Let’s hope this is the beginning of the end for statins. The so-called wonder drugs have been a cash cow for pharmaceutical companies for decades now, mostly because doctors bought into the idea that high cholesterol causes heart disease, therefore any drug that reduces cholesterol must also reduce heart disease. I’ve lost count of the people I know who don’t have atherosclerosis, but were prescribed statins simply because their cholesterol was above the supposedly magic number of 200. Their doctors weren’t treating heart disease; they were treating a cholesterol score.

While researching Fat Head, I became aware of quite a few doctors who insist that giving statins to people who don’t already have heart disease simply to beat down their cholesterol is worse than worthless … Al Sears, Mike and Mary Dan Eades, Uffe Ravnskov, Malcolm Kendrick, etc. I found the evidence they presented quite convincing. Unfortunately, the medical establishment and the media have tended to either ignore the anti-statin doctors or write them off as a bunch of kooks.

Not anymore … at least I hope not. A new meta-analysis of the effectiveness of statins (and lack thereof) was just released by the Cochrane Collaboration, and it’s bad news for the statin-makers — partly because the analysis itself isn’t flattering, and partly because the Cochrane Collaboration is a highly-respected organization whose work is considered both thorough and unbiased. Consequently, their report has generated quite a bit of media coverage. I’ve already read articles in the UK Telegraph (two), TIME’s online version, the Los Angeles Times, Miller McCune, and Reuter’s Health, among others.

If we piece together quotes from the articles, we end up with a nice summary of the statin story. Let’s start with how and why they became the best-selling drugs of all time:

Back in 1975, Henry Gadsden, the chief executive of the drug company Merck, expressed his frustration that the market for his company’s products was limited to those with some treatable illness. Ideally, he said, he would like to “sell to everyone”.

Three decades later, his dream would seem to have come true – epitomised by the most profitable class of drugs ever discovered, the cholesterol-lowering statins that are taken by an estimated seven million people in Britain, and tens of millions worldwide.

Yup, Merck and the other pharmaceuticals wanted to sell drugs to healthy people, and by gosh, they finally figured out how to do it.

The story starts with the arrival of “cholesterol consciousness”: the thesis that those indulging in (for example) bacon and eggs for breakfast boosted the cholesterol level in the blood, causing the arteries to become narrow, and making a heart attack more likely.

Although this idea has its critics, there is no doubt that the small proportion of the population with a genetic predisposition towards high cholesterol levels are at greater risk of circulatory disorders. Encouraging them to switch to a healthy diet had failed to lower that risk – so the idea gained ground that cholesterol-lowering drugs might be the answer.

The small proportion of the population with a genetic predisposition are those with familial hyperlipidemia. Their LDL is extraordinarily high because their LDL receptors don’t work and therefore don’t remove LDL from the bloodstream. Cholesterol-lowering drugs were shown to reduce their rate of heart disease by a teeny, tiny bit. From that result, the medical community decided cholesterol is a killer and we should all stop eating bacon and eggs — even though low-fat diets didn’t do diddly for the people with hyperlipidemia. Go figure.

An even more important factor, especially in the US, was the drive to establish “clinical practice guidelines”, under which panels would set the optimal treatment for any given condition. Successive guidelines have forced the “normal” level of cholesterol ever lower, resulting in leaps in the numbers deemed eligible for treatment. In the US, the figure went from 15 million to 40 million.

That’s how you sell drugs to healthy people: redefine normal cholesterol levels as dangerous. Among the un-medicated population, average total cholesterol was around 220 a few decades ago. Doctors rarely warned patients about heart disease unless their cholesterol was 250 or higher. But if 220 was the average, how did the new “normal” end up being 200?

After it was pointed out that those responsible for the most recent guidelines had failed to declare any potential conflicts of interest, it subsequently emerged that most of them had received research grants or consultancy fees from the drug companies involved in manufacturing statins.

That’s how. By declaring 200 to be the target level for cholesterol, the researchers (ahem, ahem) who wrote the guidelines guaranteed their paymasters millions of new customers.

Not surprisingly, quite a few clinical studies eventually concluded that statins prevent heart disease. I say “not surprisingly” because nearly all the studies were funded and conducted by the pharmaceutical companies. According to the Cochrane review, the studies might’ve been (surprise!) skewed to exaggerate the benefits and minimize the side effects:

In particular, while all the studies focused on benefits, only half provided information on the side effects of the drugs, said Dr. Shah Ebrahim, whose group’s findings are published by the Cochrane Collaboration, an international organization that evaluates medical research.

“There is evidence that the reports cherry-picked the best outcomes for presentation,” he added, “which will tend to inflate apparent benefits of treatment.”

While there appeared to be no difference in side effects between trials participants taking dummy pills and statins, the researchers say those results aren’t credible.

“Any appraisal we can make of adverse events is biased by failure to report these events,” Ebrahim said in an e-mail to Reuters Health. “We believe that trial funders, investigators and journal editors have failed to provide adequate information to doctors and their patients to assess the benefits and harms of statins in primary prevention.”

The good news is that while Merck and Pfizer may not report on negative side effects, more media outlets are:

Dr. Greg Burns (not his real name) is a 72-year-old retired radiologist living in Connecticut. Until early last year, he ran with his dog at canine agility meets, skied, ice skated and played 18 holes of golf. He is now unable to walk and is taking a course of medication that will postpone, by a few months, his death.

Burns’ rapid decline began in December 2007 when he suffered a short-acting stroke from which he fully recovered. His cholesterol level was elevated and so as a preventative measure his doctor prescribed a 20mg daily dose of Crestor, a cholesterol-lowering drug in the “statin” class.

A few months after beginning Crestor, Burns developed muscle cramps. He was assured by his doctors that these were not serious side effects of taking the drug. But in December 2008 when tests showed that his creatine phosphokinase – an enzyme that is released into the blood stream when muscle cells are damaged – was elevated, Dr. Burns stopped taking Crestor. When his enzyme levels returned to normal, he began taking Pravachol, another statin drug. He quickly developed weakness in his lower legs and a right foot drop.

Mayo Clinic cardiologists acknowledge that the side effects of statin drugs can include muscle pain, extreme fatigue, liver damage, digestive problems and neurological damage including memory loss.

Of course, not everyone who takes statins will experience side effects, so it’s a question of balancing benefits and risks, just like with any other drug. So let’s look at the supposed benefits.

If you’ve seen Lipitor ads on TV (and if you haven’t, it means you don’t watch TV), you know Pfizer claims Lipitor reduces the rate of heart attacks by 36%. As I’ve explained in previous posts, that figure may sound impressive, but basically it means that during the clinical trials, three out of every 100 men who took a placebo had a heart attack, while slightly less than two out of every 100 men who took Lipitor had a heart attack. So for every 100 men treated for ten years, we’re preventing (in theory) one heart attack.  That’s one heart attack, not necessarily one death. 

But even those unimpressive results were found only among with men with existing heart disease or multiple risk factors for heart disease — not among women, and not among otherwise healthy people who happen to have high cholesterol.

But of course, statins didn’t become the most profitable drugs in history by being prescribed solely to men with existing heart disease. Nope, statins became a cash cow when doctors started prescribing them to pretty much everybody whose cholesterol is above 200.  (In the UK, you can even buy your future muscle or memory problems over the counter — yippee!)

The theory, of course, was that statins could prevent heart disease from developing in the first place, otherwise known as “primary prevention.”  The Cochrane report casts more than a little doubt on that theory, as several media articles pointed out:

An authoritative review shows there is little evidence that the cholesterol-lowering drugs protect people who are not already at a high risk of heart disease.

Experts who advocate the use of statins say they have helped prolong thousands of lives by preventing heart attacks and other cardiovascular events. But a wide-ranging review of previous studies, published today in the journal The Cochrane Library, urges “caution” among GPs who prescribe them. It concludes that there is no “strong evidence” to suggest that statins reduce coronary heart disease deaths among those who have not suffered a heart attack or other cardiovascular event in the past.

Shah Ebrahim, a professor of public health at the London School of Hygiene and Tropical Medicine, who co-wrote the report, called on doctors to stop giving patients the drugs unnecessarily.

Just one life is currently saved for every 1,000 people who take them each year, the report says.

Great … so to prevent (in theory) one fatal heart attack among every 1,000 people who take statins, we’ve created lord-only-knows-how-many cases of muscle degeneration, memory loss, kidney failure, erectile dysfunction and liver damage. Of course, that works out well for Big Pharma — they sell drugs to treat those conditions, too.

I’ve said it before, and I’ll say it again: statins are some of the worst drugs ever. I’m just happy to see more people in the news media are catching on.

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60 Responses to “Bad News For Statins Is Good News”
  1. Marilyn says:

    John W., I’m sorry to hear about your wife’s MS situation. I’m an MSer, too, but the primary progressive kind, so I’ve never been offered any of those nasty drugs. Frankly, I’m still not convinced about the whole “auto immune” explanation for so many of these diseases. I try to keep my immune system in as good shape as possible, thank you very much. And you’re right, for all the side effects of the CRABs, and the very poor rate of improvement they offer, they really aren’t a very good option. Get rid of the grains, as Tom suggests, especially the gluten ones. I’m not convinced it’s necessary to get rid of dairy as a lot of sites recommend; I certainly haven’t. Rest is vitally important . . . and I should listen to my own preaching here. . . I’ve recently wondered, since cholesterol is a component of the myelin sheath (do a Google search for the two words “myelin” and “cholesterol”), if my ultra-low fat diet at the time this thing got rolling didn’t contribute to it. Just yesterday, I turned up a slip with my cholesterol reading at the time and it was 164 — on no drugs.

  2. Marilyn says:

    Just thinking: The low-fat sympathizers are fond of calling a nice fatty piece of meat a “heart attack on a plate.” So maybe we should start calling statins “Alzheimer’s in a bottle.” I think the latter might actually be more accurate.

    Love it.

  3. Robert N. Long says:

    My situation is thus, 6 or 7 times I have been given statins of different brands to lower ldl’s. Yes they lowered but accompanied by loss of energy,general pain, cramps, ect to a point where at 69 I was measuring how long I wanted to live. The symptoms are very cryptic in that they arrive so slowly that you don’t know when they started. In my case I went to a naprapath for back pain,a orthopedic doctor for my hips and shoulders , I could not hardly sit on the toilet with out falling in place and then I could hardly get up. My doctor was monitoring my enzymes and not seeing any problem! After stopping this last time after about 2 weeks I am back to being able to work in the yard,weed,garden ,cook dinner and play golf again. And yes my memory was also being effected . And I did not start looking for info on statins till today and boy what a shock I found. I am a classic person who trusts what he is told by professionals and I guess that is where my problem resides.
    6/27/2011

    Sorry to hear about the bad experiences with statins. I think the side-effects are under-reported.

  4. George T says:

    I am a large white male who is classified as obese. I have been fat my entire life and even fought with it while in the Army. My cholesterol was always “normal” until they changed the numbers. My doctor convinced me to take statins because of my risk factors for heart attack. After taking them faithfully for two years I found myself weak, having severe muscle cramps, loss of memory and a really weird feeling of having crystals in my muscles. I could massage a muscle and it felt like I was breaking up a crystal or sediment that was in my body.

    One day while sitting at the table I happened to pick up the paper that came with the medicine and read the warnings and side effects. It is a bad day when you are experiencing 9 out of the 10 listed side effects. I immediately stopped taking the drug. At my annual checkup my cholesterol was again elevated and, after I told my doctor what happened, she put me on a different brand of Statin. However, this time I knew what to look for and recognized the symptoms three weeks after starting to take the other brand of Statin. After almost two years of not taking the drug I am still having issues with numbness and feeling of weakness. I even developed a neurological heart condition. To overcome all this I have changed my diet and exercise regularly. I am still over weight but my heart condition is controlled and most days I feel strong.

    I’m sorry to hear about your experience. The drug-makers claim the side effects are rare. I claim the drug-makers are full of @#$%. I’ve heard from way too many people who experienced nasty side effects to believe they’re rare.

  5. gallier2 says:

    You know why the side effects are rare, according to the pharma industry? Of course because it sells better when it doesn’t have officially side effects, but that was not what I was getting to.
    When they do the clinical trials, they pre-screen the test subjects, those that have a negative reaction to it or who have other problems are excluded up-front. This means that the selection of people on the trial is skewed towards people who have a better resistance to the drug induced symptoms.

    Apparently that’s a common pharma practice. I read in “Anatomy of an Epidemic” that they did the same thing with trials for psychiatric drugs.

  6. Rich Chmiel says:

    I have been on statins for 14 ys now. Had triple heart by-pass in 1996 after a myocardial infraction
    Don’t know if the statins are causing these physical symptoms but I am always lightheaded,tired,muscle aches in legs at times and sleep suffers bad. My doctor believes in the benifit of using statins but I want him to do more research on them so I can get off them. Now it seems eating eggs is GOOD for you and also some cheeses too!!! What gives??

    There’s a very good chance your muscle aches are caused by the statins. That’s a common side-effect.

  7. R says:

    regarding side effects & clinical trials: I am a doctor who was at a hospital engaged in a clinical trial for a similar drug now widely used. At that time, I noticed certain side effects and reported them. Let me tell you, this caused major havoc. I was told that the things I saw officially did not exist and must therefore not be reported! Not only that but the reports were not communicated to the patients and therefore they were not given the opportunity to discuss this with their physicians or take themselves out of the trial! I refused to read any more of those examinations. Others in my department though had no qualms!

    I wish I could say I’m surprised, but I’m not.

  8. Ken says:

    I also have come to believe that Doctors are in League with the Devil
    IE:Drug Companies. Since I stopped taking Statins for supposedly high Cholesterol levels my own descision, I have experienced a large improvement in Chronic pains in my feet and toes which I always thought was due to Gout but now suspect was from the Statins. Also I was told by a Dentist recently that Statins have risks with Diabetes. So if I have been Diagnosed with that then why was I prescribed Statins.

  9. Bill Taylor says:

    simple common sense…..they have lowered the “numbers” so low that well over half of the population now need statins……the common sense is if well over half of the population have that number then that number falls into the NORMAL category not some too high category.

    more common sense while all humans are very similar we each are also very unique there is NO one size fits all number POSSIBLE.

    also the liver produces cholesterol to REPAIR DAMAGE, i as example have no discs left in my lumbar spine and bad nerve damage with neuropathy already so clearly m liver is trying to repair the damaged nerves(what cholesterol DOES), i also had infectuous hepatitis at age 10 a liver disease…….my other risk factors are very LOW but i have been prescribed 80mg of lipitor daily, years ago i was prescribed 3 pain medications at the same time and ask my doctor if i take this as prescribed what would my life be like? he said your pain would be GONE. so i asked would i still be functional, he said NO you would be in BED under those dosages……i told him no way am i taking them then……i did use aleve for years to continue working but started passing blood and had to stop taking it even…….i have learned mental techniques to live with the pain and stay very active for a person in my condition……in my opinion had i followed doctors prescriptions years ago i would already be dead and NOW if i follow this new doctors advice i wont live 10 more years from my present age of 62…….bottom line i will NEVER take a statin….and now must go see my doctor and ask him why on earth such a large dose when my NEEDS the cholesterol to attempt to heal? AND since research shows they would be of NO benefit to me at all!

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