Cholesterol and Statins – The Good, the Bad, The TRUTH

-It is impossible for a man to learn what he thinks he already knows
                                                                             -    Epictetus


Cholesterol - a substance that we are all familiar with as a major risk factor for heart disease, or not? The allegation of cholesterol as an evil villain has been preached to us on numerous occasions over the past 50 years. The evidence directly implicating cholesterol as a major cause of heart disease, when critically examined, does not stand up to scrutiny. This Lipid/Cholesterol hypothesis is a faulty dictum brought to us primarily by Ancel Keys, PhD., in the early 1950’s and has been propagated ever since. Many studies   have demonstrated no statistically significant correlation between fat and cholesterol intake and heart disease, yet we continue to use the Cholesterol/Heart Disease hypothesis as a basis for recommending medical treatment to lower cholesterol levels and prevent heart disease. Did you know that 50-75% of people who have a heart attack have “normal” cholesterol levels?


Cholesterol is an important and ubiquitous substance in the human body and is responsible for many vital functions. Cholesterol is a major component of every cell in the body and is a critical substance in the brain, as 50-60% of the dry weight of the brain is composed of cholesterol.  Cholesterol is utilized by the body to produce important hormones, such as testosterone, estrogen, cortisone, vitamin D and others – all critical to optimal function. Cholesterol is required by the liver to produce bile, which digests fat. Adequate cholesterol levels support the immune system in the fight against both infection and cancer. Of particular importance, cholesterol is the key substance found in the insulating/myelin sheaths of our nerves and brain.


These many functions demonstrate why cholesterol is a vital component to an optimally functioning body. When we artificially lower our cholesterol levels, particularly with statin medications, we risk damage to all of the above systems. The focus on cholesterol as a major cause of heart disease has, in many ways, distracted us from fully focusing on some of the more important causes of heart disease, our lifestyle and dietary choices. Inflammation plays a significant role in heart disease, and things that increase systemic inflammation, such as poor food choices, smoking, diabetes/insulin resistance, inactivity, elevated homocysteine levels, high blood pressure and stress, may be bigger factors in heart disease than high cholesterol.


We live in what could be categorized as a “one disease, one drug” culture. Many of us accept the false dogma that health comes in the form of a pill that we take each day. Forget lifestyle modification; there’s a pill we can take to make up for our wrong choices. Thoughts like these are in many ways responsible for a number of illnesses we’re currently dealing with.


Statin medications, successful at lowering cholesterol levels, are one of the accepted current treatments of choice for prevention of heart disease.  However, many of the studies “proving” the benefit of statins rely on statistical manipulation to prove value in the treatment or prevention of heart disease. Even the package insert for the very medicine being used to “prevent” heart disease states that statins do not reduce all cause mortality. This means that statins do not increase lifespan when compared to placebo. Statins may slightly decrease the risk of heart disease, but if, as research shows, their use contributes to the development of another disease, it becomes a zero sum game. Why replace one disease for another when the ultimate final outcome is no different?


If  told that patients taking a statin drug resulted in 2 people in 100 having a heart attack over a 3.4-year period and patients not taking a statin drug resulted in 3 people in 100 having a heart attack over the same 3.4-year period, those odds wouldn’t impress anyone as very favorable. Yet, according to the way the statistics are reported, this represents a 33% reduction in cardiac risk (1 divided by 3) according to the researchers. A 33% risk reduction sounds significant, but what this really means is that 1 person out of 100 taking a statin over a 3.4 year period was spared a heart attack compared to those not taking a statin over that same time period. Not as impressive or convincing as stating a 33% reduction in cardiac risk.


The number needed to treat (NNT) is what should be considered when looking at the usefulness of statins or any drugs. The NNT tells us how many people need to be treated with a drug to help just one person. As in the case above, the NNT for heart disease prevention is 100 people being treated for 3.4 years to prevent one heart attack as compared to doing nothing. In essence, 99 other people are taking the same drug and facing the health risks and expense from taking the drug, with no benefit for themselves. The risk/benefit ratio needs to be considered in the use of these drugs. In other studies, it has been shown that it would take 250 people that are low-risk for heart disease, taking a statin for 5 years to prevent 1 heart attack, according to the NNT.


The true, primary treatment indication for the use of statin medications is for the treatment of middle-aged men under the age of 65 who have cardiac disease or have had a heart attack. Statins have not been found to be useful for primary prevention of cardiac disease and have demonstrated no benefit in reducing all cause mortality in those without a previous history of heart disease. The benefit of statin use in women is even more questionable. Extrapolations are made as to the benefit of statin use for primary prevention of heart disease, but a recent thorough review by the highly regarded Cochrane Collaboration concluded that statin drugs show no benefit for heart disease prevention among those without diagnosed heart disease, a serious statement considering their many noted side effects.


With the trumped-up benefits of cholesterol-lowering medication, one would think that there would be substantially more clinical benefit than what the actual numbers show. There have been over 900 studies demonstrating the risk and adverse effects of statin drugs, yet they are frequently handed out like candy, some authorities have even recommended putting them in the water supply or giving them to children!  Statin drugs can lead to diabetes, significant muscle aches and pains, muscle destruction, peripheral neuropathy, increase in liver enzymes, lowered immune response, increased cancer risk, erectile dysfunction, heart failure, depression, and dementia (and many others). Many of the above symptoms are associated with the aging process and we accept them as such. The statement has been put forth that stains accelerate the aging process.


Vitamin D and especially CoQ10 depletion are two of the nutrient deficiencies associated with statin use. CoQ10 is a key nutrient that powers our muscles and keeps them functioning well. The organ with the highest concentration of CoQ10 in the body is the heart. It makes no sense taking a drug to “protect” our heart that depletes the very source of energy that the heart relies upon for function. It should come as no surprise that an increasing number of cases of congestive heart failure are seen in those who have been on long-term statin treatment.


The value and importance of cholesterol in the human body cannot be overlooked. Diet has little to do with cholesterol levels, other than the fact that increased carbohydrate intake is associated with higher small or bad LDL particle production, the form of cholesterol most frequently associated with heart disease. 75-80% of the cholesterol in our bodies is made by our body and only 15-20% is related to dietary intake. Many studies have failed to directly correlate dietary intake with total cholesterol levels. Some studies have even demonstrated a lowering of cholesterol levels with increased cholesterol consumption. I am not recommending that you eat poorly, as there are many mechanisms by which diet creates disease. I am pointing out that cholesterol levels are not linearly correlated to dietary fat consumption.


An elevated cholesterol level is not necessarily a disease state unto itself, but more than likely a symptom of metabolic derangement in the body. Blaming cholesterol for heart disease is like blaming a scab for the wound it is covering or blaming a fireman for the fire he has come to extinguish. Cholesterol is found at the scene of the crime but is not the guilty party. Inflammation, from one source or another, is what must be identified; cholesterol is just cleaning up the mess as a biological bandage.


 The currently recommended cholesterol guidelines are not based on a particular scientific study, but on the consensus opinion of 9 physicians, 8 of whom have ties and have received payment from the drug companies that manufacture statins. Science should not be about consensus but about facts. When presented with “scientific evidence” of the significant benefit of statins, it is always worthwhile to investigate the funding source of the studies cited. It is amazing to note the positive correlation  between statin benefit and industry involvement/financial support of the study and its authors. Bias is rampant in industry funded/coordinated studies (as opposed to independently funded studies) and in my opinion, seriously damages and taints the results of these studies. If you are told you have to get your cholesterol level below 200, you will not be able to find a scientific study supporting this specific recommendation (it’s a consensus statement). Current guidelines make patients out of an estimated 40 million or more people who, prior to the new recommendations, were considered healthy. In essence, a majority of the population now requires “treatment” for a “disease” they didn’t even know they have.


In closing, I realize this information will likely shock and annoy some, but presenting the other side of the story on the data that is available on this topic is important. Are there studies to refute what I have written above? Sure there are. Are there studies to support my line of reasoning? Most certainly there are. I do not ask that you take my word for it, but I also ask that you do not take anyone else’s word either, unless they have done the research and have no vested interest in the current dogma.


Controversy abounds on the topic of cholesterol and heart disease, so please reflect on the above information and investigate with an open mind. There are many paths to cardiovascular disease beyond cholesterol and these too must be considered in the overall picture.  I suggest reading The Cholesterol Delusion, by cardiologist Ernest Curtis, MD, or Ignore the Awkward by Uffe Ravsnkov, MD, PhD. Spacedoc.com is also a great resource for further research.






The comments in this article are my thoughts and opinions based on my reading of the medical literature. They are no substitute for consultation with your own physician and should in no way be construed as medical advice. The decision to start, continue or discontinue any drug regimen is a serious one and should be a decision made after careful discussion with your own physician.




Looking at things through an unfiltered lens,




Chris




http://www.greenmedinfo.com/print/blog/consumer-alert-300-health-problems-linked-statin-drugs?utm_source=www.GreenMedInfo.com&utm_campaign=f5d1625d85-Greenmedinfo&utm_medium=email


http://www.huffingtonpost.com/jacob-teitelbaum-md/statins-cholesterol_b_910841.html


http://www.proteinpower.com/drmike/statins/statins-and-diabetes/#more-4789

http://www.spacedoc.com/