Posts Tagged Cholesterol medications

By blocking this enzyme, the medication decreases the body’s internal production of cholesterol. Unfortunately, a well known and fairly common side effect is muscle pain and weakness …

Do Cholesterol Medications Protect Otherwise Healthy People from Heart Disease?

A recent study, published in the New England Journal of Medicine, suggests that people who have normal cholesterol might benefit by taking cholesterol lowering medications called “statin” medications. In this study, researchers gave these medications to subjects who had normal cholesterol but an elevation in an indicator of inflammation called C-reactive protein. Researchers describe to subjects as “healthy men and women” with a bad cholesterol of less than 130 mg/dl and a C-Reactive Protein level of 2.0 or higher. One group of subjects received 20 mg daily of a medication called rosuvastatin (brand name Crestor) while the other group received an inactive sugar pill. The study, which was supposed to last five years, was ended early because researchers felt that it would be unethical to study due to aggressive decreases of heart attack, stroke, vascular surgery, hospitalization or death from cardiovascular causes.

Currently over 36 million Americans qualify for cholesterol lowering medications simply based on their high cholesterol numbers. This new study would open the door for doctors to prescribe cholesterol-lowering medication to over 10 million people who have normal cholesterol numbers. So is this study all it cracks up to be? Let’s dive into the study…

If you are debating whether or not to fill that prescription for a statin medication, you may want to read this article first.

I remember when I was learning to defend against a knife attack in my blackbelt class. My instructor, a former special forces soldier, looked at us with a solemn look and said, “when defending against a knife attack, the question is not whether or not you will get cut, because you are going to get cut, the question is how serious will the wound be. Your job, in defending a knife attack, is to position yourself to limit the damage when you do get cut while disarming your attacker.” That wisdom can be applied to prescription medications as well.  As with any medication, the question isn’t whether or not side effects will occur, but do the reported benefits outweigh the numerous and almost certain risks associated with the drugs? Every day, medical doctors are forced to decide whether or not the risks of a medication are outweighed by the benefits, and how to dose and treat so that the risks of side effects are lowest while disarming the disease. Not exactly as dramatic as the knife attack, however, the outcome can be just as damaging and deadly if the wrong decision is made. The question at hand is, “are the risks of statin drugs outweighed by the benefits?”

A recent study sheds more light on the potential harm of popular cholesterol medications known as statin drugs. In this study on over 2 million men and women, researchers discovered that statin drugs significantly increased the risk of these serious side effects.
1. Moderate to severe liver damage
2. Moderate to severe muscle damage
3. Cataracts
4. Kidney damage

Do the benefits outweigh the risks?

That is what the PR firms keep telling us; but is it true? After crunching the numbers, the researchers found that you would have to treat 37 women and 33 men for five years to prevent one case of heart disease. They also discovered that stains prevent esophageal cancer; but you would have to treat 1266 women and 1082 men for five years to prevent one case.

So what about the potential side effects?

Scientists use a statistical calculation called “Number Needed to Harm” (NNH) to show risk. Let’s find out how many people will be harmed by statins in a five-year period.
1. One person will develop moderate to severe muscle damage for every 259 statin users
2. One person will develop moderate to severe liver damage for every 136 statin users
3. One person will develop kidney failure for every 434 statin users
4. One person will develop cataracts for every 33 statin users

Let’s use these numbers to figure out what we can expect per 10,000 patients who use statins for 5 years.
1. 271 fewer cases of diagnosed heart disease
2. 8 fewer cases of esophageal cancer
3. 74 cases of liver damage
4. 23 cases of kidney failure
5. 39 cases of debilitating muscle damage
6. 307 cases of cataracts

Doctors accept these risks because they assume that statins actually prevent heart disease, at best, they delay it, that is, for a few people. Based on this study, this means that 9721 out of 10,000 patients would gain no benefit from taking statins for five years. That is astoundingly dismal. Perhaps we should be looking for better options…

Cholesterol is an important component for the proper functioning of the body. When the cholesterol numbers are out of range the first option for treatment should be lifestyle changes. This audio program includes supplement and lifestyle recommendations for controlling cholesterol without drugs.

One study, which you likely never heard about, evaluated the impact of cholesterol on longevity in men and women age 65-98 years of age (mean age 76 years old). The results were nothing short of astonishing:

The group with the lowest cholesterol were most likely to die during the study
HDL level (considered the good cholesterol) had no impact on risk of death
Women had higher levels of cholesterol than men and yet they lived longer!
Men who had similar total cholesterol and LDL cholesterol levels to the women lived just as long as the women
Even the bad cholesterol (LDL) was protective against early death. This means the people who had the most “bad” cholesterol lived the longest

Yes, but is there any other research that supports these findings?

Dr. Bernard Forette in Paris, France found that women of the mean age of 82 years of age who had the highest cholesterol enjoyed the longest lifespan. Women with a total cholesterol of 272 mg/dl seemed to have the longest lifespan while those women with a cholesterol of 155 mg/dl had over five times the risk of early death. When cholesterol was excessively high, in the range of 350 mg/dl, risk of death increased to 1.8 times normal. The interesting finding was that women who had cholesterols around 200 also shared an increased risk of dying equivalent to 1.8 times normal. The bottom line is there are two groups who die early, the group whose cholesterol is very low or very high! The group with an excessively elevated cholesterol usually have an inherited condition which causes extremely high cholesterol (around 400 mg/dl or higher), this group has a higher risk of early death.

In another study performed in the Netherlands, people older than 85 years of age were followed for 5 years. The group who had cholesterol levels greater than 252 mg/dl where half as likely to die as those with cholesterols less than 194 mg/dl. The people who had cholesterols between these two extremes enjoyed two-thirds the death rates as those who had the lowest cholesterol.

The bottom line of these studies is that senior citizens should reconsider cholesterol lowering treatment. Lowering cholesterol in seniors will not protect them from early death, it will likely shorten their lives. In addition, lowering cholesterol can place seniors at increased risk of depression, energy deficits and memory problems.

What about using natural products to lower cholesterol?

In senior citizens we do not recommend lowering cholesterol unless it is extremely high. At this point natural alternatives to cholesterol lowering medications can become a proper course of action. Unless cholesterol is elevated over 280, our recommendation is to leave it alone and look to other means of protecting yourself against heart disease. These other means include controlling carbohydrate intake, taking fish oil, antioxidants and other important herbs and nutrients to protect the heart.

References:

Schupf N, Costa R, Luchsinger J, et al. (2005). Relationship Between Plasma Lipids and All-Cause Mortality Nondemented Elderly. Journal of the American Geriatrics Society 53:219-226.

Forette B, Tortar D, Wolmark Y (1989). Cholesterol as a Risk Factor for Mortality in Elderly Women. Lancet 1:868-870.

Waverling-Rijnsberger WE, Blauw GJ, Lagaay AM, Knook DL, Meinders AE (1997). Total Cholesterol in the Oldest Old. Lancet 350:1119-1123.

Statin medications
High blood pressure
Lower stress – vital adapt from Natura Health
Magnesium
Vitamin D
Omega 3
Vitamins D & K with Sea Iodine by Life Extension
HTN Complex
Perfusia SR by Thorne Research
Low cholesterol
Probiotics

Flu Season
B vitamins and dementia
Thyroid medications
Statin medications
Enlarged liver
Charlie horses
Sodium
Iosol

Orthorexia nervosa – being nervous about correct eating (people who focus on healthy eating)
Supplements (vitamins)
Amount of omega 3s to take daily
Coumadin & vitamin K
When to take fish oilBlood platelets
Coumadin & Levaquin
Medication and eye problems
Omega 3, 6, 9  & osteoporosis
Stomach irritation & spices
Cholesterol medications
Plavix
Nose bleed
Cingular
Blood pressure & turmeric
Calf muscle spasm
Curcumin & inflammation
Anemia
Omega 3

“Eat your vegetables,” that’s what Grandma used to say. And as time goes on and our medical scientists become more willing to look at how diet effect’s health, we find that Grandma was right. Eating fresh fruits and vegetables clearly can keep you healthy. “An apple a day can indeed keep the doctor away!”

Which parts of the fresh fruits and vegetables are responsible for maintaining good health? Before I answer that, let me ask a different question… why should it matter? Well, it matters to the big drug companies. If someone can discover an ingredient within the food that we eat that may save us from cancer or heart disease, then there is money to be made. The company would have to “alter” the ingredient chemically, so that they would have a “chemical entity” that they can patent and own. Then they can spend the millions of dollars needed to “prove” that it does what they say it does (clinical testing), than they can charge lots of money for the “medicine” and make billions in the process. Does anyone remember the news out of Johns Hopkins a while ago about broccoli sprouts and their reported benefit for protection against cancer? Of course, a company cannot patent broccoli, they can’t own it or stop you from buying it from the supermarket, so the race is on to make the ingredient different so someone can “own” it and profit from it.

Which ingredients have the biological activity may also be important to know because there may be cooking or processing procedures that may render the ingredient inactive, or destroy it completely. An example of this would be the essential fatty acids that were discussed in last month’s column. If one were to cook with flax oil then the omega-3 fatty acids contained therein would be destroyed. The processing of food has been shown to destroy enzymes and different nutritional components.

So… back to the question… what are the important ingredients in fresh fruits and vegetables that are responsible for maintaining good health? Of course, there are the vitamins and minerals… vitamin C, beta-carotene, zinc, selenium, etc. There are the enzymes that help digest food and help give the liver and pancreas a break from the work of digestion. There are the essential fatty acids that come from seeds and nuts. There is the fiber that we get from food.

And there are the “plant fats”, also know as sterols and sterolins. The primary fat that is found in animals is cholesterol, and the plant equivalent of cholesterol is called sterol. Animals cannot make sterols, but they can get them from the plants that they eat.

Animal studies (including humans) have demonstrated that Beta-sitosterol (the major sterol in higher plants) and Beta-sitosterol glycoside (another plant product) exhibit anti-inflammatory, anti-neoplastic, anti-pyretic and immune-modulating activities. These activities may help protect against and reverse such diseases as chronic viral infections, tuberculosis, cancer, allergies, rheumatoid arthritis, lupus, multiple sclerosis, and various other autoimmune diseases.

The immune system within our bodies is very complex. There are basically two ways that our immune system protects us from disease. The first way is by creating antibodies in response to a particular invader. This is basically how an inoculation works. We inject into the body a part of a virus or bacteria. The body recognizes the invader and creates a specific defense against it, very specific cells that are floating through the body as sentries, waiting for the arrival of the bad guy. They can only fight against that specific bad guy. When someone gets infected with the virus or bacteria then the body is already armed to get rid of it. This is also the primary way that we hand down immunity from generation to generation… antibodies are passed from mother to child through the placenta and through a nutrient called colostrum that comes from breast feeding in the first few days of life.

The second way is through a less specific corps of cells that find invaders and destroys them through various forms of chemical warfare. The natural killer cells that help protect against cancer are among these types of cells. Within these particular cells, the balance between the different components is very important to the body’s ability to effectively fight off disease.

An “auto-immune” disease occurs when, for some reason, the body’s immune system starts fighting against the body itself, or certain parts of the body. In the case of multiple sclerosis, parts of the immune system start attacking the lining of the nerve cells, called the myelin sheath, and cause nerve damage that results in muscle weakness, fatigue and vision problems. It may be that the actual problem has to do with the “balance” between certain parts of the immune system.

Some of the immune cells do the attacking and other cells tell the attacking cells when to stop the assault. Too much of one type and not enough of the other has been observed in people with certain chronic viral and bacteria diseases, and in other chronic conditions, such as allergies and auto-immune disorders. Fixing this imbalance may be the answer to helping people with rheumatoid arthritis, lupus, multiple sclerosis, chronic fatigue, fibromyalgia, persistent allergies, psoriasis… even cancer and HIV.

What does all of this have to do with sterols and sterolins… the fats that come from plants? Research has shown that beta-sitosterol and beta-sitosterol glycosides work to help maintain the proper balance within certain parts of the immune system. These plant fats help return the body to normal function, they help “normalize” immune function. Is it any wonder that vegetarians seem to suffer less from all sorts of diseases, including various cancers, heart disease, allergies and auto-immune diseases? Ongoing studies looking into the effect of these plant fats include rheumatoid arthritis, chronic rhinitis and sinusitis, hepatitis C, HIV, and cancer.

So the next question is… which plant foods will provide the most of these healthy plant fats? Almost all plant foods contain some amounts of sterols and sterolins. The following list shows the foods with the highest contents (mg of sterols/sterolins per 100 grams of edible portion).

Nuts and Seeds:
Sesame seeds 443
Sunflower seeds 349
Cashews 130
Almonds 122

Vegetables:
Peas 108
Barley 98
Squash, white 89
Potatoes, white 40
Soybeans 30

Vegetable Oils:
Olive oil 91
Wheat germ 67
Sunflower oil 60
Cocoa butter 59

Fruits:
Figs 27
Oranges, naval 17
Pomegranates 16
Apricots 16

Beans and Legumes:
Peanuts 142
Broad 95
Kidney 91

Spices, dry:
Clove 242
Oregano 177
Thyme 152

As you can see, seeds and nuts contain much larger amounts than do many other foods. However, how these foods are cooked and stored, frozen or processed can affect the amounts of the good fats. For example, freezing releases an enzyme within the food that destroys the phytosterol glycosides. Boiling vegetables causes the plant fats to precipitate into the cooking water, which gets thrown away. The vegetable oils mentioned above actually have the sterol removed, because the “cloudiness” that they cause gives the impression of impurities in the oil.

The sprouts of certain foods, if consumed at the proper time, contain much higher amounts of the plant fats. There are products available at the health food store that take the sprouts, dry them and put them in a capsule to insure a certain amount of sterols and sterolins per capsule.

In conclusion, it seems to make sense that nature has the ability to provide us with all of the nutrition that we need to live long, healthy lives. It is clear that our understanding of just how this works is still in its infancy and that as time goes on we will discover more and more. In the meantime, my recommendation is to eat plenty of fresh fruits and vegetables. Try to eat them in the packages that nature provides them, you never see a “can” of peas growing on a vine. Try to get them as close to the time when they were picked as possible and try to make sure that they were picked ripe, not ripened on a truck on the way to the store. Try to eat foods that are not treated with pesticides and other poisons.

And most importantly, think about what else your Grandma tried to tell you… if she was right about this, she was probably right about all the other things too!

The researchers determined that fish oil resulted in a 23% decrease in risk of death from all causes while statin medications resulted in only a 13% reduction. For death rates from heart disease related conditions, fish oil decreased the death rates by 32% while statins decreased the rate by 22%. Overall, the fish oil provided the most benefit compared to other treatments.
(Arch Intern Med., April 11, 2005; Vol. 165, 725-730)

Dr. Ray’s Notes:
When we look at studies for medications and supplements that impact a condition such as heart disease we want to know how that product benefits funeral rates (death rates). If a medication lowers rates of heart attack and has no benefit to longevity then it begs the question “why not?” This is the type of situation that we see with aspirin. Aspirin decreases death rates from heart attack, however, the side effects from the medication increase risk of death from other causes such as bleeding in the stomach or brain. In the end it is a wash because overall funeral rates are the same in the group who received the aspirin or the sugar pill. Said another way, people who take an aspirin a day don’t live a day longer than someone who doesn’t take an aspirin a day. Fish oil appears to decrease cardiovascular related deaths as well as death from all causes. In fairness, statins appear to achieve a decrease as well. There are two differences though, first fish oil worked better than statins and second, fish oil has almost no side effects while statins can cause pain, muscle weakness, and liver damage. I know which one I will choose, how