Jeffrey Dach MD   BLOG   Newsletter   

Natural Solutions with Bio Identical Hormones 

A Choirboy for Cholesterol Turns Disbeliever by Jeffrey Dach MD

Stephen Sinatra Lipitor Statin Heart DiseaseCholesterol and Statin Drugs -

Steven Sinatra, MD Cardiologist Turns From Choir Boy to Disbeliever 
by Jeffrey Dach MD

Steven Sinatra MD, a board certified cardiologist in Connecticut and popular author, admits he was a cholesterol believer for many years, and even gave lectures on behalf of statin makers Merck and Pfizer.  However, after years of clinical practice, Sinatra turned from choirboy to disbeliever because of the following observations:  

1) many patients with low cholesterol will go on to develop heart disease.

2) In many patients with cholesterol above 280, angiograms show normal coronary arteries.  They don't have heart disease.

3) Population studies discredit cholesterol.  For example, the French have the highest cholesterol levels in Europe of 250, and they also have lowest incidence of heart disease.   On the Greek Island of Crete, average cholesterol is well over 200, yet there was not a single heart attack there in ten years. 

4) Half of all heart attacks occur in people with normal total cholesterol.

Statin Vending Machine LipitorA Vending Machine for Statin Drugs?

Recently, Steven Sinatra MD wrote an excellent article  in the Townsend Letter in which he remarks that drug companies Merck and Pfizer have transformed the medical profession into one big vending machine for statin drugs.(1)(2)(3)(4)

Obsolete Blood Test

Dr. Sinatra also tells us that the Cholesterol blood test your doctor orders for you is now obsolete, and has been replaced by the VAP, a more sophisticated lipoprotein panel which provides a wealth of useful information absent from the old cholesterol panel your doctor orders.  What is this added information?

LDL Particles - Not All Sizes are Equal

LDL particle contains cholesterol Jeffrey Dach MD
Firstly the VAP provides LDL particle size. Small LDL particle size is the dangerous one associated with increased risk of heart disease. Large buoyant LDL particle size is the safe one, with less heart disease risk.

Secondly the VAP includes Lipoprotein (a), a marker of high risk for heart disease risk.

Left Image: LDL particle with cholesterol ester in the center surrounded by phospholipid outer coating.

Total Cholesterol?

Sinatra says total cholesterol doesn't mean much unless you have a level over 320 which increases risk of stroke.  Reducing cholesterol can be accomplished with weight reduction and increasing dietary fiber. He would not give a statin drug for this unless you are a male with documented heart disease.

Low LDL?

Sinatra says that low LDL below 80 is associated with adverse side adverse side effects of cancer, aggression, cerebral bleeding, amnesia, and immune dysfunction. 

Just Don't Do It

Here is Dr Sinatra's advice to you if your doctor tells you to take statin based on the standard cholesterol panel:

1) Don't do it. Ask for a VAP test.

2) If you are a 50-75 year old male with small dense LDL on a VAP test, then go for the statin drug. It's a good idea. If you are over 75, don't take a statin drug as the drugs cause increased mortality in the elderly.

3) If you are a woman, avoid statins, as no statin drug study has ever shown a benefit in all-cause mortality for women by lowering cholesterol, and adverse effects of the drugs are horrendous.

See my article on this topic: Cholesterol Lowering Statin Drugs for Women, Just Say No by Jeffrey Dach MD

4) If you have elevated lipoprotein (a), do not take a statin.  The drugs don't work for this. Instead use Niacin (B3) 500-2000 mg per day, fish oil 2-3 grams per day, and nattokinase 100 mg per day. 

The Greatest Scam Ever

The famous Framingham Study is the foundation and basis of the cholesterol theory of heart disease. This is the idea that elevated cholesterol levels causes heart disease, and that statin drugs reduce cholesterol thereby preventing heart disease.  A Biochemist and participant in the Framingham study, George Mann, later described it as the "the greatest scam perpetrated on the American Public".

I Stopped My Statin Drug - Now What ?

Once patients get off statin drugs, the next question is what replaces the statin drug?  What lifestyle modifications and nutritional supplements are used to prevent or reverse heart disease?  There is an entire program devoted to this.  It is called is the Track Your Plaque Program devised by William Davis MD, a Wisconsin cardiologist.  Contained within Davis's program is the Linus Pauling Protocol among other things which is described in this article:

CAT Coronary Calcium Scoring, Reversing Heart Disease by Jeffrey Dach MD

William Davis MDWilliam Davis MD Warns About the Evil Trio

If total cholesterol is not useful as a predictor of heart disease risk, what is? Which lipoprotein markers on the VAP test are the ones to look for?  Davis tells us the VAP test sometimes reveals an evil trio of lipoprotein abnormalities which are strongly predictive of heart disease, often leading to advanced heart disease at an early age.(6)

Dantes Inferno Evil Trio of Hell Here is the evil trio:

1) Low HDL--generally less than 50 mg/dl.
2) Small Particle Size LDL--especially if 50% or more of total LDL.
3) Lipoprotein(a)--an aggressive risk factor by itself.

Left Image: Dante's Inferno

If you have the evil trio, rather than robotically prescribe a statin drug, Davis recommends lifestyle modification and dietary supplements.  Davis remarks that some of his greatest heart disease reversals have been in patient with this evil trio, which responds well to the regimen listed below.  Reversal of Heart disease is determined by reduction in coronary calcium score (or less of an increase).

Here is Dr Davis' program for Reversing Heart Disease and the Evil Trio

1) Niacin--increases HDL, reduces small LDL, and reduces Lp(a)

2) Elimination of wheat, cornstarch, and sugars--Best for reducing small LDL; less potent for Lp(a) reduction.

3) High-fat intake--Like niacin, effective for all three.

4) High-dose fish oil--Higher doses of EPA + DHA 3000 mg per day.

Here are a cases from the office of people on statins that I see very day. Statin Case Reports From the Office:

Number One  - Chronic Psoriatic Rash from Statins:

Dan is about 65 with no history of heart disease and has been on a statin drug for a cholesterol of 220 about two years.  His major problem is a red raised rash on his forearms, and hands and forehead which looks a lot like psoriasis, present for about 2 years.  Dermatologists have been stumped and of no help.

Dan's VAP show large buoyant LDL particles indicating low risk for heart disease.  His coronary calcium score was 75th per centile indicating only mildly above average risk of heart disease (50% per centile is average risk).

I told Dan that the rash was most likely a reaction to the statin anti-cholesterol drug, and advised a two week trial off the drug to see if the rash resolves.  Three weeks later Dan returns to the office, and reports the skin rash is gone.

Number Two- Lupus-like Skin Lesion from Statins

Sarah is an 82 year old with no history of heart disease and on a statin drug for a cholesterol of 235.  She had been to the dermatologist because of skin lesions on her face near the temple areas which were biopsied and reported by the pathologist as inflammation in the skin suggestive of lupus erythematosis.  Sarah is concerned she has Lupus and cam to see me for a second opinion.  I told Sarah she did not have Lupus and advised her that the skin eruptions were a reaction to the statin drug.  Sarah stopped the statin drug and three weeks later reported the skin had returned to normal.

Number Three- Early Alzheimer's from Statins

Lori is a 52 year old post menopausal with chief complaint of memory loss, cognitive dysfunction and severe fatigue.  She had no history of heart disease and been on a statin drug for many years for a cholesterol of 230.   I advised her to stop the statin drug.  However, her cognitive dysfunction and memory loss continued unchanged.  She was unable to find the office for a follow up visit, gave up and drove home.

A study by Muldoon showed virtual 100% of patients on statin drugs have some element of cognitive impairment, ranging from mild to severe symptoms of amnesia and cognitive dysfunction. (5)  I have found this to be the case in actual clinical practice.

Number Four- Wheelchair bound non-healing deep infections from statins

Jim is a war veteran and was paralyzed from a roadside bomb many years ago, and has since been wheelchair bound. Although there is no history of heart disease, his doctor placed him on a statin drug for a cholesterol of 245 about two years ago.  Shortly thereafter, Jim developed non-healing chronic decubitus infections at the ischial tuberosities at the site of pressure sitting in the wheelchair.  Jim has had numerous surgical procedure and drainages, debridements, and multiple courses of antibiotics for these chronic infections which refuse to heal.  In this case, the statin drug prevents healing of chronic infection.  Jim stopped the statin drug, began an intensive nutritional  program to boost immunity and healing ability and reported improvement after 6 weeks.

Articles with Related Interest:

Reversing Heart Disease with DeToxMax Plus and Lipophos EDTA

Heart of the Matter, Maryanne Demasi, the Cholesterol Myth-Video Series

39 Reason to Avoid Stenting and Bypass

Vitamin E, Heart Disease and Tocotrienols

Calcium Tablets Cause Heart Disease

Familial Hypercholesterolemia

Saving Time Russert and George Carlin

Healthy Men Should Not Take Statin Drugs

Heart Disease Vitamin C and Linus Pauling

Getting Off Statin Drug Stories

How to Reverse Heart Disease with the Coronary Calcium Score (part one)

Reversing Heart Disease Part Three

Cholesterol Lowering Drugs for the Elderly, Bad Idea

Cholesterol Lowering Statin Drugs for Women Just Say No

Jeffrey Dach MD
7450 Griffin Rd Suite 180/190
Davie, FL 33314
Phone: 954-792-4663

Links and References:

Dr. Stephen Sinatra - From Cholesterol Choirboy to Non-Believer

Dr. Stephen Sinatra - How to Determine if You Really Need a Statin

Dr. Stephen Sinatra - Statins, CoQ10, and Carnitine

If we have to prescribe a statin we always make sure the patient takes an ample amount of supplemental CoQ10 - at least 100 mg daily and taken with a meal.

Clearing Up the Cholesterol Confusion by Steven Sinatra, MD, FACC, FACN
A well-known cardiologist explains why he doesn't think lowering cholesterol is the answer for preventing heart disease, and debunks the routine prescription of statins for all but specific cases.

Am J Med. 2000 May;108(7):538-46.

Effects of lovastatin on cognitive function and psychological well-being.

Muldoon MF, Barger SD, Ryan CM, Flory JD, Lehoczky JP, Matthews KA, Manuck SB.
Center for Clinical Pharmacology (MFM), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

CONCLUSION: Treatment of hypercholesterolemia with lovastatin did result in small performance decrements on neuropsychological tests of attention and psychomotor speed.

Lethal lipids-Heart Scan Blog William Davis MD
There's a specific combination of lipids/lipoproteins that confers especially high risk for heart disease. That combination is:
Low HDL--generally less than 50 mg/dl
Small LDL--especially if 50% or more of total LDL
Lipoprotein(a)--an aggressive risk factor by itself

Total Cholesterol and Heart Disease

Dr Malcolm Kendrick (MbChB MRCGP) MD qualified in Aberdeen Scotland. He has worked in family practice for almost twenty years, and learned that treating patients is not like treating textbooks. He has specialized in heart disease and set up the on-line educational website for the European Society of Cardiology.

Jeffrey Dach MD
7450 Griffin Road Suite 190
Davie, Florida 33314

Disclaimer click here:
The reader is advised to discuss the comments on these pages with  his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician — patient relationship.

Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.

Link to this article:

Copyright (c) 2014 Jeffrey Dach MD All Rights Reserved
This article may be reproduced on the internet without permission, provided there is a link to this page and proper credit is given.

FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of issues of significance. We believe this constitutes a ‘fair use’ of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.

Serving Areas of: Hollywood, Aventura, Miami, Fort Lauderdale, Pembroke Pines, Miramar, Davie, Coral Springs, Cooper City, Sunshine Ranches, Hallandale, Surfside, Miami Beach, Sunny Isles, Normandy Isles, Coral Gables, Hialeah, Golden Beach ,Kendall,sunrise, coral springs, parkland,pompano, boca raton, palm beach, weston, dania beach, tamarac, oakland park, boynton beach, delray,lake worth,wellington,plantation