Ancient Chinese Herb is Alternative to Cholesterol-Lowering Statin Drugs

It is incredible to think that more than 35 million people in the United States take cholesterol-lowering statin drugs such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Atorvastatin (Lipitor) and simvastatin (Zocor) are the top 5 most widely prescribed drugs in the United States!
Studies show that many people do not take their statins as prescribed or stop taking them due to side effects. If you look at conventional websites, they will usually state that side effects from statins are uncommon. However, when one digs into the data as I have, you will find that side effects are not unusual at all. For example, research published in Circulation: Genomic and Precision Medicine states that up to 29% of statin users experience myopathy, muscle pain, or muscle damage. This is a shame since there is a genetic test (SLCO1B1*5) that can help identify people who are likely to have muscle damage from a statin drug. Most doctors who prescribe cholesterol-lowering medications do not run this test to screen for those genetically predisposed to muscle damage.
If you report muscle pain, your doctor may order a test known as creatine phosphokinase (CPK). This enzyme is typically elevated with a muscle injury. However, a Canadian Medical Association Journal reported this enzyme test was almost useless in identifying muscle damage in statin users. Instead, they found that only a muscle biopsy was useful, and few doctors order this invasive test (and most patients are not thrilled to have it). The researchers also found evidence of significant muscle damage in people who had formerly used statin therapy and had been off statins for a substantial amount of time.
Additional side effects that may occur with statin use include memory loss, new-onset type 2 diabetes (some research has shown 25% increased risk), headaches, digestive complaints (belching, gas, constipation, heartburn); insomnia, nasal congestion, hoarse voice, liver damage, and kidney damage.
We address lipid imbalances through diet (Modified Mediterranean or plant-based), weight loss, blood sugar lowering, exercise, and targeted nutritional supplements for many of my patients. The majority of my patients do not require cholesterol-lowering drugs like statins.
Some patients are genetically predisposed to lipid abnormalities and require extra support that goes beyond diet and lifestyle changes. One supplement I have been using more frequently with patients is berberine. The extract of berberine comes from the plants of the genus Berberis and is found in the Chinese medicinal plant known as Coptis chinensis. This ancient Chinese herb has thousands of years of use in traditional Chinese medicine.
You may be familiar with berberine for its ability to reduce glucose levels in people with Type 2 diabetes. Remarkably, the glucose-lowering effects are comparable to the widely prescribed diabetic drug known as Glucophage (Metformin). A meta-analysis of clinical 21 trials has demonstrated that berberine has beneficial effects for Type 2 Diabetes, elevated lipids, and high blood pressure.
Berberine has been shown in several studies to lower lipid levels in a manner that is different than statin drugs. Berberine can reduce LDL cholesterol on average between 20 to 50 mg/dL and triglycerides between 25 to 55 mg/dL. It also lowers total cholesterol but does not have much effect on elevating the good HDL cholesterol. Also, remember that prediabetes and Type 2 diabetes increase the production of cholesterol in the liver due to insulin spiking. As well, the more critical LDL particles that makeup LDL cholesterol are increased from this insulin resistance. Berberine works to improve insulin resistance and reduce inflammation associated with these common blood sugar disorders.
The safety of berberine is quite good, although some people experience digestive upset such as diarrhea, constipation, and abdominal distention. Most lipid-lowering studies have used berberine at a dosage of 500 to 1000 mg daily. I recommend patients take it before meals to reduce the likelihood of digestive upset. I usually retest their cardiovascular blood markers after 3 to 6 months of supplementation. Patients are thrilled to see the normalization of their lipid and inflammation markers!
References:
Fuentes A, Pineda M, Venkata K. 2018. Comprehension of Top 200 Prescribed Drugs in the US as a Resource for Pharmacy Teaching, Training and Practice. Pharmacy 6:43
Koppen, L. M., Whitaker, A., Rosene, A., & Beckett, R. D. (2017). Efficacy of Berberine Alone and in Combination for the Treatment of Hyperlipidemia: A Systematic Review. Journal of evidence-based complementary & alternative medicine22(4), 956–968. https://doi.org/10.1177/2156587216687695
Mohaupt M, Karas R, Babiychuk E, Sanchez-Freire V, Monastyrskaya K, Iyer L, Hoppeler H, Breil F, Draeger A. 2009. Association between statin-associated myopathy and skeletal muscle damage. Canadian Medical Association Journal 181:E11-E18
Tuteja S, Rader D. 2018. SLCO1B1 and Statin Therapy. Circulation: Genomic and Precision Medicine 11. [accessed 2019 Jun 29]. https://www.ahajournals.org/doi/10.1161/CIRCGEN.118.002320
Wang, H., Zhu, C., Ying, Y., Luo, L., Huang, D., & Luo, Z. (2017). Metformin and berberine, two versatile drugs in treatment of common metabolic diseases. Oncotarget9(11), 10135–10146. https://doi.org/10.18632/oncotarget.20807
Wells J, Brummer R, Derrien M et al. Homeostasis of the gut barrier and potential biomarkers. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2017;312(3):G171-G193. doi:10.1152/ajpgi.00048.2015