Editor's Note: This is the second article in our "Confessions of a Former Drug Rep" series on medication dangers, particularly in overweight patients; and the value of nondrug alternatives to help your patients achieve lasting weight loss.
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal.
I had no significant symptoms or family history of heart disease, but my cholesterol and triglycerides were elevated, so the cardiologist thought it best to put me on a statin as a preventative measure. At baseline, my liver enzymes were elevated, but that was not considered to be an issue. Four weeks into using the drug, my enzymes were up fivefold and things went into a downward spiral from there, culminating in the destruction of my liver.
A majority of your patients are just like I was. They have elevated cholesterol and triglycerides, mostly because they are overweight or obese. If they are also seeing a medical doctor, it is likely they have been prescribed a statin, particularly if they are over the age of 40.
It is well-known that elevated cholesterol and triglycerides may lead to cardiovascular incidents. This is why medical doctors quickly prescribe statins. Triglycerides are the most prevalent fat in the body. They store energy processed through your liver from your diet. Cholesterol is an essential component of our cell membranes, needed to maintain cell structure and fluidity. It also assists in the digestive process with bile acids in the intestines, and helps the body in the utilization and production of vitamin D.
A high level of triglycerides combined with a low HDL is linked to a fatty buildup in artery walls and can lead to cardiovascular events.
The Dangers of Statins
Over the years, I have had the opportunity to promote a wide variety of pharmaceutical products across a wide range of therapeutic categories. These included antibiotics, antiparasitics, statins, gastrointestinal drugs, cough syrup, wound care, and oncology medications. Some of these drugs have lower side-effect profiles, while others have extremely toxic profiles and should be used only when absolutely necessary.
Listed below are the main statins and a brief review of their potential side effects. All statins listed are proven to reduce cholesterol. However, statins are highly metabolized in the P450 pathway of the liver and can cause significant toxicity to the liver:
- Mevacor (lovastatin): The first statin launched in the U.S. market. May cause eye problems (lenticular opacities). May elevate liver enzymes, which can lead to liver failure and even death.
- Lipitor (atorvastatin): Side effects could include muscle wasting, myopathy, jaundice, liver damage / failure and death.
- Crestor (rosuvastatin): Potential side effects include headache, muscle ache, loss of appetite, and upper abdominal pain; may elevate liver enzymes, which is an indication of toxic effects to the liver and could lead to liver failure and death.
Rhabdomyolysis is another potentially fatal side effect due to the breakdown of muscle tissue and the pressure placed on the kidneys to remove the damaged tissues. This can ultimately lead to kidney failure and death. This can be found in the warning section of statin package labeling.
Show Patients a Better Way
Recent surveys show that up to 70 percent of the patients who come to you for chiropractic care are overweight. While sometimes difficult to initiate, conversations about weight loss are vitally important to the health of your patients.
Obese and overweight people frequently have elevated cholesterol and triglycerides. A well-researched, natural weight-loss program is the first step in helping patients who will ultimately take statins if they don't lose weight.
Speaking from experience as someone whose life was saved by an emergency liver transplant, I can tell you that the side effects of statins are very real. Your overweight patients may experience some of these side effects unless someone intervenes to provide them with a solution that make statins unnecessary. I'm asking you, the doctor of chiropractic, to be that someone.
Mike Robinson held high-level positions within the pharmaceutical industry for three decades, including former national sales promotion manager for Bristol-Myers-Squibb and former vice president of sales and marketing for Romark Pharmaceuticals. He is now the vice president of NuLean (www.nulean.com) which has been serving doctors of chiropractic and their patients for more than 10 years with research-verified benefits and patient-proven results.