By Duane Graveline MD, MPH
Statins and Mitochondrial Damage Part 4 of 11
The results of longitudinal studies had strongly suggested the presence of non-cholesterol factors from observations of a positive cardiovascular protective effect to be evident in many studies even when cholesterol failed to respond to statins and, of course, new myocardial infarction cases consistently showed that 50% had normal to low cholesterol values.
These observations have made most objective researchers, like Kilmer McCully (6) seek other, non-cholesterol factors such as inflammation due to homocysteine elevation as a major cause of atherosclerosis. Transfats, oxycholesterol, cigarette smoking and hidden chronic infections are other well-known triggers to inflammation. This is further supported by the more recent demonstration of a solid relationship between CRP ( C- reactive protein elevation ) a measure of inflammation, and underlying cardiovascular risk.
My second book, Statin Drugs Side Effects, continues to be very relevant and mevalonate blockade remains a major cause of side effects, but something new has been added.
Recently, I began to ask the question, "Why do the neuropathies, myopathies and other neurodegenerative conditions resembling ALS become permanent? If CoQ10 deficiency played such a major role in the etiology of these conditions, why is it that these conditions persisted despite vigorous attempts at restoration of CoQ10? What was causing this failure of response in so many cases?
This is a fair question and a reasonable answer was long in coming but finally it came, and the answer was mitochondrial mutations. This is when I discovered that although mevalonate inhibition of CoQ10 may have played a major role in causing the initial problem, the mitochondrial change it triggered had made the condition permanent! Now, even an over-abundance of CoQ10 could not reverse the course. This made sense to me, and I soon found plenty of support from the research community.
I knew I was on the right track with my third book, the Statin Damage Crisis (7), loaded with information of particular value to those having permanent side effects from their prior statin use. This is now a crisis, for to give statins without also giving CoQ10 is to invite disaster.
Other countries such as Canada had specifically warned of this and strongly advised CoQ10 supplementation from the very beginning. The United States did not. This has been the cause of thousands of cases of permanent damage and disability from statin use.
Few knew of Merck's request to the U.S. Patent Office back in 1990 (8) for the addition of CoQ10 to their new (then) statin, lovastatin, commonly known as MevacorTM. If the vigilant media took special interest in this unusual request on the part of a drug company, I must have missed it. Merck cited "for the reduction of the anticipated inflammation to come" as their justification for change and when their patents were granted, promptly shelved them, and went on about the business of selling plain MevacorTM. No more was ever said about CoQ10 until Julian Whitaker MD first raised the issue (9).
Then in the era 2005-2007 came news about cholesterol's possible irrelevance. "You mean I can eat eggs and butter again?" Statins worked, we were gradually discovering, not by cholesterol reduction but by their powerful anti-inflammatory action. Atherosclerosis was basically an inflammatory process starting first in the subendothelial region of our arteries and demonstrating the four major elements of inflammation: platelet activation, monocyte adhesion, macrophage attraction and smooth muscle migration, all inhibited by statin's novel anti-inflammatory action.
Now the proper treatment began to involve the use of anti-inflammatory agents. Study after study proved this effect of statins. Yes, aspirin has a very similar effect, justifying the use of the term, super-aspirin, in vogue for a while to describe statin action.
The drug companies were quick to inform us that statins worked better than anything else we had for vascular inflammation, and could be used successfully for almost anything having an inflammatory component such as auto-immune diseases and organ transplant rejection, but they made certain to keep the waters muddy with respect to cholesterol.
After four decades of brainwashing and almost two decades of use, what doctor seriously wanted to accept a new inflammatory hypothesis? How do you tell your patients you have been wrong all this time? What doctor could do this gracefully?
Our new cholesterol disease was rapidly disappearing. In its place was rising a new edifice to the role of inflammation. How best to handle this confusing fact from the viewpoint of the drug industry - pretend it isn't happening! Keep the doctors focused on cholesterol as long we can, for billions of dollars are at stake. If we play our cards right, we might slide cholesterol out and inflammation in, and never miss a statin sale. As to the side effects of statins, we will pretend we do not hear them.
6. McCully K. The Homocysteine Revolution. Keats, 1997
7. Graveline D. Statin Damage Crisis. 2008
8. Merck Patent No. 4,929,437 and Patent No. 4,933,165. 29 May 1990
9. Whitaker J. Life Extension Magazine. May 23, 2002
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor
Updated September 2013