Vendryes

Dr. Anthony Vendryes, Contributor

In The Gleaner of Monday, March 19, Dr. Garth Rattray takes me to task for my advice to readers on the dangers of using the popular cholesterol-lowering drugs. He expressed 'deep concern for the lives and health of patients' that may heed my warning.

He then went on to explain why he so strongly recommends the use of a family of drugs called the 'statins' to lower cholesterol. The 'statins' are sold under a variety of names, including Lipitor (atorvastatin), Zocor (simvastatin), Mevacor (lovastatin) and Pravachol (pravastatin). Dr. Rattray, being the great advocate of 'evidence-based medicine', dismissed any concerns about the safety of these drugs with this one short sentence: "Like all drugs, statins carry possible side effects."

If I may be permitted to be a little more evidence-based, I will share with readers some of the well-documented but not publicised dangers of these drugs. I think that they will find them interesting and I will attempt to present the information in as non-technical language as possible.

The November 2003 issue of Smart Money magazine reports on a 1999 study at St. Thomas' Hospital in London (apparently unpublished), which found that between 10 and 36 per cent of patients on Lipitor (the most popular statin) reported side effects. What, you may wonder, are these side effects?

Muscle Pain and Weakness

The most common side effect is muscle pain and weakness, a condition called rhabdomyolysis, most likely due to the depletion by the drug of Co-Q10, an important nutrient that supports muscle function the drug companies insist that only two to three per cent of patients get muscle aches and cramps, research by Dr. Beatrice Golomb of San Diego, California, found that 98 per cent of patients taking Lipitor and one-third of the patients taking Mevachor (a lower-dose statin) suffered from muscle problems. Active people are much more likely to develop this problem from statin use than those who are sedentary.

Neuropathy

Neuropathy, also known as peripheral neuropathy, is characterised by weakness, tingling and pain in the hands and feet, as well as difficulty in walking. Research on 500,000 residents of Denmark found that people who took statins for one year raised their risk of nerve damage by about 15 per cent. For those who took statins for two or more years, the additional risk rose to 26 per cent.

Sadly, Dr. Golomb reports that in many cases, patients had complained to their doctors about neurological problems, onlyto be assured that their symptoms could not be related to cholesterol-lowering medications. Unfortunately, this damage is often irreversible.

Heart Failure

Cardiologist Peter Langsjoen studied 20 patients with completely normal heart function. After six months on a low dose of 20mg of Lipitor a day, two-thirds of the patients had abnormalities in the heart. According to Langsjoen, this malfunction is due to Co-Q10 depletion by the drug. Co-Q10 depletion becomes more and more of a problem as the drug companies encourage doctors to more aggressively lower cholesterol levels in their patients.

Eight out of nine controlled trials on statin-induced Co-Q10 depletion in humans showed significant Co-Q10 decline leading to a weakening in heart function and biochemical imbalances. Unfortunately, many patients with heart failure are now put on statin drugs, even if their cholesterol is already low. Interestingly, a recent United Kingdom study indicated that patients with chronic heart failure benefit from having high levels of cholesterol rather than low.

Mental Impairment

In a December 2003 article in Pharmacotherapy, cases of cognitive impairment associated with Lipitor and Zocor were reported. A study conducted at the University of Pittsburgh showed that patients treated with statins for six months compared poorly with patients on a placebo in solving puzzles and in memory tests.

Depression

Numerous studies have linked low cholesterol with depression. One of the most recent from Duke University Medical Center found that women with low cholesterol are twice as likely to suffer from depression and anxiety. The author of the study, Dr. Edward Suarez, also found that men who lower their cholesterol levels with medication have increased rates of suicide and violent death. How many elderly statin-takers are feeling miserable and depressed, when they should be enjoying their grandchildren in their golden years?

Cancer

Statins have caused cancer in all the animal research done. Because cancer takes many years to develop, and as most of the statin trials do not last longer than three years, we have not yet seen the correlation in many human studies. Still, in one trial, the CARE trial, breast cancer rates of those taking a statin went up by 1,500 per cent. Manufacturers of statin drugs have conceded that statins depress the immune system, an effect that can lead to cancer.

Pancreatic Disease

The medical literature contains several reports of pancreatitis (an inflammation of the pancreas) in patients taking statins. Researchers warned, "Prescribers of statins (particularly Zocor and Mevacor) should take into account the possibility of acute pancreatitis in patients who develop abdominal pain within the first weeks of treatment with these drugs."

Increased Risk of Death

The Honolulu Health Programme study looked at the effect of lowering cholesterol in the elderly. Researchers compared changes in cholesterol concentrations over 20 years with all-cause mortality. The data showed an increased mortality in elderly people with low blood cholesterol, and that a low cholesterol concentration actually increases the risk of death.

As I have suggested in the past, if one really needs to lower cholesterol levels, there are far healthier ways than statin drugs. I would conclude by reminding Dr. Rattray and my other medical colleagues of the Hippocratic dictum - Primum, non nocere: First, do no harm!

Pharmacist Susan Lattier checks donated drugs from local nursing homes and hospitals at the non-profit Over the Rhine Pharmacy in the Crossroad Health Center in Cincinnati, Ohio, on March 8. The nation's first not-for-profit pharmacy is located in Over-the-Rhine, Cincinnati's most notorious neighborhood - one that is more blighted by boarded-up buildings than blessed with brand new businesses. - REUTERS