Nutrients depleted by Hypercholesterol drugs

There are also many prescription drugs for hyperlipidemia. If anyone takes a prescribed medication, ask your pharmacy or doctor what kind of medicine do I take? Drug induced nutrient depletion is a key concept for those who take medicine to treat a chronic disease like hypercholesterolemia.
For the treatment, statins are a common class of drugs prescribed to lower cholesterol levels and reduce the risk of cardiovascular events. While these drugs are generally effective in managing cholesterol levels, they may also have some effects on nutrient levels in the body. We need to check this depletion caused by statins. Here are nutrients that may be affected by statin medications:

Coenzyme Q10 (CoQ10)
Coenzyme Q10 is running out while you are taking statins. Statins can reduce the levels of CoQ10 in the body. Enzymes in the liver are involved in many complex processes of making cholesterol. During this cholesterol synthesis, coenzyme CoQ10 is also produced through similar pathways. But, statins block this liver enzyme, specifically called HMG-CoA reductase, necessary for synthesizing not only cholesterol but also for CoQ10 synthesis. That is a reason why CoQ10 synthesis also stopped and depleted by statin medications. As a result, there is a significant shortage of CoQ10. In the study of atorvastatin, one of the commonly used statin medicines, CoQ10 levels in subjects were greatly decreased by 49% after 30 days of atorvastatin therapy (1).
CoQ10 is an antioxidant that plays a crucial role in human body. Highly concentrated in the liver and the heart. It generally help the cells to produce energy through metabolism. And as an powerful antioxidant, CoQ10 protect blood vessel removing free oxygen and preventing lipids peroxidation. Due to activating nitric oxide synthesis, it relaxes vascular endothelial vessels and lead to lower blood pressure.
Lack of CoQ10, there have been various adverse effects, most commonly affecting muscle pain and a rare muscle disease called rhabdomyolysis. If you take this hyperlipidemia drug for a long time, you may feel weak in your muscles. Therefore, long-term use of statins can affect cell energy generation, blood pressure, and heart function.
Supplementation of CoQ10 may be beneficial for individuals taking statins. It is better to take about 100mg daily. If you use a lot of energy using muscles, about 200-300mg is recommended. It is also important to consult with healthcare professionals before starting any supplements.

There are many mineral depletion by statins, too.

Vitamin D
Vitamin D is crucial for bone health, the immune system, and many other things in the human body. But with statins, this essential nutrient level may be reduced. There are some evidences suggesting that statins reduce vitamin D levels. The mechanisms are not yet certain, but it has been proposed that statin potency may play a role (2). Vitamin D is essential to keep bones strong. Helping calcium to be absorbed into the bones. Long-term statin therapy may reduce the density of bone. So, regular monitoring of vitamin D levels and supplementation, if necessary, may be recommended for individuals on statin therapy. Low vitamin D concentrations may be considered a modifiable risk factor for muscle-related adverse effects of statins (3).

Vitamin K2
Synthesis of vitamin K2, may be bothered by long-term statin indication. Vitamin K2 helps bones and prevents arterial calcification. It is a collection of calcium in this heart’s two main arteries. Since statins inhibit the synthesis of vitamin K2, the cofactor for protein activation, which in turn protects arteries from calcification (4). which can lead to heart failure and atherosclerosis. To prevent this, it is important to maintain a balance of vitamin K2. 

Magnesium
Magnesium is important for muscle and nerves and for maintaining a healthy heart rhythm. Statins bind to fats, which are necessary for mineral absorption, and for that, statins intake may lead to decreased magnesium levels. The connection between statins and magnesium is somewhat complicated. Both can inhibit the same enzyme, which produces cholesterols. So, while treating with statins, insufficient magnesium also could make treatment harder.

Folate (Vitamin B9)
There is some evidence that statins may reduce serum folate levels. Folate is essential for DNA synthe sis and repair, and low levels can have implications for overall health. Monitoring folate levels and considering supplementation may be appropriate.

Like statins do, Other drugs for hyperlipidemia also reduce essential nutrients. There are fibrate-based drugs that lower triglycerides. These deplete vitamin B2, B6, B12, and zinc. A drug called cholestyramine binds to bile acids and causes cholesterol to reabsorb and be eliminated . Bile acids contain a lot of fat-soluble vitamins. Bile excretion caused by cholestyramine eventually inhibits the absorption of fat-soluble vitamins, beta-carotene, folate, and iron. What kinds of nutrient are helpful while taking drugs? Calcium and magnesium! Calcium inhibits intestinal absorption of fat, and magnesium binds to fat to expel it from the body. And omega-3s intake lowers triglycerides and increase HDL.

References
1) Tatjana Rundek 1, Ali Naini, Ralph Sacco, Kristen Coates, Salvatore DiMauro. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Arch Neurol. 2004 Jun;61(6):889-92.
2) Gupta A., Thompson P.D. The relationship of vitamin D defici ncy to statin myopathy. Atherosclerosis. 2011;215(1):23–29.
3) Krista D. Riche, Pharm.D.,a,b Justin Arnall, Pharm.D.,c Kristin Rieser, Pharm.D.,a Honey E. East, M.D.,d and Daniel M. Riche, Pharm.D., FCCP, BCPS, CDE, ASH-CHC, CLSa,e,*. Impact of vitamin D status on statin-induced myopathy. J Clin Transl Endocri ol. 2016 Dec; 6: 56–59.
4) Harumi Okuyama 1, Peter H Langsjoen, Tomohito Hamazaki, Yoichi Ogushi, Rokuro Hama, Tetsuyuki Kobayashi, Hajime Uchino. Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Rev Clin Pharmacol. 2015 Mar;8(2):189-99.
5) 고지혈증 약 먹을 때 꼭 함께 챙겨야 할 영양소들. Dr. JeAhn TV


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