I’m very fortunate to have Dr David Nye here with us again today. Welcome. Thank you. Dr Nye is an integrative medical practitioner and we’ve had you on the channel before. I’d like to talk to you about a controversy today: cholesterol and the use of statins. So many people are on statins. It’s a crime because really statins have been pushed by the pharmaceutical industry, I believe, to the detriment of most of the patients. That’s a very strong statement. Do you want me to back it up? You must have a really god reason. Yes please. I think cholesterol has become such a big bogey-man word and a lot of the big studies that they’ve done over the years have been shown in recent writings to have had their findings interpreted with a bias towards the pharmaceutical industry. And if one goes back and reinterprets the information from those trials, one sees that statins do not really improve life expectancy. And really why would one take something if you don’t want to improve your life expectancy? They’re very good at bringing down cholesterol. Right. But they don’t bring down life expectancy. And this is where we really need to relook at the whole cholesterol story. Is it really a myth? Do we really need to worry about high cholesterol? How dangerous it is. And are there safer ways of dealing with it? I mean people are so scared with, ‘Ah! My cholesterol levels are so high’, but you need cholesterol. You do. I mean, cholesterol is made in the liver whether you eat fat in the diet or not. The cholesterol has got to be made because it’s the building blocks for all the hormones in the body, most of the structure of the brain is made from cholesterol. So, it’s a very important substance to have in your body and a lot of the cholesterol your liver makes is actually used in your body like a band-aid for inflammation. So it’s often an indication of inflammation in the arteries and elsewhere that you have a high cholesterol. Right. So this is where so much has been misinterpreted. In fact, I love to show my patients a picture of a nice, clean artery where a high cholesterol will sail through their artery without causing any problems. And when you have inflammation that attacks the lining of the artery, that inflammation then attract the cholesterol and that then forms a plaque that then narrows the artery, that can then block up and cause a heart attack. I need to have you back to talk about inflammation. Please. Okay. We’ll talk about that another day. So what happens when they analyse these plaques many years ago, they found the cholesterol in the plaques and they said, ‘The problem here is too high cholesterol’. And actually it’s too much inflammation and the cholesterol is the body’s response to try and improve that and to try heal it. What is the difference between LDL and HDL, just for our readers? LDL is often called bad cholesterol but in fact we now analyse the LDL even further into two subgroups: the ApoA and the ApoB. And the ApoA are like large, fluffy beach balls which are good. And ApoB are like small, dense marbles which are bad. So we want to know and we can analyse this with a simple pathology test to how much of the A and the B there is in the body. But generally with LDL, too much of that, is not a good thing. And then the HDL is a very good cholesterol. It’s the one (both of them are transporters of cholesterol) that we really want a high level, a high level as possible. And the sort of things that will give you a high HDL level is a lot of lifestyle factors and having a lot of exercise. When your cholesterol is high but you’re otherwise healthy, is there something that you would recommend that a person supplements with rather than taking statin? There are a lot of natural supplements like red rye yeast and various other things that can help to bring down cholesterol. But then again I think it’s far more important to analyse the overall risk to a patient. So, we look at other risk factors as well. We look at things like CRP which is the measurement of inflammation in the arteries. We look at homocysteine. What does it stand for, something Reactive Protein? C-Reactive Protein. Just C-Reactive Protein? C doesn’t stand for anything else? No. Not that I know of. And homocysteine is another important factor. So, we need to look at all these risk factors, we need to look at the breakdown of the cholesterol. Nothing makes me madder than when a medical aid will then ask someone to have a finger prick for total cholesterol, and based on that they will then judge whether they’re a poor risk or a bad risk. Because there’s so much more to it. We need to have a whole breakdown of all the different types of cholesterol and with that information we can then supplement more appropriately, things like niacin are very good, omega-3 fatty acids are very good. These are all things that help depending on the kind of breakdown one has. What are the side effects of statins? This is really one of the reasons why I don’t like statins and why many integrative and natural doctors don’t like them, because they have been associated with a lot of side effects. And a lot of them creep up on the patients so they don’t always recognise it as due to the statin. Things like memory loss, tiredness. Sorry, I heard it’s a precursor to dementia and Alzheimer’s. Yes. Certainly. Right. Continue. So a lot of people think it’s just old age, stress or whatever, but some very serious side effects that really affect the muscles, and even the muscles can have a condition called rhabdomyolysis which fortunately is very rare. What does that look like? It’s when the muscles get destroyed. So it’s an atrophy? Yes, it’s like an atrophy. It’s irreversible. The reason why statins have a lot of side effects is because they interfere with the formation of Co-enzyme Q10, which is a very important substance in the mitochondria (the energy houses of each individual cell). And when that CoQ10 is depleted you end up with muscle pains and tiredness and memory loss and so on. If one really has to take a statin – I will tell you just now why I think who does need to take a statin – then one can supplement with Co-enzyme Q10 to replenish that level to minimise the side effects. So, Co-enzyme Q10 is often used as a supplement to improve the heart function? It is. It’s used in so many instances where one has possibly fatigue, or mitochondrial burnout, or weak heart because the heart has so many mitochondria per cell than any other cell in the body so it has a really great demand for CoQ10. And the brain does as well too That’s interesting. How do you wean yourself off or is that something you would not recommend people do by themselves? I think one needs to do it under the guidance of a medical doctor. I usually tell people, once I’ve evaluated their cardiac risk, to stop the statin all together – you don’t need to wean off it. And it’s necessary to supplement with other things. You need to look at the whole picture, as you say. You would do a full blood count, you would look for the CRP and all the other markers. Breakdown all the other types of cholesterol and their lifestyle – so much of it is usually lifestyle. If there’s a lot of bad factors in their lifestyle those need to be corrected far more importantly than taking medication. Is there a risk of hereditary component to somebody who’s predisposed to a heart condition where they naturally do have? Yes we do have a lot of Afrikaner stock that have very high cholesterols. And I do believe again that even though they have a very high cholesterol, their lifestyle will determine what they breakdown of it’s like. You can find someone that’s got a high genetic total cholesterol but they’ve got a very good HDL which meticulates that and have a lot of light, fluffy ApoA amongst the LDL which will mitigate against that, they might have a low homocysteine with mitigates against that. So just having a high total genetic cholesterol does not necessarily put you at increased risk. Right. Could that be a reason why very young, active sportsmen sometimes die of a heart attack? Not because of a genetic high cholesterol. They die because unrecognised silent inflammation or high homocysteine or other factors. But the biggest causes of heart attacks are stress combined with inflammation, so far more important than cholesterol as a risk for heart attacks. That’s really scary. David, earlier you mentioned that some people would need a statin. Under what circumstances? I think the studies show that somebody who’s had a heart attack and has high cholesterol and wants to prevent a second heart attack, they certainly benefit statistically in the studies from being put on to a statin. But people who’ve never had a heart attack, or women in their menopausal years really don’t seem to benefit from the statins in the same way The side effects just don’t… Side effects are a problem and the morbidity (death rate) is still high even if they are on the statins. Thank you so much. I can’t wait to have you back and to talk about inflammation. You’re welcome. Thank you, David.