Endnotes to "Statins: Did your doctor tell you . . . "

Although not in standard bibliographical convention, these notes should make it easy to track down the information. I have upgraded all of the links in November 2010.

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1. Duane Graveline, M.D., M.P.H., "Statin Damage to the Mevalonate Pathway". Also Uffe Ravnskov, "6. The Effect of the statins is not due to cholesterol-lowering"

The statins inhibit the body's production of a substance called mevalonate, which is a precursor of cholesterol. When the production of mevalonate goes down, less cholesterol is produced by the cells and thus blood cholesterol goes down as well. But mevalonate is a precursor of other substances also, substances with important biologic functions.

2. "Do Statins Have a Role in Primary Prevention," a review by the Therapeutics Initiative of the Department of Pharmacology & Therapeutics of the University of British Columbia, Therapeutics Letters, April - May - June 2003. Also available in Adobe Acrobat (PDF) format.

3. Joel M. Kauffman (Professor of Chemistry Emeritus), "Statin Sales Slow"

4. Paul Rosch, "Converting Millions of Healthy People into Perpetual Patients"

5. Beatrice A. Golomb in "Beatrice A. Golomb, MD, PhD on Statin Drugs".

6. Jocalyn Clark, "A hot flush for Big Pharma," BMJ (British Medical Journal) 2003;327;400 (16 August)

7. According to Dr. Peter Langsjoen, a specialist in "congestive heart failure, primary and statin-induced diastolic dysfunction and other diseases of the heart muscle." Maryann Napoli, "Cholesterol skeptics and the Bad News about Statin Drugs"

8. Christian B. Allan, Ph.D. and Wolfgang Lutz, M.D., Life Without Bread (Keats Publishing, 2000), p. 67. Chapter five, "Less is More," found from pages 35-72, is an explanation of the body's energy production.

9. Peter H. Langsjoen, M.D., F.A.C.C., "The Clinical Use of HMG CoA-reductase inhibitors (statins) and the associated depletion of the essential co-factor coenzyme Q10; a review of pertinent human and animal data." (PDF File)

10. See footnote 9 (above).


11. "Ubiquinone in a slightly altered form known as ubiquinol is found in all membranes where it has a vital function in maintaining membrane integrity. Liver inflammation, with breakdown of liver cells releasing their enzymes into the blood stream and thereby serving as a marker of statin damage, is likely due, at least in part, to loss of cell wall integrity." Duane Graveline, M.D., M.P.H., "Aging and CoQ10"

12. "Ubiquinone is also vital to the formation of elastin and collagen formation. Tendon and ligament inflammation and rupture are frequently reported in the elderly and it is likely that the mechanism of this predisposition to damage is related to some as yet unknown compromise of ubiquonine's role in connective tissue formation." Duane Graveline, M.D., M.P.H., "Aging and CoQ10"

13. "Statins block the endogenous biosynthesis of both cholesterol and CoQl0 by inhibiting the enzyme HMG CoA reductase, thus decreasing mevalonate, the precursor of both cholesterol and CoQ10." Peter H. Langsjoen, M.D., F.A.C.C., "The Clinical Use of HMG CoA-reductase inhibitors (statins) and the associated depletion of the essential co-factor coenzyme Q10. (PDF File)

14. Christian B. Allan, Ph.D. and Wolfgang Lutz, M.D., Life Without Bread (Keats Publishing, 2000), p. 160.

15. Duane Graveline, M.D., M.P.H., "The Dark Side of Statins"

16. Nicholas Regush, Red Flag Daily's "Health Trend Forecast," May 16, 2003 (a newsletters sent to Red Flags subscribers).

"Anyone on the statin drug, Mevacor (as merely one example), might like to know that Canadian prescribing information includes a notice in the Precautions section stating the following:
Effect on CoQ10 Levels (Ubiquinone)
A Significant decrease in plasma CoQ10 levels in patients treated with Mevacor and other statins has been observed in short-term clinical trials. The clinical significance of a potential long-term statin-induced deficiency of CoQ10 has not yet been established . . .

17. Peter H. Langsjoen, M.D., F.A.C.C., "The Clinical Use of HMG CoA-reductase inhibitors (statins) and the associated depletion of the essential co-factor coenzyme Q10; a review of pertinent human and animal data." (PDF File)

18. Maryann Napoli, "Cholesterol skeptics and the Bad News about Statin Drugs"

19. Peter H. Langsjoen, M.D., F.A.C.C., "The Clinical Use of HMG CoA-reductase inhibitors (statins) and the associated depletion of the essential co-factor coenzyme Q10; a review of pertinent human and animal data." (PDF File)

20. "It has been pretty well documented from biopsies that the severity of heart failure correlates with the people who have the lowest levels of Q10." (Attributed to Peter H. Langsjoen.) Maryann Napoli, "Cholesterol skeptics and the Bad News about Statin Drugs"

"Statins kill people - lots of people - and they wound many, many more." Peter H. Langsjoen, M.D., "Introduction to the Citizen's Petition on Statins"


21. Peter H. Langsjoen, M.D., "Introduction to the Citizen's Petition on Statins"

22. "Ubiquinone in its slightly altered form known as ubiquinol is found in all cellular membranes where it has a vital function in maintaining membrane integrity. Myopathy and rhabdomyolysis represent breakdown of weakened muscle cell walls due to lack of sufficient ubiquinol for muscle cell wall integrity. This same mechanism also is responsible for nerve cell breakdown and neuropathies." Duane Graveline, M.D., M.P.H., "Muscle Pain and Statins"

23. "Watchover [a program of the FDA] was informed of each Baycol death as it occurred during these past two years but bureaucratic inertia allowed over fifty fatalities to occur before action was taken placing the credibility and effectiveness of FDA in serious question." Duane Graveline, M.D., M.P.H., "The Statin Dialogues – A Fable"

24. Dr. Julian M. Whitaker, M.D., "Citizen Petition to Change the Labeling for All Statin Drugs . . ." (PDF File)

25. "Do Statins Have a Role in Primary Prevention," a review by the Therapeutics Initiative of the Department of Pharmacology & Therapeutics of the University of British Columbia, Therapeutics Letters, April - May - June 2003. Also available in Adobe Acrobat (PDF) format.

26. Coloradohealthsite.org" Editorial Comment on Cholesterol and Statin Drugs"

27. Beatrice A. Golomb in "Beatrice A. Golomb, MD, PhD on Statin Drugs".

28. Duane Graveline, M.D., M.P.H., Zocor (Simvastatin) – UK Side Effect Reports.

29. Duane Graveline, M.D., M.P.H., "The Statin Dialogues"

30. Duane Graveline, M.D., M.P.H., "Transient Global Amnesia Associated With The Statin Drugs"


31. "Statins and Risk of Polyneuropathy: A Case-control Study," by D. Gaist, MD, PhD; U. Jeppesen, MD, PhD; M. Andersen, MD, PhD; L. A. Garcia Rodriguez, MD, MSc; J. Hallas, MD, PhD; and S. H. Sindrup MD, PhD; Neurology, May 2002.

32. See footnote 31 (above).

33. Except where noted, information from this section is from "Identifying and Preventing Statin-Associated Muscle Problems" based on the study "Statin-Associated Myopathy," by Paul D. Thompson, MD; Priscilla Clarkson, PhD; Richard H. Karas, MD, PhD ; JAMA, April 2, 2003. See also Beatrice A. Golomb in "Beatrice A. Golomb, MD, PhD on Statin Drugs".

34. "CK Blood Test Inadequate to Diagnose Statin-Associated Myopathy," a review of "Statin-Associated Myopathy with Normal Creatine Kinase Levels," by Paul S. Phillips, MD; Richard H. Haas, MD; Sergei Bannykh, MD, PhD; Stephanie Hathaway, RN; Nancy L. Gray, RN; Bruce J. Kimura, MD; Georgirene D. Vladutiu, PhD; John D.F. England, MD, the Scripps Mercy Clinical Research Center; Annals of Internal Medicine, October 1, 2002.

35. Joseph Mercola, M.D., "The Baycol Recall: How Safe is Your Statin?"

36. "Beatrice A. Golomb, MD, PhD on Statin Drugs" – http://www.coloradohealthsite.org/ – search on "Golomb".

37. "Recently, Drs. Thomas Newman and Stephen Hulley published the results from a meticulous review of what we know about cancer and lipid-lowering drugs. They found that clofibrate, gemfibrozil and all the statins stimulate cancer growth in rodents (90)." (90 = Newman TB, Hulley SB. Carcinogenicity of lipid-lowering drugs. JAMA 1996;275:55-60.) – Uffe Ravnskov, "6. The Effect of the statins is not due to cholesterol-lowering"

38. Uffe Ravnskov, "Evidence that statin treatment causes cancer," Letter to the editor of Lancet, sent 10. December 2002

39. Christian B. Allan, Ph.D. and Wolfgang Lutz, M.D., Life Without Bread (Keats Publishing, 2000), p. 160. This quote has a footnote as follows: "Sinatra, S. "Care, cancer and coenzyme Q10." J. Am. Coll. Cardiol. 33 (1999): 897-899." Also Paul Rosch, M.D., F.A.C.P. letter to the editor of the Washington Post – "All statins have been shown to be carcinogenic in animals in doses equivalent to those currently being prescribed. Although the lag time between exposure to a carcinogen and clinical detection is often a decade or more, a disturbing twelve-fold increase in breast cancer has already been reported in one study and more skin malignancies were noted in another."

40. Uffe Ravnskov, M.D., Ph.D., "1. Your cholesterol tells very little about your future health"


41. The information on cholesterol is taken from three articles:

Sally Fallon and Mary G. Enig, Ph.D., "What Causes Heart Disease"
Duane Graveline, M.D., M.P.H., "Cholesterol – Friend or Foe?"
Uffe Ravnskov, M.D., Ph.D., "1.Your cholesterol tells very little about your future health"

42. Barry Groves "The Cholesterol Myth, Part 1: Introduction"

43. Sally Fallon and Mary G. Enig, Ph.D., "The Oiling of America"

44.Except where noted, information in the following list is taken from:

Uffe Ravnskov, "Statins as the new aspirin"
Barry Groves, "The Dangers of Low Cholesterol"

45. Mary G. Enig, Ph.D. and Sally Fallon, "What Causes Heart Disease" Also in "The Skinny on Fats" – "The few studies that indicate a correlation between fat reduction and a decrease in coronary heart disease mortality also document a concurrent increase in deaths from cancer, brain hemorrhage, suicide and violent death. (6 – "Multiple Risk Factor Intervention Trial; Risk Factor Changes and Mortality Results," JAMA, September 24, 1982, 248:12:1465)"

46. "A study of elderly French women living in a nursing home showed that those with the highest cholesterol levels lived the longest (The Lancet, 4/22/89). The death rate was more than five times higher for women with very low cholesterol. Several other studies have shown similar results." Maryann Napoli, "Cholesterol Skeptics And The Bad News About Statin Drugs"

47. This is important enough and controversial enough that I am going to give the complete quote from the Colorado Health Site's "Editorial Comment on Cholesterol and Statin Drugs":

Media messages and advertisements often urge patients to use drugs to reduce their LDL cholesterol below 130 and even below 100 in order to lower their risk of heart attack. The messages typically fail to warn patients that LDL cholesterol levels below 130 may actually increase the risk of coronary heart disease. For example, the FDA has recently approved a new laboratory blood test that can increase the ability of doctors to predict the risk of coronary heart disease (CHD). The test, called PLAC, works by measuring an enzyme called lipoprotein-associated phospholipase A2. FDA cleared the test based on results of a 9 year study of more than 1,348 patients. The study was a part of a large multi-center epidemiologic study sponsored by the National Heart, Lung, and Blood Institute. Patients were free from CHD at the start of the study and were followed for the development of disease for nine years. The greatest increased risk for CHD was found in subjects with the highest PLAC test results, and LDL cholesterol levels lower than 130mg/dL. [Emphasis in original.]
Giving a statin drug to a person with LDL cholesterol of 140 or below, as is frequently done today, would result in a 30 to 60% reduction in his or her LDL cholesterol, potentially placing him or her at increased risk for heart attack if his or her lipoprotein-associated phospholipase A2 is high.

48. Malcolm Kendricks MbChB, MRCGP, "Why The Cholesterol-Heart Disease Theory Is Wrong (Part Three: A Raised LDL Level Has No Impact on Heart Disease)" – you will need to scroll down the page. Kendricks gives the following quote:

There is a direct association between falling cholesterol levels over the first 14 years and mortality over the following 18 years (11% overall and 14% CVD death rate increase per 1 mg/dL per year drop in cholesterol levels). Anderson KM JAMA 1987

49. Duane Graveline, M.D., M.P.H., "Cholesterol – Friend or Foe?"

50. Sally Fallon and Mary G. Enig, Ph.D., "Diet and Disease: Not What you Think"


51. "Most risk factors for heart disease are merely "risk markers" that simply have some statistical association with an increased incidence of coronary events. There are over 300 risk factors for heart attacks, including a deep earlobe crease, premature vertex baldness, high selenium toenail levels, having a pot belly, not having a nap or one or two glasses of wine a day." Paul J. Rosch, M.D., F.A.C.P., "Do You Have Good Blood Pressure?" (Originally published in the July Health and Stress monthly newsletter of the American Institute of Stress).

52. Dr. Peter H. Langsjoen, "To Reduce the Risk of Heart Disease, Why Don't We All Cut Off Our Ear Lobes"

53. "In order to successfully treat a disease it is necessary to remove or reduce its cause rather than its manifestations or markers." "Attempting to treat or remove such markers will accomplish nothing since they do not cause coronary disease." Paul J. Rosch, M.D., F.A.C.P., "Do You Have Good Blood Pressure?" originally in the July Health and Stress monthly newsletter of the American Institute of Stress

The following quote is from Malcolm Kendrick MbChB, MRCGP, "Idiotic Thinking In Medicine C-Reactive Protein: How The Medical Profession Will Turn A Symptom Into A Disease"

When you find an abnormality of some sort that is associated with a disease, you can make a number of different conjectures:
  1. The abnormality is caused by the disease
  2. An underlying problem causes both the abnormality and the 'disease'
  3. The disease is caused by the abnormality
  4. It's a coincidence (one in twenty chance)
  5. You haven't measured things properly

54. Malcolm Kendricks MbChB, MRCGP, "hy The Cholesterol-Heart Disease Theory Is Wrong (Part Two)" – you will need to scroll down.

"So, at what point does saturated fat get turned into cholesterol?
"Answer, it doesn't. You don't make cholesterol out of saturated fat. Cholesterol, when it is made in the liver, starts out as a substance called Acteyl-co A. This is not a fat; it is nothing like a fat. It has several nitrogen atoms in it, and nitrogen comes from protein."

55. Sally Fallon and Mary G. Enig, Ph.D., "Diet and Disease: Not What you Think"

56. Sally Fallon and Mary G. Enig, Ph.D., in "The Oiling of America", mention a 1964 study of 1,700 people by the famous heart surgeon De Bakey that showed that blocked arteries were found in people with low cholesterol as often as those with high cholesterol. (They refer to the following study: M De Bakey, et al, "Serum Cholesterol Values in Patients Treated Surgically for Atherosclerosis," JAMA, 1964, 189:9:655-59.) This is just one example.

57. There is a wealth of material available online and off about this topic, fully supported by articles from peer-reviewed medical and scientific journals. Significantly, none of the authors have any financial stake in the notion that cholesterol causes heart disease.

  • Visit the website of The International Network of Cholesterol Skeptics (THINCS). "The aim with this website is to inform our colleagues and the public that this idea is not supported by scientific evidence; in fact, for many years a huge number of scientific studies have directly contradicted it.
  • Barry Groves, Ph.D. (a doctor of nutritional science) has an excellent article "The Cholesterol Myth"
  • Uffe Ravnskov, M.D., Ph.D. has written a book The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease. (New Trends Publishing, 2000, now out of print). This book could be a textbook on how to manipulate scientific data to produce a desired result regardless of facts. A large amount of the information found in the book can be found on his website The Cholesterol Myths (scroll down to "Here are the Facts! and click on the blue numbers).
  • "The Oiling of America" by Sally Fallon and Mary G. Enig, Ph.D., reviews how this theory came to be promulgated
  • Another article, "The Soft Science of Dietary Fat" by Gary Taubes also points out how the theory was able to become accepted as fact
  • Thomas J, Moore, wrote a book Heart Failure: A Critical Inquiry into American Medicine and the Revolution in Heart Care, (Touchstone Books, 1990) Chapter 5 from the book is found online

58. Both examples taken from Sally Fallon and Mary G. Enig, Ph.D., "Diet and Disease: Not What you Think"

59. "Several speakers expressed the opinion that the statin drugs' ability to reduce cardiovascular mortality has nothing to do with cholesterol reduction, but instead can be attributed to their anti-inflammatory effects. (A viewpoint that has been appearing in medical journals over the last few years.)" Maryann Napoli, "Cholesterol Skeptics And The Bad News About Statin Drugs"

"That statin treatment works in patient and age groups in whom a high cholesterol concentration is not a risk factor for cardiovascular disease shows that the benefit is not the result of cholesterol lowering. High or low cholesterol concentrations are markers for other, more important disease factors; they are not causal factors themselves." Uffe Ravnskov, letter to the editor, BMJ 2002;324:789 (30 March)

Uffe Ravnskov, both in his book and online at "6. The Effect of the statins is not due to cholesterol-lowering" points out a half dozen reasons. "And finally, the statins protected against coronary heart disease whether the cholesterol was high or low although most studies have shown that a normal or low cholesterol is no risk factor for coronary disease." They also protected against strokes, although high cholesterol is not considered a risk factor for stroke. Clearly something else is going on.

"Statins have strong anti-coagulant effects, they stabilise plaques and increase NO synthesis." [NO is nitric oxide, a powerful anti-coagulant.] Malcolm Kendricks, MbChB, MRCGP, "Is Heart Disease All Due to Blood Clots?"

See also Malcolm Kendricks, MbChB, MRCGP, "Statins Do Not Prevent Heart Disease – At Least Not By Lowering LDL/Cholesterol Levels" – you will need to scroll down.

60. Malcolm Kendricks MbChB, MRCGP, "So, What Does Cause Heart Disease"


61. Same as 60 (above).

62. "Metabolic Syndrome and its Effects on Heart Disease and Diabetes" (Circulation, 2003-07-29) – A Colorado Health Site review of the study "Metabolic Syndrome With and Without C-Reactive Protein as a Predictor of Coronary Heart Disease and Diabetes in the West of Scotland Coronary Prevention Study, by Naveed Sattar, Allan Gaw, Olga Scherbakova, Ian Ford, Denis St.J. O'Reilly, Steven M. Haffner, Chris Isles, Peter W. Macfarlane, Chris J. Packard, Stuart M. Cobbe, and James Shepherd; Circulation, July 29, 2003."

63. Christian B. Allan, Ph.D. and Wolfgang Lutz, M.D., Life Without Bread, (Keats Publishing, 2000), p. 89.

64. Sally Fallon and Mary G. Enig, Ph.D., "What Causes Heart Disease"

The situation is further complicated by the fact that commercial vegetable oils contain mostly omega-6 fatty acids. The body uses these types of fatty acids to make localized hormones, called prostaglandins, that initiate the process of blood clotting and of inflammation. This is an important mechanism. Without it, we would bleed to death when we cut ourselves and wounds would not heal. The problem occurs when these clot- and inflammation-promoting prostaglandins are not balanced by prostaglandins that inhibit clotting.
Many of the anti-inflammatory and clot-inhibiting prostaglandins are made from omega-3 fatty acids, of which there are very few in commercial vegetable oils, or indeed in fruits, vegetables, fish and eggs raised by modern farming methods. Thus, when the diet contains too much of omega-6 fatty acids and not enough of omega-3 fatty acids, there may be a tendency to form blood clots leading to heart attacks. (25)

Here is the footnote (25) referred to by Fallon and Enig in the above quote:

Kinsella, JE. Food Technology, October 1988, page 134; Lasserre M and others. Lipids 20(4), 227, 1985; Horrobin, DF. Reviews in Pure and Applied Pharmacological Sciences, Vol 4, Freund Publishing House, 1983, pages 339-383; Devlin, TM, ed. Textbook of Biochemistry, 2nd Ed, Wiley Medical, 1982, 429-430; Fallon S and Enig MG. Tripping Lightly Down the Prostaglandin Pathways, The Price-Pottenger Nutrition Foundation Health Journal 20(3), 5-8, 1996. (Also posted on "Tripping Lightly Down the PRostaglandin Pathways".)

65. Sally Fallon and Mary G. Enig, Ph.D., "What Causes Heart Disease"

66. Christian B. Allan, Ph.D. and Wolfgang Lutz, M.D., Life Without Bread, (Keats Publishing, 2000), pp. 104-109. This book is based, in part, on the experience of Dr. Lutz with thousands of patients over several decades.

67. Malcolm Kendricks MbChB, MRCGP, "So, What Does Cause Heart Disease" and Mary G. Enig, Ph.D. and Sally Fallon, "What Causes Heart Disease" – The Enig/Fallon article stresses the importance of saturated fats in the diet – they are rich in the protective factors Vitamins A, D and E.

68. Nicholas Regush in Red Flag Daily's "Health Trend Forecast," May 16, 2003 (a newsletters sent to subscribers).

"Anyone on the statin drug, Mevacor (as merely one example), might like to know that Canadian prescribing information includes a notice in the Precautions section stating the following:
Effect on CoQ10 Levels (Ubiquinone)
A Significant decrease in plasma CoQ10 levels in patients treated with Mevacor and other statins has been observed in short-term clinical trials. The clinical significance of a potential long-term statin-induced deficiency of CoQ10 has not yet been established . . .

69. Bruce Fife, N.D., Saturated Fat May Save Your Life (HealthWise, 1999), pp. 156 to 161.

Doctors have been conservative for centuries (possibly millennia). In the mid-19th century, prior to the discovery of bacteria, Ignaz Semmelweiss (1818-1865) discovered that when physicians washed their hands in a chlorine solution prior to assisting with a woman's labor, the death rate was dramatically reduced. When he published a book about his findings in 1861, he was ridiculed. He lost at least one job for his discovery and went insane as he tried to fight for his discovery. See Dr. Mark Taylor, "Ignaz Semmelweiss: 'Please wash your hands'"

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