Statins cut cholesterol but what about the sinister side-effects? Could statins, the cholesterol-lowering drugs taken by tens of millions, be doing more harm than good to many thousands of people? This is the rather alarming suggestion to emerge from two new studies.
Readers are reminded that this article is directed solely at the cognitive loss and personality change type of adverse effect caused by statin drugs. No mention is made of neuropathies, myopathies and neuro-degenerative consequences which taken together comprise far greater problems.
The research challenges the medical convention that lowering your cholesterol is always a good thing - indeed, they suggest statins may affect intelligence, cause depression and even raise the risk of suicide. A growing body of evidence now says that having low cholesterol levels may prove as dangerous as having high readings.This has huge implications for proposals to offer statins to all men over 50 and women over 60, even if they don't have a high cholesterol count.
There is no doubt about the ability of statin drugs to lower cholesterol but cholesterol is also produced by the brain, where it is used to release vital chemicals called neurotransmitters that carry messages between brain cells. Now a study by Iowa State University suggests that statins inhibit this vital process.
When brain cells are deprived of cholesterol, they are five times less effective at releasing chemical messengers, says the research, published in the highly respected journal Proceedings Of The National Academy Of Sciences. "If you deprive cholesterol from the brain, then you directly affect how smart you are and how well you remember things," says Yeon-Kyun Shin, the biophysics professor behind the study. "This may lead to depression and irrational acts." He believes this is directly caused by disruption in the neurotransmitter release in the brain.
Many people believe statins were implicated in the suicide in April 2007 of London teacher Allan Woolley. After being prescribed the drug simvastatin, the housemaster at University College School in Hampstead complained of blackouts, insomnia and nightmares before he then killed himself by standing in front of a train.
His family and friends said his death was completely out of character. The coroner ruled that the drug 'was involved' in his suicide. Statins have been implicated in a surprising number of suicides, however, this relationship is vastly under-reported because of general lack of awareness of the possible cause and effect.
Shin's findings reinforce another new study, which found that men with a combination of low cholesterol and depression are seven times more likely to die prematurely from suicide, accidents and other unnatural causes than men with only depression. Scientists who followed nearly 4,500 Vietnam veterans over a 15-year period say the disturbing findings may be due to low blood cholesterol reducing levels of the brain's feel-good chemical messenger, serotonin.
Low serotonin is linked to depression, anger, sleep loss and other problems, says Dr Joseph Boscarino, of the American Geisinger research institute, who did the research. While doctors generally believe that having low cholesterol is a good health sign, an artificially low cholesterol achieved by the use of statin drugs may not be. Combined with other factors, it can actually put a person at risk, says the report.
These reputable studies show how people with markedly low levels of cholesterol are more likely to die from a variety of causes, including strokes, certain cancers, liver disease, lung disease and suicide. The deaths from these other causes mount so quickly that the mortality rate for those with low cholesterol equals the rate for people with very high cholesterol.
One report claims that women on low-cholesterol diets may face infertility problems. This small study of 300 patients by the Toronto Infertility Clinic says that cholesterol is essential for creating the sex hormones estrogen and testosterone. Other U.S. research found that women with low cholesterol could be twice as likely to suffer from depression or anxiety problems.
Even more worrying, studies of older people have found that those on low-cholesterol diets have a much higher rate of stroke, possibly because cholesterol has a protective effect in mature brain linings. But the link between low cholesterol, decreased serotonin and dangerous behaviour is particularly strong and disturbing. A study of 80,000 Swedes, for example, shows that men who murder in a fit of rage tend to have below-average cholesterol.
Irish doctors report that cholesterol levels are significantly lower in people who have been admitted to hospital after harming themselves. A large number of serious assaults have been unofficially tied to statin use. At least one elderly man is now jailed because of failure of the courts to accept any possible relationship of his homicidal act with the statin he was taking. The possible effect of a statin drug on the mind appears unbelievable to a legal system thoroughly enmeshed in "effects of alcohol" litigation. Is there any real difference here?
Although there is no doubt that statins are life-saving drugs for people who have already had a heart attack, research shows that in people over 69 who've had no symptoms of diabetes, angina, stroke or heart attack, statins don't reduce mortality. Many doctors feel we must be careful with this "everyone needs a statin" mentality. We are learning that the side effect risk is much too great for such liberal views.
Thousands of people have suffered memory loss with statins - some people have been unable to even recognise their spouse - yet the problem has disappeared after they stopped taking the drug. Yet rather than investigating the disturbing links with statins further, the medical establishment has largely hushed, ignored or discredited them, for fear of confusing the 'high cholesterol is bad' message.
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor