My good friend Tom Monahan (also the composer for Fat Head) just returned from visiting his family on the east coast and was dismayed to learn that his mother is still taking statins. She has of course seen the film, and Tom has sent her quite a bit of information explaining why statins are worthless for women, but apparently she wasn’t convinced. Or, since Tom has also noticed her memory is fading, perhaps she just forgot everything he told her.
Statins are the most profitable drugs in history. They’re also some of the worst.
Let’s get the big question out of the way first: do statins work? That is, do they prevent heart disease? Yes … but not by much and not for any significant share of the population taking them. They were engineered to reduce cholesterol, and they do. But the small benefit they provide is likely due to the fact that they also reduce inflammation — and you can do that by giving up sugar and processed vegetable oils.
The only people shown to benefit from statins in clinical research are men under the age of 65 who have several risk factors for heart disease. That’s it. And even for them, the benefit isn’t exactly impressive. If you watch prime-time TV for more than 10 minutes, you’ll no doubt see a commercial telling you that Lipitor reduces the risk of heart attacks by 33%. Wow! That’s a huge reduction in risk, right?
Hardly. First off, if you can manage to read the fine print during the millisecond it appears on your screen, you’ll learn that the reduction is among the group I just mentioned: relatively younger men with existing heart disease. Millions of prescriptions for Lipitor are written for suckers — sorry, I mean patients — who aren’t 1) men, 2) known to have several risk factors for heart disease, or 3) under age 65. In other words, people who don’t fall into the group that actually benefits.
And about that 33% reduction … I’ve mentioned this before, but it bears repeating: you have to understand how that figure was calculated. Among the relatively young men with known risk factors for heart disease who took Lipitor in a clinical trial, two of every 100 had a heart attack. Among the relatively young men with known risk factors for heart disease who took a placebo, three of every 100 had a heart attack. Yes, that’s a 33% reduction, but it also means that for every 100 high-risk men who take Lipitor, we may at best be preventing one heart attack.
Notice I didn’t say we may be preventing one extra death. That’s because we don’t have the figures to analyze. The pharmaceutical companies are quick to release figures showing reductions in heart attacks, but haven’t always released the total death figures. If that doesn’t make you suspicious, then you should expect to receive some emails from Nigerians who want to borrow your bank account to transfer a few million dollars out of Africa.
For the millions of statin-takers who aren’t men under 65 with several known risk factors for heart disease, lord only knows how many heart attacks — if any — are being prevented. The number has to be miniscule. And yet doctors keep prescribing statins because it makes them feel better when a patient’s “high” cholesterol level comes down.
While the doctors may feel better, the patients often feel worse. Even mainstream magazines like TIME are starting to figure it out. Here are some quotes from a TIME article published a few weeks ago:
Doctors say the majority of current statin users are healthy people who don’t have heart disease but who, like Segal, simply have high cholesterol. Use among this group, known as the primary prevention population, has made these drugs one of the world’s best-selling classes.
But Segal’s statin ended up preventing her from living a heart-healthy lifestyle. A month after she started taking the drug, she suffered muscle pain so severe, she had to stop all physical activity and was unable to sleep at night. Although her husband, who was worried about her risk of heart attack, pleaded with her to stay on the drug, she discontinued using it. The muscle pain receded. “My husband was scared for me. Doctors scare you. But I was in so much pain, I told him I would have rather died than stay on them,” says Segal.
That grim situation could have been avoided, researchers say. An estimated 12 million American women are routinely prescribed statins, which carry a risk of serious side effects. Yet there is little evidence that they prevent heart disease in women. In past research, statin therapy has been shown to prolong the lives of people with heart disease. It has also been shown to stave off the onset of heart disease in healthy at-risk adults. But researchers who have broken out and analyzed the data on healthy female patients in these trials found that the lifesaving benefit, which extends to men, does not cross the gender divide. What’s more, there’s evidence that women are more likely than men to suffer some of the drugs’ serious side effects, which can include memory loss, muscle pain and diabetes.
My mom had serious muscle pain when she was taking a statin. Her doctor never connected the pain to the statin. I did, after doing research for the film. Convincing her to give up the statin was one of my prouder moments. She not only gave up the statin, she gave up the painkiller she was taking to mask the effects.
So how common are the side effects? That depends on who you ask. According to the pharmaceutical companies, only about 2% of patients experience side effects. But Dr. Beatrice Golomb, a researcher at the University of California who’s been tracking statin side effects for years, says the rate could be as high as 30%.
Does this mean the pharmaceutical companies are lying? Not exactly. Once again, it’s a matter of how the research is conducted. When a company like Pfizer is selecting subjects for a study, they exclude the people who have reported side effects when taking other drugs. Sometimes researchers even give prospective patients a big, fat dose of something to see how they react. If the reaction is something like, “Man, that made me feel like @#$%,” the prospective patient is no longer a prospective patient.
So go figure … after cherry-picking a population that’s resistant to side effects, the researchers report a low rate of negative reactions during the clinical trials. That’s why Pfizer can refer to “rare but serious” side effects in their commercials. I’m guessing the side effects are only rare in their clinical trials. But they’re definitely serious, as this article in the UK Daily Mail recently pointed out:
For the first time, the level of harm posed by the cholesterol-lowering drugs has been quantified by researchers. They found some users are much more likely to suffer liver dysfunction, acute kidney failure, cataracts and muscle damage known as myopathy.
For some patients, the risk is eight times higher than among those not taking statins. Overall, the risk of myopathy – which may be irreversible – is six times higher for men on statins and three times higher for women.
So taking a drug that does a chemical beat-down on your liver’s cholesterol-making functions can end up causing liver damage? Well, I am shocked. Researchers have also linked statins to diabetes, and diabetes is a huge risk factor for future heart disease. (You have a risk factor for heart disease? Better take this statin.)
Myopathy is medical term for weak muscles. Statins cause myopathy because they deplete the muscles of CoQ10, and the mitochondria — the little power plants in the muscles — depend on the stuff. Not surprisingly, after being robbed of an essential nutrient, the muscles can ache and become weak. If it were just a matter of giving up the statins, maybe it wouldn’t be such a big deal. But according to Dr. Golomb’s research, more than 2/3 of the patients who suffer statin-induced myopathy never regain the full use of their muscles. The damaged mitochondria don’t recover.
Then, of course, there are the memory problems. Dr. Duane Graveline, a former NASA flight surgeon whose muscles were permanently damaged by statins, also experienced day-long episodes of transient amnesia until he traced them to his daily dose of Lipitor and stopped taking it. As I’ve written about before, my dad also suffered day-long episodes of profound confusion in his mid-60s, a few years before his Alzheimer’s became apparent. I don’t know if Lipitor caused the Alzheimer’s, but I’m convinced it at least accelerated his decline.
Dr. Golomb believes cognitive and memory problems are far more common than reported, but since most statin-takers are elderly (once again, a group not shown to benefit from taking them), their doctors assume they’re just having “senior moments.” The side effects are never reported.
Add it all up, roll it over, press it flat and give it one more analysis, and you’re looking at drugs that produce a relatively small benefit among one small slice of the male population that isn’t likely to suffer negative reactions in the first place. Meanwhile, people outside that group receive no measurable benefit (aside from making their doctors happy with their cholesterol scores) and can suffer memory problems, liver damage, kidney failure, diabetes, permanent muscle weakness, and — forgot to mention this earlier — impotence.
These are the some of the worst drugs ever. I only wish Tom could convince his mother while she still remembers who he is.
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