Statin Drugs and Fatigue
By John Toomey
This is a challenge. Right now, the belief in our world is almost cast in stone that elevated cholesterol is the cause of heart disease and that cholesterol lowering drugs, or statins, are essential for any person who presents any form of elevated risk of heart disease, particularly elevated cholesterol levels.
So I am walking on very thin ice right now, but this is a subject that must be openly discussed. All is not as it seems.
Last Thursday evening, October 24th, the ABC’s Catalyst program finally took this issue to task. A respected science investigation program, Catalyst explored the issue head on and revealed a great deal of unrest about the issue in medicine. Further, they revealed information most people had never considered, about how the original creator of the cholesterol theory, Ansel Keyes had manipulated his studies to create proof for his theories and how a US Government Senate Committee pushed the issue into policy against fierce medical and scientific resistance.
The cold hard reality is that there is very little reliable correlation between cholesterol levels and heart disease. The plaque that is extracted from blocked arteries is actually up to 90% calcium, not cholesterol as most have been led to believe.
A study published just last year in the journal Atherosclerosis2, showed that statin use is associated with a 52 percent increased prevalence and extent of calcified coronary plaque compared to non-users. And coronary artery calcification is the hallmark of potentially lethal heart disease!
You can view the Catalyst episode if you follow this link. It is a brilliant piece of journalism by Dr Maryanne Demasi. The Heart of the Matter Part 1.
The purpose of this article is to explore the impact Statin Drugs may have in creating fatigue in workers operating in moderate to high risk situations. Fatigue has been demonstrated as a major cause of industrial accidents, road accidents and marine accidents. Anything that may cause premature or avoidable fatigue should be assessed.
What do Statins do in the Body?
Statins inhibit an enzyme called HMG-CoA reductase, which controls cholesterol production in the liver. The medicines actually act to replace the HMG-CoA that exists in the liver, thereby slowing down the cholesterol production process.
Currently, over 45 million Americans are taking Statin drugs. This amounts to a massive and ongoing clinical analysis of the drugs, their effectiveness and their side effects. Reports of side effects are compiled and, if the side effects are common, reports are presented to the FDA for consideration.
What are the Current Warnings and Side Effect Alerts?
Early in 2012, internal meetings between the FDA’s Office of Surveillance and Epidemiology and the Office of New Drugs, the FDA announced it would be requiring additional warning labels for statin drugs. Among them are warnings that statins may increase the risk of:
- Liver damage
- Memory loss and confusion
- Type 2 diabetes
- Muscle weakness (for certain statins)
It has been estimated that Statin drugs are the cause of up to 60,000 new cases of Type 2 Diabetes in the US each year. Type 2 Diabetes and fatigue go hand in hand. As workers struggle to control blood sugar levels, they can lose energy rapidly and even experience dizziness.
Whilst 60,000 may not seem like a large number against 45 million taking statins, some people take statins for decades. In a large percentage of cases, patients believe they will be taking the drug for life. In this context, 60,000 per year is not an insignificant number.
Muscle weakness and poor liver function can also be significant players in the causation of fatigue.
There are currently over 900 published studies detailing statin side effects, ranging from muscle weakness to increased cancer risk.
Author’s Note: Science is the study of the predictable repeatability of something. It is rarely, if ever, about creating facts. The reason for this is because whilst we are studying one thing, something else quite un-noticed may be going on in the background, a factor not being either looked at or studied. From our observations, we may draw a conclusion about the thing we are observing, but in fact it may be the background activity that is causing the outcomes. This is a somewhat regular occurrence in science. Whilst testers seek to name the variables involved, and the bias of the testers, not everything gets covered.
A classic case is stomach ulcers. All studies up until about a decade ago proved conclusively that negative stress caused higher levels of stomach acid secretion and burning of the abdominal wall, resulting in an ulcer. But then, Professor Marshall and colleagues in Perth discovered a previously undetected bacteria surviving in the stomachs highly acidic environment. He proved that this bacteria, Pyloris Helicobacter was actually causing the ulcers. Many were left stunned by the discovery unable to believe they had been so wrong for so long.
So in this case, some of these side effects may be a direct result of the statins. But they could also be a result of the diets being followed by those who take statins.
A Note on the Drug Companies
Back in 2005, I sat with a lady over coffee who worked in a senior account executive role for a pharmaceutical company that produced a range of cardiovascular drugs, including a statin. She was very keen to hear about an accredited wellness coaching course I had developed and wanted to find out about the course and its content.
I was impressed with her intentions. She absolutely believed that she was doing lifesaving work. I asked what the company’s goal was and she said “To have every person in Australia over 50 years of age on at least one, but preferably 3 of our medications.” I asked why and she said, “Because it is the best preventative measure known to man.”
Now, whilst I did not share her opinion, she completely believed what she was saying and was inspired by her cause. She loved her work because she was ‘helping people’.
But, whilst many people on the ground, out at the coal face promoting the pharmaceutical products to the doctors, absolutely believe in their product, which must come from their product training, the companies are playing different games at other levels.
In the news today, November 5th 2013, Johnson and Johnson were fined $2.2 Billion by US authorities for illegal practices. From the Financial Times:
Johnson & Johnson is to pay more than $2.2bn in fines to US federal and state authorities for kickbacks and promotion of its medicines for diseases beyond their approved uses over more than a decade.
In the largest of a series of settlements involving the US healthcare group, it pleaded guilty to a misdemeanour linked to its past selling practices for Risperdal, its antipsychotic drug. It also agreed payments linked to its marketing of the drugs Invega for schizophrenia, and Natricore for heart failure.
See the entire article here.
This creates a major challenge for medical professionals. As it stands in the modern world, most drug research is run and funded by drug companies. Physicians who operate in allopathic medical practice have little choice but to trust that what the drug companies are supplying to them works and what they are being told is true. This may not always be the case.
Further, doctors do hope that they can trust their colleagues who are involved in drug trials and drug creation. Many medical professionals are at the coal face of the invention of new drugs. Many of these then move on to become the authors of the studies that demonstrate the effectiveness of the drug they are creating.
Medical ethics demand that they honestly declare all of their findings, along with all of their biases before doing the study and, most importantly, any financial ties they have with the associated drug companies, the companies that will be selling and profiting from the drug.
In 2006, JAMA (Journal of the American Medical Association), one of the worlds most esteemed medical journals, had its fine reputation tarnished when it was revealed the authors of a landmark study failed to reveal their ties to pharmaceutical companies. In their published studies, the doctors, specialist and professors who made up the research team, heralded to the world that it was not dangerous, as previously believed, to consume anti-depressant medications during pregnancy. The article was published with much fanfare. Only weeks later, it was revealed that all of the authors had significant ties to drug companies that sold one or more anti-depressant drugs. The study was later discredited.
Exercise has been regularly demonstrated to be the best defence against coronary heart disease and other forms of cardiovascular disease. It helps to keep the heart and the blood vessels strong, keeps the blood healthy and helps to burn off many of the excess foodstuffs consumed in the not-so-healthful western diet.
Further, a 2011 review published in Applied Physiology, Nutrition and Metabolism6 pointed out that exercise induces changes in mitochondrial enzyme content and activity (which is what they tested in the featured study), which can increase your cellular energy production and in so doing decrease your risk of chronic disease. Note: The mitochondria is the energy powerhouse of the human cell.
A broad look at the research predicts that people in the highest risk categories may reduce their heart attack risk by 10% when taking statins. For the same group, well prescribed, regular exercise has shown to reduce risks by 50%
Recent studies have revealed something alarming. Coenzyme Q10 is a primary and major player in mitochondria function. It is essential to energy production within the cell. This is especially true for cardiac muscle. The concentration of mitochondria in cardiac muscle is 200 times that of skeletal muscle.
Statins deplete CoQ10. Can you imagine what happens to heart muscle if the CoQ10 is depleted? It cannot optimally produce energy and the person’s aerobic capacity will decline. In some trials, patients taking statins experienced a decline in Aerobic Fitness levels following a 12 week exercise program and a 4.5% decline in mitochondria levels.
Basically, this study suggests that statins negate the positive effects of exercise. Patients who are taking statins should be taking a concentrated form of CoQ10.
Type II Diabetes
Diabetes can leave a person sapped of energy, in a moment. It seems more and more evident that with the right program, Type 2 diabetes can be effectively reversed. However, it does take quite a bit of self-discipline. Many do not possess this level of discipline and are left to “managing” the condition.
Blood sugar levels are crucial and are controlled by two hormones in the body, Insulin and Leptin. Insulin is a powerful coordinator of many metabolic functions and is one of the agents that plays a signalling role for the liver to produce cholesterol.
It seems very clear that the modern western diet which contains high levels of sugars and grains places considerable strain on this finely balanced system. When the insulin-leptin partnership is over-loaded, the body may lose sensitivity to insulin and it may also be subject to large fluctuations in blood sugar levels.
As sugar flows into the blood from ingested sugars and from digested refined grains, insulin goes to work to remove it from the blood and store it as fat. This sugar can cause acidity in the blood and an increase in free radical levels. As insulin works to bring sugar levels down, leptin works to tell the brain how much energy stores there are in the body.
If the body loses sensitivity to insulin and leptin, the brain my not get to learn how much energy is in store and can then seem to turn on appetite centres and a person feels hungry. Hence, the body produces more insulin and leptin. The latter is a known player in inflammatory activity in the body, so high levels of leptin are not a good thing.
It seems that many people who are taking statins and also trying to reduce cholesterol intake are also eating more grains and sugars. The net result is reduction in insulin and leptin sensitivity which can lead to type 2 diabetes and to higher levels of inflammation and disease.
It is not clear from the literature how statins actually directly cause type 2 diabetes but it appears to be related to changes in liver enzymes. One significant study showed a 48% increase in type 2 diabetes among post-menopausal women who were prescribed statins.
Compromised Liver Function
Among other things, the liver is the energy powerhouse of the human body. Statins are designed to directly block and interfere with certain enzyme actions within the liver. In an organ that is so profoundly coordinated with many inter-related functions, the activity of these drugs seems, over time to lead to impaired liver function. One of the results of impaired liver function is reduced energy.
Catalyst October 31st
Last week, on Catalyst, Part 2 of their program took a direct look at Statins and their efficacy and widespread use. It is a useful program. You can view the program here.
Since the airing of the two Catalyst shows, there have been many prominent medical professionals coming out and doing radio and newspaper interviews to debunk the content of the Catalyst programs. However, I have been dismayed as they have simply followed the same tired old line and made no attempt to explore the viewpoints presented by Catalyst and give balanced viewpoints as to why they might disagree. This would have continued to create healthy debate. Instead, they just chose to try to crush the content of the shows.
Where to From Here for Those still taking Statins?
If you or any of your people are taking Statins, I suggest that they may wish to seek a second opinion from a GP who has also undergone training in Integrative Medicine. The Australian Integrative Medical Association has a website search facility that you can use to find a practitioner near you.
Physicians practicing Integrative Medicine have done extensive training in non-drug and non-surgical methods of treating ailments and regaining health and wellbeing. Many complete a 2 year post graduate course at Swinburne University in Melbourne. Do your Search here.
I am not sure that taking statins is the best strategy for reducing the risk of cardiovascular disease. Personally, I do not believe it makes any sense. Reducing heart disease is best achieved through regular physical exercise, eating a natural diet low in processed and refined foods, getting good quality rest, taking action to reduce worry, anxiety and stress and to seek a strong sense of purpose in life.
When a person takes these things on and reclaims their own health, they build self-esteem. This can be achieved in a supportive workplace that wishes to build a strong and able workforce.