The Dr. Hyman Show
Ditch the Statins: How to Naturally Lower Cholesterol With Lifestyle Changes | Dr. Aseem Malhotra
Wed, 29 Jan 2025
Have you ever wondered if cholesterol-lowering statins are as effective as they claim? In this episode, Dr. Mark Hyman and Dr. Aseem Malhotra reveal the truth about these medications and the pharmaceutical industry’s influence on your health. Discover why lifestyle changes like diet and exercise can be more powerful than pills, and how misleading studies have shaped what we believe about heart health. In this episode, we discuss: Big pharma’s influence on medical research The benefits, drawbacks, and misuse of statins The Role of Insulin Resistance in Heart Disease The Importance of Lifestyle Over Medication The Impact of Meditation on Heart Disease View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal This episode is brought to you by BonCharge, Timeline, Paleovalley, and AirDoctor. Order BON CHARGE’s Max Red Light Therapy device today and get 15% off. Visit BonCharge.com and use code DRMARK for 15% off. Support essential mitochondrial health and save 10% on Mitopure. Visit Timeline.com/DrHyman to get 10% off today. Get nutrient-dense, whole foods. Head to Paleovalley.com/Hyman for 15% off your first purchase. Get cleaner air. Right now, you can get up to $300 off at AirDoctorPro.com/DRHYMAN.
Chapter 1: What is the main topic of this episode?
Coming up on this episode, part of the problem with the statin research is that it's not that they're bad or good. Every drug has a role, it's a tool. It's like saying water, is water good or bad? Well, if you drink too much water, you can die of seizures, but you need water to survive, right? Everything has a role. Let's talk about red light therapy.
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Chapter 2: How do lifestyle changes compare to statins for heart health?
And you have to think about it. You have to take time to think and learn. I mean, John F. Kennedy said, we enjoy the comfort of opinion without the discomfort of thought. And I think it's hard to kind of sort through it all. I mean, I found it very hard. You know, I just sort of reflect back on some of the data that I uncovered as I was sort of researching this.
And it was just one very large study showing that it was, I think, 231,000 people in 541 hospitals that had had a heart attack. And it was looked at over a six-year period. And they looked at cholesterol lipid levels for everybody. They found that 75% of people who had a heart attack had, quote, a normal LDL under 130, which is what's considered normal. 50% had optimal levels under 100.
17% had... super optimal levels under 70. But what they did found was really interesting. And again, it confirms this whole metabolic hypothesis of heart disease, that it's really related to mostly insulin resistance, that those with low HDL and high triglycerides which goes along with small, dense cholesterol particles, were much at a higher risk of having a heart attack.
And so, in fact, the average HDL in that group was 39, which should be ideally over 50, and the average triglycerides was 160, should be probably under 100, ideally under 70. And it didn't really seem that LDL was really the driver.
the triglyceride to HDL ratio, it was the triglycerides and the HDL, and it was what we generally call an atherogenic lipid profile, which is not just about the total number of cholesterol or the LDL number, it's about the quality of your cholesterol, which is the size and number of the particles, and the smaller dense particles are the ones that are more putting you at risk.
And those are the ones that are caused by sugar and starch, not fat. Fat actually improves the size of your lipid particles. Yeah.
No, fascinating. And it makes sense. But also interesting is something else that I came across in the last few years, which you'll find fascinating, Mark. And I don't know if you know this. David Diamond, who's a cholesterol researcher, published a paper I can't remember which journal it was in, very recently.
And they looked at the primary prevention randomized control trials done by, obviously by the drug companies, and secondary prevention trials. And subgroup analysis found, so these are people with statins who either were high risk of a heart attack or had a heart attack. In the patients in the trials that had normal triglycerides and HDL, no benefit at all from statins. Think about that.
So if you're triglycerides, urination, we're good. Even people who've had a heart attack, there was no benefit from the statin at all, which fits with what you just said.
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Chapter 4: What did the defamation lawsuit reveal about statins?
I've had Jeremy Nicholson on my podcast, Leroy Hood on my podcast, and they're about more data and dense dynamic data clouds of information from your biomarkers, your metabolome, your microbiome, your genome.
your transcriptome, that all teach you about sort of subtle changes that may not represent a disease today, or they don't have a drug treatment today, but that if you left untended would ultimately lead to a disease or... But may not. Or may not. But I'd rather know if my insulin is going up over 10 way before I get diabetes. No, I agree.
So 100%, I agree. There are definitely certain... Yeah, so I think there's a nuance there again. There are certain things where we know, okay, there's a very likely benefit here of you getting your insulin down, etc. I think some of the other biomarkers, it's still in a certain area. But again, Mark, you said that, okay, you're a guy...
And this is, if I was having a conversation with you and this is your preference of values, you want the data, that's your preference of values. I want to know more and more and more. And that's fine, Mark. I'm going to help you and let's do all these tests for you. Somebody else comes in, you know, and then suddenly they come back.
And the thing is, I see this, this is what happens with the whole cholesterol hypothesis, right? I've got patients coming to me for second opinion as a cardiologist. I do, you know, international consults and virtual and whatever else all around the world. And they, and I'd talk to them and I just start to tell me what's been going on.
And they, they've been living in absolute fear of death for months. And some of them break down in tears when I just say to them, listen, I've just done a cardiovascular risk here. Your LDL cholesterol is so-called high, but it's not an issue and you're fine. And your risk is only 2%. And you can just see a sigh of relief and say, doctor, thank God I've been going on thinking that I'm
Then that's, again, misuse, not good use of maybe numbers or statistics. I've been going around thinking that I've got, in the next five years, there's an 80% chance I'm going to die of a heart attack. I'm like, no, it's 2% in 10 years, right? So there's also that as well. So I do think we need to think a little bit carefully on it.
But coming back to FH, FH affects familial hyperlipidemia, genetically very high cholesterol, okay? 50% of men and 70% of women, right, with FH, untreated, big numbers, will not develop premature heart disease. But 30% of women will, and 50%, which is a lot, will get, even before maybe 50 or 60, will get heart disease.
So I did actually a review paper with a number of international scientists as well, and we published it in BMDA Evidence-Based Medicine. And we thought, okay, That's interesting. 50% of men with FH, familial hyperlipidemia, very high LDL, don't get heart disease and 50% do. Is there anything we can find that's different between them that highlights the subgroup?
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