Statins are a class of wonder-drugs here to save the world from the diseases of civilization. Or at least that is what conventional recommendations would have you believe. High cholesterol? Cardiovascular disease? Stroke? Dementia? Cancer? Hypertension? The list of conditions that doctors are prescribing them for grows on a daily basis. Statins go by various names, but you may know them best by their brand names that are endlessly advertised on television commercials day and night, such as Lipitor, Mevacor, Crestor, and Zocor, among many, many others.
Now, what if we told you that these “magic pills,” are actually stripping you of your micronutrients and are likely contributing to the very conditions they are designed to prevent. It’s true, statins, along with just about every other prescription medication, are what we call Everyday Micronutrient Depleters (EMD), a term we cover in much greater depth in Naked Calories. Basically, these drugs deplete us of the very micronutrients that could prevent the health condition or disease they are prescribed to “cure.”
Statins original mechanism of action was thought to be based on inhibition of HMG-CoA reductase, an enzyme involved in cholesterol synthesis, thereby lowering serum cholesterol levels; however, subsequent studies have shown that other mechanisms may play a greater role.
While much of the hype behind statins relies on their cholesterol synthesis inhibition, this is not necessarily the best thing for us (which is something we briefly touched upon in our saturated fat blog, and will be discussing further in an upcoming one dedicated to cholesterol). This is because cholesterol is an essential precursor to the biosynthesis of steroid hormones, bile salts, and vitamin D, and deficiencies in these will lead to a host of issues. However, almost paradoxically, various studies have found vitamin D activity to actually increase during the administration of statins.
A novel hypothesis by Grimes published in The Lancet in 2006 suggested that perhaps statins could act as analogues of vitamin D, as the benefits of the two are similar. Testing this hypothesis, in 2007 Wu-Wong, Nakane, Ma and Ju, also in The Lancet, found that at least in vitro, statins did not activate vitamin D receptors, but did not rule out the possibility of their acting as precursors that are metabolically activatedin vivo.
This all of course begs the question, wouldn't it just be easier, cheaper and safer to ensure vitamin D sufficiency rather than prescribe the statins? Vitamin D is very efficiently biosynthesized from short-term exposure to the sun. In fact, a 2012 meta-analysis by Wilding looked into this very concept and found that vitamin D levels above 40ng/mol would produce equivalent outcomes to statin therapy!
So that is the relationship to vitamin D, but what about the other micronutrients? Omega-3 fatty acids are a type of essential fatty acid known to reduce inflammation. Various studies have shown statins to have an anti-inflammatory effect, which is thought to also be part of their benefits. Unfortunately, these statins are also an EMD of these essential fatty acids, which negates their benefit. So why not just supplement with Omega-3 fatty acids, instead of taking the statins. Well, a recent 2012 meta-analysis by Kwak et al., in the Archives of Internal Medicine, found there to be insufficient evidence to support the use of Omega-3 supplements for lowering cardiovascular disease.
Do we chalk this up as a win for statins over Omega-3's? Not exactly, there are some confounding factors here. First off, we don't know the quality or quantity of the Omega-3 intake in these studies, whether they contained EPA and DHA, nor do we know what the rest of their diet and lifestyle factors were. The Omega-3 to Omega-6 ratio is also a more important variable insomuch as Omega-6 fatty acids are pro-inflammatory. Moreover, the standard American diet (SAD) is so skewed towards Omega-6's, by virtue of our high grain intake, and the improper feeding of our animals, that the ratio is estimated to be as high as 20:1 of Omega-6:3, which is magnitudes higher than our ancestral norm of roughly 1:1 or 2:1.
So rather than blindly taking statins or Omega-3 fatty acids, the more prudent course of action would be to adopt a diet focusing on foods rich in Omega-3, while minimizing those high in Omega-6. Quality animal sources include wild-caught fish and grass-fed ruminants (beef, lamb, bison, etc.), while for the vegetarian crowd chia and flax are a decent source of their precursors. Foods high in Omega-6 to avoid include grains and grain-fed animals.
All of this now brings us to the elephant in the room: Coenzyme Q10 (CoQ10). This micronutrient powerhouse plays a vital role in cellular respiration and ATP (energy) generation in most tissues including the brain, liver, musculoskeletal system, and the heart. A deficiency in CoQ10 can lead to a host of issues, chief among themcardiovascular disease. CoQ10 and cholesterol share a biosynthesis pathway, ergo something that will lower cholesterol will likely also result in a CoQ10 deficiency.
Is there anything we have been talking about that has the explicit goal of lowering cholesterol? That’s right, statins.
As we stated before, statins primary mechanism of action is to inhibit the HMG-CoA reductase pathway, which in turn prevents proper biosynthesis of both cholesterol and CoQ10. So the goal of statins is to “cure” a disease, by purposefully using a mechanism that stops the creation of a molecule necessary for avoiding the very same disease. Talk about cutting off your nose to spite your face.
Doctors and researchers freely admit that statins cause CoQ10 deficiency, so they recommend supplementing with it, particularly when you are on a statin. Some of the best sources of CoQ10 include animal liver and heart (yet another reason to include offal in your diet). If you still find this objectionable after reading our blog on organ meats and would rather supplement, our multivitamin (nutreince) contains both vitamin D and CoQ10, but, as always, be sure to take it with a quality fat, such as fish oil or coconut oil, insomuch as they are both fat-soluble micronutrients and need fat to help with absorption.
This is only a sampling of the potential issues statins represent. So the question of course is why even bother with the statins in the first place? Much of their benefit can be linked to their anti-inflammatory properties and vitamin D boosting properties. These can be adequately achieved by making appropriate diet and lifestyle choices, such as choosing properly raised plants and animals, balancing your ratio of Omega-3 to Omega-6 fatty acids, getting some sun, and taking properly formulated multivitamin. Moreover, statins explicitly cause a deficiency in a micronutrient inexorably linked to the very disease that they seek to cure. Rather than taking the statins and then supplementing CoQ10 to make it up, it would be wiser to simply insure CoQ10 sufficiency in the first place, by regularly including offal and other CoQ10 rich foods in your diet, and/or using a supplement that includes CoQ10. So while this isn't medical advice and you have to discuss anything regarding drugs with your doctor, remember that an ounce of prevention is often worth a pound of cure.