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Most people don't suffer side effects of statin medications. But for those who do, cholesterol lowering diets can make them work, just not in the ways you might expect.

People don't usually defy their doctors and refuse to take statin medications for the prevention of heart disease. Probably about 50 percent continue to take their statins indefinitely. 

About half of statin users all over the world, however, find reasons to stop their cholesterol medications due to subtle side effects. Up to about 40 percent of people taking statins in hopes of preventing a first heart attack stop them in three years or less [1]. Nearly 45 percent of people who have already had a heart attack stop taking their cholesterol lowering drugs after two years [2]. And over 50 percent of diabetics, who are at especially high risk of cardiovascular disease, and who have lots of medications to take, stop statins in just two years [3].

The problem might be that many people simply try too hard. Methods of lowering cholesterol naturally and cholesterol lowering drugs don't always mix. Certain foods and some dietary patterns can make the side effects of statin drugs worse. 

Why Do People Stop Taking Statins?

What's the most frequent reason patients stop taking the cholesterol lowering medications? In the United States, it's insurance. The leading reason people stop taking any particular statin drug is that their health insurance company, in 16.8 percent of cases, tells them it won't be paid for any more. Only about 4.7 percent of Americans who stop their statins do so because of the much-publicized problem of rhabdomyolysis, which is statin induced breakdown of muscle tissue. Another 2.5 percent quit because of joint pain. About 2 percent stop because their liver enzymes go up. Only 0.8 percent suffer memory problems or other neurological symptoms, And less than 0.1 percent are diagnosed with nutritional problems. [4] But it's likely that the real nutritional problems are serious, undiagnosed, and far more common than believed.

How Could Healthy Diet Cause Problems with Statin Drugs?

Veggies are a great source of vitamins. Fruit, eaten in moderation (a piece or two a day), is a great source of important plant chemicals, like the red and purple pigments known as anthocyanins that increase HDL [5] and prevent the excessive production of cholesterol from sugars in diabetics [6]. A fundamental principle of any healthy diet for lowering cholesterol naturally is eating more plant foods, including herbs for increasing HDL and Improving LDL.

The problem with plant foods is that plants don't "want" to be eaten. Even organic fruits and vegetables contain naturally occurring chemicals that discourage animals, including humans, from eating them. Our livers have to produce specific enzymes to detoxify these plant chemicals (which, again, aren't sprayed on the plant, but which occur naturally to protect the plant). However, our livers also have to use these enzymes to process cholesterol-lowering medications.

Here's how this reality of the way your body works causes complications with some of the most common cholesterol lowering drugs:

  • Pravastatin (the generic form of Pravachol) can cause your insulin-making cells to "dump" insulin quickly [7]. Over a few years, this can contribute to beta-cell depletion which leads to diabetes. If you regularly make sure you get enough vitamin C and potassium by drinking orange juice, your liver increases the toxicity of the drug [8]. That glass of orange juicewith your statin, could be the problem if you develop diabetes while you are on the drug, not eating too much cake and ice cream. (But avoid excessive consumption of sweets, too.)
  • Simvastatin (the generic form of Zocor) can cause nighttime leg cramps. Not everybody gets them. They are more common in people who have atherosclerosis. But they can be intensely painful. [9]  Simvastatin is cleared out of your bloodstream by a liver enzyme called CYP3A4 [10], and plant foods (especially berries, onions, and apples, which contain a chemical called quercetin) and hot peppers (which contain a chemical called capsaicin) activate CYP3A4. This leads to an odd experience for some people who take the drug. When they eat salads, or if they eat an apple a day, or if they eat a lot of Thai food or salsa, they don't have leg pains. When the skip these foods, they do. For Zocor, it is the consistency of healthy diet, or at least of chile-peppery diet, that is essential to avoiding this side effect.
  • Unlike some other statins, atorvastatin (the generic form of Lipitor) doesn't interact with grapefruit juice as long as you are taking the same dose every day [11]. However, if your doctor increases your dosage of Lipitor, then not just grapefruit juice but oranges, tangerines, lemons, and limes can increase the concentration of Lipitor in your bloodstream beyond what would be expected from increasing the dosage. Eating citrus fruit during the first three or four weeks after your doctor increases your dosage of Lipitor is the time you are most likely to have muscle pain, memory problems, or stomach upset from the drug.

Cholesterol isn't really the culprit in cardiovascular disease. There's nothing magical about lowering your cholesterol for preventing heart disease with cholesterol lowering drugs or cholesterol lowering diet. The statin drugs that coincidentally lower your cholesterol, however, have a variety of anti-inflammatory effects that really do make a major difference in your health.

If you seem to be having a bad reaction to a statin, maybe the problem really is that you are trying a little too hard with your diet. Don't eat vegetables like they were medicine. Just eat them as if they were food. Moderation even in healthy diet with only the medication you really need is a firm foundation for your future heart health.

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