Statins can cause the peripheral nerves to malfunction

This paper was published in Revista de Neurologia 2006 Dec 1-15;43(11):659-61

Study title and authors:
Multiple mononeuropathy associated to treatment with pravastatin.
Abellán-Miralles I, Sánchez-Pérez RM, Pérez-Carmona N, Díaz-Marín C, Mallada-Frechín J.
Unidad de Neurología, Hospital de la Marina Baixa, Partina Galandú s/n, E-03570 Villajoyosa, Alicante, Spain. iabellanm@jmalladaf.jazztel.es

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/17133326

This paper reports of a woman who was diagnosed with multiple mononeuropathy after beginning pravastatin therapy. Multiple mononeuropathy (mononeuritis multiplex) is the simultaneous malfunction of two or more peripheral nerves in separate areas of the body. It causes abnormal sensations and weakness. Multiple mononeuropathy typically affects only a few nerves, often in different areas of the body. In contrast, polyneuropathy affects many nerves, usually in about the same areas on both sides of the body.

(i) A 51-year-old female patient who, after beginning therapy with pravastatin, suffered with abnormal sensations in the limbs and developed an unstable gait.
(ii) Multiple mononeuropathy was diagnosed.
(iii) Her condition improved on withdrawing from the statin treatment and it became worse again when statins were restarted.
(iv) When pravastatin therapy was stopped for good, the patient's condition progressively improved until she was practically free of symptoms.

This case shows that statins can cause the peripheral nerves to malfunction.

Increasing dietary polyunsaturated fats and decreasing saturated fats is associated with an increase in both overall death rates and heart disease death rates

This study was published in the British Medical Journal 2013 Feb 4;346:e8707

Study title and authors:
Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis.

Ramsden CE, Zamora D, Leelarthaepin B, Majchrzak-Hong SF, Faurot KR, Suchindran CM, Ringel A, Davis JM, Hibbeln JR.
Laboratory of Membrane Biophysics and Biochemistry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/23386268

The objective of the study was to evaluate the effectiveness of replacing dietary saturated fat with polyunsaturated fat, for the prevention of coronary heart disease and death in men with heart disease. The study lasted for 39 months and included 458 men, aged 30-59 years, who had had a heart attack or angina.

The men were allocated into two groups and instructed to either:
(i) Increase their polyunsaturated fat intake to about 15%, reduce their intake of saturated fat and to less than 10% and reduce their dietary cholesterol to 300 mg per day. To achieve these targets these men were provided with liquid safflower oil and safflower oil polyunsaturated margarine (high polyunsaturated fat group).
(ii) Carry on with their normal diet (saturated fat group).

The study found:
(a) After 12 months the cholesterol levels of the men on the high polyunsaturated fat diet were 8.5% lower than the men on the high saturated fat diet.
(b) Men who consumed the high polyunsaturated fat diet had a 62% increased risk of death compared to the men who consumed the high saturated fat diet.
(c) Men who consumed the high polyunsaturated fat diet had a 70% increased risk of death from cardiovascular disease compared to the men who consumed the high saturated fat diet.
(d) Men who consumed the high polyunsaturated fat diet had a 62% increased risk of death from heart disease compared to the men who consumed the high saturated fat diet.

The study shows that increasing dietary polyunsaturated fats and decreasing saturated fats is associated with an increase in both overall death rates and heart disease death rates.

Statins significantly associated with worsening in knee pain and physical function in patients with osteoarthritis

This study was published in the Annals of the Rheumatic Diseases 2013 Feb;72(2):196-203

 

Study title and authors:

Associations between Statin use and changes in pain, function and structural progression: a longitudinal study of persons with knee osteoarthritis.

Riddle DL, Moxley G, Dumenci L.

Correspondence to Dr Daniel L Riddle, Departments of Physical Therapy and Orthopaedic Surgery, Basement, West Hospital, Room B-100, Virginia Commonwealth University, Richmond, VA 23298-0224, USA; dlriddle@vcu.edu.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/23172752

This study set out to determine if statin usage was associated with changes in knee pain and function in persons with knee osteoarthritis. The study included 2,207 patients with knee osteoarthritis who were followed for four years.

The study found that statin usage was significantly associated with worsening in knee pain and physical function over the four-year study period.

Iron absorption is markedly inhibited in soy infant formula

This study was published in the British Journal of Nutrition 1987 May;57(3):345-53

 

Study title and authors:

Factors influencing the absorption of iron from soya-bean protein products.

Derman DP, Ballot D, Bothwell TH, MacFarlane BJ, Baynes RD, MacPhail AP, Gillooly M, Bothwell JE, Bezwoda WR, Mayet F.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/3593666?dopt=Abstract

This study compared iron absorption rates from soya-bean-based and milk-based infant formulas. The study included 138 women aged 21 to 63. None of the women were pregnant or lactating and all were unpaid volunteers. Ethical and practical considerations precluded the study being done on infants themselves.

The study found:
(a) Iron absorption was significantly less from the soya-bean formula compared to the milk-formula.
(b) The addition of ascorbic acid (vitamin C) markedly increased iron absorption from the milk-formula (a ten-fold increase), whereas ascorbic acid had a less-marked effect on the absorption of iron from the soya-bean formula, with only a two- to threefold increase.

The study reveals that iron absorption is markedly inhibited in soy infant formula.

Statin and NSAID drugs lead to the death of a patient from kidney damage and severe skin lesions

This paper was published in the Annals of Saudi Medicine 2012 May-Jun;32(3):309-11

 

Study title and authors:

A fatal case of cutaneous adverse drug-induced toxic epidermal necrolysis associated with severe rhabdomyolysis.

Noordally SO, Sohawon S, Vanderhulst J, Duttmann R, Corazza F, Devriendt J.

Department of Critical Care Medicine, Centre Hospitalier Universitaire de Tubize-Nivelles, 1400 Nivelles, Belgium. Sheikoaleed.Noordally@chu-brugmann.be

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22588445

 
Toxic epidermal necrolysis is a life-threatening skin condition that is usually induced by a reaction to medications. Atorvastatin is a recognized cause of rhabdomyolysis (the breakdown of muscle fibers that leads to kidney damage). Naproxen is a widely used nonsteroidal anti-inflammatory (NSAID) drug that is a known cause of skin lesions.
 
This paper reports of a fatal case of drug-induced toxic epidermal necrolysis associated with severe muscle necrosis (death of muscle cells) due to the use of Naproxen and a statin.
 
(i) A 61-year-old female patient was admitted to hospital with complaints of breathing difficulties, vomiting, and diarrhea that started two days prior to admission.
(ii) Her medications included atorvastatin 10 mg once daily and naxproxen 500 mg three times a day. 
(iii) Acute kidney injury and rhabdomyolysis were present on admission to the hospital.
(iv) She had very high levels of creatine phosphokinase (indicating muscle damage by statins).
(v) Naproxen treatment had started ten days before admission and had led to the rapid onset of skin lesions.
(vi) The patient rapidly developed multiple organ failure with respiratory failure, and complete skin necrosis (death of skin tissue). Despite treatment she died the following day.

The paper concludes that the patient died of drug induced toxic epidermal necrolysis associated with severe muscle necrosis due to the use of naproxen and statin drugs leading to acute kidney damage and complete skin necrosis.

Diets high in bran decrease iron absorption by over 90%

This study was published in the American Journal of Clinical Nutrition 1989 Mar;49(3):542-5

Study title and authors:
Iron absorption: no intestinal adaptation to a high-phytate diet.

Brune M, Rossander L, Hallberg L.
Department of Medicine II, University of Göteborg, Sweden.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/2538051

Brune notes that several studies have shown that bran (and its high phytate content) inhibits the absorption of iron in man.

The present study examined the possibility that a high bran and phytate intake over a long period would induce adaption in the intestines or its microflora leading to a reduction of the inhibitory effect of dietary phytates on iron absorption. Such changes might occur in vegetarians and populations in developing countries with a usually very high dietary intake of phytates. The study included 13 dedicated vegetarians or vegans who had had a high phytate intake for around 25 years who were compared with six subjects who had a normal unrestricted diet.

The effect of bran on iron absorption was studied by comparing iron absorption from wheat rolls (i) with bran and (ii) without bran in both the vegetarian and non-vegetarian groups.

The study found:
(a) The bran rolls had a large inhibitory effect on iron absorption in both vegetarians and non-vegetarians.
(b) The effect was almost identical in both groups (93% inhibition in the vegetarian group and 92% in the non-vegetarian group) even though the vegetarians had had a very high phytate intake for a long time and the non-vegetarians had a much lower phytate intake.
(c) It can be concluded that no adaption could be observed among the vegetarians despite their high phytate intake.

The study concludes that the fact their is no intestinal adaptation to a high phytate intake has wide nutritional implications, and that a diet with a high phytate content must always be considered to impair iron absorption even if phytate intake has been high for several years.

Statins inflame and destroy blood vessels

This paper was published in Clinical Rheumatology 2008 Dec;27 Suppl 2:S75-7

Study title and authors:
A case of ANCA-associated systemic vasculitis induced by atorvastatin.

Haroon M, Devlin J.
Department of Rheumatology, Waterford Regional Hospital, Waterford, Republic of Ireland. mharoon301@hotmail.com

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/18839266

Vasculitis is a group of disorders that destroy blood vessels by inflammation. ANCA-associated vasculitides are diseases caused by vasculitis in which antineutrophil cytoplasmic antibodies (ANCAs) can be detected in the blood.

This paper reports a case of statin induced ANCA-associated vasculitides.

(i)  A 45-year-old male patient reported to an Accident and Emergency department with a six week history of pain and stiffness involving his legs. Both calves were markedly tender, and he was not able to bear weight.
(ii) He also complained of numbness involving his left big toe for a few days, which later spread to involve his arms, and tinnitus and hearing loss in his left ear.
(iii) He had been taking atorvastatin 10 mg for six months.
(iv) Investigations showed markedly increased inflammatory markers, markedly increased antineutrophil cytoplasmic antibody (ANCA) levels and muscle damage.
(v) A diagnosis of statin-induced ANCA-associated vasculitis and statin-induced distal myopathy (muscle disease) was made.
(vi) The patients symptoms and laboratory abnormalities resolved rapidly after cessation of the statin drug and implementation of treatment.

This case shows the association between statins and ANCA-associated vasculitis.