In the news the past week was a study that showed that the cholesterol-lowering drugs statins lower testosterone: they decrease aggression in men, partly through lowering testosterone levels, and raise aggression in women: Statin Effects on Aggression: Results from the UCSD Statin Study, a Randomized Control Trial. (PLOS One.)
The study is a randomized, double-blind, controlled trial, so there are none of the confounding factors so often seen in epidemiological studies. It was undertaken because it’s long been known that low cholesterol levels are associated with an increase in violence, homicides, and suicides: Cholesterol and Violence: Is There a Connection? (Annals of Internal Medicine.)
A significant association between low or lowered cholesterol levels and violence is found across many types of studies. Data on this association conform to Hill’s criteria for a causal association.
But in this case, statins were associated with less aggression in men. The reason, or one of them, is that statins lowered testosterone levels. The other reason, perhaps just as bad, was that the men developed statistically significant sleep problems.
Younger men were much more likely to be affected. Yet in women, aggression increased.
What’s going on here? It seems obvious enough: younger men are more aggressive and have higher testosterone levels; therefore they are the most affected by drugs that throw a monkey wrench into their hormonal physiology. The lowering of testosterone and the deterioration in sleep quality overrode any affect of lower cholesterol on increased violence or aggression.
In women, who of course have much lower testosterone levels, the simple act of lowering cholesterol caused an increase in aggression, since in women this is unmediated by testosterone.
If you are a man over the age of 40, and have a high cholesterol level and/or a family history of heart disease, your doctor may very well want to put you on a statin. You should be aware of their side effects.
In men who had no known heart disease who took statins for 5 years (from the NNT):
Or to look at the same number another way (from Grant Schofield), 98% saw no benefit, 0.96% benefited from preventing a (non-fatal) heart attack, 2% were harmed by developing diabetes, and 10% were harmed through muscle damage.
I don’t know about you, but I don’t like those odds.
Yet even with a great lipid profile due to a paleo diet and weightlifting, my doctor threatened to put me on a statin. No, thanks.
Statins are the standard of care, which means that if your cholesterol is “high”, your doctor will feel obligated to prescribe statins for you.
Contrary to what has been recently reported, statins do not protect against cancer; quite the opposite. (Journal of Clinical Oncology.)