After being on simvastatin for 25 years, my nurse switched me to a new ‘better’ statin, atorvastatin. But my liver function tests went through the roof: I started to go yellow, and was checked for all types of hepatitis and HIV. Finally, the conclusion was that the statin was the cause and I’m now on another. My liver function is back to normal, but I’ve been left with lasting damage to my liver (ironic as I am teetotal).
All this only became clear as I have regular blood tests for my diabetes – why aren’t people on statins monitored with blood tests?
Debbie Burunou, Bristol.
Dr Martin Scurr replies: This was a most unfortunate experience and I understand your aggravation.
Atorvastatin and simvastatin are commonly prescribed to reduce cholesterol levels. Studies have found that about 1 per cent of patients on statins experienced mild elevations in liver enzymes and in many of them those elevations resolved without stopping the statin.
However, to be sure the dose was correct, patients were routinely given liver function tests as part of regular cholesterol checks. These days, it seems that complacency – not to mention NHS cost containment – has led to that precautionary practice being abandoned.
Significant liver damage with atorvastatin is actually quite rare; it’s estimated to affect one in 10,000 users.
While it’s reassuring that your liver function test has returned to normal, as you have lasting damage you should continue to be monitored regularly (every 12 months, including a blood test for liver function). If you have not been offered this you must request it (and for other readers on these drugs, I’d suggest liver function tests periodically – such as when cholesterol is checked).
A patient with jaundice recently came to see me. He had acute severe liver damage caused by taking the antibiotic flucloxacillin. This echoes your experience and goes to show that commonly prescribed drugs, which are thought to be safe, can nonetheless occasionally cause severe reactions.
It’s a warning to anyone who takes medication to read the data sheet that comes with it. Any symptoms after starting a new prescription should always be insistently reported.
My 16-year-old grandson has a curve in his spine; what are the problems with the operation for this?
J Edwards, Caernarfon, Gwynedd.
Dr Martin Scurr replies: Scoliosis is where the spine curves sideways. Although the exact cause is often not known, it commonly develops during growth spurts around the ages of 10-15. It causes pain and even respiratory difficulty when severe.
Let me reassure you that most adolescents undergoing surgery to straighten the spine make a good recovery and see an improvement in posture and pain, resuming normal activities within six months.
Complications of surgery include bleeding, infection, and nerve damage – this could lead to weakness, numbness, or loss of bladder or bowel control but the risk is less then 1 per cent.
But the surgery is often long (five to seven hours) and post-operative lung infections are a risk factor (due to lying in a fixed position for that time).
Long-term concerns include a reduced range of motion and chronic back pain, although this is not common and will improve if the rehab plan – which will be put together by a physiotherapist – is followed to the letter.
The good news is that research shows while 5 per cent of patients need another operation within two years, the surgery is a success for the others, with the curvature corrected.
