Statins Add 5 Days to Your LifeMay 23, 2021
Statins Add 5 Days to Your Life
There are cracks in the "statin empire". The $ 18 billion industry has reached out as far as it can possibly go, even to the extent of advocating that virtually all adults should be on statins. But does it make sense and are we really treating a disease or a symptom?
The first crack appeared about 9 years ago around the simplistic rule of 200. Cholesterol above 200, you need statins. Below 200, "You're fine". Well, the Norwegians tested that in 2012 with the HUNT Study and followed some 50,000 folks for 10 years. They found that women with cholesterol over 200 lived longer than under 200. Oops! Is there a problem here? Of course, there is. The real problem is that you get into trouble in your arteries from small, dense LDL particles that have been oxidized. They occupy less volume. You can have a "low" cholesterol and not really be protected. Taking a statin, ironically, reduces the number of large, fluffy, harmless LDLs and not the dangerous small LDLs. That "magic" number of 200 doesn't make sense. It is simply a super easy tool that advertisers and patients can glom onto and believe that sounds like it makes sense. (Statins do have some helpful effect, probably as an anti-inflammatory nature.
Ask the question. Are you interested in how long you live, or how low your cholesterol is? I would contend you want to live longer. If I showed you a study of 12.6 million people, followed for some 10 years and having 694,000 deaths, you would say, "Sounds like a pretty good study to me - it's got big numbers." Well, they found that the ideal cholesterol was between 210 to 249. Sounds like the crack is getting bigger.
Ok, so just what benefit do I get from statins? Let's look at that. A study published in the British Medical Journal looking at 6 primary prevention and 5 secondary prevention studies (all they could find that included mortality and had sufficient scientific rigor) showed a surprising finding. The median survival advantage is just 4-5 days. Not much, considering cost, side-effects, and inconvenience. In fact, perhaps just plain nuts except for in very focused situations, like smokers who have had a heart attack. But folks with negative calcium CTs of their heart being advised to take a statin? That's just plain nuts. (Just look at that study. Folks with score of zero had zero mortality.)
Don't get me wrong. Cardiac disease remains the number one killer in America. It's worthy of being addressed. Just find for me the right tools. I would contend that you want to turn off oxidation and the production of small, dense LDLs. Well, now that's a worthy challenge. Once you understand what's happening, you can shape your own strategy to change it for yourself. We have to dive down into your mitochondria and the membranes of your cells. I can't fit it into this column so it's coming next week. In the meantime, consider cutting out sugar and white flour for the whole week. (Hint: if you measured the volume of your LDLs before and after the week, your LDL volume would have gone up. Your oxidized LDLs would have slipped into "safe" territory and your oxidation count would have gone down.). So next week, we will put the icing on the cake (sorry, wrong image), the olive oil on the avocado, and walk you through how oxidation gets started and how that leads to leaky endothelium in your arteries....and that's what we need to be treating. Stay tuned.
www.What will Work for me. I started my monthly 5-day fast mimicking diet this week. My first-morning fasting glucose after a 13 hour fasting period was 103. Ugh. I have such lousy genes. The Whitehall Study shows that every point over 85 on your fasting glucose results in a 6% increase risk of diabetes. Indeed, my father died of diabetes. The fast-mimicking diet will drop my glucose to the 70s by day 5, which gets me briefly into the safe zone. But insulin resistance and diabetes is all wrapped up in leaky artery endothelium, which is all wrapped up in oxidized, small dense LDLs. I'm intensely interested in this topic. And my physiology represents just about 50% of folks who think they are pretty ok and don't have much trouble, until they do. That's why this is such an important topic. But I'm not convinced a statin will help me. I am going to avoid fructose, sugar, and white flour.
References: BMJ Open, Stat News, Sci Reports, JACC Cardiovascular Imaging, Lancet,
1. Statins are an important part of cardiac care and prevention? Answer: Oh, such a loaded question. Yes, for a small number. No, for probably most people, particularly for those with a negative cardiac calcium scoring test.
2. And even if I have risk, how much extra life do I get by taking statins? Answer: 4-5 days. If that comforts you. Make sure you use those 4 days well.
3. My muscle aches and brain fog that I get with statins are worth it, aren't they? Answer: You have to decide
4. What is the level of cholesterol correlated with the longest life-span? Answer: between 210-250. Now, oxidized, small dense LDLs, that’s another story.
5. Did you know that the vast majority of primary care physicians have review of their medical decision-making around statins with economic consequences in their salary for not treating people with cholesterol over 200? Answer: Sad, isn't it? Guess who designed those "quality guidelines"? Yes, statin compensated doctors. The problem: you get caught in the cross-hairs.