First Things First, What Are Statins?
Statins are a very common medication amid the skyrocketing cholesterol levels of the general population. Our high fat and sugar diets combined with low exercise have led to fatty arteries, fat-clogged organs, cholesterol-ridden blood, and poor general health. Many turn to medication to bring their cholesterol levels (of course, your health care professionals would urge you to combine this with dietary and exercise changes as well). Statin is, first and foremost, a cholesterol-lowering drug. But there are foods to avoid when taking statins.
Statin is called an HMG-CoA reductase inhibitor and essentially works by stopping the liver’s production of cholesterol, which forces the liver to begin reducing LDL (lipoprotein cholesterol – this is the bad kind of cholesterol we don’t want) (1). By lowering LDL, cholesterol-related problems become less severe and eventually may disappear completely.
Statins have been around for quite some time, being discovered by anecdotal evidence (simply noting the drug reduced what we now call cholesterol-related symptoms, rather than discovering the exact way the drug worked) in the 1970s by Akira Endo. Many conditions, including thyroid disorders, can cause cholesterol-related problems and artery disease (2).
When you have high cholesterol, it isn’t a single-symptom condition. There is a myriad of diseases and problems that come along with having high cholesterol. Statins reduce stroke risk, improve operative outcomes, and reduce carotid disease, among others (3). Statins have been credited as anti-cancer and anti-inflammatory drugs that can also reduce the risk of Alzheimer’s disease development (4).
The only consistent negative comment about statins is that there seems to be a relationship between these drugs and diabetes development. However, clinical trials showed that while high cholesterol and old age was correlated with elevated diabetes risk, statin therapy was not necessarily correlated with diabetes development (5).
Some side effects that come with statins include headaches, dizziness, nausea, physical weakness, digestive problems, muscle pain, sleep problems, and low platelet count (6). Like all pharmaceutical interventions, there are risks, particularly with chronic use.
The best way to lower your cholesterol long term is to exercise more, eat less, and keep your focus on healthy, whole foods rather than fast food items like hamburgers that are very high in cholesterol. Statins are a good short term solution and a decent intervention for those who perhaps cannot exercise (due to a heart condition or other health problem) as much, but they shouldn’t be used in the long term.
Why should you (almost) never combine citrus fruits with statins?
Citrus is wonder foods. Packed with vitamin C and other micronutrients, high in fiber and antioxidants, they should be part of your healthy diet. But not when you’re taking statins. Citrus fruits contain a compound called “furanocoumarins,” which are part of the plant’s natural defense system (7).
Furanocoumarins are phototoxic compounds, meaning they cause chemical irritation to the skin (including the lining of your mouth) (8). The purpose of furanocoumarins is to discourage microorganisms and herbivores from gorging on the plants, ensuring the plants’ survival (9).
Some of the side-effects of eating these plants are primarily red, blotchy skin blisters that are extremely painful (inflammation at the site lasts for a while after exposure). Ingesting furanocoumarins results in potential liver failure and the risk of death (10).
Furanocoumarins deactivate a specific enzyme in our body called CYP3A4, which is the same one our body uses to metabolize statins. So, even if you’re taking your statins as prescribed, your body can’t metabolize them, and thus, you can’t absorb them (11). They’re leaving your system as intact as when they entered, having no actual effect.
- Citrus fruits
- Oranges (various)
So, do I never get to eat these foods now that I’m taking statins?
A variety of clinics, including the Cleveland Clinic and Mayo Clinic, have tried to answer this question, addressing their doctors and healthcare professionals’ panels. The fact is that there are dozens of statins on the market, and not all are affected when you eat the above-listed foods. As Dr. Hazen said in a statement addressing lovastatin and other statins and eating certain foods, “I personally tell my folks who have no issues with taking a statin, go ahead and eat the grapefruit, but in moderation” (14)
This article’s punchline is this if you are taking a new drug and aren’t sure what food or pharmaceuticals you should not take while on it, please consult your doctor! Your doctor knows best what foods and other prescription drugs will not mix with your statin. There are so many on the market now, and each one is different. On top of this, every person is different. You may not need to limit your diet as much as you fear, but you won’t know unless you ask.