In recent years, the prescription of statin drugs to reduce cholesterol has soared through the roof. You've heard of them: Lipitor (atorvastatin), Crestor (rosuvastatin), Zocor (simvastatin), and the like. The supposed benefits of these drugs, as your doctor will tell you, is that they'll reduce your cholesterol levels, hence lowering your risk of heart disease. I'm sure you all know by now how I feel about lowering cholesterol levels (see this)... but that's beside the point in today's discussion. I will just say that statin drugs' effectiveness may have been a bit overstated. Today, though, I'd like to focus on the dangers, or side effects, one may encounter in taking statins.
First, just a little information about how statin drugs work in the body. Their main function is to block an enzyme called HMG CoA Reductase. This is one of the enzymes that is involved in making cholesterol in the liver. So through blocking this pathway, the drug has inhibited the body's ability to make cholesterol molecules. As a result, your blood cholesterol level goes down, your doctor is happy, and you're happy. We've finally won the battle against cholesterol! Yeah... except cholesterol is needed in the body for all sorts of vital processes, like hormone production, vitamin D synthesis, cell membrane structure, and brain function, just to name a few. Hopefully by the end of this, you'll realize how ridiculous it is to think that blocking an important biochemical pathway like this one is a good idea.
Meet Dr. Duane Graveline. Dr. Graveline is a family doctor with a high cholesterol level, who began taking statins several years ago. Shortly after starting on statins, he suffered a serious and disturbing loss of memory, so he stopped taking the drug. He had no further problems for a year while off statins, so his doctor persuaded him to begin taking them again. That high cholesterol needed to be treated. Shortly after returning to the meds, Dr. Graveline experienced a much worse episode of memory loss, during which he regressed into his teenage years, unable to recall his training as a doctor at all. After getting off the statins, though, his memory returned again. Interesting huh? Well Dr. Graveline decided to tell his story by publishing a letter on a website called People's Pharmacy. Almost immediately, he was flooded with letters from hundreds of other statin-takers who had experienced a similar problem. Clearly, something about these drugs was causing serious impairment in the brain.
On a related note, there has been consistent data since the 1960's showing that people taking cholesterol-lowering drugs tend to die more frequently from violent deaths, such as car accidents, suicides, and shootings. This information has largely been disregarded for lack of a plausible explanation.
But how about this... 25% of the cholesterol in the body is concentrated in the brain. Until recently, we didn't understand the reason why, but new research by Dr. Frank Pfrieger shows that cholesterol is absolutely essential to neuronal communication in the brain. Cholesterol is so important, in fact, that without it the brain would be almost entirely useless. So, now we have a very plausible mechanism to explain the mysterious amnesia experienced by Dr. Graveline and others. That also may explain the increase in car accidents; lapses in brain function lead to mistakes on the road. Low cholesterol, not necessarily as a result of statins, has also been shown to lead to reduced serotonin levels in the brain. Low serotonin is one of the key brain abnormalities involved in depression, and it has been linked to increased violence and aggression as well. Here's an example of a study that linked low cholesterol levels to increases in school suspensions and expulsions. According to the researchers, "the results of the current study are consistent with the majority of previous studies examining the associations between low cholesterol and various forms of aggression in adults." Looks like it's no accident that those with low cholesterol are more likely to be suicidal or violent. Still think blocking pathways is a good idea? Read on.
As I mentioned before, statin drugs act on the enzyme HMG CoA Reductase, inhibiting its action. While this prevents cholesterol synthesis, it also prevents synthesis of another important molecule that shares the same biochemical pathway. This molecule is known as coenzyme Q10 (CoQ10). This vital substance is found in every cell in the body, and in particularly high concentrations in high-energy cells such as muscles, especially the muscle cells of the heart. CoQ10 is an important part of ATP synthesis, meaning that it is needed for your body to turn food into useable energy. If cells run out of ATP, they die... so yes, CoQ10 is seriously important. Which cells did I say had the highest concentrations of CoQ10? Ohh yes, cardiac muscle cells! And what will happen if your cardiac muscle cells run out of CoQ10, along with ATP? Heart failure. That's right, the medication that is supposed to be protecting your heart can cause heart failure. Incidentally, while heart disease rates have actually been on the decline in America, there has been a recent sharp increase in congestive heart failure. There's no evidence to prove statins are causing this recent phenomenon, but it's certainly an interesting coincidence.
You know, every time I write one of these blogs, I try my best to be as concise as possible so that I don't end up with something so long that nobody wants to read it. But, here I am again with another research-paper-length post. Anyway, in conclusion here, I'd like to reiterate the problems with blocking the pathway that makes cholesterol. Cholesterol is an important molecule with a number of vital functions in the body, not the least of which is to allow the brain to function. Without it, the brain is useless. Think about that (with your brain) next time you take your statin drug. And don't forget about that whole car accidents, suicide, violence thing. Low cholesterol levels, resulting from statins or not, increase your risk for depression. Also, blocking the cholesterol pathway prevents CoQ10 production, which is vital to every cell in the body, especially heart cells. Without it, you're at risk for heart failure (the irony kills me).
The take-home lesson: While taking a statin drug will make your cholesterol numbers look better, at least in your doctor's eyes, there are serious problems with inhibiting cholesterol synthesis. Cholesterol is far more important throughout the body than most people give it credit for. And while it may be a risk factor for heart disease in certain populations, it is not the true cause... where is the logic in treating the innocent risk factor?? It's clear to me that the path to health does not lie in working against your body's natural mechanisms; we need cholesterol, not statins.