Saturday, May 31, 2008

Cholesterol Pills - What You Haven't Heard

You know cholesterol pills will lower your cholesterol. But do you know cholesterol pills don't prevent heart attacks by lowering cholesterol? They work by what the pharmaceutical companies call "a pleitropic effect" meaning they have so many effects we can't understand or predict them all.

Cholesterol pills called statins lower cholesterol by blocking the enzyme that forms a chemical required for the earliest steps of cholesterol manufacture, the making of isoprene units. If you can't make isoprene units, you can't make cholesterol. But your body uses isoprene units for a whole bunch of purposes, so taking them out of the cellular stockpile means that you can't make a whole lot of other things either. Some people's muscles can't make the antioxidants their cells use to help manufacture ATP energy, so they feel weak and their hearts (an organ made of muscle!!) get flabby. Some people's immune systems can't distinguish healthy cells from malignant mutants or invasive bacteria, and so they develop cancer or infections. Those isoprene units are also important for brain cell growth and memory, so some people taking these pills act as if they're getting Alzheimer's. Because every cell in your body needs to make isoprene units, it seems logical that, if you take cholesterol pills long enough or in high enough doses, it's only a matter of time before they damage your health.

In spite of these risks, I still advise some people to take cholesterol pills. Why? Because some people's risk of heart attacks is so high and immediate, it's worth the relatively lower, delayed risk of devoloping the other medical problems. Male smokers who have had heart attacks and continue to smoke are ideal candidates for statin therapy.

So if not by lowering cholesterol, how do the Statins work?

Cholesterol pills of the statin variety prevent heart attacks because of their effects on the immune system. By suppressing the immune system (which needs isoprene units for all kinds of functions) drugs like Lipitor, Vytorin, Pravachol and others have a mild anti-inflammatory effect. Aspirin is another example of an anti-inflammatory medicine. But aspirin's effect is more focused on the inflammation than it is on fundamental immune system function, and so it's ability to prevent heart attacks may be as much as 100 times more powerful.

For more information about cholesterol lowering pills that you aren't likely to get from your doctor check these links: (and click your browser's back button if you want to navigate back here)

For those of you who want to know more about why cholesterol pills make people feel bad, here's a slightly more technical section: The Nitty Gritty

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