Should You Take Cholesterol-Lowering Medications?
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- Опубликовано: 31 янв 2024
- 1 in every 5 deaths in the United States is from heart disease, which is inexcusable given that there are so many ways to reduce our risks. For some people, one of those ways is to use cholesterol-lowering medications.
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Here are the links to the research papers referenced in the video:
www.cdc.gov/heartdisease/fact...
pubmed.ncbi.nlm.nih.gov/2740765/
pubmed.ncbi.nlm.nih.gov/28444...
www.sciencedirect.com/science...
www.sciencedirect.com/science...
www.ahajournals.org/doi/pdf/1...
pubmed.ncbi.nlm.nih.gov/36102...
pubmed.ncbi.nlm.nih.gov/19221...
www.uptodate.com/contents/low...
www.uptodate.com/contents/low...
www.thelancet.com/article/S01...
pubmed.ncbi.nlm.nih.gov/25575...
www.cochrane.org/CD013211/HTN...
www.cochrane.org/CD004816/VAS...
pubmed.ncbi.nlm.nih.gov/36529...
my.clevelandclinic.org/health...
www.nejm.org/doi/full/10.1056...
www.ncbi.nlm.nih.gov/pmc/arti...
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please make a section on your site FOR medical providers. One doctor here had no problem giving me rosuvastatin, was actually happy to do so. But my family doctor disagrees with it. I don't want to be an argumentative patient, but I think it would be great if I could direct her to a specific section on your site where you cite sources and explain reasoning. My doctor would not give me finasteride, because she said I didn't have hair loss that warranted it, even after I explained your video.
Rosuvastatin 2.5mg and 5mg ezetimibe took my ApoB from 116 to 43 and Ldl-c from 99 to 35. No side effects.
I just hate when they always have to come back later and say they are taking it off the market because they found it caused a neurological disorder or something else dangerous…if you’ve lived long enough, you’ve seen that over and over, more times than you can count….
@@Simon-talks Statins are highly specific in what they target unlike some drugs. We know exactly the mechanism of how statins work to a very precise degree. Also the effect of statins lowering apoB is very good for brain health and is preventative of dementia.
that's what they said about fen phen...and boniva and on and on.....
medical doctors highly recommended smoking back in the 1950's, in order to reduce stress. They also recommended leaches and blood letting a few decades before that....in a few decades, this will be looked at as goofy and dangerous too...
Isn’t Zetia only available in 10mg doses?
This was so well-articulated. Your analysis of these important studies was easy to understand and extremely informative. Your recommendations are spot on!
"we have evidence that cholesterol lowering medications do not cause neurodegeneration"
Really? I took statins for 7 months and I was loosing by god damn mind. Many people have had the same. I won't trust what ANY doctor says about anything.
With in 24 hours I stopped taking them, I felt 50% better. One week later, I was my old self.
Always very informative. Thanks from France!
Your videos always help me better understand my health and supplements that are beneficial. I am shocked that you have not addressed my problem with taking statins and often happens to others. I have taken Pravastatin since I was 28 years old and thought I did not have any side effects. Then one day when I was cleaning up outside I tore my bicep from my elbow. I have since had the tendon replaced with an Achilles tendon because there was nothing left of the old one. It was my cardiologist that informed me that it was likely the statin I was taking. Can you please create a follow up video discussing this? Please.
Thank you for this information. This helps a lot.
I looked at the PESA study referenced. It doesn't have any data on VO2 max or other tested fitness metrics. It does mention a self reported vigorous physical activity stat, but most people think they're in better shape than they are. I think there are much better studies on fitness vs. CVD risk. Also, absolute values of all cause mortality should be included in any studies like these.
I also checked it out last time he mentioned it and there were 5-10% of the healthy group that were obese.
This dude is obviously Big Pharma talking or he just dont know how read research. Could point multiple examples in his videos as you probably noticed
Great video!!👍
Thanks Brad, you've excelled yourself with this highly informative vlog...
Here is my story. I have CVD! My high cholesterol is familial. In my early 40's I started taking statin drugs. I am now 77, I have a high calcium score (>2000), I have 70% blockages in 3 locations (determined by cardiac cath). I have not had a heart attack that I know of. My cholesterol numbers are within normal range. I am starting ezetimibe to bring LDL-C number lower based on these recent studies. Now here is anecdotal testimony regarding statin vs no statin therapy. I have an identical twin brother; our lives took separate paths in our early 20's. I cannot comment on his lived lifestyle; though I know he was an avid outdoor adventurer, wilderness trekking, white water kayaking, snowboarding etc. I was fairly active myself. We both are fairly lean, looking at us you would not think we fit the description of someone who has CVD. A few years ago, while snowboarding out West my brother had a mild heart attack; a stent was put in. six months later he had bypass surgery and aortic valve replacement. He now lives with "heart failure" and can no longer live the lifestyle he was used to. In the past we never discussed health issues; but I now know that he was also prescribe statins in his early 40's, however he chose not to based on the "muscle pain" side effects. You are free to draw your own conclusions. One other fact our father lived to be 95; he had a quadruple bypass at 75.
"we have evidence that cholesterol lowering medications do not cause neurodegeneration"
Really? I took statins for 7 months and I was loosing by god damn mind. Many people have had the same. I won't trust what ANY doctor says about anything.
With in 24 hours I stopped taking them, I felt 50% better. One week later, I was my old self.
What were your high and is your lower ldl levels??
Yeah those “muscle pain” are not a joke. I am in my 40s and taking atorvastatin 10mg for the last 5 years ( now I am on atrovastatin before was on some other type, my doctor changed few do to muscle pain) I have such a bad bad muscle pain that sometimes it wakes me up in the middle of the night and i have to take pain medicine, its that strong. I am constantly in pain and my life quality is worsen for this time. I walk and feel like I’m 80 years old. So you’re lucky just like my husband that you don’t have this painful side effect l, bot don’t minimize others reaction and experience. You are putting yourself on pedestal and looking down on your brother. I am going to stop it and try something else , if my doctor is willing to give me. Can’t stand this pain anymore
Hi Dr. Brad. Thank you for you do and really appreciate this video. Can you please share what blood tests you are doing to help you decide if should add Ezetimibe?
Indian gooseberry (Amla) and bergamot both have small, but reasonable studies that show LDL cholesterol and cardiovascular risk factor reduction similar to low dose statins. In my statin intolerant patients I consistently saw 20to 35% reductions in LDL cholesterol levels, reduced triglycerides, and increased HDL levels.
Yes, it is impressive. Dr. Greger is a big fan of it. I find it helps my exercise routine at the gym if I take it with Cordyceps about 3 hours before.
I am female, almost 70, eat a very healthy Mediterranean diet, exercise daily, and maintain a lean bodyweight and have no family history of early heart disease. My LDL is always high, but mostly all of large particle size. My HDL is usually around 100, give or take a few points. Given my strange numbers over the years, my cardio doctor suggested a cardiac calcium test. My score was zero, and my heart is pretty strong from decades of distance running (now race walking). We are taking a 5 year wait and see approach.
EXACTLY..... HIGH CHOLESTEROL DOESN"T MEAN YOU HAVE PLAQUE BUILD UP!!!
@@walterski8377. Hopefully!!
Good information thank you. I just added Zetia to my 5mg of Crestor and my LDL dropped significantly. I’m also on a low carb diet, which apparently helps the Zetia work even better.
Great content Brad, it's good to hear an influencer being positive about statins, I'm 61 years old and I work out hard, cycling, running, and weights, I exercise at least 1000 minutes a week and I'm a very healthy weight so you would expect my cholesterol to be fantastic but no my cholesterol was high which was down to genetics and also a high protein diet, also I eat plenty vegetables, I take Rosuvastatin 10mg every other day and Ezetimibe 10mg every day which got my LDL down to 62.62, what's more, no side effects and feeling very healthy, I will continue with the medication for the rest of my life.
I understand that the type of protein affects its impact on cholesterol levels. Red meat and white meat bump it up more than nonmeat sources apparently - perhaps fish or plant proteins might be worth a try?
Have you been watching the LMHR trial? Your high ldl may be due to how lean you are.
Take the time to do the research yourself as most Drs won't.
@@tomgoff7887 I do eat a lot of fish, although I don't eat pork because of its high-fat content, I do eat a lot of plants but I need the protein because of my training, and I no time to get the plant protein, mainly because I like meat and fish protein.
@@liveloveride1676 OK . Thanks and good luck. I too take a statin because I can't get LDL down low enough with diet and exercise alone.
COME ON, you need a Coronary Calcium Score before deciding on taking any cholesterol medicine!!! High Cholesterol DOES NOT AUTOMATICALLY MEAN YOU HAVE PLAQUE BUILD UP IN YOUR ARTERIES!!!
Thanks Brad for another great video. Any guidance on how to convince GP to prescribe statins in Australia or NZ if your LDL is normal according to the guideline but far from ideal?
Same question from France !
I’m presently using all four of these interventions with great success. My cholesterol was”high” but not into FH ranges. A CT-CAC showed some calcified plaque.
Happy to see this information, hopefully it will help stem the tide of “cholesterol is a myth” misinformation that’s growing.
Same here, recently have really high LDC-C, so I got precribed statins was doubting cause all the amount of misinformation and the wave of not bad cholesterol but after hearing both sides I prefer to be safe and use them
LDL was 190. I received a stent due to high calcification. I went on Rosuvastatin 20mg and Ezetimibe. LDL went down to 84. Adjusted my diet, exercise a lot more, switched from coffee to green tea and 2 teaspoons psyllium every day. Now my LDL is 79. I'm eager to try Bempedoic Acid when it becomes available in Thailand hopefully in fall 2024
This is extremely helpful
Please consider adding the next video link to the Infos, as the links in the end cards do not work in Browsers like Brave.
Thank you.
Thanks 😮
Thank you for this information. I have struggled with finding anything to help guide my decision making about taking my statins. The muscle pain was so intense on simvastatin that I couldn’t take it. I’m now on a low dose of rovistatin and it is not causing any muscle pain. I’m going to keep taking it.
Other videos say that the muscle pain effects of statins appear in 5% to 20% of users or more. One explained that the drug maker funded studies lower the side effects by administering the drug during a six week pre-trial period, and then removing the persons reporting side effects at the commencement of the trial. I’m just getting back to regular exercise after two months of unexplained shoulder pain. That was after taking rosuvastatin for a year and a half. The pain has no apparent cause - not an injury, not related to weightlifting. Given a choice between exercise and a statin, I’ll go with exercise.
German physician in his early 30s here. I started with 10mg Rosuvastatin a year ago to reduce LDL from 80mg/dl to 50mg/dl. I've never been 100% sure if it was necessary, as my general lifestyle is pretty healthy. Now I am glad that you come to the same conclusion as I did.
Hey Brad
Which of those 4 medications is generally speaking overall the safest/ the one with the least amount and severity of side effects? (if one only cared about this fact)
Thanks for this. This was timely for me, as I just got my latest blood tests yesterday. Good on most items, high HDL (85) I take Omega-3 maybe that does that, low triglycerides (80), low CRP / low inflammation, but high LDL-C (146) and ApoB at 104 mg/dL which is borderline high. I want to lower Apo B to below 80 mg/dL, which would be in ~10th percentile of US adults my age, but don't want to over-medicate. Tests say my CVD risk is below average but would be lower if I could get ApoB/LDL down. your video confirms low-dose Statin + Ezetimibe is a decent approach for someone in my situation. I will talk to doctor about it.
My family doctor checks Creatine Kinase levels when prescribing Statins, like Atorvastatin (Lipidor).
Choloesterol does not past the Blood-Brain Barrier. That is why that is why your brain cholesterol level is independent from your cholesterolemia.
It'a nice to see someone on RUclips rationally assessing the evidence instead of venting angry opinions based on misrepresenting the evidence base.
What do you think of the UK's NG238 patient decision aid 'should I take a statin?'
Hey Brad, any comment on tendon rupture risks with bempedoic acid? NIH says only when combined with high dose statins, but my cardiologist disagrees.
Male 57 years with controlled T2D for two years with drastic lifestyle change my doctor put me on very low dose statin even my ldl was around 100 for long time. After 3 months my average blood sugar was up %20 and weirdly I developed itchy skin. I stopped taking statin and symptoms stated fading. I have allergies to tetracycline and symptoms were extremely similar with statin use. For now I am not taking it and maybe give it a go again to be sure I am allergic to statin ingredients. Eliminating process what I did with food after I got CGM.
@DrBradStanfield Any comment on plant sterols/phytosterols as a supplement?
Thanks for the informative video. Ok, high ApoB resp. LDL cholesterol is strongly associated with increased risk for cardiovascular disease and a respective mediction is accordingly associated with risk reduction. But how can this be reconciled with the studies that have shown, for example, an increased all-cause mortality risk for middle-aged, non-statin taking men with an LDL-C below 70mg/dl (Sung et al. 2019, n~350,000)? Also other studies seems to point to a rather protective effect of higher cholesterol levels in older patients. How sure can we be that lowering cholesterol levels with medication is really beneficial for a person with otherwise no particular cardiovascular risk factors?
Can you do an update on your supplementation regime? Do you still take a separate niacin?
Informative and data supported presentation. Some comments. I think you forgot to mention what low dose of statins is... I know it varies depending on a statin type but I think it is still work mentioning. Also berberine works and fairly reliably so but effects are small just 20% LDL-C lowering. However, on a flip side unlike statins, it actually reduces insulin resistance. Now moving on to more effective treatments. As there is currently pharma subsidy for PCSK9 inhibitors , one can get them in the US for just $5 per month after insurance. Hence, I think, while the subsidy lasts, the combo of a statin and PCSK9 inhibitor is the most effective way to go to reduce LDL-C levels.
He said 5 to 10 mg for low dose statin. I had to go back and check, he said it quickly.
Any chance you can do a review of the literature on if it is possible to reverse atherosclerosis/plaque size?
I have high ApoB, Lp(a), etc. I’m realizing it’s likely time to consider medication. Who would you say would be the best to manage this? Cardiologist, Lipidologist, GP, or ? I am so curious who to see. Thanks!
All three if you can afford it. Good ones preferably. If money is an issue, there's an algorithm that they will likely follow. Tests for fasting blood glucose, CRP, HbA1c, apoB, Lp(a), Triglycerides, measure blood pressure and resting heart rate, calculate BMI. Then will be standard recommendations to improve diet, stop smoking,start exercising (strength and cardio) , moderate salt and sugar intake, manage sleep and stress,lower BMI if needed. If the numbers are really bad dumb ones will put you on high dose statin, smart ones will put you on low dose statin and ezetimibe. If numbers are super bad they will consider using PCSK-9 inhibitors if you can afford it. A few years into the future if olpasiran is proven to better the outcomes best ones will recommend that for wealthy patients or those at extreme risk. That's all I can think of immediately .
@@demonfedor3748 Thank you so much for your in-depth reply! I'm an otherwise very healthy woman with healthy markers and lifestyle habits. My GP says she will put me on a statin, but it isn't in a hurry (when does that happen? lol); therefore, I'm thinking I need to speak with a specialist for a more detailed discussion. I guess I will try to get in to see either a cardiologist or a lipidologist with a good reputation.
Oreo cookies seems to work good to lower ldl
Here we go 😂
@@Joseph1NJthat doesn't exist according to Brad.
😂😂
Since the big push to get everybody on statins started and the definition of high blood pressure lowered resulting in an increase of numbers being treated for hypotension, CVD has rapidly increased, all cause mortality increased and life expedience decreased.
More and more people are saying 'Something Does Not Compute' and questioning if there is any honestly remaining in health research.
@DrBradStanfield: Please walk through these studies comparing relative and absolute risk.
Thanks! Could you talk about higher than normal lp(a) please? I know it's genetic but is there anything we can do?
First thing that comes to mind is: what IS my current blood cholesterol level? I’d really like to experiment more with measuring stuff like this, but it’s not common practice to do your own blood tests… Or for doctors to test healthy patients. Any product you would recommend?
Lots of independent labs in the US will do 'on demand' blood tests for consumers. Out of pocket, of course, but most of them aren't very expensive.
HI which foods contain high doses of bempedoic acid?
It's a new drug, i don't think it's in any food.
Thank you for accurate information. 5 mg of statins has reduced my Apo b and LDL by 35% with no side effects.
Doctor you did not mention the fiber Pysilium Husk or Isab Gol which lowers cholesterol.
Dr. Stanfield, do you measure you LDL after fasting or non- fasting? ( I started on 5mg of Rosuvastatin and my LDL is now 79 fasting and 55 non-fasting.) Please let me know. Thanks. Big fan! Dimitri
why are the arterial anti-inflammatory properties of statins hardly discussed?
Because it would alert the average idiot to the fact that cholesterol is not the enemy. Lol
the potential anti-inflammatory actions of statins warrant further research: "statins appear to reduce arterial inflammation, but whether that’s from cholesterol reduction or something else is being debated."
www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/inflammation-and-heart-disease
@@DrBradStanfield thank you
forgot red yeast rice
Did you forget to buy red yeast rice when you were in the grocery store ? How is your memory problem relevant to the subject ?
Dr Brad,
I hope you are well.
I find it really hard to find an answer regarding total Cholesterol level. So I get the mentioned study show strong link between higher LDL and heart disease but the question is: what if the total Cholesterol level is high but LDL level and tri are normal? What if the total Cholesterol is high because of HDL level? Is that still at high risk?
AFAIK, the answer is no, only LDL is the risk factor.
HDL is called the 'good cholesterol' because high HDL is not a risk and does not cause CVD, in fact is actually associated with lower CVD risk. If you have high HDL and low LDL, you can celebrate your good numbers, you are at lower risk from CVD.
@@patrickmcguinness1363 well thank you for your answer. I find it very confusing why my doctor trying to put me on statin treatment where I have only higher HDL cholesterol levels?
@alialwayel6706 go listen to Dr dayspring on a you tube with Dr Carvalho and it might give an Answer. My HDL and LDL were both on high side, with HDL at 85. Anyway, Dayspring said that could be due to HDL used in transport of cholesterol from gut, sign of a hyper absorber. For such a person ezetimibe, which blocks gut absorption of cholesterol, could help lower blood lipid levels.
@alialwayel6706 some doctors don't know better, sigh. If you apoB is high, statins are helpful. Goong based on HDL is just wrong.
According to Nootropics Expert on RUclips, some animal studies showed that berberine causes DNA damage. Adding silymarin milk thistle; however, was able to counter this effect. Should we also supplement with silymarin milk thistle if we supplement with berberine?
Can you please link or tell me video name in which nootropics expert says this? The only data I could find is that berberine caused DNA damage in cancer cells
@@bravo8017 I must admit that I only repeated what David Toman, author of Nootropics expert said about berberine. I also realize that any questions about DNA damage/repair is beyond the scope of the guidelines and is probably inappropriate for this channel. By revealing the data that you just found provided me with more information than I already knew. So, thank you.
Dr Brad, did you see the Harvard researcher whose LDL goes way up on a low-carb diet? He added a couple Oreos to his daily regime for a few weeks and it dropped his LDL lower than Crestor!
Think one issue in analyzing LDL is the fact that it must be calculated. If you have low triglycerides the Friedewald equation likely overestimates your LDL levels. If your doctor isn't math aware, they may well overestimate the issue.
What about "Red Yeast Rice" + coq10 as a cholesterol-lowering supplement?
Does it work?
Interestingly Red Yeast Rice actually contain a natural statin chemically identical to lovastatin as its main active component. When using it, it is important to make sure it is a quality tested product, because contaminated red yeast can produce toxins.
I want to know that too.
It’s like taking a very weak statin (and Coq10 doesn’t do much)
Any comments on taking CoQ10 with statins?
Covered this in a previous video 😀
Multiple randomized controlled trials done, no benefit seen with CoQ10. If there was good evidence, CoQ10 would be regularly prescribed with statins as part of a guideline
Bempedoic acid side effect is tendon damage. This drug may raise the risk of tendon tear or injury.
I stopped taking omega 3 (fish oil) because i bleed easily. I put fish oil in the same "don't use" category as baby aspirin. I'm male, old, with no history of heart problems, so the recommendation is that the risks of aspirin (brain bleeding) outweigh the benefits.
I would appreciate any advice about fish oil. I know the action is different but the outcomes are similar.
Maybe just take a moderate dose…
What about red yeast rice based supplement? I'm using red yeast rice supplement, which lowered my LDL and APO B almost to the levels I got using 15mg of statin.
I heard that Oreo cookies outperform statins in lowering LDL, and it sounds so much more pleasurable.
I was on that therapy and wasn't responding as well as hoped, so my doctor had to change my prescription to Double Stuf.
They also cure diabetes permanently and remove a pre diabetic state.
Truly a superfood!
@@peterRobinson10101 at least good to eat before doing annual routine labs.
I had a stent put in 2 months ago. I have been on crestor 20mg for the last two months. my LDL-C is 40mg/dl and my Apo B is 0.8 g/l (80 mg/dl) my triglycerides are 1.0 mmol/l (18 mg/dl)
you say 5-10mh of rosuvastatin. a hypothetical person has been on 5mg now for at least 6 months and is in the low 90s for cholesterol. Would it be a "better" idea to try 10mg rosuvastatin, or ezetimibe?
Mentioned at 7:30
@@RickinICTim not rewatching the whole thing, but at another point in the video, doesn't he say he is thinking about going from 5 to 10? 10 is still considered low does. So if they are on 5, should they try 10 first and see if their numbers go down, or try ezetimibe first and see if the numbers go down? Just wondering about optimal order i guess.
what about lecithin..?
Can I combine berberine with with Rosuvastatin?
What about Nattokinase?
I have seen studies with a graph that goes back about 100 years showing as processed sugar use increased heart problems increased in an almost perfectly parallel way.
Do you know how many other variables you could plot that have the same increase? You can't just prove something is causal because it correlative. You could also show that ice cream causes drowning because during the summer when there is an increase in swimming (and so increase in drownings) there's also an increase in ice cream sales.
Not sure if any definitive studies have been done, but NATTOKINASE supplements (Soy Beans) are supposed to be highly effective in lowering LDL. Fermented soybeans, Katto (a popular dish in Japan) contain high levels of Vitamin K are thought to prevent calcium deposits in the arteries.
What are your views on the recent study undertaken with oreos that were more effective than statins at lowering LDL in certain individuals? And no mention of triglycerides? The information on supplements is good but rather listen to specialists when it comes to specialist medical fields. Primary care givers only know so much.
Shh, Brad has already decided that high LDL causes atherosclerosis.
I mostly cleaned up my diet a few month back. I will soon get my numbers and see where I am. If they aren't good then rosuvastatin 5 mg and ezetimibe 10 mg are already waiting for me. Wanna see how low can I drop them.
I've known multiple people that had cognitioin and memory problems while on statins. The people that realized this early and got off statins reported their memory came back and they could once again think much better. One friend that had a heart attach says he doesnt care what the risk is, he will NEVER take statins again after trying them and having trouble thinking and with his memory and functioning at work as a business analysts in IT. Once he got off the statins he returned to normal. Just because the studies didnt find memory/cognition issues doesnt mean they dont exist.
what does it mean (or would happen) if you lower your LDL levels with statins BUT the statins for some reason elevates your triglycerides ?
and what do you think about Dr Paul Mason work and being against statins. Apparently the creator of statin, the japanese bloke refused to take statins when he was diagnosed with high cholesterol
High TGs points to insulin resistance. Improve your diet, workout regularly, and get lean in addition to the statin and TGs should come down. Also make sure you get your Apo-B tested and not just LDL-c because you may have remnant cholesterol which the statin isn’t tackling well so see if there is a discrepancy between your LDL value and your Apo-B value. But to lower remnant cholesterol advice would still be as I mentioned.
How about taking plant sterols/stanols with a meal? Like CholestOff from NatureMade? I just take that and Omega 3 from Nordic Naturals and canned sardines/mackerel/salmon.
I would have to see real studies done.
Not recommended. You will lower cholesterol but raise other equally atherogenic particles in exchange (which never get measured unless you do the Boston heart health test)
@@Seanonyoutube Which atherogenic particles are raised by plant sterols?
@@anonymous-it4uh beta-sitosterol. Not a problem if you’re just eating tofu in normal quantities, but can be a problem in super-physiologic amounts such as with phytosterol supplementation. This is particularly a problem it you have a defective ATP-binding-cassette which isn’t too uncommon. The way you find this out is by measuring sterol concentrations in your blood, typically as Campesterol and Sitosterol (if you live in the US you can order the Boston heart health test to get these values). If these sterols are significantly elevated, that will tell you your ATPBC is defective aka you are a “hyper absorber”. If that is the case, be especially careful of supplementing plant sterols. This test can also inform you which therapies will work best for you. If you are indeed a hyper absorber, then ezetimibe can work wonders for you. But if you are a hyper producer, then statins will be more effective. Good luck 👍🏽
@@anonymous-it4uh sent you a long reply but now I can’t see it. Hope you got it. Tired of YT randomly deleted my comments.
Why don't more people who are concerned lower the satured fat foods instead? It's quite easy to cut out 90% of it.
Unless you have genetic pre-disposition to high LDL regardless of diet, statins makes little sense.
Exactly. But they push the drugs because of the massive profits and just like with semiglutides, they just know that people are gonna keep eating McDonald’s and drinking Mountain Dew
Saturated fast is the healthiest fat you can eat in big amounts
Said absolutely no studies, ever.@@stefdiazdiaz7067
What about garlic supplementation?
I use garlic and red yeast rice
@chrisjenkins5707 red rice yeast is a statin just not pharmaceutical grade
@@Gamingwithmatteo311yes, that’s why I use it
why not a statin then, it's cheaper and more reliable in dosing@@chrisjenkins5707
I was expecting you to mention Trimethyglycine
I am one of those two patients in a hundred where Rosuvastatin muscle soreness is concerned. I developed myositis in my calf muscles. I'm a runner, so it was particularly troubling. It felt like extreme lactic acid buildup. They were very stiff. I tried to go for a run. I started out jogging flat-footed, thinking they'd loosen up, but no. I made it about fifty yards and had to limp back to my car. It took a couple months to resolve once I discontinued the statin. I have no idea if it was low or high dose. I know my NP advised me to take half a pill instead of the full, but I wanted it to resolve first. maybe I'll try the low dose. Or, ask about the Bempedoic Acid. Thanks for the info.
You can try ezetimibe alone and see where your numbers land a month or two down the road.
@@demonfedor3748 I have a script for that as well. In another video, Brad said that Ezetimibe and Rosuvastatin work well together. So that was the plan. It was back in August, and I was experiencing a side effect that I can't recall now, but I stopped it right about the time I got the additional script for Rosuvastatin, so I went with that. Maybe it's worth a revisit. Maybe I'll try a small dose, as Brad suggested here. Thanks for the suggestion!
@@davidperfette1425Good idea. Hope low dose statin will gives you minimal trouble. If not there are other statins to try,or bempedoic acid if finances allow. I've seen studies comparing rosuvastatin+ ezetimibe vs atorvastatin+ezetimibe. The latter combo was slightly better,but higher chance if side effects. However your mileage may vary.
I took Fish Oil capsules. My LDL shot up from 91 to 148.
You may check AIM HIGH trial more carefully. Despite their summary, all they shown is that Niacin alone or combined with statins helps not significantly better than statins alone. Not that it doesn't help.
Extended release niacin also risks liver damage as at least one study shows. However, what about high dose niacin that is instant release and causes flushing?
No it doesn’t. And all you need is the anti flush formula….
Niacin is known to increase blood glucose quite considerably
And regular, rigorous exercise, coupled with a healthy diet and keeping your bodyfat levels down to a healthy level are known to keep blood glucose levels low and normal
Hey Doc, are you aware of any interactions between statins and creatine?
3:48 is it safe to lower blood cholesterol levels?
6:34 interesting stat on the limited benefit of statins.
We should focus on the small dense LDL. The value of LDL cholesterol itself does not mean much .
Something about Psyllium husk?
On supplements, what about red yeast rice? I started on RYR and it lowered my cholesterol
Yeah the supplements are a better way, since pharma has become so money hungry and corrupt in recent years and drugs are often discovered “later” to be unsafe and causing so many deaths
@@Joseph1NJ no, you’re buying into the propaganda….no health enthusiasts are dying from taking niacin, lol. Wake up
Red yeast rice works great 👍 and niacin is safe and effective. Don’t believe the propaganda.
@@Joseph1NJ no, you have no clue what you’re talking about. They are overwhelmingly dangerous and a scam.
Red yeast rice works great 👍
Im a Kiwi and have high cholesterol, Im about to do a fasting blood test to see what its like now. Im 70 this year and have always had elevated cholesterol but now my Dr is recommending I do start statins assuming my test remains high. It seems that there are some possible side effects and from what I hear they are not as uncommon as reported but I dont know. However what is concerning me is a recent meta study that basically showed that taking statins didnt have any benefit but may have the side effects. Im really struggling to know what to do here, how can it be there are so many conflicting studies from reputable sources, I am totally confused. With our health system in the mess it is and the lack of doctors, it took me 2 months to get my last appointment, I try to take responsibility for my own health as recommended but it seems impossible to "be informed" with so much opposing information. I would prefer not to take any drugs but Im not averse if they have proven benefits but I cant say statins fall into this area with what Im seeing. I have no doubt you are saying what you honestly believe but I get the impression those saying the complete opposite also believe what they are saying. so what do I do
One question - will azetemibe do anything if you are vegan? It's unclear to me based on how you put it - that it was causing cholesterol not to be absorbed in the gut - do you mean dietary cholesterol? I believe what I've heard is that even with vegans it's shown to help. I have heart disease and so want to keep my numbers as low as possible. But despite a very low-fat diet, they still bounce around from 35 to 55 from year to year. I would love to take Repatha but it is way too expensive and insurance won't pay unless your LDL is over 100 on the max tolerated statin dose, I believe. I'm on 10mg of Resuvastatin, which helps keep things lower, but I was initially on 20mg but my liver enzymes were elevated so they had to lower it. I get that I'm still under 60, but some years just barely. And I've seen charts where your risk continues to go down even under 30. One day we'll all just get the genetic crspr treatment that changes your dna so that you have the PCSK9 mutation, maybe even at birth, and then heart disease will be all but eliminated. But until that kind of treatment is made widely available, we'll continue to see heart disease as a major killer...
As I understand it, your liver directly contributes cholesterol to the bile released by your gallbladder to digest fatty foods (plant or animal fat). After the bile has done its job breaking down the fat, and as the food moves through your intestine, cells in your gut lining reabsorb much of that cholesterol (in addition to cholesterol in the food itself).
Ezetimibe significantly reduces how much cholesterol those cells absorb. So, it not only reduces how much dietary cholesterol is absorbed, but it also prevents your body from "recycling" much of the cholesterol it secreted to help break down the fat in that food. Instead, it just passes in your stool lowering your cholesterol level.
Eating heathy is the answer not taking a drug that will most likely cause issues down the road. My father took statins for over 30 years. His finale 10 years were filled with neurological problems to the point where he couldn't walk. I'm still very skeptical of them.
@@stevet5549 there's just a lot of what-ifs still on statins and neurological issues, and not enough study.
You've mentioned the PESA study before and I've critiqued it in your comment before.
I'll repeat, 5-10% of the healthy group were obese.
Just say we cannot conclusivey say at this time and soon we will have the LMHR study to inform us of the mechanism of action better.
Obese by what measure? If it was BMI, that means little because BMI doesn't account for body composition. Many extremely fit athletes with low body fat are 'obese' by BMI standards because they have a lot of lean mass. So, they would definitely fit in a 'healthy' group despite their 'obesity'.
@@RickinICT I am overweight by the BMI. You've got to be a body builder to be obese.
From memory the average muscle mass in the study was really low. The obese group also included women and that couldn't be due to muscle mass.
What mops up those bad LDL particles
If you're interested in up to date information on this topic, and not studies from 10 years ago given by a primary care physician, Research Dr Aseem Malhotra, he specialises in cardiology and has been practising for over 20 years, recieved his fellowship into the Royal College of physicians and his up to date information blows holes many of Brads points. In saying this, Brads info on supplements is good, but best leave the specialist topics to the experts, or at least research some recent papers rather than highlighting half a sentence feom a 11+ year old paper, links to the studies referenced for transparency would also be more honest to the viewers.
Can you discuss the increase in type 2 diabetes when taking statin drugs?
Actually watch this video, he discusses it.
Does thyroid disease cause increased cholesterol levels?
Yes. Low thyroid will increase LDL
LDL is a causal factor of atherosclerosis, however, LDL levels are very poor predictors of heart disease. Insulin resistance, blood pressure and triglycerides levels are much better predictors of CVD.
Additionally, having very low LDL is a strong predictor of poor health, specially in the elderly (No, it isn't due to reverse causality). However, it isn't clear whether statin-induced very low LDL is a a cause for concern.
Yes it is reverse causality. What evidence do you have that it isn't? Clinical trials clearly show that reducing LDL to very low levels reduces the rate of adverse events.
Dr. Brad, you (and other RUclips doctors) always point out the "blood-brain" barrier risk, when talking about benefits of using hydrophilic statins vs. lipophilic versions.
My question to you Brad = Why would you not want a statin to clear up plaque in the brain vessels?
Clotting in the brain, I believe, is a possibility as well? 🤔😉
pubmed.ncbi.nlm.nih.gov/34958045/
Good question. They have different effects on the brain in Parkinson's as well apparently: "This study suggests that hydrophilic, but not lipophilic, statins may be associated with faster PD progression."
Because cholesterol doesn't pass the blood-brain barrier, so the brain cannot rely on circulating hepatic cholesterol to make up any shortfall in its own production. So, why would you want to introduce a statin that could cross the blood-brain barrier and interfere with the brain's ability to create the cholesterol necessary for neuron function?
@@RickinICT Hi there! 🙂
I already dug a little bit more into this topic, turns out, both versions can cross the blood brain barrier....the hydrophilic versions is only a bit less likely. My current conclusion, is that the statin dose is the more important parameter, instead of solubility! 😉
Dr Brad my LDL-C is basically perfect.
My LDL-P is horrible! 2500+
Appears to be genetic because….
I eat very clean…. Meats and vegetables, low sugar.
42yo
6’2” 195 pounds, can squat 300x5 x 3 sets.
Thoughts? Statin for me?
On bergamot, has not done anything for me.
Really appreciated this video. ❤
When you say LDL-C is perfect, what is the actual number? If you don't know your ApoB, what is your non-HDL-c?
Well, I start doing intermittent fasting 17 to 20 hours a day five days out of the week and loss 60 pounds in two months
This video made me concerned about high dose niacin. Seems to be really harmful yet very popular for it's theoretical benefits.
Omega 3 supplements may also cause atrial fibrillation
You're pretty badarse doc. I'm a skeptic of statins (partly due to their unselective effects in the body and its links with insulin resistance; Dr Ronald Krauss' research also shed light that they aren't the most efficient at targeting the bullet LDL) but i'm starting to appreciate the benefit of them by watching some of your content. I'm more optimistic of bempedioc acid though. I think part of the fear towards pharmaceuticals is the distrust towards the industry from previous scandals e.g. the painkiller scandal among US doctors. There is also a lazy approach towards healthcare where docs give the impression of being pill-pushers. Another important factor is the supplement industry influence in the market as a natural solution. I am curious where statins come from because i was surprised when i discovered that metformin is a natural pharmaceutical.
Thank you Dr Brad.. But i disagree with you regarding controlling cholesterol by drugs.. most studies did not take into consideration what the participant diet, survey a non healthy population will not give good results..
Brad, "farm boy logic - powers of observation" here, but these population studies including the PESA study seem to be done on USA population where anecdotally diet is of very average quality. The observation is that a population of whole food eaters, whether plant bases to carnivore, would possibly yield different outcomes in regards to many markers including LDL-c.
I know as an MD that's all you have to go on, but I am tired of studies done on an overall "sick" population
He makes a number of claims that have no support in good research. Like so many in this field it's good to ask show me the study. My Kaiser dr said I should be on a statin because of my age (80 at the time) because my age alone was a "health risk." I laughed. Then I said show me the research study that Kaiser uses for this recommendation and I bet I can show you it's crap research. ( I was a psychotherapist who loved debunking claims for the clinical superiority of this or that theory or treatment methodology.) So he send me the study. 100 men WHO HAD ALREADY HAD HEART ATTACKS.) Well that should be the end of it because that's secondary prevention. I have never had a heart attack. But then the findings was a 24% reduction in the chance of a heart attack taking the statins. So I explained the difference between absolute and relative risk. To his credit he was troubled and said, "What am I to do. This is Kaiser's protocol and I have to follow it." I said you could explain to patients that this is the protocol but the decision is yours and if you are interested I can give you some information about the drug and it's effectiveness to help you decide. He left Kaiser about 6 months later and I don't know how he handled this issue
Thank you for this anecdote.
Isn't red-yeast rice a form of low-level statin? at least that's what several doctors (including my cardiologist) told me. I was taking red-yeast rice and berberine but still had 201 LDL. Adding Ezetimide + PCSK9 took my LDL from 201 down to 27 in 6 weeks, whee! There's a lot of evidence that high triglyceride is also dangerous, but idk how to control that :-/