About ninety million people in the U.S. are on a statin drug for lowering cholesterol. The mechanism of how a statin drug works and its side effects are usually dismissed because of the dangerous perception high cholesterol represents. The mevalonate pathway is a sequence of cellular reactions leading to the synthesis of cholesterol, dolichol, ubiquinol (Coenzyme Q10), sex hormones, and protein synthesis. Anyone who is on a statin should understand how a statin can influence all these other processes.
The Mevalonate Pathway:
The top red line shows how statins inhibit HMG-CoA reductase. All that flows b elow that point is affected by the statin. Also affected is Geranylgeranyl diphosphate synthesis which leads to lowered ubiquinone (coenzyme Q10) and Dolichol production. Coenzyme Q10 is an important molecule that acts like an antioxidant and helps with mitochondrial function by increasing ATP which is fuel for energy. This is vitally important for the heart and brain which has a tremendous number of mitochondria. It should be no surprise then that statins cause fatigue.
Geranylgeraniol (GG) is a molecule that converts into Coenzyme Q10 so insufficient GG will result in lowered CoQ10.
Dolichol is a membrane anchor for the attachment of sugar to a protein. With statins, the reduced synthesis of the cell wall protein called Glut 4 results in the cell’s inability to bind a molecule of glucose onto its surface. This results in a statin induced elevation of blood sugar.
Dr. Barrie Tan who founded American River Nutrition, and who was the first to discover the usefulness of the annatto plant to derive tocotrienols (a type of vitamin E) was the first to market a commercial source of GG (also from the annatto plant) using a pure physical extraction without solvents. Dr. Tan sells his GG to other vitamin manufacturers. Aging, and diets deficient in Coenzyme Q10 or GG which is high in colorful foods with carotenoids and organ meats are risk factors for health problems. However, statin use causes the following health problems. Two are SAMS (statin associated muscle symptoms) such as sarcopenia (muscle loss), and SADS (statin associated diabetes symptoms) both resulting from lowered CoQ10 and GG. While most doctors including myself have long recommended taking Coenzyme Q10 when taking a statin, Dr. Tan points out that Coenzyme Q10 is a large molecule that is absorbed at about 1-3%. That may seem sufficient because our diets only provide about 5 mg per day, but even with extremely high doses of Coenzyme supplementation, which was able to raise blood levels, the actual cellular absorption was insignificant. Because GG (Geranylgeraniol) is a much smaller molecule, (about 2.5x smaller), the absorption rate is about 44% and the results for improving SADS and SAMS symptoms are better too. Statins also result in lowered sex hormones in both men and women, and lowered production of MK 4, all of which can improve with GG supplementation. MK4 is the form of vitamin K2 responsible for moving calcium from the blood into bones to help osteoporosis instead of it being deposited elsewhere such as in your coronary arteries. MK4 (K2) is the key nutrient to prevent bone loss, and it is composed of one molecule of GG and one molecule of vitamin K1 becoming vitamin K2. Simply stated: While CoQ10 supplementation has benefits, GG is a superior way of delivering CoQ10 to the body and can more easily mitigate the side effects of statin medication. Studies show that GG improved blood CoQ10 levels of animals, and ongoing studies on humans should prove equally encouraging so in the meantime a product that combines CoQ10 with GG is best. Designs for Health has a product called CoQnol which has 200 mg of ubiquinol, and 120 mg of GG manufactured by Dr. Tan which is far superior to what I had been using in the past which only had 100 mg of ubiquinol.
Final Thoughts
If you are on a statin for elevated cholesterol or bisphosphonate medication for bone loss, and you are experiencing symptoms of fatigue, muscle pain, loss of muscle mass, osteoporosis, reduced sex drive, diminished bone density, or elevations of fasting blood sugar and Hemoglobin A1c, GG can help the body repair or prevent the consequences of the downstream effects along the mevalonate pathway. The association between statin use and premature cognitive decline is still being debated. Currently, I have not read anything about GG helping in this area even though there is evidence of it helping mitochondrial health by improving oxygen consumption.
This newsletter is dedicated to a close friend and colleague that passed away suddenly last week.
Rest in peace Dr. Jaime Warren.
You will be missed.
