Are Statins Evil?

Don’t hate me, however I take statins on the advice of my doctor. This isn’t a suggestion that it’s best to, however that is my story and my clarification for why I do. 

I not too long ago posted on my social media that I had elevated my statin dose from 20 mg to 40 mg. I did this to help my longevity targets. I used to be stunned by the variety of unfavourable reactions I acquired. From the responses, one would have thought that I used to be going to drink gasoline!

Earlier than I talk about why I made a decision (with my physician’s help) to up my statin dose, I’ll talk about why this dialog is related. The primary reason behind mortality worldwide and within the US is heart problems (CVD). (1) Most cancers is a distant second. So, if we will perceive the causes of CVD and use this understanding to assist us mitigate the dangers why shouldn’t we?

Based on the Heart for Illness Management, a very powerful danger components for heart problems are: hypertension, elevated low-density lipoprotein ldl cholesterol (LDL-C), diabetes, smoking and secondhand publicity to smoke, weight problems, poor weight loss plan, and lack of bodily exercise. (2)

Though I’ve by no means smoked or had hypertension and have good physique composition, train extensively and eat effectively, I’ve had excessive LDL-C ranges all through a lot of my grownup life. Earlier than therapy, my LDL-C ranges averaged round 140 mg/dl and peaked at 180 mg/dl. 

Twenty years in the past, I resisted the recommendation of my docs to take a statin to decrease my LDL-C to below 100 mg/dl. Like many others, I didn’t need to take a drug that might have unfavourable unintended effects. I believed that my elevated excessive density lipoprotein (HDL-C) was defending me.

Ten years in the past, I reluctantly started taking 5 mg of simvastatin each day. Ultimately, based mostly on the pleading of my physician, we elevated the dose to 10 mg. At 10 mg, my LDL-C averaged 120 mg/dl. Just a few years in the past, I elevated the dose to twenty mg with none noticeable unintended effects. This lowered my LDL-C to 100 mg/dl.

Based mostly on my present understanding of the analysis, the choice to delay therapy and begin with a low dose had been in all probability not the most effective decisions. 

There may be compelling proof, and far of the medical group agrees, that an elevated LDL-C is a major contributor to heart problems. A 2017 meta-analysis revealed within the European Coronary heart Journal got here to the next conclusion:

Meta-analyses (of over 200 research) involving greater than 300,000 members and 80,000 Coronary Coronary heart Illness (CHD) circumstances present compelling proof that LDL-C is causally related to the danger of CVD (heart problems) and that the causal impact of LDL-C on CVD is essentially impartial of the mechanism by which LDL-C is ‘lowered’.

The article goes on to elucidate that lifetime publicity to elevated LDL-C is a causal part of heart problems. (3) Due to this fact, the sooner the therapy is began, the higher.

Moreover, the speculation that prime ranges of HDL-C is protecting towards CVD has not confirmed to be true. Examine after examine has did not validate that greater ranges of HDL-C present safety towards CVD. (4) (5) (6)

There are numerous pharmaceutical choices for reducing LDL-C, every having totally different mechanisms of motion, doable unintended effects, and prices. Probably the most generally used medication are statins, Zetia (Ezetimibe) and PCSK9 inhibitors. (7)  Statins have been round for over 30 years and now generics can be found and inexpensive. PCSK9 inhibitors are newer medication and are dearer however can be found when different choices don’t work. 

Statins work by blocking an enzyme that synthesizes ldl cholesterol within the liver. Usually the liver synthesizes and deposits ldl cholesterol inside provider proteins that transport the ldl cholesterol particles from the liver to different components of the physique by way of the blood stream. It needs to be said that ldl cholesterol is a essential part of the cell membrane (cell wall) of cells and likewise serves as a precursor of varied necessary hormones. 

The issue with LDL ldl cholesterol particles is that the ldl cholesterol in LDL particles can adhere to the outer membrane (wall) of blood vessels within the coronary heart (and different locations within the physique) and type plaques which may result in narrowing of the vessels and ultimately partial or full blockage of blood circulate.

The usage of statins has saved many lives. Jennifer Robinson, a doctor, professor of epidemiology within the College of Iowa School of Public Well being, and co-author of a examine that studied lipid (fats) reducing and cardiovascular outcomes decided that, yearly, 1000’s of individuals with excessive LDL-C who take statins are spared a untimely loss of life. (8)

The principle concern I had, and that many different folks have, is the potential unintended effects of statins. The most typical aspect impact reported is muscle soreness. Based on the Mayo Clinic, roughly 5% of sufferers on statins will expertise this aspect impact. The Mayo Clinic additionally lists different doable unintended effects together with danger of diabetes, liver injury and neurological issues.

One respondent to my submit on social media commented that inside days of beginning a statin they skilled important muscle soreness. On this case, the answer is simple sufficient. Cease taking the statin however don’t surrender on treating elevated LDL-C. Zetia can also be low-cost and has proven to be efficient in many individuals.

There are docs who recommend statin unintended effects happen at greater charges and are harsher than being reported. Dr. Aseem Malhotra is one such physician though I’ve not seen any proof supporting his claims. (9) It’s noteworthy that many individuals in double blind trials report having muscle soreness when they’re taking a placebo and never the precise drug. 

One other argument I’ve heard towards LDL-C therapy is having a zero or low calcium rating. A calcium rating is a take a look at that estimates the quantity of calcification within the coronary blood vessels. It’s used as a short-term, two- to five-year, predictor of cardiovascular occasions. You will need to perceive {that a} calcium rating of zero doesn’t essentially point out wholesome arteries. (10) There can nonetheless be important injury and irritation to the arteries even with a calcium (CAC) rating of zero as proven within the following diagram.

Picture from the 2021 paper, “Coronary Artery Calcium Rating – A Dependable Indicator of Coronary Artery Illness?”

Given my historical past, my physician and I made a decision to be extra aggressive and get to the 70 mg/dl or decrease degree for LDL-C. Accordingly, I elevated my dose to twenty mg of Atorvastatin twice a day. Doses of as much as 80 mg per day are generally utilized in follow. 

Since my purpose is to stay a protracted and wholesome life and to not essentially to be drug-free, if medicines, backed by science, might help me obtain my purpose then by all means I’ll use them. Statin medication may be an necessary device for many individuals and subsequently statins will not be the boogie man and will not be evil. 

Keep in mind that you alone are accountable for your well being. If you wish to stay a protracted, wholesome life and have no idea your LDL-C degree, I urge you to get examined quickly. Getting the blood take a look at is simple and low-cost. In most states you may order it your self with out having to undergo your physician. With the suitable knowledge and data, you may communicate together with your physician extra knowledgeable and be within the driver’s seat in terms of your well being and how you can finest obtain your well being targets. 

Written by Greg Damian: I’m a 60-year-old writer, motivational speaker, well being and health disruptor and a coach. My e book, Abs at 60: The 4 Steps to Look and Really feel Youthful at Any Age was not too long ago launched on Amazon. My mission is to assist 5000 folks shed weight or to appear and feel youthful. I do that by making use of my 4 step DOLR(TM) system that’s described within the e book. Every chapter has a set of questions so that you can reply. You may obtain a free workbook that features all of those questions at www.absat60.com

Written by Greg Damian. Edited by Mark Chavez MD, AKA The Well being MD. Well being Teaching and Concierge Doctor training “Objective Directed Well being and Longevity Drugs.” Inventor of The Gravity Ball Technique of Grip-Free Resistance Train. Writer of the e book The 5 Habits of Wholesome Individuals. 

References

  1. https://www.who.int/news-room/fact-sheets/element/the-top-10-causes-of-death
  2. https://www.cdc.gov/chronicdisease/sources/publications/factsheets/heart-disease-stroke.htm
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5837225
  4. https://www.hsph.harvard.edu/information/options/why-good-cholesterol-may-not-always-be-good
  5. https://www.jacc.org/doi/10.1016/j.jacc.2022.09.027
  6. https://www.nih.gov/news-events/nih-research-matters/when-hdl-cholesterol-doesnt-protect-against-heart-disease 
  7. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013
  8. https://now.uiowa.edu/2018/04/ui-study-statins-save-lives-people-high-levels-bad-cholesterol 
  9. https://doctoraseem.com/the-great-statins-divide/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723785


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