Lower Cholesterol, Develop Diabetes?
Are statin drugs helpful? What concerns should you be aware of?
Statin Drug Basics
Statin drugs are among of the most prescribed drugs in the world. From 2012-2019, the number of people using statin drugs in the U.S. increased from 37 million to 92 million, which is about an increase of 149%. Two common statin drugs are Lipitor and Crestor. Lipitor generates about $2 billion each year for Pfizer, while Crestor generates about $1 billion each year for AstraZeneca. Collectively, statins have earned over $1 trillion since they were introduced. Despite their wild popularity in medical practice, is this the best choice for dealing with the issue of high cholesterol? What are the implications of high cholesterol and what are considered optimal levels for good health? Are there any consequences of taking a statin that one should be aware of?
How do statins work?
Statins are a widely prescribed class of drugs to lower cholesterol. Their mode of action is primarily via inhibition of an important liver enzyme. This enzyme is involved in the production of cholesterol in the body. In this case, HMG-CoA reductase, the rate-limiting enzyme in the cholesterol biosynthesis pathway, is blocked by the statin. Essentially, the drug biochemically blocks the production of cholesterol in the body. But does shutting down a natural process in the body with a drug come with a price?
What causes cholesterol levels to be elevated?
Statin drugs are prescribed to most patients when their bloodwork (labs) come back with results that indicate a level of cholesterol that is higher than optimal levels. One way we can end up with higher levels of cholesterol is through what is consumed in the diet. Any food that is sourced from an animal has some cholesterol. Plants, including vegetables, fruits, nuts and seeds do not contain cholesterol. Beef, chicken, salmon, milk, eggs and butter are all saturated fats that, when consumed, are sources of cholesterol in the body.
There are other things that can cause cholesterol to become elevated. Having a BMI of greater than 30, which is at the level of obesity, puts you at risk for higher cholesterol levels. Age is also a factor and high cholesterol is more common in people over the age of 40. The age factor may be associated with a decreasing efficiency of the liver to regulate fats in the body. Consumption of caffeine may increase cholesterol by as much as 10%.
What are the implications of high cholesterol?
High cholesterol levels in the body may lead to the accumulation of deposits on the wall of the arteries. Arteries are vessels that take oxygenated blood from the heart to reach the cells of the body. Good flow through these arteries is crucial to good health.
Plaques on the wall of the artery can lead to reduced blood flow through the vessel. This can lead to chest pain. If the plaques that form eventually rupture, a blood clot may form. This can lead to the entire blockage of flow through the artery, which results in a heart attack (myocardial infarction). If this type of clot occurs in the brain, this can lead to a stroke.
A rise in total cholesterol level from 200mg/dl to 260 mg/dl increases the risk of death by 500%. People with total cholesterol levels below 180 mg/dl during their lifetime rarely have heart disease. Each 1% decrease in cholesterol is represented by a 2% to 3% decrease in the risk of dying from heart disease.
High cholesterol is an issue to consider and look for ways to achieve optimal levels. With this in mind, is a statin drug the best choice to solve this problem?
What is “bad” and “good” cholesterol?
LDL is a type of lipoprotein. The meaning of the letters is “low-density lipoprotein”. As you can tell by the name, these are a combination of fat (lipid) and protein. These proteins are transport mechanisms for fat to move through the blood. Generally, LDL is moving fat from the liver into the vessels. This has often been called the “bad” cholesterol because it could cause the buildup of plaque on the artery walls, So, when you go to the doctor, they often focus on how high your LDL cholesterol is. Optimal levels of LDL are considered to be below 100 mg/dl.
HDL is another type of lipoprotein, which is high-density lipoprotein. HDL carries cholesterol from the rest of the body back to the liver. Because of it’s “clean-up” role in this way, it has been called the “good” cholesterol. There has not, however, been sufficient evidence that endeavoring to increase HDL cholesterol levels is on its own beneficial. In other words, some have said to increase consumption of olive oil to improve HDL. There is currently no evidence that this will result in lowering of heart disease or eliminating the effects of high LDL in the body.
This was recently confirmed by Dr. Nathalie Pamir, an associate professor of cardiovascular medicine in the Oregon Health and Science University School of Medicine. “It’s still cholesterol at the end of the day,” Pamir said. “More and more studies are coming out showing that HDL levels above 80 are detrimental with regards to cardiovascular outcome
It is more likely that endeavoring to keep total cholesterol at a low level (below 180 mg/dl) is the best bet for overall circulatory health.
What are some of the problems with statin drugs?
Commonly reported side effects of taking statin drugs include reports of fatigue and muscle pains. Other concerns include the depletion of Coenzyme Q10, increased risk of Type 2 Diabetes and increased buildup of calcium in the vessels, which acutally may lead to increased coronary artery risk. Let’s look at what we know about these issues.
Depletion of Coenzyme Q10
Going as far back as 2002, holistically oriented doctors expressed their concerns that the drugs would cause the depletion an important antioxidant, Coenzyme Q10. Ironically, CoQ10 is incredibly important for the heart. Not only is it an antioxidant that helps to eliminate free radicals produced in the mitochondria during energy production, but also an electron carrier needed for energy production. So, CoQ10 is important for mitochondrial function. One of the places in the body that is rich with mitochondria is the heart itself. Those taking a statin drug need to be aware that it may deplete CoQ10 levels in the body.
On May 23, 2002, Dr. Julian M. Whitaker filed two citizens petitions with the Food and Drug Administration. The petitions called on the Commissioner of Food and Drugs to change the labeling of all statin drugs, and to issue a Medication Guide, warning consumers of the need to take coenzyme Q10 (CoQ10) whenever they take a statin drug, as follows:
“Warning: HMG CoA reductase inhibitors block the endogenous biosynthesis of an essential cofactor, coenzyme Q10, required for energy production. A deficiency of coenzyme Q10 is associated with impairment of myocardial function, with liver dysfunction and with myopathies (including cardiomyopathy and congestive heart failure). All patients taking HMG CoA reductase inhibitors should therefore be advised to take 100 to 200 mg per day of supplemental coenzyme Q10.”
The petitions explained that statins deplete coenzyme Q10 stores in the body and as a result, increased the risk of congestive heart failure and cardiomyopathy risk. They called on the FDA Commissioner to take immediate action to safeguard the millions of statin drug users. To this day, there has been no adoption of this warning or any such disclosure when statin drugs are prescribed.
Increased risk of Diabetes Type 2
Data from a recent study has revealed that taking statin drugs create a 38% increased risk of developing Type 2 diabetes. Somehow, the statin or its effects on the body may be causing a change in insulin sensitivity (likely meaning more insulin resistance).
In a 2019 paper from scientists at Erasmus University Medical Centre (published in the British Journal of Clinical Pharmacology), health records of 9,535 people aged 45 years or older were examined. When they were followed up 15 years later, the researchers noted that the people who had had taken statins had higher blood glucose levels and higher levels of insulin resistance, which are key risk factors for type 2 diabetes.
Depletion of Vitamin K: Increased calcification?
A 2021 study, published in the Kaohsiung Journal of Medical Sciences, found a connection among statin use, coronary artery calcification, and Vitamin K deficiency. Vitamin K is an important nutrient which protects the body from the buildup of calcium. Low levels of vitamin K have been associated with increased calcium in soft tissue such as arteries, resulting in vascular calcification. Arterial calcification is the build up of calcium inside the artery walls and is one of the major risk factors for cardiovascular injury or death.
In addition a 2020 study, published in the journal Arteriosclerosis, Thrombosis and Vascular Biology, also concluded that, “Statins are capable of increasing atherosclerotic calcification.”
Natural alternatives to statin drugs
Are there things that can be done to lower cholesterol without drugs? The adoption of a low-fat, no-cholesterol diet changes the dominant flow of cholesterol and fat from into the artery wall, to out of the artery in a very short amount of time. This means not consuming any animal-derived foods. Foods that contain cholesterol include beef, pork, chicken, fish, milk, butter and eggs. Within days of removing these foods, arterial flow may be improved.
This dietary change also quickly reduces pressure inside the plaque. It may then reduce the risk of rupture, and the clotting off of the blood vessel that too often follows. In addition to the profound cholesterol lowering effects of a low-fat, no-cholesterol diet there are many other benefits of a healthy diet that reduce the risks of heart attacks and strokes almost overnight. Animal (saturated) fats are the strongest promoters of blood clotting that we contact daily. The day you stop eating animal fats is the day your blood “thins” out; and in the event one of your plaques does rupture the blood is less likely to clot (the blood vessel remains open.)
Animal fats increase the production of prostaglandin hormones that cause the blood vessels to constrict, which may slow the flow of blood and increase the chance of the blood clotting. One last factor is the sludging of blood cells that follows meals high in any kind of fat. Fat from the food enters the blood stream and coats the blood cells causing them to stick together. The clumped blood moves slowly and clots easily.
Adopting this type of a food plan is my #1 recommendation for reducing cholesterol. If you are interested in learning more about how to adopt this lifestyle, check out my High-Vibe Nutrition Course.
Supplements for Lowering Cholesterol
If you are in the process of adopting the diet mentioned above, but feel you need additional supplementation as you make the transition here are some supplements that can be helpful. Nothing is as powerful, however, as adopting a high carbohydrate diet of whole, unprocessed starches, fruits and vegetables. Here are the supplements:
Red Yeast Rice
Red yeast rice has a long history in Chinese herbology and is recognized to have a 'warming' nature, invigorating the blood and improving blood circulation. This fermented form of rice contains substances called monacolins. One of them, monacolin K, is chemically identical to the active ingredient in the cholesterol-lowering drug lovastatin. This red yeast rice a natural source of this cholesterol-reducing substance, that decreases the production of cholesterol by the liver.
Red yeast rice (Monascus purpureus) is a essentially source of naturally occurring statins. Because red rice yeast extract delivers a mix of those compounds rather than a single type of molecule, it is much less likely to cause the side effects that sometimes occur with the pharmaceutical version, but we do need to be aware that it still blocks the production of cholesterol and in this way, it may have detrimental effects similar to statins including blocking the production of CoQ10.
Policosanol
Policosanol is a term for a group of long-chain alcohols extracted from the waxy coating of sugar cane. It is commonly used for reducing high cholesterol, including total and LDL (low-density lipoprotein) cholesterol.
Amla
Amla is an extract of Indian gooseberry. It has been know to assist in promoting healthy cholesterol levels, triglyceride levels and overall good heart health. It may also promote healthy endothelial function overall. The endothelium is the inner lining of the artery. To have good circulatory healthy overall, it is necessary to care for the health of the entothelium.
In a clinical study, lipid lowering action of Amla has been reported in patients aged 35-55 years when it was given for 28 days in a row. 500mg of Amla extract was given and was shown to have an impact in reducing total cholesterol and LDL.
Conclusion
It’s best to be aware of the optimal levels of total cholesterol and LDL cholesterol and their importance in maintaining healthy vessels. Learn to adopt a lifestyle that can help to achieve these optimal levels naturally. As you adopt a diet that lowers cholesterol, consider the use of the above supplements as they may serve as an effective adjunct to this process.
Ariel Policano is a naturopathic doctor specializing in energy medicine, frequency technologies and principles of nature cure. Learn more at her YouTube Channel, @arielpolicano and at geniusbiofeedback.com