Let’s get right to the research.
In July 2021, a paper in the Journal of lipids (1) offered us this assessment of the concern about the side-effects of statins: “Given the high incidence of cardiovascular events in the United States, strict control of modifiable risk factors is important. Pharmacotherapy is helpful in maintaining control of modifiable risk factors such as elevated lipids or hypercholesterolemia. Hypercholesterolemia can lead to atherosclerotic disease which may increase the risk of acute coronary events. Statin therapy has long been a mainstay in the treatment of hypercholesterolemia, but while highly regarded, statin therapy also has side effects that may lead to patient noncompliance.”
A study from August 2020 (2) published in the International journal of biological sciences says this:
Statins have primarily been utilized for metabolic and angiographic (cardio) medical applications because of their cholesterol-lowering effects. Similar to other drugs, statins may also induce a series of potential side effects.
Statins inhibit the HMGCR (rate-limiting enzyme) activity in early stages of mevalonate pathway (it limits cholesterol, and vitamin K production, and coenzyme Q10 production, and all steroid hormone production), and then indirectly affect a number of intermediate products, including non-sterol isoprenoids (coenzyme Q10, dolichol (low dolichol, simply explained here as a unsaturated chemical compound) levels have been linked to Alzhiemer’s disease) etc.), which can result in impaired functions of body organs.
Recently, scores of studies have uncovered additional functional mechanisms (side-effects) of statins in other diseases, such as diabetes mellitus, nervous system diseases, coronary heart disease, inflammation and cancers. Statin care should be taken in the treatment of many diseases including cancers. Since the underlying mechanisms are not fully understood.
Statin’s inefficient management of cardiovascular conditions may cause diabetes
In January 2021 another study (3) suggested this assessment of the risk of statins:
“Statins have transformed the treatment of cardiovascular diseases through primary and secondary prevention of events. Despite the success of statin’s inefficient management of cardiovascular conditions, certain clinical trials, reviews, and meta-analysis point out that statins have the propensity to induce diabetes.”
Why are people on statins?
Most of the time someone researching articles like ours on cholesterol medications are researching for a diagnosis of high cholesterol they have just received and are doing their homework. Many times however the person reading our articles are researching information for someone else who is brushing off the need for good health or face emotional challenges that poor health brings them. An article on statins and cholesterol is usually one of those subjects where the spouse, loved one, or adult child is doing the research for someone who does not understand or does not put the proper care into their health.
Statins are medications given to patients with high cholesterol. The belief is that by reducing the bad cholesterol levels (LDL) and promoting good cholesterol (HDL) levels, some patients may see a reduced risk of heart attack and stroke risk. However, there are side-effect risks linked to taking statins, such as muscle pain and fatigue, the possibility of making your type 2 diabetes problems worse, digestive issues, liver issues, sleeping issues, and the overall concern in the medical community that statins do not work as intended.
Patients taking statins do not always follow the physician’s prescriptions on lifestyle change
Here is a January 2020 study (4) from the University of Bologna. It highlights the concern in the medical community that patients taking statins do not always follow the physician’s prescriptions on lifestyle change. That somehow the statins are giving the patients a false sense of security that they do not have to make lifestyle changes.
For some of you, you probably did not need a study to tell you your husband, wife or parent does not always follow the doctor’s advice. But it may be helpful to understand that you are not alone in your struggle to help your loved one achieve better health.
When cholesterol medication is given, it is given typically with the understanding that the patient:
1) Adheres to a better diet,
2) Limits or stops alcoholic consumption,
3) Stops smoking if they do,
4) Gets more exercise and activity.
What the Bologna researchers found was that:
55.4% of the patients had not changed their lifestyle since taking statins and felt less contented with their life status.
10.7% were not even educated or aware of the idea that these medications were given to them for cholesterol-lowering effects.
Minor depression was the most frequent diagnosis (8.9%) in these patients. It was significantly associated with the absence of lifestyle modification, even though all minor depressed patients were aware of the effects of statins.
Those who were unaware showed significantly lower well-being (positive relations; purpose in life.
Sound familiar? These people are somewhat depressed, not adhering to healthier lifestyles, continuing on with poor health choices.
What is somewhat perplexing is that statins are being explored as an antidepressant medication with new and conflicting research suggesting it may be helpful or may not be helpful in patients suffering from depression, bipolar disorder, and mood and cognitive problems.
Do statins turn physical health problems into mental health problems?
A 2018 study from the University of Louisville School of Medicine (5) offers this on the idea that statins and depression in a coexisting state with coronary artery disease, hypertension, and diabetes.
“Depression is a common malady associated with numerous chronic medical conditions such as coronary artery disease, hypertension, and diabetes. Statins provide protection against coronary and cerebrovascular diseases by decreasing cholesterol synthesis in the liver. Statin medications also reduce inflammation. Since the pathophysiology of depression involves inflammation, statins could have a role in the treatment of mood disorders and might become a pharmacotherapy option for patients experiencing depression. There is evidence suggesting an antidepressant effect when statins are adjunctively co-prescribed with antidepressant medicines. However, confounding data also exist refuting a positive effect of these drugs at elevating mood. More research is required to confirm a potentially beneficial effect of prescribing statins to people with clinical depression.”
A July 2021 study (6) denies statins cause depression, suggesting: “Robust evidence indicates that statins are unlikely to lead to depressive symptoms in the general population.”
A February 2021 study (7) added to the controversy suggesting “(a demonstration) that there was an increased risk of diagnosed major depressive disorder in patients treated with higher doses of statins when compared to non-statin-treated patients. Interestingly, low-dose statin treatment was related to an underrepresentation (not fully reported) of major depressive disorder when compared to non-statin-treated patients. ”
The rush to prescribe statins for heart disease with benefit of combating depression? “Hype or hope?”
A July 2020 study (8) with the title: “Statins in the treatment of depression: Hype or hope?,” suggested that: “Many patients with depression do not respond sufficiently to antidepressant treatment, necessitating other treatment approaches. HMG-CoA reductase inhibitors (i.e. statins), which are frequently used for their cardioprotective properties, have also been studied regarding potential antidepressant effects. Possible mechanisms underlying an antidepressant effect of statins may include the anti-inflammatory, antioxidant and lipid lowering properties of this class of drugs.”
Their findings offered this assessment:
Statin treatment in individuals without major depressive disorder do not seem to affect mood or protect against development of depression. (Does not work in people who have mild symptoms), when combined with serotonin reuptake inhibitors (SSRIs), statins may help some. The treatment results are somewhat inconclusive.
Poor adherence to lifestyle changes because statins do not make the patient feel well. What are the options?
In these two studies, there is an understanding that some people on statins are not healthy and this is creating a feeling of depression and unwellness.So what can you do to help yourself or a loved one?
Modify medication dosage?
A January 2020 study suggests strategies proposed by different studies vary according to the severity of symptoms of intolerance including maintenance of the statin therapy (dose reduction, addition of a statin of equal or lower intensity or alternate days’ uptake) and lipid-lowering therapy with other drugs (ezetimibe monotherapy or association with statin tolerated dose). (9)
Reduce statin dosage add CoQ10?
CoQ10 is a naturally occurring antioxidant that studies report is beneficial for patients with heart disease. CoQ10 levels have been shown to be reduced in patients taking statins. An October 2019 study suggests “the addition of CoQ10 with half dosage statin in patients with previous intolerance to statins improves the perception of clinical symptoms such as asthenia (weakness), myalgia or pain.” (10)
A May 2021 study (11) added: “Clinical evidence shows that CoQ10 supplementation for prolonged periods is safe, well-tolerated and significantly increases the concentration of CoQ10 in plasma (levels). CoQ10 supplementation reduces oxidative stress and mortality from cardiovascular causes and improves clinical outcome in patients undergoing coronary artery bypass graft surgery, prevents the accumulation of oxLDL (bad cholesterol) in arteries, decreases vascular stiffness and hypertension, improves endothelial dysfunction by reducing the source of (inflammation causing) Reactive oxygen species (ROS) in the vascular system and increases the Nitric Oxide levels for vasodilation.”
Change lifestyle and eliminate statins?
This is our goal. At the Magaziner Center, we believe in balancing cholesterol levels naturally, and that there is no one-size-fits-all treatment for high cholesterol and cardiovascular health. We take the time to look at each patient’s unique biochemistry and specific contributing factors. With our unique and extremely thorough blood and urine testing, we are able to create a plan and course of treatment specific to each individual. Our goal is not to simply lower cholesterol, but to get our patients to optimal cardiovascular health, which results in properly balanced cholesterol levels without relying on dangerous and potentially harmful drugs.
This is not an easy challenge for some people but it begins with the idea of what is wellness and how it can be realistically achieved. If you would like to explore more information, please contact our office so we can start a conversation with you.
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References
1 Su L, Mittal R, Ramgobin D, Jain R, Jain R. Current Management Guidelines on Hyperlipidemia: The Silent Killer. Journal of Lipids. 2021 Aug 6;2021.
2 Zhang Q, Dong J, Yu Z. Pleiotropic use of Statins as non-lipid-lowering drugs. International Journal of Biological Sciences. 2020;16(14):2704.
3 Keni R, Sekhar A, Gourishetti K, Nayak PG, Kinra M, Kumar N, Shenoy RR, Kishore A, Nandakumar K. Role of Statins in New-onset Diabetes Mellitus: The Underlying Cause, Mechanisms Involved, and Strategies to Combat. Curr Drug Targets. 2021 Jan 20. doi: 10.2174/1389450122666210120125945. Epub ahead of print. PMID: 33494673.
4 Bernardini F, Gostoli S, Marchetti G, et al. A survey on lifestyle and awareness of the use of statins in a sample of cardiopathic patients [published online ahead of print, 2020 Jan 20]. Psychol Health Med. 2020;1–9. doi:10.1080/13548506.2020.1717555
5 Singh D, Lippmann S. Can Statins Diminish Depression? Prim Care Companion CNS Disord. 2018;20(1):17br02169. Published 2018 Jan 25. doi:10.4088/PCC.17br02169
6 De Giorgi R, Rizzo Pesci N, Quinton A, De Crescenzo F, Cowen PJ, Harmer CJ. Statins in Depression: An Evidence-Based Overview of Mechanisms and Clinical Studies. Frontiers in Psychiatry. 2021:1250.
7 Leutner M, Matzhold C, Kautzky A, Kaleta M, Thurner S, Klimek P, Kautzky-Willer A. Major depressive disorder (MDD) and antidepressant medication are overrepresented in high-dose statin treatment. Frontiers in medicine. 2021;8:56.
8 Köhler-Forsberg O, Otte C, Gold SM, Østergaard SD. Statins in the treatment of depression: Hype or hope? [published online ahead of print, 2020 Jul 8]. Pharmacol Ther. 2020;107625. doi:10.1016/j.pharmthera.2020.107625
9 Almeida JT, Esteves AL, Martins F, Palma I. Abordagem aos Doentes com Intolerância às Estatinas: Revisão Baseada na Evidência [Approach to Patients with Statin Intolerance: Evidence-Based Review]. Acta Med Port. 2020;33(1):49–57. doi:10.20344/amp.10376
10 Derosa G, D’Angelo A, Maffioli P. Coenzyme q10 liquid supplementation in dyslipidemic subjects with statin-related clinical symptoms: a double-blind, randomized, placebo-controlled study. Drug Des Devel Ther. 2019 Oct 21;13:3647-3655. doi: 10.2147/DDDT.S223153. PMID: 31695332; PMCID: PMC6814351.
11 Rabanal-Ruiz Y, Llanos-González E, Alcain FJ. The Use of Coenzyme Q10 in Cardiovascular Diseases. Antioxidants. 2021 May;10(5):755.
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