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What Do Statin Drugs Do?

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If you have high cholesterol, chances are it has been recommended that you take a statin to help lower your numbers with medication. Statins are also known as HMG-CoA reductase inhibitors because the enzyme, HMG-Co A reductase, is required by the liver to make cholesterol. If you block the enzyme then you block cholesterol production.

Many people hear the word "cholesterol" and think the worst, however cholesterol is required by the human body to create hormones such as estrogen, testosterone and even vitamin D. Our cells use cholesterol to maintain their membranes and keep them fluid instead of stiff. The gallbladder uses cholesterol to create bile for fat digestion and absorption, specifically of the fat soluble vitamins A, D, E, and K.

Cholesterol production starts with Acetyl-CoA that converts into mevalonate via HMG-CoA reductase and occurs in the liver. Then there is dietary cholesterol brought in from the foods we eat such as dairy products, eggs, meat, and fats. It is transported through the blood within lipoproteins, hence the names on lab work such as ‘LDL,’ or low-density lipoprotein, and ‘HDL,’ or high-density lipoprotein.

Ideally your total cholesterol should be under 200 mg/dL, your LDL should be under 100 mg/dL and your HDL, above 45 mg/dL. The higher the LDL you have, specifically the higher the number of particles of LDL that are smaller in size, is considered more concerning as it increases your risk for atherosclerosis, stroke, and heart attack. It is possible to have too low of a cholesterol level, and while research is limited, it is associated with depression, cancer, low hormone levels, and hemorrhagic stroke.

Statin medications do come with their risks. The most prominent ones are muscle pains, weakness, and fatigue, however,the worst possible muscle side effect is rhabdomyolysis (the breakdown of muscle tissue).

The next most common complaints are cognitive in that they feel that their brain function declines. It is also possible to develop too low of cholesterol on statins that can cause low mood and low hormone levels leading to problems.

Finally, statins block the production of Coenzyme Q10, which is a potent antioxidant used in the production of energy in our mitochondria, however supplementing with this nutrient has shown mixed reviews in the research for alleviating side effects. Regardless, I still recommend it to patients.

Not everyone needs a statin, and many may be able to use other options such as high dose, good quality fish oil, changing diet and exercise, fiber supplements (over-the-counter and medication), or red yeast rice, to name a few. Talk with your healthcare provider about what might work best for your situation.


1) Cholesterol. Web. January 11, 2012.

2) Statin Adverse Effects: A Review of the Literature and Evidence for a Mitochondrial Mechanism. Web. January 11, 2012.

3) Should I take coenzyme Q 10 with a Statin? Web. January 11, 2012.

Reviewed January 12, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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