Top Docs 2016: Sunshine & Statins

Drugs that keep high cholesterol in check can come with a catch: painful side effects. One researcher figured out that vitamin D could ease the pain.
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Illustration by Patrick Hruby

Charles J. Glueck, MD, Endocrinologist Director,
Mercy Health–Jewish Hospital Cholesterol & Metabolism Center

—As told to Alyssa Brandt

“Statins are amongst the most valuable medicines we have because they reduce the risk of heart attack and stroke by about 60 percent. But about 20 percent of patients taking statins flat-out can’t tolerate them because they develop painful muscle aches, cramps, tenderness, and weakness, which degrades the quality of their lives. So even though they’re at high cardiac risk, they won’t take the statin. We’ve found that a very common cause of statin intolerance is low vitamin D, and when you do the simple thing of bringing a patient’s vitamin D level up to normal, 85 to 95 percent of people waltz off into the sunset, able to tolerate their statin drug.

We had already done a lot of pioneering research into the role low vitamin D plays in polycystic ovarian syndrome (PCOS). In 2008, three African-American sisters came to my office, all of whom had early heart disease and high cholesterol, and all of whom couldn’t tolerate statins. I was aware of a bright light blinking in the deep recesses of my mind: We had known from previous research that African-Americans are much more likely to have low vitamin D, because dark skin pigmentation inhibits vitamin D production. I said to myself, I bet they all have low vitamin D and that if we give them vitamin D we’ll solve their problem. That was the stroke of genius, in a manner of speaking. Knowing what I did about African-American vitamin D deficiencies, and knowing what I know about statins, all of a sudden these things clicked together. That was the genesis of our initial discovery. Subsequently over the next five data publications, ours being the first, we’ve been able to point out that the interaction of low vitamin D with the statin hurts the muscle cell and causes the painful symptoms. Our entrée to the discovery, as many entrées into clinical research are, was the patient telling us the answer.

In my career of almost 50 years, we’ve gone from horse-and-buggy to intergalactic rocket ships in terms of our ability to prevent disease and death from the number one killer in America, which is heart disease. Anytime you can do a 65 percent reduction in a disease that kills a majority of Americans, that ain’t bad.”

 

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