Dr. Wy, why should I take a statin to lower cholesterol since there are many other choices like bergamot and berberine that I can get without a prescription?

Ask Dr. Wy…

Richard Wyderski, MD, FACP

Dr. Wy, why should I take a statin to lower cholesterol since there are many other choices like bergamot and berberine that I can get without a prescription?

You’re right that there are other medications that can make the cholesterol numbers look better. 🙃

But decades ago we learned from a prescription drug called clofibrate that just because the numbers are better doesn’t mean that we’re better off. That drug INCREASED the risk of death and was taken off the market. We really need evidence that whatever we use reduces the risk of stroke, heart attack, and death. And statins have that kind of evidence!

In 2022 the United State Preventive Services Task Force reviewed 22 trials that reported on the benefits of statin use compared to placebo for primary prevention.

Statin therapy was associated with decreased risks of death, fatal or nonfatal stroke, and fatal or nonfatal heart attack. Almost all of these trials only included patients under the age of 75, so we only have indirect evidence that they are effective in older adults. That means they probably work in older adults, but the evidence needs to be taken with a grain of salt. There are placebo-controlled trials underway to find out. And we need similar trials to find out about other drugs like berberine and bergamot. We just don’t know yet!

The evidence for statins causing significant harm show that muscle and liver damage are rare though possible. An increased diabetes risk was demonstrated in people who were already at risk for developing diabetes, though the risk increase was less than 1%.

So that’s why statin drugs are #1 on the list to lower cholesterol. We know they work!

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