Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
10 Nov

Statin Insanity

iStock 000004888482XSmallDon’t know whether to laugh or cry (I have already screamed), but the headline in today’s LA Times and in many major papers across the country seemed like a paid advertisement for Big Pharma.

“A New Front on Heart Disease: Stain drugs can cut cardiac and stroke risks in people with normal cholesterol levels, researchers say.”  Wow! As I predict Dr. Michael Eades will say, “Jesus wept.”  As I say, “here we go again digging a hole to place the ladder in so you can wash the basement windows.”

The message in the newspaper, extrapolated from conclusions reached by the researchers, suggests that even healthy people (like you and me) with low or normal cholesterol levels can reduce their risk of heart attacks and strokes by taking rosuvastatin (aka Crestor). Of course, the study was funded by AztraZaneca, maker of Crestor. Grok wept.

Many of my fellow health bloggers will be writing about this study in the coming days. Some of those very smart people will explain this far more eloquently than me, but I would bet they all will agree that the headlines from this study are dangerous, ill-thought and possibly paradigm-shifting in the wrong direction.

In essence, the study looked at people who had relatively low cholesterol (and specifically low LDL) but high C-reactive Protein. CRP is a marker of arterial inflammation, which I have always maintained is a far greater “cause” of heart disease than cholesterol levels. (Oh, by the way, did I mention that the lead investigator in this study owns a patent on the test for CRP). Of note, the median age of this group was 66, more than half were overweight according to BMI charts and 41 percent had metabolic syndrome. The study found after two years that there were fewer cardiac and stroke “incidents” in the group taking rosuvastatin than in the placebo group. Fair enough, I guess. But in terms of serious cardiac and stroke events, the reduction went from 1.7 percent in the placebo population to .9 percent in the statin group – a total reduction of .8 percent (zero point eight percent). And as Merril Goozner says, the difference between both of these fairly old and not-too-healthy groups in all the serious adverse events of any type reported (including all cardiovascular events) was almost exactly equal, so “giving statins to people with elevated CRP did nothing to improve this population’s overall health.” Meanwhile, Here’s what spacedoc has to say about the dangerous side-effects of Crestor:

Cognitive, muscle and nerve problems, due to the inevitable impairment of glial cell cholesterol synthesis and mevalonate blockade are only part of the problem. The Crestor side effect potential, that it shares with all other statins, is far more basic than this. Now we have learned that mitochondria are an inevitable target of statins. Because of inhibition of CoQ10 availability with its powerful anti-oxidant effect, mitochondria are left fully exposed to the mutagenic effect of free radicals. The resulting mutations of mitochondria are what is causing the legions of permanent, disabling side effects.

Sweet.

If anything, this study is just another bit of proof that total cholesterol and even total LDL are not the proximate cause of heart disease. Oxidation and resulting inflammation are. Furthermore, it suggests that reducing inflammation has a far greater benefit than reducing LDL cholesterol. I agree. So why won’t the medical establishment acknowledge this? The bigger question is: why would any doctor agree to prescribe a dangerous, expensive statin to the general public to save a few more lives by reducing inflammation (NOT by reducing cholesterol), when this could be far more easily and more significantly achieved (at far less cost, with far fewer side effects and with far greater effectiveness) with Omega 3-rich oils (I herein disclaim that I sell fish oil) and a few simple dietary adjustments like cutting back on grains and trans fats?

The fact that the media has bought into this hype again reminds me to remind you that all health decisions are best left to the expert – in this case, it’s YOU. You know what to do.

Further Reading:

The Beginning of the End? – Statins for Children

The Definitive Guide to Cholesterol

Flame Thrower: Top 10 Natural Ways to Reduce Inflammation

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Doctor to me one year ago – “Your lipid profile is a mess. Try to eat better and get some excercise. If you don’t improve over the next year we can look at statins.”

    My grandfather to me recently – “Lipitor is great. I am on it and your uncle (who is a leading oncologist!) put himself on it strictly as a preventative measure.”

    Me to all of them – “Forget your statins! I don’t need them!”

    And so I went primal… and now I truly don’t need them. Doctor agrees.

    But anyways, according to this study I should take them anyways? That sounds like what my uncle is doing (scary). Phooeey. I will pass thank you.

    Son of Grok wrote on November 10th, 2008
  2. Ironically, (chinese water) snake oil is rich in EPA, and would probably be more effective at preventing death than statins.

    Will wrote on November 10th, 2008
  3. Mark,

    First off, I totally agree with you about the whole statins issue. It’s just another example of big pharma trying to exaggerate a situation while offering people a short cut (that doesn’t even do much) for the price of a pill when all they need to do is tweak the diet. Why is it happening? Because people WANT it to happen. People want these shortcuts cause they’re lazy, go figure… I still love them nonetheless.

    Now onto my topic/question. You mentioned that in the study, “…more than half were overweight according to BMI charts…”

    How much stock do you put in BMI charts? I’m sure that you were trying to prove a point based on the information given by the study, but I’m just curious as to what your stance is on this.

    Thanks bud!

    All the Best,

    Andrew R

    Andrew R wrote on November 10th, 2008
  4. Thanks so much. This is just insane, and I even got an email about it from a friend yesterday morning. He would not listen to my response about the bias in the “study.”

    wamylove wrote on November 10th, 2008
  5. Once at the hospital, I saw a pharmacy student wearing a T-Shirt that read, “Drugs are my Life!”

    Seems a lot more people than pharmacy students are wearing them now :-(

    Dr. J wrote on November 10th, 2008
  6. I saw a report on the study this morning and almost blew my coffee out my nose.

    I don’t understand how the public (and the gov’t and private insurance companies who end up paying in part for these ridiculous prescriptions) doesn’t scrutinize this stuff. As someone whose family’s health insurance premiums skyrocketed this past year, it really infuriates me that studies like this get so much positive press and that seemingly every doctor thinks nothing of handing these pills out like candy. I’m all for paying into the system to make sure everyone is taken care of (including me), but the system is screwed up!

    If individual people and their doctors make ill-informed and even dangerous decisions – well, I suppose that’s their business. But when I’m asked to subsidize Big Pharma profits as a result, it makes me livid.

    Jen wrote on November 10th, 2008
  7. And last week the Feds lowered the bar for exercise. Now let’s have a Crestor with our One A Day. I’m a fish oil guy, and also take a systemic enzyme both anti-inflammatories. So no thanks.

    RonD wrote on November 10th, 2008
  8. Some people just choose to believe any and everything their Dr. tells them they need to take this pill and that pill. I know some people that have paid the price because they just pick up their written out prescription, “never” read the side effects. They feel bad from the side effects, then go back to the Dr. then he gives them more pills for the side effects, etc. I have a good friend that her husband is a M.D. and he was “taught” at Med School to write prescriptions. The pharmaceutical companies love this, it goes hand in hand. If only more people would “take charge” of their own health, more people would be healthier. Your health is your own choice of what to do to get better. If all these pharmaceutical drugs are so great, why are they killing people every year and why are some of these drugs recalled? I say-NOT so great!

    Donna wrote on November 11th, 2008
  9. Classic treat the symptom and not the problem mentality.

    Son of Grok wrote on November 11th, 2008
  10. Andrew, I’m not a big fan of BMI. It becomes truly distorted among younger people with good muscle mass. In this study, with average age of 66 and a tendency toward metabolic syndrome anyway, I’d defer to the BMI as a slightly more accurate predicter of overfat (rather than well-muscled).

    Dr.J, it’s a sad commentary when those shirts – even if worn in jest – say out loud what the doc’s subconscious believes. One of my life goals is to find a way to allow physicians to find the time (and be compensated) to educate rather than medicate. The danger of this study, of course, is that many docs will now feel relieved that the standard of care includes routinely prescribing a statin. This unburdens them of the proactive educating. I fear that this study opens the door to the next level: a full-on no-holds-barred investigation of statin use on the general public.

    Mark Sisson wrote on November 11th, 2008
  11. Had a cholesterol test back in July and my Total was 217, HDL – 50, LDL – 153, and Tri – 71. My doctor was concerned but now that I look further at the test my C-RP was 0.14 and my homocysteine was 8.3. I’m guessing that’s pretty low for C-RP. I’ve been doing IF and Zone/semi-Paleo for the past six weeks and had another taken on his advice two weeks ago. I guess my total went up to 229 but now I’m waiting to get the actual paperwork and look at the C-RP number. He wants me to see him in another 90 days and get it done yet again and he did mention statins if I don’t get my total down.

    Chad wrote on November 11th, 2008
  12. Hey Mark,

    I figured that was your stance on it, I was just double checking.

    Thanks!

    All the Best,

    Andrew R

    Andrew R wrote on November 11th, 2008
  13. Any CRP value less than 0.5 ml/L is in the noise of the measurement.

    SB wrote on November 11th, 2008
  14. Dr. Eades has put up a great post on this–what a crock! I was watching the Leher Newshour on PBS and they had one M.D. who was gushing over the result but at least they balanced that with another who was saying “not so fast.”

    DaveC - DaveGetsFit wrote on November 11th, 2008
  15. Hey DaveC,

    Can’t believe I missed it. You should throw up a link to it.

    Thanks bud,

    Andrew R

    Andrew R wrote on November 11th, 2008
  16. DaveC,
    I watch PBS Leher Newshour almost every night, i missed it too. I’m such a sportsfan i must of changed the channel to Ice Hockey or ESPN. Wish i would saw that!

    Donna wrote on November 12th, 2008
  17. Here’s the link to the Eades post:

    http://www.proteinpower.com/drmike/cardiovascular-disease/1853/

    Donna: The funny thing is that I normally NEVER watch it but just happen to surf to it that day. The doctor with the somewhat dissenting view stated that all other remedies (like diet and exercise) should be tried before putting anyone on lifelong medication. What a concept!!!

    DaveC wrote on November 12th, 2008
  18. Thanks for the link DaveC

    All the Best,

    Andrew R

    Andrew R wrote on November 12th, 2008
  19. DaveC,
    Appreciate the link,thanks!
    I watch it often, i like to hear different controversy’s they get into.

    Donna wrote on November 12th, 2008
  20. Just to be clear , Mark. Those were pharmacy students wearing that shirt. Not doctors, not even a pharmacist, just a college student studying pharmacy.

    Dr. J wrote on November 12th, 2008
  21. Like Son of Grok, I had high cholesterol and my doc was threatening statins. I ate so many crackers with bad oils in those days! But the doc said, it’s just in your genetics, you can’t change it. Flash forward a couple years and I’m eating wheat/dairy free due to digestive intolerance…lotsa red meat and eggs. And I get these GREAT cholesterol test results. “I wish I had THOSE numbers,” my doc says. So I start to tell him about the diet changes, all the almonds and olive oil, and he cuts me off and says “It’s just your genetics, it’s not related to diet or exercise.” !!!

    Danielle Thalman wrote on November 13th, 2008
  22. I went off Lipitor nearly 2 years ago (I am 69 in December) and had almost instant improvement in memory and other side effects. I now have 30ml of cod liver oil daily for heart health. My cholesterol did increase initially but is now on the way down. I have also started 1 teaspoon of turmeric daily and, while I can’t prove it, it appears that that may be helping to lower my cholesterol. 2 years ago I also: threw away the margarine and went back to butter; stopped using ‘skin free’ chicken and started to cook in fat rather than vegetable oil. I feel much better. OK so I got a pulmonary thrombosis but that was after lying in bed for weeks with a broken foot elevated above my heart. My heart, with a double bypass, a heart attack and 2 stents in my history is in great condition. Oh yes; I broke my foot while moving furniture when I tripped on an undone shoelace and fell off the truck on to a concrete path. (lifting heavy things occasionally.)

    Victor wrote on November 25th, 2009
  23. Here it is folks. And the angels wept…

    Incidence of High Cholesterol Drops in US

    ‘As for the cause of the overall [LDL cholesterol] reduction, ‘we don’t know why, we can only speculate,’ Kuklina said. It could be changes in lifestyle, such as better diet, or it could be more widespread use of cholesterol-lowering medications such as statins, she said.

    ‘But we still have many people we could put on statins,’ Kuklina noted.

    http://www.nlm.nih.gov/medlineplus/news/fullstory_91963.html

    Chadwick wrote on November 29th, 2009
  24. I disagree. The body of scientific literature suggesting that statins are wonder drugs continues to grow. If anything, they’re both safer and more effective than anybody thought, and may even be a preventative for Alzheimer’s. The incidence of heart disease in the deveoped world is declining. So much so that cancer has replaced heart disease as America’s number one killer. Statins may be the reason.

    Having said that, it is ALWAYS better to put yourself in a position where you don’t need medication, and diet and exercise are the way to go. I would guess that 95% of everyone who eats and exercises as perscribed by this forum could throw away their statins. However, the overwhelming majority of people DON’T live this way: fact is, they’re fat, dissipated, lazy; they have atrocious eating habits, and they’re not going to change. Suggesting that they shouldn’t take statins is irresponsible.

    Carl Browne wrote on June 11th, 2010
  25. My active 73-year-old mother is prone to strokes and currently in the hospital rehabbing from her most recent. And I just discovered they put her on a statin. In arguing with the doctor about it, she said that ‘the studies’ find it is the best way to stop the inflammation. She’s going to give me more ‘information’ on that. She did at least agree to add CoQ10 to her supplements. That’s the only concession she made to the badness of statins.

    My mother does have a lot of inflammation. She was taking prednisone for polymyalgia rheumatica. She’s often been tested for inflammatory markers, SED rates in particular. But other than the prednisone, which I got her to go off of last summer, no one has been interested in inflammation. Not that I want them to give her a drug. I want her to consume more anti-inflammatory foods. Her blood sugar has been high every time they’ve tested it but they’ve said nothing and not tried to treat it. Which is good. I want my mother to deal with it by eating better. I hadn’t been able to convince her that her diet isn’t as good as she thinks it is or that Coca Cola is as bad for her as I say it is, but I might be convincing her now.

    Her lipid panels have been fine all two times she has been tested.

    Betterways wrote on January 27th, 2012

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