Statins are a class of drugs that inhibit the production of fats, including triglycerides and cholesterol, in the blood. Doctors are conventionally trained to put patients on statin drug therapy at the first sign of elevated cholesterol levels. The heart disease prevention guidelines released in November 2014 qualified almost half of Americans from 40 to 75 years of age, and nearly all men over 60, for the use of statins. That is a lot of statins potentially running through the blood of Americans. Since statins are not only used to lower cholesterol, but also to maintain cholesterol levels, many people, once they start on the drug, will stay on this drug for the rest of their life. Before taking statins at the first sign of a problem, or if seeking a lower statin dosage, you may want to consider natural options and lifestyle adjustments.
A basic understanding of cholesterol may help you understand your options. Cholesterol is a fat-like substance innate to our bodies, minimally derived from food and mostly produced by the liver. Though it gets a bad rap, cholesterol is an essential component of cell membranes, required for building healthy cells, producing hormones, and generating vitamin D. Cholesterol is carried through the bloodstream attached to two types of lipoproteins called low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is known as “bad cholesterol” because it transports cholesterol from the liver throughout the body, potentially allowing it to be deposited in artery walls. HDL is known as “good cholesterol” because it picks up cholesterol from the blood and delivers it to cells that can use it, or takes it back to the liver to be recycled or eliminated from the body.
It is theorized that lowering cholesterol levels potentially lowers the risk of angina (chest pain), heart attack, and stroke. However, there is controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis). The lipid hypothesis proposes that when there’s too much LDL in the blood, it can contribute to plaque formation along with fat and calcium, which builds up on artery walls causing arteries to harden—known as atherosclerosis. Atherosclerosis narrows arteries and slows the flow of oxygen-rich blood to the heart and other parts of the body, increasing the risk of heart attack and stroke. According to the inflammation hypothesis, chronically high levels of inflammation creates small lesions on arterial walls; the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. As with most processes in the body, the cause of heart disease is likely a combination of the lipid and inflammation hypotheses.
Statins decrease the synthesis of cholesterol and pull more cholesterol out of the blood. This is good. The side effects are sometimes not so good. Those taking statins may complain of muscle and joint aches, nausea, diarrhea, constipation, liver damage, and memory loss. In addition, there is new information that reveals statins may increase blood sugar and contribute to diabetes. A 2015 study revealed a 46% increased risk of type 2 diabetes mellitus attributed to a decrease in insulin sensitivity and insulin secretion in non-diabetic individuals taking statins. Diabetes is a known contributor to heart disease; therefore, doctors are prescribing statins to decrease the risk of heart disease, but are simultaneously increasing the risk of diabetes, which increases the risk of heart disease. That’s the complication of the automatic prescription of statins by a doctor who follows conventional protocols: we need to consider the side effects, and the potential connection to increased risk of type 2 diabetes.
There are numerous gentle and effective ways to treat elevated cholesterol and prevent heart disease before turning to statins. The best initial lifestyle approach to lower cardiovascular disease risk, taking both the lipid and inflammation hypotheses into account, is to lower inflammation in the body rather than just focusing on lowering LDL levels. When your doctor tells you to initiate statin therapy, don’t be afraid to inquire about options and explore them. In many cases, the risk of heart disease can be effectively targeted by adopting an anti-inflammatory diet, incorporating exercise into your daily routine, and supplementing with various antioxidants, plant sterols, and B vitamins. I have used this approach with numerous patients, tracking lipid levels and markers of systemic inflammation such as sedimentation rate (ESR) and c-reactive protein (CRP), and have seen incredible improvement in just a few weeks.
- Decrease inflammation through diet. Minimize sugar, white flour, white rice, dairy, processed foods, and alcohol. Emphasize vegetables, whole grains, clean protein, and fruit. Read more about an anti-inflammatory diet in my article, “Food As Preventative Medicine.”
- Exercise. Thirty to sixty minutes of exercise 5 times per week is one of the most effective ways to lower inflammation, cholesterol, and blood sugar. It’s also great for emotional health and stress relief, two incredibly important variables in mitigating heart disease.
- Lower LDL and triglycerides au natural. Talk to a naturopathic doctor about naturally derived supplements that target cholesterol and inflammation; specifically, ask about essential fatty acids, resveratrol, CoQ10, alpha lipoid acid, glutathione, plant sterols, niacin (vitamin B3), and panthethine (vitamin B5).