Bioidentical Hormones 101 
The Book, by Jeffrey Dach MD

Chapter 41. A Choirboy for Cholesterol Turns Disbeliever .

Chapter 41.  A Choirboy for Cholesterol Turns Disbeliever

Steven Sinatra MD, a board certified cardiologist in Connecticut and popular author, admits he was a cholesterol believer for many years, and even lectured on behalf of statin makers Merck and Pfizer.  However, after years of clinical practice, Sinatra had a change of heart. He transformed himself from a choirboy for cholesterol drugs into a disbeliever because of the following observations: 

Observations That Show Cholesterol IS NOT the Cause of Heart Disease

(1) Many patients with low cholesterol will go on to develop heart disease.

(2) In many patients with cholesterol above 280, angiograms show normal coronary arteries.  They don't have heart disease.

(3) Population studies discredit cholesterol.  For example, the French have the highest cholesterol levels in Europe of 250, and they also have lowest incidence of heart disease.   On the Greek Island of Crete, average cholesterol is well over 200, yet there was not a single heart attack there in ten years. 

(4) Half of all heart attacks occur in people with normal total cholesterol.

A Vending Machine for Statin Drugs?

Steven Sinatra, MD remarked in his writings that drug companies Merck and Pfizer have transformed the medical profession into one big vending machine for statin drugs.(1-4)  Dr. Sinatra also informs us that the routine Cholesterol Blood Test ordered by your doctor is now obsolete, and has been replaced by the VAP test, a more sophisticated lipoprotein panel which provides a wealth of useful information absent from the old cholesterol panel.  What is this added information?

The VAP Test - LDL Particles - Not All Sizes are Equal

Firstly the VAP Test provides the LDL particle size. Small LDL particle size is the dangerous one associated with increased risk of heart disease. Large buoyant LDL particle size is the safe one, with less heart disease risk.  Secondly the VAP includes Lipoprotein (a), a marker of high risk for heart disease risk.

What is the Value of a Total Cholesterol Test?

Sinatra says total cholesterol doesn't mean much unless you have a level over 320 which increases risk of stroke.  Reducing cholesterol can be accomplished with weight reduction and increasing dietary fiber. He would not give a statin drug for this unless you are a male with documented heart disease.

Adverse Effects of Low LDL

Sinatra says that statin drugs can drive down LDL, yet low LDL below 80 is associated with adverse side effects of increased risk of cancer, aggression, cerebral bleeding, amnesia, and immune dysfunction. 

Just Don't Do It

Here is Dr Sinatra's advice to you if your doctor tells you to take statin based on the standard cholesterol panel: 

Dr Sinatra’s Advice:

(1) Don't do it. Ask for a VAP test.

(2) If you are a 50-75 year old male with increased numbers of small dense LDL particles on a VAP test, then go for the statin drug. It's a good idea. If you are over 75, then don't take a statin drug as the drugs cause increased mortality in the elderly.

If you are a woman, avoid statins, as no statin drug study has ever shown a benefit in all-cause mortality for women by lowering cholesterol, and adverse effects of the drugs are horrendous.

If you have elevated lipoprotein (a), do not take a statin.  The drugs don't work for this. Instead use Niacin (B3) 500-2000 mg per day, fish oil 2-3 grams per day, and nattokinase 100 mg per day.


The Greatest Scam Ever

The famous Framingham Study is the foundation and basis of the cholesterol theory of heart disease. This is the idea that elevated cholesterol causes heart disease, and statin drugs reduce cholesterol thereby preventing heart disease.  A biochemist and participant in the Framingham study, George Mann, later described this as , " the greatest ‘scientific’ deception of the century, and perhaps any century.(17)

I Stopped My Statin Drug - Now What?

Once a patient decides to get off statin drugs, the next question is what replaces the statin drug?  What lifestyle modifications and nutritional supplements are used to prevent or reverse heart disease?  The answer is that an entire program has been devised for this.  This program is called “Track Your Plaque”, and was devised by William Davis MD, a Wisconsin cardiologist.  Contained within Dr. Davis's program are lifestyle and diet modifications and targeted supplements based on the VAP- Lipoprotein results.  A complete description of this program can be found in Natural Medicine 101.

 William Davis MD Warns About the Evil Trio

If total cholesterol is not useful as a predictor of heart disease risk, what is? Firstly, Dr. Davis uses the calcium score as a predictor of heart disease risk.  Secondly, there are a few lipoprotein markers on the VAP test which are useful.  Dr.  Davis tells us the VAP test sometimes reveals an evil trio of lipoprotein abnormalities which are strongly predictive of heart disease risk, often leading to advanced heart disease at an early age.(6)

The Evil Trio of Dr Davis

1) Low HDL--generally less than 50 mg/dl.
2) Small Particle Size LDL--especially if 50% or more of total LDL.
3) Elevated Lipoprotein(a)--an aggressive risk factor by itself.

If you have the “Evil Trio” on your VAP test, rather than robotically prescribe a statin drug, Dr. Davis instead recommends lifestyle modification and key dietary supplements.  Davis remarks that some of his greatest heart disease reversals, with reduction in calcium score,  have been in patient with this Evil Trio, which responds well to the regimen listed below.  Reversal of heart disease is determined by reduction in coronary calcium score (or less of an increase) on follow up scans.

Here is Dr Davis' Program for Reversing Heart Disease and the Evil Trio

1) Niacin--increases HDL, reduces small LDL, and reduces Lp(a)
2) Elimination of wheat, cornstarch, and sugars--Best for reducing small LDL; less potent for Lp(a) reduction.
3) Reduce carbohydrates and increase healthy fats --Like niacin, effective for all three.
4) High-dose fish oil--Higher doses of EPA + DHA 3000 mg per day.

Statin Drug Case Stories:
Here are a few statin drug  case histories from my office:

Case Number One  - Chronic Psoriatic Rash from Statins:

Dan is about 65 with no history of heart disease and has been on a statin drug for a cholesterol of 220 about two years.  His major problem is a red raised rash on his forearms, and hands and forehead which looks a lot like psoriasis, present for about 2 years.  Dermatologists have been stumped and of no help.  Dan's VAP test show large buoyant LDL particles indicating low risk for heart disease.  His coronary calcium score was 75th percentile indicating only moderately above average risk of heart disease (50% per centile is average risk).  I told Dan that the rash was most likely a reaction to the statin anti-cholesterol drug, and advised a two week trial off the drug to see if the rash resolves.  Three weeks later Dan returns to the office, and reports the skin rash is gone.

Case Number Two- Lupus-like Skin Lesion from Statins

Sarah is an 82 year old with no history of heart disease on a statin drug for a cholesterol of 235.  She had been to the dermatologist because of skin lesions on her face near the temple areas which were biopsied and reported by the pathologist as inflammation in the skin suggestive of lupus erythematosis (SLE).  Sarah is concerned she has Lupus and came to see me for a second opinion.  I told Sarah she most definitely did not have Lupus and advised her that the skin eruptions were a reaction to the statin drug.  Sarah stopped the statin drug and three weeks later reported the skin had returned to normal.

Case Number Three- Early Alzheimer's from Statins

Lori is a 52 year old post menopausal with chief complaint of memory loss, cognitive dysfunction and severe fatigue.  She had no history of heart disease and been on a statin drug for many years for a cholesterol of 230.   I advised her to stop the statin drug.  However, her cognitive dysfunction and memory loss continued unchanged.  Her memory was so bad, she got lost and was unable to find her way to the office for her follow up visit.  She wandered around and eventually made her way home    A study by Muldoon showed virtual 100% of patients on statin drugs have some element of cognitive impairment, ranging from mild to severe symptoms of amnesia and cognitive dysfunction. (5)  I have found this to be the case in actual clinical practice.

Case Number Four- Wheelchair bound non-healing deep infections from statins

Jim is a war veteran and was paralyzed from a roadside bomb many years ago, and has since been wheelchair bound. Although there is no history of heart disease, his doctor placed him on a statin drug for a cholesterol of 245 about two years ago.  Shortly thereafter, Jim developed non-healing chronic decubitus infections at the ischial tuberosities (buttocks) at the site of pressure sitting in the wheelchair.  Jim has had numerous surgical procedure and drainages, debridement, and multiple courses of antibiotics for these chronic infections which refuse to heal.  In this case, the statin drug prevents healing of chronic infection.  Jim stopped the statin drug, began an intensive nutritional program to boost immunity and healing ability.  Six weeks later he reported considerable improvement.

For references and links, see my web site:

References for Chapter 41. A Choirboy for Cholesterol Turns Disbeliever

Dr. Stephen Sinatra - From Cholesterol Choirboy to Non-Believer, Spacedoc blog.

Dr. Stephen Sinatra - How to Determine if You Really Need a Statin

Dr. Stephen Sinatra - Statins, CoQ10, and Carnitine

Clearing Up the Cholesterol Confusion by Steven Sinatra, MD, Townsend Letter.

Am J Med. 2000 May;108(7):538-46. Effects of lovastatin on cognitive function and psychological well-being. Muldoon MF, Barger SD, Ryan CM, Flory JD, Lehoczky JP, Matthews KA, Manuck SB.

Lethal lipids-Heart Scan Blog William Davis MD

(7) Cholesterol Lowering Statin Drugs for Women, Just Say No by Jeffrey Dach MD

(8) Cholesterol Lowering Drugs for the Elderly, Bad Idea

(9) Heart Disease, Ascorbate, Lysine and Linus Pauling by Jeffrey Dach MD

Saving Tim Russert and George Carlin by Jeffrey Dach MD

(11) Lipitor and The Dracula of Modern Technology by Jeffrey Dach MD

(12) CAT Coronary Calcium Scoring, Reversing Heart Disease by Jeffrey Dach MD

(13) Heart Disease Part Two by Jeffrey Dach MD

Crestor, Jupitor, CRP and Heart Attack by Jeffrey Dach MD

Vitamin C and Stroke Prevention by Jeffrey Dach MD

(16) Cardiac Bypass, Angioplasty and Stenting by Jeffrey Dach MD

(17)  “Saturated fat and cholesterol in the diet are not the cause of coronary heart disease. That myth is the greatest ‘scientific’ deception of the century, and perhaps any century.” - George V. Mann, M.D. Professor of Biochemistry, The Physician’s Concise Guide To: The Cholesterol Myth.

Author: Jeffrey Dach MD

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