Tuesday, January 29, 2013

Statins starve your brain

They DO reduce cholesterol but that is the last thing you want for good mental functioning.  No wonder statin users often seem like Alzheimer's sufferers

Two recent studies have confirmed the vital importance of cholesterol, in particular, for brain function and the strength of the immune system.

Scientists at Karolinska Institute in Stockholm, Sweden and Swansea University's College of Medicine have identified two steroid-type molecules that play an important role in the survival and production of nerve cells in the brain.

These two molecules are cholic acid (a bile acid ) and 24S,25-Epoxycholesterol (a derivative of cholesterol)

24S,25-Epoxycholesterol can be used to turn stem cells into midbrain dopamine-producing neurons, and may help combat Parkinson's disease.

"...24S,25-Epoxycholesterol, influences the generation of new dopamine-producing nerve cells, which are important in controlling movement." said Professor William J Griffiths.

"What we have shown now is that cholesterol has several functions, and that it is involved in extremely important decisions for neurons. Derivatives of cholesterol control the production of new neurons in the developing brain. When such a decision has been taken, cholesterol aids in the construction of these new cells, and in their survival. Thus cholesterol is extremely important for the body, and in particular for the development and function of the brain." Ernest Arenas, Professor of Stem Cell Neurobiology at the Department of Medical Biochemistry and Biophysics at Karolinska Institutet.

It is important to note that 24S,25-Epoxycholesterol is produced by the mevalonate biochemical pathway - the pathway that is blocked by cholesterol-lowering statins.

The research was published in the journal Nature Chemical Biology.

The second study was completed by a team of researchers at the University of Freiburg, Germany. Prof. Wolfgang Schamel and colleagues investigated the 'memory' of the immune system.

When the immune system is first exposed to a new pathogen, it develops the ability to be more sensitive to it when it enters the body the next time. This 'memory' of the immune system is provided by a clustering of T cell receptors. The new study, published in the journals Immunity and Journal of Biological Chemistry, has demonstrated that cholesterol plays a key part in this process.

We already know that one of the most common adverse effects of cholesterol-lowering statins is cognitive decline, and there is a strong correlation between low cholesterol levels and increased infections.


Popular media misrepresent effects of statins

The benefits of statins are so widely preached that journalists think they MUST be good stuff, I guess

A national newspaper here in the UK (the Daily Mail) recently reported "How a 40p statin can stop deadly form of blood poisoning"

OK, here we go again. It's a great pity that much of the mainstream media no longer consider the implications of what they publish.

This article relates to a recent study published in the journal Critical Care, which investigated the use of a statin in people with sepsis (which is a harmful or damaging response to infection).

It was a small study of 100 people with sepsis. 49 were given a statin and 51 were given a placebo.

I'm not criticising the study itself. From a certain point of view, it might make sense to try the use of statins in cases of sepsis. Statins are known to have anti-inflammatory effects and inflammation, of course, is a key feature of sepsis. However, the anti-inflammatory effect may weaken the body's immune system overall.

Another important point is statins, of course, lower cholesterol, and low cholesterol levels have been consistently shown to increase the risk for infection.

Therefore, as with any medication, the benefits and risks have to be balanced.

Using some criteria, the use of the statin did reduce the severity of sepsis, however, there were the same number of deaths in both the statin and placebo group. So there was no evidence that the statin actually provided any extension of life. In addition, after one year, there was no difference in hospital readmission between the statin and placebo group. It is also worth mentioning that the researchers measured the patients perceived quality of life index and, at discharge, the people who did not receive the statin had a better quality of life index.

The way that the Daily Mail skewed the results in favour of statins was misleading. For example, by the statement: "The findings suggest the drugs, which cost as little as 40 pence a day, could help to reduce the death toll from a condition that affects around 37,000 people a year in Britain"

The study did not find a reduction in the death rate at all. This is factually incorrect.

And this recent study did not really tell us anything new; it certainly was not newsworthy.

In 2012 there was a detailed review of the use of statins in cases in sepsis, published in the Annals of Intensive Care. The study can be found here:

Statins in the Critically Ill, by Isabelle De Loecker and Jean-Charles Preiser

The authors of this study provide a balanced review of the use of statins in cases of sepsis and, all things considered, there was no clear evidence of any nett benefit associated with the use of statins.

The Daily Mail article also took the opportunity to portray statins as cheap, by referring to "a 40p statin". I have complained about this many times before, but I must say it again - statins are not cheap, they cost the `health' service in the UK 450 million pounds each year, not to mention the costs of administering the cholesterol test itself, which probably doubles the cost.


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