The headline is broadly defensible, but the qualifications matter. Effect sizes vary by population, the strongest claims rest on shorter trials, and credible voices push back on how it's typically framed.
there's a narrower subset of people that um do do do get brain fog and do experience brain frog from statins and and we don't really understand the why there we have some theories as to why you know maybe they're maybe they're getting too much of a reduction in central cholesterol synthesis
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there are some and again this is kind of the nuance of manipulating the lipid system with statins there are some studies that suggest that like on a really large scale you know maybe statins slightly reduce dementia risk but there's just so much nuance in there in terms of this type of statin the type of person you know whether you're completely suppressing their cholesterol production in their brain and if you're doing that you're definitely gonna increase your risk of dementia
the DES master all is an indication of how much cholesterol our bodies are making and in carnivores people want ketosis I always see an elevated this monster all because these pathways are being activated and these pathways are shared between ketogenic pathways and cholesterol pathways that is what happens we make more cholesterol that's why LDL goes up on these diets so the DES monster all is not something to worry about it's gonna be high I don't think it's something that most people need to get but is an interesting thing it's probably relevant if you're honest and to get it as master all level because a low des monts raw level would be problematic and as I talked about in the podcast with Tommy would the brain has its own supply of cholesterol it's not made in the periphery and transported across the blood-brain barrier so if you have low peripherals as master all you worry that if the statin is crossing the blood-brain barrier which is what it would do if it were a lipophilic statin you would inhibit the production of this master all they're inhibiting the production of cholesterol in the brain would be a very bad thing because it's needed for membranes and cellular metabolism
because of the limited but to me quite convincing data on the plausibility of Alzheimer's disease in patients with overly suppressed cholesterol synthesis
are you concerned that statin use even though at the population level statin use is always associated with a lower risk of dementia that in certain individuals it can exacerbate it I hate to say this but yes
it's probably the patients in whom we overly suppress synthesis for whom they don't make that much even with suppressed cellular synthesis which has nothing to do with the amount of cholesterol you measure in the blood
there are going to be a subset of patients whose risk of dementia does go up with a statin
to the extent that statins do sort of impair a cell's ability to make cholesterol it does that not only in the liver that makes it mostly cholesterol but also in the brain and people say it doesn't matter about getting cholesterol too low because cells can if your brain makes its own cholesterol if it does if it needs it if it's not poisoned the hmg isn't poisoned by the statin but if it is that gets into the brain and it can't make its own cholesterol and when you look at demented people they have lipid depleted brains
my hypothesis nowadays is these small number of people who get brain fog I wish I had disero levels on them could some people be very sensitive to the effects of a Statin we know in the periphery hyp synthesizers of cholesterol respond incredibly well as that and so excuse me over synthesizers do hypos synthesizers do not
I think if you were somebody who could measure 24s hydroxy cholesterol in the serum you would not see it in somebody who had cholesterol synthesis suppression in the brain