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The Great Cholesterol Myth: A Book Review

by Lee Kurisko, MD

Have you ever been told by your doctor that your cholesterol is a bit high and you need to be on a statin medication to reduce it?  If so, you better read this book.   I have actually found that this book is a page-turner that I had having difficulty putting down.  Admittedly, I am a geek for this type of thing, but the message of this book should be considered by the at least 11 million people in the United States consuming these medications.

Several years ago, I too was told by my family practitioner that my cholesterol was too high and I needed to start a statin.  As an MD myself and a perpetual skeptic, I questioned the notion of poisoning one of the key biochemical pathways in my body just to make a lab test look better when I was in the peak of health and at low risk for heart disease.  My skepticism was justified and this book confirms it.

After that visit to the doctor, I read voraciously on the subject and consulted with a preventative cardiologist that I implicitly trust.  I have since learned more in the extensive cardiovascular section of my Anti-aging, Regenerative and Functional medicine fellowship program.  All tolled, I have spent innumerable hours on the topic.  If I were to do it over again, I would have read The Great Cholesterol Myth first.

Drs. Bowden and Sinatra have done a brilliant job distilling the essential points of this complex topic.  Catering to the intelligent layperson, anyone that takes the time to read this book will likely have a better grasp of the topic than their own doctors, cardiologists included.

Of late, it has been considered an unquestionable axiom that high cholesterol must be lowered with statin medications.   There is even a school of thought that people with normal cholesterol levels should be on statin meds to reduce it further.

If you read this book, you will see the madness in such claims. Cholesterol is a key component of every cell membrane in your body.  If you had no cholesterol, you would be instantly dead.  The brain is the richest repository of cholesterol and its presence is crucial for cognition and memory.  Without cholesterol, we would be sexless eunuchs incapable of reproduction.  Cholesterol is also necessary for manufacturing cortisol and related hormones required to deal with stress, maintain blood pressure, and the mineral balance of our bodies.  Cholesterol is the precursor of Vitamin D, which is essential for health.  Cholesterol is a precursor for bile, which is necessary for digestion.

The premise of the book is that the benefits of pharmaceutical suppression of cholesterol are marginal at best and only apply to a very limited segment of the population.   With limited benefit, the potential side effects are legion.

The group that may have some benefit from cholesterol meds are middle-aged males that have already had a heart attack.  According to Bowden and Sinatra there is no benefit for other groups.  Even with the potentially reduced risk of cardiovascular death for this select group, it must be kept in mind that all-cause mortality is not reduced.  That is epidemiology-speak for the fact that taking a statin will not lengthen your life by a single day!  The risk of death from cardiovascular disease may go down fractionally, but your risk of dying of other things goes up!  The cardiovascular benefit is barely measurable.  One meta-analysis showed only a 1.5 percent absolute risk reduction for a cardiac event.  Side effects are common.  I suspect that few patients would agree to consuming a medication with serious potential side effects for such a slight benefit.

Muscular weakness and pain are common side effects.  Statins even increase your risk of congestive heart failure when their purported purpose is to prevent heart disease!  Statins are now recognized to increase the risk of diabetes, and they may even increase the risk of depression and cancer!

The good Drs. Bowden and Sinatra also handily debunk the notion that saturated fat is bad for us and instead cast the blame for cardiovascular disease squarely where it belongs, on trans-fats and omega six polyunsaturated fats along with processed carbohydrates.  A recent meta-analysis of 21 studies with a total of 347,747 patients followed between five and twenty-three years showed absolutely zero correlation between saturated fat intake and cardiovascular disease.  That is an enormous number of patients followed over a very significant time period.  Despite this, we still hear the mantra to reduce our intake of saturated fat.

I give two thumbs way up for The Great Cholesterol Myth.   Even before reading this book, I had made the decision that I would not touch a statin med with a ten-foot pole.  That has been my decision looking at my own situation.  I do not recommend that you make any changes on your own, but if you take these meds, you better have a serious conversation with your physician.  If he or she is not familiar with these issues, tell him about this book, and if they won’t read it, get another physician.

Lee Kurisko MD is Chief Medical Officer of MediBid.  He is trained as a family physician, radiologist, and neuroradiologist. He is author of “Health Reform- The End of the American Revolution?”  He is now pursuing Board Certification in Anti-Aging and Regenerative Medicine.”   His blogposts on health and fitness can now be seen at www.healthandfitnessdoctor.com



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