The Truth about Statin Drugs | Chris Kresser

The Truth about Statin Drugs

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Since their introduction in the 1980s, statin drugs have been almost universally hailed as “wonder drugs” by medical authorities around the world. The global market for statins was $16 billion in 2016, and approximately 40 million Americans (that’s one in every five adults!) takes a statin. (1)

statin drugs
Do statin drugs really improve heart health? iStock/SelectStock

Cardiovascular disease (CVD) is still the leading cause of death in the United States, claiming 350,000 lives annually. (2) Medical authorities and doctors claim that statins reduce the risk of CVD and vascular deaths by lowering levels of total cholesterol and proclaimed “bad” low-density lipoprotein (LDL)-cholesterol.

But are statins really as safe and effective as mainstream medical authorities claim? The unequivocal answer is NO.

Statin drugs are not always safe or effective, despite what mainstream medicine claims. Check out this article to find out the truth about statins, when they work, and when they don’t. #chriskresser #healthylifestyle #wellness

The Side Effects of Statin Drugs

There’s no denying that statins are effective at lowering blood cholesterol levels. Depending on the dose and circumstance, LDL-cholesterol (LDL-C) can be lowered by 30 to 60 percent. (3)

However, high cholesterol in the blood is just one of many factors that contribute to heart disease, and the evidence is mixed on how strong of a CVD risk predictor LDL and total cholesterol are. As I discuss below, LDL particle number (LDL-P) may be a better indicator of heart disease risk. For more information on this topic, check out my article “The Diet-Heart Myth: Why Everyone Should Know Their LDL Particle Number.”

It’s important to note that cholesterol is vital for our bodies to function properly—it doesn’t exist just to give us heart disease. Cholesterol provides structure to our cell membranes, and cholesterol is a precursor to many biologically necessary products, including: (3)

  • Sex steroids
  • Corticosteroids
  • Bile acid
  • Vitamin D

Statins work by inhibiting beta-hydroxy-beta-methylglutaryl-CoA (HMG-CoA) reductase—an enzyme involved in cholesterol synthesis. But this enzyme has other jobs, too, such as aiding in the synthesis of coenzyme Q10 (CoQ10), a key mitochondrial antioxidant needed for cellular energy metabolism. (4)

Therefore, tinkering with cholesterol synthesis via statins can yield unwanted side effects. The most common statin-related side effects are muscle-related issues, including:

  • Pain
  • Lethargy
  • Weakness
  • Myopathy, in rare cases

Muscle problems are reported in 10 to 30 percent of patients from observational studies, and in up to 5 percent in randomized controlled trials (RCTs). (5, 6)

New-onset diabetes while taking statins occurs most often in women and in people who already have some metabolic risk factors. (7, 8) Some studies have found no association with statins and diabetes, (9) while a meta-analysis of 13 RCTs found that statin use was associated with a 9 percent relative increased risk of diabetes. (10)

Other less common side effects associated with statin use have been reported, but not all have been proven to be caused by statins themselves:

  • Hemorrhagic stroke (11)
  • Liver dysfunction (12)
  • Cognitive disturbances (13)
  • Depression and mood instability (14)
  • Skin infections (15)
  • Decreased libido and impotence (16)
  • Rhabdomyolysis (very rare, but can lead to life-threatening kidney failure) (17)

Are the Claims about Statins Overstated? Absolute vs. Relative Risk

“Statins reduce deaths from coronary heart disease by 28 percent in men.” This is a headline from 2017 reporting the results from a long-term study on cholesterol-lowering statins. (18) Sounds pretty impressive, doesn’t it?

An important thing to understand about drug clinical trials and medical claims is the difference between relative risk and absolute risk. For example, imagine that your risk of developing Condition A is one-half of 1 percent—0.5 percent. That’s your absolute risk, and it’s quite low. Now, imagine that Drug B reduces your chance of developing Condition A down from one-half of 1 percent to one-quarter of 1 percent.

We could report this reduction in one of two ways:

  • Your relative risk of developing Condition A was reduced by a whopping 50 percent, from 0.5 percent to 0.25 percent, from Drug B.
  • Your absolute risk was reduced by a mere one-quarter of 1 percent, or 0.25 percent, for an already low-risk event.

Reporting relative risk reduction without acknowledging absolute risk reduction can overinflate the benefits of a drug or treatment. Many statin studies and claims perfectly exemplify this phenomenon.

In a large meta-analysis from The Lancet that summarized and evaluated 26 RCTs, the authors report that all-cause mortality is reduced with statin treatment by 10 percent each year for every 39 mg/dL reduction in LDL-C. (19) They are reporting relative risk. 

However, the data from tables and figures reveal something much less impressive. Taking all trials together, the per annum death rate for overall mortality went from 2.3 percent to 2.1 percent for every 39 mg/dL reduction in LDL-C. That’s an absolute risk reduction of a mere 0.2 percent. The absolute risk reduction for all vascular-related deaths across all studies was only reduced from 1.3 percent per year to 1.2 percent with statin treatment.

It’s difficult to put numbers and cost on even a single life saved, but it’s hard to argue the fact that a 10 percent relative risk reduction sounds a lot more “impressive” and worth it than a 0.2 percent absolute risk reduction.

Statins Don’t Benefit Otherwise Healthy People

Initially, statins were prescribed only to people who had very high LDL-C and a history of atherosclerotic cardiovascular disease (ASCVD). This is referred to as “secondary prevention.” Over the years, treatment standards have expanded to include people who are “at risk” of developing ASCVD based on a number of criteria, but don’t actually have it. (20, 21) This strategy is called “primary prevention.”

Many studies have been conducted to justify prescribing statins for primary prevention. Although statins moderately reduce cardiovascular events such as heart attack in people without heart disease, the research doesn’t indicate that statins reduce overall mortality in these populations.

  • The WOSCOPS study found a slight reduction in death from cardiovascular causes, but no significant effect on death from non-cardiovascular causes or death from all causes was found compared to placebo. (22)
  • In the AFCAPS/TexCAPS study, men and women with high total cholesterol and LDL-C levels but no heart disease were prescribed statins. Major coronary events at the end of the study were slightly reduced, but overall deaths did not differ between drug and placebo. (23)
  • In patients with elevated C-reactive protein (CRP) levels, an indicator of chronic inflammation, either placebo or statins were given to otherwise healthy men and women. Although statins reduced death from both cardiovascular causes and all causes, a higher incidence of diabetes was reported in the statin-treated group. (24)

Although a handful of studies have found significant reductions in death from any cause by prescribing statins to people without heart disease, the absolute benefits are extremely small. (25, 26) The majority of the literature fails to demonstrate clear benefits of statins for primary prevention. (27, 28, 29) For more on this topic, check out my article “The Diet-Heart Myth: Statins Don’t Save Lives in People without Heart Disease.”

Statins Don’t Increase Survival in the Elderly

Despite the fact that the vast majority of people who die from heart disease are over age 65, there is limited evidence that statins benefit this population. (30) In the PROSPER trial, a study that dealt exclusively with the elderly, statins reduced the incidence of death from heart disease. (31) However, this decrease was almost entirely negated by a corresponding increase in cancer deaths. As a result, overall mortality between the statin and placebo groups after over three years was nearly identical.

Another study analyzed the effects of statins vs. standard care in patients over age 65 without CVD, as a secondary analysis of a previous study. (32) The authors reported that over six years of treatment, patients treated with statins actually lived an average of 33 days fewer than those receiving usual care—a very small absolute change, but not at all in favor of statin treatment.

Although outlier data exist (33), the bulk of the evidence suggests that statins don’t extend life in the elderly, regardless of whether they have heart disease or not. And, in fact, the highest death rates in the elderly, especially those over age 80, are associated with the lowest cholesterol levels. (34, 35)

Mixed Evidence on Statins for Women

Drug trials have a long history of underrepresenting women as participants. Statins are no exception. Even as recent as 2017, a review paper admits that “up-to-date evidence shows that statins have not been adequately tested in women, especially in primary prevention trials.” (36) As of 2016, women comprised less than 25 percent of all statin trial participants to date. (37)

For primary prevention of CVD, studies have consistently reported that, although statins may reduce the risk of a coronary event and even vascular-related deaths, overall mortality is unchanged compared to placebo for women, even when overall mortality is reduced significantly (but marginally) in men. (38, 39, 40)

For secondary prevention of CVD, reports have been somewhat mixed. One large meta-analysis of 11 RCTs found that in women, statins reduced the risk of all cardiovascular events, but not overall mortality. (41) Another meta-analysis looked at eight primary prevention and 10 secondary prevention trials, and found that statins did benefit women in terms of cardiovascular events and death from all causes. (42)

Do Statins Help Anyone?

To sum up thus far:

  1. Statins can lower cholesterol levels and moderately decrease the risk of CVD-related deaths in some populations.
  2. There is little to no evidence that statins increase life expectancy in women, in the elderly, or in people without pre-existing heart disease.
  3. Statins carry non-negligible risks.

So whom do they help?

Studies consistently show that statins benefit middle-aged men who already have heart disease (secondary prevention). Many large controlled trials, including 4S, CARE, LIPID, HPS, TNT, MIRACL, and PROVE-IT, have shown relative risk reductions in vascular events and cardiac death between 7 percent on the low end and 32 percent on the high end, with an average risk reduction of around 20 percent. (43, 44, 45, 46, 47, 48, 49)

However, absolute risk reductions were much more modest, ranging from 0.8 percent to 9 percent. And, importantly, not every trial found that statins improved overall mortality. (44)

LDL-P: A Better Marker for Cardiovascular Risk?

Cardiologists and other doctors consider LCL-C the enemy and a great predictor for CVD later in life. In my clinical experience, I have found that LDL-P is a much better marker for CVD risk than LDL-C. The two sometimes are correlated, but often they can be discordant, leading to unnecessary or harmful treatment. (50, 51) Peer-reviewed research has confirmed that LDL-P is a much better predictor of CVD and vascular events compared to LDL-C. (52, 53, 54)

It’s beyond the scope of this article, but I wrote about the four main causes of high LDL-P in a previous article. The cause dictates appropriate treatment, which doesn’t often involve statins.

What’s an Alternative to Statin Drugs?

So what if you are at risk for heart disease and you’d prefer not to take a statin? There are many clinically proven ways to prevent heart disease naturally by adjusting your diet and lifestyle. In fact, the INTERHEART study, which looked at the incidence of heart disease in 52 countries, revealed that over 90 percent of heart disease is preventable by diet and lifestyle modifications. (55)

How to Live a Heart-Healthy Lifestyle

To prevent heart disease, the American Heart Association recommends a so-called “heart-healthy diet,” which emphasizes nutrient-poor foods like industrial seed oils and whole grains while restricting nutrient-dense foods like red meat, animal fat, and cholesterol.

A better dietary approach to heart health should include foods like:

  • Cold water, fatty fish
  • Monounsaturated fats from avocados, macadamia nuts, olives, and olive oil
  • Antioxidant-rich foods, like colorful fruits and vegetables
  • Soluble fiber

Other lifestyle factors that have a profound effect on lower CVD risk include:

  • Exercise
  • Better sleep
  • Stress management

For more on how to live a heart-healthy lifestyle, check out my article “The Diet-Heart Myth: How to Prevent and Reverse Heart Disease Naturally.” 

Changing your diet and lifestyle isn’t an easy task to accomplish—even when there’s a good reason to do so, like improving heart health. That’s because achieving real, lasting behavior change isn’t a simple matter of acquiring new information. It’s a complex process that requires motivation, accountability, empowerment, and support—and that’s where health coaches excel.

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  1. While i hear all the negative about the use of statins, and i can attest to that as i have been on them for a while, unfortunately i have yet to see alternatives that are proven to work. It is fine to say exercise/diet etc does good, which it does to a certain extent, but there has been no studies to prove that these alone will be effective, i have tried exercise and diet, but it made little if any difference, i was told that it had to do with genetics, so my numbers will always be high unless i take a statin. if the alternative world was able to make their point by studies and numbers, the statin use would decline almost immediately, Nobody wishes to take a statin but are caught in a struggle, this is after yr health and life……and there is just no known alternative that is proving to be a better substitute for statins.

    • Ian, the points have been made over and over… The problem is that there is relatively little funding or media coverage for that side of it when there are $26 billion on the other side…

    • I, too, feel somewhat caught in the whole “get your cholesterol numbers down” thinking. After decades of having that beat into our heads, it’s hard to buck that. But, what I am also reading are some really very good arguments that cholesterol, itself, is not the issue–not the “bad” guy. I read something just the other day that 70% of the people who have heart attacks are taking statins–I will have to research that one because if that’s true, that’s saying a WHOLE lot. In any case, I just keep hearing myself asking this one question over and over: is high cholesterol a bad thing??

      • Well, that is not as straightforward a question as it may seem… The first thing you have to understand is that what most people think of when they refer to cholesterol isn’t cholesterol. There is no such thing as good cholesterol, bad cholesterol, or other… There is just cholesterol. The good/bad/etc are the lipoproteins that carry the cholesterol.

        Almost all of the cholesterol in your body is manufactured by your body… and your body uses it for many things, including repairing damage, building the myelin sheaths in your brain, etc. There is a reason your body makes the stuff.

        Again, I am simplifying(oversimplifying) all of this, but basically there are 2 types(well, more like 5… but who is really counting?) of lipoproteins. HDL and LDL. LDL takes cholesterol and carries it around the body and deposits it where there is arterial damage so the cholesterol can be used to repair it… And HDL reclaims the cholesterol after it is repaired and takes it out of the system. As long as the source of the damage is not dealt with your body will keep sending out more and more cholesterol. That is also why they find cholesterol at the damage sites.

        The statin industry, and indeed the entire cholesterol industry, are busy blaming the symptom rather than dealing with the cause…

        • I understand everything you’re saying. And I believe I’ve read most of this along the way. But, for some reason, I continue to feel somewhat confounded by it all. Not confounded by the actual information, but by the plethora of conflicting opinions. Also….I’m curious what your thoughts might be as to what “the cause” might be?
          Well, I just happened to be at my doc’s yesterday for an annual check-up/cholesterol check. I stopped my statin a year ago. I had an NMR a month ago: TC 307; LDL 218; HDL 58; LDL-P was 2,467! (s/b under 1000-1400?? I’ve heard this range). Even naturopath practitioners who understand the lipid hypothesis to be a fallacy, are saying what really matters is the LDL-P particle number, of which mine is high. But then I read where others say the entirety of the lipid hypothesis is a hoax and don’t pay attention to ANY of your cholesterol numbers. My inflammation markers (homocysteine; C-RP) are low. Triglycerides are higher than I’d like: 157. My fasting insulin level is 6.62uIU/ml, not bad. But that my cholesterol is high, that the particle number is SO high temps me to be concerned.
          I am pretty well convinced that cholesterol, contrary to being a “villain,” is actually a vital and necessary component of good health. But then I do wonder if higher C numbers is indicative of something else that is not right. So you can kind of see how my thinking goes and how I end up feeling like I’m chasing my tail. And, as far as I know, heart disease does not even run in my family, cancer does! That’s the funny thing! But!! Every time I go to the doc now, she wants me to go on statins. I otherwise like her, and think of her as competent, and if I have pneumonia or a broken arm, I want her there to help me. But yesterday she threw out the 30% risk reduction by taking a statin…it’s really hard to even talk with her about it because the entirety of her thinking is SO conventional and mainstream and utterly unaware of the other points of view about cholesterol. And since I’d been on a statin for ~6 yrs., with no apparent side effects, she thinks there’s no reason I should not go back on them. I even said to her “ah, well, just because I wasn’t having side effects from the statins doesn’t mean there might not be a long term negative impact on my health, or that they aren’t otherwise damaging me.” She didn’t say anything. But I hate that there will now always be this point of contention between us. Don’t get me wrong, she is totally leaving it up to me if I take the statins or not (which I’m thankful for!!), but she thinks I’m making a mistake.
          Ok, I’ve totally talked your ear off. By-the-way, I’m wondering if you’re the James I might know from elsewhere here on the web…his last name would be H*******N. Might that be you? In any case, thank you for taking the time to read my rants and responding! Best regards.

          • Sorry, not the same James.

            Part of the problem that we have(if not most of the problem that we have) is dietary. We’ve been told that industrial seed oils are good for us and animal fats and other good fats are bad for us.

            We’ve been told to cut our dietary sources of cholesterol when dietary cholesterol doesn’t affect serum cholesterol but is necessary for manufacturing hormones…

            We consume way too much sugar/grain/starch which causes problems with insulin, liver function, etc…

            We consume soy (and other things, although imo soy is the biggest one) which screw with our hormones…

            My opinion is that the first intervention we should be doing for people with problems is dietary. Cut the sugar, cut the grains, cut the start, cut the soy. Introduce good fats, good vegetables, good meats…

            • I agree. I think my tack is going to be leaning towards Paleo/Primal eating….no sugar, grains, I never at a lot of soy. Buying grass-fed meats/eggs/butter. Although I’m not a couch potato, I need to be a little more active. Oh, and a couple of VERY interesting supps I’ve read about lately are nattokinase and serrapeptase, they’re supposed to work on eradicating plaque and calcium build-up in the arteries, respectively—they sound interesting, need to do more reading though. I take Vit K and cod liver oil. Not a lot else. I’ll, of course, continue reading…always. I really need to just make peace with not taking statins, eat/live well, and just let the cards fall where they may. No one lives forever (nor do I want to), but I do want to “figure” this out, make a decision, make peace with it, then let it go and get on with life. When I get into studying this stuff, it tends to consume my attention and actually take away from the enjoyment of living.

          • You might consider haviing a full cellular level nutrient panel conducted to see if you are deficient in those things your body needs to not get diabetes, cardiovascular disease and heart disease. I learned a littl late the side effects of statins. I was healthy until my family doctor prescribed a statin for me. I should not have listened to him. Good luck!

  2. Help! I’m a 53 year old man in pretty good health, just a bit overweight, non smoker or drinker. Discovered 2 years ago my calcium score was 1180! Blew me away. Last year discovered 80% blockage in right coronary artery requiring a stent. Just passed my stress echo with flying colors. Do I stay on the Crestor prescribed 2 years ago? Thanks!

    • Normally I would start with the disclaimer that I am not a doctor, but honestly most doctors don’t bother to inform themselves about statins and won’t give you an informed opinion….

      My opinion, after researching this for my father, is that Statins are probably one of the most dangerous things you can be taking, and provide no benefit that you can’t get by taking over the counter anti-inflammatories.

      Take a look at my above post for an explanation of what they actually do…

  3. Hi Chris,

    What do you think about the updated Corhane review which do suggests that statins are effective for the primary prevention of CVD? http://www.ncbi.nlm.nih.gov/pubmed/23440795

    Also, there have been studies since that show effectiveness for woman as well:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097284/

    Finally, what do you think about blood glucose levels as a way to measure CVD risks?
    http://www.ncbi.nlm.nih.gov/pubmed/23351551

    Thanks Kaspars

    P.S. I very much enjoy reading this site and listening to your podcasts, a wealth of information. Thank you for that!

  4. Hi there,

    Just came across your information.

    I was always against stain-use from the widespread information that gets purported by ‘alternative medicine’ in terms of the issues with myopathy and rhabdomyolysis, and memory problems.

    I have just written a report on long-term statin use for a class my cardio class at University and the issue I take with your article is that you look at a few very, very large meta-analyses and then use that to form judgements.

    Statins have a strong correlation with reduced heart disease (30-35% reduction in LDL-C and 20-25% reduction in mortality from CHD) and these values have been established across wide number of studies. The problem most people make is they say the cholesterol has very little to do with it (they would be right) but the pleiotropic effects of statins is huge. Reduced inflammation, up-regulated nitric oxide, huge antioxidant benefit and stability of the endothelium is massive. They are marketed as cholesterol lowering drugs (which they do) but the main benefits seem to come from the above beneficial effects.. And so when you tell people to stop taking statins cause they cause muscle degradation or they cause this or that.. Or that cholesterol has nothing to do with it.. It could do a lot of harm (people have heart attacks when stopping statins use due to immediate drop in nitric oxide and spiked blood pressure)..

    Take home message – cholesterol has very little to do with CHD other than being a mediator in the process – statins have a wide-spread affect other than just cholesterol. First, you should fix your lifestyle (i.e. start exercising, start taking CoQ10, omega 3s, eating less refined CHOs) and then reduce statin use. The ill-harm that comes from reduced CoQ10 levels can be mediated via a supplement and most people’s muscle pain goes away when they use that supplement.

    Also, when you say there is no reduced mortality in people taking the statins vs. placebo, you have to remember that people will die of something, eventually. So sure, they die of cancer, but their quality of life may have been hugely increased by not having CHD.

    • The way you talk, you are still thinking of statins as a cholesterol lowering drug. Since that it was they are prescribed for it would make sense to assume that when you ask “What do statins do?” the answer would be “lower cholesterol.”, but that is not the case.

      There have been several drugs that actually did lower cholesterol(cholestenone, Triparanol, etc) but in each case they never made it to clinical trials or were pulled shortly after they did because they are extremely dangerous. In the case of Triparanol, for example, it increased the blood levels of desmosterol(one of the precursors for cholesterol) which had similar effects to cholesterol, so it didn’t provide any net gain. These drugs also caused lens cataracts and hair loss. Rats tested at high dosage actually went blind.

      So if statins don’t inhibit cholesterol, what do they do? Well, they went all the way back to the basic building blocks and blocked it there, by inhibiting the entire mevalonate pathway. Statins interfere with the pathway right near the top, by blocking the Hydroxymethylglutharyl-CoA(HMG-CoA). This is equivalent to trying to reduce the emissions on your car by welding the intake for your gas tank closed.

      So what does it block, besides cholesterol?

      Well, it blocks all of the following, among many others:

      Acetone, Acetoacetic acid, beta-Hydroxybutyric acid, Mevalonic acid, Phosphomevalonic acid, 5-diphosphomevalonic acid, Isopentenyl pyrophosphate, Dimethylallyl pyrophosphate, Geranyl pyrophosphate, Prephytoene diphosphate, Phytoene, Androstenedione, 5-Androstenediol, Testosterone, Dihydrotestosterone, DHEA sulfate, Epitestosterone, Farnesyl pyrophosphate, Squalene, Lanosterol, …

      Among the end-points that are blocked are the Dolichols, Ubiquinones, Squalene, Heme A, Sterols, and Prenylated proteins.

      So what does that matter? Well, lets take dolichols… While they have many effects, for our purpose here let us examine their function in the brain. As our brains develop the levels of dolichol increase and the substantia nigra gets darker(caused by neuromelanin, of which the major portion is made of dolichols). In Alzheimer patients, they have found that there are decreased levels of dolichols, and several drug companies are testing various drugs(i.e. Ropren) to deal with neurodegenerative diseases by addressing dolichol deficiency. Statins cause artificial dolichol deficiency. Gee, I wonder what that would do…

      What about squalene? Well, it is the biochemical precursor to all steroids. It is also vital for vitamin D synthesis… But I guess that none of those are really important, right?

      Have you seen the list of side effects for, for example, lipitor?
      abdominal pain
      acute renal failure
      altered liver function
      anaphylaxis
      angioedema
      angioneurotic edema
      anxiety
      arthralgia
      Cataracts
      chest pain
      chills
      cholestatic jaundice
      cirrhosis
      constipation
      cranial nerve dysfunction
      decline in cognitive function
      decreases in libido
      depression
      dizziness
      drowsiness
      dyspepsia
      dyspnea
      erythema multiforme
      fatigue
      fatty changes in the liver
      fever
      flatulence
      flushing
      fulminant hepatic necrosis
      gynecomastia
      headache
      hemolytic anemia
      hemorrhagic stroke
      hypospermia
      insomnia
      leukopenia
      liver dysfunction
      Loss of apetite
      malaise
      memory loss
      myalgia
      myopathy
      nightmares
      Opthalmoplegia
      pancreatitis
      paresthesias
      peripheral edema
      peripheral nerve palsy
      peripheral neuropathy
      polyneuropathy
      rhabdomyolysis
      Stevens-Johnson syndrome
      thrombocytopenia
      thyroid dysfunction
      toxic epidermal necrolysis
      Transient Global Amnesia
      tremors
      urticaria
      vertigo
      vomiting
      weakness

      How many of their patients do you think doctors are warning about those side effects? How many patients are being prescribed statins when they are in groups that show no benefit to it AT ALL(i.e. women)? Not only that, but there is an abnormally depressed reporting of adverse effects, and it has actually been fairly well documented that doctors are resistant to attributing these adverse effects to the statins and reporting them as such.

      Take home message: Statins are really really bad news, and you shouldn’t START taking them in the first place. Granted if you have been on a significant dose for some time you should wean yourself off rather than going cold turkey, but you should still get off them

      • As someone who has studied dreams, a nightmare symptom I would say is your bodies and your minds way of saying “GET OFF OF THE MEDICATION! YOU’RE POISONING YOURSELF!!!”

      • Not so much for a “side effect” but your minds way of warning you that you’re hurting yourself.

        That happened to me while on red yeast rice. After the nightmare, I immediately stopped taking it, to add, the nightmare showed me what was happening to me, or what would happen to me if I continued to use it.

        If the conscious mind knew as much as the subconscious mind, we would be much better off as a species.

  5. Chris,

    Do you believe a daily low dose aspirin (81 mg) is just as effective as a higher dose at treating heart disease, but with–perhaps–a smaller risk of internal bleeding? My doctor says I would “benefit” from a statin, but I have refused thus far to take one, and am considering aspirin as a part of an approach to reduce the risk of CVD. My Apo-B is 143 with pattern B LDL and high blood sugars and high blood pressure. I definitely have to do something to reduce my risk of CVD.

    Thanks Chris

    • Paul if you’re doctor is hounding you about a statin, ask him to compromise with Red Yeast Rice which is much more gentle on the body because it has low dose lovastatin naturally occurring, and just make sure to tell him its a standardized product. If you want the best advice about how to Lower your cholesterol naturally, besides the obv. Of taking Krill, Garlic, eating an organic apple once a day. You should make your family doctor/primary care physician a Naturopathic Medical
      , which treats you by making your diet
      fit your body, natural supplements, homeopathy, chiropractic adjustments, Ayurvedic medicine, Chinese medicine, and if you need medication they can do that too. Its a high valueable, and under utilized

  6. Hi Chris
    I understand you are not taking any new patients, but would like to know if you can recommend someone who has a nonstatin approach to lipids. Please don’t tell me to go to the paleo doc site because most of the people on there are chiropracters (not that I have anything against them, but I probably need an MD). I have extremely high cholesterol (61 y.o. thin female) and up until recently have been on 10 mg of lipitor, but stopped it because my blood sugars have been labile and I think I’m one of those who have developed diabetes from statins. I fit the typical profile.
    Right now I am trying to control my blood sugar by low carbing (we raise our own grass fed animals/milk/eggs etc), but still not sure what to do about the high cholesterol. Thanks

  7. In the end, we can’t trust most doctors as they recommend what drug companies tell them and not what science tell them. I eat well (most of the time mostly vegetables and very little meat and little sugar) and I have a very good HDL level but a little high LDL level.

    I am 47. A doctor specialized in lipid clinic told me right away that I had to take statins even if I do not have any heart problem.

    I really am frustrated regarding this doctor urge to prescribe drugs to enrich companies instead of trying to find other ways. Are doctors really independent???

    • 50 mg a day is a standard dose. There isn’t much evidence that higher amounts are beneficial, and they may be harmful.

  8. Last May (2011) my NEW doctor started me on a statin drug after cholesterol came back at 262. HDL (60’s)and Triglycerides (80’s). LDL 170’s. I asked nurse about side effects and was told not to worry about it. I said what the heck and started taking them. 6 weeks later cholesterol numbers fine. continued on statin. couple months later found my hips hurting so bad couldnt sleep. Then found i couldnt run without massive joint and muscle pain. I decided to do research of side effects and found the statin drugs to be the cause. Stopped them and was fine within a short time. My doctor said I HAD to take them. I asked about diet and exercise and she said a man my age (54) couldnt control my cholesterol without drugs.
    Well I refused to take the statins again and started educating myself. Through my reading I discovered the importance of Omega 3 (EPA DHA) in our diet and how Omega 6 causes inflammation. Taking 2+ grams a day of Omega 3 (EPA DHA), also take Niacin, 1 gram a day.. 4 months later, without Statins, my total cholesterol is 217, HDL is 67, Triglycerides 71 and LDL 136. Combined with this started eating way better, avoiding the simple carbs, vegetable oil etc etc etc. I have lost 10 lbs without trying ( I am 6′ tall and did weigh about 194)
    The biggest thing is I FEEL GREAT!!!!!!
    I tell people to read your articles all the time, changed my life. Thank you!!!

    P. S. I am looking for a new doctor.

    Dave

    • Dave – your numbers are impressive. I went off of my statin a year ago; my doc is wanting me back on them (chol ~300). I started eating in the Paleo way, but with dairy. I’m curious, two years later now, how are you doing? How are your numbers? Have you made any changes to your supplements?

      • Cindy, Sorry I missed your question. UPDATE: Blood test last week. LDL 118. Total cholesterol 196. ALL blood test results in NORMAL ranges including liver functions. 3 years of diet, exercise and NO prescription drugs. Niacin, Omega 3, vitamins daily. Not bad for a “man my age”. lol

  9. Chris,

    Above, you state: “Statins have never been shown to be effective in reducing the risk of death in people with no history of heart disease.”

    This is what I had thought as this is basically what has been promoted in the popular media outlets.

    I’d be interested in your thoughts on the following article published in the NEJM:
    “Long-Term Follow-up of the West of Scotland Coronary Prevention Study”
    http://www.nejm.org/doi/full/10.1056/NEJMoa065994#Background=&t=abstract

    Are you familiar with this study?

    This shows a reduction in (total) mortality in healthy patients (elevated cholesterol as well as no previous MI). I wonder why this hasn’t been cited more in popular media?

  10. Chris,

    Above, you state: “Statins have never been shown to be effective in reducing the risk of death in people with no history of heart disease.”

    This is what I had thought as this is basically what has been promoted in the popular media outlets.

    I’d be interested in your thoughts on the following article published in the NEJM:
    “Long-Term Follow-up of the West of Scotland Coronary Prevention Study”
    http://www.nejm.org/doi/full/10.1056/NEJMoa065994#Background=&t=abstract

    This shows a reduction in (total) mortality in healthy patients (elevated cholesterol as well as no previous MI). I wonder why this hasn’t been cited more in popular media?

  11. Here are my numbers:
    49 year old female
    overweight
    normal bp
    normal sugar readings
    0verall chol: 281
    hdl 73
    ldl 193
    triglycerides 152
    crp 7.2

    My doctor has been bugging me for the past 2 years about going on statins. The main concern is my ldl and crp readings(which he admits are not always accurate). I’ve had these readings for many years, no matter what weight I am at or exercise level.
    Took pravastatin 2 years ago for a feww months and stopped after memory issues and muscle pain.
    I’d really appreciate input.

  12. Here are my numbers:
    49 year old female
    overweight
    normal bp
    normal sugar readings
    0verall chol: 281
    hdl 73
    ldl 193
    triglycerides 152
    crp 7.2

    My doctor has been bugging me for the past 2 years about going on statins. The main concern is my ldl and crp readings(which he admits are not always accurate). I’ve had these readings for many years, no matter what weight I am at or exercise level.
    Took pravastatin 2 years ago for a feww months and stopped after memory issues and muscle pain.
    I’d really appreciate input.

  13. Thanks for the heads-up on that book, abolderwoman.  Actually I just received an email a couple of days ago from a woman who suffered from muscle damage as a result of taking statins.  She was wondering what she can do to address the persistent weakness she’s experiencing – even though she is no longer taking the drugs.  I’ll forward this to her.

  14. Thanks for this post and comments regarding CoQ10, which most physicians seem to ignore. There’s a very good book related to this discussion — “Drug-Induced Nutrient Depletion Handbook.”  It’s not as up-to-date as some of us would like, but it’s still helpful for anyone wondering about how specific drugs can affect our health.   (fyi, I have no connection to this book or its authors — just find it useful and thought others might, too.)

  15. The comment by Micki Jacobs is incorrect.

    Aspirin is NOT in any way a vitamin K antagonist.  Aspirin is not an anticoagulant like warfarin.  Aspirin is an antiplatelet drug.  It is an irreversible inhibitor of cyclooxygenase, which is an ezyme involved in the production of prostaglandins and, important for this topic, thromboxane.

    Thromboxane causes platelets to clump together.  This clumping together to repair damage blood vessels is often what leads to heart attacks and strokes.  Therefore, Aspirin works to reduce the incidence of stroke and heart attack by blocking the ability of platelets to clump together.

    That’s not to say that low-dose Aspirin does not have it’s own potential adverse effects.  Even low doses of Aspirin can greatly increase one’s risk for gastrointestinal ulcers.  However, everything the aforementioned comment mentioned about it’s effect on Vitamin K is completely false.

    Aspirin has absolutely no effect on Vitamin K.

  16. Aspirin is a vitamin K antagonist. This means that the low dose aspirin that is so often recommended is preventing vitamin K from ensuring strong, flexible arteries with little to no calcium deposition – which is probably what REALLY causes CVD. Not to mention that aspirin ups the risk of bleeding out.
    Aspirin on a daily basis is ill-conceived and is based on the paradigm of CVD occurring as a result platelets sticking together and then hanging up on build-up in arteries. Instead, it appears that calcium build-up is the first action of problems which occurs throughout life from early on – due to insufficient K2 and insufficiency of other calcium metabolism co-factors – and then the build up causes cholesterol to try to repair this problem and then docs think they need to “thin” blood and reduce cholesterol carrier proteins (LDL and VLDL) and they block the vitamin K action of making calcium go to the teeth and bones by hampering the carrier protein of vitamin K (yep, LDL and VLDL are the carrier proteins of vitamin K and beta carotene, among other beneficial proteins) via statins and aspirin. Hence, we have the wrong paradigm, the wrong treatments, and we need less aberrant forms of calcium, more calcium metabolism co-factors and fewer docs prescribing.

  17. Hi Marc,

    Welcome to The Healthy Skeptic and thanks for your comment.

    Yes, that’s exactly right. Statins powerfully inhibit CoQ10 production and that is very likely one reason are not effective for more than 95% of the population and actually increase total mortality in many cases – in spite of their anti-inflammatory effect.

    This is one of the many “untold stories” of statin drugs. Thanks for bringing it to our attention!

    Chris

    • Can you link me to some of the studies/data showing that they increase total mortality?

      I am currently having a discussion with my father, who’s doctor told him that statins decrease total mortality, and he has gone back on them. I can’t find any reputable studies either way… (and sorry for resurrecting a post this old, but…)

      • They decrease total mortality in men with pre-existing heart disease, but not in women, men or women over 65, or men without pre-existing heart disease. The mortality reduction in men with pre-existing heart disease is small, and in my opinion is better achieved using other means.

      • Read the JUPITER trial. Ask Chris why the trial was stopped early, after just 1.9 years median duration, by the study’s Independent Data Monitoring Board, because the interim results met the study’s predefined stopping criteria (it had been predetermined that it would be unethical to continue the study once it became clear that the patients in the nonstatin arm of the study had a significantly higher cardiovascular risk than the statin arm’s patients). Of course that study only had 17,802 patients and none had evidence of heart disease.
        They’ve been proven to not only stabilize vessel plaques that can cause infarction, but also regress them. The newest guideline (ATP4) for cholesterol are very statin friendly… why? Many insurance companies send notes to doctors asking why their patients with high risks (known CAD and DM) are not on statins. Why would insurance companies care unless it saved them money aka needing to pay for less myocardial infarctions.
        Read the ATP4 guidelines that are based on real general studies/information without selecting bits and pieces of info and making generalized opinions. We should not fear these yeast-derived (simvastatin, lovastatin, pravastatin) medications.

    • Hi Mark
      I read your comments on statin drugs a lot of the symtons I have lethargy muscle weakness etc
      I spoke to my doctor regarding this and said it is a very small minority of people that have side affects and it was media hype. I would like to know if I can just go off them because my memory is clouded and I am sick of it. I would rather take aspirin.
      Is there a safe way to take aspirin without damaging the lining of the stomach.
      I am 57 years old
      Kind regards
      Julia Pogson

  18. We should also keep in mind that statins interfere with co-enzyme Q10 production. CoQ10 is extremely important for mitochondrial energy production and is especially important for heart function. It is also a powerful antioxidant which may prevent arteriosclerosis by preventing the accumulation of oxidized fats. It has been shown in clinical studies to modulate high blood pressure, regulate heart rhythm, and increase exercise tolerance in cases of angina and congestive heart failure.

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