The Great Cholesterol Myth (19 page)

The doctor barely knew what CoQ
₁₀
was, was utterly clueless about its importance, and was completely unaware of this critically important side effect of the drug he had prescribed—a drug that is especially unnecessary in this case, because high cholesterol is actually
protective
for older people.

This, folks, is just one example of what we like to call “cholesterol madness.”

If you are on a statin drug and need to remain on one for whatever reason, don’t spend one more day without supplementing with CoQ
₁₀
. Run, don’t
walk, to your nearest pharmacy or health food store and pick some up. We recommend a minimum of 100 mg twice a day, preferably of the ubiquinol form or a highly bioavailable ubiquinone.

One of the good things about statin drugs is that they are anti-inflammatory. This is important and probably one of the main reasons statins show any of the benefit they sometimes do. Inflammation, as you learned in
chapter 3
, is one of four major contributors to heart disease.

We want our anti-inflammatory arsenal to be as powerful as possible, because inflammation is a major component of every degenerative disease known to humankind. Anti-inflammatory foods, supplements, drugs? Bring ‘em on!

So the fact that statins are anti-inflammatory is a good thing. But the way they accomplish this anti-inflammatory action may not be without problems.

One of the compounds made in the mevalonate pathway is something called nuclear factor kappa B, also known as NF-kB. NF-kB is an important part of the immune system, but it is highly inflammatory. (Remember, inflammation is an important part of the healing process, so you need some inflammatory compounds in your body to help fight infectious microbes.) It’s widely believed that the main reason statins are so anti-inflammatory is because they turn down the volume on NF-kB production (just as they turn down the volume on CoQ
₁₀
production, another “branch” in the mevalonate pathway that’s short-circuited by statins).

You might well ask how this could be anything but a good thing, right? Statins lower NF-kB, which is an inflammatory chemical, and the less we have of those the better!

Well, maybe.

Although at first blush it might seem that lowering this powerful inflammatory chemical produces a wholly good effect, the problem is that NF-kB is neither “good” nor “bad.” Some infectious organisms—
E. coli
and salmonella, for example—actually manage to infect the body by inhibiting NF-kB, just as statin drugs do. Other microbes, such as the bacterium that causes chlamydia, actually
enhance
NF-kB. The Epstein-Barr virus inhibits NF-kB at some points in the life of the virus and activates it at other points.

The point is, no one knows the long-range consequences of constantly suppressing NF-kB by cutting off the mevalonate pathway, as statin drugs do. Some of the results—for some people, with some conditions—are indeed positive. Some of the results—for
other
people, with
other
conditions—could be disastrous. There are far easier, safer, and more natural ways to reduce inflammation than by using a drug that has been shown to have a strong link to serious side effects and may—as in the case of long-term suppression of NF-kB—have consequences we don’t even know about yet.

But the impact of cholesterol lowering on the immune system is not limited to the effect on NF-kB. Research has shown that human LDL (the so-called “bad” cholesterol) is itself able to inactivate more than 90 percent of the worst and most toxic bacterial products.
⁷

A number of studies have linked low cholesterol to a greater risk for infections. A review of nineteen
large, peer-reviewed studies of more than 68,000 deaths found that low cholesterol predicted an increased risk of dying from respiratory and gastrointestinal diseases, both of which frequently have an infectious origin.
⁸
Another study that followed more than 100,000 healthy individuals in San Francisco found that those who had low cholesterol at the beginning of the fifteen-year study were far more likely to be admitted to the hospital because of an infectious disease.
⁹
And an interesting finding from the MRFIT study found that sixteen years after their cholesterol was first checked, the group of men whose cholesterol level was 160 or under were four times more likely to die from AIDS than the group of men whose cholesterol was over 240!
¹⁰

And now for the part that no one is talking about. The dirty little secret about statin drugs. Please don’t shoot the messengers. Ready?

Statin drugs have a terrific ability to completely mess up your sex life.

No kidding.

Not only is this a common side effect of cholesterol lowering, but it’s also vastly underreported. And worst of all, many people who experience sexual dysfunction, especially men, have no idea that it might very well be related to the drug they’re taking to lower their cholesterol.

Erectile dysfunction affects more than half of all men between the ages of forty and seventy years.
¹¹
We’ve already seen how lowering cholesterol can have serious consequences for memory, thinking, and mood. Just as the brain needs cholesterol for neurotransmitters to properly function, the gonads need it to produce the hormonal fuel to keep our sex lives humming. All the major sex hormones—testosterone, progesterone, and estrogen—come from cholesterol. It’s utterly preposterous to assume that lowering cholesterol, which is tantamount to downsizing your body’s own sex hormone factory, is not going to have a profound effect on sexual functioning.

Of course it is. And it does.

Several studies have shown beyond any doubt that statin drugs lead to a reduction in sex hormones, most notably testosterone.
¹²
And this is a very big deal indeed.

Remember, low testosterone is not just a male problem—women also make testosterone (albeit much less of it), and it’s increasingly clear that even this small amount of testosterone strongly influences women’s sexual desire. (Most anti-aging clinics now routinely prescribe small, physiologic doses of testosterone to postmenopausal women to treat sagging libido levels and improve general well-being. Testosterone is vitally important to both sexes!)

We know for sure that low cholesterol is linked to low testosterone in women from studies conducted on women with a condition known as polycystic ovary syndrome (PCOS). Women with PCOS suffer from an abnormal increase in their testosterone levels, but when you lower their cholesterol their testosterone plummets, leaving little doubt about the anti-hormone effect of statin drugs.
¹³
The effect on men is pretty easy to document, and many studies have done just that. One study showed that Crestor, one of the most popular statin drugs, increased the risk of erectile dysfunction at least two and up to seven times!
¹⁴

If libido and sexual health were the only things disturbed by diminishing levels of testosterone, that would be reason enough to be deeply concerned. But low testosterone has a much more global influence on overall health. Low testosterone is associated with decreased life expectancy, as well as increased risk of mortality from cardiovascular disease.
¹⁵
And for those who have testosterone levels below a certain threshold, the risk is doubled!

As important as it is, testosterone certainly isn’t the only driver of sex and desire in either males or females. Another important hormone—known as the “hormone of love”—is oxytocin.

Oxytocin is produced in the brain, and levels are very high during childbirth and nursing because one of its functions is to help the mother bond with the child. When you cuddle after sex, you’re flooded with oxytocin. (Males also make oxytocin, just a lot less of it than females do.) Researchers love to study male prairie voles because they are a rare exception to the male–female oxytocin dichotomy; male prairie voles, unlike males of most species, make a ton of the stuff. Male prairie voles are also a rare example of monogamy in the animal kingdom, and this has long been attributed to their oxytocin production, resulting in fairly permanent “pair-bondings.” The bottom line is that oxytocin, which helps you feel good and bond with another person (or another prairie vole!), is an important part of human sexual desire, expression, and satisfaction.

So what does oxytocin have to do with cholesterol?

Unlike testosterone, oxytocin is not made from cholesterol. But oxytocin gets into its target organs via cell receptors, and those cell receptors are highly dependent on cholesterol-rich membranes. Critically important parts of the membranes known as lipid rafts don’t work well without cholesterol, meaning that lowering cholesterol interferes with the ability of hormones such as oxytocin to reach their destination and work their magic. (As we’ve seen, this also happens with neurotransmitters in the brain that depend on cholesterol-rich membranes for cellular communication.)

Finally, statins also interfere with serotonin receptors in the brain.

In case you’re not familiar with serotonin, it’s one of the critical neurotransmitters involved in mood. The most commonly used antidepressants, including the blockbuster drugs Prozac, Zoloft, Lexapro, and the like, are known as
selective serotonin reuptake inhibitors
(SSRIs) because they act mainly to keep serotonin hanging around the brain longer. Serotonin has a great deal to do with our feelings of relaxation, well-being, and satisfaction.

So how exactly do statins act on the physiology of serotonin?

Simple. Much like oxytocin (discussed above), serotonin depends on cell receptors to get into the cells. Serotonin receptors—just like oxytocin receptors—are anchored into the cholesterol-rich lipid rafts in the cell membrane. If you lower cholesterol you’re going to interfere with serotonin getting into the cells. It’s that simple. In fact, research has convincingly demonstrated that serotonin receptors can be rendered dysfunctional by statin drugs.
¹⁶

The noted French researcher Michel de Lorgeril, M.D. (lead author on the Lyon Diet Heart Study), is so strongly convinced that statins are screwing up our sex lives that he devoted an entire book to the subject. His only book in English, it offers a brilliant argument supported by ninety-two references from peer-reviewed journals and textbooks. The name of the book—
A Near-Perfect Sexual Crime: Statins Against Cholesterol
—pretty much tells you what de Lorgeril thinks about statins and our sex lives.

Earlier, we discussed how the majority of cholesterol-lowering studies didn’t show any difference in death rates between patients who took cholesterol-lowering meds and patients who didn’t. In some of these cases, a slight reduction in heart disease deaths was clearly offset by a slight increase in deaths from other causes, so the overall net “gain” in terms of lives saved was a big fat zero.

But studies show even more troubling results. For example, a study in the
Journal of Cardiac Failure
showed that low cholesterol was actually associated with a marked increase in mortality in heart failure cases.
¹⁷
And the Italian Longitudinal Study on Aging, published in the
Journal of the American Geriatric Society
, found that those with cholesterol levels lower than 189 were far more likely to die than those with the highest cholesterol levels. The researchers concluded, “Subjects with low total cholesterol levels are at higher risk of dying even when many related factors have been taken into account,” adding that “. . . physicians may want to regard very low levels of cholesterol as potential warning signs of occult disease or as signals of rapidly declining health.”
¹⁸

There are also troubling indications that statin drugs may be associated with a higher risk for cancer and diabetes, though the evidence is far from conclusive. Researchers from the Department of Medicine at Tufts Medical Center and Tufts University School of Medicine examined twenty-three statin trials looking for any connection between cholesterol levels and cancer. They concluded that “the risk of cancer is significantly associated with lower achieved LDL-cholesterol levels,” adding that “the cardiovascular benefits of low achieved levels of LDL-cholesterol may in part be offset by an increased risk of cancer.”
¹⁹
Further, a meta-review of five statin trials found that an increased risk of diabetes was associated with “high-dose” statin therapy.
²⁰
This finding was also seen in the well-known JUPITER trial, about which we’ll have a lot more to say in a bit.

Remember Duane Graveline? The astronaut medical doctor who came down with transient global amnesia as a result of statin drug use? Graveline has spent the past decade or so accumulating data on statin side effects. Hundreds if not thousands of people have written to Graveline detailing their side effects with statin drugs, and his website contains dozens of essays on these various syndromes, conditions, and side effects.
²¹
In addition, Teresa Graedon, Ph.D., and Joe Graedon, M.S., authors of the popular
The People’s Pharmacy
, have published a number of letters from readers on their website regarding statin side effects. Three examples: