Are statins safe?
The concern is that they affect the steroid synthesis pathway, and people worry that reducing the throughput of that pathway would put kids at risk for growth abnormalities, either pubertal or developmental. We don’t have any evidence to support this, but we should use them with patients who are extremely affected with high LDL levels. The concern is that doctors will start putting all overweight kids on statins instead of working with them to change their diet and exercise. In fact, most overweight kids have high triglycerides, not high LDL, and statins are not the drug of choice for hypertriglyceridemia. We use statins for extremely resistant cases where there is an underlying genetic or familial propensity in addition to the lifestyle issues. If a patient is on statins, what should doctors monitor? There’s a risk for elevations in the liver function tests, alanine aminotransferase and aspartate aminotransferase and risk of rhabdomyolysis, or less severe muscle side effects. Our prac
