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Post LAD stenting Statins causing neuropathy

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hi I am after some help on what medication I should take. My current cholesterol levels without any med's are 1.09 HDL, 1.7 LDL & 2.8 Tri = 5.6 total cholesterol. I am in the high risk catergory as I had a stent fitted last year (April 12') in my LAD. Rest of the arteries were good so I think i have a good chance to keep my cardiovascular system in good order with the right approach from here on in. I am a non smoker. No diabetes issues. Since the stent I have reduced my weight from 106kg to 86kg's and radically changed by diet (now eating all the right foods, wasn't before unfortunately way to much junk food and lack of veges and fruit). My total cholesterol at the time of my stent issue was 6.4 (obviously way to high).

With 40mg of Lipitor (after the stent was fitted) my cholesterol plummeted to 2.2 total cholesterol (which I consider is way to low and sent my body into meltdown). With 20mg of Lipitor I can maintain a comfortable 3.5 total cholsterol.
With 145mg of Lipidil I can maintain a comfortable 4.5 total cholsterol

My problem is that the Lipitor caused me to have some neuropathy issues (confirmed by neruologist) and I stopped taking that drug after 5 months. I am still battling these issues to this day but feel like I am getting on top of them finally. My nero told me that it's to early to be going back onto statins at this stage and I am going to follow her advice, although my cardiologist thinks otherwise (but I'd expect that would be his approach as he's only concerned about my cholesterol levels).

I have just started some nicitinic acid (250mg x 3 times per day) as I figured this is a natural supplement but don't know much else about it. I also have some Questran Lite as an option also if the nicitinic acid doesn't work for me.

I am after your advice and direction please, given my above circumstances and situation where I really need to get my cholestrol level down, I want to go onto a lipid lowering drug (to compliment my diet and exercise plan) but I don't know enough about how all the above drugs work (such as the statins work on the HMG-CoA, what process does Lipidil use to lower cholesterol and could it also have the same effect on my nerves as the lipitor did????) and given that the statins had some a dramatic effect on my nerves I cannot afford to take something again that will inflame the whole situation again for me.

What would you recommend my best course of action be?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Hello, Thanks for your query at DoctorSpring.

Let me know your other associated symptoms along with mentioned.
Do you have neck pain while moving/ any past history of neck injury?
Do you tingling sensation with pain in both upper limb?
Are you an alcoholic or a smoker?
Do you have some sort of stress?

with the available described details, there appears to be least possibility of Lipitor induced neuropathy. lipitor is an oral medication and generally affects nerves in whole body; not remain confined to only upper limb.

Viral infections may cause neuropathic symptoms and again generally involves whole
body. Viral causes could be better evaluated by local physician by exact
prevalence of virus in defined endemic area.

You should again consult with internal medicine specialist/ neurologist or your treating and should go for thorough check up.

You should also go for x ray cervical spine, CT/ MRI cervical spine (if needed), serology test for Epstein Barr virus, cytomegalovirus, herpes simplex virus (as these are commonly associated with neuropathic symptoms), erythrocyte sedimentation rate,serum protein electrophoresis for better evaluation.

You should also go for nerve conduction velocity studies of both upper limb.
Improvement in symptoms after antibiotics appears to be psychological relief and neither antibiotic is found to be effective in neuropathic pain.

Treatment depends on exact diagnosis.
Meanwhile, you should continue pregabalin, methylcobalamin, multivitamin.

Let me know the results of above advised investigations.

Take care, please let me know if you have any other queries.
Get well soon,
Dr. Mayank Bhargava

Patient replied :

yeah my current symptoms are pain in the underside of my feet, numbness in the toes constantly - this is why I find hard to beleive that the nero last week said that the nerves in my feet were perfect and that I definately didn't have neuropathy. My health was perfect 12 months ago prior to starting the lipitor (which I stopped after 5 months use and have not restarted since). My hands are not numbness but at night time I get some 'deadness' in the fingers and when I awake and start moving them again they come back to life. After doing a lot of gripping sports like golf or squash 24 hours later the muscle at the base of my thump is sore and also my some of fingers get stiff and sore also (all this sounds like carpel tunnel as the nero suggests but it seems strange that it started exactly the same time as when the feet issues did which makes can't but help think the 2 are related). No neck injuries and I have had MRI's on from the top of my neck right down to my tail bone and all ok. Any suggestions on where to from here?


There is possibility of peripheral neuropathy as symptoms are present in upper and lower limb.

You should go for above advised investigation and serum creatine phosphokinase.

You should also go for above advised medication as limited medication are available for cure of neuropathic symptoms.

Take care,
Dr. Mayank Bhargava

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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