Statins are not the Answer.

With all due respect to practitioners who are practicing by the book, I would like to express my extreme frustration with said “book”.

The tides have officially and indisputably turned regarding cholesterol’s role in heart disease. The three important take-home facts are:

1. Dietary cholesterol does not have a long-term impact on serum cholesterol levels.
2. Neither dietary cholesterol nor saturated fat cause heart disease.
3. Certain types of dense cholesterol molecules can cause disease, but they are best treated by decreasing intake of refined carbs (flour & sugar), slow-release niacin and/or lifestyle/mental-emotional changes.
4. Bonus fact: Humans have been eating cholesterol for millennia without ill effect, but the same can hardly be said of refined flours, sugars and vegetable oils.

What conclusion do those facts point to with neon-light intensity? The necessity for statins does not match the enormity of their use. The only population for which there’s even a smidge of evidence that statins are helpful is middle-aged men who either had a heart attack or have documented heart disease.

Why is statin use a problem?

The drug has been associated with some serious side effects. Statins block the production of HMG-CoA reductase, an enzyme that kicks off downstream production of cholesterol, as well as a bunch of other important biochemicals. This stream is called the “Mevalonate Pathway,” pictured to the right.

Documented side-effects include

–> 1) Diabetes. Now, how’s that for a side effect? The FDA has required that a warning about this association be added to the drug label. This is a big deal since, in my opinion, the FDA is really far behind on a lot of equally-important details.

• It’s not officially known why statins cause diabetes, but some believe it’s because statins decrease the body’s production of “prenylated proteins.” (Middle circle on the bottom of the Mevalonate Pathway.)
• A detailed description of that potential connection is here.
• More about diabetes and blood sugar here.

–> 2) Depletion of CoQ10 (middle circle on the bottom of the Mevalonate Pathway).

• Coenzyme Q10 is required by every single cell in the body to allow mitochondria to produce ATP, which is used for energy.* What cells sweat harder than heart cells? …Well, some liver cells actually do, but the heart works very hard and needs that ATP!
• Less ATP = less ability to do work = less oxygenation of body tissues = necrotic tissue & inflammation = bad news.

*Red blood cells do not have mitochondria and, therefore do not make ATP, but they may use CoQ10 for something else!

–> 3) Impaired memory,aka “transient global amnesia.

• An agile memory requires a healthy brain, and guess what the brain is partly comprised of. Guess… cholesterol!
• Add this to the fact that many people limit eggs and other animal products because of the cholesterol those foods contain… guess what these foods also provide. Vitamin B12, which is necessary for the formation of myelin sheaths, which insulate nerve cells and allow them to fire.

–>4) Muscle degeneration, aka rhabdomyolysis. Some doctors say they can tell who’s been on statin drugs for a while just by watching them walk. Often the calf muscles are the victims of statin-induced muscle damage. This condition results when the muscles literally fall apart. Breakdown products of muscle are really hard on the kidneys and can cause kidney failure. Rhabdomyolysis can be caused by many different things, including physical trauma (including from extreme exercise) and infection. A tell-tale sign is brown urine, but it does not occur for all affected people.

Statins do confer a benefit for some people… but not from their interference with the body’s production of cholesterol! What statins seem to offer is an anti-inflammatory effect (by inhibiting NF-kB). However, statins aren’t the only thing that can lower inflammation! There are plenty of natural solutions to inflammation that lack serious side effects:

• Hydration with clean water with a pinch of sea salt (for those few who are not salt-sensitive)
• Plants like nettles, turmeric, black cumin seed oil and boswelia serrate. (But don’t take these every single day for the longterm. Three days on and three or four days off is a good policy, otherwise they will begin to have a negative effect.)
• Proper balance between omega 3 and omega 6 fatty acids (decrease vegetable oil and supplement with anchovies, sardines or fish oil supplements)
• Low-refined-carb diet (decreased flour and sugar, consistent intake of high-quality, clean protein)
• Avoiding nutrient deficiencies with a lab test.
• Mindfulness practices, such as meditation and being hyper-aware of gratitude.

So, then with what claws are statin drugs still clinging to our doctors’ consciousnesses, posturing in their treatment protocols and scratching themselves onto prescription pads? Fear. Fear, and the difficulty/inconvenience of diet, lifestyle and metal-emotional change.

• Doctors should know better, but should their patients be expected to doubt their validity and double-check their advice? Even if someone does branch out and do their own research, the majority of any Google searching will produce conventional advice that runs counter to the more enlightened, cutting-edge, scientifically-based information upon which this blog post is based.
• To learn the truth, patients must know where to find it! Or, they will learn it through an informed friend/loved-one… or maybe even by overhearing strangers talk about it in an elevator.
• As doctors’ patients become better informed and learn the backstory, which I’ve tried to provide above, they will refuse to participate in the statin ruse and will let their bodies celebrate their Mevalonate Pathway like it’s 2999– I just hope it doesn’t take that long…

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Want some practical information so that you can take action?

How to test for cholesterol:

1) Run multiple tests. The values measured by lipid panels will vary because the physiological processes they measure are dynamic. Therefore, before getting freaked out by your numbers– and especially before taking any drug-related action, you should wait a couple weeks and run the tests again.

2) Don’t buy into the ranges suggested by the labs! Work with a practitioner who has a handle on the reality of cholesterol and who does not have a trigger-happy statin-prescribing finger.

• The suggestion that normal total cholesterol is between 100 and 199 mg/dL is out-of-the-park INSANE. The only reason I can think of that people okayed that range is that they, themselves have cholesterol levels of between 100 and 199… or they’re on the statin payroll.
• A total cholesterol level lower than 250 has been associated with mental health disorders such as, mild to severe depression, suicide, poor impulse control, schizophrenia, bipolar disorder, aggression and general, no-good, criminal behavior (see references below). Cholesterol down, road rage up? …Something to think about.
• …And don’t even get me started on the suggestion of some to give statins to children, who need cholesterol to build their brains and eyeballs, and create hormones, which direct their growth and maturation!

3) Consider digging into your cholesterol values a little more deeply. A couple tests are available that measure your lipid particle size. The smaller the cholesterol molecule, the more dangerous it is. For example, high numbers of a low-density LDL should create zero concern, whereas higher-density molecules would warrant further investigation.

• Some say these labs are not helpful because they differ each time you take them and can be replaced by simple questions about your health history. But, if your insurance company covers it, more info used in the context of your entire health picture can’t ever hurt!
• A Lipid Particle Profile (LPP) measures various different subsets of cholesterol. You can get the supplies for this test kit during your nutrition session at BuzzNutrition.
• A Vertical Auto Profile (VAP) is something your doctor can order for you– or you can order it yourself through a site like, DirectLabs.com (search for “VAP”).
• If low-density cholesterol is found to be an issue, statins are not the answer! There is no link between statins and a decrease in this type of cholesterol (called Lp(a), “el pee little a”). Rather, decrease in refined carbs and/or no-flush niacin are the ways to go.

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My two cents on statins

With no disrespect to any doctor who is trying their best to help their patients: using a statin to force total cholesterol lower than 250 mg/dL, in anyone other than a older man with confirmed heart disease, is malpractice. The anti-inflammatory benefits that statins confer are not nearly worth their side effects, especially since so many natural substances and food/lifestyle choices are safely anti-inflammatory. Furthermore, treating so-called high cholesterol without seeking out the root cause is against the Hippocratic Oath to “do no harm.” High cholesterol is an indication that there is inflammation in the body. The body makes cholesterol to lower inflammation and protect from its damage. It’s like a healing salve. Forcing the body to stop making cholesterol removes its ameliorative effects PLUS does nothing to solve the fundamental problem. Without addressing the root cause, the fire will continue to burn and the body will continue to suffer.

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References

These excellent articles by Chris Kresser provide general backstory, studies and explanation of why cholesterol and saturated fat do not cause heart disease:

• The Diet-Heart Myth: Cholesterol and Saturated Fat Are Not the Enemy
• Three reasons why you should be skeptical of the new cholesterol guidelines
• Study reveals doubt on cholesterol drug
• Why you should eat more (not less) cholesterol
• A free eBook about cholesterol and heart health

 Regarding the connection between cholesterol and mental health (gleaned with gratitude from robbwolf.com):

• Horsten, Myriam (1997).  Depressive Symptoms, Social Support, and Lipid Profile in Healthy Middle-Aged Women.  http://www.psychosomaticmedicine.org/content/59/5/521.long
• Steegmans, Paul (2000).  Higher prevalence of depressive symptoms in middle-aged men with low serum cholesterol levels.  http://www.psychosomaticmedicine.org/content/62/2/205.full.pdf+html
• Morgan, R.E. (1993).  Plasma cholesterol and depressive symptoms in older men.  http://www.sciencedirect.com/science/article/pii/0140673693925569.
• Bjorkhem, Ingemar (2004).  Brain cholesterol: Long secret life behind a barrier.  http://atvb.ahajournals.org/content/24/5/806.short
• Shrivastava, Sandeep (2004).  Chronic Cholesterol Depletion Using Statin Impairs the Function and Dynamics of Human Serotonin 1A Receptors.  http://pubs.acs.org/doi/abs/10.1021/bi100276b.
• Reese, Jordan (2008).  Penn Biophysicists Create New Model for Protein Cholesterol Interactions in Brain and Muscle Tissue.  http://www.upenn.edu/pennnews/news/penn-biophysicists-create-new-model-protein-cholesterol-interactions-brain-and-muscle-tissue.
• Fantini, Jacques (2009).  Sphingolipid/cholesterol regulation of neurotransmitter receptor conformation and function.  http://www.sciencedirect.com/science/article/pii/S0005273609002971
• Shin, Yeon-Kyun (2009).  Cholesterol, Statins, and Brain Function: A Hypothesis from a Molecular Perspective.   http://www.ibc7.org/article/journal_v.php?sid=31.

• Also, this one from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/expert-answers/cholesterol-level/FAQ-20057952