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The popular poem about the blind men and the elephant tells the story of six blind who men inspected the same animal and came to markedly different conclusions.  I want to introduce you to a look at the science of statins and cholesterols and see if you will be able to see a different animal from what you may have understood in the past.

Let’s first of all take a look at the names of commonly prescribed statin medications:  Advicor, Altocor, Lescol, Lipitor, Mevachor, Pravochol, Pravigard, and Zocor.   Statin medications are used to lower cholesterol, the idea being that high cholesterol is the cause of heart disease.  The prevailing thought is that statins reduce cholesterol, and that by reducing cholesterol, they reduce the risk of heart disease and stroke.  This article is going to look at that information in a very different light, and my sources are gleaned from the studies and writings in traditional medical journals.

Let’s start with how statins work.  We know they interfere with an enzyme called HMGCoA reductase,  which converts HMGCoA to mevalonate.  Mevalonate is a precursor to farnesyl pyrophosphate, which is a precursor to both Coenzyme Q-10 (CoQ10) and cholesterol.  Having established that statins reduce both cholesterol and CoQ10, let’s look at how energy is made in the body.  We will now do the super simplified biochemistry as it relates to ATP (energy) production. 

Glucose is the breakdown product of all carbohydrates and sugars.  Once glucose enters the cell, it is broken into two pyruvate molecules, producing two ATP molecules.  Pyruvate enters the mitochondria (the powerhouse of the cell) and enters the Krebs cycle (citric acid cycle) and produces two more ATP molecules in the process.  Pyruvate, byproducts of the Krebs cycle, and other substances enter the electron transport chain.  The electron transport chain yields oxygen and water, while producing an amazing 32 ATP molecules.  CoQ10 is required for the fifth of nine steps in the electron transport chain.  Reduction of any of the materials at any of the nine steps seriously compromises energy production of all living cells.

The bottom line is, if CoQ10 is affected, the whole electron transport chain is affected, the whole 32 ATP molecules are affected, and the cell is left with markedly less energy to run the cellular processes.   Is it any wonder that fatigue within a few months is a common side effect of statins, and rhabdomyolysis (muscle breakdown) is a life-threatening complication of statin use?

The next question is, do statins reduce cholesterol levels?  The answer is yes.  If we read from the PDR (Physician’s Desk Reference) 2004 Edition, it says, “Lipitor lowers plasma cholesterol and lipoprotein levels. . .Lipitor also reduces LDL production. . .Lipitor also decreases VLDL and triglycerides.”

Now, let’s look at some fascinating information gleaned from medical journals.  From the Journal of the American College of Cardiology, Volume 36, #6, 2000, we find “levels of total cholesterol, LDL cholesterol, HDL. . .did not predict survival.”  In other words, there was no relationship between cholesterol levels and cardiac death.  Next, from the British Medical Journal (which is comparable to the highly esteemed JAMA and New England Journal of Medicine in the U.S.), July 4, 1992, Volume 305, pages 15-19.  Their meta analysis of 21 studies comparing cholesterol and heart disease revealed the following:  “Lowering serum cholesterol concentrations does not reduce mortality and is unlikely to prevent coronary heart disease. . .claims of the opposite are based on preferential citation of supportive trials.”

And the last comes from the American Journal of Cardiology, Volume 36, #6, 2000, “initiation of statin therapy was associated with improved survival regardless of the lipid levels.”  Thus we see that statins decrease heart disease, but not because they reduce cholesterol levels.  In fact, there is very little relationship between cardiovascular disease and cholesterol levels.  However, it does appear that statins reduce heart disease through another mechanism.  We know that statins are antioxidants (albeit expensive ones) and it is perhaps through this antioxidant property or the fact that they reduce inflammation that we can account for their ability to reduce heart disease. 

Interestingly, one of the best markers for heart disease is known as highly sensitive C-reactive protein (hs-CRP), which is an inflammatory marker.  In the American Heart Hospital Journal of 2003, Volume 1, pages 207-211, they concluded “analysis showed that the predictive value [for heart disease] of hs-CRP was in most cases independent of … cholesterol levels.”  The Wall Street Journal, January 6, 2005, reports the following: “In two separate studies on statin use, researchers found that statins produced more benefits for patients when they helped achieve low levels of CRP, regardless of how well the drugs reduced the LDL. . . .The findings challenge the widely held notions that statins save lives and reduce heart attacks solely by lowering LDL cholesterol, and suggest the drugs work by lowering CRP as well.”

Controlling inflammation is the key to controlling vascular and heart disease.  Let’s review some effective ways for reducing inflammation:

1.       Diet

Let’s look at the diet first.  Avoid the common inflammatory triggers, which include caffeine, sugar, and aspartame (NutraSweet).  Eat real food and avoid processed foods. 

2.       Supplements

Second, we need to consider supplements.  The antioxidants, vitamins C, E and beta-carotene reduce inflammation by reducing the damage that free radicals cause.  Omega 3 fatty oils have also been found to reduce vascular disease.  The B vitamins B6 and folic acid have been shown to reduce homocysteine levels, which is a harmful substance to blood vessels (and also the brain).

3.       Stop Smoking

Cigarette smoke is probably the most damaging trigger of free radical release of any common exposure.  Free radicals are truly at the core of inflammatory conditions, including vascular and cardiac disease. 

4.       Baby Aspirin

One baby aspirin, 81 milligrams taken every other day (not every day) has shown a reduction in vascular disease. 

5.       EDTA chelation therapy

Last but not least is EDTA chelation therapy.  Intravenous EDTA chelation therapy markedly reduces free radical action in the body.  It also has the potential to remove toxic metals, which may be contributing to free radical production.  Specifically, it can remove copper and iron, both of which are catalysts for free radical destruction.  Copper and iron are released from red blood cells when blood clots.  EDTA chelation has also been found to increase energy production, specifically in the heart muscle. 

In 1993, Drs. Chappell and Stahl did a 19-article meta analysis involving 22,765 patients.  Their study showed an 87% improvement in cardiovascular disease with EDTA chelation.  This was 87% objective improvement, meaning actual laboratory test results and not just subjective reports from patients.  In that same year, Drs. Hancke and Flytie took 65 patients scheduled for bypass surgery.  After EDTA chelation, 58 out of the 65 cancelled their surgery.  These two physicians also took 27 patients who were on the waiting list for amputation.  Twenty-four out of those 27 cancelled their surgery after EDTA chelation.  In comparing costs, it is interesting to note that for $2000-$5000, a patient can receive improvement in vascular symptoms that will favorably affect every vessel of the body, as opposed to a $50,000+ surgery that may temporarily repair one to five vessels and leave the rest of the vessels in the body in the same condition in which they were when the surgery began.   

Before I go on, let me review what I have discussed, so that you may catch the importance of what I have shared with you:

1. Statins reduce levels of CoQ10 and cholesterol.
2. Low CoQ10 levels decrease energy and cause fatigue.
3. Statins decrease heart disease, but not because they reduce cholesterol levels (probably they reduce heart disease because they are an antioxidant or because they reduce inflammation).
4. Cholesterol is not the major cause of heart disease.
5. Inflammation is the major cause of vascular and heart disease.
6. Controlling inflammation is the key to controlling vascular and heart disease.
7. Controlling inflammation can be accomplished much more safely and effectively without the use of statins. 

If I have not convinced you that lowering cholesterol levels has very little to no effect on cardiac disease, and you do want to reduce your cholesterol levels, let me suggest some safe ways to do it:

1. Niacin, in the form of inositol hexaniacinate (the non-flushing form of niacin): 400mg, 1-2 times per day.
2. Policosinol. 
3. Garlic: at least 1000mg/ day (the nice thing about garlic is that it also decreases platelet “stickiness”).
4.  Vitamin E:  800-1200 IU per day.  This also reduces platelet stickiness (don’t worry about the recent vitamin E scare.  That research was highly flawed and over-sensationalized by the media. The vitamin E issue has some interesting information that you should explore.  Further information is available at my blog site but it also appears below in the Healthful Hints section).
5. Gugulipids, 340mg capsule, 1-2 capsules, 2-3 times per day.
6. High fiber diet
7. High fish oils: 9.2 grams of EPA per day.

We have now looked at the “animal” of cardiovascular disease from a different perspective.  As with the elephant in the story of the six men from Indostan, though each piece of information is partly true, the whole picture can be explored from a different perspective. 

Healthful Hints

1. The key to this whole thing is: eat a good diet and get the nutrients you need. 
2. If you or someone you love has been diagnosed with cardiovascular disease, it may be wise to explore these and other studies as you prayerfully determine the options you have for treatment.
3. For added information and dialogue about this and other key health issues from a preventive standpoint, check out my new blog site, www.drstangardner.com.

2005 Meridian Magazine.  All Rights Reserved.