Stats on Statins, Dr. Briffa

'We're told by the authors this meta-analysis that treating with statins prevented 11 major vascular events for every 1000 people treated for a period of 5 years. Put another way, 91 people would need to be treated for 5 years to prevent one major vascular event. Or in other words, only about 1 per cent of people treated with statins for 5 years will benefit (and about 99 per cent won't).

"Professor Baigent and his colleagues give us some soothing reassurances about the fact that the benefits of statins vastly outweighing the risks of adverse events such as myopapthy (muscle pain and weakness). They quote of the excess incidence of myopathy as 0.5 cases per 1000 people over 5 years. However, the source they quote is based on diagnosing myopathy once the marker for muscle damage (creatine kinase) is at least ten times the upper limit of normal. Many individuals will have significant pain and weakness with much lower levels of creatine kinase. Statins are also linked with adverse effects on the liver and kidneys, and increase risk of diabetes too. Overall, adverse effects of statins affect about 20 per cent of people who take them."

http://www.drbriffa.com/2014/02/14/its-about-time-some-people-were-straight-with-the-statistics-on-statins/

Why would a health and diet blogger care about statin research?  Because the case for statins is the case for high carb, low fat, and I think that diet will kill you.  Taking statins is not a topic I should make recommendations one, one way or the other.  But if you know how weak the statin case is, you can infer that the case made by what Mike Eades calls the statinators is very weak:
1.  We can't prove that dietary reduction of blood cholesterol lowers mortality rates
2.  But, since statins lower blood cholesterol, and statins reduce heart disease, we can assume that lowering blood cholesterol is good for you.

For one, this assumption is invalid; there could be a number of reason why a statin might reduce heart disease.  Two, the reduction of heart disease is risk is not very dramatic (see above).  Three, it is accompanied by an increased risk of death from other causes, thus all cause mortality for statin users is identical to that of non-statin users.

In other words, what is known about statins doesn't say anything good about eating a low fat diet.  

The Statin Confusion Continues

Why might low LDL-cholesterol levels be a risk factor for mortality? The authors point out that cholesterol can alter the functioning of certain inflammatory substances (including C-reactive protein and cytokines), and therefore low-cholesterol might lead to a more inflammatory state (which is not healthy).

One very interesting thing about this study was that it found that mortality across the groups was no different in individuals not treated with statins. What this suggests is that statins might be having a direct effect that is harmful to the hearts and health of individuals with heart failure.

http://www.drbriffa.com/2014/01/31/statins-associated-with-increased-risk-of-death-in-those-with-heart-failure/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+drbriffa%2FsOZf+%28Dr+Briffa%27s+Blog+-+A+Good+Look+at+Good+Health%29

Not easy to make a lot from this summary of the study except it flies in the face of the conventional wisdom about what statins are good for.  Be healthy - it sucks less than being sick.  

BMJ: We Missed the Mark on Sat Fat

This is a great read, I highly recommend you read the whole piece.

"The aspect of dietary saturated fat that is believed to have the greatest influence on cardiovascular risk is elevated concentrations of low density lipoprotein (LDL) cholesterol. Yet the reduction in LDL cholesterol from reducing saturated fat intake seems to be specific to large, buoyant (type A) LDL particles, when in fact it is the small, dense (type B) particles (responsive to carbohydrate intake) that are implicated in cardiovascular disease.4

"Indeed, recent prospective cohort studies have not supported any significant association between saturated fat intake and cardiovascular risk.5 Instead, saturated fat has been found to be protective. The source of the saturated fat may be important. Dairy foods are exemplary providers of vitamins A and D. As well as a link between vitamin D deficiency and a significantly increased risk of cardiovascular mortality, calcium and phosphorus found commonly in dairy foods may have antihypertensive effects that may contribute to inverse associations with cardiovascular risk.6 7 8 One study showed that higher concentrations of plasmatrans-palmitoleic acid, a fatty acid mainly found in dairy foods, was associated with higher concentrations of high density lipoprotein, lower concentrations of triglycerides and C reactive protein, reduced insulin resistance, and a lower incidence of diabetes in adults.9 Red meat is another major source of saturated fat. Consumption of processed meats, but not red meat, has been associated with coronary heart disease and diabetes mellitus, which may be explained by nitrates and sodium as preservatives.10

"The notoriety of fat is based on its higher energy content per gram in comparison with protein and carbohydrate. However, work by the biochemist Richard Feinman and nuclear physicist Eugene Fine on thermodynamics and the metabolic advantage of different diet compositions showed that the body did not metabolise different macronutrients in the same way.11 Kekwick and Pawan carried out one of the earliest obesity experiments, published in the Lancet in 1956.12 They compared groups consuming diets of 90% fat, 90% protein, and 90% carbohydrate and showed that the greatest weight loss was in the fat consuming group. The authors concluded that the “composition of the diet appeared to outweigh in importance the intake of calories.”

"The “calorie is not a calorie” theory has been further substantiated by a recent JAMAstudy showing that a “low fat” diet resulted in the greatest decrease in energy expenditure, an unhealthy lipid pattern, and increased insulin resistance in comparison with a low carbohydrate and low glycaemic index diet.13 In the past 30 years in the United States the proportion of energy from consumed fat has fallen from 40% to 30% (although absolute fat consumption has remained the same), yet obesity has rocketed."

This one is a mind blower, as I have read the NNT was 100, whereas baby aspirin is 40.  It's much worse than that:

"A meta-analysis of predominantly industry sponsored data reported that in a low risk group of people aged 60-70 years taking statins the number needed to treat (NNT) to prevent one cardiovascular event in one year was 345.20 The strongest evidence base for statins is in secondary prevention, where all patients after a myocardial infarction are prescribed maximum dose treatment irrespective of total cholesterol, because of statins’ anti-inflammatory or pleiotropic (coronary plaque stabilising) effects. In this group the NNT is 83 for mortality over five years. This doesn’t mean that each patient benefits a little but rather that 82 will receive no prognostic benefit.21 The fact that no other cholesterol lowering drug has shown a benefit in terms of mortality supports the hypothesis that the benefits of statins are independent of their effects on cholesterol."

http://www.bmj.com/content/347/bmj.f6340

Kresser On Statins

"To summarize:

• The only population that statins extend life in are men under 80 years of age with pre-existing heart disease.
• In men under 80 without pre-existing heart disease, men over 80 with or without heart disease, and women of any age with or without heart disease, statins have not been shown to extend lifespan.
• Statins do reduce the risk of cardiovascular events in all populations. A heart attack or stroke can have a significant, negative impact on quality of life—particularly in the elderly—so this benefit should not be discounted.
• However, the reductions in cardiovascular events are often more modest than most assume; 60 people with high cholesterol but no heart disease would need to be treated for 5 years to prevent a single heart attack, and 268 people would need to be treated for 5 years to prevent a single stroke.
• Statins have been shown to cause a number of side effects, such as muscle pain and cognitive problems, and they are probably more common than currently estimated due to under-reporting."

http://chriskresser.com/the-diet-heart-myth-cholesterol-and-saturated-fat-are-not-the-enemy

The article is a remarkably readable review of a tough topic. Biggest takeaway - statins are the best evidence available that "cholesterol" is the agent of heart disease. If statins don't actually reduce heart disease, the case that "high cholesterol" is the cause of arterial disease has next to no evidence as support.

Even if statins were proof of the cholesterol = causation issue, there's still no proof, and nearly no evidence, that reducing consumption of saturated fat (and replacing it with other fats or carbs) will result in less heart disease or "lower cholesterol".  The opposite is more likely for most of us.  

Can I Eat Paleo Without Getting Heart Disease?

Kresser Heart Disease Compendium
Want to review why you can in good conscience enjoy bacon, steak, burgers, cheese and butter and live to tell the tale? Read on.  

• Study Reveals Doubt on Cholesterol Drug
• Three Eggs a Day Keep the Doctor Away!
• The Truth About Statin Drugs
• Research Alert: Antidepressants & Cholesterol
• Inflammation Worsens Danger of Heart Disease
• More on Statin Side Effects
• More Silly Shenanigans Against Saturated Fat
• Have Some Butter With Your Veggies!
• New Study Puts Final Nail in the "Saturated Fat Causes Heart Disease" Coffin
• Ten Steps to Preventing Heart Disease Naturally
• Why You Should Eat More (not less) Cholesterol
• For a healthy heart, stick to butter

Mercola: Statin Drugs May Accelerate Cardiovascular Disease

What can you conclude from reading stats like this:
"A new study in the journal Atherosclerosis1 shows that statin use is
associated with a 52 percent increased prevalence and extent of
calcified coronary plaque compared to non-users. None of the
participants in the study - 6,673 in all - had any known coronary artery
disease at the time of undergoing coronary CT angiography (CCTA) - a
non-invasive method that allows you to see coronary atherosclerotic
features, including plaque composition.

"Arterial plaque is a hallmark of cardiovascular disease and increases
your risk of all-cause mortality, so clearly, anything that increases
calcification and stiffening of your arteries is wisely avoided. And
statins seem to fall into this category.

"These disturbing findings come right on the heels of another study
published in the journal Diabetes Care,2 which discovered that type 2
diabetics with advanced atherosclerosis who are frequent statin users
have significantly higher amounts of coronary artery calcification
compared to less frequent users of the drug.

"Furthermore, in a subgroup of participants who initially were not
receiving statins, progression of both coronary artery calcification as
well as abdominal aortic artery calcification was significantly
increased when they began frequent statin use."

http://articles.mercola.com/sites/articles/archive/2012/10/15/statin-dru
gs-on-coronary-disease.aspx?e_cid=20121015_DNL_art_1

I don't think you can conclude much at all. While it is true that
calcification is a serious abnormality and is associated with very poor
cardiovascular health - this is an observational study. These people
are all sick already, so the most that can be said is that statins do
not arrest all of the problems associated with being sick and thus
"needing" statins in the first place.

Furthermore, the Cochrane Collection, the closest thing we have to an
impartial interpreter of the mixed scientific results on statins, has
already made a strong case that the only folks who can improve their all
cause mortality rates are those who are under age 65 and have previously
diagnosed heart disease. IOW - by their research, statins are a no win
as a long term, primary prevention strategy, although they are used for
that purpose quite commonly.

As Dr. M's writer reports, there are significant potential side effects
from statin use - and frankly, little reason to believe they would be
effective. But studies like the ones cited above just can't show
causality - no matter how much we might like to believe that they do.
That's not to say that if I was a diabetic taking a statin that I would
ignore the results of a study like these - they should be frightening
for anyone who thinks a statin is a magic bullet.

Most importantly, the vast majority of folks who have a lipid profile
that might prompt an MD to recommend statin usage can correct that
rapidly with carbohydrate restriction (the side effect of which is
appetite reduction, glycemic control, and weight loss). Eat meat, eggs
and vegetables, nuts and seeds, little fruit or starch and no
sugar/wheat.

FDA Statin Warning

Well, at least they admit this much.
http://online.wsj.com/article/SB10001424052970203833004577251392001194250.html?mod=djemalertNEWS

 

Women, Statins

http://www.time.com/time/magazine/article/0,9171,1973295,00.html

Interesting article, complex topic.

First, there's very little info that supports the efficacy of statin use for females, so I hope those who are getting that recommendation will take the time to research the matter carefully.  My opinion based on experience is that doctors have as difficult a time keeping up with medical developments as any other profession does - there's absolutely not a guarantee that the doctor knows more than you do or could - especially since it's not the doctor's life that's at stake.

You needn't take my word for that - have a listen to this episode of Jimmy Moore's excellent podcast, for a decryption of how cardiologist Lowell Gerber found his way out of the low fat woods using carb restriction, and along the found out "that my patients had not been lying to me".  IOW, the patients kept saying "Doc, I am doing what you say" but their conditions were worsening; it was only when the doc took his own advice that he realized he'd had them barking up the medically correct but wrong tree.

When looking at statin results, the confusing language is hard to get around.  They talk about reduction of mortality from cardiac events.  They talk about "reduction of risk."  They talk about better cardiac results for this group or that group.  But often, what is found in statin trials is the cardiac disease is interrupted, apparently, but other disease risks increase.  Many statin trials show a wash for all cause mortality; thus the Cochrane Collection's ambivalent report on their efficacy in a 2011 meta analysis.

Further, statin trials are short, meaning there is probably time to evaluate the benefit but not to evaluate the side effects.  With many medications, the benefits make themselves know before the costs - for example, alcohol and cocaine (and stimulants in general).

One thing I think HAS been proved about statins, and that is that they work, if they do, due to a reduction in inflammation.  They are supposed to work by lowering levels of lipoproteins (the vessels that transport cholesterol), but that causality has never been proved.  I would say it was convincingly disproved by vytorin, a med which combined statins with another cholesterol lowering drug, and was effective at lowering cholesterol - but increased mortality of those taking the drug (as I've reported on before).

Notice in the two year old article linked above, however, the entire intro is build around the "cholesterol gunks up your arteries like grease in a pipe" model.  How quaint!

If you want to dig deep into the science of lipoproteins, cholesterol and disease - I recommend this podcast/transcript from Chris Kresser with Chris Masterjohn, and this link from chriskresser.com: Cholesterol

Here's the BLUF:  think of heart disease as the result of broken glass floating around in your blood vessels, and the atherosclerotic plaques are your body's response to the cuts.  What do I mean by "broken glass"?  Masterjohn equates easily oxidized particles in the blood to glass - useful when whole, but dangerous when broken.  The particles in your blood that oxidize most easily are LDL particles with a high content of polyunsaturated fatty acids (PUFAs), and the small, dense LDL particles left over after your body responds to high carb intake via conversion of glucose to triglycerides.  Under the "what to do" category, think of inflammation reduction via carb restriction and low intake of PUFAs, ingesting enough of the essential vitamins and minerals, maintaining a healthy gut, and cultivating a good set of gut bacteria.  Easier said than done, sure, but the first step is - carb restriction.  No sugar/no wheat is part two.  These two are probably 80% of the formula.

Eat meat, vegetables, nuts and seeds, little fruit or starch, no sugar/wheat.

Kresser: Statins

Statins are the most popular drugs in history. Drug companies made $26 billion selling statins alone in 2008. 25 million Americans take them, and the number is growing each year.

One reason why statins are the best-selling drug category by far is that 92% of people taking them are healthy. The FDA has approved the prescription of statins to people at low risk for heart disease and stroke, who don’t even have high cholesterol. Two years ago the American Academy of Pediatricians recommended that statins be prescribed for kids as young as eight years old.
With sales statistics like this, you’d think statins are wonder drugs. But when you look closely at the research, a different story emerges. Statins have never been shown to be effective for women of any age, men over 65, or men without pre-existing heart disease. Early studies did suggest that statins are effective for men under 65 with pre-existing heart disease, but later, more rigorous clinical trials has not confirmed this benefit.
In addition, statins have been shown to have serious side effects and complications in up to 30% of people who take them. Studies have also shown that the majority of these adverse events go unreported, because doctors are largely unaware of the risks of statins.
http://chriskresser.com/the-hidden-truth-about-statins

Plain truth, which I think even doctors would agree with - if you can get healthy by eating smarter, and stop using statins, it is an all win case for virtually any of us.

Statin Trifecta

http://people.csail.mit.edu/seneff/why_statins_dont_really_work.html

This is a long, brilliantly written post, with a very interesting conclusion, that lives up to its title (How Statins Really Work Explains Why They Don't Work):

So, in my view, the best way to avoid heart disease is to assure an abundance of an alternative supply of cholesterol sulfate. First of all, this means eating foods that are rich in both cholesterol and sulfur. Eggs are an optimal food, as they are well supplied with both of these nutrients. But secondly, this means making sure you get plenty of sun exposure to the skin. This idea flies in the face of the advice from medical experts in the United States to avoid the sun for fear of skin cancer. I believe that the excessive use of sunscreen has contributed significantly, along with excess fructose consumption, to the current epidemic in heart disease. And the natural tan that develops upon sun exposure offers far better protection from skin cancer than the chemicals in sunscreens.

http://articles.mercola.com/sites/articles/archive/2011/06/22/new-study-show-using-statins-actually-worsens-your-heart-function.aspx?np=true

I wouldn't say that Dr. Mercola's site is an unbiased source for information but that's probably to the good in this case, because his site will publicize information like this:

A study found that statin drugs are associated with decreased myocardial (heart muscle) function.

Statin use is known to be associated with myopathy, muscle weakness and rhabdomyolysis, a breakdown of muscle fibers resulting in the release of muscle fiber contents into the bloodstream. For the study, myocardial function was evaluated in 28 patients.
According to Green Med Info:

“There was significantly better function noted ... in the control group vs the statin group”.

A study found that statin drugs are associated with decreased myocardial (heart muscle) function.

Statin use is known to be associated with myopathy, muscle weakness and rhabdomyolysis, a breakdown of muscle fibers resulting in the release of muscle fiber contents into the bloodstream. For the study, myocardial function was evaluated in 28 patients.
According to Green Med Info:

“There was significantly better function noted ... in the control group vs the statin group”.

http://www.drbriffa.com/2011/08/10/scientists-sometimes-shift-the-scientific-goalposts/

Dr. Briffa is also refreshing for his "biased" reporting:

It’s easy to believe that statins have dramatic life-saving properties. The reality is, however, that for the majority of people who take them, they don’t. In the biggest and best review published to date, statins were not found to reduce overall risk of death in individuals with no previous history of cardiovascular disease [1]. What this study shows is that for great majority of people who take statins, the chances of them saving their life are, essentially, nil (just so you know).

Space Doc On Statins

A healthy 50 year old male ponders this current ad for Lipitor®. "80% of people who have had a heart attack have high cholesterol" it says. This sounds very persuasive yet it is misleading because it all depends upon your definition of high cholesterol.

During my 23 years of general practice, before the era of cholesterol causality, the normal range of cholesterol was 100 to 300. Then overnight it seems, a new disease was created known as hypercholesterolemia and everyone with a cholesterol level of 200 or higher was afflicted with it.

This was the beginning of what I have come to call the cholesterol craze and the drug companies' progressive development of cholesterol lowering drugs, culminating in 1988 with the statins. Since then the acceptable, lower level of cholesterol has fallen from 200 to 170, then 150 and now 130, so this "80% of people who have had heart attacks have high cholesterol" is now true because nearly all people are "caught" by this newest lower value of 130.  At the rate of change seen these past twenty years, soon our acceptable level of cholesterol will be 110 and statin makers will be able to say with complete honesty that almost 100 percent of people who have heart attacks have high cholesterol simply because nearly everyone has high cholesterol if you lower the desirable level sufficiently.


The reality that cholesterol levels are completely normal in more than half of new heart attack cases is what convinced Uffe Ravnskov, MD ( The Cholesterol Myths ) and Kilmer McCully, MD ( The Homocysteine Revolution ) that the theory of cholesterol causation was wrong. It just did not fit the facts.

http://www.spacedoc.com/cholesterol_heart_disease

Dr. G says it well.  There is a lot of misinformation about statins.  The real risk to manage is out of control blood glucose.  If you can stabilize your glucose, you reduce the other symptoms of disease and your risk of contracting them.  Not to mention - while you are alive, you live, instead of limping along preserved by statins and other meds.

When a statin commercial says something as banal as "80% of people who have had heart attacks have high cholesterol" you should listen for what that means (nothing, correlation is not causation), as well as for what they do not say - which is that lowering cholesterol has not been proven to reduce all cause mortality.  All cause mortality is the only meaningful statistic when evaluating a therapy.  Bottom line:  statins should only be used for a specific population with specific criteria, not for every SOB with "high cholesterol".  Caveat emptor.

Statin Risks

As a population we’re living longer. Generally speaking, older individuals are more prone to chronic conditions such as heart disease. With statin drugs continuing to be a mainstream mainstay in the prevention of heart disease, the elderly represent a growing market for these drugs.

While this may be lucrative for pharmaceutical companies, are there any real benefits to be had from prescribing statins to elderly individuals?

One of the most significant trials of statin therapy in the elderly is known as the PROSPER study [1]. In this study, almost 6,000 men and women aged 70-82 were treated with a statin (pravastatin) or placebo for over three years. Each of the individuals in this trial had either a history of cardiovascular disease (e.g. a previous heart attack) or significant risk factors for cardiovascular disease. In this sense, the individuals were deemed to be at relatively high risk of cardiovascular events such as heart attack or stroke. This is relevant as relatively high-risk individuals stand to gain more from statin therapy compared to low-risk individuals.

Risk reduction of non-fatal and fatal heart attacks (added together) was 19 per cent in the group taking the statin. Stroke incidence was not affected. Cancer rates were 25 per cent higher in the group taking pravastatin.

Read the Full Article here: http://www.thecholesteroltruth.com/statins-associated-with-significantly-increas

Risk trade offs are a factor to consider.

Athletes and Statins, Problems

http://healthydietsandscience.blogspot.com/2010/04/statins-and-muscle-problems-in-athletes.html?spref=tw
Bottom line for me is I wouldn't consider doing statins unless I have a heart issue.  There's good reason to believe almost anyone can avoid having to use these things if they don't eat like a USDA food-pyramid-moron.  This study shows what one would think it would show - if you take a powerful medicine that affects cellular energy production and short circuits your body's ability to operate normally, it's no free lunch.  The embedded video is also worth looking at.

I see Lipitor commercials frequently as we track the Grizzly's through the NBA tournament - this is a novel experience for me, by the way, as I've never watched an NBA game before - and the language is remarkably and deliberately vague.  They go way out of their way to avoid making detailed claims, and rely heavily on innuendo like "80% of people who die from heart disease have high cholesterol."  That makes me go "hmmmm."  Why not say "people who take our medicine get well" or "people who use statins, even young, lean and fit people without currently diagnosed heart disease (like the model on this commercial), show a reduction in all cause mortality"?  There's a reason they don't say things like that, and I'm sure you can figure it out.

I also have to let out a moan when the commercial protagonist complains that "diet and exercise didn't do it for me."  Well, if you eat the moron low fat USDA food pyramid junk with 11 servings of whole grains daily, that's not going to help you, your family or me stay off of statins either.  If that's your plan, skip all the agony of eating that nonsense and just get the statin Rx filled.  Better yet - eat meat, vegetables, some nuts and seeds, little fruit or starch, and no sugar/wheat and be healthy.

Knowing How They Work, You'll Know They Don't

http://pi-bill-articles.blogspot.com/2011/03/how-statins-really-work-explains-why.html

The statin industry has enjoyed a thirty year run of steadily increasing profits, as they find ever more ways to justify expanding the definition of the segment of the population that qualify for statin therapy. Large, placebo-controlled studies have provided evidence that statins can substantially reduce the incidence of heart attack. High serum cholesterol is indeed correlated with heart disease, and statins, by interfering with the body's ability to synthesize cholesterol, are extremely effective in lowering the numbers. Heart disease is the number one cause of death in the U.S. and, increasingly, worldwide. What's not to like about statin drugs?

I predict that the statin drug run is about to end, and it will be a hard landing. The thalidomide disaster of the 1950's and the hormone replacement therapy fiasco of the 1990's will pale by comparison to the dramatic rise and fall of the statin industry. I can see the tide slowly turning, and I believe it will eventually crescendo into a tidal wave, but misinformation is remarkably persistent, so it may take years.

I have spent much of my time in the last few years combing the research literature on metabolism, diabetes, heart disease, Alzheimer's, and statin drugs. Thus far, in addition to posting essays on the web, I have, together with collaborators, published two journal articles related to metabolism, diabetes, and heart disease (Seneff1 et al., 2011), and Alzheimer's disease (Seneff2 et al., 2011). Two more articles, concerning a crucial role for cholesterol sulfate in metabolism, are currently under review (Seneff3 et al., Seneff4 et al.). I have been driven by the need to understand how a drug that interferes with the synthesis of cholesterol, a nutrient that is essential to human life, could possibly have a positive impact on health. I have finally been rewarded with an explanation for an apparent positive benefit of statins that I can believe, but one that soundly refutes the idea that statins are protective. I will, in fact, make the bold claim that nobody qualifies for statin therapy, and that statin drugs can best be described as toxins.


Why do I blog about statins as much as I do?  Mainly, it's a result of my horror at some of the people I've met who take statins.  It would appear that doctors will give that stuff to just about anyone with a bit of abnormal blood work - never mind age, gender or other significant factors.  


Perhaps you think you should take statins - that's fine with me.  What I react to is young, very healthy people being advised to take these powerful drugs and seemingly not knowing the side effects - AND, knowing that for the vast majority the symptom that is being treated - a poor blood lipids profile - is completely treatable by restricting carb intake to 100g/day, with the primary side effect of that treatment being weight loss, better sleep, greater energy levels, and removal of the need to eat every few hours to avoid a blood sugar crash.  


Why don't doctors use diet to treat their patients' abnormalities on a fasting lipids profile?  My post tomorrow will describe the experience many have when they try the doctor recommended diet.  It's much like what was described in this post about Clarence Bass.

What Famous Low Fat Advocate Got Cancer and Killed Himself?

Low Cholesterol and Suicide
Low serum cholesterol has been linked in numerous scientific papers to suicide, accidents, and violence (1)(2)(3)(4)(5)(6)(7). No one knows whether violence and suicidal risk have a metabolic byproduct of low cholesterol, or whether having low cholesterol will predispose you to suicide out of hand (8). However, the brain's dry weight is 60% fat, and cholesterol plays a vital role in neuron signaling and brain structure. In fact, one quarter of your body's free cholesterol is found in the nervous system (9). It would make sense that if your cholesterol drops too low then mood and behavior could be affected.
Statins seem to improve mortality for middle-aged men who have known heart disease, have had a stroke, or have high levels of inflammatory markers. If you don't meet those particular criteria, statins will give you no mortality benefit. A recent Cochrane review (18) urged caution in using statins for population-wide prevention of cardiovascular disease, as the risks may well outweigh the benefits.
My brain needs cholesterol! So does yours.  Dismantling your body's ability to make it might have some far-reaching effects.


Ever notice the statin add small print?  Usually, it says something about a reduction in deaths due to heart disease.  But would you trade dying from a heart attack in order to die from cancer, or some other non-heart related death?  Because if you aren't not 65 or under with a previously diagnosed heart condition, that's what you are doing, according to the stats.  Bottom line for me is that I don't think there's any good reason to trust the entire line of logic that results from assuming that fat and cholesterol drives the chronic diseases of the West.  Why do I use words like 'trust' and 'assumption'?  Because after forty years of trying, the fat/cholesterol conjectures remain unproved, and perhaps disproved. 


The cholesterol/mental health connection provides no proof, either, but since I don't eat to lower cholesterol, I suppose I can let this one go!


By the way, the famous guy was Pritikin.  Tragic irony is all you can say to a guy who advocates ultra low fat and dies like that.

Fat Head On Statins

I’ve lost count of the people I know who don’t have atherosclerosis, but were prescribed statins simply because their cholesterol was above the supposedly magic number of 200. Their doctors weren’t treating heart disease; they were treating a cholesterol score.
http://www.fathead-movie.com/index.php/2011/01/20/bad-news-for-statins-is-good-news/

A new meta-analysis of the effectiveness of statins (and lack thereof) was just released by the Cochrane Collaboration, and it’s bad news for the statin-makers — partly because the analysis itself isn’t flattering, and partly because the Cochrane Collaboration is a highly-respected organization whose work is considered both thorough and unbiased.


Pfizer claims Lipitor reduces the rate of heart attacks by 36%. As I’ve explained in previous posts, that figure may sound impressive, but basically it means that during the clinical trials, three out of every 100 men who took a placebo had a heart attack, while slightly less than two out of every 100 men who took Lipitor had a heart attack. So for every 100 men treated for ten years, we’re preventing (in theory) one heart attack.  Even those unimpressive results were found only among with men with existing heart disease or multiple risk factors for heart disease — not among women, and not among otherwise healthy people who happen to have high cholesterol.

The Statin/Rhabdo Connection

All medical interventions involve some risk/reward curve. After all, NSAIDS (like ibuprophen) cause more deaths each year than AIDS. However, there's reason to believe that the risk/reward curve for statins is different than what most physicians assume. I cannot and would not advise anyone on use of statins, except to be careful about high intensity workouts if you use them. But I hate to think of how many uninformed statin users (and prescribers) there are. How can they make realistic decisions? Most of them could use diet to eliminate the symptoms that make their doctors think they'd be a good candidate for statins. We met Dr. Graveline in an earlier post (Dr. Graveline on Statins), and here's a follow up from his very interesting web site:

"In August 2001 the statin drug, Baycol, was removed from the market after causing at least 60 deaths. As a result, the safety of all statin drugs has subsequently come into question. While the Food and Drug Administration (FDA) maintains that statins in common use cause considerably fewer adverse side effects than Baycol, the agency acknowledges that their use does pose some risk.
"All statins increase a patient's chances of developing myositis and rhabdomyolysis, potentially fatal conditions that cause muscle pain and muscle deterioration and may lead to kidney failure. According to the FDA, the chances of developing myositis or rhabdomyolysis from statins are low. As such, they remain on the market.
"It should be noted that with the exception of Baycol, most doctors believe that the benefits of statin therapy far outweigh the risks associated with this class of drugs. No small part of this belief is based on ignorance, for deaths and disability from rhabdomyolysis is often not effectively communicated to the busy practicing physician.
"Until recently my own access to this kind of information was derived primarily from my hundreds of reports from disgruntled statin users. Even some of my astronaut friends have been ravaged by statins with disabling aches and pains, persisting years after the offending statin was discontinued. Many of the letters I receive report this kind of problem, muscle pain appearing shortly after starting their statin that appears to be permanent in that it does not go away even after years.
"Reports of rhabdomyolysis have been sparse but I put that in the category of "dead men tell no tales" for deaths are rarely reported to me. The letters I have received have been mostly narrow escapes from rhabdomyolysis of the type publicized in Smart Money magazine of the unfortunate husband of Sharon Hope, who only now is becoming somewhat functional but not at all like he was in his former CEO capacity.
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"A review of FDA records on statin use up to the year 2000 revealed that a surprising 81 rhabdomyolysis deaths and over 385 hospitalizations for rhabdomyolysis were caused by a statin other than Baycol (cerivastatin). Of these 81 deaths, 13 were due to Lipitor (atorvastatin), 27 were due to Mevacor (lovastatin) 10 were due to Pravachol (pravastatin) and 30 deaths were due to Zocor (simvastatin).
"These rather astonishing figures were those up to the year 2000. Since that time promotion and sales of all statins have sky-rocketed, higher and higher dosage levels are in vogue and the super-powerful statin, Crestor, has been added. When the FDA finally sees fit to release current figures for rhabdomyolysis deaths and hospitalizations, I should not be surprised to learn that the pre 2000 figures will be quadrupled.
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"All this to lower one's cholesterol in a research environment that increasingly is telling us of cholesterol's irrelevancy in the atherosclerotic process. We now increasingly think that inflammation is the culprit. Why then this misguided focus on cholesterol? Yes, statin drugs are powerful anti-inflammatory agents. That appears to be their mechanism of action in cardiovascular risk reduction. It makes sense to me that dosing of these powerful drugs should be based on inflammatory markers not cholesterol levels. Duane Graveline MD MPH, Former USAF Flight Surgeon,
Former NASA Astronaut, Retired Family Doctor" http://www.spacedoc.net/statin_rhabdomyolysis.htm

Statin Issues

Muscle problems includes rhabdomyolosis, and by the calculations of Dr. Graveline (http://inflammationawarenessnow.com/dr-duane-graveline-on-statins-873.htm), more folks have been killed by this condition that will be saved .... by a wide margin.

Date:   January 29, 2009

First Comprehensive Paper on Statins’ Adverse Effects Released

A paper co-authored by Beatrice Golomb, MD, PhD, associate professor of medicine at the University of California, San Diego School of Medicine and director of UC San Diego’s Statin Study group cites nearly 900 studies on the adverse effects of HMG-CoA reductase inhibitors (statins), a class of drugs widely used to treat high cholesterol.

The result is a review paper, currently published in the on-line edition of American Journal of Cardiovascular Drugs, that provides the most complete picture to date of reported side effects of statins, showing the state of evidence for each.  The paper also helps explain why some people have a higher risk than others for such adverse effects.

“Muscle problems are the best known of statin drugs’ adverse side effects,” said Golomb.  “But cognitive problems and peripheral neuropathy, or pain or numbness in the extremities like fingers and toes, are also widely reported.” A spectrum of other problems, ranging from blood glucose elevations to tendon problems, can also occur as side effects from statins.

The paper cites clear evidence that higher statin doses or more powerful statins – those with a stronger ability to lower cholesterol – as well as certain genetic conditions, are linked to greater risk of developing side effects.

“Physician awareness of such side effects is reportedly low,” Golomb said.  “Being vigilant for adverse effects in their patients is necessary in order for doctors to provide informed treatment decisions and improved patient care.”

The paper also summarizes powerful evidence that statin-induced injury to the function of the body’s energy-producing cells, called mitochondria, underlies many of the adverse effects that occur to patients taking statin drugs.

Mitochondria produce most of the oxygen free radicals in the body, harmful compounds that “antioxidants” seek to protect against.  When mitochondrial function is impaired, the body produces less energy and more “free radicals” are produced.  Coenzyme Q10 (“CoQ10”) is a compound central to the process of making energy within mitochondria and quenching free radicals.  However, statins lower Q10 levels because they work by blocking the pathway involved in cholesterol production – the same pathway by which Q10 is produced.  Statins also reduce the blood cholesterol that transports Q10 and other fat-soluble antioxidants.

“The loss of Q10 leads to loss of cell energy and increased free radicals which, in turn, can further damage mitochondrial DNA,” said Golomb, who explained that loss of Q10 may lead to a greater likelihood of symptoms arising from statins in patients with existing mitochondrial damage – since these people especially rely on ample Q10 to help bypass this damage.  Because statins may cause more mitochondrial problems over time – and as these energy powerhouses tend to weaken with age—new adverse effects can also develop the longer a patient takes statin drugs.

“The risk of adverse effects goes up as age goes up, and this helps explain why,” said Golomb.  “This also helps explain why statins’ benefits have not been found to exceed their risks in those over 70 or 75 years old, even those with heart disease.”  High blood pressure and diabetes are linked to higher rates of mitochondrial problems, so these conditions are also clearly linked to a higher risk of statin complications, according to Golomb and co-author Marcella A. Evans, of UC San Diego and UC Irvine Schools of Medicine.

The connection between statins’ antioxidant properties and mitochondrial risk helps explain a complicated finding that statins can protect against the very same problems, in some people, to which they may predispose others – problems such as muscle and kidney function or heart arrhythmia.

This paper was funded in part by a Robert Wood Johnson Generalist Physician Faculty Scholar award to Dr Golomb.http://health.ucsd.edu/news/2009/1-29-statin-study.htm

Vytorin Again

"The really tough thing for the statinators and other worshipers at the alter of the lipid hypothesis to come to grips with is that the Enhance study showed that those subjects taking Vytorin reduced their LDL-cholesterol by 40 percent more than those taking the statin alone ( 58% drop on Vytorin - 41% drop on Zocor), yet plaque increased in the subjects on Vytorin. But do you hear any head scratching over this? Anyone saying, "whoa there, a lower cholesterol equals more plaque'? Any body at all (other than yours truly, of course) seizing on the obvious? Nope. Not a one. The cry of the herd is 'back to statins alone.'
Maybe it's just me, but I would like to think that if I believed with all my heart that LDL-cholesterol caused plaque formation, and then a study came along showing a huge decrease in LDL-cholesterol accompanied by an increase in plaque formation, that my faith might be a little bit shaken. But not so with the statinators."
http://www.proteinpower.com/drmike/statins/vytorin-dis-enhance-d/

Dr. Graveline on Statins

http://www.spacedoc.net/ - This is the doctor's web site.

http://inflammationawarenessnow.com/dr-duane-graveline-on-statins-873.htm
This is a podcast interview.

http://www.thelivinlowcarbshow.com/shownotes/?s=graveline  This is Jimmy Moore's outstanding interview with Dr. G.  This is worth the time to listen and digest - the Dr. makes a strong case.

Dr. Graveline has a fascinating story - NASA flight surgeon being just a part.  He was later prescribed lipitor, and suffered severe side effects.  After researching statins, he's found some fascinating statistics on statin mortality that are, to say the least, sobering.