Part 1 discussed how
cholesterol is an essential molecule for the body, especially for the
nervous system and spinal cord. In spite of the hype otherwise, too low
cholesterol levels are associated with numerous health problems,
including compromised mental health, infectious disease, and increased
risk of dying.
For example, a recent
Norwegian study indicated death rates were highest in individuals with
the lowest cholesterol levels. In women specifically, as cholesterol
levels increased to what had been previously deemed especially
unhealthy, death rates declined. The investigators concluded “clinical
and public-health recommendations regarding the dangers of cholesterol
should be revised.”
Given such
recommendations, many are reconsidering the prevalent practice of
prescribing cholesterol-lowering drugs, especially when such drugs are
associated with numerous adverse effects. Recently, the Food and Drug
Administration announced that many of these drugs will now have to be
labeled with side-effect warnings. Even if risks are relatively low,
because the consumption of these drugs is so extensive, the cumulative
societal health impact over time may be substantial.
Statins
The most commonly
prescribed cholesterol-lowering drugs are statins (see table). They work
by blocking an enzyme involved in cholesterol synthesis. As an analogy,
view this biosynthesis like a heavily trafficked, eight-lane Interstate
highway leading to a pro-football stadium being shut down to two lanes
due to construction. Statins are the molecular equivalent of
lane-narrowing traffic cones and speed bumps in the
cholesterol-producing, biochemical pathway. As a result of these
barriers, less cholesterol can get into the “game.”
Many scientists now
believe that any statin-induced reduction in cardiovascular-disease risk
is not directly due to cholesterol lowering but related to other
physiological factors, such as lessening inflammation. This appears to
be the case for SCI, where rat studies suggest that the statin drug
Lipitor limits the infusion of inflammatory molecules into the injury
site, reducing damage.
Statins are hugely
profitable. For example, Lipitor is the world’s top-selling medicine,
generating over $13 billion in sales in 2010. Taking statins is not like
taking antibiotics for a UTI in which once the infection has been cured
you can quit taking the drug. With statins, nothing is fixed; you are
expected to take them the rest of your life. As such, you are
essentially providing drug makers a life-time financial annuity that
either you or society must pay. Given the massive numbers of people
prescribed statins, one can only imagine the health-care savings that
would accrue if the underlying foundation for statin use was no longer
valid.
Side Effects
Because statins
reduce cardiovascular-disease risk by only a small amount at best, any
life-extending benefits are counterbalanced by a multitude of
devastating side effects. In other words, you may avoid a heart attack
but, for example, be more prone to get cancer or a neurological
disorder. In the case of Lipitor, 100 people will have to take the drug
for over three years to prevent one heart attack. The other 99 will be
taking on a lot of adverse side effects for no benefit at a huge cost.
Because many of the side effects only surface over time, they are not
attributed to statin use but interpreted as new, distinct health issues,
requiring treatment with yet additional drugs.
A tip-of-the-iceberg
listing of adverse effects is provided below:
Diabetes:
Because diabetes is related to cardiovascular problems, physicians often
prescribe statins. In fact, however, statin use actually raises blood
sugar levels, increasing diabetes risk. Because cholesterol is the
biochemical precursor to vitamin D, statin use may compromise vitamin-D
levels, a nutrient that regulates blood-sugar levels.
Polyneuropathy
is a condition in which peripheral nerves are damaged. Statin users have
more polyneuropathy, a serious implication for diabetics already
predisposed to this disorder.
Muscle Damage:
Many statin users experience muscle pain and weakness. Research
indicates that statins compromise the ability of muscles to repair and
regenerate. These problems may be caused by a depletion of Coenyzyme Q10
(CoQ10), a nutrient vital for cellular energy production. Because CoQ10
is manufactured by the same biochemical pathway that generates
cholesterol, statins inhibit its production, contributing to muscle
weakness. If you take statins, take them with CoQ10, a readily available
nutritional supplement. Recognizing the problem, at one time, drug
makers even considered adding CoQ10 to their statin formulations.
Heart Failure:
Because the heart is a muscle, evidence suggests that statin-induced
CoQ10 depletion may actually promote, not prevent, heart failure.
Stroke:
Statin use increases second stroke risk.
Liver Damage:
In a Swedish
study, 57% of all statin-connected adverse drug reactions were related
to drug-induced liver injury.
Impotence:
Because cholesterol is the biochemical precursor for testosterone, it’s
not surprising that the use of cholesterol-lowering statins is
associated with sexual dysfunction. Given that SCI already compromises
testosterone production, it is questionable whether individuals with SCI
should be administered a drug that further inhibits testosterone
synthesis.
Cancer:
Animal studies suggest that statin consumption increases cancer risk.
Several human studies validate this concern.
Memory Loss
is associated
with statin use. For example, former Astronaut Dr. Duane Graveline has
written Lipitor: Thief of Memory (2006) and other books
describing how he lost his short-term memory after taking Lipitor (see
sidebar &
www.spacedoc.com).
Neurodegenerative
Disorders:
Statin use has been linked with several neurodegenerative disorders. For
example, statin-depleted CoQ10 levels may facilitate the development
of Parkinson’s disease, associated with shaking and difficulty with
walking, movement, and coordination. In another example, research
suggests that patients with ALS (amyotrophic
lateral sclerosis) who possess higher cholesterol levels live
longer.
Conclusion
My college chemistry
professor believed that scientists should run society because they have
been trained to be objective. After spending years in Washington, DC
policymaking positions, I roll my eyes when remembering his naivety and
now cynically believe that sanctimoniously called “objective science” is
an oxymoron. Although an invaluable sign post
guiding us to new knowledge, the scientific process is imbued at all
levels with subjectivity, including, in the case of cholesterol-lowering
drugs, economical agendas and underlying statistical manipulation.
For
example, a 2004 National-Institutes-of-Health expert panel recommended
that acceptable cholesterol levels be revised downwards, a decision that
would greatly increase statin-drug market size. Surprise, surprise, the
majority of panel members had financial conflicts of interests with
statin-drug makers.
Statistical
manipulation is another issue. Considered objective-science’s
cornerstone, statistics are used to anoint study validity, theoretically
transcending subjectivity. In reality, they are more reflective of Mark
Twain’s wisdom: “There are three kinds of lies: lies, damned lies, and
statistics.” By tweaking, manipulating, and presenting data in a fashion
that promotes desired results, statistics are used to bolster economic
agendas. For example, if TV news show reports that a study demonstrates
that a certain drug greatly lowers disease risk, the proclamation
usually reflects only relative, not absolute, risk. To illustrate, if 10
out of 10,000 untreated people normally die from a disorder but only 5
die in 10,000 treated individuals, the relative risk has decreased by
50%, but the absolute risk reduction (5 out of 10,000) is less
impressive. Both risks are valid, but one sounds earth-shaking and the
other insignificant.
In addition, although
risk reduction for a specific endpoint (e.g., cardiovascular disease) is
emphasized, the more important effect on overall mortality is often
ignored. In other words, will you live longer?
In conclusion, as
with all things in life, truth is relative and depends upon the goals,
objectives, and perceptions of those assessing it. You need to determine
your own truth for your situation by educating yourself on potential
risks relative to benefits. It’s your life; do not abdicate your
responsibility.
