We have been indoctrinated into thinking that elevated cholesterol is the cause of heart disease.[1] Thus, most doctors will prescribe medications that decrease cholesterol, particularly statin medications, which have been shown to be safe in most studies.[2] Thus, if the “bad” cholesterol is very high, this may be a good therapy. However, sometimes a good thing brought to an extreme can cause problems. We should not forget the rest of the body while focusing on just the heart. We all need some cholesterol for brain function, to make hormones, and many other functions.

You may develop a side effect from statin drugs which may force you to discontinue the statin and do something different to decrease heart disease risk. The most common unwanted side effect is muscle weakness, which is commonly known and seen by most physicians. However, a lesser realized potential side effect can also be a decrease in mental cognition.

We need cholesterol to think. Almost 25% of your cholesterol in your body is in your nervous system and is necessary for your brain to function normally.[3] Your brain needs cholesterol and other lipids for their fuel to provide the brain power for us to remember things and have cognitive abilities. When you don’t fuel your brain adequately, it doesn’t function as well and thus cognitive function can decline.

Recently there have been some studies that have suggested a link between statin use and cognitive decline..[4],[5],[6], [7] Other studies have suggested a beneficial effect of statins on brain function,[8][9] and one showed a decrease in the risk of developing Alzheimer’s disease.[10] The confusion may be clarified by realizing that the effects are most likely dose related; i.e. higher dose statins appear to cause the problem of cognitive decline while lower dosage of statins may not.[11]

Another study recently done in the United Kingdom[12] found that some statins have a negative effect on learning and memory skills, while others don’t. Although their research used rats, the conclusions may pertain to humans. In those rats given pravastatin, they demonstrated significantly impaired performance in simple learning and memory tasks, while atorvastatin had no effect. Luckily, the effect was fully reversible once treatments ended. [13] These changes were not observed in the rats given atorvastatin.

So what do we do clinically? Overall, it would appear that high doses of statins probably do cause some mental impairment when used long term. In fact, this prompted the FDA to issue a warning that all statins have been reported to potentially affect cognition and the whole class carries an FDA warning.[14] They recommended further evaluations should be pursued. We believe that you should lower the dose to one that causes less problems, and treat the high cholesterol with other methods.

At our office in Dallas, TX, we have seen similar reactions of declines in cognitive function in our patients on high dose statins. It appears obvious that reducing your cholesterol reduces brain function since it requires adequate cholesterol to function properly and low cholesterol has been associated with some cognitive impairment per se. Therefore, we try to give statins only in very low dose when needed if the bad cholesterol is very elevated. However, if possible, we prefer more natural alternative methods to decrease cholesterol and decrease heart disease.

These methods include weight loss and maintaining an appropriate weights, adequate exercise, and natural products that decrease cholesterol. These may include the use of Bergamet, which is a naturally occurring substance derived from a citrus fruit only found in southern Italy. Taken twice a day, Bergamet has been shown to decrease cholesterol levels by around a third. [15]

A study conducted at the University of Rome showed that Bergamet can reduce abnormal lipid values in several ways. It reduces total cholesterol, by up to 31%) (LDL by 30%), it increases HDL (the “good” cholesterol) by 41%, if reduces triglycerides by up to 41%, and it reduces blood glucose levels by up to 22%.[16]

Bergamet is considered a bioflavonoid and a phytosterol. Another phytosterol that has shown to naturally decrease cholesterol is Sterolipin. This work in this fashion: Cholesterol is naturally secreted in your intestines with bile to emulsify fats. It is then reabsorbed with the fats into your body. Phytosterols help prevent this reabsorption. Thus, both Sterolipin and Bergamet decrease cholesterol by increasing cholesterol excretion through the gut through their phytosterol actions.[17]

Thus, proper cholesterol levels may be achieved without exposing the brain to high doses of statin drugs. If you would like further information on improving your health naturally, make an appointment to see Dr. True at 817-399-8783.

 

[1] Hsu I, Spinler SA, Johnson NE (1995) Comparative evaluation of the safety and efficacy of HMG-CoA reductase inhibitor monotherapy in the treatment of primary hypercholesterolemia. Ann Pharmacother 29: 743-759

[2] Davidson MH (2001) Safety profiles for the HMG-CoA reductase inhibitors: treatment and trust. Drugs 61: 197-206

[3] Dietschy JM, Turley SD (2001) Cholesterol metabolism in the brain. Curr Opin Lipidol 12: 105-112

[4] King DS, Wilburn AJ, Wofford MR, Harrell TK, Lindley BJ et al. (2003) Cognitive impairment associated with atorvastatin and simvastatin. Pharmacotherapy 23: 1663-1667.

[5] Padala KP, Padala PR, Potter JF (2006) Simvastatin-induced decline in cognition. Ann Pharmacother 40: 1880-1883

[6] Muldoon MF, Ryan CM, Sereika SM, Flory JD, Manuck SB (2004) Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Am J Med 117: 823-829

[7] Evans MA, Golomb BA (2009) Statin-associated adverse cognitive effects: survey results from 171 patients. Pharmacotherapy 29: 800-811

[8] Etminan M, Gill S, Samii A (2003) The role of lipid-lowering drugs in cognitive function: a meta-analysis of observational studies. Pharmacotherapy 23: 726-730.

[9] Jick H, Zornberg GL, Jick SS, Seshadri S, Drachman DA (2000) Statins and the risk of dementia. Lancet 356: 1627-1631

[10] Wolozin B, Kellman W, Ruosseau P, Celesia GG, Siegel G (2000) Decreased prevalence of Alzheimer disease associated with 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors. Arch Neurol 57: 1439-1443

[11] Evans MA, Golomb BA (2009) Statin-associated adverse cognitive effects: survey results from 171 patients. Pharmacotherapy 29: 800-811

[12] Stuart SA, Robertson JD, Marrion NV, Robinson ESJ, “’Chronic Pravastatin but Not Atorvastatin Treatment Impairs Cognitive Function in Two Rodent Models of Learning and Memory”, PLOS ONE : e75467.

[13] Evans MA, Golomb BA (2009) Statin-associated adverse cognitive effects: survey results from 171 patients. Pharmacotherapy 29: 800-811

[14] FDA (2012) Drug Safety Communication: Important safety label changes to cholesterol-lowering statin drugs. http://www.fda.gov/Drugs/DrugSafety/ucm2​93101.htm.

[15] Vincenzo Mollace, et al., “Hypolipemic and hypoglycaemic activity of bergamot polyphenols: From animal models to human studies” Fitoterapia, Vol.82,Issue3, April 2011, 309-316

[16] Department of Cariology, University of Rome, “Tor Vergate” and the Vascular Medicin Atherosclerosis Unit of Cardiology, Villa Salus Medical centre, Marinella, IT.

[17] Natalizia Miceli, et al., Hypolipidemic Effects of Citrus bergamia Risso et PoiteauJuice in Rates Fed a Hypercholesterolemic Diet:, J.Agric.Food Chem., 2007, 55(26), PP 10671-10677.