Dietary factors and therapeutic lifestyle changes have no side effects. They should be considered the first line of defense in preventive cardiology. . . . Rather than . . . targeting cholesterol numbers alone, doctors owe it to their patients – and patients owe it to themselves- to look further into these controversial issues before embracing potent drugs that might not truly serve the needs of the people for whom they’re being prescribed.
~ Stephen Sinatra, MD, FACC, Co-Author With Jonny Bowden, PhD, CNS The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease – And the Statin-Free Plan That Will (2015)
Have you ever wondered whether taking your cholesterol-lowering statin drug will actually prevent heart disease? Consider this statement John Abramson, MD, author of Overdosed America, published in The Lancet (2007), one of the world’s top peer-reviewed general medical journals, after analyzing eight randomized trials that compared statins to placebos:
“. . . statins should not be prescribed for true primary prevention in women of any age or men older than 69 years. High-risk men age 30 to 69 years should be advised that about 50 patients need to be treated for five years to prevent one event. In our experience, many men presented with this evidence do not choose to take a statin, especially when informed of the potential benefits of lifestyle modification on cardiovascular risk and overall health (emphasis added). This approach . . . would lead to statins being used by a much smaller proportion of the overall population than recommended by any of the guidelines.”
Part 1 of this two-part article (March 2017 issue) addressed a more updated approach to preventive cardiology, including key points from The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease – And the Statin-Free Plan That Will, the thoroughly documented book that Stephen Sinatra, MD, FACC, recently co-authored with Jonny Bowden, PhD, CNS (Sinatra/Bowden). A more detailed discussion of the significant disadvantages of taking statins, and a supplements-based approach to prevention of heart disease, follows.
The Evidence Against Statin Drugs
According to Sinatra/Bowden, statin drug benefits have been greatly exaggerated, and any advantage statins offer has nothing to do with their ability to lower cholesterol. Though recognizing that statins reduce inflammation, provide antioxidant protection, and enable blood to flow more easily, they maintain that doctors should prescribe statins only to middle-aged men who have had a heart attack and are at very high risk for another one, and never to children, the elderly, or most women.
The authors’ evidence-based position stems from these proven cholesterol-lowering and other side effects of statins:
- Cognitive/Memory Dysfunction: they reduce cholesterol in the brain, which requires it for healthy cell membranes and their ability to “talk” to each other (neurotransmitter transmission)
- Energy Reduction (Weakness/Fatigue): they uncontrovertibly deplete body stores of the antioxidant CoQ10, without which the body cannot function (see below)
- Muscle Pain & Heart Damage: their depleting CoQ10 damages muscles that rely on it for energy production
- Sexual/Erectile Dysfunction: they reduce production of all of the major sex hormones (testosterone, progesterone, estrogen), and interfere with the function of oxytocin (the bonding/love hormone produced in the brain) and serotonin (the mood hormone) receptors in the brain
- Increased Risk of Infection: their anti-inflammatory effect reduces NF-ĸB, a highly inflammatory but critical component of the immune system and the healing process; they lower LDL, known to be able to inactivate more than 90% of the most toxic bacteria, especially those that cause respiratory and gastrointestinal diseases
- Increased Risk of Cancer, Diabetes & All-Cause Death.
As if this frightening list of potential side effects were not enough to discourage a patient from taking statins, it is also valuable to keep in mind that cholesterol is: (1) used to manufacture the hormones cortisol (the fight-or-flight hormone) and vitamin D (less than optimal levels are linked with heart disease, osteoporosis, depression, cancer, weight loss difficulty, and all-cause mortality); and (2) a critical component of all cell membranes (especially those of the brain, nervous system, spinal cord, and peripheral nerves).
The Natural Statin Alternative Beyond Diet Changes: Dietary Supplements
As discussed in Part 1, cardiovascular wellness begins with a healthy, clean diet. In my clinical practice, numerous dietary supplements have proven to be critical foundations of the path to long-term heart health, even if a patient prefers to follow his doctor’s advice to take a statin drug. Although the scope of this article does not allow for a complete discussion, Sinatra/Bowden agree that these nutrients provide a solid starting point:
- L-Carnitine (Ideally, as Aceytl L-Carnitine Alginate). With CoQ10, D-ribose, and magnesium (see below), Sinatra recommends this amino acid as one of the “Awesome Foursome” in metabolic cardiology. It transports fatty acids into the powerhouses of cells to be burned as energy. Sinatra/Bowden write, “Because the heart gets 60 percent of its energy from fat, it’s very important that the body has enough L-carnitine to shuttle fatty acids into the heart’s muscle cells.”
- CoenzymeQ10 (CoQ10). This antioxidant, which Sinatra calls “the spark of life,” is critical to the generation of cellular energy (ATP) and enables oxygen utilization. It is highly concentrated in organs with higher energy requirements (especially those that manufacture it, the heart, liver, kidneys, and pancreas), but is also found in every cell of the body. Sinatra/Bowden recommend at least 100mg twice per day, especially for every patient taking a statin. Ideally, ubiquinol (the active, reduced form that is absorbed up to eight times better than regular, CoQ10) should be taken with a fat only in the morning and afternoon.
- Curcumin (Turmeric). Substantial scientific evidence indicates that curcumin: (1) combats the inflammation and oxidative stress that causes atherosclerosis (hardening of the arteries), (2) reduces oxidized LDL cholesterol, (3) raises protective HDL cholesterol; and (4) reduces triglycerides.
- D-ribose. Without this five-carbon sugar there would be no ATP, and with no ATP there would be no energy. Although all cells create D-ribose, they do so slowly and to varying degrees depending on the tissue. The heart, skeletal muscles, and the brain can only make enough D-ribose for their daily needs and do not store it. The presence of heart disease results in chronic deficient blood flow and oxygen so that tissues cannot make enough D-ribose and cellular energy levels are constantly depleted. Sinatra thus recommends from 5 grams/day (cardiovascular prevention, athletes on maintenance, and healthy people who engage in strenuous activities), to 10-15 grams/day (most patients with heart failure, ischemic cardiovascular disease, or peripheral vascular disease), to 15-20 grams/day (advanced heart failure, frequent angina, severe fibromyalgia/muscle cramps/neuromuscular disease).
- Fish Oil [Omega 3 Essential Fatty Acids (EFAs)]. EFAs, containing EPA and DHA, are vital components of cell membranes and particularly important for overall heart health. Omega-3s: (1) reduce “stiffness” and promote proper blood vessel dilation; (2) reduce inflammation; (3) promote normal blood pressure, cholesterol, and triglyceride levels; and (4) reduce the risk of fatal arrhythmias and sudden cardiac death. Since Sinatra/Bowden maintain that, “fish oil saves lives,” they recommend 1-2 grams/day and consumption of wild, cold water fish as often as possible.
- Magnesium. Not only is magnesium required for over three hundred biochemical reactions in the body, but it also functions as a natural calcium-channel blocker (aka calcium antagonists, a group of drugs that affect the way calcium passes into certain muscle cells and are used to treat high blood pressure, angina, and some abnormal heart rhythms). Coronary artery calcification is a long-recognized major risk for heart disease (see Part 1, Agatston score). Maintaining adequate magnesium levels prevents the rise of intracellular calcium, inhibits platelet aggregation (important in the development of clots), and dilates the arteries (to enable the heart to pump more easily and reduce blood pressure).
The final critical piece of the cardiovascular prevention puzzle is the management of stress, which contributes to all diseases (especially various aspects of heart disease) and Sinatra/Bowden label, “The Silent Killer.” Since stress response can determine whether one lives long and has quality of life, learning techniques that can promote acceptance of, and adaptation to, stress is essential. Proven options include consciousness and emotional management programs, daily meditation, prayer, and deep breathing and, of course, regular physical exertion. It’s never too late to adopt a cardiovascular prevention plan. Decide to create one today to maximize your chances of having the healthiest and longest life possible.
The statements in this article have not been evaluated by the Food and Drug Administration and are not intended to take the place of a physician’s advice. The natural remedies discussed herein are not intended to diagnose, treat, cure or prevent any disease.
Submitted by Michael Dworkin, PD, CCN, a Registered Pharmacist and State Certified Clinical Nutritionist (CT Cert. No. 232), with J. Erika Dworkin, Certified Lifestyle Educator and Board Cert. Holistic Nutrition (Cand.). Co-owner of the Manchester Parkade Health Shoppe (860.646.8178, 378 Middle Turnpike West, Manchester, CT, www.cthealthshop.com), Pharmacist Dworkin has been guiding patients since 1956. Erika is available to speak to groups.
All statements in this article are research-based and references are available upon request.