STATINS: Should you take them?

PS

Paul Saladino1h 34m · 2022-08-30

Claims Made

178

Claims Supported

75

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42%

Support rate

75 of 178 claims supported

75 supported103 partial / not

Claims from this content

138

Well SupportedThe Rotterdam Study indicated a correlation between higher intake of Vitamin K2 and improved health outcomes.Well SupportedWhen Framingham data is not stratified by metrics associated with insulin resistance, LDL cholesterol shows a linear correlation with cardiovascular disease incidence.Well SupportedAtherosclerosis does not develop in veins, suggesting that endothelial damage is necessary for its initiation.Well SupportedStatins inhibit HMG-CoA reductase in the liver, which is part of the mevalonate pathway involved in Coenzyme Q10 synthesis.Partially Supported

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A. Volkovreader

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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.

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Would love a "what would change this verdict" RSS feed. Sign me up if it exists.

Statins are HMG-CoA reductase inhibitors that interrupt the mevalonate pathway, critical for cholesterol synthesis.

Not SupportedStatin trials often exclude participants who experience side effects during a pre-randomization period, leading to biased results that do not reflect real-world outcomes.

Well SupportedDiabetics and insulin-resistant individuals have impaired immunity and wound healing.

Not SupportedNative LDL cholesterol alone is not sufficient to cause atherosclerosis.

Partially SupportedNo statin trial has had dementia as a primary outcome, but in trials where dementia was a secondary outcome, there was either no change or a reduction in dementia risk.

Partially SupportedChanges in trial guidelines in 2004 affected the assessment of statin efficacy.

Partially SupportedInsulin resistance or metabolic dysfunction may play a significant role in the accumulation of LDL in arterial walls.

Not SupportedMainstream cardiology largely ignores data suggesting the connection between ApoB and heart disease is significantly attenuated in the context of insulin sensitivity.

Well SupportedThe speaker eats an animal-based diet of organs, meat, fruit, honey, and raw dairy, which is considered the healthiest diet on the planet.

Well SupportedLDL particles play a valuable immune role and must be maintained at an optimal, wide-ranging level in the blood.

Well SupportedStatin therapy may reduce testosterone levels and aggravate symptoms of erectile dysfunction.

Partially SupportedA significant portion of the panel recommending lower statin prescription thresholds had financial ties to cholesterol-lowering drug manufacturers.

Well SupportedPeople with familial lipodystrophy develop significant atherosclerosis despite not having elevated LDL levels.

Not SupportedPhysicians' belief that LDL causes atherosclerosis is a grave oversight, and eliminating LDL could lead to severe consequences.

Not SupportedStatin use is associated with an increased risk of diabetes, with relative increases up to 363% and an absolute risk increase of 2-3%.

Well SupportedSaturated fat is essential for the human body and is associated with increases in HDL cholesterol and testosterone, and is a backbone for cholesterol molecule formation.

Partially SupportedChildren with Smith-Lemli-Opitz syndrome exhibit developmental abnormalities due to deficits in LDL particles and lack of cholesterol production.

Well SupportedThe speaker's LDL cholesterol is lower now than when on a ketogenic diet or earlier in their carnivore journey due to the addition of carbohydrates.

Not SupportedStatins may worsen diabetes by inhibiting the formation of heme and coenzyme Q10.

Well SupportedDihydro vitamin K1 can inhibit the formation of vitamin K2 in the human body.

Not SupportedPrescribing statins solely based on high LDL levels without considering all risk factors is a disservice to the patient.

Partially SupportedThere was a non-significant increase in deaths in the PCSK9 inhibitor arm of the Fourier trial compared to the placebo arm, despite very low LDL levels.

Partially SupportedAn animal-based diet high in saturated fat and carbohydrates exceeding 200 grams per day resulted in fasting insulin levels below 3 micro IU/mL.

Not SupportedAchieving LDL levels of 20-30 mg/dL would likely lead to significant health problems.

Partially SupportedStatin trials after 2004 showed minimal to zero absolute risk reduction in all-cause mortality.

Well SupportedApolipoprotein B (ApoB) containing particles like LDL and VLDL are important for carrying fat-soluble vitamins and antioxidants, and for cell membrane components, hormone building blocks, and immune response.

Well SupportedThe risk of developing type 2 diabetes from statins may be 2-4 times higher in women than in men.

Partially SupportedPaul Saladino's LDL is 533 mg/dL, LDL particle number is 3283 nmol/L, and LDL size is 24.7, with total cholesterol of 647 mg/dL and HDL particle number of 50.6 mcmol/L.

Partially SupportedLowering LDL in individuals with diabetes and damaged endothelium is reasonable, but correcting the root cause of diabetes is also crucial.

Partially SupportedIn the Fourier trial, patients treated with a PCSK9 inhibitor and statin achieved LDL levels around 33 mg/dL, compared to 90-100 mg/dL in the control group.

Partially SupportedStatins should not be routinely prescribed to individuals unless they exhibit insulin resistance, characterized by low HDL and high triglycerides.

Partially SupportedThe exact role of LDL in atherosclerosis, whether causative or protective, is not definitively known.

Not SupportedStatins may stimulate atherosclerosis and heart failure by decreasing key intermediates like prenyl pyrophosphate, HMG-CoA, coenzyme Q10, selenoproteins, and vitamin K2.

Partially SupportedIndividuals with Abetalipoproteinemia experience failure to thrive, fat malabsorption, vitamin deficiencies, and severe developmental issues due to the absence of ApoB-containing particles.

Not SupportedInterrupting the body's biochemical cascades with medications like statins may not be wise.

Not SupportedLifestyle changes can positively alter health outcomes despite genetic predisposition.

Partially SupportedObservational studies on statins are subject to healthy user bias.

Partially SupportedFor individuals with low fasting insulin, LDL is an indicator of inflammation rather than causative of atherosclerosis.

Partially SupportedReversal or halting of atherosclerosis is primarily driven by addressing insulin resistance and inflammation.

Partially SupportedMonacolin K, found in red yeast rice and oyster mushrooms, is a mycotoxin that fungi produce to deter predation.

Partially SupportedAtherosclerosis is observed in arteries but not in native veins, suggesting a factor beyond APOB is required for its initiation.

Partially SupportedPatients with the lipid triad (low HDL and high triglycerides) had significantly lower event-free survival in the 4S trial.

Partially SupportedStatin trials published before 2004 showed significant improvements in cardiovascular event ratios for both secondary and primary prevention based on LDL levels.

Partially SupportedDolichol is critical for insulin receptor function within caveolae in cell membranes.

Partially SupportedStatins may negatively impact erectile dysfunction due to their precursors being cholesterol-based.

Partially SupportedSome research suggests potential pharmacological mechanisms by which statins might stimulate atherosclerosis and heart failure.

Partially SupportedStatins were originally derived from monacolins, such as monacolin K from red yeast rice, which has led to recalls due to adverse effects.

Partially SupportedThere was no observed difference in the impact of hydrophobic versus hydrophilic statins on the incidence of dementia and Alzheimer's disease.

Partially SupportedLovastatin, the first statin approved in 1987, is a mycotoxin originally derived from a fungus found in red yeast rice and oyster mushrooms.

Partially SupportedMost physicians would recommend a statin for a total cholesterol of 254 mg/dL, triglycerides of 68 mg/dL, HDL of 64 mg/dL, and LDL of 179 mg/dL.

Partially SupportedThe incidence of statin side effects in clinical practice is closer to 30%.

Partially SupportedThe majority of statin trials are sponsored by industry, with the ALLHAT trial being a notable exception showing no significant benefit for pravastatin in primary prevention.

Not SupportedThe CTT collaborative's reviews of statin data advocate for wider statin use in healthy individuals over 50 regardless of cholesterol levels.

Partially SupportedMore frequent statin use was associated with accelerated progression of coronary artery calcium score in type 2 diabetes patients with advanced atherosclerosis.

Partially SupportedSelenoproteins are crucial for managing oxidative stress and redox balance.

Partially SupportedThe CTT collaboration has received significant pharmaceutical funding and does not permit third-party examination of statin side effect data.

Partially SupportedThe mevalonate pathway produces critical downstream intermediates beyond cholesterol, such as CoQ10, dolichol, and precursors for selenoproteins and vitamin K2.

Partially SupportedA high-saturated fat diet led to personal health improvements, contradicting cardiologist advice.

Partially SupportedStatins interrupt the body's conversion of vitamin K1 to vitamin K2 by interfering with mevalonate pathway intermediates.

Not SupportedStatins inhibit vitamin K2 synthesis, which can increase the risk of vascular calcification.

Partially SupportedIndividual health, longevity, and quality of life are primarily determined by diet, not solely by genetics.

Partially SupportedAn animal-based diet including meat, organs, fruit, honey, and raw dairy is evolutionary appropriate for humans and improves health without side effects.

Partially SupportedEight of nine members on the National Cholesterol Education Panel that revised guidelines in 2004 had financial ties to statin manufacturers.

Not SupportedThe funding and interests behind studies can manipulate data to make drugs like statins appear less harmful and more beneficial than they might be.

Not SupportedStatins may impair hippocampal synaptic plasticity and cognitive function.

Partially SupportedSelenoprotein P may be involved in insulin receptor signaling, and iodothyronine deiodinase is critical for T3 formation from T4.

Not SupportedThe speaker questions whether LDL and apob particles are directly causative of atherosclerosis, citing the lack of atheromas in captive animals.

Partially SupportedElevated LDL cholesterol and particle count for years should theoretically lead to atherosclerosis, but a zero coronary artery calcium (CAC) score indicates otherwise.

Not SupportedCardiovascular risk calculators are flawed because they treat age as a risk factor instead of insulin sensitivity.

Partially SupportedElevated LDL particle count or apob should be discussed with a doctor who considers context rather than reflexively prescribing a statin.

Partially SupportedChimpanzees have higher LDL levels than humans but do not develop arterial atheromas.

Partially SupportedIndividuals with glycogen storage disease type 1A have elevated LDL but do not show increased rates of atherosclerosis, contradicting the hypothesis that LDL is causative.

Not SupportedHeated or partially hydrogenated seed oils may be harmful because they can produce dihydro vitamin K1, which inhibits vitamin K2 formation.

Limited ResearchLipophilic statins like simvastatin and atorvastatin may pose a greater risk to cognition and memory than hydrophilic statins due to their ability to cross the blood-brain barrier.

Partially SupportedA coronary artery calcium (CAC) score is a tool for predicting cardiovascular risk.

Not SupportedFocusing solely on LDL without considering insulin sensitivity, HDL, and triglycerides is a mistake made by many physicians.

Not SupportedAchieving very low LDL levels (20-30 mg/dL) may have unaddressed problems not adequately considered by the Western medical system.

Partially SupportedNo single tablet can completely neutralize the health harm caused by unhealthy eating habits.

Partially SupportedAn LDL level of 250 mg/dL is desirable for insulin-sensitive individuals as it signifies greater delivery of cell membrane components, hormone building blocks, and participation in immune response.

Partially SupportedEndothelial damage is a prerequisite for atheroma formation.

Partially SupportedFeeding humans pure cholesterol does not necessarily lead to atherosclerosis.

Partially SupportedEffective methods to reduce heart attack risk include healthy eating, exercise, maintaining a healthy weight, and not smoking.

Partially SupportedStatin drugs are controversial due to serious side effects and require careful consideration of their benefits for humans.

Partially SupportedA statin medication should only be taken if it will prolong life and improve quality of life and no other health improvements are possible.

Partially SupportedAn animal-based diet including bone marrow, liver, and beef organs helped an individual reverse vasculitis and improve kidney function.

Partially SupportedEliminating seed oils and replacing them with olive oils was the most impactful aspect of the Diet and Leon Heart Study.

Partially SupportedSimvastatin therapy showed no discernible difference in outcomes out to 66 months for patients with isolated LDL elevation who did not also have low HDL and high triglycerides.

Partially SupportedDietary interventions like eliminating seed oils may be more effective for cardiovascular event risk reduction than statins and have no side effects.

Partially SupportedInhibition of HMG-CoA reductase by statins leads to decreased levels of dolichol, which can negatively affect the positioning and actions of the insulin receptor in cell membranes.

Partially SupportedAll-cause mortality is the most important endpoint when evaluating cardiovascular medications like statins and PCSK9 inhibitors.

Partially SupportedStatin use is associated with an increased prevalence and extent of coronary plaques possessing calcium, warranting further investigation.

Partially SupportedSome studies indicate statin treatment may decrease the risk of overall and hip fractures and increase bone mineral density.

Partially SupportedStatins' interruption of prenyl intermediates can lead to decreased formation of selenocysteine tRNAs, impairing the incorporation of selenocysteine into selenoproteins.

Partially SupportedStatins, with the exception of Pravastatin, can neutralize the cardiovascular risk associated with consuming a 7-ounce hamburger patty, quarter pounder with cheese, and a small milkshake.

Partially SupportedStatin treatment is associated with an increased diagnosis of osteoporosis, and this association is dose-dependent.

Partially SupportedGenetic conditions like Smith-Lemli-Opitz syndrome demonstrate potential negative consequences of extremely low LDL.

Partially SupportedUK general practitioners were reluctant to adopt the lower 10% cardiovascular risk threshold for prescribing statins.

Partially SupportedInsulin resistance is likely the root cause of atherosclerosis and may involve LDL but is not solely caused by it.

Partially SupportedFollowing 2004, all-cause mortality benefits in statin and PCSK9 inhibitor trials have decreased significantly.

Partially SupportedThe absolute risk reduction in all-cause mortality from the 4S statin trial was 3.3% with a 25% LDL reduction.

Partially SupportedResearch is needed to determine the optimal human diet and equip physicians with dietary recommendations.

Partially SupportedStatins should be considered very carefully for individuals who are insulin sensitive, aware of their diet, and following an animal-based diet.

Partially SupportedThe 4S study provides data relevant to whether statins would be beneficial for individuals with a specific lipid profile.

Partially SupportedMycotoxins are defense chemicals produced by organisms such as fungi to deter predation.

Partially SupportedStatin treatment results in a small average gain in overall survival within randomized trials, and withholding statin therapy should be considered.

Partially SupportedSelenium is essential for the production of selenoproteins involved in managing oxidative stress, DNA repair, insulin receptor signaling, and T3 hormone formation.

Partially SupportedEndothelial damage at arterial branch points may lead to atheromas in individuals with impaired immunity and wound healing, such as diabetics.

Partially SupportedBayer recalled the statin Serivastatin in 2001 and paid over $1 billion to settle lawsuits related to serious side effects.

Partially SupportedAn NIH panel in 1990 advised caution regarding lowering LDL in humans, but this conclusion was largely ignored.

Partially SupportedHigh-dose statin treatment may impair bone remodeling.

Not SupportedProprietary statin trial data prevents independent analysis of past reported side effects.

Partially SupportedCoenzyme Q10 is naturally found in high concentrations in organ meats, particularly the heart.

Not SupportedThe pharmaceutical industry may minimize reported side effect rates from statin medications.

Not SupportedStatins may worsen coronary artery calcification and deplete vitamin K2 status.

Not SupportedVegetable diets and drugs like prednisone, dapsone, and rituximab were not successful in helping an individual get off medications for vasculitis.

Partially SupportedA meta-analysis of 21 trials did not establish a conclusive association between absolute LDL cholesterol reduction and individual clinical outcomes.

Partially SupportedTreating 100 adults aged 50-75 without CVD with a statin for 2.5 years prevented one major adverse cardiac event in one adult, with no mortality benefit.

Not SupportedThe diet-heart hypothesis originated in 1913 with rabbit studies, but rabbits are herbivores and their atheromas differ from human ones.

Partially SupportedThe lowering of testosterone by statins could have implications for drug development and prevention of non-communicable chronic diseases.

Partially SupportedA 45-year-old male with a total cholesterol of 250, HDL of 65, and blood pressure of 110/70, without diabetes or smoking, has a 1.6% 10-year atherosclerotic cardiovascular disease risk.

Partially SupportedStatin therapy can neutralize the cardiovascular risk from unhealthy dietary choices, such as consuming a McDonald's meal.

Partially SupportedAdding simvastatin to existing treatments provided substantial additional benefits for high-risk patients with a very low annual excess risk of myopathy (0.01%).

Not SupportedStatins may interfere with the mevalonate pathway, potentially worsening vascular calcification.

Not SupportedThe direct toxicity of LDL cholesterol to the endothelium is not well-supported by evidence, and statins have benefits beyond LDL lowering that are ignored by Western medicine.

Partially SupportedAn LDL level of 20-30 mg/dL is evolutionarily inconsistent and difficult to achieve with diet alone.

Partially SupportedIn many trials of cardiovascular medications, particularly in secondary prevention, all-cause mortality does not significantly change despite reductions in recurrent coronary events.

Partially SupportedA breakfast of raw milk, raw egg yolks, bananas, dates, and ground beef with raw butter increases cardiovascular risk due to saturated fat and elevated LDL.

Partially SupportedMeta-analyses suggest that absolute risk reductions from statin treatment for all-cause mortality, myocardial infarction, and stroke are modest.

Partially SupportedMcDonald's food contains processed sugar, grains in buns, seed oils, and PFAS due to processing and packaging.

Partially SupportedMitochondrial problems can lead to diabetes and insulin resistance.

Not SupportedA drug should not be taken if it will not prolong life or improve quality of life, especially when alternative methods exist.

Partially SupportedThe Vioxx scandal involved 88,000 heart attacks and 38,000 deaths, leading to $5 billion in damages.

Partially SupportedIncreased body cholesterol production may be triggered by consuming fewer polyunsaturated fats and more saturated fats.

Partially SupportedThe majority of cholesterol in the body is produced internally, with dietary cholesterol being a minimal contributor to serum cholesterol levels.