Almost every week in my office, I see a new patient who is on a statin drug prescribed by the patient’s MD for high cholesterol. Of all the drugs that have been prescribed en masse, nothing is more futile than the statin drug. In 2010, the best-selling drug was Lipitor (a brand name statin) with sales of 7.2 billion dollars. So I’d like to start with some basic facts about statins.
What are the criteria then for so many prescriptions? The data from the companies that sell these drugs are very clear and available to the public. However, it can be confusing for the layperson to sort through it all–so I will do my best to translate some of the data for you.
In statistics there is a number used to determine the effectiveness of a medication; this number is known as Number Needed to Treat (NNT). It represents the number of patients who need to be treated in order for one to benefit from the drug. If a drug has an NNT of one, it means that every person who takes the drug receives a beneficial outcome. If it has an NNT of 10, it means you have to treat 10 people for one to have a benefit. The NNT of Lipitor is 100. Another way to say this is that Lipitor has a 99-percent failure rate.
What Lipitor will do is lower your cholesterol. If this is so, why doesn’t it prevent heart disease? The simple answer is that there is no correlation between heart disease and cholesterol. In other words, of the people who have heart attacks, about one-half will have “high” cholesterol and one-half will have normal or low cholesterol.
Cholesterol is not fat; it is a waxy substance of which about 80 percent is made in the liver. It is produced from a molecule called HMG-CoA. Statins poison the enzyme that converts this molecule to cholesterol. They also stop the production of CoQ10, which is an essential part of the production of ATP, the main energy unit of our cells. Ironically, the highest concentration of CoQ10 is in the heart.
Cholesterol is the substance from which all of our steroid hormones (estrogen, testosterone, cortisol etc.) are made. It is also present in every cell membrane. When there is damage to the wall of an artery, cholesterol is sent in to “patch” that damage. Cholesterol itself, however, needs to be transported and the proteins that transport it to and from the cells are known as low-density lipoproteins (LDL) and high-density lipoproteins. (HDL). These are often erroneously referred to as “bad” and “good” cholesterol respectively. LDL is responsible for taking cholesterol from the liver to the tissues, and HDL is responsible for recirculating the HDL from the tissues back to the liver. They are strictly shuttles that take cholesterol to and from tissues. LDL particles, however, come in different sizes and new tests can determine what your LDL particles are made of. They basically fall into two types: large buoyant and small dense. It is the small, dense particles that can get under the lining of your blood vessels and oxidize and cause a plaque to form. The large buoyant particles are too large to get under the lining and do not pose a threat.
Statin drugs do nothing to modulate the size of the particles. This is done through diet alone. And the most offending food, the one that drives those small, dense particles? Sugar. Sugar is the main cause of both increased small LDL particles and increased triglycerides (fat) – not saturated fat. One of the worst things you can do for your heart is to go on a low-fat diet. A low-fat diet is, by definition, a high-carbohydrate diet, which is a recipe for heart disease, obesity, high blood pressure, diabetes etc.
If your doctor is trying to put you on a statin, or if you are currently on a statin, I would highly recommend that you get the more specific particle testing done. The two labs that we use at our office are the Lipoprotein Particle Profile by Spectracell Laboratories and the VAP Cholesterol test through Quest Diagnostics.
A normal total cholesterol level is between 180 and 250. These numbers in themselves are meaningless because two people can have the exact same numbers but be at completely different risks. A total cholesterol count below 160 becomes problematic because the body doesn’t have enough of the building blocks it needs to maintain cellular health and steroid hormones.