A few months ago, a blood test showed I had high cholesterol. My doctor suggested statins - cholesterol lowering drugs. I immediately snapped into healthy skeptic mode. And I hope you do the same.
I call any medication that you take regularly, and for a long time, a lifer drug. These include statins, blood pressure lowering drugs, prescribed testosterone and many others.
There’s no doubt that lifers can be lifesaving. A landmark 2012 study found statins can reduce the risk of heart attack and stroke by roughly 20 percent. And for blood pressure, even a modest five-point drop in your systolic number, the top one, is linked with a 10 percent lower risk of major cardiovascular events.
But press the pause button here.
You never want to go on a lifer based on one blood test or any other one-time snapshot of your health. Cholesterol and testosterone levels, for example, can vary depending on the time of day, what you’ve eaten, stress, and how much sleep you got the night before.
Same for blood pressure. It can spike if you’ve had caffeine or alcohol. And the reading can be flat-out wrong if the cuff is too small — or too large — for your arm. Even talking can throw off the measure! Given my proclivities, I now wonder if I’ve ever had a truly accurate blood-pressure reading.
The upshot? Before accepting a lifer prescription, always ask for a repeat test at a different time of day, and under different conditions.
You know how to inquire about side effects when you’re prescribed medication. But you also should think ahead. Ask what happens if you have to stop a drug later on because there’s some change in your health or a new side-effect crops up. You’ll need to inquire now about how your body might respond then.
Will you go through withdrawal? Will there be a rebound effect where the symptoms that first pushed you to the drug come back with a vengeance? Most people who stop taking those new weight loss drugs - Wegovy, Ozempic - see their old weight quickly return in about a year-and-a-half. And paradoxically, prolonged antacid use primes your stomach to push out more acid. You stop, and your stomach may wind up more acidy than ever.
For men who take testosterone - and this is a little scary - the body can become so reliant on prescribed testosterone, that it may give up on producing any of its own. So if you have to stop the exogenous - outside - hormone, you may find yourself bereft of testosterone altogether.
As for me, I asked my doctor if instead of statins, I could try to lower my cholesterol with diet, and then repeat the test. She agreed, and my next reading came back normal.
Lifer drugs are rarely for acute emergencies. You haven't broken a leg or have a raging fever. Usually, before committing, you have time to decide.
So use it. Once you know you’ve chosen a lifer thoughtfully, it’ll be a lot easier to live with.
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