Cholesterol reducing pills: Do they have a downside?

August 3, 2005

Medications taken against cholesterol may prolong life in the event of arteriosclerosis and perhaps even heart failure. However, new figures seem to indicate that many patients get serious side effects from taking such medications, which side effects could have been avoided had they also taken Co-enzyme Q10.

Millions of people worldwide use cholesterol reducing medicine in the form of statins. These people most often have clogged coronary arteries and the statins are used to protect them against further atherosclerosis, blood clots, and strokes. They work, but to a lesser degree than many people think.

If they are given to one hundred 40-80 year old people who are at high risk due to atherosclerosis or diabetes, they prevent about one coronary blood clot or one stroke per year. In the course of five years, about two deaths are avoided.

Many of the treated meanwhile develop heart failure, which is reduced pump function of the heart, because atherosclerosis damages the heart muscle permanently. They begin to complain of tiredness and increasing shortness of breath.

Is it risky to take cholesterol lowering pills in this situation? There can be debated. The debate is due to the way that the medicine works. It blocks the livers production of mevalonic acid, which is necessary for the production of cholesterol, but it also blocks the production of vital Q10! Not only does the blood’s cholesterol level fall, but also the bloods Q10 level.

Because Q10 is necessary for the tissues to create energy it is easy to imagine that a heart muscle which is weakened by heart failure, is further weakened when Q10 is removed.

Apparently statins work anyway. Statins are believed to lengthen life in heart failure. Not because they lower cholesterol, which may actually be damaging when suffering from heart failure, but because statins have other effects than reducing cholesterol. They are antioxidants and counteract inflammation. In addition they promote the creation of new blood vessels in the heart. None of these effects have anything to do with cholesterol.

Maybe the positive effects of statins outweigh the dramatic Q10 loss that they cause. Nonetheless, it is hard to believe that this loss is completely harmless, especially with heart failure.

The American cardiologist P.H. Langsjoen is one of those who warn that we find ourselves in an epidemic of heart failure with unclear reasons and who believe that statins could be one of the reasons.

At a congress in Los Angeles he put forth data which indicates previously unrecognised side effects. Two thirds of 51 newly referred statin treated patients complained of muscle pain, more than 80% were abnormally tired, and almost 60% had shortness of breath. When they stopped using statins and instead received Q10 (240 mg/day), most became symptom free.

At the same congress a randomised trial showed that muscle pain and tiredness was present in one out of every ten on those treated with statins, but disappeared when they took Q10 (100 mg/day). Just as important, more than half experienced an improved quality of life and many showed improved heart function.

Pills against cholesterol lengthen life, but it is necessary to take Q10 if quality of life also increases so that a longer life is a life worth living.

By: Vitality Council

1. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: A randomised placebo-controlled trial. Lancet 2002;360:7-22.
2. Langsjoen PH et al. The clinical use of HMG CoA-reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications. Biofactors. 2003;18(1-4):101-11.
3. Liao JK. Statin therapy for cardiac hypertrophy and heart failure. J Investig Med. 2004 May;52(4):248-53.
4. Bandolier. Statins in heart faikure.
5. Fourth Conference of the International Coenzyme Q10 Association. Los Angeles April 14-17 2005.

Broccoli and Spinach are Not Likely to Affect INR Blood Test

December 10, 2004

Promising Dutch study of Vitamin K. The somewhat cryptic headline is probably nonsense to most people, but nevertheless has great importance to all those taking blood-thinning (anticoagulating) medicines such as Marevan (Warfarin) and who are doing the regular blood test control, called INR.

If you are undergoing treatment with anticoagulant drugs such as Marevan, you should regularly be tested with a blood test called INR.

This blood test is designed to estimate if the dose you receive is correct, but it should also prevent overdosing in which the blood would get “too thin”. This condition is dangerous and can result in internal bleeding.

12 healthy volunteers were included in a study in which they were given a correct dosage of anticoagulants for 13 weeks and adjusted to a maintenance dose with a constant and stable INR value that would prevent them from forming blood clots.

Then, they were given increasingly large daily doses of vitamin K from 50 mcg. to 500 mcg. during the course of one week. Not until the dose reached 150 mcg. of vitamin K a day taken as a dietary supplement, was any effect on INR observed. Even at this dose, INR was only affected in 3 out of the 12 trial subjects.

When the trial subjects were given food that is particularly rich in vitamin K, i.e. broccoli and spinach, there was no clinically relevant effect on INR because the effect was so transient, and the authors suggest that the reason might be a poor bioavailability of the vegetables. This may be surprising, as kale, spinach, and broccoli can contain up to 400 mcg. of vitamin K per 100 g.

Doses of 100 mcg. vitamin K as an easily absorbable dietary supplement had no effect on INR.

If this study on healthy, young trial subjects can be repeated with the same result on patients with a predisposition to forming blood clots, it would make life significantly easier on a great number of people who every day stare in despair at the long list of foods containing vitamin K that they are not allowed to eat while taking Marevan.

By: Vitality Council

Schurgers LJ, Shearer MJ, et al: Effect of Vitamin K Intake on the Stability of Oral Anticoagulant Treatment. Dose-Response Relationships in Healthy Subjects. Blood 2004;104(9):2682-2689.

Cholesterol Medicine Halves the Amount of Coenzyme Q10 in the Blood

August 16, 2004

Heart specialists normally shrug off the suggested recommendation that patients treated with cholesterol lowering drugs must take Coenzyme Q10. While it is common knowledge that such medicine interferes with the body’s ability to create Coenzyme Q10, and that Q10 is essential for life, conventional medical thinking still holds that supplementation is superfluous because of the belief that medical treatment is effective and increases life span!

Now this conventional thinking is being challenged by new studies showing that one of the most commonly used cholesterol lowering medicines not only decreases but actually halves the amount of Coenzyme Q10 in the blood.

By: Vitality Council

Rundek T, Naini A, Sacco R, Coates K, DiMauro S. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Arch Neurol. 2004;61(6):889-92.

Feel Safe to Use Ginkgo biloba

June 24, 2004

A large number of people use this natural remedy on account of its ability to improve memory. This ability has been documented in numerous studies, including British ones. According to the press, the WHO is quoted for having warned against a danger of hemorrhage when Ginkgo biloba is consumed together with anticoagulants.

There are reports of two deaths and a number of non-fatal bleedings from a total of 22 countries. The suspicion is that Ginkgo biloba enhances the effect of the anticoagulants.

Anticoagulants themselves involve a serious risk of internal bleedings, and every year, hundreds of people die as a result of taking anticoagulants. Therefore, without a scientific investigation, it is impossible to know whether it is Ginkgo biloba, the anticoagulants, or solely a combination of both that is responsible.

Every year, several hundred people – in Scandinavia alone – die from this inevitable side effect of anticoagulants, but a great many more are saved by it. The fact that some of the people who have suffered a cerebral haemorrhage have used Ginkgo biloba at the same time, in no way proves that the combination is risky.

More than 30 medicaments in general use can either fortify or weaken the effect of anticoagulants. Both situations can be highly dangerous. Examples of medicine that fortify the effect of anticoagulants are sulpha drugs used against cystitis, a number of antibiotics, and common painkillers like aspirin.

Kale, chicory, spinach, and many other vegetables also affect the treatment. That Ginkgo biloba should affect the treatment, however, has been repudiated in the only serious study performed to date. It is of Danish origin and was published in the Danish Weekly Magazine for Medical practitioners last year.

In a double-blind, randomized trial it was established that neither Ginkgo biloba nor co-enzyme Q10 had any influence on the haemorrhagic tendency in the 24 participants who were all being long-term treated with warfarin which is the most commonly used anticoagulant.

Unfortunately, anticoagulants do involve a risk of internal bleedings. This is unevitable. However, there is nothing to indicate that the this risk should be increased by taking Ginkgo biloba. On the contrary; present knowledge indicates the opposite!

Professor Ralph Edwards of the WHO Monitoring Centre in Uppsala, Sweden, feels abused by the press in this matter, as he says:
“We have NOT warned against Ginkgo biloba. There is no news in the statement of the WHO which is only a press release about new guidelines on information regarding dietary supplements and natural medicine. It is not even very likely that Ginkgo biloba should interact with anticoagulants, but it is common sense not to use a vasodilating supplement together with anticoagulants or in relation to an operation.”

By: Vitality Council

Ugeskr Laeger. 2003;4;28;165(18):1868-71. [Effect of Coenzyme Q10 and Ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo-controlled cross-over trial].

Also see the original press release of the WHO.

Q10 and Ginkgo biloba may be taken together with blood thinners

May 5, 2003

Q10 and Ginkgo biloba may be taken together with blood thinning medication. A Danish study shows that it is non-dangerous to take the two supplements together with the blood diluting substance Warfarin.

An article in the danish medical journal, Ugeskrift for læger, rejects the suspicion that the two supplements may either weaken or enhance the effect of Warfarin (Marevan), which is typically used in the prevention and treatment of blood clots, eg in the heart or brain.

By: Vitality Council

Ugeskrift for Laeger, 28. April 2003, no. 18.