Blood test can reveal effects of Lipitor

Dear Dr. Gott: I have been taking Lipitor for several years to lower my cholesterol count. However, for the past six months, I have repeatedly complained to my doctor about the severe muscle pain I have experienced. During an office visit he checked the strength in my extremities and assured me that my pain was caused by simple muscle strain that could safely be ignored.

Then I read your column about muscle damage as a consequence of statin therapy. As you suggested, I asked him if I had ever had a CPK (creatine phosphokinase). He said he was doing all the necessary testing. However, I pressed him to order the test, which he did.

The next day, I received a telephone call from the doctor who told me that my CPK was “off the charts” and I was to discontinue the Lipitor immediately. In our hospital lab, the normal range for CPK is 80-170. Mine was 906.

After two weeks off Lipitor, my muscle pain disappeared.

I want you to know that I consider your column to be a lifesaver – at least in my case. Thank you.

Dear Reader: You’re welcome. I’m glad I could help.

Just to review the problem, one of the most serious (but uncommon) side effects of the “statin” drugs (prescribed to lower cholesterol) is a condition known as rhabdomyolysis, a breakdown of muscle tissue that can release large amounts of protein into the bloodstream. This protein will damage the kidneys.

At the same time, the damaged muscles also leak an enzyme called creatine phosphokinase, which can be measured by a blood test. In your case, the level was very high, indicating that you were suffering considerable destruction of muscle cells, the cause of your pain.

Although not everyone with muscle damage will have an elevated CPK level, the presence of high amounts is virtually diagnostic of rhabdomyolysis in a patient taking Lipitor or other similar medicines. You were indeed fortunate to have discovered the cause of your muscle pain before your kidneys were permanently harmed.

To give you related information, I am sending you a copy of my Health Report “Understanding Cholesterol.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: My scalp itches intensely. A dermatologist examined me but couldn’t find anything wrong. Could I have something in my scalp that needs to be examined under a microscope?

Dear Reader: Possibly. But if the skin of your scalp appears to be normal – no rash or seborrhea, for example – there may be nothing to examine.

I suggest you seek out another dermatologist for a second opinion.