Monday, March 5, 2012

Statins: The Good, the Bad and the Ugly

Heart disease is the number-one cause of death in the United States, and high cholesterol is a major risk factor for the condition. Fortunately, there are several ways a person can achieve healthy cholesterol levels. One of the primary methods has been the use of cholesterol-lowering drugs known as statins. Lipitor, Zocor and Crestor are popular brand names in this class.
These prescription medications are designed to block cholesterol production in the liver. And while studies suggest that statins have been effective at reducing instances of heart disease, these drugs are not harmless. We are becoming more aware of their overuse and potentially harmful side effects. In fact, it has become necessary for the U.S. Food and Drug Administration (FDA) to require a change in safety warnings on statin labeling.
New safety warnings include alerts about possible dangerous changes in cognition and blood sugar levels. Memory loss caused by a statin can be reversed if a person stops taking the drug. However, the impact on blood sugar could lead to type 2 diabetes, a lifelong illness. A few years ago, the JUPITER trial, which was meant to justify the use of statins, found a 27 percent increase in type 2 diabetes in study participants.
Memory loss and diabetes aren't the only possible dangers of statins. Other health threats have been examined over the years. For example, studies have shown that statin use can lead to a deficiency in coenzyme Q10 (CoQ10), essentially advancing the body's aging process. Muscle weakness, fatigue, congestive heart failure, joint and muscle pain, seizures and cognitive impairment are all symptoms of CoQ10 deficiency.
If you get these symptoms, ASK for a CoQ10 blood level. If it’s below the median value, take CoQ10 orally. If it’s REALLY low, you may need to take up to 1000mg daily for a month to get your energy producing powerhouses or mitochondria back on line. Then you can lower the dose.
It has also been found that people with undiagnosed hypothyroidism can develop a rare, life-threatening disease known as rhabdomyolysis when on statins. Rhabdomyolysis breaks down muscle fibers and releases them into the blood stream, which can ultimately cause kidney damage.
And speaking of the thyroid ... Statins may also lead to selenium deficiency. Selenium deficiency, in turn, can cause a disruption in thyroid hormone metabolism.
I know this is a lot of clinical information, but this is evidence that statins, although helpful, should be taken with caution. For you as a patient, this means reading the warnings on your prescription's safety label, and asking your doctor important questions such as what side effects you might be at high risk for. And if you develop symptoms, get the right tests to determine what’s going on. It’s important to know that Motrin is not the right treatment for joint pain when on a statin. And neither Provigil nor Ritalin is the right treatment for fatigue or lack of focus when on a statin.
Another important step in protecting yourself against statin side effects while still lowering your risk of heart disease is to explore other treatment options for high cholesterol. Lifestyle changes such as eating a heart-healthy diet, becoming physically active and quitting smoking are critical to healthy cholesterol management.
Supplements such as beta-sitosterol, psyllium, garlic, calcium D glucarate and nonflush niacin are also helpful in lowering cholesterol.
If your doctor determines that you should remain on a statin while also pursuing lifestyle and alternative treatments, you may want to consider supplementing your therapy with a special form of Vitamin E: tocoTRIENOLS. These work synergistically with the statins or red yeast rice to lower cholesterol AND support the production of CoQ10. I’ve found I can lower the dose of statins needed substantially (to reach a healthy cholesterol level) by adding tocos 100mg at night with the statin. Less statin, less side effects. Tocos must be taken 12 hours away from regular Vitamin E supplements to get this effect. So take regular Vitamin E in the AM and tocos in the PM.
Selenium is also an excellent supplement to take when on a statin to avoid bad side effects. However, there's a slight possibility that selenium supplementation can reduce statin effectiveness, so you should always make your doctor aware of any supplements you're taking.
Finally, never stop using a prescribed medication without your doctor's supervision.
So, with all of this in mind, here's your to-do list for getting your cholesterol under control:
  1. Talk to your doctor about your options, concerns and questions. If you'd like my advice on a treatment plan, contact Chris Eller here at Vaughan Integrative Medicine to make an appointment with me. He can be reached at (336) 808-3627, extension 13.
  2. Start eating the heart-healthy way. Incorporate more healthy fats, fruits, lots of vegetables, lean meats and beans into your diet, while reducing foods that are high in simple sugars and trans fats.
  3. Exercise at least 20 minutes a day most days of the week.
  4. If you smoke, quit. Now! Smoking oxidizes your cholesterol, making it more dangerous to you.
  5. Always take regular Vitamin E 400 IU, mixed tocoPHEROLS, if you have high cholesterol. Cholesterol only causes problems if it’s oxidized. Vitamin E keeps cholesterol from getting oxidized.
  6. Consider taking the supplements I've mentioned in this post. You can stock up on personalized, pharmaceutical-grade supplements at the Natural Vitality Center. Those of you in the Greensboro, N.C. area may want to visit the Natural Vitality Center store at 1301 W. Wendover Avenue, Suite D.
Take care of yourself,
Elizabeth Vaughan, MD