The Scary Scoop Behind the Statin Controversy

statinsIf your doctor has or, in the future, prescribes statin drugs for you, we urge you to read further. First off, we are not doctors and hold no special expertise in medicine or, more specifically, the use of statins. Recent announcements regarding new guidelines for prescribing statin drugs raises some serious red flags about which you should be aware if you take or are considering taking any statin medications.  If you are on the verge of starting a statin drug regimen, please make no mistake about this: making a decision to take statin drugs is a serious one that should be undertaken with caution because:

  • Statins have to be taken continuously; you won’t get “cured” and you likely won’t be able to get off them;
  • Statins are not cheap;
  • Statins can cause side effects, one of which is an increased risk of diabetes.
  • Statin drugs are very controversial in the medical and natural-healing worlds because there are reasonable alternatives;

Generally speaking, statin drugs reduce low-density lipoprotein (LDL), also known as “bad” cholesterol.  However, high LDLs are sometimes due to genetics and in such cases are not an indicator as to whether you are at risk for heart disease and stroke. Many health experts maintain that changes in lifestyle (exercise and diet) can reduce cholesterol more effectively with few, if any, side-effects.   However, statin usage has been clearly tied to persistent muscle pain and increased risk of diabetes.

Statins May Not Be As Effective As Advertised

Anywhere from 50 to 200 healthy people need to take a statin daily to prevent a single heart attack for five years, so even small harms may outweigh the potential benefits.  One recent study suggests that perhaps 15 to 20 percent of older adults should be taking statins – far less than the 30 or 40 percent suggested by current medical guidelines.

Statins Have Undesirable Side-Effects

Side effects attributed to statins include: insomnia, muscle pain and an increased risk for type 2 diabetes

Moreover, 12-20% of patients will suffer from various muscle and organ problems.  And, perhaps most importantly, if you are 50 years old or younger and are prescribed statins,  be aware of the fact that there is no authoritative study of statins’ long-term effects.  You are playing Russian Roulette with your life if you begin a statin regimen in your early or mid-life years.

Seniors generally derive very little benefit from statins — they should likely avoid them unless they’re experience severe heart disease.

Frighteningly, statins have also been linked to polymyalgia rheumatica, a debilitating muscle disease that no one should have to experience.   Yet, this condition is viewed by many in the industry as a direct reaction to statins.

Why MDs Like to Prescribe Them

Doctors often cite some  statins guideline changes announced in 2013.  They were crafted by a set of health professionals who are tied to the pharmaceutical industry.  They are extremely controversial because elements of these guidelines appear not to be well-supported by science. And some very knowledgeable people have raised alarms about the guidelines.  Our concern:  the medical industry is increasingly interested in reducing costs.

Treatment of stroke and heart disease is VERY expensive.   Statin drugs present a very lucrative opportunity for the industry to reduce its costs.    The economics are compelling, as noted in a number of studies.   But the economics for the patient may not be well served:  it is far cheaper to eat red yeast rice and increase exercise than to become dependent upon a fairly expensive drug.  Statin drugs cost about $100 per month — apples are about one-fifth that cost.

Additional Tests To Take Before Taking Statins

Total cholesterol is NOT an effective gauge for heart attack risk. Before agreeing to statins, what you need is a complete picture of your risk for heart disease, heart attack or stroke.   Dr. Andrew Rubman recommends that before agreeing to a statin regimen, you should have your doctor take these additional tests:

  • Test for fatty-acid balance: The balance of fatty acids, such as omega-3 and omega-6, affects cholesterol and triglyceride (blood fat) levels and is important for heart health.  This test shows whether dietary adjustments are needed to improve fatty-acid balance.
  • Statin-induced myopathy genotype test: Statin drugs, prescribed to reduce LDL cholesterol, sometimes cause statin-induced myopathy—muscle aches, cramps and in rare cases a life-threatening condition of severe muscle breakdown called rhabdomyolysis. This test looks for a gene that increases the risk of statin-induced myopathy by up to 17-fold.
  • Prediabetes Assessment: This assessment uses a patient’s blood glucose level along with height, weight and certain medical history information to predict the patient’s 10-year risk for developing type 2 diabetes. Since diabetes is a direct contributor to heart disease and inflammation, identifying a patient’s diabetes risk (and reducing it if necessary) is an important part of protecting heart health.
  • HDL Map Test: HDL is not all “good”—there’s a kind of HDL called apoA-1 that is associated with lower cardiovascular disease risk and a kind of HDL called prebeta-1 that is associated with higher cardiovascular risk.  This test helps estimate disease risk far better than knowing just the total HDL number…and helps doctor and patient determine a treatment strategy and track how well it’s working.
  • Test for cholesterol balance: This measures markers of LDL cholesterol that can determine whether cholesterol-lowering drugs are likely to be effective for the patient.

These tests are available through a number of diagnostic labs, including Boston Heart Diagnostics in Framingham, MA.

Better Alternatives to Statins?

Apples.  That’s not a typo: apples!  Aside from exercise, a number of foods have been found to contribute to reduced blood cholesterol and blood pressure.   The most intriguing one is the daily apple.  Yes, an apple a day might not only keep the doctor away, but it may ward off strokes and heart disease.  I only wish I were making it up, but a November 2013 British medical study validated that prescribing either an apple a day or a statin a day to everyone over 50 years old is likely to have a similar effect on population vascular mortality.  The report concluded that “choosing apples rather than statins may avoid more than a thousand excess cases of myopathy and more than 12 000 excess diabetes diagnoses.”

Other alternatives to statins include sesame and rice bran oil have been staples of Asian cuisine for centuries and their use seem to correlate to the low levels of heart disease and blood pressure in those cultures.   In fact,  other heart-healthy fats — including olive oil, avocado, nut butters, fatty fish, and flaxseed — may have similar benefits.   Harvard University reports that a number of foods can reduce LDLs  and that refraining from meats; dairy and snack foods can significantly reduce LDLs.     Former President Bill Clinton — when faced with chronic heart disease — changed his diet with remarkable results.

Conclusion

Learn more about statins if you are being advised to take them.  If you understand the economic compulsion behind the industry’s embrace of statin drugs and you understand the health risks, compared to lifestyle changes, then you are in a position to better understand whether you should begin a statin regimen.   While statins do show benefits for some patients,  it is clear that not all patients benefit.

New guidelines for hypertension (blood pressure) are a bit more promising in that they suggest the reduction of hypertension medication for persons over the age of 60 if their blood pressure is under 150/90.   Random controlled trials results published in the Journal of the American Medication Assoc. revealed no data to show that older people get any benefit from further reducing their blood pressure substantially below the 150/90 benchmark.    So if you are taking diuretics, ACE inhibitors, Angiotension receptor blockers (ARB), beta-blockers, calcium channel blockers or vasodilators and your blood pressure is consistently in the 150/90 range, you may want to explore reducing or ending that medication….of course, with consultation with your physician.  This means, people taking drugs like Prinivil, Levatol, Cardizem, Procardia, Tekturna, Capoten and Norvasc may want to reassess.

Scott Grundy, a physician at the University of Texas Southwestern Medical Center suggests in an NPR story that people in this considering statins to a special kind of CT scan that looks for calcium deposits in heart arteries, a signal for clogs that could cause trouble.  He is quoted as saying: “If you have no coronary calcium, then your chances of having a heart attack over the next 10 years are very low.”

None of this is to say that you shouldn’t take hypertension or statin drugs.  It is inarguable that some have benefited from the drugs with little or no adverse health effects.  But the controversy over the new guidelines should make you pause and wonder whether you are better served by examining alternatives — including lifestyle changes — before jumping onto the pharma bandwagon.   And, as a last resort, if you are fairly certain you want to travel down the treacherous statin road, read the Spacedoc blog first.   Written by a former NASA cardiologist, it’ll open your eyes to some profound complications about which your doctor never told you.

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