Do Statins Mess With Your Head? Studies Link Irritability and Cholesterol Meds
Not to cast aspersions on the people I love, but I started to notice something not so flattering about the older folks in my family: They all got irritable and lost their memory as they aged. They also all took statins, daily drugs to lower their cholesterol, and enjoyed a life of eating cheese, lots and lots of cheese. Even when they were active, fit, and walked or swam or played golf every day, their mental acuity and attitude declined so fast that I had to look for a reason. Why would a day on the golf course turn sour just because of a lost ball? Something was at work here. I started to dig.
There is one exception, my mother-in-law, an avid golfer until 95, a cheerful lady, and sharp as a tack all through her life. And she took nothing, not even a baby aspirin a day. I admit to all you doctors reading this that what follows here is a study of just a few people, but still, it caused me to start to research statins and mental or personality changes, and I didn't like what I found.
About 30 percent of Americans over the age of 40 take a statin, such as Lipitor, Mevacor, Crestor and Zocor, according to the CDC, which reports that statins are among the most widely prescribed drugs in the world, because they work to lower LDL cholesterol. Millions of patients have avoided heart disease, stroke, and cholesterol-related blockages, which undoubtedly save lives. But at what cost to our minds and mental health? According to a study in the Annals of Internal Medicine, 70 percent of patients continued to take a statin after "adverse" side effects. Wouldn't it be easier and better for all to simply try a dietary change?
Statins have been studied for decades now, and with over 30 percent of Americans taking these so-called miracle drugs to lower blood cholesterol, it begs the question: Are people on statins irritable and losing their memory due to age and infirmity? Or is a widely-disseminated drug treating a condition, high cholesterol, that could otherwise be treated by dietary changes? And is it causing harm to the brain in ways we don't recognize as tied to the drug? Here is my personal "case study of my family:"
Statins, irritability, mood disorders and memory loss: Here's my observation
My dad started to get short-tempered in his mid-70s, which was also about the same time his health began to fail him. He had heart problems and balance problems, and if he got up too fast from the dinner table he was prone to fall down, which led to hip problems which led to walking problems and then some executive function issues, and at one point when I saw his toiletry kit, on a weekend in the Hamptons, he showed me the 13 pills he took every day. I asked, "What are all these for? and he explained his doctors insisted he needed every single one. I said, "Daddy you are like a chemical soup, and these are all interacting with each other." He shrugged.
I didn't know then what I know now: That heart patients who change their diet, give up meat, cheese, dairy, and all animal fat, and eat a whole food plant-based approach without oil, have reversed their heart disease. Watching Forks Over Knives, the documentary about how diet can reverse disease and help people get off their meds, might have convinced him. Or maybe not. Not everyone has the ability or propensity to change. As the years went on his temperament changed and he was no longer the cheerful "Hail Fellow Well Met" guy I always thought of as my beloved and popular Dad.
I chalked all of this up to the fact that he was a lion in winter, no longer able to roar as loudly or laugh as fully, or move as quickly on the tennis court or even hold himself steady enough to skipper our little day sailor, an Oday we had always loved sailing together. I had always remembered him as able-bodied and game for anything: skiing, sailing, jogging, tennis, swimming, and golf, increasingly golf during his last decades. He never thought to change his diet, which was a typical American male way of eating. He loved cheese and crackers, and his favorite lunch was a ham and cheese sandwich with mayo.
Meanwhile, he took statins, and I started to wonder whether his mental changes had anything to do with the meds. I started to do some research and became convinced that statins, which 30 percent of Americans take every day, are not such perfect pills. Yes, they lower your cholesterol, but they also have been found to change your mood, personality and cause irritability and mental decline, according to studies I found during a simple search.
Statins, personality changes and dementia: The connection has been studied
My mom's mind began to slip away when she hit her early 80s and I chalked it up to the usual memory-stealing age-related decline that many people seem to have to deal with as they age. She was slender, a walker, a swimmer and fit as could be. But no matter that she moved with elegance and a steady gait, her mind wasn't working as well as it should. As she walked home from her ladies club she couldn't tell you what she had eaten for lunch. She took statins and drugs to avoid her heart from racing or fluttering. She also got anxious as her memory slipped away, but I assumed that her anxiety was a natural side effect of losing one's memory. Could it be related to the statins? I began to search for answers.
Anecdotally I tried to think of who I knew who was over 60 and not on a statin. I realized the most cheerful older person in my life was also the one who took no medications or pills whatsoever. Yes, there was one older person in my life who was always cheerful, always sharp, always on it: My beloved mother-in-law. Gigi had a sharp mind, remembered details of our last conversation or past events that would astound me, and she was always upbeat and ready with a compliment or affirmative observation, even if her life could have been stressful. She never let on. She would follow up with questions weeks after I had told her a small fact about her grandchildren, who she adored: How was Julian's interview? How is Josie liking her new apartment? She played golf with a skip in her step and loved nothing more than to go out on the course with my son, just the two of them, a mismatched pair as he towered above her (she barely scraped 5 feet in her jaunty golf beret, while he had a good foot on her, and then some, even slouching). The conversations they enjoyed spanned the personal, about relationships and the professional, as she would regale him with stories about his grandfather's TV producing career. She never forgot a thing, never became irritable, and always looked on the bright side of every situation. Food taking too long? We had more time to visit over lunch. She ate a mostly plant-based diet of vegetable soups, salads, and fish. At 95 she played golf every day and walked the course most of her life, enjoying easy raport with the caddies. Most notably she never took a pill in her life.
This "kitchen science" world according to Lucy is not actually relevant except to make me wonder: Is there a cause and effect? Were people who took statins messing up their brains? All for the sake of eating cheese, meat, dairy, and animal fat, which are known to drive up blood cholesterol? I looked up the connection between statins and irritability, memory loss, personality changes, and found study after study, article after article, connecting the two.
It's almost too easy to find headlines on studies like:
Mood, Personality, and Behavior Changes During Treatment with Statins: A Case Series
That study got my attention, as did call outs like:
"Psychiatric adverse effects, altering mood, personality, and behavior, sometimes arise in patients receiving statins.
"Statin psychiatric effects can include irritability/aggression, anxiety or depressed mood, violent ideation, sleep problems including nightmares, and possibly suicide attempt and completion." Come to think of it as my dad got sicker he also got more depressed. This also makes sense but which came first? The statin or the mood swing?
As I read all this I think... Whoah. The conclusion of that first study states: "Though statins are widely tolerated, they may be among the growing list of prescription agents that, in some participants, may increase the risk of serious psychiatric events and/or behavioral changes. In the cases cited here, these adverse experiences posed risks to the safety of self and others—sometimes, tragically, adversely affecting marriages and careers, or culminating in death. The possibility of such ADRs, even if rare, should be recognized by physicians who prescribe cholesterol-lowering drugs, such that if personality or behavior changes arise, the drug can be included in considerations of etiology and treatment."
"The possibility ... should be recognized by physicians..." Physicians? The ones playing golf with the pharmaceutical executives and salespeople? And by the way: How would they even know? Presumably, these docs aren't sitting with their dad when he has a tantrum in a restaurant because the waiter is taking too long or the ambient noise is too loud. Once in a doctors' office, patients are unlikely to snap or forget where they are. I was never asked to report to my mom's heart doctor that she forgot to meet her kids for dinner, couldn't find the restaurant or got lost on parent's visiting day at my son's school.
Yes, that happened... But no one asked me, the loving family member, whether my dad was intolerable to be around when he should have been thrilled to have his family with him. Or whether my mother had to stop going out by herself because she didn't know her way home.
Was it the statins? Or would she have been demented anyway? We will never know. We had her take memory boosting drugs (Aricept and Namenda) to treat her mental loss, but those seemed like putting a bandaid on an open gaping wound, or closing the barn door once the horse had gotten out. Even her doctor, a specialist in dementia who was well-known and super admiring of my mother's resilience in the face of fading short-term memory loss, admitted neither of these drugs appeared to do anything. It was simply what you did: You added more medicine on top of medicine and never questioned whether her heart pills were the culprit or a change in diet might have staved off the onset of her disease. And so she kept eating her beloved ice cream, her favorite cheeses and her breaded fried chicken breast with mashed potatoes since at that stage in life (mid-to-late-80s) and as her world got smaller, it seemed mean to take away these small pleasures.
We are from a family of cheese lovers. And we all take statins. All except me
My dad ate cheese every night before dinner, and sometimes also for lunch (grilled cheese sandwiches or ham and cheese, accompanied by a creamy tomato soup). No one ever questioned that eggs were for breakfast, often with bacon, and sometimes bacon on a sandwich for lunch, and steak or chicken or lamb or fish for dinner. Usually with a cheese plate with cocktails before dinner (never hummus or eggplant or beet spread) and usually dessert included ice cream or cookies or both. It's a miracle we were not all obese with the amount of we all ate, three times a day. But despite appearing fit, trim, and being extremely active, we all have elevated cholesterol and also low blood pressure, something both my parents handed down to me.
Taking meds is something I don't want to repeat. Why" I "feel" drugs more acutely on my system. I took the pill in college and it made me feel blue. I took a painkiller for knee surgery and it made me have weird dreams. I decided at about the age of 30: No more drugs. And I edited a magazine for wellbeing for 13 years and saw the amount of money big pharma spends to "sell" Americans on drugs, like heartburn medicine after we eat too much or statins for a life of loving cholesterol-elevating foods. Why not just change how we eat?
A doctor once told me, "Both your parents are on statins, blood thinners, and other heart meds? You will be too." (She meant well. I switched doctors.) We were expected to simply accept the fact like it's our hard-wired DNA: Everyone in my family is addicted to cheese, along with dairy, and meat and we all have high cholesterol and take statins. No thank you. Until 18 months ago when I went meat and dairy-free, no one had ever thought to change their diet. High cholesterol? Blood pressure falling too low? Just add drugs.
Here's another quick search I found. Another reason to not take statins, at least for me:
Severe irritability associated with statin cholesterol-lowering drugs
"As use of a drug becomes widespread, the full spectrum of its effects becomes clearer. Although a link has been suggested between low or lowered cholesterol and irritability/aggression, less is known about possible links between irritability and statins," the study states. Super. Let's read further:
"Six patients referred or self-referred with irritability and short temper on statin cholesterol-lowering drugs... In each case the personality disruption, once evident, was sustained until statin use was discontinued; and resolved promptly with drug cessation.
The study told a story of going off the drugs to see what would happen. Once the patients got off the drugs, the irritability subsided. When they were put back on the statins, the short-tempered problems occurred. And this study found pretty major issues, including; "Manifestations of severe irritability included homicidal impulses, threats to others, road rage, generation of fear in family members, and damage to property." Is a love of cheese worth that?
"The role of statins in both cognitive impairment and protection against dementia"
That's the title of another study that found when we have a problem we go to the doctor who gives us a pill. We are a nation of pill poppers: "Nearly 30% of adults 40 years and older in the United States are on a statin," this study tells us. And of course we usually take more than one pill. Most pills are not study in conjunction with other pills, and no one really can tell you what more than 4 drugs all do when combined together in the body, day after day. As for statins, the study declares: "Their widespread use heightens the importance of careful consideration of their varied effects on the body. Although randomized controlled trials have not confirmed cognitive impairing effects with statins, continuing evidence suggests statins have the ability to cause reversible cognitive impairment in some patients." I witnessed it.
The study continues. "Paradoxically, statins have also been shown to decrease the risk of dementia, Alzheimer’s disease, and improve cognitive impairment in some cases." Presumably, according to no one but me, this is because those diseases are linked to high cholesterol in the body. Lower the cholesterol, lower the diseases. But there's a better way. Lower the cheese and dairy and meat and poultry consumption. How about doing that?
Statins are lifesavers but so is changing one's diet. One is easy, the other hard
So here is where I net out: Rather than eat cheese, or meat, poultry or eggs or any type of animal fat, and dairy, which contain saturated fat, which is well-known to raise your LDL cholesterol in the blood, also known as "bad" cholesterol, I chose to get off the cheese, meat, dairy, and animal products all at once, 18 months ago. In three weeks I went to my new plant-based doctor, who checked my blood cholesterol.
In just three weeks my LDL and total cholesterol had dropped 30 percent. (My HDL is always robust since I workout 6 days a week.) I told my brother this. He and I are both fit people with the same genetic heritage. He talked to his doctor about it. The quote from his cardiologist and repeated (albeit second hand to me through my brother) was basically this:
- Question: How many people try to lower their cholesterol through diet?
- Doctor's Answer: About one in 10.
- Question: How many of those succeed?
- Doctor's Answer: About one in 10. Take the statin, since you know it will work to lower your cholesterol.
So that makes me one in 100 who did it the natural way: by switching to a plant-centric diet. I know there are things I have to give up. Jarlsberg and Brie, for starters. grilled cheese sandwiches and scrambled eggs. I have found delicious vegan cheese made from cashew nut milk and JUST Eggs made from mung bean. I try to eat as plant-based as possible and manage to do it about 95 percent of the time. (I will admit to occasionally having a bite of fish.) But I figure it's a fair trade for keeping my brains intact and upbeat a little while longer. I'll make that bargain any day.