By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Popular drugs in this class include: Simvastatin (Zocor), Atorvastatin (Lipitor), Lovastatin (Mevacor), Pravastatin (Pravachol), and Rosuvastatin (Crestor)
Statin drugs are pharmaceutical blockbusters, with sales of $17 billion annually. For years, drug makers have promoted them ad nauseam, to doctors and the public alike, in a relentless campaign to portray cholesterol as the bad boy of cardiovascular disease. The industry has poured millions of dollars into studies proving that statins cut deaths from heart attack and stroke—yet half the people who die from heart disease have “normal” cholesterol levels. The truth is, these drugs can be both a blessing and a curse.
Benefits of Statins
Statins can generate large and sometimes phenomenal reductions in cholesterol by blocking the body’s production of it. However, these drugs don’t only lower cholesterol. Statins shine as anti-inflammatories—a benefit that’s often overlooked, but, I believe, the most important. Chronic inflammation is an underlying cause of heart disease. Arteries become inflamed, as does the blood (it becomes thicker), and if you can reduce this inflammation, you can help lower your risk of heart disease.
My position on statins is that they are excessively and obsessively prescribed for lowering cholesterol and under-prescribed for their anti-inflammatory properties. When I recommend a statin, it is not for the purpose of lowering cholesterol, but rather for reducing arterial inflammation and thinning the blood at the same time.
The Downsides of Statins
As I’ve written many times before, the body needs cholesterol to function. It is vital to basic health and human physiology, including the preservation of resilient cell membranes and the production of steroid hormones. Cholesterol is also an agent in the body’s immune system.
I’ve long been troubled by the danger of reducing cholesterol too much, as well as the other downsides associated with statin drug use. Of particular concern is how statins inhibit the body’s natural production of CoQ10, one of the most powerful weapons we have against heart disease. CoQ10 is essential for cellular energy production, which explains why statins can have a negative effect on the heart’s pumping ability. I’ve also seen studies suggesting a greater risk of cancer for people who take these drugs. In women, especially, the use of statins may deplete levels of CoQ10 even further, contributing to a weakened immune system, which could lead to cancer.
Moreover, the body’s cholesterol production pathway is shared by other important biochemicals, which means they, too, are often impaired by statins. This sets up the potential for multiple side effects. Among the most common are muscle pain, headache, nausea, vomiting, diarrhea, abdominal pain or cramps, constipation, gas, and upper respiratory infection. As I detailed in July 2009, statins can also cause amnesia and other mental deficits.
CoQ10 depletion is a serious issue. Studies have shown that those with the lowest levels of this nutrient have a greater risk of congestive heart failure and lower chance of survival. And, as I said earlier, CoQ10 is also vital to the immune system.
Statins can also contribute to vitamin E deficiency, which can lead to muscle damage, nerve problems, infertility, destruction of red blood cells, and anemia. Levels of beta-carotene (the precursor to vitamin A) may also be reduced by statins. Its deficiency can lead to inflammation of the eyes and blindness, increased susceptibility to infections, and loss of appetite.
This is why anyone on a statin must supplement with CoQ10 (100–200 mg daily); vitamin E, in the form of mixed tocopherols (200 IU daily); and beta carotene (7,500 IU daily).
Who Should Take Statins
- Men between age 50 and 75 with a history of heart disease, including blocked coronary arteries, angina, heart attack, and stents.
- Men with low HDL cholesterol—that is, below 30 mg/dL, and particularly below 25. HDL protects against heart disease, and a low level is frequently associated with thicker blood.
- Anyone with a coronary calcium score greater than 200, as determined by electron beam computed tomography (EBCT) scanning, and especially in the presence of high levels of inflammatory mediators in the blood (such as CRP or fibrinogen).
Who Should Not Take Statins
- I don’t recommend statins for primary prevention. Yet, three-quarters of all statin users currently take the drugs for preventive reasons, hoping to avoid a stroke or heart attack. But in a recent meta-analysis of multiple randomized controlled trials, and involving roughly 65,000 people, there was no evidence supporting the use of statins for primary prevention. And as one leading researcher said, the reality for people without heart disease is that the drugs are “more risky than helpful.”
- Except for men with heart disease, I would be particularly reluctant about prescribing statins for the elderly, in whom higher HDL cholesterol levels have been found to be protective.
- I have been disappointed by the lack of effectiveness of statins in women and would not recommend them unless heart disease was progressing at an accelerated pace.
Alternatives to Statins
There are many natural anti-inflammatories that can be used as alternatives to statins. Just to name a few: CoQ10 (100–200 mg daily); curcumin (500 mg daily); nattokinase (100 mg daily); a mixed vitamin E compound (200 IU daily); and fish or squid oil (1 gram daily). And don’t forget what may be the most powerful anti-inflammatory and blood thinner of all: Earthing.
This article originally appeared in the May 2011 issue of Dr. Sinatra’s monthly written newsletter, Heart, Health & Nutrition. HMDI has reprinted this article with permission from Healthy Directions, LLC (© 2011 Healthy Directions, LLC).