Long-term Statin use from a young age, will this affect ATP goals and 1st class medical?

T

Turbo Kid

Guest
So, I'm a student pilot in my very early 20's and I am trying to figure out how to manage my cholesterol. I have been monitoring my lifestyle habits the last decade or so after my father had a heart attack in his 30's and my grandfather had one in his 60's. Both of them have high cholesterol, maintain a good diet and are not overweight. So that leaves me: extremely active, maintaining a healthy diet as preventative, and not overweight. To monitor my risk for cardiovascular issues I decided to go to a Cardiologist for blood work in the end of 2022 (after getting 1st class medical mid 2022) and discovered I unfortunately have high cholesterol. I spent all of 2023 changing even more of my lifestyle eating better, working out more, no drinking/smoking (nor ever have for that matter for personal reasons), and just went back in for blood work again and just got the results back in early 2024 that my levels increased an additional 20 points. I know that I have a few years of 3rd class remaining but would like to renew my first class again sometime this year.

Having said all of that, I am looking for preventative options and everything points me to statins. Is this an issue for maintaining my 1st class medical being on statins and are there any restrictions? Also how do the airlines/ FAA with getting an ATP license view this issue? Also (I know that this is case by case) but has anyone personally had any negative side effects/ experience to statins?

I am open to any suggestions since regardless or not if I continue to fly career-wise unfortunately have to make some changes to be around for a while.
 
I can't speak to your question about FAA medicals directly, but I do have some comments and references for you

Ask your doctor what the absolute risk reduction is that you get from a statin. When they give you some large percentage.... correct them.... you want to know the absolute risk reduction, not the relative risk reduction.

If you are young and highly active, I'm guessing that you are lean. Look up the term "lean mass hyper responder", and see if you fit. You might not exactly fit the numbers criterea if you aren't low carb...but maybe you are that phenotype and your diet just isn't showing it to you yet.

This last video talks a bit about what the lean mass hyper responder is, and is a nice intro to an interesting study. This guy is no slouch. Dartmouth undergrad. Phd from Oxford, and is currently a med student at Harvard. if you really want to geek out,here's his published paper https://www.mdpi.com/2218-1989/14/1/73
 
Turbo Kid said:
So, I'm a student pilot in my very early 20's and I am trying to figure out how to manage my cholesterol. I have been monitoring my lifestyle habits the last decade or so after my father had a heart attack in his 30's and my grandfather had one in his 60's. Both of them have high cholesterol, maintain a good diet and are not overweight. So that leaves me: extremely active, maintaining a healthy diet as preventative, and not overweight. To monitor my risk for cardiovascular issues I decided to go to a Cardiologist for blood work in the end of 2022 (after getting 1st class medical mid 2022) and discovered I unfortunately have high cholesterol. I spent all of 2023 changing even more of my lifestyle eating better, working out more, no drinking/smoking (nor ever have for that matter for personal reasons), and just went back in for blood work again and just got the results back in early 2024 that my levels increased an additional 20 points. I know that I have a few years of 3rd class remaining but would like to renew my first class again sometime this year.

Having said all of that, I am looking for preventative options and everything points me to statins. Is this an issue for maintaining my 1st class medical being on statins and are there any restrictions? Also how do the airlines/ FAA with getting an ATP license view this issue? Also (I know that this is case by case) but has anyone personally had any negative side effects/ experience to statins?

I am open to any suggestions since regardless or not if I continue to fly career-wise unfortunately have to make some changes to be around for a while.
Click to expand...

No, the statins shouldn't be an issue, I would do what your doctor recommends. Hopefully @bbchien or @lbfjrmd will check in with a more official answer concerning the FAA.

I had high cholesterol in my 20s also, my dad died from a heart attack at 51 years old. So I had family history against me too. I did the diet and exercise thing, same result as you. So I chose to listen to the doc and start the Statins. That was about 35 years ago. I have a couple friends, at the same time as me they had same type of cholesterol problems. Both decided they didn't want to be taking meds for the rest of their lives and didn't follow their doc's recommendation. Both have had pretty bad heart attacks, one fortunately got to the ER in time to not have much damage, the other was more severe, fortunately made it through, but is very disabled now. Both take statins now, plus a lot of other drugs. I, knock wood, haven't had any issues. I try to eat right and exercise more than most in my age group. I take my statin every day, and it is no big deal.

Every drug has risks and side effects. It's funny, when the doc prescribed the statin, I was worried. I talked to him about it. He told me those side effects are rare, there are a lot of options, if I have an issue we'll change the statin and work through it. I never had an issue. Keep the lifestyle changes, take the pill, ignore the noise.
 
Brad W said:
I can't speak to your question about FAA medicals directly, but I do have some comments and references for you

Ask your doctor what the absolute risk reduction is that you get from a statin. When they give you some large percentage.... correct them.... you want to know the absolute risk reduction, not the relative risk reduction.

If you are young and highly active, I'm guessing that you are lean. Look up the term "lean mass hyper responder", and see if you fit. You might not exactly fit the numbers criterea if you aren't low carb...but maybe you are that phenotype and your diet just isn't showing it to you yet.

This last video talks a bit about what the lean mass hyper responder is, and is a nice intro to an interesting study. This guy is no slouch. Dartmouth undergrad. Phd from Oxford, and is currently a med student at Harvard. if you really want to geek out,here's his published paper https://www.mdpi.com/2218-1989/14/1/73
Click to expand...
I'm not low carb but very lean and in shape so it is possible, I do see my cardiologist again in a week or so and will inquire about being a lean mass hyper responder. Thank you for the insight, I appreciate it!
 
PaulS said:
No, the statins shouldn't be an issue, I would do what your doctor recommends. Hopefully @bbchien or @lbfjrmd will check in with a more official answer concerning the FAA.

I had high cholesterol in my 20s also, my dad died from a heart attack at 51 years old. So I had family history against me too. I did the diet and exercise thing, same result as you. So I chose to listen to the doc and start the Statins. That was about 35 years ago. I have a couple friends, at the same time as me they had same type of cholesterol problems. Both decided they didn't want to be taking meds for the rest of their lives and didn't follow their doc's recommendation. Both have had pretty bad heart attacks, one fortunately got to the ER in time to not have much damage, the other was more severe, fortunately made it through, but is very disabled now. Both take statins now, plus a lot of other drugs. I, knock wood, haven't had any issues. I try to eat right and exercise more than most in my age group. I take my statin every day, and it is no big deal.

Every drug has risks and side effects. It's funny, when the doc prescribed the statin, I was worried. I talked to him about it. He told me those side effects are rare, there are a lot of options, if I have an issue we'll change the statin and work through it. I never had an issue. Keep the lifestyle changes, take the pill, ignore the noise.
Click to expand...
Definitely good to hear about your long-term success with statins, haven't seen anyone else in a similar situation at this age point personally besides yourself although I know they are out there. While I do know statins are safe, long-term use is my primary focus (as I'm sure it is/was for you) seeing that I hopefully have 60+ years ahead of me. I also appreciate the response, thank you!
 
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