The Dark Side of Cholesterol Drugs

Modern health and dietary recommendations place a large amount of emphasis on cholesterol. This emphasis does include the cholesterol that we get in our diet, but the focus is on the levels of cholesterol in the bloodstream.

The idea is that we want to reduce the level of cholesterol in our blood in order to significantly decrease our risk of heart disease.

The relationship between cholesterol and heart disease is actually a controversial one, and that is something I discuss in a more detailed post.

However, the focus here isn’t so much on whether cholesterol is good or bad, but on cholesterol drugs side effects.

After all, it’s important to know about the good and the bad of any drug – preferably before you start taking it.

Drugs for Fighting Cholesterol

The specific class of medication used to fight cholesterol are the statins and large amounts of this type of medicine is consumed every single day. 

It is produced by the drug industry, which is large and makes a considerable amount of money from statins.

This creates a concerning situation where medicine is being created and researched by a group that benefits from making as many sales as possible.

Many observers (myself included) find this pattern especially concerning, because it gives the drug companies every incentive to hide or underestimate the negative impacts of the medication, while over-promoting the positive benefits.

Even more significantly, research suggests that the vast majority of cardiovascular risk can be decreased by changes in diet and lifestyle (1), not through statins.

How Statins Work

Statins do their job by blocking off a specific biological pathway, one that leads to cholesterol synthesis. That approach is the reason that statins are able to lead to such large decreases in cholesterol and it’s why they are often hailed as a ‘wonder drug’.

However, the human body is a complicated thing. It is made up of a large collection of interlocking systems.

This means that any given pathway is going to produce precursors that are used for other pathways as well.

In the case of statins, the pathway blocked off is known as the Mevalonate Pathway. Specifically, statins inhibit one enzyme in this pathway, called HMG-CoA Reductase (2).

Blocking that pathway really is fantastic if you want to reduce cholesterol at all costs, but it isn’t as good once you start looking at the other outcomes .

Specifically, the pathway goes through a number of different precursors to produce cholesterol, CoQ10 (short for Coenzyme Q10) and some prenylated proteins (3,4).

By blocking that pathway, you are also blocking the production of those other chemicals.

For the most part, the research by drug companies has focused almost exclusively on the impact that the drugs have on cholesterol and on heart disease, rather than the other impacts that they can have.

It’s also important to note that in general, research into medication tends to look at its impacts on people who aren’t taking a lot of different medications.

This is unrealistic, because many people are taking multiple medications for a wide range of conditions. Often, some of the medications are there simply to counter the side effects of previous medications.

So, a lot of the research into the drugs is somewhat idealized and is certainly unrealistic. That isn’t encouraging.

Is it Worth It?

The theory is that any side effects of statins are worth it because statins reduce the risk of heart disease.

Most medical professionals present this idea as fact, but really, it’s much more complex than this.

For example, research has actually been very mixed about whether or not statins can extend life.

In fact, for most people with no history of heart disease statins end up having no benefit at all (5). At the same time, the number of people experiencing side effects is relatively high (6).

Some research even suggests that the percentage of people experiencing side effects may be around 17% (7).

This is a significant number, and the actual symptoms vary, including myalgia and fatigue, as well as memory loss (8).

Additionally, some studies have been unable to even find a difference in survivability between people who do and do not take cholesterol drugs (9).

This may be because statins may act to slightly decrease survivability for some people through decreasing heart disease risk, but at the same time can increase the risk of death in other ways.

Even if statins really do decrease the risk of heart disease significantly without increasing any other disease risk, they still aren’t as good as they appear.

For example, one claim is that statins can reduce your heart disease risk by a third (10).

That’s great if your risk of developing heart disease is high.

But, what if it’s not?

There is actually a growing emphasis on the idea of prescribing statins to healthy people, with the idea that this is a protective move.

For people in that group, the benefits of statins are pretty dubious.

Let’s look at it by the numbers.

If you had a 10% risk of heart disease, dropping that by a third would decrease your risk by 3.3% – which isn’t a whole lot in the grand scheme of things. If you had a 5% or even a 1% chance of developing heart disease, the change in your risk would be even smaller.

So, why bother?

The idea seems to be that any reduction in risk is a good thing.

I might agree with that if statins were completely safe and only offered positive outcomes.

But that isn’t the case.

Is it worth going through the risk of severe side effects to decrease your risk of heart disease by less than 5%? What about less than 1%?

At the same time, you don’t really know what the long-term impacts of the drugs on your body are going to be. After all, you are cutting off a whole pathway – that’s bound to have some impacts on your body.

For people who have had a heart attack previously, statins may still be a good practice for reducing risk. However, for everyone else, it seems like you are trying to manipulate your body’s chemistry for no real reason and you are just as likely to do harm as to actually do good.

Statins in Seniors

Statins are especially common medications for seniors, but surprisingly, the support for this population isn’t as strong as it is implied.

For example, there have been some warnings about prescribing unneeded statins to people over 70 years of age (11).

This specifically applies to people who don’t have a pre-existing cardiovascular condition.

For elderly without a heart condition, the use of statins has been linked to impaired memory, increased risk of diabetes and potentially an increased risk of cancer (12,13) – and that’s on top of all of the other side effects associated with statins.

Being Aware of Cholesterol Drugs Side Effects

One of the worst things about statins is that most people aren’t made aware of the side effects of the drugs or the areas where statins may increase the risk of other conditions.

Instead, they end up taking the medication simply because they are convinced that the positive benefits of the medication far outweigh the negative ones.

This might be true for people with a history of heart disease, but for everyone else, it is much less clear.

Regardless of your situation, it is important to take the time and research about cholesterol drugs side effects. It’s also important that you do more than simply ask your doctor about the side effects, because most physicians are in a position where their perspectives are biased to some degree or another. 

After all, most medical professionals were taught how ‘evil’ cholesterol is and many feel that finding every possible approach to lower cholesterol is critical.

Dr. Mercola has a good article that focuses on the various statins out there, along with their associated side effects. Likewise, Dr. Axe offers considerable details about the side effects of one particular statin, Lipitor. Many of those side effects apply to other cholesterol drugs as well.

Despite the large number of people who experience side effects, physicians still frequently feel that a person might be exaggerating their side effects or misunderstanding them in some way. For example, the side effects might come from something else altogether, but the patient attributes them to the statins.

Resolving Side Effects

It can often be difficult to resolve the side effects associated with cholesterol drugs, particularly as doctors have a habit of treating the side effects as if they are unavoidable.

Aside from stopping the medication altogether, probably the most effective approach to decreasing the side effects that can come with cholesterol medication is the use of CoQ10 supplements.

This approach is particularly relevant because the production of CoQ10 is blocked off by the same mechanism that blocks cholesterol production.

Because of this, over time people will tend to become CoQ10 deficient, because they aren’t able to produce CoQ10.

There have been a number of studies examining the effectiveness of CoQ10 supplements for this role, and patients do often experience a decrease in side effects (14).

As a consequence, many of the side effects that are associated with cholesterol medication may actually occur because the individual is deficient in CoQ10.

The problem is, one of the health benefits of CoQ10 is decreased risk of cardiovascular disease.

This means that cholesterol medication acts to decrease the risk of heart disease in one way, and increase it in another.

It is difficult to know what this does on the large scale. This means that in theory, statins could decrease the risk of heart disease, do nothing, or even increase it. For the most part, the research simply hasn’t been done and drug companies are still more focused on their profits.

Supplementing statins with CoQ10 has the ability to remove this deficiency. This can potentially help to reduce the side effects and may even increase protection against cardiovascular disease.

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