Are Statins Safe The Argument Goes On

Today's post from liveinthenow.com (see link below) is somewhat of a counter argument to yesterday's post concerning whether statins are harmful or not for people living with, or susceptible to, neuropathy. In this article, the author is convinced that neuropathy is just one of many potential dangers associated with statins. It has to be said that across the internet generally, there are more articles warning of the dangers of nerve damage from statins, than suggesting that those dangers are exaggerated but that may be because new evidence seems to be emerging as more research is done. If you have cholesterol problems and signs of neuropathy, or even fall into neuropathy risk groups, it may be wisest to a) do as much of your own research as possible and b) consult your doctor(s) carefully before joining the statins band-wagon. Cholesterol can be improved by other means, nerve damage can not!

Statin Drugs Cause Even More Nerve Damage Than We Thought
Posted by Sayer Ji

Have the nerve-damaging properties of statin drugs now been confirmed? There are over 300 adverse health effects associated with the use of this chemical class of cholesterol-lowering medications known as statins, with myotoxicity (muscle-damaging) and neurotoxicity (nerve-damaging) top on the list. When will the FDA step in and warn the public, as proof of the problem in the biomedical literature reaches an alarming level of clarity?

The neurotoxicity of statin drugs are back in the news. Following on the heels of the FDA decision earlier this year to require statin drugs manufacturers to add “memory loss” as a side effect of this chemical class, a new study in published in the Journal of Diabetes reveals a clear association between statin use and peripheral neuropathy in a US population 40 years of age and older.

The study found “The prevalence of peripheral neuropathy was significantly higher among those who used statins compared to those who did not (23.5% vs. 13.5%; p < 0.01),” which is a 75% increase in relative risk.

Case reports of statin-induced peripheral neuropathy have existed in the medical literature for over 15 years. Now, larger human studies are confirming that statin drugs do damage to the peripheral nerves. Moreover, much of the damage is occurring below the threshold of clinical surveillance, silently causing harm in unsuspecting patients.

For example, in 2011, the results of a 36-month prospective clinical and neurophysiological follow-up of patients treated with statins over 3 years was published in the journal Neuro Endocrinology Letters, revealed in forty-two patients that despite the fact that they did not report subjective symptoms typical for peripheral neuropathy, damage was occurring. They concluded: “The study confirmed that long-term treatment with statins caused a clinically silent but still definite damage to peripheral nerves when the treatment lasts longer than 2 years.” Click the hyperlink to view all 9 studies on statin-induced peripheral neuropathy on Greenmedinfo.com. Or, view an even more sizeable dataset (54 studies) on statin-associated neurotoxicity.

While this research is adding to a growing awareness of the nerve-damaging properties of statins, this side effect is just the tip of a massive iceberg of under reported deleterious effects. For example, our project has identified 314 possible adverse effects of statins thus far. Conversely, we have identified a wide range of health benefits of cholesterol, running diametrically opposed to the over-simplification inherent in the cholesterol hypothesis (some say “cholesterol myth“) of heart disease causation.

http://www.liveinthenow.com/article/statin-drugs-cause-even-more-nerve-damage-than-we-thought

SCIENTISTS REVEAL HOW LUNG CANCER SPREADS

Scientists have revealed the mystery behind spreading of lung cancer.

The researchers at the Cancer Research UK Manchester Institute discovered that the ties which lash cells together - controlled by a protein called TIAM1 - were chopped up when cell maintenance work goes wrong.

Healthy cells routinely scrap old cell parts so they could be broken down and used again. But this process spiraled out of control in lung cancer cells, which scraped too many TIAM1 ties.

Targeting this recycling process could stop lung cancer from spreading by keeping the cells stuck firmly together.

Lead researcher, Dr Angeliki Malliri, at the Cancer Research UK Manchester Institute at the University of Manchester, said that the research showed for the first time how lung cancer cells severed ties with their neighbours and start to spread around the body, by hijacking the cells' recycling process and sending it into overdrive. Targeting this flaw could help stop lung cancer from spreading.

Anti Depressants For Neuropathy The Right Choice

Today's post from themighty.com (see link below) is an article about anti-depressants and depression. What has this got to do with neuropathy you may ask? Well, one of the first stage treatments for neuropathic symptoms is anti-depressants. That's depressing in itself, especially when you learn that they very rarely work over any extended period of time but when neuropathy patients announce that they're on anti-depressants, they raise all sorts of pre-judgements and stigmas from others, that have nothing to do with the nerve damage they're combating. Furthermore, as this article very clearly states, anti-depressants very often have side effects that are worse than the symptoms they're meant to suppress. Yet doctors and neurologists across the world blithely issue prescriptions for anti-depressants; sometimes for months and years, because they are high on the list of first stage treatments for neuropathy and they've become standard. The fact that they can affect your health otherwise is seen as 'collateral damage'. Yet the fact is that most patients do not respond well to them and move on to other drugs meant for other conditions, often with the same result. If you're on amitriptyline, or something similar for your neuropathy, this article may help you to understand what may happen to you as a result. If you're having problems it may be time for a talk with your doctor. Worth a read.

When Depression Makes You Want to Avoid Everyone... Including Your Therapist By Ramona Samuels Contributor 05/04/16

A Few Things I Want to Clear Up About Antidepressants

For some reason, I always believed medication was “bad.” I don’t know if that was ingrained into my psyche or if it was taught, or just assumed, but it seems like medication for a mental need is treated much differently than the rest of the body.

Have you ever rolled your eyes at someone who needed medication for another issue? Have you ever wondered if someone was “faking it” for attention if they needed medication for their heart? Or did you tell someone with diabetes to “think positive” and skip the insulin? Of course not! But these are reactions that happen all the time in the field of mental health, and I believe these reactions are hurting all of us.

Let me clear a few things up, because I have battled depression for close to 30 years. Some years were harder than others, and some episodes simply didn’t clear until I relied on my doctor and medication. In fact, I am sure it has saved my life a number of times.

Here are some things I want to clear up:

Antidepressants are not “uppers.” They’re meant to reduce the symptoms of depression. It’s not like speed and it doesn’t make you weird. Let’s get that notion cleared up.

Antidepressants do not make you void of emotions. Someone close to me once said they were afraid if they went on medication they wouldn’t have spiritual experiences any more. I’ve heard people say they were afraid they wouldn’t be able to feel anything if they went on a med. Some people start meds and are shocked to learn they still have bad days and feel a little depressed occasionally.

Your soul is still in tact, your heart still beats, you still get excited and disappointed. I still feel like me — just a better, less-reactionary me. I can observe my worthless feeling and let it go, reminding myself of the good around me. I can have a thought of death enter my mind and see it, and have the mental power to deal with it in a healthy way. I cry if I’m sad. I laugh when I am happy. I feel things every day.

Staying on medication is not a sign of weakness. This one I wish I could shout from the rooftops: “If you need medication, stay on it!” Too many people take their medication and “feel OK,” and tell themselves “I can go off this now.”

First of all, there’s a reason you started medication and a reason it worked. There’s a physical need here, and because of our shortsightedness we forget that. If you’re in this situation, please reflect on what urged you to actively treat your illness, and honor that.

Secondly, pulling yourself off meds can be risky. More risky and dangerous than people are willing to talk about (and they should be talking about it more). It should be treated as seriously as the heart, diabetic or blood pressure medication. Please, please, please, don’t just go off “cold turkey” and wreak that havoc on your brain.

I don’t understand how society seems to believe it’s unacceptable to treat one of our most precious and vital working parts. I get it, because I feel it. It’s a real stigma and chances are at one time or another in your life, you have said or reacted in a way that added to this stigma. That is the tragedy of it.

While it’s true medication can be a temporary thing and does not have to be a life sentence, any change in dosage or phasing out of it should be done under the care of your doctor and with lots of help and support from those around you. It is not a luxury, it is a necessity.

I have tried to be braver in my conversations about my mental illness. I’ve started telling people how I treat it, talking about it more and sharing my experiences with a little more courage. I’ll admit, I’ve contributed to this stigma most my life through my fear to speak up and speak out. As long as those who deal with mental illness are ashamed of it, and those who don’t deal with mental illness give them reasons to be ashamed, things will never change. I just happen to believe we are all too caring and all too connected to let that happen.

Editor’s note: This piece is based on the experience of an individual and should not be taken as medical advice.

http://themighty.com/2016/05/myths-about-taking-antidepressants-for-depression/

Can Diabetes Meds Prevent HIV Related Neuropathy

Today's post from positivemindbody.wordpress.com (see link below) looks at the possibility that drugs used to control blood sugar levels in diabetics may actually help in preventing neuropathy. Diabetics have always been told to keep their blood sugar levels under control in order (amongst other things) to reduce the chance of neuropathy (which is a very common side-effect of diabetes) but these Canadian studies carried out by CATIE pose the question as to whether these drugs may help anyone at risk from neuropathy - diabetic or not. It was more an 'observational' study, where the results came as a 'bonus' and it concerned drugs other than Insulin but if further studies are carried out which are more directed at precisely this possibility then the case may be proved. Either way, to the layman it seems a logical development. Neuropathy has always been categorised according to its cause (diabetes, cancer drugs, HIV, alcohol et al) but as we all know, the end results are pretty much the same for everyone. If controlling blood sugar levels helps diabetics to avoid neuropathy, would it do the same for other high-risk groups? Hopefully research will provide the answer in the near future.

Can diabetes medicines help prevent HIV-related nerve damage?

Created on 10 October 2012

People with HIV infection can develop damaged nerves in the hands, feet and legs. This condition is called peripheral neuropathy (PN). As a result of PN, people can develop very painful sensations in their limbs, such as burning or stabbing pains. They can also lose their ability to feel hot or cold in the affected limb. Sometimes, depending on the severity of nerve damage, they may even feel numbness. Neurologic testing can reveal reflexes that have degraded. Having symptoms of PN can impair quality of life.

PN can occur in people with HIV infection because the mitochondria (energy-producing parts) of cells become damaged. When mitochondria do not produce enough energy, nerve cells can malfunction or even die.

Some studies have found factors that may increase the risk for developing peripheral neuropathy, such as the following:

• having a low CD4+ cell count
• being older
• being taller
• excessive production of harmful substances by HIV-infected cells
• exposure to so-called “d” drugs – older anti-HIV drugs that are no longer routinely recommended for first-line therapy in Canada or other high-income countries, such as ddI (didanosine, Videx), d4T (stavudine, Zerit) and ddC (zalcitabine, Hivid)
• co-infection with CMV (cytomegalovirus)
• excessive intake of vitamin B6 (pyridoxine)
• deficiency of B-complex vitamins
• excessive intake of alcohol
• having diabetes
• excessive exposure to drugs with the potential to cause nerve damage, including the antibiotics isoniazid and metronidazole (Flagyl); the anticancer drugs vincristine, etoposide, paclitaxel, docetaxel and cisplatinum

A research team in the U.S. recently reviewed health-related information collected from 1,592 HIV-positive people (80% men, 20% women) in an attempt to find associations between various factors and the future risk for developing symptoms of PN in people who had symptom-free PN. Participants were monitored for about five years and underwent neurologic and other assessments.

The researchers found that exposure to what they called “neurotoxic ART” (combinations that included “d” drugs) was associated with a twofold increased risk for developing symptoms of peripheral neuropathy.

However, what surprised the researchers was that participants who used medicines other than insulin (such as metformin (Glucophage)) to help control their blood sugar were less likely to develop symptoms of PN.

Due to the observational nature of the present study’s design, its conclusions are not definitive. However, they are suggestive of a protective effect of diabetes medicines on nerves. The researchers are not certain how or why this occurred.

Muscle and fat cells are dependent on insulin to help pull sugar from the blood into them so that that their mitochondria can use sugar as a source of energy. Canadian researchers have found that while nerve cells are not dependent on insulin for helping to transport sugar from the blood into nerve cells, these cells are sensitive to its effects. That is, insulin might have other effects on nerves, perhaps helping them grow and survive. If nerve cells in the periphery (outside of the brain and spinal cord) lose their sensitivity to insulin, they can malfunction and degenerate. Many diabetes medicines work by making cells more sensitive to the effects of insulin and that may be one possible way that these drugs could help prevent the worsening of peripheral neuropathy.

The findings from the U.S. study about the potentially beneficial effects of insulin-sensitizing agents such as metformin in HIV-positive people at risk for symptoms of PN need to be confirmed in a study of a more robust design. If they are confirmed, clinical trials of insulin-sensitizing agents commonly used in the management of type 2 diabetes may be the next step. Such research may, in part, explain the beneficial effect of the antioxidant alpha-lipoic acid, which has been tested in clinical trials of HIV-negative people with peripheral neuropathy and to help improve insulin sensitivity.

http://positivemindbody.wordpress.com/2012/10/11/can-diabetes-medicines-help-prevent-hiv-related-nerve-damage/

The Best Footware For Neuropathy

Today's post from diabetesforecast.org (see link below) looks at the importance of the right shoes if you have nerve problems in your feet. Most people are put off therapeutic shoes for two reasons: the expense and the depressing lack of style. However, things are improving slowly and there are reasonably priced and attractive shoes available if you look around. The tips shown here are important though: if you're going to spend money on the right shoes, you need to be aware of the pitfalls. A useful article.

6 Tips for Therapeutic Shoes
By Lindsey Wahowiak August 2014

Look for these healthful features in diabetes-friendly footwear

Everyone can benefit from a shoe that fits well. Therapeutic shoes have special features—see what qualifies them as medical treatment for people at risk for foot problems or who already have some damage. 

1. Adjustable

An adjustable closure, such as shoelaces or no-tie straps, can allow for different foot needs, day to day and hour to hour. If you have difficulty tying laces (for example, because of nerve damage in your fingers), a Velcro closure might be best.

2. Wide Toe Box

Pain from squeezing feet into too-small and too-narrow shoes can lead to some ugly side effects. So letting your piggies wiggle will keep them from rubbing against each other and developing deformities. 

3. Forgiving Material

Leather and microfiber are two materials that expand, preventing irritating friction if your foot swells. A shoe without some give is a shoe that will cause a blister. 

4. Special Foot Bed

Therapeutic shoes typically have a foot bed that is wider and made with shock-absorbing materials. Your podiatrist or other specialist might also suggest a custom insert, which can relieve heel or arch pain, and can take pressure off areas that might be prone to calluses. 

5. Fitted By a Professional

Some shoes at your local discount store might meet the criteria of a therapeutic shoe, but your feet should be measured and the shoes fitted by a professional, such as a podiatrist or orthotist. If you have neuropathy, for example, you might not be able to feel how well a shoe does or doesn’t fit. “The goal of the shoe is really to cater to what your specific problems are,” says Crystal Murray Holmes, DPM, assistant professor at the University of Michigan. “You want to be fitted for the shoe [by] someone whose credentials make them a specialist in looking at foot structures, measuring, and deciding what’s appropriate for the shoe.” Specialists can also help you navigate insurance and Medicare coverage for therapeutic shoes.

6. Extra Deep

An extra-deep shoe cradles your foot. Support around your ankle gives you more stability. The extra depth gives foot deformities such as bunions and hammer toes the space they need. A deeper shoe also gives you room for an insert or orthotic. 

Who Needs a Special Shoe?

If you have existing foot problems, therapeutic shoes can help you prevent more complications. Medicare (and many other insurance plans) covers the cost of one pair of therapeutic shoes each year for people with diabetes who have at least one of these qualifications: a previous amputation, past ulcers, calluses that could lead to foot ulcers, nerve damage (neuropathy), poor circulation, or a foot deformity. 

Sock Shop

The layer between the shoe and your foot is important. When you are fitted for your shoes, make sure you wear the same kind of socks you’ll wear with the shoes. Avoid socks that have seams—they can cause rubbing or irritation that can lead to a blister or callus. Socks that fit appropriately are important: Don’t wear socks that cut into your leg or ankle or socks that fall down your ankle and bunch up in your shoe. A breathable material, such as cotton, or a wicking material, such as microfiber, can keep bacteria from forming. And talk to your doctor: You may need a compression sock or stocking, depending on the circulation in your feet or legs.

http://www.diabetesforecast.org/2014/08-aug/6-tips-for-therapeutic-shoes.html

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