Statins Friend or foe??
Recently NICE announced a review of the policy and guidance for the prescription and use of Statins, basically they are advising a significant increase to the prescription and use of these drugs and from what I can see the decision is not based on any new scientific evidence, just a review of policy, why this change I don’t know. What would be good is if they actually looked properly at the science behind cholesterol, sugar, lifestyle and the use of Statins, So just some useful information as to what really is going on and some of what happens in your body.
What are Statins? Statins (HMG CoA reductase inhibitors) are prescription medicines that people take to bring their cholesterol down to normal levels. Some statins can decrease your LDL (bad) cholesterol by 50% or more. Different brands of statins are on the market, as well as generic statins, which cost less. Statins are tablets or capsules that you swallow whole once a day. The label on your medicine bottle will tell you if you need to take your statin at a certain time of day and if you need to take it with food. Some of the types of Statin: Atorvastatin, Fluvastatin, Lovastatin (Mevacor® or Altoprev™), Pitavastatin (Livalo® or Zypitamag®), Pravastatin, Rosuvastatin (Crestor® or Ezallor Sprinkle®) and Simvastatin (Flolipid® or Zocor®). Sometimes, Statins are put together with another medicine in one pill to either enhance the effects or produce a slightly differing outcome, such as: Simvastatin with ezetimibe or niacin, Atorvastatin with ezetimibe or amlodipine and Lovastatin with niacin
What do statins do? Statins decrease your LDL (low-density lipoprotein) or bad cholesterol and may increase your HDL (high-density lipoprotein) or good cholesterol. LDL is bad because it may potentially build up inside your arteries, more of that later. HDL is good because it brings cholesterol to your liver, which gets it out of your body. Statins get in the way when your liver is trying to make cholesterol. Like a good footballer who doesn’t let an opponent get the ball, statins don’t let your liver have an enzyme it needs to create cholesterol. Your body makes a high proportion of your cholesterol, so helping it make less can make a big difference. You also get some cholesterol from absorption from what you eat and also your diet can encourage the needless production of cholesterol. It’s a tricky balance and in most cases only some of this is understood or communicated to the patient. More on this later. In a small number of cases you can get genes from your parents that tell your body to make more cholesterol than you need or not to absorb the cholesterol it needs but this is indeed an incredibly small number of high cholesterol sufferers.
Why are statins used? Statins bring down your cholesterol level to make you less likely to have a heart attack or stroke. Your body uses cholesterol when it makes vitamin D, hormones and the acid you use to digest food. But if you have too much cholesterol in your blood, it can collect inside your arteries. This creates obstacles that make it harder for your blood to get through your blood vessels. If cholesterol keeps building up in your arteries, it can do more than just make them narrow. The plaque (obstacles) in your blood vessels can become unstable and break open, leading to a heart attack. How common are statins? Statins are one of the most common prescription drugs, in the UK and America, combined more than 55 million adults take them.
Risks. The chart below shows some of the risks in taking Statins and is actually compiled from the information on the NHS website. Common side effects Side effects can vary between different statins, but common side effects include: Headache Dizziness Feeling sick Feeling unusually tired or physically weak Digestive system problems, such as constipation, diarrhoea, indigestion or farting Muscle pain and weakness Soft Tissue pain Sleep problems Low blood platelet count
Uncommon side effects Uncommon side effects of statins include: Being sick Memory problems Hair loss Pins and needles Inflammation of the liver (hepatitis), which can cause flu-like symptoms Inflammation of the pancreas (pancreatitis), which can cause stomach pain Skin problems, such as acne or an itchy red rash Sexual problems, such as loss of libido (reduced sex drive) or erectile dysfunction
Rare side effects Rare side effects of statins include: Loss of sensation or tingling in the nerve endings of the hands and feet (peripheral neuropathy) Tendon problems (tendons are tough cords of tissue that connect muscles to bones)Source: NHS
Not very encouraging! It’s interesting to note that as a Soft Tissue Practitioner I see a number of people taking Statins who suffer from a number of the above issues and on stopping taking them feel so much better. It should also be noted, in my experience, that a lot of GP’s do not discuss the side effects with patients new to taking Statins.
An Opposing View To Statins. So let’s just take a good look at Cholesterol and how it affects our body. Firstly we need Cholesterol, it is the first line of defence when our body is in disease and is produced to go to the injury site and start the repair. Hold that thought. So the body does not know the difference between the injuries and disease that happen inside the body, if something is wrong it will go through the required steps to fix it, that includes all malfunction. Hold that thought as well. So the biggest source of disease in our bodies in this modern world that we live in is inflammation, I’ll explain. So you do not have to have an injury in the body to have inflammation, it can be caused by diet, stress, lifestyle emotional upset and a whole host of internal and external influences. One of the biggest causes of this “miscellaneous” inflammation is diet and primarily sugar. Forget eating the wrong fats, sugar is now the silent killer and is in just about everything we eat. And this is how it works, get’s a bit technical but bear with.
In our bodies with have endless miles of veins, arteries and capillaries which on the inside are covered by a thin layer of cells called the Endothelium, the heart is as well. This layer of cells covers the internal lining of all these structures and is incredible, it is the link between the internal body and the blood, is the main communication vehicle for the bodies chemical structure, controls coagulation, controls the muscle control of the heart, veins, and arteries, the list goes on and on. A hugely important structure and is now known as an organ in it’s own right and if opened up and spread out, would cover the surface area of two tennis courts. So let’s introduce sugar into the equation, I mentioned earlier that it really is the silent killer and in most cases more detrimental to the body than anything else we digest. It changes blood chemistry almost immediately, not for the good, and also very quickly becomes addictive for the “sugar high” that it induces, let’s face it, we all know someone addicted to those dreadful energy drinks. When excess sugar is consumed it’s very hard for the body to cope as it’s easily absorbed into the blood stream, it causes an enormous amount of inflammation in the body and upsets Homeostasis. One of the major issues is that the sugar molecules in the blood stream stick to the Endothelium and upset the workings and balance of these critical cells. In some cases these cause blisters on the lining, and here’s the rub, the body then produces Cholesterol to start the healing process, the Cholesterol covers the blisters and in the process reduce the capacity of the vein or artery. This gives the appearance of the Cholesterol reducing the capacity but the Cholesterol is merely a thin coating on blistered cells of the Endothelium with sugar being the root cause of the issue. Now I’m not for one minute advocating patients stop taking Statins or refusing to start taking them if they are genuinely required. Any prescription for Statins must be the outcome of a really robust medical and lifestyle assessment to ascertain if the Cholesterol reading is high, not just higher than a stupid average marker that some desk bound scientist has decided is a safe limit without taking into account the individual patients circumstances and that other safer factors in lifestyle can’t achieve the required outcome, and that there is at least an annual medicine review, and that a Creatine Kinase (CK) blood test is carried out every six months, and that the patient is made aware of all the side effects in a robust manner. I see the outcome of over prescription of Statins on nearly a weekly basis, these drugs when prescribed correctly do a fantastic job but at the moment I fear they are the easy option and being handed out like Smarties or if I was being really cynical, just delivering higher profits to certain pharmaceutical companies. The paragraphs above are a summary of a much longer and complicated story and set of facts, the book below, written by an eminent Doctor, Neurologist and Nutritionist, Dr. Campbell-McBride, is fascinating and explains all you need to know. Sometimes a bit of a dry read but really worth getting stuck into. You have to read this book if you care about your body.
An interesting read, I'm sure you'll agree? contentious ...... yes! But we have to get away from mass prescription of drugs and start treating every patient as an individual with individual needs and taking into account every medical option and science fact not just repeating the same old thing over and over again.