The statin Problem

I will start with two statements (These are my own views): 

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• Drugs cannot fix a lifestyle problem.
• Blood serum cholesterol levels have very little to do with coronary heart disease.

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Since studying biochemistry in UL I have always been fascinated with what the downstream effects of medicinal drugs are in the body. Many of these we take for granted such as forms of antibiotics but we won’t dive into topics like anti microbial resistance here. Mainly one I want to dive into is that of statins. Statins come in many variations and are well known as a “cholesterol” reducing drug which inhibit the production of cholesterol. Although this can be seen as a good thing in terms of Coronary issues I have been fascinated to see the severity of some of the downstream effects of statins in some of my patients.

I am a big supporter of if your GP prescribes prescription drugs for lifestyle related issues such as elevated cholesterol levels without questioning diet sleep and exercise levels, then you have a dealer not a healer.

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In every case of polymyalgia , fibromyalgia , and rheumatic issues there are a few things in common with every patient without fail:

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• Poor lifestyle 
• Medication overuse including statins 
• Poor self image 
• Emotional Trauma 

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More often than not the combination of these issues is what yields the issue.

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Why do people get prescribed statins?

It is important to remember statins are prescribed to aid on lowering cholesterol levels AS A MEANS of treating heart related issues such as Coronary heart disease.

Mainly people who present to a doctors office with elevated cholesterol levels. Statins have been seen to inhibit the production of LDL cholesterol which is low density lipoprotein In the blood. High levels of LDL cholesterol have been linked with cardiovascular disease and atherosclerosis aswell as stroke, angina and other heart related issues. Commonly a GP will investigate whether CVD runs within the family and if the GP feels the patient is at risk they may prescribe statins. While I understand that statins do work in short terms scenarios. My issue is more with longstanding use of statins for years without ever even attempting to remedy the issues with the patients health. High cholesterol is a symptom not a disease. 

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Positive effects of cholesterol

Cholesterol is one of the most critical chemicals needed by the body. However, it has been characterised as a pest that must be stamped out at all costs. Cholesterol is necessary for the following reasons:

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1. Serves To Waterproof Each Cell

2. Repair Injuries:all scars,including those we call plaque

3. Making VitaminD

4. Making bile 

5. Mineral Metabolism

6. Cholesterol Antioxidant (electrondonor)

7. Memory

8. Uptake Of Serotonin In The Brain

9. One-half of the dry weight of the brain is cholesterol

10. Making Adrenal Hormones That Control All Sugar Metabolism

11. Making adrenalin so we can deal with stress

12. Making sexual hormones

13. Control Allergies

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Understanding Muscular Issues Associated with Long-Term Statin Use

Statins are widely prescribed medications used to lower cholesterol levels and reduce the risk of heart disease, stroke, and other cardiovascular conditions. While they are highly effective at managing cholesterol, long-term statin use has been associated with various side effects, including muscle pain and weakness—conditions that can significantly impact quality of life. In some cases, these muscular issues can become severe and potentially lead to serious complications.

In this blog post, we’ll explore the muscular problems related to statin use, why they occur, and what you can do to manage them.

What Are Statins and How Do They Work?

Statins, also known as HMG-CoA reductase inhibitors, work by blocking an enzyme in the liver responsible for producing cholesterol. This helps lower the levels of low-density lipoprotein (LDL) cholesterol, often referred to as "bad" cholesterol, while potentially increasing levels of high-density lipoprotein (HDL), or "good" cholesterol. Reducing LDL levels is important for preventing plaque buildup in arteries, which can lead to heart attacks, strokes, and other cardiovascular issues.

So we know statins can positively effect the above however they come with a host of sideffects. More importantly they only begin to treat the symptom of high cholesterol. Not the underlying issues which are causing the high cholesterol.

The most common statins prescribed include atorvastatin (Lipitor), simvastatin (Zocor), and rosuvastatin (Crestor). While these drugs are effective in reducing cholesterol, they can also cause side effects, particularly when used over extended periods.

Muscular Issues Linked to Long-Term Statin Use

1. Myalgia (Muscle Pain): The most commonly reported muscular issue associated with statins is myalgia, or muscle pain. Patients often describe it as soreness, tenderness, or aching in the muscles. The pain can be mild or severe and may affect any muscle group in the body, including the arms, legs, and back. Myalgia does not typically cause muscle weakness, but it can significantly affect a person’s daily life and ability to exercise.
2. Myopathy (Muscle Weakness): Myopathy refers to a more generalized muscle weakness that can be caused by statins. Unlike myalgia, which involves pain without loss of strength, myopathy results in a noticeable decrease in muscle function. This condition can affect mobility, make routine tasks more difficult, and reduce overall physical stamina.
3. Rhabdomyolysis (Severe Muscle Breakdown): Though rare, rhabdomyolysis is the most serious muscular complication associated with statins. It occurs when muscle fibers break down and release a protein called myoglobin into the bloodstream. High levels of myoglobin can cause kidney damage and lead to potentially life-threatening complications. Symptoms of rhabdomyolysis include intense muscle pain, weakness, dark-colored urine, and extreme fatigue. Anyone experiencing these symptoms should seek immediate medical attention.
4. Statin-Associated Autoimmune Myopathy (SAAM): In very rare cases, long-term statin use can lead to an autoimmune condition known as statin-associated autoimmune myopathy. This condition occurs when the immune system mistakenly attacks healthy muscle tissue, causing chronic inflammation and muscle weakness. Unlike typical statin-related myopathy, the symptoms of SAAM persist even after stopping the medication, requiring treatment with immunosuppressive drugs.

Why Do Statins Cause Muscle Problems?

The exact mechanism by which statins cause muscle problems is not fully understood, but several theories have been proposed:

1. Coenzyme Q10 (CoQ10) Depletion: Statins interfere with the body’s production of Coenzyme Q10 (CoQ10), a vital substance that helps cells produce energy, especially in muscle cells. CoQ10 is crucial for proper muscle function, and low levels may lead to muscle pain and weakness. Some researchers believe that supplementing with CoQ10 may help mitigate statin-related muscle problems, though this is still an area of ongoing study.
2. Disruption of Muscle Cell Membranes: Statins may disrupt the integrity of muscle cell membranes, making them more prone to damage. This can lead to inflammation and the breakdown of muscle fibers, resulting in pain and weakness.
3. Genetic Predisposition: Some individuals may be genetically predisposed to experiencing muscle problems while taking statins. Certain genetic variations can affect how the body processes statins, increasing the likelihood of muscular side effects.
4. Statin Dosage and Potency: Higher doses or more potent statins are more likely to cause muscle-related side effects. Individuals on higher doses of statins, or those taking medications like atorvastatin or simvastatin, may be at a greater risk of developing myopathy or rhabdomyolysis.
5. Drug Interactions: Statins can interact with other medications, increasing the risk of muscle damage. For example, certain antibiotics, antifungal medications, and drugs used to treat HIV or hepatitis C can amplify the effects of statins, raising the risk of muscle issues.

But more Importantly across much of the pharmaceutical and biopharmaceutical world a lot of the effect mechanisms are not known. For example something as simple as paracetamol to SSRI ( selective serotonin reuptake inhibitors) which are some of the most common medications on the market; the way in which they work is not fully known. What really amazes me is that people will pump their body with the usual drugs like pain killers, statins , beta blockers etc yet not drink milk and butter because dairy is not good. 

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The way in which we live our lives is the biggest dictator of good or poor health.

Risk Factors for Statin-Related Muscle Problems

While anyone taking statins can potentially experience muscle-related side effects, certain factors can increase the likelihood of developing these issues, including:

• Age: Older adults are more susceptible to statin-related muscle problems due to natural declines in muscle mass and strength.
• Gender: Women appear to be more prone to muscle pain and weakness from statins compared to men.
• Pre-Existing Conditions: People with conditions like hypothyroidism, kidney disease, or diabetes are at higher risk of developing muscle complications.
• High-Dose Statin Therapy: Those taking higher doses of statins are more likely to experience muscle pain and weakness.
• Physical Activity: Paradoxically, people who exercise regularly may be more likely to notice muscle pain when taking statins due to the strain on their muscles from physical activity.

Managing Statin-Related Muscle Issues

If you're experiencing muscle pain or weakness while taking statins, it’s important to discuss your symptoms with your GP. There may be  several strategies that can help manage these side effects: 

1. Lowering the Dose: Reducing the dosage of statins may alleviate muscle problems while still providing enough cholesterol-lowering benefits to protect against heart disease.
2. Switching Statins: Some statins are less likely to cause muscle pain. For example, switching from a higher-potency statin like simvastatin to a lower-potency one like pravastatin or fluvastatin may reduce muscular side effects.
3. Taking Statins Every Other Day: For some patients, taking statins every other day or a few times a week may reduce muscle pain without compromising cholesterol control. This option should be discussed with a healthcare provider.
4. CoQ10 Supplementation: Some studies suggest that taking CoQ10 supplements may help reduce muscle pain associated with statins. However, more research is needed to determine its effectiveness.
5. Lifestyle Changes: Incorporating heart-healthy habits, such as a balanced diet, regular exercise, and weight management, can sometimes reduce the need for high-dose statin therapy.
6. Alternative Medications: In cases where statin use is not tolerated, alternative cholesterol-lowering medications like ezetimibe, PCSK9 inhibitors, or fibrates may be considered.

Conclusion

I am not totally against the use of statins even though I’m pointing out the I’ll effects above. However long term use and abuse can have severe consequences on the body energetically , physically and emotionally. We are energetic beings and when we do not energise ourselves and then also take substances which can have negative effects on energetic pathways we are leaving ourselves wide open for a host of chronic ailments. 

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In an ideal world , statins would be prescribed to lower the cholesterol levels while lifestyle changes are adhered to. Once the cholesterol has dropped the statins should be discontinued. No different to the removal of orthotics and rehabilitation of the foot and ankle following their implementation ( which is another story). These are tools they are not fixes.

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There is one major bugaboo to all of this train of thought however. In my opinion and if you see below some scientific papers, they have found very little correlation at all between higher mortality rates and blood serum cholesterol levels. I don’t believe cholesterol levels increase the risk of coronary heart disease. See the attached papers below for reference and make your own mind up.

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Why are statins so widely prescribed ?

Money.

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• Is Relationship Between Serum Cholesterol and Risk of Premature Death from Coronary Heart Disease Continuous and Graded? Findings in 356,222 Primary Screenees of the Multiple Risk Factor Intervention Trial (MRFIT),” Stamler, J., Wentworth, D., and Neaton, J.D., JAMA (1986 Nov 28), 256(20): 2823–8, ISSN: 0098-7484.
• Risk Factors for a Major Coronary Event after Myocardial Infarction in the Scandinavian Simvastatin Survival Study (4S). Impact of Predicted Risk on the Benefit of Cholesterol-lowering Treatment,” Wilhelmsen, L., Pyorala, K., Wedel, H., Cook, T., Pedersen, T., and Kjekshus, J., Eur Heart J (2001 Jul), 22(13): 1119
• Independence of Serum Lipid Levels and Dietary Habits, The Tecumseh Study,” Nichols, A.B., Ravenscroft, C., Lamphiear, D.E., and Ostrander, L.D., JAMA (1976 Oct 25), 236(17): 1948–53
• Design of Practical Fat-controlled Diets, Foods, Fat Composition, and Serum Cholesterol Content,” Brown, H.B., Farrand, M., and Page, I.H., JAMA (1966 Apr 18), 196 (3): 205–13.
• Why the Cholesterol-Heart Disease Theory Is Wrong,” by Malcolm Kendrick, Mbchb, Mrcgp:
• The Relationship of Oxidized Lipids to Coronary Artery Stenosis,” Kummerow, F.A., Olinescu, R.M., Fleischer, L., Handler, B., and Shinkareva, S.V., Atherosclerosis (2000 Mar), 149(1): 181–90 ISSN: 0021.

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