Do Statins Cause Memory Loss?

Written by Dr. Steve Chaney on . Posted in current health articles, Drugs and Health, Health Current Events, Supplements and Health

Is the Cure Worse Than the Disease?

Author: Dr. Steve Chaney

 

statins and diabetesDo statins cause memory loss?  They are at it again. The medical profession is telling us that yet another study shows that statins are safe, so almost everyone should be taking a statin drug. There is only one problem. That’s not what the study really showed.

Let’s start at the beginning. For people who have already had a heart attack it is pretty clear that statin drugs save lives. If stain drugs were only prescribed for people who have had a heart attack or were at high risk of having a heart attack, I would be a proponent of their use.

However, the guidelines developed by the pharmaceutical and medical industry recommend statin use for millions of Americans who have never had a heart attack and who are at low to moderate risk of ever having a heart attack. That is problematic.

As I documented in a recent “Health Tips From the Professor”  the benefits of statins are marginal at best in healthy people who have not yet had a heart attack.

In addition, statins have some significant side effects. For example, up to 5% of people taking statins develop muscle pain and weakness. For most people the muscle pain is merely an inconvenience, but in a small percentage of cases it can lead to serious complications.

More concerning are the required label warnings that statins can lead to memory loss, mental confusion, high blood sugar and type 2 diabetes. In fact, a recent study described in “Health Tips From the Professor” suggests that statins may increase diabetes risk by as much as 46%.

In other words, statins may not kill you, but they sure can make life miserable. For many people, the most troubling aspect of statin use is memory loss. One of the most terrifying aspects of aging is the thought that you might be able to keep your body healthy but lose your mind.

However, recent headlines have proclaimed that we can “forget” about statins causing memory loss (Pardon the pun. I couldn’t resist it). They claim that a recent study has shown that statins don’t actually cause memory loss. The problem is that is not exactly what the study showed. It is only the medical profession’s interpretation of what the study showed.

Why Might Statins Cause Memory Loss?

iron and brain developmentStatin drugs block cholesterol synthesis, and cholesterol is an integral part of the myelin sheath that coats our neurons. You can think of myelin as being like the plastic coating on an electrical wire. It is that plastic coating that allows the electrical current to travel from one end of the wire to the other without shorting out. Myelin plays essentially the same role for our neurons.

Because of the importance of cholesterol in maintaining the integrity of myelin, there was concern from the earliest days of statin development that it might adversely affect memory. Thus, multiple clinical studies have been performed to determine whether statin use adversely affects memory.

Unfortunately, the previous clinical studies have been inclusive. Some suggested that statins cause memory loss. Others found no correlation between statin use and memory loss. A few actually suggested that statins improved memory. There are a number of reasons why the previous studies came to different conclusions including use of different statin drugs, different duration of the studies, and differences in how memory was measured.

Do Statins Cause Memory Loss?

blood pressure medicationsThis study (Strom et al, JAMA Internal Medicine, doi: 10.1001/jamainternmed.2015.2092) differed from previous studies in that:

  • It focused on short term memory loss, and
  • It also included a group of patients who were using non-statin cholesterol lowering drugs.

The study drew on patient data from the online Health Improvement Network database collected from general practitioners offices throughout England between July 7, 2013 and January 15, 2015. The study compared 482,543 statin users with 482,543 matched controls using no cholesterol lowering medication and 26,484 patients using non-statin cholesterol lowering medications. The average age of the participants in this study was 63. Memory loss within the first 30 days after initiation of drug therapy was assessed by scanning the medical records in the database for codes related to memory loss.

The results were stunning!

  • Stain drug users were 4-fold more likely to experience short term memory loss within the first 30 days than non-users, and the likelihood of memory loss was dose dependent.
  • The users of non-statin cholesterol lowering drugs were also 4-fold more likely to experience short term memory loss within the first 30 days than non-users.
  • As you might expect there was no significant difference in memory loss between users of the statin and non-statin cholesterol lowering drugs.

How Were The Results Interpreted?

The results seemed to be pretty clear cut, but it was a somewhat misleading interpretation of the results that was widely publicized. The authors of the article correctly pointed out that there are two possible interpretations of these results. Either…

  • All cholesterol lowering drugs cause acute memory loss….or
  • The association of memory loss with cholesterol lowering drugs is the result of something called “detection bias”.

Let me explain. Some memory loss is fairly common for people in their 60s and beyond. The term “detection bias” simply means that the patients might have been more acutely aware of memory loss because they were monitoring themselves for side effects to the drug they just started taking.

Of course, the medical profession is so confident in the benefits of statins that they focused on the second interpretation, and that is the one that you heard about in all of the press releases about this study. If you believe that the self-reported memory loss in this study was entirely due to detection bias, then the most logical interpretation of the study is that statin drugs really don’t cause memory loss.

However, I consider the first interpretation to be the most likely of the two. If use of cholesterol lowering drugs were associated with a 25% or 50% increase in memory loss, detection bias could have been a credible interpretation of the data. However, a 4-fold increase in memory loss is hard to ascribe to detection bias alone.

Furthermore, the first explanation is fully consistent with what we know about myelin. Because of the importance of cholesterol in maintaining the integrity of the myelin sheath, it is logical that any drug that dramatically lowers cholesterol levels could have an adverse effect on cognitive function.

Are There Other Options Besides Statin Drugs?

Because of the marginal benefits in healthy people and the multiple side effects, some experts are starting to step up and say that statins may be overprescribed. For example, Dr. Roger Blumenthal, MD, a professor and director of the Ciccarone Preventive Cardiology Center at Johns Hopkins recently said: “Statin therapy should not be approached like diet and exercise as a broadly based solution for preventing coronary heart disease. These are lifelong medications with potential, although rare, side effects, and physicians should only consider their use for those patients at greatest risk…”

So, what are the alternatives?

#1: Lower Cholesterol Naturally With Some TLC

healthy livingsThe National Heart Lung & Blood Institute recommends that something called Therapeutic Lifestyle Change or TLC should always be tried first for patients with elevated cholesterol, and that statins only be used if the lifestyle approach fails – a message that seems to have gotten lost in the translation in many doctor’s offices. The TLC recommendations are:

  • Add 2 grams per day of plant stanols and sterols to your diet. In most cases some that will require some degree of supplementation.
  • Eat less than 7 percent of your daily calories from saturated fat
  • Eat less than 200 mg a day of cholesterol
  • Make sure that you get 10-25 grams per day of soluble fiber.
  • Get only 25–35 percent of daily calories from total fat (this includes saturated fat calories)
  • Consume only enough calories to reach or maintain a healthy weight
  • In addition, you should get at least 30 minutes of a moderate intensity physical activity, such as brisk walking, on most, and preferably all, days of the week.

There is ample evidence that implementation of these lifestyle changes will reduce cholesterol levels and reduce the risk of heart attack and stroke without any side effects. The reduction in cholesterol levels is more modest than what can be achieved with cholesterol lowering medications, but perhaps that is the point. Perhaps the medical profession is being too aggressive in reducing cholesterol levels with drug therapy.

If you are a bit overwhelmed by the TLC recommendations, there is good news. Even one or two of the lifestyle changes mentioned above can substantially reduce your risk of heart attack or stroke. For example, in a previous “Health Tips From the Professor,apple a day keeps statins away, I reported on a study claiming that simply eating one apple a day would be just as effective as statins at reducing cardiovascular deaths.

#2: Reduce Other Risk Factors Associated with Heart Disease

Elevated cholesterol is not the only risk factor associated with heart disease. In fact, many experts feel that it isn’t even the most important risk factor. High blood pressure, high triglycerides, inflammation and damage to the endothelial lining of our arteries are other important risk factors for heart disease. If you are leery about using statins to reduce your cholesterol levels, you might want to explore other natural approaches to reducing heart disease risk. For example:

  • Nitrate from foods such as beetroot and spinach reduce blood pressure and improve endothelial health. This is also a topic I have covered in a previous “Health Tips From the Professor” Nitric Oxide Benefits Side Effects.
  • Resveratrol and related polyphenols reduce inflammation and improve endothelial health.

I could go on, but you get the point. There are other natural approaches for reducing heart attack risk. Statins and other cholesterol lowering drugs are not the only game in town.

     Red Yeast Rice Yeast Rice Side Effects?

red yeast rice side effectsHowever, just because a supplement is natural doesn’t necessarily mean that it is either safe or effective. Red yeast rice is a perfect example. Many people think of red yeast rice as a natural way to reduce cholesterol levels. They believe red yeast rice side effects are non-existent. Nothing could be further from the truth!

The active ingredients in red yeast rice are a class of compounds called monacolins, which are close analogs of the statin drugs. In fact, the most abundant monacolin, monacolin K, is identical to the statin drug lovastatin.

That destroys one myth. If a red yeast rice product contains as much monacolin K as a lovastatin pill, it would have the same benefits and the same side effects.

It only gets worse! In fact, you have no way of knowing how much monacolin K is in your red yeast rice supplement. Because lovastatin is a drug the manufacturers are caught in a Catch-22 situation. If the manufacturers were to actually standardize or disclose the levels of monacolin K in their product, the FDA would consider it an unapproved drug.

When manufacturers don’t standardize their active ingredients bad things happen. How bad, you might ask? A recent study analyzed the concentration of active ingredients in 12 commercially available red yeast rice supplements (R. Y. Gordon et al, Archives of Internal Medicine, 170: 1722-1727, 2015). The results were appalling:

  • Total monacolins in the supplements ranged from 0.31 to 11.15 mg/capsule.
  • Monacolin K (lovastatin) ranged from 0.10 to 10.09 mg/capsule.
  • To put that into perspective therapeutic doses of lovastatin range from 10 to 80 mg/day.

It gets even worse! The study also measured levels of a toxin called citrinin that is produced by a fungus and is potentially toxic to the kidneys. This is not a toxin that you would find in a pharmaceutical product like lovastatin, but it was present in high levels in one third of the red yeast rice formulations tested.

To sum it all up, if you were to go out and purchase a red yeast rice supplement.

  • You might get a batch with no active ingredients. It wouldn’t have any of the side effects of a statin drug, but it wouldn’t have any efficacy either.
  • You might get a batch that would have the same efficacy and the same side effects as a low dose statin drug.
  • You would have a 33% chance of getting a batch that was contaminated with a toxin that you would never find in a statin drug.

I don’t know about you, but after reading that study I have no desire to ever try a red yeast rice supplement.

Do statins cause memory loss?

 

 

The Bottom Line

  • For people who have already had a heart attack statin drugs are clearly beneficial. They save lives.
  • If you haven’t already had a heart attack and your doctor prescribes a statin, you may want to have a serious discussion with your doctor about alternative approaches for reducing heart attack risk. You may even want to seek a second opinion from a doctor with a more holistic orientation. Recent research suggests that statin drugs:
  • Are of marginal efficacy in low to moderate risk individuals who have not suffered a heart attack.
  • Can cause muscle pain and weakness, which can lead to serious illness in a small percentage of the cases.
  • May increase the risk of developing type 2 diabetes by up to 46%.
  • May cause memory loss and mental confusion.
  • A recent study showed that both statin and non-statin cholesterol lowering drugs caused 4-fold greater short term memory loss in older adults compared to matched patients who were not taking statin medications.
  • The medical profession has chosen to interpret this study as showing that statin drugs don’t cause short term memory loss, and that is the interpretation that has been widely reported in the press. I feel that the more logical interpretation of the data is that both statin and non-statin cholesterol lowering drugs cause short term memory loss.
  • Fortunately, there are natural approaches for reducing cholesterol levels and heart disease risk without any side effects. For example, the National Heart Lung and Blood Institute recommends a natural approach called Therapeutic Lifestyle Change or TLC .
  • There are also natural approaches for reducing other risk factors for heart disease such as high blood pressure, high triglycerides, and inflammation. These include things like omega-3 fatty acids, nitrate from vegetables like beetroots and spinach, and polyphenols like resveratrol just to name a few.
  • However, natural is not always better. Red yeast rice, for example, is neither safe nor effective. For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (2)

  • Marsha Reiner

    |

    My doctor put me on a stating AGAIN ! I quit again! Now he put me on a drug for triglycerides which I will not fill the prescription!

    Reply

    • Dr. Steve Chaney

      |

      Dear Marsha,
      I do not recommend ignoring a doctor’s recommendations entirely. Instead, you might wish to have a discussion with your doctor and ask about natural approaches you could take. If your doctor is unwilling to have that discussion, you might want to ask for a second opinion or search for another doctor.
      Dr. Chaney

      Reply

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Latest Article

What Is The Planetary Diet?

Posted May 21, 2019 by Dr. Steve Chaney

Is Your Diet Destroying The Planet?

Author: Dr. Stephen Chaney

 

Earth Day has come and gone, but you are still committed to saving the planet. You save energy. You recycle. You drive an electric car. But is your diet destroying the planet?

This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) serves as a dire warning of what will happen if we don’t change our ways. I touched on this report briefly in a previous issue of “Health Tips From The Professor,” What Is The Flexitarian Diet , but this topic is important enough that it deserves an issue all its own.

The commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The commission described the typical American diet as a “lose-lose diet.” It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

How Was The Study Done?

The study (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) was the report of the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. This Commission convened 30 of the top experts from across the globe to prepare a science-based evaluation of the effect of diet on both health and sustainable food production through the year 2050. The Commission included world class experts on healthy diets, agricultural methods, climate change, and earth sciences. The Commission reviewed 356 published studies in preparing their report.

 

Is Your Diet Destroying The Planet?

When they looked at the effect of food production on the environment, the Commission concluded:

  • “Strong evidence indicates that food production is among the largest drivers of global environmental change.” Specifically, the commission reported:
  • Agriculture occupies 40% of global land (58% of that is for pasture use).
  • Food production is responsible for 30% of global greenhouse gas emissions and 70% of freshwater use.
  • Conversion of natural ecosystems to croplands and pastures is the largest factor causing species to be threatened with extinction. Specifically, 80% of extinction threats to mammals and bird species are due to agricultural practices.
  • Overuse and misuse of nitrogen and phosphorous in fertilizers causes eutrophication. In case you are wondering, eutrophication is defined as the process by which a body of water becomes enriched in dissolved nutrients (such as phosphates from commercial fertilizer) that stimulate the growth of algae and other aquatic plant life, usually resulting in the depletion of dissolved oxygen. This creates dead zones in lakes and coastal regions where fish and other marine organisms cannot survive.
  • About 60% of world fish stocks are fully fished and more than 30% are overfished. Because of this, catch by global marine fisheries has been declining since 1996.
  • “Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”
  • The world’s population is expected to increase to 10 billion by 2050. The current system of food production is unsustainable.

When they looked at the effect of the foods we eat on the environment, the Commission concluded:

  • Beef and lamb are the biggest contributors to greenhouse gas emissions and land use.
  • The concern about land use is obvious because of the large amount of pasture land required to raise cattle and sheep.
  • The concern about greenhouse gas emissions is because cattle and sheep are ruminants. They not only breathe out CO2, but they also release methane into the atmosphere from fermentation in their rumens of the food they eat. Methane is a potent greenhouse gas, and it persists in the atmosphere 25 times longer than CO2. The single most important thing we can do as individuals to reduce greenhouse gas emissions is to eat less beef and lamb. [Note: grass fed cattle produce more greenhouse gas emissions than cattle raised on corn because they require 3 years to bring to market rather than 2 years.]
  • In terms of energy use beef, lamb, pork, chicken, dairy and eggs all require much more energy to produce than any of the plant foods.
  • In terms of eutrophication, beef, lamb, and pork, all cause much more eutrophication than any plant food. Dairy and eggs cause more eutrophication than any plant food except fruits.
  • In contrast, plant crops reduce greenhouse gas emissions by removing CO2 from the atmosphere.

 

What Is The Planetary Diet?

In the words of the Commission: “[The Planetary Diet] largely consists of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, poultry, and eggs. It includes no or a very low amount of red meat, processed meat, sugar, refined grains, and starchy vegetables.”

When described in that fashion it sounds very much like other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable. Here is a more detailed description of the diet:

  • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
  • It allows the option of adding one serving of dairy a day (It turns out that cows produce much less greenhouse emissions per serving of dairy than per serving of beef. That’s because cows take several years to mature before they can be converted to meat, and they are emitting greenhouse gases the entire time).
  • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
  • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

This is obviously very different from the way most Americans currently eat. According to the Commission:

  • “This would require greater than 50% reduction in consumption of unhealthy foods, such as red meat and sugar, and greater than 100% increase in the consumption of healthy foods, such as nuts, fruits, vegetables, and legumes.”
  • “In addition to the benefits for the environment, “dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10.8-11.6 million deaths per year globally.”

What Else Did The Commission Recommend?

In addition to changes in our diets, the Commission also recommended several changes in the way food is produced. Here are a few of them.

  • Reduce greenhouse gas emissions from the fuel used to transport food to market.
  • Reduce food losses and waste by at least 50%.
  • Make radical improvements in the efficiency of fertilizer and water use. In terms of fertilizer, the change would be two-fold:
    • In developed countries, reduce fertilizer use and put in place systems to capture runoff and recycle the phosphorous.
    • In third world countries, make fertilizer more available so that crop yields can be increased, something the Commission refer to as eliminating the “yield gap” between third world and developed countries.
  • Stop the expansion of new agricultural land use into natural ecosystems and put in place policies aimed at restoring and re-foresting degraded land.
  • Manage the world’s oceans effectively to ensure that fish stocks are used responsibly and global aquaculture (fish farm) production is expanded sustainability.

What we can do: While most of these are government level policies, we can contribute to the first three by reducing personal food waste and purchasing organic produce locally whenever possible.

What Does This Mean For You?

If you are a vegan, you are probably asking why the Commission did not recommend a completely plant-based diet. The answer is that a vegan diet is perfect for the health of our planet. However, the Commission wanted to make a diet that was as consumer-friendly as possible and still meet their goals of a healthy, environmentally friendly, and sustainable diet.

If you are eating a typical American diet or one of the fad diets that encourage meat consumption, you are probably wondering how you can ever make such drastic changes to your diet. The answer is “one step at a time.”  If you have read my books “Slaying The Food Myths” or “Slaying the Supplement Myths,”  you know that my wife and I did not change our diet overnight. Our diet evolved to something very close to the Planetary Diet over a period of years.

The Commission also purposely designed the Planetary Diet so that you “never have to say never” to your favorite foods. Three ounces of red meat a week does not sound like much, but it allows you a juicy steak once a month.

Sometimes you just need to develop a new mindset. As I shared in my books, my father prided himself on grilling the perfect steak. I love steaks, but I decided to set a few parameters. I don’t waste my red meat calories on anything besides filet mignon at a fine restaurant. It must be a special occasion, and someone else must be buying. That limits it to 2-3 times a year. I still get to enjoy good steak, and I stay well within the parameters of the Planetary diet.

Develop your strategy for enjoying some of your favorite foods within the parameters of the Planetary Diet and have fun with it.

The Bottom Line

 

Is your diet destroying the planet? This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report serves as a dire warning of what will happen to us and our planet if we don’t change our ways.

The Commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The Commission described the typical American diet as a “lose-lose diet.”  It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

The Planetary Diet is similar to other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable (for details, read the article above).

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

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