An estimated 38 million North Americans are candidates for statin drug therapy for cholesterol lowering, and this number is expected to increase over the next few years. The statin drug class includes well-known drugs such as Lipitor (atorvastatin) and Zocor (simvastatin).
Statins work by reducing the ability of the liver to make cholesterol. These drugs reduce total cholesterol levels by 15-35% and LDL-cholesterol (the bad cholesterol) by 25-50%, and have resulted in decreased mortality rates due to cardiovascular disease (CVD).
In Britain, the popularity of these drugs has been so great that lower doses of certain brands are now freely available over the counter in order to decrease health care costs due to prescription coverage. Recently, scientists have shown that the statin drugs may also decrease levels of certain inflammatory agents, which may further decrease risk for CVD.
Although there are many positive reasons for the use of statin drugs, these compounds may cause detrimental effects on depletion of certain nutrients in the body, some of which may be cardio protective. These include the antioxidant coenzyme Q10 (CoQ10) and the omega-3 fatty acids eicosapentaenoic and docosahexaenoic acids (EPA and DHA). In addition, studies suggest that individuals following the American Heart Association’s (AHA) low fat, low cholesterol diet further reduces their intake of certain vitamins and minerals.
CoQ10 is an antioxidant found naturally in our body, and is considered to be an anti-risk factor for cardiovascular disease. CoQ10 is derived from the same biosynthetic pathway as cholesterol, thus inhibiting the synthesis of cholesterol also results in the inhibition of CoQ10 synthesis. Lower levels of CoQ10 in our body can have negative effects on the oxidation of LDL cholesterol and may cause other detrimental heart concerns. Furthermore, some of the side effects of the statins (i.e. exercise intolerance and muscle pains) may be due to a CoQ10 deficiency. Fortunately, statin-induced CoQ10 deficiency is preventable with CoQ10 supplementation and there does not appear to be any negative effects of CoQ10 supplementation on statin-induced cholesterol lowering.
Omega-3 fatty acids, including EPA and DHA are cardio protective fats found mainly in fish and fish oils. Supplementation with fish oil, and high dietary intakes of these fats, has shown to decrease levels of triglycerides, another CVD risk factor, and to decrease CVD risk. Simvastatin use has been shown to increase the ratio of arachidonic (an omega-6 fatty acid) to EPA (an omega-3 fatty acid) in blood. Use of statins and omega-3 fatty acids together may further reduce levels of cholesterol and other CVD risk factors, reducing CVD risk over statins alone.
The AHA recommends a low fat, low cholesterol diet to anyone with high cholesterol levels, even if on statin medication. These diets contain more than enough of most vitamins and minerals. However, studies have suggested that individuals on this diet may be consuming inadequate intakes of certain vitamins, such as vitamin E, as well as various minerals including calcium, iron and zinc. In addition, consumption of this type of diet may actually increase levels of blood triglycerides.
Although statin use may be beneficial to many individuals, it appears that supplementation with certain nutrients should be considered to prevent deficiencies and to further reduce CVD risk. For more information on how a health assessment can help you determine your specific supplementation needs based on your prescription medication use, please visit www.onepersonhealth.com and complete a health assessment today.
Dr Conquer is a University Professor of Human Biology and Nutritional Sciences. Dr. Conquer is an expert in the field of Nutrigenomics – the study of genetics and its impact on nutrition and continues pursuing her passion in this field, as an education and researcher in Ontario Canada.