Tuesday, July 21, 2009

Statins, Pregnancy, Sepsis, Cancer, Heart Failure: A Critical Analysis


Over the last few decades, the American pharmaceutical industry (henceforth, "Big Pharma") has applied a very successful formula to market fear and convert it into a multi-billion dollar industry. The algorithm goes like this:
  1. find a substance whose concentration can be measured cheaply
  2. find a prevalent disease whose presence correlates with a high concentration of that substance
  3. find a drug that reduces the concentration of that substance
  4. advertise aggressively to the general public and medical professionals, claiming a miracle cure.

In a substitution of variables, the substance is cholesterol, the disease is heart disease, and the drug is Lipitor, and, voila! Through aggressive advertising campaigns, Big Pharma has managed to convince the American public and the American doctors that statin drugs are the best thing since sliced bread.

But are they right? I think the evidence shows that very few people currently taking statin drugs are actually benefiting from them. Furthermore, many of them are actually worse off than they would have been had they never been on statins. Below, I will argue that any benefits incurred in combating heart disease are more than offset by increased susceptibility to fetal damage, toxic infection, and cancer.

I am certainly not alone in my concern about the ever increasing usage of statin drugs to fight a "disease," "hypercholesterolemia" [high cholesterol], that I would argue is not a disease at all. The Weston A. Price Foundation is trying hard to spread the word about the many roles of cholesterol and the myriad side effects associated with statin usage. They share with me the growing alarm over the ever widening definition of who qualifies for statin drugs:

"Who suffers from hypercholesterolemia? Peruse the medical literature of 25 or 30 years ago and you'll get the following answer: any middle-aged man whose cholesterol is over 240 with other risk factors, such as smoking or overweight. After the Cholesterol Consensus Conference in 1984, the parameters changed; anyone (male or female) with cholesterol over 200 could receive the dreaded diagnosis and a prescription for pills. Recently that number has been moved down to 180. If you have had a heart attack, you get to take cholesterol-lowering medicines even if your cholesterol is already very low--after all, you have committed the sin of having a heart attack so your cholesterol must therefore be too high. The penance is a lifetime of cholesterol-lowering medications along with a boring lowfat diet. But why wait until you have a heart attack? Since we all labor under the stigma of original sin, we are all candidates for treatment. Current edicts stipulate cholesterol testing and treatment for young adults and even children." (Statin Drugs: the Problem) .

Let me first briefly introduce a bit of biology and terminology. Cholesterol is a biological substance that is a direct precursor to many very important substances, including the sex hormones estrogen and testosterone, the adrenal hormones hydrocortisone and aldosterone, bile acids which help you digest fats, and, most especially, vitamin D. It is well known that vitamin D plays a critical role in fighting infection and cancer, in addition to its essential role in calcium metabolism and bone health. Since cholesterol is so crucial to well-being, the body is able to manufacture as much as it needs in the liver, even in the absence of a supply from food sources. There is plenty of evidence that cholesterol is protective against infection, a topic that will be central to this essay. (Cholesterol Benefits) .

When you have your cholesterol measured, the numbers will come back factored into three components: LDL, HDL, and "other." In simple terminology, LDL delivers cholesterol (from the liver) to the peripheral tissues, and HDL delivers cholesterol (e.g., from food sources) to the liver, where it is converted to bile acids and released into the digestive system to break down consumed fats. LDL is the one that is usually labelled as "bad," but, as you will see later, this is a misnomer.

Big Pharma is intent on getting as many people as possible on as high a dose of statins as they can possibly justify. They are arguing now that people whose cholesterol levels are fine should take statins if their C-reactive protein, an indicator of inflammation, is high (C-Reactive Protein and Heart Disease) . They also claim that people with a known heart condition should aim to achieve an LDL level below 70 mg/dl ( 70 mg/dl LDL Goal ) . This can be accomplished (relatively easily in many cases) by taking 80 mg (four times the standard dosage) of a statin drug every day. They are now even prescribing statins for women in their 20's who are married and fertile, without regard to the damaging effect these drugs are known to have on a fetus.

What I find particularly frustrating, and what is perhaps my main reason for writing this essay, is that, in my view, many of the health benefits of high cholesterol are currently being mis-represented, paradoxically, as benefits of statin drugs. There is currently a barrage of news items on the Web claiming that statins are protective against cancer, sepsis, and Alzheimers' disease. The researchers behind the retrospective studies where an apparently beneficial effect is observed are careful to say that "randomized controlled studies have yet to be conducted," but the media miss those subtleties and turn the claims into "facts." At the same time, when it became clear that very low values of LDL are problematic for both infection and cancer, Big Pharma tried to distance itself from the tight association statin drugs have with cholesterol levels. Incredibly, they claim that, because low LDL is problematic regardless of whether it occurs naturally or artificially through statin use, statins are somehow exonerated. While I agree with their claim that statins are not "carcinogenic," in the sense that they don't directly cause cancer, statistics show that, over the long term, people who sustain a lower cholesterol level in the blood are at higher risk for cancer (and infection) than people with high cholesterol. Essentially, by taking a statin, you are shifting the odds on what you die of. Pay the money, suffer the side effects, and as a result you may end up dying of cancer or a runaway infection before you would have died of heart disease if you had never taken the drug in the first place.

In the next section, I hope to make it clear that one demographic that should never be prescribed a statin drug is pre-menopausal women. In the following sections I will discuss sepsis (blood poisoning), and cancer, and will show how Big Pharma has successfully manipulated the truth to make it appear that statins are protective against both of these, when in fact the exact opposite is true. The last section before the summary presents the infectious theory of atherosclerosis, which has recently received considerable attention. I will describe, in as simple terms as possible, how cholesterol may play a central role in the artery wall in fighting the infective agent. The arguments presented there lead to the conclusion that statins work against even the long-term health of the heart itself.

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