At the Marc Bony Chiropractic Center in Mataró, we explore whether cholesterol pills are the only solution. Discover natural alternatives to take care of your health.
Cholesterol Pills or Not
According to experts, there is a debate over the recommendations for the millions of people who take statins to prevent heart disease and strokes. A vascular surgeon explains why he feels better without them.
- Dr. Haroun Gajraj: «After taking a closer look at the research, I came to the conclusion that statins weren't going to save me from a heart attack and that my cholesterol levels were almost irrelevant.".
When I had a routine health checkup eight years ago, my cholesterol was so high that the lab thought there had been a mistake. I had 9.3 millimoles of cholesterol per liter of blood—almost double the recommended maximum. It was a huge scare. My primary care physician immediately prescribed statins, the cholesterol-lowering medication that’s supposed to prevent heart disease and strokes. For eight years, I faithfully took my 20-mg atorvastatin pills, with no side effects. Then, one day last May, I stopped taking them. It wasn’t a decision I made lightly; after taking a closer look at the research, I came to the conclusion that statins weren’t going to save me from a heart attack and that my cholesterol levels were almost irrelevant.
When I told my doctor about my decision three months later, I wasn't entirely honest. Instead of saying that I had my doubts about the medication, I told my doctor that I had stopped taking statins because they were causing me pain in my arm. He didn't bat an eye.
The study published by the pharmaceutical industry this month—a study that I suspect relies heavily on data from the pharmaceutical industry, as Dr. James Le Fanu pointed out in these pages last week—may suggest that side effects are rare, but previous studies have found that one in five people taking statins experiences adverse side effects, including muscle pain, diarrhea, memory loss, and blurred vision.
The doctor simply suggested that I try a different brand of statin. The sooner the better, he said, since I had already stopped taking my prescription three months ago. «Wait,» I said. «Can you run a blood test first?» When the results came back, he was surprised to see that my total cholesterol was lower than when I was taking statins. After three months without taking the pills, it was 5.4 mmol/L (5.4 millimoles per liter of blood), compared to 5.7 mmol/L the previous year. The major changes I’ve made in my life since I stopped taking statins are cutting out sugar (including alcohol and starchy foods like bread) and eating more animal fat.
Many experts today believe that sugar is emerging as a true villain in the history of heart disease; meanwhile, after decades of being demonized, saturated fat has been exonerated of causing heart disease, according to a recent meta-analysis of 70 studies conducted by the University of Cambridge.
I usually ate red meat three or four times a week and enjoyed butter, whole milk, and lots of eggs. I thought that after three months on a diet high in saturated fat, my cholesterol would have skyrocketed to pre-statin levels—but no, it went down and has stayed low for seven months. Not only that, but my LDL cholesterol levels (also called “bad” cholesterol) were also lower than when I was taking statins, and my HDL-to-LDL ratio (HDL is also called “good” cholesterol) was below four for the first time—an excellent sign, according to medical wisdom.
And it's not like I was worried about any of this. Yes, it was the statins that were supposed to be lowering my cholesterol levels so drastically. But so what? I think high cholesterol has been the scapegoat for far too long. Yes, in some circumstances, it may be a sign of heart disease, but There is no evidence of a causal link.
In my opinion, high total blood cholesterol or high LDL levels do not cause more heart attacks than non-medical causes of car accidents, even if they are present at the scene. Lowering cholesterol with medication alone without addressing the dietary and lifestyle factors that actually cause heart disease is absurd. In addition, there are plenty of other, more reliable indicators of heart disease risk. What surprised my doctor the most was that these indicators were apparently better now than when I was taking statins. My blood pressure was low. For the first time in many years, I was thinner, especially around my waist. My triglycerides—a type of fat in the blood that is linked to heart disease—were lower than they had been at any time in the past eight years. My fasting blood sugar was at an optimal level, whereas a year earlier it had been too high. My total white blood cell count—a marker of inflammation—was lower.
One marker in my blood test—called glycated hemoglobin (A1c)—which is associated with high levels of heart disease and overall mortality, was exactly within the normal range. Finally, my C-reactive protein (CRP) level—a protein that rises in response to inflammation—was very low. Therefore, biochemically, I was in excellent shape—better than when I was taking statins. «Have you started running?» my doctor asked, puzzled.
No, I've always run. For years, I've exercised three times a week, eaten lots of fish, quit smoking, and tried to keep my stress levels low.
The only thing that had changed was my intake of sugar and animal fat. That checkup was seven months ago, and now, at 58, I don’t take a single pill. My doctor is happy. I haven’t felt this good in years, and at the same time, I’m deeply concerned about the recommendations that advocate for even greater use of statins. Until 2005, statins were prescribed only to people with a risk of at least 30%—or even higher—of having a heart attack within about 10 years.
So they reduced the risk to 20 %. Now, the NHS project guidelines will cover those with as little as a 10 % risk—in other words, most men over 50 and most women over 60. I am a vascular surgeon. Before founding a private clinic in Dorset 11 years ago that specializes in varicose veins, I worked in the NHS for 13 years. At the time, I didn't question the medical advice on cholesterol, and even though statins were an amazing medication.
And they probably are, for men with heart disease—not necessarily because they lower cholesterol, but because they can reduce other risk factors, such as the inflammation marker CRP. Exercise, weight loss, and omega-3 supplements also lower CRP levels.
But what about other groups—such as women, the elderly, and people like me who haven’t been diagnosed with any heart disease? The evidence that we benefit from cholesterol-lowering medications is ambiguous at best. The SEARCH 2 study, one of the most extensive and recent studies, followed 52,000 men and women aged 20–74 in Norway with no preexisting heart disease for 10 years. The results for women were clear.
The lower a woman’s total cholesterol, the higher her risk of death—whether from heart disease or any other cause, including cancer. These findings are consistent with previous studies. For men, high cholesterol was associated with heart disease and death from other causes. However, so was low cholesterol—below 5 mmol/L. Once again, this is merely an association and not a causal link. A level between 5 mmol/L and 7 mmol/L was considered optimal.
Guess what? This is already the national average. Furthermore, numerous studies have linked high cholesterol levels to increased longevity in older adults. As for me, I haven’t been diagnosed with heart disease, and no one in my family has ever had a heart attack. However, my four uncles and my sister have diabetes. A Canadian study, published last year in the BMJ, has shown that Statins increase the risk of diabetes, which gives me some hope. The controversy surrounding these drugs was reignited last week when Professor Sir Rory Collins of the University of Oxford warned that doctors who hesitate to prescribe them to those at risk could cost lives.
Doctors, by definition, are general practitioners. They don’t have time to read and analyze the data in every document for every medical condition. Even so, in a recent study published in the journal *Pulso*, six out of 10 doctors opposed the proposed bill to lower the risk level for patients prescribed statins. And the 55% group said they wouldn't take statins or that I wouldn't recommend them to a family member, based on the proposed new guidelines. If that isn't obvious, I don't know what is. Best regards, Marc Bony
