Does Cholesterol Really Matter?
Julian Whitaker, MD
Let’s take a close look at one of medicine’s sacred cows—the belief that lowering cholesterol with drugs protects against heart attacks and premature death. Our obsession with cholesterol began in the 1950s when studies linked high consumption of animal fat with high rates of heart disease. This opened the door for clinical trials that laid the foundation of a new paradigm: the cholesterol theory of cardiovascular disease.
This theory has had profound ramifications. It changed the way we eat (fats bad, carbohydrates good) and contributed to our problems with obesity and diabetes. It wormed its way into “clinical practice guidelines”—cholesterol management has become a “standard of care” that doctors are expected to follow. It spawned the invasive heart surgery industry, based on the presumption that cholesterol-laden blockages must be bypassed or propped open. And it led to the creation of the best-selling class of medications in history: cholesterol-lowering statin drugs, which generate more than $15 billion in worldwide sales every year.
But it’s all a house of cards. No matter what you’ve been led to believe, a high cholesterol level is not a reliable sign of an impending heart attack. In fact, growing numbers of experts question whether cholesterol matters at all. As for statin drugs, for most of the 40 million Americans recommended to take them for the rest of their lives, they’re an ineffective, expensive, side effect–riddled fraud.
Statin drugs do lower cholesterol, but so what? We’re not treating lab numbers. We’re treating patients, and the ultimate goal in cholesterol management is to reduce risk of cardiovascular disease. Except for a very limited number of people, there is absolutely no evidence that statins protect against heart attack or premature death.
Are you over age 65? Not a single study suggests you’ll receive any benefits, even if your cholesterol goes down substantially. A woman of any age? Same story. A man younger than 65 who has never had a heart attack? Ditto, no help at all. For middle-aged men who have had a heart attack, statins may lower risk of a repeat heart attack, but that’s the extent of it.
I know this is hard to buy in light of the multiple drug advertisements and glowing endorsements from doctors. But keep in mind that pharmaceutical companies do a superb job of pulling the wool over the eyes of consumers and physicians alike by withholding unfavorable study results and making false, misleading, and often deceptive claims.
A Statistic We Can Understand
That’s why I want to step around confusing statistics and tell you about an easy-to-understand measure that you’ll never hear about in drug ads. It’s called “number needed to treat,” or NNT, and it describes the number of patients who would need to be treated with a medical therapy in order to prevent one bad outcome. Experts consider an NNT over 50 to be “worse than a lottery ticket.”
Lipitor ads claim that this drug reduces risk of heart attack by 36 percent. Sounds pretty good until you look at the fine print, do the math (which John Carey did in a great article in Business Week), and figure out that the drug’s NNT is 100. This means that 100 people must be treated with Lipitor in order for just one heart attack to be prevented. The other 99 people taking the drug receive no benefit.
To put this into perspective, the NNT of antibiotics for treating H. pylori, the underlying cause of stomach ulcers, is 1.1. These drugs knock out the bacteria in 10 out of 11 people who take it, making them a reliable, cost-effective therapy. At the other end of the spectrum are statins, which as a class have an NNT of 250, 500, or higher depending on the study you look at. What a deal for drugs that can cost more than a thousand bucks a year and are almost guaranteed to cause problems.
Goodbye Drugs, So Long Symptoms
Statins lower cholesterol by suppressing the activity of an enzyme in the liver involved in the production of cholesterol. But this enzyme has multiple functions, including the synthesis of coenzyme Q10. CoQ10 is a key player in the metabolic processes that energize our cells. No wonder statin users often suffer from fatigue, muscle pain and weakness, and even heart failure—the cells are simply running out of juice.
The second most frequent adverse effects of statins are problems with memory, mood, suicidal behavior, and neurological issues. Other common complaints include sexual dysfunction, and liver and digestive problems. Symptoms range from minor (achiness, forgetfulness) to serious (complete but temporary amnesia, permanent memory loss) to lethal (congestive heart failure, rhabdomyolysis or complete muscle breakdown). One statin drug, Baycol, was taken off the market a few years ago after it caused dozens of deaths from rhabdomyolysis. Several studies have also linked statin drugs with an increased risk of cancer.
Because physicians rarely warn of these side effects, few patients suspect their drugs may be the reason they begin feeling bad—and it’s often a revelation when they put two and two together. Simply discontinuing these medications can result in tremendous improvements in health and well-being. Texas cardiologist Peter Langsjoen, MD, published a study showing that when symptomatic patients got off their statins and started taking 240 mg of CoQ10 per day, they had significant decreases in fatigue, myalgias (muscle aches), dyspnea (shortness of breath), memory loss, and/or peripheral neuropathy.
Not a Drug But a Program
As you can see, we need to shift away from this myopic focus on statin drugs and lowering cholesterol, and take a more holistic view. Folks, you don’t need statins—you need a program that addresses all the known risk factors for heart attack, stroke, and other cardiovascular disorders.
Inflammation, not high cholesterol, is the primary cause of heart disease. Harvard researchers have discovered that a high blood level of C-reactive protein, a marker of inflammation, is more predictive of heart disease than cholesterol. To get a handle on inflammation, lose weight—especially if you carry excess fat in the abdominal area. Exercise. Stop smoking. Eat plenty of vegetables and several weekly servings of salmon, sardines, and other omega-3 fatty acids, and avoid sugars and starches.
The beauty of this program is that it targets not only inflammation but other conditions that contribute to cardiovascular disease, including high blood pressure, diabetes, even cholesterol. Best of all, it’s a foundation for overall good health.
Your program should include a well-rounded nutritional supplement regimen, as well. My number-one suggestion for inflammation in all its guises is fish oil. This supplement also improves blood flow, discourages excess clotting, helps normalize heart rhythm, and saves lives by reducing risk of sudden cardiac death.
Folic acid and other B-complex vitamins are important because they lower levels of homocysteine, a toxic amino acid that damages the arteries. The mineral magnesium relaxes the arterial walls, which improves blood flow, lowers blood pressure, and helps prevent arrhythmias. And antioxidants, such as vitamins C and E, provide protection against damaging free radicals—another contributor to cardiovascular disease.
Supplements that boost the heart’s energy are recommended as well. One is coenzyme Q10. In addition to serving as a potent antioxidant, CoQ10 also increases the heart muscle’s efficiency and protects against the adverse effects of statin drugs. Another is D-ribose, a natural sugar that is the structural backbone of adenosine triphosphate (ATP), the energy that fuels cellular function.
Don’t Obsess About Cholesterol
As far as cholesterol lowering is concerned, there are a number of natural therapies that work well, including flaxseed and other sources of fiber, niacin, plant sterols, and policosanol.
In short, do what you can to manage your cholesterol, but don’t worry about it if your level is particularly stubborn. The average cholesterol of people who have heart disease isn’t much higher than the level of those who don’t. If high cholesterol runs in your family, concentrate on what you can control, and remember, numbers aren’t everything.
- Here are suggested daily doses of the supplements discussed above: fish oil 2–8 g, folic acid 800–1,200 mcg, magnesium 500–1,000 mg, vitamins C 1,000–5,000 mg, and E 400–800 IU, CoQ10 100–400 mg, D-ribose 10–15 g, flaxseed 1/4 cup, niacin 500–2,000 mg, plant sterols 1,500–2,000 mg, and policosanol 20 mg. Look for these supplements in your health food store or order them by calling (800) 810-6655.
- Discuss this information with your doctor. If you are interested in learning about the protocol we use at the Whitaker Wellness Institute to prevent and treat heart disease, contact a Patient Services Representative at (866) 944-8253 or click here.
- Carey J. Do cholesterol drugs do any good? Business Week. 2008 Jan 17. Available online at www.businessweek.com/magazine/content/08_04/b4068052092994.htm.
- Langsjoen PH, et al. Treatment of statin adverse effects with supplemental coenzyme Q10 and statin drug discontinuation. Biofactors. 2005;25(1–4):147–152.
- Marchioli R, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction. Circulation. 2002 Apr 23;105(16):1897–1903.
- Ravnskov U. The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease. New Trends Publishing, Washington, DC, 2000.
Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2008. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.