Is Cholesterol Medicine a Hoax: How Statins Wreck Your Health
In essence, there are two conflicting recommendations from doctors. We invite you to explore the evidence, sources, and references (below) in this article and decide which perspective aligns best with your health priorities.
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Only Extremely High Levels Were a Problem
The Framingham Study, which began in 1948, involved 5,209 people from Massachusetts (3). It was instrumental in starting the myth that high total cholesterol is a major risk factor for heart disease, but what many people don’t realize is the correlation only existed if cholesterol was over 300 milligrams per deciliter (mg/dl). “Very few people have total cholesterol that high,” Malhotra says (4).In the Framingham Study, the majority of people with cholesterol levels over 300 mg/dl had a genetic condition called familial hyperlipidemia, which leads to very high levels of cholesterol. About 1 in 250 people have this condition, according to Malhotra (5).
What also wasn’t widely publicized about the Framingham Study was what occurred in people who were in their 50s, 60s and beyond. In this age range, as cholesterol dropped, mortality rate increased. “So, the association of cholesterol and heart disease is quite weak, first and foremost,” Malhotra says (6).
Malhotra and colleagues conducted a study to determine if a correlation exists with lowering LDL cholesterol and total cholesterol and preventing heart attacks and strokes, and no clear correlation was found. “This is based upon randomized, controlled trial data, so this is the most robust evidence you can get,” he says (7).
LDL Cholesterol Doesn’t Cause Heart Disease
In the context of statins, Malhotra says, they do lower LDL cholesterol, but they also have anti-inflammatory and anti-clotting properties, and this is where any benefit comes in for preventing heart attacks and strokes. However, if you’re at low risk of heart disease, this benefit amounts to only about 1%. Among those who’ve had a heart attack, the benefits aren’t much better. Malhotra explains (8):He also points out that, over that five-year period, taking a statin once you’ve had a heart attack will only increase your life expectancy by four days.9 Further, a comprehensive review of the literature, published in 2018, found that LDL cholesterol does not cause heart disease, so statins’ ability to lower LDL is of dubious value:
However, there is an increasing understanding that the mechanisms are more complicated and that statin treatment, in particular when used as primary prevention, is of doubtful benefit.”
The review delved into three reviews published by statin advocates, which claimed to support the LDL cholesterol-heart disease link.
However, the authors noted, serious errors were involved in their research, along with other “obvious falsification of the cholesterol hypothesis … the conclusions of the authors of the three reviews are based on misleading statistics, exclusion of unsuccessful trials and by ignoring numerous contradictory observations.”10 They further stated (11):
Low Blood Cholesterol Associated with Increased Late Life Mortality?
Research published in Frontiers in Endocrinology (2024) found a revealing link between low total cholesterol (TC) levels and increased mortality risk in those aged 85 and above. This research challenges the conventional dogma that lower cholesterol is always better, especially for older adults.The study, which analyzed data from the Chinese Longitudinal Healthy Longevity Survey, found that individuals with TC (total cholesterol) levels below 3.40 mmol/L (131 mg/dL) had a significantly higher risk of all-cause mortality compared to those with higher levels.2 In fact, the mortality risk increased by 12% for every 1 mmol/L reduction in TC. These findings suggest that maintaining higher cholesterol levels may benefit longevity in your later years.
Study Challenges ‘Bad Cholesterol’ Label for LDL
Another 2024 study (JAMA) involving more than 4 million people across China challenges this belief, suggesting LDL may not be as harmful as previously thought—at least, not for everyone.Research led by Dr. Liang Chen and colleagues reveals a more nuanced picture. While high LDL levels are linked to increased mortality in some groups, they do not pose the same risk for others, they found. The relationship between LDL and mortality varies significantly based on an individual’s cardiovascular disease risk and overall health status.
Statins Don’t Protect Your Heart
Despite the questions surrounding their safety and effectiveness, statins are recommended for four broad patient populations (12):- Those who have already had a cardiovascular event
- Adults with diabetes
- Individuals with LDL cholesterol levels ≥190 mg/dL
- Individuals with an estimated 10-year cardiovascular risk ≥7.5% (based on algorithm that uses your age, gender, blood pressure, total cholesterol, high density lipoproteins (HDL), race and history of diabetes to predict the likelihood you'll experience a heart attack in the coming 10 years)
Even in the case of recurrent cardiovascular events — and despite an increase in statin use from 1999 to 2013 — researchers writing in BMC Cardiovascular Disorders noted, “there was only a small decrease in the incidence of recurrent CVD, and this occurred mainly in older patients without statins prescribed.” (14)
Cholesterol Treatment Trialists Monopolize Statin Debate
Rory Collins heads up the Cholesterol Treatment Trialists' (CTT) collaboration, a group of doctors and scientists who analyze study data and report their findings to regulators and policymakers.15 Collins coauthored a 2008 study16 that claims statins lower your risk of heart attack by 36%.
Table 417 in this study shows the rate of heart attack in the placebo group was 3.1% while the statin group's rate was 2% — a 36% reduction in relative risk. However, the absolute risk reduction — the actual difference between the two groups, i.e., 3.1% minus 2% — is only 1.1%, which isn't very impressive.
In the real world, if you take a statin your chance of a heart attack is only 1.1% lower than if you're not taking it, as Malhotra told Joe Rogan. Just like COVID-19, the drug companies manipulated their statistics and grossly exaggerated statin benefits by conflating relative and absolute risks.
Collins is also noteworthy, as he spearheaded an attack against Malhotra by contacting the British Medical Journal and demanding it retract one of Malhotra’s studies, which cited a statistic that statins cause side effects in 18% to 20% of people who take them.18 Rather than retract the study, an independent panel reviewed the study, calling only for a correction to be added:19
“The corrections explain that, although the 18-20% figure was based on statements in the referenced observational study by Zhang et al — which said that "the rate of reported statin related events to statins was nearly 18%,” the articles in The BMJ did not reflect necessary caveats and did not take sufficient account of the uncontrolled nature of the data of Zhang et al.”Malhotra pointed out that, had the article been retracted, it would have been career-destroying for him, as it would have damaged his credibility. “I was on trial, essentially, for two months,” he says, “and it was very tough.” But when the panel came back, it voted 6-0, unanimous in favor of Malhotra’s study. “There was no call for retraction.”20
No Relationship Between LDL, Risk of Heart Attack
Other research has also found unimpressive results for statin treatment, including a systematic review and meta-analysis of 21 trials21 using similar criteria to the CTT.22
One of the authors, Maryanne Demasi, Ph.D., explained the study “found no consistent relationship between lowering LDL-C with statins and death, heart attack or stroke,” even though the “public health mantra about cholesterol has always been ‘the lower the better.’”23,24 It also once again highlighted the misleading nature of using relative risk reduction in place of absolute risk:25
“Statins are very effective at lowering LDL-C, but in some trials, that did not necessarily translate into a meaningful benefit for the patient. This contradicts the prevailing view, promoted by the CTT, that there is a strong “linear” relationship between lowering LDL-C and cardiovascular outcomes from statin therapy.Our analysis also highlighted the significant difference in the relative risk reduction (RRR) and absolute risk reduction (ARR) of statin therapy on death, heart attack and stroke.
For example, if your baseline risk of having a heart attack is 2% and taking a drug reduces that risk to 1%, then in relative terms you halved your risk (50% RRR) which sounds impressive, but in absolute terms, you have only reduced your risk by 1% (ARR).
Our analysis showed that trial participants taking a statin for an average of 4.4 years, showed a 29% RRR in heart attacks, but the ARR was only 1.3%. If this is not effectively communicated to a patient, can they make a fully informed decision about their treatment?”
Statins Will Wreck Your Health
In short, statin drugs have not derailed the rising trend of heart disease, and instead have put users at increased risk of health conditions linked to their use, such as diabetes,26,27 dementia28 and others, including:
- Cancer29
- Cataracts30
- Musculoskeletal disorders, including myalgia, muscle weakness, muscle cramps, rhabdomyolysis and autoimmune muscle disease31
- Depression32
A 2015 review, published in Clinical Pharmacology, suggests that statins may also act as “mitochondrial toxins,” impairing muscle function in the heart and blood vessels by depleting coenzyme Q10 (CoQ10), an antioxidant cells use for growth and maintenance. Multiple studies show that statins inhibit CoQ10 synthesis, leading many patients to supplement.
In the event you’re taking statins, be aware that they deplete your body of coenzyme Q10 (CoQ10) and inhibit the synthesis of vitamin K2. The risks of CoQ10 depletion can be somewhat offset by taking a coenzyme Q10 supplement or, if you're over 40, its reduced form ubiquinol. But ultimately, if you’re looking to protect both your brain and heart health, avoiding statin drugs and instead optimizing your diet.As a general rule, the sicker you are, the more you need. The suggested dose is usually between 30 mg to 100 mg per day if you're healthy, or 60 to 1,200 mg daily if you're sick or have underlying health conditions.
If you have an active lifestyle, exercise a lot or are under a lot of stress, you may want to increase your dose to 200 to 300 mg per day. Importantly, if you're on a statin drug, you need at least 100 mg to 200 mg of ubiquinol or CoQ10 per day, or more. Ideally, you'll want to work with your physician to determine your ideal dose.
- Omega-3 index
- HDL/total cholesterol ratio
- Fasting insulin level
- Fasting blood sugar level
- Triglyceride/HDL ratio
- Iron level
This is because nearly all processed foods contain seed oils and processed sugar in the form of high fructose corn syrup, both of which contribute strongly to virtually every chronic degenerative disease, including the most common ones of heart disease, cancer and diabetes.
Risk of Diabetes Doubles With Cholesterol Medication
Past studies have demonstrated that statins increase the risk of diabetes. Another study led by a graduate researcher at The Ohio State University explored this link in research published in Diabetes Metabolism Research and Reviews (2019). The study was a retrospective evaluation of medical records using employees and spouses from a private insurance plan.Yearly biometric screening, health surveys, medical claims and pharmacy data were gathered from 2011 through 2014. Individuals who had indications for statin use, or who had a previous cardiovascular event, were enrolled. Adults who had Type 2 diabetes before the study or who acquired it in the first 90 days were excluded.
Records were classified as belonging to a statin user if they had two or more prescriptions filled, but individuals using statins before January 2011 or within the first 90 days of enrollment in the insurance were excluded. Data were collected from 755 individuals using statins and 3,928 who were not.
After accounting for factors such as age, gender, ethnicity, education and body mass index, the researchers found those who used statins during the study were two times as likely to be diagnosed with diabetes than those who did not take statin medications.
Interestingly, individuals who used statin drugs longer than two years experienced an increased risk of more than three times as likely to get the disease. The data also indicated that individuals taking statin medications had a 6.5% increased risk of high blood sugar as measured by hemoglobin A1c values.
The hemoglobin A1c blood test is an average level of blood sugar measuring the past 60 to 90 days. The test measures how much sugar is bound to hemoglobin on red blood cells. Since red blood cells live for up to 90 days, the test is an average of your blood glucose level during this time.
Simple Strategies to Normalize Your Cholesterol Levels
Before becoming concerned about your cholesterol levels, it's important to evaluate whether you really need a statin drug to reduce your risk of a cardiovascular event. Updated guidelines published by the American Heart Association and the American College of Cardiology are based on a personalized risk assessment.However, the U.S. Department of Health and Human Services critically evaluates those with cholesterol levels over 200 milligrams per deciliter. We believe this total cholesterol measurement has little benefit in evaluating your risk for heart disease unless the number is over 300.
In some instances, high cholesterol may indicate a problem, provided it's your LDL or triglycerides and you have low HDL. A better evaluation of your risk of heart disease are these two ratios in combination with other lifestyle factors, such as your iron level and diet.
- HDL/Cholesterol ratio — Divide your HDL level by your cholesterol. This ratio should ideally be above 24%.
- Triglyceride/HDL ratio — Divide your triglyceride level by your HDL. This ratio should ideally be below 2. Data demonstrate a ratio greater than four is a powerful predictor of coronary artery disease.
- 1 American Heart Association January 6, 2020
- 2 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023
- 3 Lancet. 2014 Mar 15; 383(9921): 999–1008
- 4 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023, 0:53
- 5 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023, 1:50
- 6 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023, 3:31
- 7 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023, 4:12
- 8 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023, 5:07
- 9 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023, 7:07
- 10 Expert Review of Clinical Pharmacology 2018, Volume 11, Issue 10
- 11 Expert Review of Clinical Pharmacology 2018, Volume 11, Issue 10, Conclusion
- 12, 13 BMJ Evidence-Based Medicine August 4, 2020 doi: 10.1136/bmjebm-2020-111413
- 14 BMC Cardiovasc Disord. 2018; 18: 209
- 15 CTT Collaboration, About
- 16 European Heart Journal February 1, 2008; 29(4): 499-508
- 17 European Heart Journal February 1, 2008; 29(4): 499-508, Table 4
- 18, 19 BMJ Independent statins review panel
- 20 YouTube, PowerfulJRE, Cardiologist on the Over-Prescribing of Statins for Heart Disease April 29, 2023, 11:50
- 21 JAMA Intern Med. 2022;182(5):474-481. doi: 10.1001/jamainternmed.2022.0134
- 22, 23, 25 Substack, Maryanne Demasi March 14, 2022
- 24 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on […]: Executive Summary. Journal of the American College of Cardiology. Page 4, #2
- 26 Medical News Today June 26, 2019
- 27 Diabetes Metabolism Research and Reviews May 24, 2019
- 28 Journal of Nuclear Medicine May 2021, 62 (supplement 1) 102
- 29 Cancer Epidemiol Biomarkers Prev. 2013 Sep;22(9):1529-37
- 30 Open Journal of Endocrine and Metabolic Diseases 2013, Vol. 3, No. 3
- 31 JAMA Intern Med. 2013;173(14):1318-1326
- 32 Annals of General Psychiatry, 2017;16:20
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