Busting The Cholesterol Phobia
By Dr. Harold Gunatillake
There is one drug that earns billions of dollars, accounting for 40 billion plus in sales worldwide every year, manufactured just by one or two giant companies in the US. This drug is prescribed by Western qualified doctors all over the world to most of their patient over the age of 40, when blood cholesterol levels rise beyond the normal range recommended by the pathology laboratories. A “cholesterol-phobia” is created for a man made disease with no symptoms.
It is a talking point at gatherings, socials, and you hear quite loudly with no guilt, ”My doctor said I have too much of cholesterol.”
An article by Tahnee Hopman on “Keep an eye on those cholesterol levels” (Feb 17, 2008. Sunday Times) states after an interview with Dr. Gotabhaya Ranasinghe, Cardiologist at Sri Jayawardenepura General Hospital, that “Statins are the most effective drug to combat high cholesterol. They reduce the risk of a heart attack by around 40-45% as well as the risk of strokes and cause the regression of cholesterol deposits in the arteries. As with most forms of medication, there are a few side effects, but these can be minimised by changes in dosage. In some cases, the side effects can disappear with time.”
Sales increase tenfold
The sales of ‘statins’ in Sri Lanka have increased at least tenfold, just ask any pharmacist in the city or the suburbs. Most average wage earners are concerned as statin tablets have to be taken as prescribed daily for the rest of their lives, doesn’t come cheap. The price of each American labelled statin tablet costs more than the price of a packet of rice and curry, most wage-earners eat for lunch.
Beds in government and private hospitals, including the intensive care units, are mostly occupied with patients suffering from coronary heart disease. These are people who have taken their statins most religiously for many years, as prescribed by the family doctors.
Long waiting lists exist in the cardiac units in all surgical hospitals, private and public, for open heart surgery and balloon angioplasty and stents.
More hospitals in the main cities are contemplating opening more cardiac units in their respective wings, though the cost of equipment and maintenance are formidable and need frequent upgrading. Is the magic pill, ‘Statin’ really doing its job, or are we all being taken for a ride by the giant American drug companies? Think about it!
Shot-gun therapy
The slogan, “Prevention is better than cure” is been slogged by the private hospitals advertising a whole heap of packages at formidable prices, and the people get sucked into going through various tests, when there are no symptoms of any disease. We call this the ”shot-gun therapy.” The employers in big commercial companies aid and abet this medical system for their employees. These commercialised health adverts will encourage our people to become “hypochondriacs” and hit their pockets with expensive bills, some may be paid by the employer.
Invariably, some spot blood deficiency will be detected in these samples and they will be highlighted with a ‘star’, to denote that some abnormality has been detected. The client gets worried, he goes from specialist to specialist when a minor deficiency can be corrected by diet, exercise and assurance alone, and reviewing at a later date.
In some developed countries you could get ‘health help’ by ringing a specific hot-line telephone number, where the doctor on call will advise the caller on health issues free of charge. The time is ripe for our Health Ministry to create a similar service: it will benefit most of the average educated people by providing such information.
Cholesterol is not something alien to the body. It is needed and found in all cells. The brain, heart muscles, liver, nerve cells, and others, are full of cholesterol needed for their normal metabolic functions. Cholesterol is also required for hormones (including sex hormones), bile acids, and in conjunction with sunlight manufactures vitamin D, a most vital vitamin for survival. This applies to saturated fats, too.
Cholesterol — good and the bad, uses the blood stream as a pathway to transport it, to the respective organs. The amount that is circulating in the blood stream at a time is less than 7% of the total amount in the body. It is like lorries transporting bags of cholesterol through the roads to the required sites. These lorries may have a bag or two packed carrying an extra load, why worry about it!
The theory is that when a few bags of cholesterol fall on the way side, they tend to block the road.
Do they really block the road or are there alternate blocking material already settled in to block the road: that would be the million dollar question.
Autopsies (examination on corpses), consistently show no relationship between blood cholesterol level and the amount of plaques (mounds) in the arteries. According to Dr. Earl Benditt’s group at the University of Washington arterial plaques begin as changes to the smooth muscles lining the arteries. These smooth muscles proliferate, become fibrous (hard), and eventually manufacture their own cholesterol. This gives clear evidence that high cholesterol level in the blood does not influence plaque formation. Furthermore, even if cholesterol gets deposited in the plaques, it takes place irrespective of the amount of cholesterol you consume in your diet.
Dr. Paul Rosch, MD, a clinical professor of medicine at New York Medical College, is of the opinion that half of all heart attacks occur in people with normal cholesterol levels.
He further believes that stress has more deleterious effects on the heart than cholesterol.
High blood cholesterol is said to promote hardening (atherosclerosis) of blood vessels and cause coronary heart disease. But studies have shown that people whose blood cholesterol is low becomes just as atherosclerotic as people whose cholesterol is high. 60% of people who have coronary heart disease have low cholesterol levels.
There are many other factors that can cause heart disease. Those factors are ignored and cholesterol seems to be blamed as a single factor for heart disease, according to the studies. This is how vested interests could influence researchers in such trials.
The giant drug companies manufacturing these drugs, through their well maintained researchers are made to propagate the theory that cholesterol is the culprit. Every month one or more prestigious medical journals will carry cholesterol papers extolling the virtues of cholesterol drugs.
Manufactured in the liver
In reality this is far from the truth. 80% of the daily requirement of cholesterol is manufactured in the liver. Saturated fats in the diet play an important part in this manufacture, too.
In the liver Acetyl-CoA from sugars and fatty acids are converted to HMG-CoA. HMG Co-A is converted to mevalonate, which is then converted to isoprene and coenzyme Q10. Isoprene is then converted to squalene which forms cholesterol. Bit confusing, isn’t it?
Statin drugs partially block the enzyme HMG-CoA reductase which is necessary to convert HMG-CoA to mevalonate. Fortunately, statin drugs are not potent enough to totally block the cholesterol cycle. If that happens you would die suddenly of cholesterol starvation.
The liver has on its own a ‘homeostatic’ mechanism to maintain a balance of all the biochemical activities in the body. If you eat less cholesterol, the body, including the liver merely compensates by making more. The ‘Vegans’ would be dead if there was no such mechanism. Although the media and food companies still warn against cholesterol in diet, it has been repeatedly demonstrated that the level of cholesterol in your blood is affected very little by the amount of cholesterol you eat. You are allowed to consume on an average 300mg of cholesterol in food daily.
For example an egg has 190 mg of cholesterol (70 cal), and one could easy afford to eat an egg per day. The other food you eat with cholesterol would be the meat, butter and dairy products. Think how much of them you consume daily? Forget thinking about cholesterol and enjoy your food without inhibitions and hang-ups. Just take care not to eat too much of saturated fat in meat.
Side effects of statin drugs
Side effects after taking statin medication regularly are rare. It affects only about 2 % of the population taking the medication. Presently, more and more people are experiencing side effects by taking statins for long periods.
When you are on statin drugs you could develop muscle pain, weakness, fatigue, peripheral neuropathy, numbness of the extremities like fingers and toes. A more serious side effect would be Rhabdomyolysis (wasting of muscles), a potential fatal muscle disease. Besides muscle pain, the other major symptom of rhabdo-myolysis is dark, red, or cola coloured urine.
You must see the doctor if early side effects are experienced. You may think that those side effects like joint pains, muscle aches, especially when sleeping may be side effects from other medications you take, or from some other disease affecting your body, and may want to get more medicine from the doctor for those symptoms.
First, before you see the doctor, stop the statin for a few days and observe whether the side effect symptoms subside, and then decide to see the doctor.
Really speaking, stopping statins will be good for your health.
To be continued next week
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Really good article. Thank you.
Please do a follow up article on homocystine and its’ relationship to health management. tatins vs. folic acid, B6 and DHA..
Please do a follow up article on homocystine and its’ relationship to health management. Statins vs. folic acid, B6 and DHA..
Excellent article which highlights an example where drugs are given to patients without any real science behind it. A “cholesterol scare” has been craftily stage managed so that the layman is led to believe that blood cholesterol is the primary cause of atherosclerosis, when in fact so many factors are involved. Thank you sir for this article which needs to be very widely circulated.
Very good post. Hope to see a lot more good posts in the near future.