Patient may need to stop taking Zocor

Dear Doctor: I am 82 and recently have been diagnosed with inclusion body myositis. I have been on Zocor for more than 15 years. Do you think the statin could be a cause of this disease? I don’t know whether to continue taking it. My doctor is vague about this. — D.A.

Inclusion body myositis is a relatively rare disease, only a few new cases per million people per year. It is most common in older men. It begins slowly, with weakness that is hardly noticeable at first, and most people have symptoms for more than five years before getting a diagnosis. It tends to affect the legs first, with gradual muscle atrophy. It also may affect swallowing muscles.

Treatment is with prednisone or other steroids, and possibly with more-powerful medicines such as methotrexate and azathioprine. The response to treatment often isn’t as good as we would hope.

Statins do not cause inclusion body myositis. Two medicines, colchicine ( for gout) and chloroquine (malaria and some rheumatologic conditions), can cause a condition that looks like inclusion body myositis.

All statin drugs may cause muscle weakness or inflammation, which would affect you more severely than others.

I would consider why you are taking the Zocor. If you have NOT had a heart attack or do not have known blockages in your arteries, I would think about stopping. Don’t stop without talking to your doctor. Dear Doctor: I have a question about vitamin D-3 pills. How does 400 mg fit into such a tiny pill? I also thought you needed sunlight to make vitamin D. — A.S.

Four hundred milligrams is very small. Most of the tablet isn’t even vitamin D — it’s starch and other materials to hold the tablet together.

Skin does make vitamin D-3 from precursors, in the presence of sunlight. Several factors affect this process. During winter months at moderately high latitudes (above the line from Los Angeles to Atlanta), the sunlight might not be strong enough to efficiently convert enough vitamin D, so many are deficient in the vitamin D in winter.

People who don’t go outside, who usually wear clothing and hats or who have darker skin are less able to create vitamin D. People over 70 also are less able to make their own vitamin D. There is controversy about whether supplementation will improve overall health. Dear Doctor: Years ago, I was told that eating raw carrots and fresh spinach improves vision.

Is there truth to this? If so, why am I afflicted with macular degeneration after having eaten these for a long time? I also have taken vitamins for 10 years to preserve vision. Do these have justification? — Anon.

Fresh vegetables with beta carotene and certain multivitamins and minerals have been shown to slow the effect of age-related macular degeneration.

It may be that you would have got macular degeneration both sooner and more severely had you not had a healthy diet and taken the vitamins.

Unfortunately, we don’t know of any preventive, nor any treatment that is 100 per cent effective.