Cholesterol and Statin Drugs - Post 16

First I want to start out by saying I am not a doctor and I am not making a diagnosis or treating any medical condition. I am not suggesting that anyone stop any medications they are currently taking without consulting with their physician first.
The intent of this discussion is for educational and informational purposes only.
Centuries ago there was some excellent advice given to physicians that bears repeating now:
“The physician is only the servant of nature, not her master.
Therefore it behooves medicine to follow the will of nature”

Paracelsus 1493-1541
How ironic is it that medicine has forgotten this sage advice. Now, at the first sign of elevated cholesterol instead of turning to nature to try to find out what is causing the elevated cholesterol. Medicine takes the easy way out and immediately prescribes a cholesterol lowering drug. As you will see in the following discussion, when confronted with higher than normal cholesterol the body is trying to tell us something is wrong.  With this in mind let’s discuss cholesterol does in the body and what statins do in our bodies.
Several enzymes are involved in your body that are used to produce cholesterol. Cholesterol is a necessary compound in our bodies. We cannot live without cholesterol. It is found in every cell membrane in the body.
Cholesterol is used by the body to produce the adrenal hormones; testosterone, progesterone, estrone, DHA, and cortisol just to name a few. When these hormones are out of balance you get autoimmune disorders, fatigue, fibromyalgia, chronic fatigue syndrome, low libido, cancer and more. Also when they are out of balance it can cause allergies, asthma, blood sugar problems, inflammation, reproductive problems and more.  Our bodies must maintain the proper balance of all these hormones to function optimally.
Several factors can cause the hormone system to become out of balance. Primarily these include poor diet, vitamin and mineral deficiencies, environmental toxins and adverse drug reactions.
What happens when the hormone systems are out of balance? Thankfully, when we were designed we were equipped with the ability to compensate for this so we can continue to live. For instance if we have a deficiency in one of these critical hormones the body detects the deficiency then it signals to increase the production of the compounds that are needed to produce the hormone and in this case that compound is cholesterol.
When the healthcare professional does the blood test to detect cholesterol levels they see the increase in cholesterol. They then immediately start treating it with drugs to get the cholesterol back down to the “normal” range without ever trying to figure out why it was elevated in the first place. We use a drug to lower the cholesterol back down, this then causes the body to not be able to correct whatever hormone deficiency that triggered the increase. Without correcting the deficiency our bodies then begin to exhibit the different medical problems discussed earlier.
What does cholesterol do in the body? Is cholesterol the villain? Is cholesterol so bad that even healthy people need to take cholesterol medications to get their numbers down even lower?
Cholesterol is needed to maintain a healthy immune system and to maintain an optimally functioning hormone system.
There are five major functions of cholesterol in our bodies.
1.    Cholesterol and Vitamin D
Cholesterol is used to make vitamin D. Without adequate levels of cholesterol we become vitamin D deficient. Everyone knows that vitamin D is important for our bones but it is also critical to maintain a well functioning immune system.
Vitamin D deficiency has been linked to many cancers including breast, colon and prostate cancers.
There have been numerous reports in the media lately about the deficiency of vitamin D. Of course they always mention the fact that we no longer get adequate amounts of sunshine to produce vitamin D naturally. What they fail to mention is that sharp increase in the use of cholesterol lowering drugs has also lead to an increase in vitamin D deficiency.
2.    Cholesterol is necessary for mineral absorption and digestion of fats
Cholesterol is the main ingredient in bile salts. Fat absorption is not possible without bile salts. This then leads to a deficiency of all the fat soluble vitamins; A, D, E, and K. Once again these deficiencies lead to many medical conditions.
3.    Cholesterol is part of every cell of the body
Trillions of cells use cholesterol to build their structure. It is the “glue” that holds the lipid layers together. It gives the cell membrane the strength it needs. Without it the cells become leaky and this leads to chronic illness and cancer
4.    Cholesterol and the nervous system
It is needed for the myelin sheath that covers all nerve cells. It is important for memory function. It is the main organic molecule in the brain.
Brain fog is very common in people with low cholesterol levels.
It is also important for neurotransmitter function including serotonin. Low cholesterol levels inhibit serotonin receptors.
5.    Cholesterol and Immune System
It is necessary for the immune system to fight infections. Inadequate cholesterol levels in men have been associated with lowered levels and responsiveness of immune cells. Fewer circulating lymphocytes, total T-Cells and Helper T-cells.
Now that we have established how critical cholesterol is to our overall health and we have established that elevated cholesterol is a sign of other medical conditions that need to be addressed let’s look at what statins do and don’t do.
The drug manufactures would like us to think that lowering our cholesterol protects us against heart disease. They bombard us and the doctors with drug reps, fancy New York ad campaigns, and important sounding studies all claiming that lowering our cholesterol lowers are risk of heart attacks. The wizard of oz looked important too until the curtain was pulled back. Let’s look behind the curtain at the research and see what is really true.
If reducing cholesterol levels lowers the risk of heart disease you would assume that people who lower their cholesterol levels will live longer compared to those who do not lower cholesterol levels. The most important statistic of any study is the mortality rate – how many are alive at the end of the study.
Let’s take a close look at the mortality rate of the five studies cited by the American Heart Association.
1.    Heart Protection Study (2002) Over 20,000 adults in UK age 40-80 who were at a high risk for heart disease were followed for 5 years.  They were divided into 2 groups. A placebo group and a group getting simvistatin 40mg/day. At the end of 5 years the placebo group had an 85.4% chance of survival. The statin group had an 87.1% chance of survival. That is not even a 2% difference. In fact the Doctor involved in the study wrote “Low cholesterol concentrations have been related to depression, cognitive impairment, and suppression of the immune system. Does a reduction of 1.7% in mortality balance these risks?” Funny that wasn’t mentioned by the American Heart Association.
2.    Prosper (2002) 5804 adults were examined to look at the effect of pravastatin versus placebo in the risk of developing heart disease and stroke. At the end of the 3 year trial the placebo group had 89.5% alive compared to the treatment group of 89.7% alive. That is only 2 tenths of a percent difference. This is not even statistically significant. As a side note cancer was significantly increased in the treatment group.
3.    ALLHAT (2003) 10,355 adults over 55 were randomized to receive either pravastatin or usual care (which means diet and lifestyle changes). At the end of 6 years 84.7% of the “usual care” group was still alive compared to 85.1% of the statin group. That is again less than 1% difference. Not statistically significant.
4.    ASCOT-LLA 19,342 high blood pressure patients between 40 and 79 with risk factors of cardiovascular disease. The statin group in this case did have reduce the number of cardiac events compared to the placebo group however at the end of 3.3 years 95.9% of the placebo group were still alive compared to 96.4% of the statin group. Only ½ % difference.
5.    PROVE-IT 4,162 patients who had a heart attack or angina were given either Lipitor or Pravachol. In this study there was no placebo group. The absolute reduction in death of Lipitor was 2.2% versus 3.2% from Pravachol.
So when we look at these studies the reduction in the risk of death was insignificant. Does this insignificant change in death rate warrant the increased risks of side effects from statins?
Let’s look at some other studies and what the outcomes of low cholesterol compared to higher cholesterol was:
  • In women of all ages and men over 55, higher cholesterol levels may actually result in a decreased mortality (Q J Med 2003;96:927-34)
  • One study showed that in the elderly female, a lower cholesterol level (less than 155mg/dl) was associated with  5.2 times higher death rate as compared to a woman with a cholesterol level of 272mg/dl (Lancet 1:868-870. 1989)
  • Breast cancer rates in humans that took statins were shown to increase by 1,200% (relative risk)
  • JAMA reported on a study of 5,170 subjects taking a statin versus 5,185 subjects treated with "usual care" (lifestyle changes) found that the statin did reduce cholesterol however (not widely reported) the mortality rate between the 2 groups was nearly identical (so why take the statin with all its side effects) also the coronary heart disease rates were not different between the control group and the statin group (JAMA Dec 18, 2002 18;288:2998-3007)
  • The Framingham study (one of the longest ongoing studies on heart disease) reports after 30 years of follow up, there is no increased overall mortality with subjects with high cholesterol for those over 50. Furthermore, researchers reported that FALLING cholesterol levels were found to increase the cardiovascular death rate - a 14% increase for every 1mg/dl drop in cholesterol. (JAMA Vol 257. No 16, 4.24.1987)
  •  A study of 11,563 subjects found that those with cholesterol below 160mg/dl had 49% increases in all-cause mortality as compared to those subjects with a cholesterol level over 160mg/dl. Non cardiac death increased 2.27 times in the low cholesterol group compared to the control group (Eur Heart Journal 1997 18, 52-59)
  • In 977 elderly patients (>70 y/o) studied, researchers found no correlation between elevated cholesterol levels and increases in mortality from coronary heart disease, all-cause mortality or hospitalization from heart attacks or angina. (JAMA Vol 272 No 17 Nov 2, 1994)
  • Studies have found a correlation with low cholesterol levels and increased risk of mortality from cancer of the lung, liver, pancreas and bone marrow as well as increased risk of death from respiratory, hepatic and digestive disease (Arch. Intern. Med 192;152. 1490=1500)
  • A study of 5,491 men aged 45-68 y/o found that falling cholesterol levels from 180-239mg/dl down to less than 180mg/dl were associated with a 30% higher risk of all-cause mortality and a significant increased risk of death from cancers of the esophagus, prostate, and bone marrow (Circulation 1995;92:2396-2403)
So as seen above the overall mortality rate of taking statins compared to placebo is insignificant. Further the increased risk for mortality from other causes is increased in the lowered cholesterol group. So what exactly does statins do and why does it seem to decrease cardiovascular events?
What are the side effects of Statins?
1.    Muscle Pain and weakness. This is the most common side effect. The drug manufactures report that it occurs 1-5% of the time but I believe this is much higher because I see patients in my pharmacy complaining of this almost on a daily basis.
Why does this happen?
When we block the production of cholesterol with a statin drug we also block the production of a very important co-enzyme. CoQ10. Co-enzyme Q10 is used in the energy production inside of every cell in the body. So when the cells are depleted of this energy source we get fatigue. The cells that comprise the most used muscles in the body are the ones that are affected first. Of course we see this as pain in our arms and legs but there is one muscle that is used even more. In fact this muscle never rests. Of course I am talking about our heart. When muscle pain and weakness occurs our doctors get concerned because they know it can quickly lead to death.
2.    Body aches and Pains these pains are probably related to CoQ-10 as well. The body aches and pains usually go away after the statin drug is discontinued
3.    Heart Failure About 50% of people with heart failure will die within 5 years of their diagnosis. It is the most common reason Medicare patients are admitted to the hospital. An East Texas Medical Center studied 20 healthy patients with normal cardiac function. After 6 months on Lipitor 66% developed problems with diastole—the filling phase of the heart cycle. It is the same problem that congestive heart failure patients experience. They concluded that the statins dose-related depletion of CoQ10 was the culprit.
4.    Brain Fog and Dementia Over 50% of the dry weight of the brain is made of cholesterol. The elderly are even more sensitive to decreased cholesterol levels. Cholesterol levels <150mg and="" brain="" cholesterol="" compared="" consistently="" dementia="" dl="" exhibit="" fog="" higher="" levels.="" p="" those="" to="" with="">5.    Cancer All cholesterol drugs have been associated with an increased rate of cancer. Multiple studies have shown that statins have caused cancer in mice. As mentioned above, breast cancer rates in humans have increased 1,200%. Since none of the studies have lasted long enough to determine the exact rates. When you think about what statins do to cholesterol levels and you look at what deficiencies of the different hormones cause, it is easy to see why there is an increase in cancer among those with cholesterol lowered by statins.
6.    Depression There are numerous studies that show a connection between low cholesterol and depression. This is easily understood when you consider that blocking cholesterol production affects the adrenal hormones as well as serotonin receptors. Both conditions have the effect of causing depression.
Do Statins Prevent Heart Attacks?
Well studies have shown that statins do decrease the risk of heart attack. You know what? So does aspirin. In fact a study was conducted that compared those taking statins to a group taking an aspirin a day. This study showed that statin drugs did not reduce cardiovascular events any more than aspirin. What is up with this one? Well it appears that statins not only reduce cholesterol but they also reduce inflammation just like aspirin. It is the reduction of inflammation that appears to have the cardio protective benefits. But with all the potential side effects of cholesterol why risk it when you can achieve the same outcome with aspirin. This is where I think the drug manufactures begin their deceit. Since they cannot sell an expensive new drug to reduce inflammation when aspirin does the same thing for a lot less money, they have created a whole new problem, high cholesterol. They can then patent a whole new class of drugs and treat a whole new condition when in reality it is not the cholesterol that is the problem it is actually inflammation and inflammation can be reduced with a $3 bottle of aspirin not a multi-billion dollar drug.
No wonder our health care system is going broke.
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