Are your Anti-cholesterol Drugs Compromising your Energy Levels?

The Technical Bit

Anti-Cholesterol drugs such as statins reduce your cholesterol by slowing down the production of cholesterol by the liver.  They do this by interfering with the action of a key enzyme, HMG-CoA-Reductase.  Cholesterol production is not fully blocked nor is the production of other substances that are derived from the same pathway, such as steroid hormones and vitamin D.

Close up of a Statin tablet – the controversial cholesterol lowering drug.

Because cholesterol synthesis is reduced, the liver takes up more cholesterol carrying LDL particles from the blood. The net result is a reduction in circulating LDL-cholesterol (bad cholesterol).

Statins also help to stabilise the fatty plaques (fatty deposits or atheroma) within the lining of the arteries. This is why people who are at high risk of heart disease or stroke or who have diabetes, may be prescribed a statin even if they have a normal cholesterol level.

There’s no doubt that a healthy lifestyle helps lower cholesterol. The question is whether it can lower your levels enough – and that depends on how high your levels are and what your doctor has set as your goal.

Eating a heart-healthy diet can lower LDL cholesterol at least 10%. If you lose 5% to 10% of your body weight, you can cut LDL cholesterol 15%, and reduce triglycerides 20%. If you exercise at a moderate intensity — meaning you have enough breath to talk but not sing — for at least 2 ½ hours a week, you can further cut triglycerides 20% to 30%. (Exercise can also increase your HDL, the “good” cholesterol.)

That’s a great start, says Michael Miller, MD, director of the Centre for Preventive Cardiology at the University of Maryland Medical Centre. “Lifestyle changes certainly are the cornerstone of cholesterol reduction.”

So does taking a statin mean you can sit on the couch and eat bacon all day?

Of course not. Doctors say the best way to protect your heart is to make healthy lifestyle changes while taking a statin. I say the best way is to make healthy lifestyle changes and avoid the statin unless you are diabetic or have recently had an acute cardiac event.

Potential Side Effects

If you look at the medicine supported websites you’ll see the following:

Like many pharmaceutical drugs, statins can have body wide side effects and may also interact with other medicines you take.  potential side effects can include:

• More common: Headache, GI problems, muscle and joint aches, or rash
• Less common: Memory loss, mental confusion, high blood sugar, and type 2 diabetes
• Very rarely: Muscle or liver damage
• Nevertheless, much is left to be understood and accomplished because approximately 60% of patients treated with statins did not have a beneficial reduction in CV events. 

MY VIEW

Did I just hear that right? 60% of people on statins get no benefit from reduction in heart attacks! I wonder what the figures are for reduction in heart attacks by adopting a healthier lifestyle. When you consider that 9% of people on statins will get adverse effects on every cell in their bodies. This is due to a reduced ability to release energy from the mitochondria (the powerhouses of the cell) due to the reduction of Co-Enzyme Q10. This is well documented to adversely affect muscle, but it can also lead to fatigue of nerves too. However some studies have found that Statins may help improve dementia. These studies however are not high quality and further research is needed. (3)

When I see data like that and patients who are stiff and ache all over I begin to question if this reliance on statins is worth the loss of quality of life for at best a 40% reduction in CV events. I also wonder why time and time again patients who are on statins don’t get advised to take Co-enzyme Q10 when statins adversely affect your ability to produce energy through the inhibition of Co Q10.

Here’s another little known fact. After a year of taking Atorvastatin any increase in HDL (the good fat) is gone and in fact a reduction in the good fat from the starting baseline is often found. It is also noted that the first dose is the most effective, subsequent increases in dose have a much reduced benefit at 6% reduction in LDL as opposed to around 50% for first intial dose.

If your GP recommends that you go on a statin and you have struggled with commonly associated significant stiffness aches and pains; there are alternatives available. Colesevalam is a statin that works more specifically at a “gut level”, so does not produce side affects of  muscle and joint pain and stiffness. It can for some however cause constipation and flatulence. So neither is perfect but may be a more favourable solution. It is however much more expensive that a generic statin.

Here’s a viewpoint from a GP;

http://www.theguardian.com/commentisfree/2014/jul/18/statins-gp-vested-interests-nice-drug-company-heart-attacks

The important bits: Nice (the National Institute for Health and Care Excellence) has issued guidance that proposes reducing the cardiovascular primary prevention risk threshold – the level of risk at which statins can be prescribed – from 20% to 10%. In other words an increase in prescribing of statins.

In May 2014 a national conference of general practitioners passed a unanimous motion calling for Nice to recommend such changes only on the basis of a full disclosure of trial data. This was followed in June by an unprecedented open letter to Nice (click link to read) from a number of senior doctors and academics expressing four main areas of concern: medicating healthy people; non-disclosed side-effect data; relying on industry-funded statins trials; and conflicts of interest within Nice.

My View;

There needs to be more transparency with respect to statins. Eat a diet high in good fats and lower in bad fats. There is plenty of info out there and we will add some suggestions in the near future.

1. A viewpoint on statin effects – benefits and problems Thomas F Whayne, Jr, MD PhD FICA Int J Angiol. 2008 Winter; 17(4): 178–180.

2. Coenzyme Q10 and statin-related myopathy. Drug Ther Bull. 2015 May;53(5):54-6. doi: 10.1136/dtb.2015.5.0325.

3. Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects.Swiger KJ¹, Manalac RJ, Blumenthal RS, Blaha MJ, Martin SS. Mayo Clin Proc. 2013 Nov;88(11):1213-21. doi: 10.1016/j.mayocp.2013.07.013. Epub 2013 Oct 1.