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Ask Dr. Gott 12/03
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   DEAR DR. GOTT: About three years ago, my doctor put me on Zocor for high cholesterol (225). Taking the Zocor reduced my cholesterol to 154. After about six months on the Zocor, I started having pain in my upper-arm muscles, just below the shoulder. I told him about it, and he said all I had was bursitis and walked away without doing an exam. Now the pain is also in my other arm and at the bottom of my neck on one side. It’s difficult to turn my neck either way. On top of this problem, I also have developed a strong odor to my urine, but its color is normal. I asked him if he thought this was caused by the Zocor and he said probably.
    At 76, I’m on Diovan and Zocor. Do you think the Zocor could be causing the muscle pain and urine odor? Should I seek a second opinion?
    DEAR READER: To answer your question, I must first ask a few. First, why were you put on a cholesterol-lowering medication? A cholesterol of 225 for a man of (then) 73 is normally nothing to worry about. Simple diet and exercise could have lowered it to below 200, but, as I have said before, cholesterol levels above 200 are common and often harmless in the elderly. However, if you have a history of heart disease, stroke or other cardiovascular disorders, I agree that using statins to lower your cholesterol was the right decision.
    Statins are notorious for the side effects of muscle pain and weakness. However, this is usually generalized, not specific to small areas. This is not to say that your muscle pain isn’t caused by the Zocor. From your description, the pain seems to be localized only in your neck and shoulders. I believe this is more likely to be caused by arthritis in your neck, spinal problems such as a herniated disc or the result of immobility caused by the original shoulder pain. This simply means that the injury to your arm and shoulder could have caused the the pain in your other arm and neck because the muscles have degraded from lack of use. Pain in a shoulder can be the result of a torn rotator cuff, ligament problems or even arthritis.
    You need imaging studies (CT scan and MRI) of your neck, shoulders and upper back to rule out these problems. See an orthopedic specialist for this testing and further examination. In the meantime, discontinue the Zocor (after speaking with your physician).
    As for the urine odor, this can be caused by something as simple as eating more garlic, onions or other strong-smelling foods. This is not a hazard to your health, but if you are concerned, ask your physician for a urine culture or for a referral to a urologist, who can help you further.
    To give you related information, I am sending you copies of my Health Report “Understanding Cholesterol” and “Bladder and Urinary Tract Infections.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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