Take the following true-false test and see how you do. I’ll give you the correct answers below, from an alternative medicine standpoint, and I’ll explain each answer so you can understand the science behind them. (Of course, what you might call “correct” depends on if you believe the information I share with you or the present prevailing philosophy).

1) I will be healthier and live longer if my total cholesterol level is low, especially less than 200.
2) Lower cholesterol levels decrease my risk of heart disease.
3) Lower cholesterol levels increase my life span.
4) Statin medications (Lipitor, Zocor, Mevacor, Crestor, Pravachol, …) reduce cholesterol levels.
5) Statins decrease my risk of heart disease and risk of heart attack.
6) Statins increase my life span.
7) Statins are anti-oxidants.
Statins decrease my risk of stroke.
9) Statins interfere with production of CoEnzyme Q10, the major energy producing molecule in the body.
10) Side effects to statins are minimal, and certainly are outweighed by their benefits.

Answers:

1) False
2) False
3) False
4) True
5) False
6) False
7) True
False
9) True
10) False

Now I’ll explain the answers. We’ll talk about each of these concepts, but first I need to reveal something very important: we need cholesterol in our bodies. Cholesterol is not the bad guy it is often made out to be. Here’s why:
1) Cholesterol makes all of our major hormones, including progesterone, estradiol, testosterone, cortisol (our personal steroid), aldosterone (that regulates salt and water in our bodies).
2) Vitamin D (which should be classified a hormone) is made directly from cholesterol as the UV rays from the sun hit the skin and initiate that conversion.
3) Cholesterol is one of the most plentiful and important anti-oxidants in the body. It is in all cell membranes (all 30 trillion of them), protecting each cell membrane from the constant barrage of free radicals in the body.
4) Cholesterol is a precursor for bile, which assists in the breakdown of fat in the intestinal tract.
5) Cholesterol, along with omega 6 oils, protects the skin from becoming dry.

Let’s look at each of these questions and explore the science behind them.

The first three questions are linked together:
Question #1- I will be healthier and live longer if my total cholesterol level is low, especially less than 200. False.
Question #2- Lower cholesterol levels decrease my risk of heart disease. False
Question #3- Lower cholesterol levels increase my life span. False

U Ravnskov printed a landmark article in the British Medical Journal in July of 1992 (1) which looked at the science behind this issue of cholesterol, lowering cholesterol levels, and their effect on heart disease and longevity. He reviewed the finest 22 studies from around the world, documented the science behind them and their drawbacks, and came to the following conclusion: Lowering serum cholesterol concentrations does not reduce mortality and is unlikely to prevent coronary heart disease. Claims of the opposite are based on preferential citation of supportive trials. His book, The Cholesterol Myth, reviews in greater depth this whole concept, and is easy reading for the lay person and professional alike.

Joel M. Kauffman, Ph.D. reviewed this issue in his book Malignant Medical Myths. He examined relative risk of death with treatment, absolute risk of death with treatment, number of patients needed to treat for 1 year to prevent 1 death (or as shown in many studies, the number of patients needed to treat for 1 year to cause 1 death), and could find minimal to no overall improvement in death rate for treated individuals. (2) And this is with the studies that have been released, while we know that many of the worst studies will never be printed. Dr. Bernard Forette and a team of French researchers from Paris found that the cholesterol level at which people live the longest is 272. (3)

The much-touted Framingham study, after 30 years of follow-up, showed that those individuals whose cholesterol levels increased during that period of time had the longest life, and those people whose cholesterol had decreased had the greatest risk of dying. “For each 1% drop of cholesterol there was an 11% increase in coronary and total mortality.” (Anderson et al., 1987)

If an examination is made of heart attack victims, it will be found that 1/2 have cholesterol levels above 200 and the other 1/2 have levels below 200, again establishing no relationship of cholesterol levels to heart disease.

Question #4- Statin medications (Lipitor, Zocor, Mevacor, Crestor, Pravachol, …) reduce cholesterol levels. True.

I find there is about a 40 point drop in cholesterol levels with the use of statins. Unfortunately, based on the above science, there is no reason to have lower cholesterol levels; in fact, it will be harmful to your body. Your body predetermines the cholesterol level you should maintain. I’m not sure anybody knows how or exactly why your body decides its ideal level. If you eat more cholesterol, your body will make less cholesterol to maintain that level. Usually, only about 15% of the serum cholesterol concentration comes from the diet; 85% is manufactured in the liver. When physicians decide to interfere with the physiology of the body, it is important to establish clear benefit that cannot be gained by safer means.

Question #5- Statins decrease my risk of heart disease and risk of heart attack. False. Well, maybe partly true.

There is no decrease in fatal heart attacks, but there is a small decrease in non-fatal heart attacks, but it is less than the reduction seen with aspirin. And if there is a reduction in heart mortality from statins, but no reduction in overall mortality, then statins must be killing people in some other way.

Question #6- Statins increase my life span. False.

Everybody agrees that statins will not prolong your life, including the pharmaceutical companies.

Question #7- Statins are anti-oxidants. True.

If statins decrease heart disease, it is because of their anti-oxidant properties (albeit an expensive anti-oxidant) and not because of their cholesterol-lowering properties. This is a little known fact about statins.

Question #8- Statins decrease my risk of stroke. False.

The reduction of stroke risk in the ALLHAT trial (4) and the ASCOT trial (5) was so small as to make it negligible. Again, knowing that negative data is suppressed and not in print makes it questionable whether barely significant data is truly significant. In fact, much of the data on women and statins shows an increased death rate, so nobody releases that information, focusing only on data from men, but prescribing for women just the same.

Question #9- Statins interfere with production of CoEnzyme Q10, the major energy producing molecule in the body. True.

Statins are an HMG-reductase inhibitor, which means it interferes with that enzyme, so the body does not product cholesterol. Unfortunately, the production of CoQ10 is also reduced, because it is downstream to this enzyme. CoQ10 is the major step in a 9-step process to form ATP, our body’s major energy source. This is never mentioned in the statin literature, although the pharmaceutical industry is well aware of this fact. In fact, the first statin was submitted to the FDA with an option to include CoQ10 with the statin.

Because muscles require the most energy, they are often the first organs to feel the effects of the energy drop. This may result in muscle pain, aches, and stiffness. As it progresses, the muscle protein may actually start breaking down, releasing the muscle protein into the bloodstream for removal by the kidneys. If the kidneys get overwhelmed with the amount of this protein, they may go into kidney failure. This was the cause of the deaths for which Baycol was removed from the market in 2001. Many of my patients complain of tiredness and weakness after being placed on statins. Unfortunately, it is difficult to make the connection to statins, and they usually attribute it to getting older. Not so!

Question #10- Side effects to statins are minimal, and certainly are outweighed by their benefits. False.

In the CARE trial, the risk of breast cancer in women in the placebo group was 0.3%, while the risk in the provastatin group was 4.5%. (6) No benefit here.

Muscle breakdown has already been mentioned. Cerivastatin was removed from the US market after 772 cases of rhabdomyolysis (muscle breakdown) was seen over a 3 year period, resulting in 72 deaths. (7)

Neuropathy has been reported in the British Medical Journal in 2001 by Elias Ragi, MD. In the elderly, 80% of his patients present with loss of coordination, documented by nerve conduction studies. (8) Denmark reported a number of cases of polyneuropathy, more frequently occurring in patients taking statins for more than 2 years. (9) What will happen with 20 years of statin use?

Congestive heart failure, chronic fatigue, confusion and vertigo have all been well documented as results of statin use. (10)

So what’s the deal with the increase in heart attacks and strokes? Is it cholesterol—or is it something else? I’ll be covering that “something else” in the next few days. My perspective may surprise you! But it will definitely give you an effective way to begin taking more control over your health. Stay tuned.

(1) Cholesterol lowering trials in coronary heart disease: frequency of citation and outcome, U Ravnskov, British Medical Journal, 4 July 1992, Vol. 305, pages 15-19.

(2) Kauffman, Joel, Malignant Medical Myths, p. 89.

(3) Forette B, Tortrat D, Wolmark Y (1989). Cholesterol as risk factor for mortality in elderly women. Lancet 1: 868-870.

(4) ALLHAT (2002). Major Outcomes in Moderately Hypercholesterolemic, Hypertensive Patients Randomized to Pravastatin vs Usual Care. Journal of the American Medical Association 288:2998-3007.

(5) Sever PS, Dahlof B, Poulter NR et al. (2003), Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial—Lipid Lowering Arm (ASCOT-LLA): a multicentre randomized controlled trial. Lancet 361:1149-1158.

(6) Ravnskov U (2000). The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease, Washington, DC: New Trends Publishing.

(7) Wolfe, Sidney, Public Citizen, FDA data submitted from the US market resulting in the removal of cerivastatin from the market.

(8) Ragi, Elias, Royal Devon and Exeter Hospital in England, electronic posting to the British Medical Journal, 12 Nov 2001.

(9) Gaist D, Jeppesen U, Andersen M et al. (2002). Statins and Risk of Polyneuropathy. Neurology 58:1333-1337.

(10) Cohen JS (2001). Over Dose. The Case Against the Drug Companies. New York, NY: Taracher/Putnam.