Over 100 million Americans suffer from elevated cholesterol and C-reactive proteinsmarkers linked to heart attack and other cardiovascular disorders. To combat these problems, modern science has created statins. While over 20 million people take these medications, up to 42 percent experience side effects, and up to 70 percent eventually stop treatment. Here, for the first time, is a guide that offers easy-to-follow solutions to the statin dilemma. What You Must Know About Statin Drugs & Their Natural Alternatives begins by explaining elevated cholesterol and C-reactive proteins. It then examines how statins alleviate these problems, discusses side effects, and offers information on both safe usage and effective alternative treatments.
If you have elevated cholesterol and C-reactive proteins, or if you are currently usinga statin, this book can make a profound difference in the quality of your life.
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About the Author
Jay S. Cohen, MD, is an Associate Professor (Voluntary) of Family and Preventive Medicine at the University of California, San Diego. Dr. Cohen is a widely recognized expert on prescription drugs and their natural alternatives. He has published scientific papers in leading medical journals and has written articles for Newsweek, Bottom Line Health, and Life Extension Magazine. A highly sought-after speaker, Dr. Cohen is also the founder of the Center for the Prevention of Medication Side Effects, which offers commentary on current issues in medical care.
Table of Contents
1. Avoiding Statin Overtreatment or Undertreatment,
2. How Much Cholesterol Reduction Do You Really Need?
3. The Right Statin at the Right Dose,
4. Low-Dose StatinsThe Evidence,
5. Why Do People Respond So Differently to Statin Drugs?,
6. Women and SeniorsSpecial Considerations with Statin Drugs,
7. Effective Strategies for Dealing with Side Effects and Other Problems with Statins,
8. Effective Alternative Therapies for Reducing Cholesterol and Other Risk Factors,
9. Essential Nutrients for Cardiovascular Health,
10. Which Heart-Healthy Diet Is Right for You?,
11. How to Cut Statin Costs by Fifty Percent or More,
Conclusion: Putting It All Together,
Appendix A: Dr. Cohen’s Principles for Safe, Effective
Medication Therapy, 169
Appendix B: Summary of Cholesterol-Lowering
About the Author,
How many of these questions about statin drugs, the top-selling drugs for lowering elevated levels of cholesterol and C-reactive protein, can you answer?
• Do I need to lower my cholesterol level?
• Do I need to take a statin drug?
• Which statin is best for me?
• What is the right dose for me?
• What are the side effects and how can I avoid them?
• Are there long-term risks with statins?
• If side effects occur, what can I do?
• Are there alternative methods I can use instead of statins?
• Are there other things I can do to preserve cardiovascular health?
• What is the best heart-healthy diet for me: low-carb or low-fat?
• How important is exercise, and how much is necessary?
• How can I save 50 percent or more off the high cost of statin drugs?
These are important questions for the 100 million Americans with elevated cholesterol. These questions are even more important for the 20 million Americans who take statin medicationsLipitor, Zocor, Pravachol, Mevacor, Lescol, or Crestorand for the 25 million more who are slated to be taking statins soon.
Taking statins is simple, right? Elevated cholesterol = statins. Yet statins are potent drugs that can cause serious side effects. Are doctors prescribing statins with the care needed to use them effectively and safely? Are doctors carefully selecting the right statin at the right dose for people as individuals? Are doctors thinking about how to reduce people’s risks of side effects and long-term toxicities? Are doctors offering you and others ways for keeping statin costs as low as possible? Are they informing you about other safer, proven-effective, less expensive alternatives? For many statin users today, the answer is no, no, no, no, and no.
Statins help millions of people, but like all drugs, they can also cause harm. Medicine’s most respected pharmacology reference, Goodman and Gilman’s Pharmacological Basis of Therapeutics, states: “Any drug, no matter how trivial its therapeutic actions, has the potential to do harm.” Statins’ effects are not trivial.
Statins are very powerful chemicals that exert effects in every cell of your body. Many of these effects are good, but some can be bad. How can you maximize the benefits while minimizing the risks? Just as when buying a car or choosing a college for your child, the more information you have, the better your chances are of doing it right. What information do you need to take statins safely and effectively? That is what this book provides.
Most doctors will simply tell you that statins are safe and hand you a prescription. Yet statins have many common side effects that cause physical discomfort or mental impairment in millions of people. Sixty to seventy-five percent of people started on statins stop taking them. The average patient lasts only eight months on statins. Why? Side effects. Inadequate effects. Cost. These are the issues that come up again and again when I give seminars, speak with people, or read their letters. These are the problems that mainstream medicine has not learned to overcome.
But they can be overcomeindeed, they can be preventedwhich is why I have written What You Must Know About Statin Drugs & Their Natural Alternatives. I am pro-medication and pro-statins, but my first responsibility, like all doctors, is to “Do No Harm.” Sometimes doctors cannot avoid doing harm, but this is not the case with statin drugs. Statin risks can be dramatically reduced with a treatment model that emphasizes precision and safety, as this book will describe.
Statins can be very effective drugsif given for the right reasons to the right persons at the right doses with the right treatment goals. Unfortunately, millions of people are prescribed statin doses that are too strong for their treatment goals, provoking side effects. Fifteen to forty-two percent of people given statins get side effects. That’s 7 to 15 million people. These side effects may be considered minor by doctors, but abdominal discomfort, muscle or joint pain, or memory impairment are not minor to you. And some statin side effects are not minor even to doctors: severe muscle pain or weakness, nerve injuries (some permanent), acute muscle breakdown, kidney and liver irritation or toxicity, and rarely, death.
Moreover, when 60 percent to 75 percent of people needing statins quit treatment, no one benefits. The long-term consequences of premature heart attacks and strokes harm not only patients and their families, but remain a costly, unsolved problem for hospitals, healthcare systems, insurers, and even the pharmaceutical industry and U.S. Food and Drug Administration.
The good news is that most of these problems are preventable, but only if you and your doctor know how. This is explained in Chapter 1, Avoiding Statin Overtreatment or Undertreatment: The Precision-Prescribing, Safety-First Method. The precision-prescribing, safety-first method will allow you to maximize the benefits of statins while minimizing the risks.
The most important question, of course, is whether you need statin therapy at all and, if so, how much? Chapter 2, How Much Cholesterol Reduction Do You Really Need?, answers these questions. Chapter 2 briefly explains the role of cholesterol, low density and high density-cholesterol (LDL-C, HDL-C), and C-reactive protein (CRP) on artery-clogging atherosclerosis and cardiac disease. Because of confusion about treatment goals, many doctors prescribe statin doses that are overly aggressive for people’s requirements. This excessive treatment brings little extra benefit in exchange for significantly increased risks. It’s not a good deal. That is why it is important for you and your doctor to know how much cholesterol-lowering is really beneficial, so treatment can be tailored to your needs and goals. Chapter 2 also tells you about five other risk factors that are often overlooked. These risk factors explain why half of the people who get heart attacks have normal cholesterol levels, so you want to know about them.
Chapter 3, The Right Statin at the Right Dose, explains why the standard initial doses of statins are unnecessarily strong for millions of people. Because of the omission of important information from package inserts and the Physicians’ Desk Reference (PDR), many doctors, not intentionally, overshoot the mark when prescribing statins, giving patients very potent doses when mild ones would do. Chapter 3 describes who is most likely to benefit from the precision-prescribing method and what your goals should be when first starting treatment.
Chapter 4, Low Dose StatinsThe Evidence, provides several strategies for choosing the right statin at the right dose for you. Chapter 4 presents the scientific evidence on the lower, safer, proven effective doses of each statin. It’s not enough for me to say that lower statin doses work. Medical treatment should be based on scientific proof whenever possible, and that is what this chapter provides.
Chapter 5, Why Do People Respond so Differently to Statin Drugs?, explains why different people respond so differently to statin drugs. It explains why some people need strong statin doses while others need just a little, and how to identify each without causing harm. Chapter 6, Women and Seniors Special Considerations with Statin Drugs, focuses on two groups that require extra attention and information in order to use statins effectively and safely. Few patients or their doctors know about the issues discussed in these chapters, but they are essential for optimal care with minimal risk.
Chapter 7, Effective Strategies for Dealing with Side Effects and OtherProblems with Statins, answers the many questions that people sustaining statin side effects have asked me. Unfortunately, the medical system isn’t very good about identifying or handling side effects, so I have divided Chapter 7 into seven sections that identify specific problems and offer practical solutions.
Many people do not like taking prescription drugs. If you’re one of them, Chapter 8, Effective Alternative Therapies for Reducing Cholesterol and Other Risk Factors, is for you. There are several proven-effective alternative therapies worthy of consideration that cost much less than brand-name statins. Because making the right decisions about reducing cholesterol and other risk factors will have a major impact on your long-term health, I always recommend that you and your doctor make decisions about these alternative methods together.
Whether you take a statin or an alternative therapy or do nothing at all, there are four nutrients that everyone should consider for preventing cardiovascular disease. Chapter 9, Essential Nutrients for Cardiovascular Health, describes them and their importance: omega-3 fatty acids (fish oils), coenzyme Q10, folic acid, and magnesium. Most people are sorely deficient in these nutrients, whose vital roles in maintaining a healthy heart and vascular system are backed by extensive scientific study.
Nutrition, of course, is also a big part of the equation for heart health. Yet there is so much confusion today. Low-carb or low-fat? Atkins or Ornish? Chapter 10, Which Heart-Healthy Diet Is Right for You?, provides original, clear guidelines to help you determine the best diet for you. This chapter also discusses exercise: the part it plays and the surprisingly little amount that’s required to maintain heart health.
Obviously, you cannot take statins if you cannot afford them. Their high cost is another reason that people avoid taking statins, quit taking them, or take them less often than necessary. Chapter 11, How to Cut Statin Costs by Fifty Percent or More, explains why statin costs are so high and provides several strategies for substantially reducing the cost of treatment. This chapter also gives you a comparative analysis of statins versus natural alternatives, a cost analysis most doctors or healthcare systems have never seen or considered. If cost is an issue for you, you need to know about all of these options.
The book concludes with Putting It All Together, an overall strategy for setting your priorities and reaching your goals. Heart disease and strokes can be prevented. Vascular health can be preserved. By defining which steps you needstatin drugs or natural alternatives, essential nutrients, diet, and exerciseand how to easily employ them together, you and your doctor can decide how to improve the quality and extend the duration of your life.
I have written What You Must Know About Statin Drugs & Their Natural Alternatives to provide original, practical information that you will not find in statin package inserts, the PDR, or medical textbooks or consumer references on statins or medications. Most books on cholesterol discuss statins with the usual pharmaceutical industry slant, which is the information that results in millions of side effects and millions of people quitting needed treatment. Such methods are wasteful and harmful. This book is much different: It is a primer on how you can decide whether you need treatment and, if so, exactly how much you need and how to accomplish it safely.
The best treatmentstatin or alternativeis the least powerful treatment that works. This book helps you define exactly what that is for you. In addition, unlike other books, this book provides information about essential nutrients that are vital, yet usually overlooked, for preserving cardiovascular health. Most doctors think they know everything they need to use statins properly, but they don’t. I learned similar lessons the hard way when I treated patients. There is a tremendous amount of important information that doctors do not get through their usual sources, most of which comes from the pharmaceutical industry, and that you do not get through the media and typical bookstore references.
Most doctors and consumers do not know, for example, that medication side effects are the number four leading cause of death in America year after year, decade after decade. They also do not know that medication reactions cause more than 106,000 deaths, 1 million hospitalizations, and 2.2 million severe, often permanent disabilities each year. Worse, these numbers may be underestimates because they represent only hospital patients, not the 100 million outpatients taking prescription drugs. Most doctors and consumers do not know that many of these problems are preventable. These problems can be prevented, but only if you and your doctor have the information needed for matching your treatment to your actual needs and tolerances. This is the basic principle of the precision-prescribing, safety-first method.
You have a right to information that makes it possible to obtain optimal care with minimum risk. This right is known as informed consent. This right applies to medication treatment just as it does to surgery. But to fully exercise your right of informed consent, you must receive enough information to make an intelligent choice. Most people do not receive enough information about statins to fully exercise their right of informed consent. Indeed, most people do not know that they have choicesmany choicesabout different doses and alternatives when considering statin drugs. Many of their doctors don’t know this either. Unless you receive information about how to maximize the benefits while minimizing the risks and costs of statins, you have not received informed consent. You aren’t alone. Studies show that only a small percentage of patients receive sufficient information to make an informed consent in doctors’ offices.
Statins can do a lot of good or cause serious harm. The difference depends on the decisions that are made based on the information available. The information available to most patients and their doctors today is inadequate to make informed choices for using statins safely and effectively. What You Must Know About Statin Drugs & Their Natural Alternatives provides the information you need to do just that.