Q: My physician has advised me to begin taking a statin — atorvastatin — however I’ve heard muscle ache and dementia are attainable unwanted effects. Are you aware how dangerous it’s?

Katylin F., Franklin, Tenn.

A: Folks’s reactions to medicines are sometimes complicated and onerous to unravel. Statins are a superb instance of that. Nationally, as much as 50 p.c of sufferers prescribed statins both take diminished doses or go off the meds fully as a result of they really feel they’re having a unfavourable response to the drug. Complaints embody muscle ache, headache, dizziness and nausea. That’s a disgrace as a result of statins are confirmed to cut back the danger of heart problems and of dying from related vascular or heart-related complication, equivalent to blood clots, strokes and coronary heart assault.

Now, a meta-study revealed within the European Coronary heart Journal has found out what number of of us worldwide are actually illiberal of statins: 9 p.c. Nonetheless, the worldwide group of researchers, who checked out 176 research that included greater than 4 million sufferers, did discover that some subgroups of individuals have elevated dangers for statin intolerance: They’re people who find themselves older, feminine, Black or Asian, overweight, abuse alcohol or have diabetes, an underactive thyroid gland or power liver or kidney failure. Sure medicines, together with medicine to manage arrhythmia and calcium channel blockers, additionally up the danger of statin intolerance.

As for dementia, atorvastatin and rosuvastatin lower irritation and may very well lower the danger of dementia.

So discuss together with your physician about your danger elements and ask what the bottom dose you may take may be. Then give the statin a strive, together with aggressive life-style modifications that may shield your cardiovascular well being. Ditch pink or processed meats, extremely processed meals and added sweets and sugars, and go for reasonable or no alcohol consumption and a plant-based weight loss plan. Your aim? An LDL below 70 or apolipoprotein B below 70. For strong steering on making these decisions, check out my books “What to Eat When” and the “What to Eat When Cookbook.”

Q: My dermatologist and first care and diabetes docs are all pushing me to make use of telehealth visits for routine check-ins and a few checkups. Do you assume that is good drugs?

Steve R., Austin

A: Telemedicine has arrived. Based on the Division of Well being and Human Companies, neighborhood well being facilities report a 6,000 p.c enhance within the variety of digital visits — up from 478,333 in 2019 to twenty-eight,550,608 in 2020. And so they’re not going away any time quickly. In reality, HHS is giving $55 million in grants to 29 neighborhood well being facilities nationwide to assist them enhance each entry to and the scientific high quality of digital care. Now, the trick is so that you can learn to make these telehealth visits be just right for you. HHS offers these pointers:

  Identical to you prepare for an in-person go to, write down your questions on issues or signs so that you make certain to get solutions.

  Write out a listing of your present medicines (or collect the precise bottles).

  In case your physician has requested info like your temperature, glucose ranges, blood strain or weight, have this info prepared.

  Ensure you’re comfortably seated in a quiet room and the digicam is well-positioned and regular. (Then you may present your dermatologist that tough spot of pores and skin that issues you.)

  Take notes about what your physician says throughout the e-visit or report the dialog in your pc or telephone.

Keep in mind, simply since you had a digital appointment, your interplay together with your physician doesn’t cease if you log off. In the event you forgot to ask one thing or want clarification, name the workplace or electronic mail your physician via a affected person portal. And ensure your physician’s workplace follows up on referrals, prescriptions or lab work as promised. If you take cost of the telehealth course of, the comfort of being at dwelling and the zoomed-in closeness of the digicam could make telemedicine a robust a part of your good self-care routine.

Contact Dr. Roizen at sharecare.com.

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