Statins – Is There a Dark Side?

Integrative Clinical Pharmacist Scott Berliner, RPh

The product safety information goes like this: “Lipitor is not for everyone. It is not for those with liver problems. It is not for women who are nursing, pregnant or may become pregnant. If you take Lipitor, tell your doctor if you feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Tell your doctor about all medications you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before and during treatment and may adjust your dose. Common side effects are diarrhea, upset stomach, muscle and joint pain, and changes in some blood tests. When diet and exercise alone are not enough, adding Lipitor can help lower cholesterol. Lipitor is one of many cholesterol-lowering treatment options that you and your doctor can consider.”

The above “safety information label” clearly states when diet and exercise alone are not enough, then add Lipitor, which has been among the top-used prescription drugs for many years. Sales are in the billions of dollars. Yet very few of the patients who come into my pharmacy are even aware that diet and exercise can help their blood lipid problem. All muscles in the body need to be exercised to maintain strength and promote circulation; the heart muscle is no exception. A Mediterranean diet is a recommended nutritional approach.

In 2006, a four-year, double blind study among diabetics who take oral medication (not insulin) showed no reduction in death in the statin group versus the placebo. For these people there was no reduction in cardiovascular death, nonfatal heart attacks, stroke, survival from a heart attack after CPR, and worsening or unstable chest pains. In 2005, in the New England Journal of Medicine, published that Lipitor does not prevent obstruction of the heart valve that leads to the aorta (aortic stenosis).

Another study, published in the American Journal of Clinical Nutrition (July 2006) found that the addition of fish oil to the diet improved HDLs (“good” cholesterol), but when Lipitor was added there was no added benefit.

You may see a number of commercials touting the benefits of statins like Lipitor. Keep in mind that this is marketing, no matter who the spokesman may be. For example, Dr. Robert Jarvik, the inventor of the artificial heart, is being paid more than a million dollars by Pfizer, Lipitor’s manufacturer, to promote the drug.

The mechanism of action of all these drugs is similar. They work on inhibiting an enzyme that makes cholesterol in the liver. This is why people taking statins need to have their liver markers checked regularly. There are many reports of people being on these drugs for years without any noticeable side effects and then suddenly have muscle weakness or pain. This is a potentially serious side effect, so if you are taking a statin drug, please be sure to remind your physician to check your liver enzymes. Another consequence of blocking the enzyme that leads to cholesterol production is that the same enzyme is also important for production of Co Enzyme 10. Co Q 10 is essential for muscle health and energy production.

A note of importance: people using statins should avoid grapefruit and grapefruit juice which can interact with these drugs in the liver as they induce similar liver enzymes.

I encourage all patients with any of the above issues to stay on their medications, but seek out an integrative physician trained in managing these issues more naturally with less toxicity.