Carolina Holistic Medicine | Functional & Alternative Medicine | Charleston, SC

Two Dangerous Drugs to Avoid (one of them is a Statin)

I am going to write about two of my least favorite drug classes. They are the Statins and the Proton Pump Inhibitors. In my entire practice (clinics serving patients in the Myrtle Beach & Charleston, SC area) I have maybe five (5) patients total on a statin and maybe even less on a PPI. Only the most severe cases of cholesterol imbalance or GERD warrant these medications in my humble opinion. The untoward effects of both classes of medication will often outweigh any benefit in the long term. The past three-decades of medical research that promotes the lowering of cholesterol to stop or lower risks of heart attacks has been shown recently to be faulty and there are many now re-examining the study results and statistical analysis. Things came into question when 50% of heart-attack victims were shown to have normal cholesterol levels, so why is cholesterol (LDL-C) so darn important? This raised some red flags as to what may really be the cause of heart disease. Well it is not actually cholesterol it appears, yet mainstream medicine is slow to adopt the changes and new information. Inflammation as it turns out and the imbalance between sympathetic and parasympathetic nervous system may play a much larger role in Cardiovascular Disease, heart attacks (AMI) and stroke (CVA) than does cholesterol. GERD is another medical condition that has been handled badly since I exited medical school. The answer seems to be more meds and tossing aside any non-pharmaceutical interventions, lifestyle modification and nutrition.

Let us start with the statins. Back in 1976, a Japanese biochemist named Akira Endo isolated a factor from the fungus Penicillium citrinum which he identified as a competitive inhibitor of coenzyme A reductase (HMG-CoA reductase) that is a enzyme in the manufacturing of cholesterol in the liver. Statins were born. The pharmaceutical industry went wild as the race was on to develop better, longer acting drugs. Several have popped up over the decades each trying to best the previous. Problem is the distraction of all the R&D money going into this ‘’cold war’’ of statin development, people lost track of some basic concerns and what really causes heart disease. Bruce Roth an American medicinal chemist at the age of 32, developed atorvastatin, sold as Lipitor® that would become the largest-selling drug in pharmaceutical history in 2003. Nevertheless, statins as a class worldwide are one of the top selling prescription drugs for chronic use. The more common ones are Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Rosuvastatin and Simvastatin (know by brand names as well such as Crestor®, Lipitor®, etc.)

So, for one thing many don’t believe statin therapy is the answer to CVD problems for the vast majority of folks. Second, the long-term use of these meds as a class is not without issues & problems. I will list a few we currently know about:

· Muscle pain and damage (rhabdo) is the most common side effect reported.

· Liver damage; in cases statin drugs can damage hepatocytes (liver cells) and raise serum transaminases which signal inflammation & injury of these liver cells

· Know to increase serum blood sugar levels and cause Type 2 Diabetes (T2DM)

· Know to cause neurological side effects and possibly bring on dementia like features such as confusion and memory loss.

Side effects are worse in folks taking multiple lipid lowering medications; females; those over 80-years of age; those with kidney or liver disease; those who drink alcohol and folks with hypothyroidism or neuromuscular disorders such as ALS. There is a whole list of other medications that interact badly with statins such as Amiodarone, Gemfibrozil several HIV drugs, and some antibiotics and antifungals, and even immunosuppressant meds such as cyclosporin that we see in our transplant patients. If you must take a statin, it is a good idea to take coQ10 as a supplement because statins deplete this rather important compound we make in our bodies. When deciding to use statin therapy one must weigh the good and the bad; and currently there just is not enough really good reasons for so many to be on this ‘’dangerous’’ drug.

Alright, so who has not seen the TV ad where Larry the Cable Guy is pitching over the counter Prilosec (yes, the purple pill)? Crazy ad, in that it does not preach correct eating habits, but rather “eat what ya want! we got a pill to follow for your reflux.” Is that the message we want to give and from a fellow who does not appear to be the picture of good health? So now on to Proton Pump Inhibitors (PPIs) and their issues. The problem is a poor diet or eating too much – too fast and having dysmotility in the stomach and upper GI track. With poor closure of the lower esophageal sphincter (LES) is what causes heart-burn (AKA reflux or GERD). Symptoms occur when the stomach acid actually burns the tissue of the esophagus (not designed to hold gastric acids) and this causes pains (and in some cases a pre-cancerous state of those esophageal cells). We run to the doctor when the burning becomes too painful or annoying to ignore and we get placed on a PPI typically in a 5-minute visit with your local PCP who has not time to discuss non-pharmaceutical options or dietary changes.

The PPIs reduce the production of stomach acid by shutting down the parietal cells found in the stomach. No acid- no burn, problem solved. Or is it? This is why the prescription (Rx) and OTC drugs such as Prevacid®, Nexium®, Prilosec® and Zegerid® along with Dexilant®, Protonix® and Aciphex® are big sellers. Prilosec® was the first and was developed in 1979 and heralded the use of this drug as a ‘’fix’’ for GERD. In 2017 sales globally of omeprazole (Prilosec®) was $2.66 Billion.

I have fixed many with GERD who were getting relief with PPIs, by the simple use of lifestyle modification, better nutrition, the correct way to eat and improving body position, and also the judicious use of some probiotics & digestive enzymes in the harder to treat. Weaned them off the PPIs they no longer needed. This is good as we removed a rather “dangerous” drug as we will see below.

Some of the dangers of PPIs in long-term use are:

· Kidney disease & acute interstitial nephritis

· Hypomagnesaemia (low magnesium in bloodstream)

· Reduction in iron & zinc absorption in the gut

· Cancer (higher risk of neoplasia) gastric carcinoid, tumors and gastric cancer

· Fractures and bone thinning (osteoporosis)

· Infections & Pneumonia

· Clostridium difficile infections (gut) & other enteric infections

· Adverse perinatal & postnatal events with use in pregnancy

· Vitamin deficiencies such as vitaminB12 deficiency and possibly other B-complex vitamins

· Thrombotic events due to interactions with the drug clopidogrel (Plavix)

· Increase in dementia

· Increase risk of adverse cardiac events

Again, with better and safer options to treat GERD; why risk it with PPIs.

Before you stop taking such medications as statins or PPIs please consult a Functional Medicine doctor who knows how to safely taper you off these meds and substitute with safer interventions.

Skip to content