Statins, drugs that lower cholesterol, are among the most widely prescribed medications in America. For those who have experienced an acute cardiac event, such as a heart attack, statin treatment may be warranted to prevent a second event. This is called secondary prevention. However, the data is weak that statins are beneficial for primary prevention i.e. preventing cardiac events in those who have never had a heart attack. And yet, they are handed out like candy on Halloween. But now some experts are questioning which is healthier, the statin or the Halloween candy!?!
A review article published in the Expert Review of Clinical Pharmacology by Harumi Okuyama and colleagues entitled, “Statins Stimulate Atherosclerosis and Heart Failure,” lays out nicely three main mechanisms by which statins might actually be toxic to your body!
The diagram summarizes the three mechanisms detailed above and also points to some other troubling disease-related implications of these mechanisms. First, statins inhibit “Heme A” synthesis (mechanism 1). “Heme A” is a critical component of cytochrome c oxidase in the electron transport chain. Since cytochrome c oxidase (a.k.a. complex IV) is known to be impaired in Alzheimer’s disease, one could question if statins could increase a person’s risk for developing dementia. Second, selenoproteins are involved in several steps of glucose metabolism, suggesting that treatment with statins could cause diabetes through mechanism 2. In fact, this is more than speculation. Statins are known to increase a person’s risk of developing type II diabetes. Third, iodothyronine deiodinases, enzymes important in the activation of thyroid hormone, are a selenoproteins. This means that statins could also contribute to hypothyroidism. And fourth, although perhaps this was already implied, by inhibiting the synthesis of Vitamin K2 (mechanism 3), statins could contribute to osteoporosis.
To be clear, with the exception of the diabetes connection, the above comments are purely SPECULATIVE HYPOTHESES that may only apply to some people and are not to be construed, in any way, as medical advice. In fact, statins have even been associated with DECREASED risk of dementia and osteoporosis, in some populations. The point I’m trying to make is not that statins are bad. My objective with this piece is simply to play devil’s advocate against a class of drugs that perhaps we prescribe too widely without weighing the potential cons.
Good science, and good medicine, are about being cautiously skeptical.
Below are some data from the review, for those who want a peak.
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