Statins - villan or hero?
Are you already taking statins? Know someone who does? Been recommended that you need to? Are you just curious?
There is a LOT of controversy about Statins. My aim with the following is to simplify the main information that I have found from current, and I believe, reliable sources. I understand that the topic is ‘hot’ and widely debated and also extremely confusing for us plebs out there, which is why I wantedto research this for some clarity about the basic premise. Do we need Statins? Are they evil? What are they really for?
Explaining cholesterol is out of the spectrum of this brief blog. I am currently working on a cholesterol blog, till then please search on the net or blow your mind with an extraordinarily detailed explanation of cholesterol from go to woe with Dr Peter Attia here.
So what are Statins?
Statins are a group of medications that have been created to help lower cholesterol for those with heart disease. These are some common ones
- atorvastatin (Lipitor),
- fluvastatin (Lescol, Lescol XL),
- lovastatin (Mevacor, Altoprev),
- pravastatin (Pravachol),
- rosuvastatin (Crestor),
- simvastatin (Zocor),
- pitavastatin (Livalo).
Side effects
- Headache
- Nausea vomiting
- Constipation
- Diarrhoea
- There are also severe side effects associated with the liver, although they are rare.
When are you prescribed them?
Traditionally Statins were prescribed for those who had had a heart attack, stroke, athlerosclerosis, genetic disposition or whose LDL levels were in the dangerously high category. The controversy and outcry seems to have started when many countries decided to make it standard that anyone with a family history of heart disease were offered it even if their LDL C and triglyceride levels were low, or anyone who’s LDL had reached a point that was considered upper normal previously. So from about 190 mg/dl (8-9 mm) to anyone over 130 mg/dl. A handy reference range is here
What does a Statin actually do?
In a nutshell, Statins lower LDL and decrease general inflammation. The jury is still out whether its the LDL lowering effect or the anti-inflammatory effect that has the benefit. Regardless, we know they work. LINK
Thats it, case closed
Well…. kind of….
As in the beginning of this post I listed several of the Statins available, there are many options and they are stronger, weaker, and have different effects with different people, so you may need to try several before you find one that works with you.
So, yes they do lower LDL, in particular, they predominantly lower the larger particles of LDL in cholesterol, not so much the smaller particles.
One of the most important numbers to have taken if you suspect you are at risk, is the NUMBER of LDL particles the are being transported. These particles are different sizes and the smaller ones tend to be cleared less by the body and seem to be the ones that cause trouble. However, this is not entirely proven, as smaller particles also tend to at the same time to increase the number of LDL particles in the cholesterol. As you can imagine, you can fit a lot more smaller objects in an area than you can larger. Like a jar with tomatoes, when thats full, you could fit some cherry tomatoes and increase the overall tomato number.
So Statins clear more of the larger particles which has an overall effect of lowering the LDL particle numbers , and thats very important as is the anti-inflammatory affect.
The troublesome part of statins is that they lower cholesterol synthesis in other parts of the body Cholesterol is vital for the production of hormones, such as sex hormones, vitamin D, cortisol. No cholesterol, no life. This is why you would want to use a statin only if you were in the high risk group and not necessarily if you didn’t have those risk factors
When should you question it?
World expert Dr Ronald Krauss has been leading many studies for decades on statins, heart disease and factors that will lower them. His opinion is that people are put on statins too prematurely and that possibly is why there is suddenly studies showing increases of diabetes and Parkinson’s for those who take statins long term.
In a nutshell, if you have LDL below 150 and have had no history of heart disease, perhaps this is the time to question Statins and get your LDL particle number measured.
If you are in the extreme level of LDL, high blood pressure, previous heart disease history, then it would appear statins are a good option. The fact is that they lower LDL in general and that has been conclusively proven to lower your risk and at this point, that is the most important thing.
Are there other options for the established high risk person?
(I MUST reiterate that I am no doctor. Ask your doctor about anything you are thinking of trying and please heed their advise. Heart disease is extremely complicated and individual, some work well with one thing, some with others)
- To minimise risks of heart disease and if you not already at risk or if you are right in the middle of the risk zone and had had an episode already, so …. all of us, then a healthy diet filled with whole unpackaged foods and daily exercises will definitely be of benefit. Unfortunately, as we have found after the egg cholesterol myth was busted, diet has a small impact on cholesterol levels. Diet alone will not be enough to lower substantially the LDL level in those that have established heart disease. That said it WILL improve your life and health in other ways that are extremely important. Exercise also will not fix a high LDL, but it will help your health tremendously. The healthier your lifestyle is, the better you will live. I think thats really what we all want. A decent age but to be healthy, happy and vital to the end and not crawling slowly to the finish line.
- Dr Peter Attia will sometimes put his patients on a PCSK9 inhibitor instead of statins
- Niacin is also sometimes prescribed as it has a cholesterol and triglyceride lowering effect while preserving HDL.
- Bergamot is an interesting one. It lowers cholesterol while preserving HDL as well. This doctor has used it successful in conjunction with statins
If you are on Statins
I’ll assume you have established a diagnosis of heart disease.
- There seems to be a high blood sugar side affect in statins that could lead to diabetes. A whole foods diet is important. One that focuses on protein, certain fats and vegetables for the majority of your intake will keep these levels lower. Bitter melon is a superb extract you can get at health food stores. Take 2 with food and it will work to stabilise your blood sugar (do not take this if you are on blood sugar lowering medication). Exercise is particularly useful to balance blood sugar levels and a casual stroll after your biggest meals is perfect to keep the levels down, not to mention its fabulous for digestion, casual though, not a power walk!
From: https://www.drcolinobrien.ca
- Keep the healthy fats up! Statins effect on lowering cholesterol has ramifications for the vital role cholesterol plays in making our hormones. We need cholesterol to live and function.
- Have a look at the Mediterranean diet, there's good research out there that indicates that is helpful.
- Dr Krauss has lead some research on a high fat diet that has been efficacious
- Take a liver supplement with milk thistle to help the liver process the statin and cholesterols. Great supplement, we should all take that, a general detox to keep our liver as clean as possible.
- There's been talk of CoQ10 and Vitamin K2. Statins can lower our amounts of it. Jarrow CoQ10 has been tested and has been given the tick for delivering what it says, 200mg is good. Plus a good K2 supplement, around 180mcg.
- It can affect the production of Vitamin D, so supplementation is useful and can mitigate the muscle weakening effects in many.
- Another reason for exercise. Statins can cause muscle wasting. Counter act that with a good strength program (you are never too old for this!)
Useful Tests
- Ask your doctor for the LDL-P NMR test or information on it if you are interested. This is not a free test. We priced it recently at $180 AUS. However, if you see your LDL is not extreme and you are otherwise healthy and relatively lean, this is a worthwhile investment to make.
- Get regular ALT tests to ensure the liver is coping with the medication
- Get a regular blood glucose test to keep a check on the levels
- Regular checks of Vitamin D levels
I hope you feel a bit more certain about Statins. I certainly do. Before I had looked into this properly, I was definitely on the “statins are dangerous, bad, evil” bandwagon. Knowing some people going through this has made me look deeper and I am so very grateful for that. Its been a good reminder to keep reading, never assume you know, and check all sides of a tale. Statins I feel, have their place when your health is seriously at risk. They don’t take the place of a healthy diet and lifestyle, they work together, and by keeping an eye on how your body is responding to them with regular tests and inner checks, you should avoid much of the down sides.
If you want help with a diet and exercise plan that will work well with your health situation please contact me. I can create something for you or help you implement what you have been advised to do. You don’t have to go through that uncertain how to activate a plan like that, I can help you. If I can’t, be assured I shall let you know and recommend you to others. Your health is the most important thing you have, you are IN CONTROL!
Cheers for now! :-)
Good Podcasts to listen to
Let me know if you come across others that are particularly relevant