Statin drugs are prescribed to lower cholesterol levels. There are recent news reports reporting studies that the benefits of statin drugs outweigh the risks. New guidelines came out in November 2013 that increase the population of people being recommended for statin treatment.
Many medications have a desired target range in the labs with both an upper and lower limit. Warfarin, a blood thinner, is titrated based on INR labs so blood doesn't get too thin or too think. Diabetes medications are titrated based blood sugar levels so blood sugar doesn't drop too low or go too high. However, the conventional wisdom on statins seems to be titrate so that cholesterol just goes lower. But, how low is too low for cholesterol?
Evidence does suggest that when cholesterol goes too low (<150-160 mg/dL), there is an increased risk of cancer, hemorrhagic stroke, unnatural and violent deaths, depression, and cognitive decline (PMID: 24840261, 24495778 and 24512018). Despite all the bad press that cholesterol gets, cholesterol does play an important function in our health--production of sex hormones, building healthy cell membranes, production of vitamin D and bile for digestive function to name a few. Additionally, the brain needs cholesterol to function properly. We know what happens when we have too much cholesterol, but what about when we don't have enough for the brain, vitamin D production, hormone production, and digestive function?
If you find yourself being prescribed statin drugs, I encourage you to have a conversation with your doctor about how low is too low and how is this medication going to be monitored so you stay in the optimal range.
Perhaps some of the risks of statin drugs would be lessened if these medications were titrated with an observed lower limit to cholesterol levels.
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