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Statins in our Drinking Water?


The class of cholesterol lowering drugs known as statins has gained an incredible following in the medical community. This is mainly due to its significant effect on lowering cholesterol and its effect on reducing heart attacks and strokes[1]. 


The enthusiasm of many medical physicians regarding the use of statins, even on healthy adults and children, has led me to question whether one day they will suggest putting statins into our drinking water, like fluoride.  I know it sounds Orwellian and probably won’t happen, but the zeal in which I see physicians pushing statins while dismissing their side effects does remind me of a bad zombie movie.  I have heard physicians tell patients that everyone should be on statins and that these have fewer side effects than your daily vitamins. According to one study, a survey of 650 patients, it was found that physicians tend to ignore or dismiss patients’ concerns about statin side effects[2].


Cardiovascular disease is unquestionably the number one killer in the United States.  As a result, this causes our culture to direct anxiety toward the perceived enemy: cholesterol.  Most Americans over 35 can probably tell you their latest cholesterol number, and furthermore, the terminology of the lipid panel (HDL, LDL, triglycerides…) has become a standard part of the American lexicon.  But instead of seeking what we have known for years will help prevent heart disease and stroke, (diet, exercise, smoking cessation, and weight reduction) our society has sought the easy solution:  take a pill and forget about healthy lifestyles.


Statins not only block the production of cholesterol, but also other beneficial physiological pathways.  For instance statins inhibit the body’s production of Coenzyme Q-10[3].  CoQ-10 is vital to heart strength and muscle health. Its depletion may be the source of myalgia that has been linked to statin use.  In addition to its association with myalgias, statin use has also been connected to rhabdomyolysis (diffuse muscle breakdown that sends remnants of deteriorated muscle cells into the blood stream resulting in renal damage and sometimes death), liver damage, memory loss, peripheral neuropathy, and weakness.


Are Chiropractors and Health Food Vendors Pushing Statins?


Seeking to avoid the unnecessary use of drugs, many chiropractors advise patients in natural ways to lower their cholesterol and cardiovascular risk. They may recommend exercise, omega 3 oils, and a diet that is rich in green leafy vegetables and fruit.  They may even recommend the herbal supplement red yeast rice.  The active ingredient of red yeast rice is monacolin K which has been found to be identical to lovastatin.  Red yeast rice is a statin, an unregulated statin, with all of the side effects of the pharmaceutical statin drugs.


How should this information affect my practice?


Since chiropractors tend to attract numerous patients with musculoskeletal pain, it would be wise to inquire about statin use and exercise.  If a patient with myalgia is taking statin drugs, a three month trial course of supplemental CoQ10 would be a reasonable supplement to patient care[4] (after reviewing CoQ10’s drug interactions and affect on bleeding tendencies).  Warn patients on statins to be careful about performing vigorous exercise since they are at greater risk for rhabdomyolysis.  Also, do not recommend red yeast rice to anyone already taking statins as you would be increasing the patient’s dose.  In fact I do not feel comfortable recommending red yeast rice to my patients at all.


In a society plagued with obesity, inactivity, and a diet high in saturated fats and refined carbohydrates, we should emphasize taking away the many causes of cardiovascular disease first, and save the use of statins as a last resort.


[1] Hulten E et al. The Effect of Early, Intensive Statin Therapy on Acute Coronary Syndrome A Meta-analysis of Randomized Controlled Trials. Arch Intern Med. 2006;166, 1814-1821.

[2] Golomb BA, McGraw JJ, Evans MA, et al.: Physician response to patient reports of adverse drug effects: Implications for patient-targeted adverse effect surveillance. Drug Safety 30: 669–675, 2007

[3] Ghirlanda, et al., "Evidence of plasma CoQ10-lowering effect of HMG-COA reductase inhibitors: a double-blind, placebo-controlled study," Journal of Clinical Pharmacology. 1993 Mar; 33(3):226-229.

[4] CASO, G., KELLY, P., MCNURLAN, M., & LAWSON, W. (2007). Effect of Coenzyme Q10 on Myopathic Symptoms in Patients Treated With Statins The American Journal of Cardiology, 99 (10), 1409-1412 DOI: 10.1016/j.amjcard.2006.12.063