statin

Side Effects of Statins Worth the Cholesterol Reduction?

September 11, 2012 by James Bogash

We’ve been brainwashed to believe that cholesterol = heart disease and thus statins like Lipitor are the answer. But what about the side effects of statins?

I’ll admit it. I’m no fan of the statin class of drugs to lower cholesterol (collective gasp!).

What I will further admit is that I remain absolutely stumped as to why this class of drugs even exists. There are times that I seem to be the sole dissenter and that mainstream medicine puts them in cereal boxes and has them in the candy dish next to the sign in sheet in the office.

Trust me–I’ve looked at the data. Again and again and again. But I just don’t see it.

This particular study should, yet again, put things into perspective. Given the recent concerns that the statin class of drugs increases the risk of diabetes, researchers looked at the risk / benefit of statins with the risk of diabetes in mind.

Here’s what they determined:

In those with 1+ risk factors for diabetes, statins gave a 39% reduction in a cardiovascular event
A 17% reduction in dying
A 28% increase in diabetes

Putting this into perspective, this resulted in:

134 vascular events or deaths avoided
54 new cases of diabetes diagnosed

Keep in mind that, in the Jupiter trial that was reviewed here, almost 2/3 participants were already at risk for diabetes. However, the researchers did NOT include those with an HDL : triglyceride ratio > 3, which may have sent the number of participants at risk much higher.

The percentage numbers above are relative numbers, not absolute reductions because the absolute numbers are not so fantastic.

So, following the absolute numbers of statin effectiveness, we treat 1,000 people for 5 years and we have 11 less cardiac events, but about 4.5 new cases of diabetes (who will likely later die of cardiovascular-related complications).

This is considered good medicine and is the best that cardiology has to offer for “prevention.”

Prevention is no way, shape or form should increase the risk of ANYTHING. In contrast, true preventative measures would cut across disease labels to lower the risk for EVERYTHING.

To offer a drug…worse–to spend tens of billions of dollars annually–that has such a paltry effect at preventing something while almost half the numbers “saved” will get another dangerous diagnosis is just plain ludicrous to me.

But maybe I’m just overly sensitive.

So what have you done to successfully lower your cholesterol?

Drug to Lower Cholesterol Drug Can Destroy Your Brain

June 27, 2012 by James Bogash

I’ll admit it. I’m no fan of drugs to lower cholesterol. 30+ blog posts on the topic should convict me. But linking statins to dementia is new news even to me.

To understand this association, there are two things you need to understand.

First, statins like Lipitor, Crestor and Zocor block an enzyme called HMG-CoA reductase. This is the enzyme that produces cholesterol in our bodies. However, this enzyme also produces a tiny little compound called Coenzyme Q10.

You may have heard of CoQ10 before because it is absolutely essential to make energy in every one of our cells. CoQ10 has been shown to play a role in various chronic diseases and conditions. They may include:

The other factor to understand for this post is that Alzheimer’s disease is associated with the presence of two abnormal proteins in the brain, called neurofibullary tangles (NFT) and amyloid plaques (AP) made up of tau proteins. It is pretty clear that these proteins are the result of damage to the brain, rather than creating the disease.

So, we can understand that anything that increases the production of tao protein is probably not a good thing.

By now, you can probably guess what prescription medication was shown to increase the production of tao protein in this particular study.

Yep.

The statin class of drugs was shown to increase the presence of tao protein. If you combine this fact with the well accepted fact that statins reduce blood levels of CoQ10 and CoQ10 plays a distinct role in Alzheimer’s disease progression, you can see a serious problem here.

The bottom line? Lowering your cholesterol with statins may make your cholesterol levels look better, but the list of problems this class of drugs contributes to get longer all the time. This leaves lifestyles changes as the only viable option.

If you are taking statins to lower your cholesterol, tell me some concerns you may have over the long term damage that may be occurring…

Cholesterol High? If You Take Lipitor, Then You Need to Know This

June 19, 2012 by James Bogash

Statins are drugs used to lower cholesterol numbers. Lipitor, Crestor and Zocor are just a few. They are given out like candy. But just how well do they work?

Lipitor was the first drug to ever break $20 billion in annual sales. Make no mistakes, this class of drugs has been one of the most successful financial windfalls that the pharmaceutical companies have ever experienced, with Pfizer leading the pack with Lipitor sales. And well it should, because it cuts heart attack rates by 50%.

I would imagine that, for the uninformed doctor who does not read medical literature, a 50% reduction in the rates of heart attacks in his or her patients sounds like a great idea. No wonder it’s sitting on the checkout counter right next to the mints.

But, let’s look at this from another angle. Let’s say there’s a very rare type of cancer that attacks the tip of the pinkie. 2 people in the US get this cancer every year. Windfall Pharmaceuticals develops a drug that can lower the rate of the cancer every year. But you have to treat everyone in the US who has a pinkie to see this benefit. So, we treat some 300 million people for years and years to prevent a single case of pinkie cancer per year.

For those of you good with math, this is a 50% reduction.

Kind of sucks for the 299,999,999 other people who won’t actually get a benefit, especially when their is a very long list of side effects associated with this particular medication. Windfall Pharmaceuticals, however, could not be happier.

So back to the statin story.

We have already established that statins cut the rates of heart attacks by 50%. But this is the RELATIVE risk, not the ABSOLUTE risk. The absolute risk refers to how many actual people will be saved from having a heart attack when a group of people take a statin. The numbers may surprise you.

The most recent numbers are highlighted in this particular study. When 1,000 patients with high cholesterol are treated with a statin for 5 years, a mere 11 heart attacks will be avoided. Doing simple math, this equates to a cost of some $$3,650,000 to prevent 11 heart attacks, or $331,818 per heart attack prevented.

So, for those of you who think organic food and a gym membership is expensive, I’m thinking that $66,364 per year will buy a lot of produce and your own personal trainer (and chef, for that matter) to come 3 times per week.

The real kick in the gluts is the article’s conclusion, which states, “This benefit greatly exceeds any known hazards of statin therapy. Under present guidelines, such individuals would not typically be regarded as suitable for LDL-lowering statin therapy. The present report suggests, therefore, that these guidelines might need to be reconsidered.”

Basically, this panel thinks we need to stop giving statin pills and just dump the stuff in the water supply because we aren’t using it enough. I’m not sure what fairy tale would they happen to be living in, but I’d place some bets on what type of companies they own stock in.

This, of course, takes none of the side effects of statins into account, which have gotten quite lengthy, and can include:

Potential increase in the risk of cancer
Increased risk of chronic muscle diseases
Problems with the functioning of the heart
Reduction in cognitive function
Increases the risk of your muscles melting, a condition called rhabdomyolosis
Increases risk of long term muscle damage, even after discontinuation
Nullifies–YES, nullifies, the positive effects of exercise on the heart

So, the next time your doctor suggests you should take a statin, ask him or her for 5 solid recommendations to help you lower your cholesterol naturally. (For a pretty solid list, check my recommendations) Then, ask him what the absolute risk reduction would be for you.

If either of these answers fall short, maybe it’s time to find a new doctor.

What have you done to lower your cholesterol naturally?

Can Your Cholesterol Drug Destroy Arteries?

May 14, 2012 by James Bogash

Your doctor checks your cholesterol and it comes back high. You try walking around the block for 2 days and cutting back from 7 days to 6 eating McDonalds. Alas…it does not work. You can almost feel your arteries harden. Medication is the ONLY answer to your plight. Cholesterol drugs protect the arteries, right?

The clear answer to this question is….Maybe.

Regular readers of the Rantings know how little of a fan I am of the entire statin class of drugs. Clearly, this class of drugs, for primary prevention of deaths related to heart attacks, is just a hair above worthless. If they didn’t have a long list of potentially fatal side effects and cost the healthcare system 10’s of billions of dollars per year AND they’re weren’t more effective alternatives available (Dr. Dean Ornish proved that lifestyle could reverse plaquing in the coronary arteries in the 70’s), then their paltry effectiveness wouldn’t be a big deal.

Back to the issue at hand. Will this class of drugs protect my arteries?

I guess it just depends. On what, you ask? It’s not really a question anyone can answer right now. What we can say, from this particular study, is that half show some very mild improvement in blood vessel diameter (3.2%) while the other half show larger losses (-5.3%) in the diameter of the blood vessels.

So it’s basically a crap shoot until researchers can spends hundreds of millions of research dollars to figure out who gets better and who gets worse, keeping in mind that “better” translates into a negligible improvement in overall mortality rates. Sheeeeezzz…

Called me biased, but wouldn’t the right lifestyle changes to pull back from diabetes and improve your entire lipid blood panel be a safer, cheaper and better idea??

BENEFITS ARE EQUAL WITH DIET AND DRUGS – (03-06-05)

May 10, 2012 by James Bogash

Direct comparison of dietary portfolio of cholesterol-lowering foods with a statin

Hmmm…over a quarter of the patients in this study achieved BETTER lowering with the diet. All patients benefited at least as well with the diet as with the drug. So, the benefits are equal–why not just take the drug? Simply because the dietary intervention has also lowered the risk for any number of other chronic diseases.

The statin drug has just effected cholesterol (and even this is questionable for lowering risk of cardiac deaths) and may actually INCREASE your risk of other diseases by lowering CoQ10 production.

Read entire article here

PAINFUL COMBINATION – STATINS FOR CHOLESTEROL AND ARTHRITIS

May 3, 2012 by James Bogash

I just left a meeting where I found out one of our members had been hospitalized for kidney failure following rhabdomyolysis (muscle damage). The first thought to pop into my mind was statins. This may or not have been the case, but it is a well known association with taking statins to lower cholesterol.

Since their introduction, the statin class of drugs (think Lipitor, Crestor) has been on a pedestal. By 2003, Lipitor was the best selling drug in history. Just like every drug, the statin class of drugs has a dark side and contributes to conditions such as muscle damage, heart damage, liver and kidney problems, diabetes and cancer.

The sad part about all this is that basically, statins absolutely suck at preventing a first heart attack (the data is somewhat better for 2nd heart attacks, but still trumped by dark chocolate…). There is no other way to describe it. I have review the absolute effectiveness of statins in previous posts. Compare this to the effects of natural approaches:

The bottom line is that statins are a very ineffective at preventing a first heart attack (overall, lowers absolute risk of having a heart attack about 1%, the risk of dying from a heart attack even less) and there are natural approaches that are much more effective and safer and cheaper. Worse, there are side effects that are high prevelant and occasionally life threatening.

However, if none of the above side effects really concern you, here’s a new one to add: Damaging rheumatoid arthritis.

In this particular study, researchers found a strong association (absolute 7.3% increase–that means an extra 7 cases of RA for every 100 patients treated with statins) between statin use and rheumatoid arthritis. Keep in mind that RA is one of the most debilitating forms of arthritis.

All because of the use of a drug that will make your numbers look better, but don’t actually fix anything. Lifestyle is the ONLY thing that can do that.

STATINS PRODUCE MORE HARM THAN GOOD

July 12, 2011 by James Bogash

It should come as no big shock that I am certainly not an advocate of the statin class of drugs to lower cholesterol. There are many reasons why I am so vehemently opposed to the use of this drugs. How could this be, when it cuts the risk of a cardiac event by 50%??

For primary prevention (meaning we are trying to prevent a first heart attack), in almost all studies I’ve read, regardless of what value you look at (cholesterol, hsCRP, LDL), a statin will cut the RELATIVE RISK down by 50%. If you are a physician that does not understand research and take the drug company’s headline as gospel, this seems like a godsend. Every patient walking through the door is going to get their blood pressure checked and get a prescription for a statin, thinking that you are doing wonders for your patients.

However, before we jump up and down in excitement, we need to understand relative vs absolute risk. In most of the studies, the numbers are pretty consistent. Treat 100 people for 3 years and, instead of 2 people having a heart attack, only 1 does. The RELATIVE drop from 2 to 1 is a 50% reduction and sounds great. But since the overall risk is pretty low in this population (typically referred to as a 10 yr risk), the absolute risk reduction is a paltry 1%. This flat out sucks.

There are some lifestyle interventions or supplements that fall into the same category. The relative risk reductions may appear more powerful than if you put it into absolute risk reductions. Here’s the difference. Statins are very expensive (although with the loss of the patent on Lipitor the prices will drop substantially) and have a long list of side effects. Muscle damage (the damage is present even if someone taking statins does not have muscle pain). Depletion of CoQ10. Probably the greatest scare is the increased risk of diabetes.

But, the biggest, staring you right in the face, answer is that I have NEVER not had a patient bring their cholesterol levels in line with the right lifestyle choices. This is and will always be the only appropriate way to handle lipid issues. The vast majority of patients with lipid (total cholesterol, triglycerides, HDL, VLDL) problems are pre-diabetic. So giving these patients a drug that will worsen the physiological state that is making the number off kilter is just plain bad medicine.

http://jama.ama-assn.org/content/305/24/2556.abstract