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BLOG: July 2007
Statins: benefits, dangers and alternatives
First came the high-cholesterol paranoia. Hard marketing of cholesterol-lowering drugs - statins being the head runner for the past two decades - followed. As a part of it, statins' adverse side effects are routinely downplayed, while the alternatives are downgraded or ignored. And there we have it: over 20 millions Americans, at present, are taking statin drugs, some by handful, many just in case. Mevacor, Lipitor, Crestor, Pravochol, Zocor and other alien-sounding statin brands became household names.
A recent BBC article on statins is a picture of industry's deception scenario. While there is a statement that the lack of physical activity - no mention of the diet, or environmental toxins - is to blame for the epidemic of cardiovascular disease, it goes right on to state that many prefer to skip exercising and simply pop a pill to "offset the ill-effects of an unhealthy lifestyle".
Does this suggest that you can be a couch potato, suffocating in junk foods, alcohol and cigarette smoke, and fix it all up simply by popping statin pill, or two, down your throat, day after day? It certainly gives wrong message to those all too willing to accept it at face value. To add cream to the cake, the chief doctor - U.K.'s government's "heart czar" - is cited saying that statins "are effective and very, very safe". So much so, that a blanket statin prescription to all those over 50 years of age would be just a great move - if it only wouldn't interfere with the freedom of choice.
Is it really all that great about statins? Also, is exercising really the only alternative to lower the risk of cardiovascular disease? Let's take a closer look.
Benefits-wise, studies indicate that statins tend to reduce "bad" LDL cholesterol, incidence of heart attacks and heart-related mortality. The numbers vary from one study to another, with the choice and distribution of participants, dosage, study type and data manipulation. The studies are either more reliable, direct studies, based on the actual treatment practice (clinical trials), or statistical, based on a certain number of direct studies' results ("meta-analysis").
Large direct studies require significant time and resources; they have to be funded by someone, and that someone is most often the
pharmaceutical company manufacturing the drug.
Also, researchers conducting studies often have financial or professional ties with pharmaceutical industry. In short, since billions of dollars are at stake, we can reasonably expect that these studies are, on average, biased to benefit drug manufacturers. That is, biased to statins' overall efficacy, diminishing their adverse health effects. Exactly how much is impossible to tell.
Consequently, statistical ("meta") studies based on these direct studies also reflect this bias.
So, let's do our own little "study" and, in the process, try to shed some more light on factors shaping up statin studies and their presentation to ordinary folks like you and me.
First off, how do statins work? By blocking the liver enzyme necessary for cholesterol production. It is a dangerous idea to begin with. You see, there is a reason that your liver produces cholesterol; frankly, if it wouldn't, you'd fall ill pretty quickly, and then you'd die. This cholesterol is very much needed, and doesn't deserve the "bad" attribute; if it is bad, why is it that its optimum blood level is double that of the "good" (HDL) cholesterol? Are the body and evolution so much out of touch with the reality? Nope. What is called "good" cholesterol is simply the excess that body takes to the liver for elimination.
Put simply, your body needs and uses "bad" cholesterol, about 80% of which is produced by the liver. And "good" cholesterol is that same cholesterol, only on its way to the liver to be disposed of. Until proven wrong,
it seems wise to
assume that the body knows what it needs to do,
If so, you may ask, how is it that this cholesterol ends up clogging your arteries, which is definitely bad for your health?
The picture is very complex but, essentially, cholesterol clogs your arteries mainly
For one, your body uses cholesterol and repair proteins to patch the inflamed inner linings of your blood vessels damaged by oxidation (free radicals) and toxins, as well as to stiffen up cellular membranes in the blood vessel and other exposed inner linings (intestine, lungs) trying to protect them. If your liver is producing more cholesterol, this is one of the possible reasons: it is forced to by your nutritional deficiencies, unhealthy diet and/or lifestyle, or underlying health disorder.
The elevated "bad" cholesterol signals that you have one or more of these problems.
The Big Pharma's solution? Kill the messenger...
The excess cholesterol can also come from diet high in animal fats. About 1 in 3 individuals are sensitive to it (the other 2 are not affected, because their liver reduces its cholesterol production accordingly). But even if dietary cholesterol rises your blood cholesterol level,
it will do you little harm unless it is oxidized by free radicals,
which also makes it very likely that your blood vessel lining is damaged, accumulating cholesterol/repair proteins/calcium deposits.
Yet another likely contributor to elevated cholesterol is chronic stress, reducing your antioxidant levels and, at the same time, stimulating cholesterol production needed to manufacture stress hormones.
If this makes sense to you, that the statin "solution" is missing the main problem, you are on the right track. More on that little latter. For now, let's turn to the effects of statin treatment, starting with the benefits.
Benefits of statins