it hurt me I believe I took phenofibrate and I couldn't tolerate that I took a Statin at and then it hurt really bad trust in the Lord with all your heart and lean not on your own understanding and all your ways acknowledge Him and He will direct your path he's a great physician he uses doctors to help us but doctors make mistakes I was misdiagnosed for 4 years they said I had depression when it was anxiety I even got shock treatments which were no help at all I'm the Lord finally after four or five hospitalization sent me a doctor that help me put me on the right medication that I've taken for about 30 years with no problems and I still take it I take less than what I did when I started everyone said I would have to keep taking more and more but the Lord has helped me he's a great physician he died on the cross for our sins he loves us he will use any sickness or any kind of a problem in our life to get us to look to him as our savior and our God he died for us and he is God and he will help us he does love us and turn to him and in Jesus in Jesus name