I am about to write about a topic that is absolute taboo in today’s medicine. To question the effectiveness or logic of prescribing cholesterol-lowering drugs (statins) is simply not tolerable! The use of this class of drugs is so accepted by the medical community that anyone who baulks at their use is made to feel like an uneducated fool. The exact same attitude was held only a few short years ago regarding the use of female hormone replacement. To question the use of Premarin (horse estrogens) was heresy. Doctors blindly prescribed this drug, but vehemently defended its use. Then one day that all changed after studies showed that they indeed did increase the risk of heart attacks, strokes, and cancer. One day the attitude was, “How dare you question the use of this drug.” The next day it changed to, “How dare you prescribe this drug.” This same blinded, unquestioning use of statin drugs parallels the story of Premarin. You decide who the uneducated fool is when it comes to the medical community’s statin drug intoxication.

When you go for a doctor’s visit the topic of cholesterol will most certainly come up. Drug companies have pounded the fear of God into doctors when it comes to cholesterol. If your blood level of cholesterol is above the unnaturally set number of 200 mg/dl, you will most certainly be told that you have to do something in order to escape the inevitable occurrence of either a heart attack or stroke. That “something”, many times, is a statin drug like Lipitor, Crestor, Zocor, Vytorin, or the like.

What is amazing and disturbing is that your doctor will not tell you the truth about statin drugs. Why? Because they honestly DO NOT KNOW what I am about to tell you. The reason why they do not know has everything to do with the fact that they only get their information from the pharmaceutical industry. The vast majority of doctors do exactly zero independent study on the drugs they so vehemently promote and defend. By the end of this article you will be able to comfortably test your doctor’s knowledge regarding this issue in order to determine whether they have put you or a loved one on a statin drug for a good reason or because of purely blinded faith in the information supplied to them by the pharmaceutical companies.

Most of us have seen the commercials for Lipitor staring the creepy inventor of the artificial heart, Dr. Robert Jarvik. Maybe it is just me, but that guy creeps me out! The printed ad for this advertisement claims that “Lipitor reduces the risk of heart attack by 36%...in patients with multiple risk factors for heart disease.” WOW... 36%. How can anyone argue against that number? No wonder why doctors prescribe Lipitor like candy!

Now, let me share with you the real numbers and the facts. Prepare to be upset by the deception.

The incredibly impressive 36% reduction of heart disease was determined after a large clinical study showed that 3% of patients taking a PLACEBO (sugar pill) had a heart attack compared to 2% of the patients taking Lipitor. That is a 1/3 reduction in risk which, when the numbers were ran, became a 36% reduction of heart disease in those taking Lipitor. Think about these numbers for just a second. The reduction of heart attack was in only 1 out of every 100 patients verses those taking NOTHING. So, 100 people have to take Lipitor for one person to gain a benefit. In other words, 99% of people taking Lipitor gained no benefit from heart disease!

What may have escaped you was the very important statement that the reduction was only found in those patients with multiple risk factors like diabetes, smokers, and those with prior heart attacks. The effects were only seen in males and not females. Statin drugs have shown NO significant benefit at reducing heart disease in those without multiple risk factors! So, in this study Pfizer made sure they cherry picked people with multiple risk factors in order to better their chances of showing a benefit. Why? Because they knew that they could then market a 36% reduction of heart attacks to doctors who would swallow the hook whole without even thinking about questioning the results.

Now let’s consider some interesting statistics about these drugs your doctors love so much. In people with multiple risk factors the benefit of taking a statin is only 1 out of 100 people. In people without multiple risk factors, which constitutes the majority of people taking these drugs, the benefit is estimated at 1 out of every 250/300 people! The real problem is that the number of people experiencing side-effects from this drug is WAY HIGHER than the amount experiencing a benefit!

If you look at the Doctor’s Prescription Information provided to physicians by Pfizer (http://www.pfizer.com/files/products/uspi_lipitor.pdf), they list the occurrence of some of the side-effects for Lipitor. Here are some of the statistics:

2.3% (2-3 out of 100) experience liver cell death at above normal levels. Sometimes this rise in liver enzymes is life threatening. Never is it a good thing.

A two year cancer study in rats using very high doses of Lipitor resulted in a “significant increase in liver (cancer)…” A two year cancer study in rats given very high doses resulted in the formation of rare cancerous tumors in muscle in 2 rats. The question of whether taking lower doses for decades would increase the risk for cancer has not been answered. One recent study did show an increase in liver cancer with patients receiving statin therapy who had the lowest level of “bad” LDL cholesterol.

“However, the risk of cancer is significantly associated with lower achieved LDL-C levels. These findings suggest that drug- and dose-specific effects are more important determinants of liver and muscle toxicity than magnitude of LDL-C lowering. Furthermore, the cardiovascular benefits of low achieved levels of LDL-C may in part be offset by an increased risk of cancer.” Effect of the magnitude of lipid lowering on risk of elevated liver enzymes, rhabdomyolysis, and cancer: insights from large randomized statin trials. J Am Coll Cardiol. 2007 Jul 31;50(5):409-18.

The question of cancer causing potential has not been answered, but should not simply be dismissed when only 1 out of 100 high risk people benefit.

The following events occurred in greater than 2 out of 100 people. Take note of how many side effects were experienced and that these are not at all insignificant.

Pfizer lists another 120 symptoms that have been reported in less than 2 out of 100 patients taking Lipitor.

The message to take home from these statistics is that for every one person helped by statins there are dozens of people who either experience severe side-effects or have to live with minor side effects. I wonder what other drugs these people have to take in order to relieve those “minor” side-effects they experience from their statin drug?

I guess the question I ask myself is why doctors are so adamant about prescribing a drug to EVERYONE regardless of whether or not they have multiple risk factors. If you walk into a doctor’s office with a cholesterol level over 200 mg/dl you are more than likely going to be given a statin drug. This is especially true if you have had consistent readings over 200 mg/dl. An even more important question would be to ask why doctors have such a love-affair with statin drugs when they are grossly ineffective for 99% of their patients.

Call Your Doctor

Those of you familiar with my writings know that I constantly preach that YOU have to be in charge of your health care decisions. Use your doctors as tour guides but make sure they know where they are going before you jump into the cart they put before you. In that vain, I strongly suggest that you call your doctor or make an appointment with them to discuss their prescription to you of a statin drug. Your goal is simply to find out why they think you are the 1 out of a 100 (if you have multiple risk factors) or 1 out of 250/300 (if you do not have multiple risk factors) who may benefit from this drug.

The best approach, as I see it, is to not be confrontational at all. There is no need to belittle your doctor and to point out that they are pharmaceutical drones. This kind of confrontation will hurt your relationship with your doctor. No, I suggest that you ask them a couple of non-threatening questions with the goal of finding out if they know the facts. If they do not, then you have to decide whether or not it is wise for you to follow the advice of someone who is misinformed.

Question 1: I was reading about the side-effects of statin drugs and I guess I was wondering what is the true benefit of my taking this drug? (You are going to get an answer like, “There are numerous studies showing the significant benefits of lowering your cholesterol and the reduced risk of heart disease.” This is not completely true, by the way.)

Question 2: Do the studies show a benefit for patients like me? (This is especially important to ask if you do not have multiple risk factors. You are going to get an answer like, “They show a benefit for anyone.” This is not true, by the way.)

Question 3: If you had to guess, how many patients out of 100 benefit from taking statins? (You are going to get a number WAY higher than 1 out of 100! I will salt and eat my shoe if you do not. In fact, I would not be surprised if they did not tell you that everyone benefited from statin drugs.)

Finally: Thank you, doctor, for clearing up this subject for me. (You have not confronted your doctor in a way that will strain your relationship, but you found out valuable information regarding whether or not you should continue taking their advice on the subject. When someone proves to you that they are ignorant about a subject, explain to me why you would take their recommendation? )

The Bottom Line:

You have to come to understand that your doctors know very little about the drugs they prescribe for you. You may think that I am being a little over-board by making this statement. Let me give you a real-life example. A patient of mine emailed me to tell me that she was having problems with dizziness. She noticed that she experienced this dizziness for days after taking her prescription progesterone, which had been given to her by a fertility specialist. She called him to ask if this could be the cause and was told that it could not be the progesterone but had to be something else. I brought her to WebMD.com and pulled up the side-effects for this drug. Under the listing: “Inform your doctor immediately if you experience any of these potentially serious side-effects:”, number two was dizziness! How could a specialist who prescribes this drug hundreds of times a month not know this information? Unfortunately, this is not an isolated case.

I know that there will be those of you who will be asking, “But, if I stop doing what my doctor tells me won’t he/she get mad at me when he/she eventually finds out?” If they do, you have a doctor who is more worried about a bruised ego than about you. Who cares if they get mad? This is about YOU, not them. Set them straight if need be.

If you have questions about what to do regarding cholesterol control, I strongly advise you to download my audio CD for FREE: Cholesterol: Angel or Devil .