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Statins?

Should Statin Drugs Ever be Used?

I recently had the opportunity to participate in a round table discussion focused on the topic of statin medications used to lower cholesterol. As many of you are now aware, a new set of “guidelines” developed by the American Heart Association and American College of Cardiology was recently issued instructing healthcare practitioners as to when to prescribe this group of drugs.

Incredibly, under these guidelines almost half of the American population between the ages of 40 to 75 and virtually all men over age 60 would qualify for the use of this potentially dangerous class of medications.

Mainstream medicine seems focused on the provision of more and more medications for one and all. But while there are some incredibly wonderful drugs available for us to use, it makes sense to take a step back and reconsider the idea of risk versus benefit with this new recommendation as we should with the use of any drug.

Keep in mind that the use of statins is anything but a free ride. Complications that are well documented include increased risk of diabetes, memory loss, liver damage and serious muscle damage.

So please read this interesting discussion where I’m joined by Dr. Stephen Sinatra, a board-certified cardiologist, and Dr. Beatrice Golomb, associate professor of medicine at the University of California, San Diego.

  • Mark Peloquin

    The links to the research papers in the blog post above associated with the text “increased risk of diabetes” and “serious muscle damage” do not work.

    • David Perlmutter

      Thanks for pointing this out Mark. We’ve now fixed these so they should be working for everyone.

  • Lynn Dell

    It looks like a great discussion to read, and I hope to get to it tomorrow.

    Lipid panel testing needs to be more specific than it usually is, before medicating, if medication is to be given at all. Small LDL should be distinguished from regular LDL, and you need to know whether the HDL one has is the “good” kind, or “not so good” kind.

    I agree with what you’ve already said – it’s the carbs that drive this engine into the ground, and the way to deal it its to lower carb consumption, to improve A1C, and to lessen small LDL circulating. High blood glucose, high A1C, visceral fat and all point to bad LDL. I sure am glad for you and Dr. Davis and others who show that it is high blood glucose and high insulin which drive the lipid panels bad and drive obesity, and, of course, diabetes.

    Unfortunately it’s easier to swallow a pill than to make the changes that will really help.

  • Kiwi

    My question is a simple one. If you don’t have inflammation why throw these statins down your throat enriching the drug companies?

  • Lynn Dell

    I’ve read some of the discussion, and skimmed through some parts that were arcane for me. You mention two things that happen to LDL – glycation, and oxidation. I wish I knew more about that. Secondly, this is the first time I’ve heard that statins are more suited to males who have certain medical criteria, and not females so much. Thirdly, it was interesting to hear about cataracts increasing in those on statins.

    I think this line from Dr. Sinatra sums up the main idea of the discussion: “Right, so our plea to physicians is: instead of focusing on cholesterol, let’s focus on other factors that cause inflammation and oxidative stress in the body that then lead to illness, whether it is cardiovascular disease, neurological, or even cancer.”

  • TechnoTritcale

    This from last month (UK):
    “Why I’ve ditched statins for good”, by Haroun Gajraj, MD.
    http://www.telegraph.co.uk/health/10717431/Why-Ive-ditched-statins-for-good.html

    Money quote:
    “Just lowering cholesterol with drugs without sorting out the dietary and
    lifestyle factors that actually cause heart disease is nonsensical.”

    I’m tempted to say that prescribing statins, to anyone, without also addressing the causes of CVD is malpractice. But in their defense, MDs aren’t addressing diet due to their appalling ignorance about the role of nutrition in human health. Increasingly, however, this ignorance will be seen to be willful.

  • Kelly

    I’m sending a big THANK YOU – on my yearly phys. My new Dr. Ordered lipid panel- handed me the scrip. and before I went to the lab I wrote in AC1 – and the test results came back
    AC1 was 6.0
    LDL was 165
    HDL was 59
    Mind you I weight 94 lbs -have RA and eat a fairly GF diet.
    Now I need to figure where to go from here
    Dr wants me on statins- I said ” absolutely Not”
    Any advice would be very much appreciated!!
    P .S. Dr. Was confused about how AC1 got on the request.

    • David Perlmutter

      Glad to hear of your health turnaround.

      • Kelly

        We not sure my health has turned around-
        LDL has gone up from 119
        A1c has gone up from 5.4
        My weight has dropped to 94 –

  • Adrienne

    Regarding heart disease and carbs, how is it that you list Dr. Masley’s book in recommended reading when he is opposed to carbohydrate restriction?

  • bridj

    I understand that Niacin (Vitamin B3) may be a healthier substitute for statins in that it emphasizes HDL while converting the oxidized/damaged LDL into a healthier result. To be begun at lower doses no more than 50mg and gradually increased if necessary. Nitrous oxide or cardio chelation are other options. (EDTA has recently been approved by the FDA though previously shunned…Undeniable eradication for so many.)

  • Amber

    I am a holistic healthcare provider and have a male diabetic patient in generally good health in his late 60’s on lipitor 10mg daily with a total cholesterol of 119, HDL of 58 and an LDL of 29 (yikes!). HgA1c was 6.0. I find these cholesterol numbers to be absurdly low, but the prescribing doc thinks the diabetes diagnosis warrants use of a statin regardless of how low the numbers are. His cholesterol was only 180 before starting statins. What can a patient say to their PCP in this sort of situation? He does not want to disobey his doctor’s orders nor does he have the medical background to argue with his doctor. He also does not want to appear disrespectful. But I think his cholesterol is dangerously low. Any suggestions for how patients can have these tough conversations with their doctors?

  • Wheats

    What are your thoughts about Red Yeast Rice and Niacin? Several years ago when my cholesterol was close to 300, my doc began trying to get me on a statin. I’m active. I run several miles a day. My pulse is typically around 50. Blood pressure is always normal. I’m 48 and at 5′ 11″ and 200 pounds. Though stocky, I could probably benefit from losing 15 more pounds (I recently lost 12 by starting my gluten free diet a few months ago).

    Re: Statins, I have long resisted them, and without having your book to reference yet, I lowered my cholesterol to 170 primarily by taking Red Yeast Rice, and later also taking non-flush Niacin. Now reading your book with respect to statins, I’m questioning the Red Yeast Rice and Niacin to control my cholesterol. Would you recommend dropping those if I can maintain a strict gluten free diet and get my weight down?

    • David Perlmutter

      I shy away from wanting to lower cholesterol, even naturally.

      • Chris

        My Lp(a)-p is 233 and my doctor wants me to take Red Yeast. My cholesterol is low, I’m thin and after I’ve been eating grain/sugar/starch/legume/dairy free for one year now my high blood sugar levels have finally come down.
        Dr.Perlmitter, what is your take on high Lp(a)-p, please? I would really appreciate your input.

        • David Perlmutter

          I am not an advocate of Red Rice Yeast.

          • ChrisP64

            I took Red Rice Yeast for a while and my cholesterol easily became “normal”, but I realized this must not be a good idea, even if it was natural, so I quit taking it. My cholesterol scores rose again. When I was strictly following the Whole 30 program, eating only limited amounts of good carbs and plenty of fats, my doctor was amazed at my cholesterol scores. They were in the “normal” range again. Sooooo…. I’m a little uncertain about what type of cholesterol numbers I should be aiming for. If I eat a healthy diet, which is harder than taking Red Rice Yeast : ), I will probably have “normal” scores again. Is that good? I’ve fallen off of the wagon, so my fasting insulin score is high and my A1C indicates prediabetic, so I clearly need to work on that. My doctor talked me into taking RRY before bed only, because “cholesterol is synthesized at night”. She said I’d have the benefit of cholesterol in my body all day long. I’m having second thoughts about this. If I don’t take RRY and a healthy diet brings my cholesterol scores back to “normal”, should I be content or concerned? What is a good score for cholesterol controlled by a diet low in carbs? I’ve had to cut SOME of the healthy fats, to achieve weight loss.

  • ibana

    What do you think about Red Yeast rice to lower cholesterol. According to m doctor is safer than taking statins.

    • David Perlmutter

      I am not a fan of trying to lower cholesterol, even if using a natural option like Red Yeast Rice.

  • Bob W

    My cholesterol levels have shot up since I stopped taking statins one year ago.
    My overall cholesterol is 218, my HDL is 32, and my LDL is 151. In addition, my Hemoglobin A1C has gone from 6.1 to 6.9, which now classes me as a diabetic, I believe. I have been eating mostly a low gluten, low-glycemic, low-carb diet over the past year. I’ve been eating eggs almost every day, and a glass of wine 4-5 times a week. Also fruit and veggies intake has been increased substantially over the this period of time. So why are my numbers so bad? Am I at risk? I have my physical exam coming up soon; what should I tell/ask my doctor when he lambasts me for the bad numbers?

    • Tammy

      Maybe change your Dr. Check out http://www.reviveprimarycare.com to find a new one who is a functional medicine MD.

    • Ree

      “Mostly low gluten” is very different from the results you get with gluten FREE. Plus, be aware there are at least 24 “gluten free” foods your body can mistake for Gluten that you need to consider. Eating “a little gluten ” is the equivalent of saying “a little bit pregnant”

  • JOE LYONS

    I HAVE TAKEN STATINS FOR ALMOST 20 YEARS. I TAKE 10MG. IIM STARTING TO FEEL A LITTLE DIMENTED. I GUESS WHAT IM SAYNG IS IM STARTING TO FEEL SPACEY. I HAVE DIABELETES AROUND 130 AND I TAKE A BETA BLOCKER, AND HIGH BLOOD PRESSURE MEDICINE. IM 65 AND THINK THAT HIGH BLOOD PRESSURE, DIABETES, ETC CAME YEARS AFTER I WAS PUT ON STATIN DRUGS. DO YOU THNK STATINS DRUGS CAUSED THIS ?

    • David Perlmutter

      While possible, there could be any number of myriad factors at play here Joe, so it is tough to offer a definitive answer.

  • Kathy

    Our GP suggested my husband take statins to reduce further kidney damage. He has chronic kidney disease. Creatinine 2.2. His cholesterol is just slightly above normal. Do you agree with his recommendation?

    • David Perlmutter

      I am not one to support statins, but I am also not familiar with your husband’s medical condition. You should seek to consult with a physician in your area.

  • We all know that the Drug industry, by means of willing physicians, pushes the drugs that make them money! I hear people complaining that the latest medication the Dr. put them on is making them sick. Especially my elderly friends. We live in a money hungry society, and the drug industry is one of the worst. They make unheard of dollars on cancer related drugs alone. Time we listen to someone who knows what they are talking about, done the research, and cares for the people. That, for one, would be Dr. Perlmutter

  • judy@2flnomads.com

    How do I find a physician in the Miami area who follows same statin theories

  • Ronald Weiner

    Dr. Perlmutter, I am very appreciative of all your efforts to get the truth out about statins and grains.
    I am being continually and strongly recommended to use statins by my Dr.
    I am very concerned and would very much like your opinion or thoughts.
    I am a 68 year old male, healthy, cycle weekly, golf and do resistance training weekly. I have been off statins for 1 year; on and off for 5 years. I am on a very low carb diet for this last year (ketogenic) with a daily carb intake of <40grams.
    I had a NMR Lipo profile this last week with the following results:
    Total Cholesterol: 382; Triglycerides 103 and HDL 65.
    My LP-ir score is <25. My HA1c is 5.8. It does not want to come down! Any suggestions on this would be helpful. If you are taking on new patients, I would definitely pay you a visit.
    Thanks
    Ron W

  • Pingback: Looking at Cholesterol and Sodium on the LabelJubilee Health Place()

  • Lisa

    I am 66 yrs old and have what I consider to be excellent health, but just had my blood test results back with a 491 total Cholesterol and 397 for LDL’s. In all your discussions, I have not seen figures this high, and my dr. says it’s the highest she’s ever seen. She is, of course, pushing statins, but I am refusing. I hope I am not being a fool. It would be reassuring to see some other numbers up as high as mine. No heart disease in my family. My mom had 420 total ch. but she died at 83 of lung cancer from smoking.

  • Suzanne Young

    Not really an article for the layman, but interesting to dig into the nuances of this subject. I’m sure your input was an education to these other bright sparks in the field. Dr P, I have a friend who had a triple bypass 10 years ago and was put on Thor up until now. He’s 69. Trim healthy and a clean eater with lots of supplements. How would we know if it’s good move to take him off statins or not? I was keen that he should right away, after reading your article, I’m not so sure…

  • Jon Quigley

    Dr. Perlmutter-
    Any advice on statins versus fenofibrate versus Cholestyramine to treat high cholesterol? My mom has Alzheimers, as did her mom – and I am concerned about beginning statins as a 45 year-old, otherwise healthy person.
    Thanks!!
    Jon Quigley

  • RebVio

    Should statins be used for secondary prevention of stroke for female patient who had a a first mild stroke at age 89? Doctors are saying that statins will stabilize plaques. I’m not convinced.

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