Prescription Alternatives
Page 18
Why Does Cholesterol Accumulate in the Arteries?
Drug company advertising for cholesterol-lowering drugs gives the impression that excessive cholesterol in the blood simply deposits itself on the artery walls and that lowering cholesterol levels with drugs stops that process. It would be nice if it was that simple, but once again the magic pill theory falls short.
High cholesterol is a symptom of an underlying nutritional deficiency or toxicity (such as those previously mentioned) that damages the arteries. Cholesterol takes many forms, and some forms act as a component in the repair glue that the body calls on to repair damaged artery walls. If the cholesterol called in to do repair work is oxidized, the artery continues to get the message that it’s damaged, and more cholesterol gets piled on. In a kind of double whammy, the same nutritional deficiencies and toxins that allow cholesterol to become oxidized also impair the ability of the liver and other organs to do their cleanup work to eliminate harmful fatty acids in the blood. The inflammatory process that kicks in to try to repair artery damage only accelerates the expansion of the artery wall, contributing to the chain reaction of cholesterol accumulation and causing further cholesterol oxidation. One of the ways cholesterol becomes oxidized is when you don’t have high enough levels of antioxidants in your body to neutralize the harmful cholesterol.
Myth of the Cholesterol Count
Another cholesterol myth perpetuated by the drug companies is that everyone with a total cholesterol count over 200 mg/dL should be concerned. This claim is not backed up by research. Our individual biochemistry allows for a wide range of cholesterol levels. Your relative levels of HDL and LDL cholesterol are more important than your total cholesterol. A very high level of LDL “bad” cholesterol probably indicates that your body is not efficiently removing cholesterol from your blood, but that inefficiency, and the heart disease that may accompany it, is most likely caused by poor nutrition, a sedentary lifestyle, and stress.
What is more important is that your HDL “good” cholesterol levels stay high and your LDL “bad” cholesterol levels stay low, relative to each other. However, keep your focus on high levels of HDL. A recent study in China found that people with low counts of LDL and low counts of HDL still have high coronary risk. We’ll give specific suggestions later in the chapter for raising HDL levels.
The best way to evaluate your cholesterol status using the measurements given in most blood chemistry panels is to measure the ratio of your total cholesterol to your HDL count. For example, if you are a man and your total cholesterol count is 250 and your HDL is 85, you divide 250 by 85 and your ratio will be 2.9. When you calculate your ratio, compare it to these numbers: the average ratio for women is 4.4; for men, it is 5.0. If your ratio number is low, that’s a fair indicator that your cholesterol balance is healthy.
Here’s a general rule for total cholesterol levels: if your total cholesterol levels are under 200, consider this a green light. Don’t worry, be happy! If your cholesterol levels are over 200, be aware that this might be an indication of some damage to your arteries. If you’re leading a healthy lifestyle, don’t be overly concerned, but be watchful. Consider this a yellow light. If your cholesterol levels are over 300, your body is trying to tell you something: “Help! You’re plugging up my arteries!” Consider this a red light. You need to seriously evaluate your diet and lifestyle.
No matter what category you fall into, please do not try to totally eliminate cholesterol from your diet. It is the fundamental building block of all your sex hormones and the adrenal hormones, and it plays an important part in the excretion of fats. Cholesterol is also found in high amounts in the brain and nervous system, where hormones play a critical part in balancing all bodily systems. We all need some cholesterol in our diet. If your cholesterol levels are high, your answer probably lies in overall diet and lifestyle changes.
There’s More to Heart Health than Lower Numbers
While a cholesterol-lowering drug will usually do a very good job of lowering your cholesterol, there’s scant, if any, evidence that it will help you live longer or reduce your risk of a heart attack unless you are extremely ill or have just suffered from a heart attack. There are no studies showing that women benefit from cholesterol-lowering drugs. Nor are there any studies showing that these drugs reduce heart attacks or death in men from ages 65 to 75. Since heart disease takes decades to develop, it’s highly unlikely that cholesterol-lowering drugs will help anyone over the age of 75. That leaves men from ages 35 to 55, but even here the evidence of benefit is slim, and the possible side effects are sobering.
Believe it or not, there is complete consensus (or should we say lip service) among drug companies, physicians, and organizations such as the American Heart Association that the first step in lowering cholesterol should be a “vigorous” attempt to improve diet and increase exercise. Sadly, few physicians are following this advice, and drug company advertising and marketing certainly doesn’t reflect it. But it’s well-known that cholesterol-lowering drugs can cause severe side effects and that long-term follow-up studies are sadly lacking. The studies that do exist juggle numbers and play with statistics to the point where the information becomes meaningless.
Every information sheet on the most commonly prescribed cholesterol-lowering drugs will tell you that they cause cancer in rodents when taken long-term in relatively normal doses. It’s also well-known that they can cause severe emotional imbalances in men, along with a wide array of life-threatening side effects. A study done at the Henry Ford Medical Center in Detroit showed that men taking cholesterol-lowering drugs had a higher risk of suffering from depression, crying spells, anxiety, worry, and suicidal thoughts. Yet physicians routinely prescribe these drugs indefinitely for their older patients.
The wisest course of action is to avoid these drugs unless you are in imminent danger of a heart attack due to clogged arteries. If that’s the case, it’s important to do everything possible to reverse your heart disease using the cholesterol-lowering plan outlined here and to get off the drugs as soon as possible. These drugs can have ominous side effects, especially when used on a long-term basis. The New England Journal of Medicine published research showing that genetics likely plays a role in the muscle pain, weakness, and nerve damage that can be a side effect of statins.
Cholesterol-Lowering Drugs
Examples of Bile Acid Sequestrants
Cholestyramine (Questran, Prevalite)
Colesevelam (Welchol)
Colestipol HCl (Colestid)
The bile acid sequestrants, also known as “bile-blockers,” such as cholestyramine (Questran) and colestipol HCl (Colestid) are resins, often taken in powder form, that block the production of bile. Cholesterol is the building block of bile, a substance normally released via the liver to break down fats in the intestines and enhance their absorption. After bile breaks down fats, it is reabsorbed back into the liver. The bile-blockers bind to bile in the intestines so it can’t be reabsorbed and is instead excreted in the feces. This forces the liver to take up more cholesterol from the blood to produce more bile, in effect lowering cholesterol levels (and making your liver work a lot harder).
Seems like a neat solution, but the bile-blockers also bind to the fat-soluble vitamins such as A, D, E, and K, so that instead of absorbing these vitamins you excrete them. (Sound familiar? Olestra, the fake fat, does the same thing.) Ironically, a shortage of vitamin E can be a direct cause of heart disease, which is what the drugs are meant to prevent in the first place. There is some evidence that along with blocking cholesterol absorption these drugs are blocking the absorption of the important EFA (essential fatty acids) oils that are essential to good health. Bile-blocking resins also lower folate (folic acid) levels, which raises homocysteine levels, another potent risk factor for heart disease.
Here’s a medical maze for you. Physicians prescribing bile-blockers will read on the drug information sheet that anticoagulant, blood-thinning drugs such as warfarin (Coumadin) can become le
ss effective when prescribed along with a bile-blocker. Yet long-term use of a bile-blocker can cause a deficiency of vitamin K, which will increase the tendency to bleed, making the drugs more effective. In other words, what will happen when you combine these two types of drugs is truly unpredictable—and that is very dangerous.
What Do They Do in the Body? Lower cholesterol by blocking the reabsorption of bile.
What Are They Prescribed For? Lowering cholesterol levels.
What Are the Possible Side Effects? Constipation occurs in up to 50 percent of all patients who use these drugs! Constipation can be severe, especially if you already have a problem with constipation or hemorrhoids.
Chronic use of these resins can lead to excessive bleeding or poor clotting from a vitamin K deficiency. Vitamin D deficiency can also be a problem, resulting in rashes and irritations on the skin, tongue, and anus, as well as poor bone formation. Vitamin D deficiency also increases the risk for heart disease and many types of cancer.
In addition, osteoporosis, liver dysfunction, and disturbances of the acid-base balance of the body are side effects of these drugs.
They can also raise triglyceride levels. High triglyceride levels increase the risk of heart disease.
Most alarming, however, is the research that reports cancer as a possible side effect. Several studies stated that some rats who were given bile acid sequestrants grew cancerous intestinal tumors.
CAUTION!
Think Twice About Taking These Drugs If . . .
• You have constipation, especially if you are over 60 years of age.
• You have blood clotting problems, osteoporosis, or severe vitamin deficiencies.
• You have a gallbladder obstruction (bile duct obstruction).
• You have phenylketonuria, a genetic disease; hypothyroidism; diabetes; kidney and blood vessel disorders; dysproteinemia; obstructive liver disease; or ischemic heart disease.
What Are the Interactions with Other Drugs? Because bile acid sequestrants may delay or reduce the absorption of other drugs you take with them, it’s best to take other medication at least one hour before or four to six hours after taking bile acid sequestrants.
What Are the Interactions with Food? These drugs decrease the absorption of nutrients you get from your foods such as sugars, fats, vitamins, and minerals.
What Nutrients Do They Deplete or Throw out of Balance? Calcium, carotene, electrolytes, folic acid, iron, and the fat-soluble vitamins, A, B12, D, E, and K.
What Else to Take While Taking These Drugs. Take supplements of vitamins A, B12, D, E, and K as well as folic acid, iron, electrolytes, beta-carotene, and calcium.
To reduce constipation, drink plenty of water and eat foods high in fiber such as whole grains, vegetables, and fruit.
Other Tips on These Drugs. Because of the absorbing mechanism of these drugs, take other medications or supplements at least one hour before or four to six hours after a bile acid sequestrant.
Examples of Statins (HMG-CoA Reductase Inhibitors)
Atorvastatin (Lipitor)
Fluvastatin (Lescol)
Lovastatin (Mevacor, Altocor, Altoprev)
Mevastatin
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
These drugs are known as the cholesterol-blockers or statins, and if you live in the United States and watch TV, you’ve seen endless expensive ads for these drugs. The statins may be the most heavily and aggressively marketed drugs in history. The drug companies are working overtime to manipulate you, us, and everyone else from Congress to the American Medical Association (AMA) to the American Heart Association to the individual doctor to get us all on statin drugs. Every few years they manage to get “normal” cholesterol level numbers reduced so that today, virtually everyone over the age of 50 would need to take statins based on their cholesterol numbers. And it’s working! In 2006 Lipitor (atorvastatin calcium) was the top-selling drug in the United States. There is zero (that’s right—zip, zilch) evidence that statins reduce the risk of heart disease or death for women, and yet women spend billions of dollar a year on them.
Statin drugs directly block an enzyme (HMG-CoA reductase) needed to make cholesterol in the liver. These drugs originate from an ancient Chinese medicine called red yeast rice, which is rice fermented with red wine and the yeast Monascus purpureus. Lovastatin is actually the name of a compound found in red yeast rice. The rest of the statins are essentially lovastatin “tweaked” to create more potent and patentable drugs, which also have more side effects.
The biggest danger and most common side effect of taking statin drugs is liver damage. It’s frightening to imagine what’s happening to a liver subjected to, say, a dose of Mevacor (lovastatin), a couple of martinis, and a Tylenol (acetaminophen), all of which compromise liver function. This type of triple whammy could be enough to cause serious problems in someone already ill or weak, yet few physicians would think to mention this to their patients. American medicine has a tendency to pay no attention to the liver until it is very damaged.
Remember, cholesterol is the basic building block for the cortisones, testosterone, estrogen, progesterone, and DHEA. Is it any wonder that people taking cholesterol-blocking statins suffer from steroid-hormone-related complaints, such as men growing breasts and being impotent, women becoming bald, and both suffering from insomnia and fatigue? Cholesterol is essential for proper brain function. Is it any wonder that men with very low cholesterol are depressed and suicidal, and that memory problems are a complaint of those on this drug?
But perhaps even more serious than the preceding side effects is the fact that the same mechanism that blocks cholesterol production also blocks the production of CoQ10, a substance essential to a healthy heart and muscles. Your physician may tell you that you’ll never have a shortage of CoQ10, but this is not borne out by the facts. The truth is that heart disease patients are consistently found to have low levels of CoQ10. About 1 out of every 200 people who use the statins has side effects of muscle pain and weakness, which can be a sign of even more serious problems, leading to kidney failure and even death. All indications are that the cause of these symptoms is a deficiency of CoQ10. So once again, we have a cholesterol-lowering drug supposedly given to reverse heart disease but causing a deficiency of a substance crucial to a strong and healthy heart.
Keeping cholesterol in a healthy range is a good idea, and taking a statin drug short-term may be a wise choice, but the concept that these drugs are harmless and can be taken for life is misguided and dangerous. As you’ll discover later in this chapter, you can also choose to take a red yeast rice supplement, which is the natural form of the statin drugs and has been shown to safely and effectively lower cholesterol. But keep in mind that it, too, is a statin and also has the potential to cause the same kinds of problems.
What Do They Do in the Body? These drugs directly block an enzyme needed to make cholesterol in the body.
What Are They Prescribed For? Lowering cholesterol levels.
What Are the Possible Side Effects? The most common side effects of the statins are stomach ulcers, liver damage, and a dangerous disease called rhabdomyolysis that actually destroys muscle tissue. Baycol (cerivastatin), a statin that was recalled in 2000, caused at least 31 fatal cases of this disease. The risk of rhabdomyolysis increases as the statin dose increases and in those with diabetes and kidney disease. In fact, rhabdomyolysis can cause kidney damage.
The watchdog group Public Citizen has petitioned the Food and Drug Administration (FDA) to ban rosuvastatin (Crestor) because of concerns of rhabdomyolysis and kidney toxicity. According to Public Citizen, some of the major U.S. health insurers have refused to reimburse for Crestor because of safety concerns.
Other side effects of the statins include back pain, insomnia, heartburn, greater susceptibility to upper sinus infections, alteration of taste, dizziness, memory loss, numbness in the extremities, tremors, loss of libido, impotence, enlarg
ed thyroid, and skin conditions such as bumps and rashes. They also tend to increase the formation of cataracts, and they cause cancer and birth defects in rodents and dogs. Some patients have experienced steroid-hormone-related complaints such as impotence, insomnia, and fatigue.
Be aware! Many of these symptoms are attributed to aging rather than to the statin side effects, resulting in a poor quality of life for potentially millions of people. These side effects are also likely to get you on the drug treadmill, as your doctor prescribes sleeping pills for insomnia, acid blockers for heartburn, antibiotics for sinus infections, and erectile dysfunction drugs for impotence. No wonder the statins are such a cash cow for the drug companies!
CAUTION!
Think Twice About Taking These Drugs If . . .
• You have a stomach ulcer.
• You have the following conditions: infection, a suppressed immune system, hypertension, trauma, uncontrollable seizures, or endocrine or electrolyte disorders. These drugs can cause kidney failure in patients with severe cases of these conditions.
• You have liver disease, poor liver function, kidney disease, or poor kidney function, or you drink substantial amounts of alcohol. They can damage your liver and kidneys significantly.
• You are scheduled soon for surgery. Ask your physician how you can safely discontinue using these drugs.
• You have any disease that contributes to increased blood cholesterol such as hypothyroidism, diabetes, kidney and blood vessel disorders, liver disease, or dysproteinemia.
What Are the Interactions with Food? Take lovastatin and fluvastatin with meals. Pravastatin and simvastatin are taken without regard to food.
What Nutrients Do They Deplete or Throw out of Balance? CoQ10.
What Else to Take While Taking This Drug. CoQ10 (ubiquinone or ubiquinol), 30 to 200 mg daily. To support your liver, you can take the herb silymarin (milk thistle), the supplement alpha-lipoic acid, and NAC (N-acetyl cysteine).