DEAR DR. DONOHUE: I am a 70-year-old retired surgeon who has taken Lipitor for the past five years. I also am a serious slalom water-skier. This sport puts great stress on muscles. While skiing, I suffered a silent tear of the hamstring muscle that became painful several hours later. A large hematoma formed. I know that a complication of Lipitor is muscle weakness, and I discontinued it immediately. Is the mechanism of muscle weakness known? Do the muscles strengthen again in time, and how long does that take? I want to return to skiing. – B.W.

ANSWER:
Statin drugs (Lipitor, atorvastatin; Zocor, simvastatin; Pravachol, pravastatin; Crestor, rosuvastatin; Lescol, fluvastatin; and Mevacor, lovastatin) are the most effective cholesterol-lowering drugs available. It seems that just about everyone over 50 takes one of them. They can cause muscle problems. Myalgia is one of those problems. It is muscle inflammation with tenderness and pain. Myopathy is another problem. It’s muscle achiness and weakness. And the third, and most serious, complication is rhabdomyolysis, muscle disintegration. This happens very rarely, to about one in 10,000 users. Lowering the dose, switching to another statin or changing to a different medicine is usually all the treatment necessary, except for rhabdomyolysis.

The exact mechanism that causes statin-induced muscle trouble hasn’t been clearly demonstrated. It’s postulated that it might be due to a lessening of the production of mevalonate, a body material critical to muscle health.

People simultaneously taking drugs like gemfibrozil, some anti-fungals, macrolide antibiotics like erythromycin, the heart medicine digoxin and the blood thinner Coumadin are more likely to develop muscle complications with statin drugs.

Almost all recover from this side effect without any permanent damage. Recovery might take a month or two. Rhabdomyolysis, however, can be deadly. You’ll ski again. I’ll wave as you pass by.

DEAR DR. DONOHUE: I have used aluminum waterless cookware since 1958. When I simmer tomato sauces in it, I notice that the pot is shiny afterward. Yikes! Does that mean aluminum has gone into the sauces and into us? Is that harmful? Does it lead to Alzheimer’s disease? – L.P.

ANSWER:
Traces of aluminum have been found in the brains of some Alzheimer’s patients. To date, there has been no conclusive link between aluminum and Alzheimer’s. Furthermore, aluminum cookware releases very little of this metal into the food cooked in it. Most experts do not advise people to stop using such cookware.

Alzheimer’s disease is a tragedy for the patient and the patient’s family. The booklet on it describes what it is and how it’s treated. Readers can order a copy by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have mucus that drains down into my mouth and throat constantly. I hope you can offer some help for me. – H.E.

ANSWER:
You’re describing postnasal drip, the irksome trickling of mucus into the back of the mouth and throat. It is thick, gluey and tastes awful. The mucus often comes from chronically infected sinuses.

Try saltwater irrigation of the nose to clear up some of this mucus. Boil some water, and into a cup of boiling water add a quarter-teaspoon of salt. Let the water cool. With a bulb syringe, available in drugstores, gently flush both nostrils.

Before going to bed, take a drug that contains both an antihistamine and a decongestant. Drixoral Cold and Allergy Tablets is one such drug. It can slow the trickle at night, when it’s usually at its worst.

You might have to enlist the help of an ear, nose and throat doctor, who can inspect your sinuses and tell you if you need more intensive treatment.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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