Statins and their effect on the endocannabinoid system
In the spring of 2023, Kristýna Čillíková, vice-chair of the Czech Alliance for Cardiovascular Diseases, told Czech Television that more than 80% of adults in the Czech Republic are currently struggling with high cholesterol levels. It is a problem that can negatively affect the quality of life and its duration.
What is cholesterol?
Cholesterol is an organic molecule belonging to the group of steroid substances. Most of the cholesterol in the human body is produced in the liver, but it is also found in the diet, especially in animal products such as meat, dairy products and egg yolks.
Cholesterol has a number of functions in the human body. It is involved in the formation of bile acids, the production of hormones (cortisol or testosterone). It is an essential building block for many cells, which it helps to ensure proper function. Cholesterol is also essential for the production of vitamin D.
The human body can make cholesterol on its own, but if there is too much in the blood, problems can occur.
In medical practice, there are three types of blood fats - HDL (the 'good' cholesterol, which helps the body get rid of LDL cholesterol), LDL (the 'bad' cholesterol, which builds up in the arteries and can cause health complications if they become blocked) and TGA (cholesterol, which also needs to be controlled as it can do similar damage to LDL cholesterol).
Higher cholesterol levels are mainly linked to a less than optimal lifestyle. Of all the factors, diet has the biggest impact.
It is important to bear in mind the risks, which are mainly related to possible cardiovascular disease. High cholesterol leads, for example, to atherosclerosis, which can cause myocardial infarction or stroke.
How to fight high cholesterol? Statins are an option
According to experts from the Czech Alliance for Cardiovascular Disease, the fight against high cholesterol is relatively simple. The ideal way is regular exercise and a properly composed diet. Doctors often recommend that people consume vegetable fats instead of animal fats.
One of the possible ways to lower cholesterol levels in the body are statins, drugs that are developed to regulate this substance in the blood. They are commonly prescribed by doctors all over the body.
Many patients ask their doctors what statins are and how they work. The answer is that statins, in many cases, are good at suppressing an enzyme called HMG-CoA reductase, thereby inhibiting the production of cholesterol in the body. Through the action of this enzyme, HMG-CoA is converted into mevalonate, which is then converted into cholesterol through a series of further reactions.
Statins can be used to interrupt the formation of cholesterol inside the cell. They act as a kind of trap, taking up cholesterol directly from the blood and subsequently reducing its level. Doctors usually decide to prescribe statins when cholesterol levels are already very high (more than 6.2 mmol/l).
Patients at highest risk are those who have had a stroke or heart attack. They are often referred to statins for life. But doctors also prescribe them to patients with diabetes, kidney disease and those with an accumulation of several risk factors. This includes mainly people who struggle with high blood pressure. Often, smokers in particular have these problems.
What are the side effects of statins?
Cardiologists state that the use of statins also has its risks. These are mainly related to side effects, which include sleep disturbances or hair loss. Muscle pain is also very common.
However, most people do not need to take statins. Boycotting this treatment may cause more problems than benefits. The harm of statins is out of the question for most patients.
Side effects are often related to factors beyond the patient's control. These include, for example, old age. However, other risk factors that can cause adverse effects include alcohol consumption, excessive consumption of grapefruit or grapefruit juice, increased physical activity or vitamin D deficiency.
Statins and ECS
Some recent research has looked at the link between statins and the endocannabinoid system, a complex system of cell signalling that is used to regulate a range of functions in the body, including hormone levels, body temperature, sleep and mood. The latest study from the spring of 2023 points to the disruptive effect of statins on the endocannabinoid system. This may explain the side effects of statins, which include muscle weakness and pain.
CBD and cholesterol
A 2013 study in the British Journal of Clinical Pharmacology showed that CBD oil may indirectly regulate blood cholesterol levels, thereby reducing the risk of cardiovascular disease. Three years later, a scientific paper published in the journal Diabetes Care followed this up by suggesting that CBD could increase the body's ability to process unhealthy fats, and in overweight individuals, CBD use was shown to lead to lower LDL cholesterol levels.
In 2020, a study was published in the Journal of Dietary Supplements, which was backed by Professor Hector Lopez. Its results suggest that CBD use may raise HDL cholesterol levels, due to its effect on brain receptors. However, scientists are not yet clear about the interaction of CBD with statins, so the use of CBD products alongside prescription drugs should always be consulted with a doctor.
Which statins are the best?
According to information from the prolekaře.cz website, there is a choice of about six statins on the Czech market. Torvastatin, simvastatin and rosuvastatin are among the most commonly prescribed ones and, according to experts, they can reduce cholesterol levels by up to 50%.
Is there a substitute for statins?
There are alternatives to statins too. For example, Riyaz Patel, MD, BHF Clinic Research Fellow at University College London, lists fibrates, nutrients such as niacin and bile acid sequestrants. These drugs can have different effects and may be a suitable alternative for those who cannot take statins.
There are also natural alternatives, but these do not fully replace medicines prescribed by doctors. Examples include the omega-3 fatty acids found in fish oil or flaxseed. Mention should also be made of sterols and stanols, which are found in some plant foods.
Red yeast rice, which has been popular with Asian traditional herbalists since the eighth century AD, can also lower blood cholesterol levels. Decoctions of deaf-mustard are also an option. However, even these alternatives can have side effects and interact negatively with other medicines, and should be discussed with a doctor.
How to discontinue statins optimally?
Definitely, you should never discontinue statins without consulting your doctor. If discontinued prematurely, the risk of heart problems may increase. Only your doctor should decide whether something like this is appropriate and whether it is the right time to do so.
If discontinuation of statins is recommended, there is usually a gradual reduction in the amount, with the doctor measuring your blood cholesterol levels regularly. This way, he can check how the body is responding to stopping statin drugs. After complete discontinuation, you need to think about following a healthy lifestyle.
Conclusion
The human body cannot do without cholesterol. But it is necessary to regulate its level. That is what statins are for, drugs that are used to lower cholesterol and prevent heart disease. They help regulate cholesterol levels in the blood and reduce the risk of atherosclerotic plaque formation in the blood vessels. But statins are often associated with side effects. These include sleep disturbances or hair loss.
However, there are alternatives to statins too. Studies have shown that CBD oil has the potential to indirectly regulate blood cholesterol levels, and may also raise levels of 'good' HDL cholesterol. Red yeast rice or decoctions of milk thistle are also worth considering. However, the use of these products should always be consulted with a medical professional.