Statins: Friend or Foe?
By Patricia Deckert. D.O.
Statins are prescription drugs that reduce the production of cholesterol by the liver. The most popular statins are:
Concerns about Statins
We understand that there is negative public sentiment about taking statins to achieve lipid lowering goals. The most common worries are that this medication is toxic to the liver and that it damages muscles.
In our understanding of the credible research, these concerns are overblown. The literature in the field tells us that the risk of serious side effects to the liver, muscles, or kidneys with this class of drug is minimal in low doses.
Therefore, in our practice we spend a lot of time trying to convince patients that a very small dose of this medication may be necessary if we are unable to achieve our goals through supplements, diet, weight loss, and exercise.
When it is indicated, we will prescribe statins along with a comprehensive approach to reducing elevated cholesterol. This comprehensive approach puts an emphasis on improvements in lifestyle and nutrition. As always, patient safety is our Number One concern.
Why Use Statins?
Statins block the enzyme in the liver that is responsible for making cholesterol. While every cell in the body needs cholesterol in order to function normally, too much cholesterol in the bloodstream can contribute to the buildup of cholesterol-containing plaque within the arteries. This condition is called atherosclerosis.
As plaque accumulates on the artery walls over time, it can reduce or even block the flow of blood to the tissues that the arteries supply. If plaque narrows an artery significantly, or if it ruptures and forms a blood clot that obstructs blood flow, a vascular event such as heart attack or stroke can occur.
If the heart doesn’t get enough blood from the arteries that supply it, the result is angina (chest pain) or a heart attack. If the brain doesn’t get enough blood, the result is a stroke. If the legs don’t get enough blood, the result is intermittent claudication (pain in the legs while walking).
By reducing cholesterol production, statins can slow the formation of new plaque and occasionally even reduce the amount of plaque that already exists. Statins may also stabilize plaque so that it is less apt to rupture and form clots, but the mechanisms of this are not fully understood.
Statins also reduce inflammation. It is now believed that inflammation in the artery walls may be an important contributor to atherosclerosis.
Thus we find that statins are our friend when used in low doses and where specifically indicated. We determine that need by doing advanced lipid testing. The low doses can work when used with specific supplements and lifestyle modification.