Effects of Statin Therapy
On The Down Side
By Bonnie Jenkins, Advanced Natural Medicine Bulletin
Last weekend, while I was catching up on all of the news with my mom, she happened to mention that her doctor wanted to put her on Pravachol and that she was a little concerned. She should be worried. Although doctors hand out statin drugs like candy, they carry some serious side effects.
A few months ago, I told you how statin drugs like Pravachol, Zocor and Lipitor can impair brain function, lower immunity and increase the risk of cataracts (“How low can you go?” 7/24/03). And a clinical trial published in the Journal of the American Medical Association found that, while statin were considerably more effective than diet at reining in high cholesterol levels, these drugs lower serum antioxidant levels by as much as 22 percent. In fact, Zocor (the drug used in the study) lowered blood levels of vitamin E by 16.2 percent, beta-carotene by 19.5 percent and Co-Q10 by a whopping 22 percent!
So with all of these negative side effects, why would my mom even consider taking Pravachol to lower her cholesterol? Why would you – especially when there’s a natural supplement that can lower cholesterol as well or better than statins?
If you’re a long-time subscriber, you might remember H.C., a reader wanting information on the cholesterol-lowering effect of policosanol. I told him how policosanol can lower LDL (bad) cholesterol as much as 20 percent and raise protective HDL cholesterol by 10 percent. But my answer was brief at best, and this powerful supplement deserves much more than just a passing glance.
Policosanol is the generic name for a mixture of alcohols isolated and purified from sugar cane, whose main component is octacosanol. Sugar cane doesn’t have a corner on octacosanol however – it can also be found in rice and beeswax. But the type found in sugar cane seems to be the most effective and is the primary type used in clinical studies.
Study after study has found that policosanol is just as effective as statin drugs. But, because it works differently, it doesn’t carry the risks common to statins. While statin drugs directly inhibit the cholesterol-producing enzyme, policosanol regulates the production of the enzyme to lower, more favorable levels. Policosanol also enhances our body's ability to remove and process LDL cholesterol from the blood and cells.
A numbers game
Unlike most things that sound too good to be true, policosanol is one supplement that has stood up under rigorous scrutiny and even exceeded expectations. In fact, policosanol has undergone as many clinical trials as most drugs. Here are just a few of the highlights:
A team of German scientists reviewed the literature on placebo-controlled lipid-lowering studies using policosanol as well as studies investigating its mechanism of action and its clinical pharmacology. This is what they found: At doses of 10 to 20 mg. per day, policosanol lowers total cholesterol by 17 to 21 percent and low-density lipoprotein (LDL) cholesterol by 21 to 29 percent. Better yet, policosanol raises high-density lipoprotein (HDL) cholesterol by eight to 15 percent – more than statin drugs.
In one Cuban study, after 6 weeks on a lipid-lowering diet, 179 older patients randomly received a placebo or policosanol at doses of 5 mg. followed by 10 mg. per day for successive 12-week periods. The researchers found that, along with lowering total and LDL cholesterol, and boosting HDL, both doses of policosanol significantly improved overall cardiovascular health and stamina.
Taking on the drug giants
In a direct comparison with statin drugs, policosanol also holds its own. LDL and total cholesterol lowering is similar, with policosanol performing better on HDL. In a side-by-side comparison study from Chile, for example, 10 mg. of policosanol reduced LDL 24 percent compared with 22 percent for Mevacor and 15 percent for Zocor.
Another study found that 10 mg. of policosanol a day is more effective in normalizing HDL and has a better safety and tolerability profile than 20 mg. of Mevacor a day in patients with high cholesterol and non-insulin dependent diabetes.
Policosanol also performed better than or equal to other cholesterol-lowering drugs, including Pravachol, and Olbetam (Lorelco and Otbetam are not currently available in the U.S.) with fewer side effects. And daily doses of 10 mg. of policosanol have been shown to be equally effective in lowering total or LDL cholesterol as the same dose of Zocor or Pravachol.
The real up-side of course, is that you won't be suffering from any secondary illnesses down the road, or any of the adverse effects associated with cholesterol-lowering drugs. But, that’s not to say policosanol is totally without side effects. Some people may experience mild insomnia, headach, diarrhea, nervousness and weight loss. But these side effects have only been reported on less than one percent of the subjects tested – and they are usually temporary.
Unlike statins, which become increasingly toxic with higher doses, policosanol achieves its maximum effect at very low doses and taking more is neither more effective nor more toxic. Animal toxicity studies doses up to 1,500 times the normal human dose (on the basis of body weight) have shown no negative effects on carcinogenesis, reproduction, growth and development, including a study on three generations of rats.
One controversy surrounding policosanol is how it impacts Co-Q10 levels. Some preliminary research suggests that, like statins, policosanol may reduce Co-Q10 levels. But most experts maintain that the supplement has little, if any, impact on this heart-healthy enzyme.
On the off-chance that these early studies prove to be true, a number of policosanol supplements have added Co-Q10 – just to be on the safe side.
This just in . . .
Here’s one for the “well, duh” file. A new study shows that including fruits and veggies (particularly yellow and green varieties) in your diet may protect you from stroke. Since most of the nutritionists I know have been saying exactly the same thing for years, this isn’t exactly news – at least not in alternative circles.
A stroke occurs either when the blood supply to part of the brain is suddenly interrupted due to the presence of a blood clot (ischemic stroke) or when a blood vessel in the brain bursts (hemorrhagic stroke). Antioxidants are a known factor in promoting blood vessel health. So basically, this new study just confirms what we already knew. But it is important simply because of its scope.
In the study, researchers analyzed information from nearly 15,000 men and more than 23,000 women. All of the participants answered questions about how often they ate green and yellow vegetables and fruits. At the end of the study, the researchers looked at the death certificates for all of the subjects who had died during the follow-up period.
The researchers say that 1,926 participants died of a stroke during the study. Forty-eight percent had ischemic strokes and 32 percent had hemorrhagic strokes. Twenty-one percent had other diseases that eventually resulted in a stroke. When analyzing the fruit and vegetable intake of the participants, the study authors found that those who ate green or yellow vegetables nearly every day reduced their risk of death from any stroke type by 26 percent compared with those who ate vegetables no more than once a week. The researchers also report that eating fruit nearly every day reduced the risk of stroke death by 35 percent in men and 25 percent in women.
While this particular study highlights the fact that eating plenty of fruits and vegetables helps protect against both major types of stroke, their benefits don’t stop there. Fruits and vegetables also guard against cancer, diabetes and heart disease. The common thread, of course, are the antioxidants, fiber and other phytonutrients found in fruits and veggies. Think of them as nature’s nutritional powerhouse.
So, while this isn’t earth-shattering news, it is a good reminder to make sure you include lots of produce in your diet every day.***
Antti J, et al. "Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men." Journal of the American Medical Association. 2002;287:598-605.
Castano G, et al. “Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older
“Fruits and Vegetables Protect Against Stroke.” Ivanhoe Newswire. 23 Sept 2003.
Gouni-Berthold I, Berthold HK. Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent. American Heart Journal. 2002;143:356-365.
Menendez R, Amor AM, Rodeiro I, et al, Policosanol modulates HMG-CoA reductase activity in cultured fibroblasts. Archives of Medical Research. 2001;32:8-12.