Statins are prescribed to over 200 million people across the globe in an effort to prevent and lower your risk of cardiovascular events like heart attack, stroke, and heart disease.
For people with diabetes, who inevitably face a higher risk of these heart-related conditions, statins could be beneficial but recent research suggests they may actually worsen insulin resistance and increase the likelihood of prediabetes becoming type 2 diabetes.
In this article, we’ll look at the proposed benefits of statins, the side effects, and the research comparing the benefits vs. the risks, especially regarding insulin resistance.
What are statins?
Statins are a class of drugs designed to lower your LDL (also known as “bad”) cholesterol.
Your LDL cholesterol essentially encourages the buildup of fat in your arteries (also known as atherosclerosis) which increases your risk of heart attack and stroke because it narrows your arteries and impairs healthy blood flow, explains the American Heart Association.
LDL goal: less than 100 mg/dL (2.60 mmol/L)
Your HDL (“good”) cholesterol carries LDL cholesterol away from your arteries and to your liver where it is broken down and eventually excreted from your body. Your HDL cholesterol can eliminate about 25 to 33 percent of your LDL cholesterol. And too little HDL cholesterol is dangerous to your heart health, too.
HDL goal: more than 60 mg/dL (2.60 mmol/L)
In fact, your body needs both types of cholesterol in order to function.
According to the Cleveland Clinic, statins also improve the function of the lining of your blood vessels, reduce inflammation, and repair existing cell damage from oxidative stress. They also prevent your blood from clumping together which reduces your risk of a blood clot.
The American Heart Association (AHA) recommends statins for patients who are:
- 40 to 75 years old with LDL levels between 70 to 189 mg/dL
- a history of cardiovascular issues including heart attack, stroke, chest pain, peripheral artery disease, or transient ischemic attack
- 21 years or older with LDL levels of 190 mg/dL or higher
There is a great deal of ongoing controversy over the safety and benefits of statins. Many in the medical world wholeheartedly support the use of statins, but just as many argue adamantly against them.
Let’s take a closer look at the side-effects and research.
Side-effects of statins
For some, especially those with a “statin intolerance,” the side-effects of this drug can be unbearable. For others, the side-effects are minimal.
Common side-effects include:
- Muscle pain — especially in athletes
- Upper respiratory symptoms
- Liver function abnormalities
- Fatigue and exhaustion
Research: the benefits of taking statins
There have been many studies seeking to identify the benefits and risks of taking statins. Like many medications, research can be found both supporting and dissuading the use of this medication.
Both the American Diabetes Association and the American Heart association acknowledge the risks associated with taking statins but argue that the benefits outweigh the risks.
They also emphasize the theory that patients who developed type 2 diabetes after starting statin therapy were already facing a high-risk of the disease, and likely would have developed it anyway.
One of the most significant studies demonstrating the benefits is the Jupiter Trial, which involved 15,000 patients.
“The trial showed that compared to patients taking the placebo, patients taking a statin had a 54 percent lower chance of heart attack, 48% lower chance of stroke, 46 percent lower chance of needing angioplasty or coronary artery bypass surgery, and a 20% lower chance of dying from any cause,” explains the Cleveland Clinic of the trial.
Another study, Prove IT-TIMI 22, looked at the benefits of statins in patients who had already experienced an acute cardiovascular event, and whether lowering their LDL levels well below 70 mg/dL were more beneficial than lowering to just below 100 mg/dL.
The results showed patients taking a statin in this group had a significantly lower risk of death, heart attack, or stroke.
Research: the risks of taking statins
People with diabetes are frequently encouraged to start statin therapy because common issues that come with high blood sugars (like obesity and high blood pressure) dramatically increase your risk of heart disease, heart attack, and stroke.
If taking a statin worsens your insulin resistance, is it truly improving your health?
Patients taking statins could see a significant increase in their risk of developing type 2 diabetes, according to research published in Diabetes Metabolism Research and Reviews.
The increased risk of diabetes is the direct result of two factors: worsened insulin resistance and rising blood sugar levels.
“Other past research, with 150,000 female participants, revealed a 71 percent increased risk of diabetes,” said Dr. Alexander Reeves, MD, a neurologist and former professor of neurology at Dartmouth Medical School who speaks around the world on the dangers of statin therapy.
Reeves is adamant that the risks of taking statins do not outweigh the benefits.
He also pointed to five major studies on statins that, when combined, essentially determined only one death from a heart attack or stroke would be prevented if 129 patients were treated with statins for 640 years. Undermining the entire argument that reducing high LDL cholesterol levels reduces a patient’s risk of a heart attack.
“This recent study from Ohio State also took for granted that lowering cholesterol with statins was considered a major benefit based on the flawed use of the ‘relative-risk’ reduction,” he added.
“Knowing the real stats makes it ludicrous to prescribe statins,” said Reeves, “and the increased incidence of diabetes is only one of many deleterious effects of this drug.”
Other risks of statin use include an increase in the likelihood of congestive heart failure, CoQ10 depletion, depression, and anxiety.
Congestive heart failure
The other research, in contrast, demonstrates that simply reducing cholesterol levels not only has little impact on a patient’s risk of a heart attack but also severely increases their risk of other health issues, including congestive heart failure.
“Congestive heart failure (CHF) is now the most common cause of hospitalization in the 65 and older population,” said Reeves. “The prevalence of CHF increased 230 percent between 1980 and 2006 during which time statin use also grew almost exponentially, in the absence of any other major significant potential etiology, with the exception of type 2 diabetes, which was also increasing at an epidemic rate.”
The CHF “epidemic,” suggested Reeves, parallels the rising use of statins which are now estimated to be used by ¼ to ⅓ of all adults over 45 years old.
Depleting CoQ10 — linked to Parkinson’s, diabetes, heart issues
Other identified consequences of taking statins include your body’s “ubiquinol” levels, which is better known as CoQ10. This coenzyme is a critical part of any human or animal’s wellbeing, and statins have proven to drop CoQ10 levels in the body by as much as 50 percent, explained Reeves.
Present in every cell of your body, CoQ10 is necessary for the maintenance and production of energy. It’s found in concentrated amounts in the tissue of your heart, brain, kidneys, and muscles. It’s also a powerful antioxidant and fights-off free radicals that would otherwise damage your cells and DNA.
“Significant disabilities might occur quickly in some, or it can take years in others when CoQ10 levels drop this severely,” said Reeves.
Low levels of CoQ10 have been linked to diabetes, Parkinson, and other heart problems. In patients who began taking statins prior to developing any of those conditions, experts skeptical of statins postulate that the drug may have contributed to its onset.
A 2015 study from Japan suggests that not only do statins have little or no impact on preventing atherosclerosis, but this drug may also actually cause the buildup and hardening of fats, cholesterol, and plaque in your arteries — increasing your risk of a heart attack or stroke.
“The epidemic of heart failure and atherosclerosis that plagues the modern world may paradoxically be aggravated by the pervasive use of statin drugs,” explained the study.
“In my own — and many of my colleagues’ — experience with patients, very few statin users are also taking ubiquinol or ubiquinone, two different forms of supplemental CoQ10,” said Reeves. “And they clearly should be.”
Treating other unpleasant side-effects of statins with CoQ10 has been researched, including one of the most significant: muscle pain.
Another common issue statin users face is muscle pain — something supplemental CoQ10 has the potential to help alleviate.
“A significant percentage of heavy-duty endurance and resistance-trained athletes taking statins develop muscle pain, and not surprisingly, quickly stop taking the drug,” said Reeves, referring to a variety of research on the topic of statin use in those who exercise. (1, 2, 3)
In contrast, patients who are not active less likely to show symptoms of muscle pain.
Depression and anxiety
Statins have also been associated with depression and anxiety because of the drug’s impact on serotonin levels.
As a neurologist, Reeves added that the incidence of suicide, irritability, and aggression have all been associated with low cholesterol levels because cholesterol plays such an important role in the “interneuronal communication” — which is how neurons in your brain communicate with each other.
Why your body needs cholesterol
In addition to lowering LDL cholesterol, statins also significantly decrease a patient’s concentration of “good” HDL cholesterol, which plays a critical role in transporting “maintenance cholesterol” throughout the entire body where it replenishes necessary stores in your body’s tissue, cell walls, and membranes.
This distribution of cholesterol also plays a vital role in hormone and enzyme production, explained Reeves, and in reducing and managing acute and chronic inflammation.
“Your liver produces cholesterol because every cell wall in your body depends on it,” said Reeves. “Without cholesterol, you melt. You die. Cholesterol is anti-inflammatory. When you have inflammation in your body, cholesterol levels go up to help manage that inflammation.”
This means a patient with other health concerns or unhealthy habits may show high cholesterol levels in their routine lab work and be treated for high cholesterol rather than being treated properly for those other issues.
Then, by reducing cholesterol with the use of statins, the patient’s overall inflammation may actually grow worse which in turn could worsen health concerns like insulin resistance and blood sugar levels.
When you consume enough cholesterol, your body actually backs off on its own production.
“And finally,” adds Reeves, “it’s not a surprise that it has now been observed that the elderly with the highest cholesterol levels — HDL and LDL — have the greatest longevity.”
Should you stop taking statins?
Unfortunately, determining whether or not you should continue taking statin drugs is tricky. Depending on who you ask, you’ll get a very different answer.
Most likely, mainstream cardiologists and endocrinologists will encourage you to take statins.
If you speak to a more progressive medical professional, you may find encouragement to stop taking statins while focusing on improving your HDL cholesterol naturally and letting it improve your LDL, also naturally.
Instead of statins
Whether or not you continue taking statins, you’ll want to focus on improving your HDL, and blood sugar, and insulin sensitivity.
Natural ways to increase your HDL, according to Reeves, include:
- Get regular exercise
- Quit smoking
- Follow a Mediterranean-like diet
- Eat mostly whole foods (especially vegetables!)
- Decrease processed foods
- Get omega-3 fatty acids from seafood or a supplement
- Eat cholesterol from fresh, organic, cage-free eggs
- Drink the occasional glass of red wine
- Reduce heavy alcohol consumption
As with most aspects of improving your health, the same habits apply to your cholesterol levels. Make a commitment to improving your habits and you will inevitably improve your cholesterol, your insulin sensitivity, and your blood sugar levels.