How Statins Work: What Statins Do and Are They Safe?

11/03/2017 | 6 min. read

Dr. Stephen Sinatra

Dr. Stephen Sinatra

How Statins Work

I’m often asked how statins work. This is a very good question, since there’s a huge difference in the way people think they work, and the real reason they can benefit your heart.

What are statin drugs? Statins are potent anti-inflammatory medications also known as HMG-CoA reductase inhibitors. Statins are by far the most aggressively marketed and popular cholesterol-lowering drugs.

The most often prescribed statin drugs include:

  • Zocor (simvastatin)
  • Lipitor (atorvastatin)
  • Mevacor (lovastatin)
  • Pravachol (pravastatin)
  • Lescol (fluvastatin)

In clinical studies, statins have shown significant reductions in coronary events such as heart attack, bypass, and hospitalization. But while statins can benefit your heart, I’ve long maintained that they can be a blessing and a curse since statins can have a tremendous downside.

Are Statins Good for You?

To determine if statins are good for you, you need to first understand how statins work. Statins work by blocking the enzyme pathway that leads to the creation of cholesterol in your liver. That’s why statins are effective at lowering cholesterol numbers. But lowering cholesterol isn’t the true reason statins can benefit your heart.

The real benefit of how statins work is that they are anti-inflammatory agents. So, in theory, if you take an anti-inflammatory like a statin drug, it could do some good. The other thing a statin does is it changes the shape of red blood cells, making the blood less viscous or sticky. The term for that is called “blood rheology.” The important takeaway here is that statins work in two ways: they are strong anti-inflammatory agents and they make the blood less sticky.

Are Statins Effective?

There are cases where I wholeheartedly think statins are effective. But I also believe strongly that statins are not for everyone.

Are statins good for you? Statins are good for you if you: 

  • Have advanced coronary disease
  • Are a male under 75
  • Are a female with advanced coronary artery disease that is getting out of control

So, in other cases are statins bad? They can be. I almost never recommend statins to young women or even children with high cholesterol. That’s because, for this group of people, the side effects of statins far outweigh the benefits. So, there is a time and place when I think statins are good and I wouldn’t hesitate to use them, but only if you fall in one of the populations I mentioned.

Are Statins Safe to Take?

If you’re wondering “are statins are safe to take,” it’s important to know that statins have a dark side. If your doctor tells you to take a statin medication, you need to make sure you know all the facts about statins first. Despite positive results in some patients, you need to be careful because statins can be bad. 

Some common side effects of statin drugs are:

  • Weakness of limbs and hands
  • Muscle pain
  • Liver problems
  • Stiffness
  • Fatigue

Plus, there are other side effects associated with statins such as gastrointestinal problems, erectile dysfunction, memory problems, and diabetes. Research has also come to light showing that statins can accelerate aging. This is another reason I don’t recommend them, particularly in men over 75, unless they have a coronary problem with advanced coronary disease.

In one study published in the American Journal of Physiology, researchers at Tulane University examined the impact of treating stem cells with statins. What this study revealed is that statins damage stem cells by keeping them from replicating as they normally should. This is important because stem cells are what protect our joints, brain, as well as our muscles from damage—the same systems in our bodies that are greatly impacted as we age.

Are Statins Bad?

One of the many problems with statin medications is that they interfere with the body’s production of Coenzyme Q10 (CoQ10), a natural substance that’s critical for cellular energy production. A Swiss study showed subtle muscle cell damage—even in the absence of symptoms.

The secret to how statins lower cholesterol is that they intercept about 20 different biochemical pathways, including the pathway for CoQ10. That’s why it’s absolutely critical that if you take a statin you want to chase it down with CoQ10.

I have long believed that CoQ10 is one of the most important nutrients to protect your immune system. I couldn’t imagine practicing medicine without it. CoQ10 is responsible for energy production in every cell in your body, which is especially critical for the heart since it consumes more energy than any other organ in your body. If you don’t have sufficient CoQ10, this can be taxing on your heart, and you notice a decline in your energy level.

So while there’s data in favor of statins for people with both high cholesterol and advanced heart disease, statin drugs definitely aren’t for the majority of the population. And far too many people are being prescribed statins unnecessarily for high cholesterol.

Are Statins Harmful?

Using statins to lower a cholesterol number is just bad medicine. Cholesterol does good things for the body and, in most instances, cholesterol is your friend and not your enemy. It’s unfortunate that cholesterol has been wrongly vilified for years. The truth is, your body requires cholesterol for your immune system to stay healthy, your brain to function properly, and more. In fact, driving your cholesterol too low with statins can have significant consequences for your health.

A few years back, the Food and Drug Administration (FDA) required makers of cholesterol-lowering statin medications to put new warnings on the label—in particular, that these drugs increase the risk of developing type 2 diabetes and memory loss/confusion. I applaud the FDA for finally looking out for consumers and warning the public about the dangers of statins, but I wonder what took them so long.

Are statins harmful to your brain? The issue of statins and memory loss hasn’t gotten as much attention, and quite frankly isn’t cut and dried. The reason statin medications can affect the brain is that cholesterol is critical for the formation and function of synapses, which are the structures between neurons in the brain that enable you to think and process information. When you take away the brain’s supply of cholesterol, it’s almost impossible to think.

The Bottom Line on Statins

Are statins effective? In my opinion, the only people who should be on statin medications are males younger than 75 with coronary artery disease. In those cases, statins can be good and the benefits outweigh the potential risks. The main benefits are not statins’ ability to lower cholesterol but rather their anti-inflammatory and blood-thinning properties.

Are statins harmful? If you are a younger to middle-aged woman, stay away from statins because the benefits are not worth the risk.

If you’re on a statin drug, it is imperative that you take it in conjunction with CoQ10, because statin medications deplete the body of this critical nutrient. That’s a core side effect of how statins work. At the very minimum, you’ll want to take 200 mg of highly-absorbable CoQ10 in divided doses with your statins.

Keep in mind: Memory issues—and the whole host of other side-effects caused by statins—don’t necessarily disappear when the drugs are stopped. But with patience and the right combination of nutrients, you can turn those unwanted side effects around.

Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy.

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