Cholesterol, statins and muscle growth

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Vince Gironda, the Iron Guru, used to recommend eating up to three dozen eggs a day in order to pack on mass fast. His rational was that the high cholesterol content would trigger a natural anabolic effect.
Ronnie Coleman, in his last video, Relentless, is taking a cholesterol lowering drug. Yet, such drugs are said to be detrimental to muscles.
Both behaviors seem contradictory!
• Is high or low cholesterol better for muscle growth?
• Why would anyone use a muscle wasting drug?
New research reconciles this paradox revealing that proper cholesterol manitions can optimize muscle growth.
Acute training impact on cholesterol level
If moderate weight training does not seem to affect cholesterol levels, a traumatic workout will most definitely induce an acute reduction of blood cholesterol level within 2 hours (1). This shortage of cholesterol can last up to several days during the recovery phase. This lowering effect is due to an accelerated uptake of cholesterol by skeletal muscle. It reveals our fibers need this extra cholesterol in order to recover and grow.
Considering the positive impact of cholesterol on muscle growth (see below), it might be a good idea to include cholesterol-rich foods such as whole eggs in you first real post-workout meal. This strategy would make sure your muscles obtain all the cholesterol they need, preventing any potential shortage which would postpone recovery.
Dietary cholesterol intake on muscle growth
Riechman has studied the impact of cholesterol on (resistance) training-induced hypertrophy (2). This research has been conducted on elderly men and women, yet its findings seem relevant to younger subjects:
For 12 week, those people weight trained. When their daily cholesterol intake was inferior to 3.5 mg per kg of lean mass, no hypertrophy was detected. Strength only increased 36%. When their cholesterol consumption was above 5.7 mg/kg, muscle mass increased an average of 2.1 kg. Heavy cholesterol consumers experienced a strength increase of 86%.
Muscle growth and strength gains are closely related to dietary cholesterol intake. Considering a large egg contains around 200 mg of cholesterol, a 220 lbs bodybuilder would need at least 3 whole eggs a day.
Blood cholesterol level on muscle growth
Subjects with serum cholesterol lower than 178 mg/dl did not experienced much growth (+300 g of lean mass). When serum cholesterol was above 238 mg/dl, lean mass increased an average of 2.3 kg. The correlation between serum cholesterol and strength gains is statistically weaker. Subjects with low cholesterol level experienced an increase of 37% Vs 70% for subjects with high levels.
Muscle growth is positively correlated with blood cholesterol level.
Cholesterol lowering drugs on muscle growth
Statins are a class of drugs prescribed to lower the level of cholesterol in the blood. This class of drugs includes lovastatin (Mevacor), Simvastatin, (Zocor), fluvastatin (Lescol), pravastatin (Pravachol), rosuvastatin (Crestor) and Atorvastatin (Lipitor). The mechanism by which statins lower cholesterol is by blocking the enzyme in the liver, hydroxy-methylglutaryl-coenzyme A (HMCoA) reductase, responsible for producing cholesterol. Statin drugs lower total serum cholesterol levels, including HDL, as well as LDL levels.
Cholesterol intake and blood level represent two independent variables affecting hypertrophy. Subjects who responded the best to weight training were those consuming a cholesterol rich diet AND having a high blood cholesterol level AND using anti-cholesterol statin drugs. It is very surprising to discover that such drugs improved muscle gains as they are associated with myalgia, muscle weakness and muscle wasting in sedentary subjects.
Statin drugs accelerate muscle hypertrophy. The more we train, the more resistant our fibers get. It is increasingly difficult to damage them sufficiently to force them to grow. By rendering our fibers more fragile, statin drugs allow each rep to be more damaging to our muscles. As our muscles cannot seem to strengthen its fibers enough to counteract this fragilizing effect, they have no choice but to keep on growing.
Will cholesterol-related muscle catabolism favor growth?
I am not surprised that catabolic drugs facilitate muscle gains in trained subjects. I have already explained this paradox in a previously published Clenbuterol article. Even cholesterol seems to enhance catabolism. Following an acute eccentric workout, soreness as well as strength loss are higher in young men consuming a whole egg diet rather than a low cholesterol diet (1). In response to this exacerbated catabolism, muscle strengthening is much more robust with the whole egg than with the white egg diet (1). This greater anabolic response explains the results observed on elderly. It also suggests that conclusions reached in older subjects apply to young men as well.
It may be important to note that if training-induced catabolism is enhanced by cholesterol lowering drugs, they also protect muscle cells from apoptosis (death) (3). This protective effect may facilitate an additional growth response.
Anabolic steroids and cholesterol
Anabolic steroids can either increase or decrease cholesterol levels depending on the choice of the drug as well as the individual response of the user. For example, orally active 17-alkylated anabolic-androgenic steroid are known to cause and undesirable reduction in HDL cholesterol levels. A severe reduction (which can go as low as having almost no cholesterol) is really bad for 2 reasons:
• Cholesterol is needed for muscle growth (as well as for general health). It is very hard to bring cholesterol production back up to normal even with discontinuation of the steroids.
• An increase in serum cholesterol levels would be a much better scenario as more cholesterol would be available for growth. It would also provide a good reason to get a prescription for the anti-cholesterol drug class of statins.
In conclusion:
• With regards to muscle hypertrophy, It is a good idea to follow a high cholesterol diet (at least 3 whole eggs a day).
• This is especially true if your training is both intense and traumatic.
• Be careful during a low calorie diet as cholesterol intake usually is reduced during this period.
• Cholesterol level tends to decline in summer, so be careful at that time, too.
• Whole eggs are very appropriate and recommended following a workout.
• Steroid users should closely monitor their blood cholesterol level as a decrease may reduce muscle growth.
• Steroid users with high cholesterol levels should consult a physician and may consider the use of statin drugs in order to grow even more rapidly.

[liftsiron]

First of all testosterone is synthesized from cholesterol at a rate rate of 2-7 mgs a day depending on the individuals production of converting enzymes, it dosen't much matter if you eat one egg a week or a hundred a day, you are not going to get more testosterone. What you will get is a very messed up blood lipid level which in time will lead to a severely screwed up heart. For anyone taking gear the cholesterol conversion to test is a moot point anyhow. As far as taking statin drugs there are multiple side effects.


The Major Side Effects of Statin Drugs

While the FDA has deemed statins to be safe to use for their intended purpose, no drug is totally without side effects in susceptible individuals. As the use of statin drugs continues to increase and people have been taking statins for a prolonged period that is significantly longer than the time period required for testing drugs, the side effects of statins affects more people than ever before.

Since the drug companies that manufacture statins have become aware of the incidence of serious side effects, they added a warning to statin advertising that was not present in the earliest advertising. This warning states, “Unexplained muscle pain and weakness could be a sign of a rare but serious side effect and should be reported to your doctor right away.” People who take statin drugs need to heed this warning immediately because in extreme cases the side effects of statins can be fatal.

Muscle pain and muscle weakness are two of the main side effects of statin drugs. While muscle pain and muscle weakness sound ordinary enough, due to the manner in which statin side effects can act in the body they are potentially dangerous side effects of statin use. Another is memory loss. Anyone who is taking statin drugs for any reason should be aware of these side effects and their symptoms. The medical establishment recommends that anyone who suspects they are experiencing any of the possible statin side effects consult with their medical professional.
Muscle Pain and Rhabdomyolysis

Muscle symptoms are a common side effect of statins; many people experience aching in the shoulders, pain in the jaw, or muscle pain in the legs. The muscle pain is a symptom muscle breakdown that is occurring in the body due to the side effect of the statin drug. When tissues break down, the body must eliminate the excess waste products. The waste products then overload the kidneys, causing more serious problems. Rhabdomyolysis (often called rhabdo for short) is the medical term for the breakdown of muscle fibers that results in the release of muscle fiber contents into the bloodstream. Besides muscle pain, the other major symptom of rhabdomyolysis is dark, red, or cola colored urine.

Severe rhabdomyolysis can result in death from acute kidney failure due to overload of the kidneys with deteriorated muscle tissue. If fact, the cholesterol lowering drug Baycol was removed from the market after being implicated in over 60 deaths due to rhabdomyolysis. However, rhabdomyolysis remains a dangerous side effect of statins in general.

According to the FDA MEDWATCH Reporting System, over 3300 cases of statin-associated rhabdomyolysis were reported between January 1, 1990, and March 31, 2002. Researchers estimate that between 1% and 5% of statin users will experience muscle pain and weakness as a side effect. While most people who experience muscle pain will return to normal after discontinuing statin use, some susceptible individuals suffer permanent muscle damage from statin use. Dr. Gregg C. Fonarow, UCLA professoer of cardiology, was recently quoted as saying between 2% and 8% of statin patients report muscle pain. A 2008 study of in vitro muscle cells exposed to simvastatin found that at a dose equivalent to 40 mg/day, new muscle cell growth was reduced by 50%. While this does not translate directly to how statins work inside the body, it does provide scientists proof that statins directly affect muscles.
Muscle Weakness and Neuropathy

While we joke about how things get on our nerves, nerves are real fibers in the body that send signals to control the movement of muscles and the functioning of organs. To review some basic anatomy, the human nervous system consists of the central nervous system, which is just the brain and the spinal cord, and the peripheral nervous system, which contains all the other nerves. The peripheral nervous system controls autonomic (that is, automatic) functions of the body like breathing and heartbeat.

Neuropathy, short for peripheral neuropathy, simply means a malfunction of the peripheral nervous system that occurs without any inflammation of the nerves. There are many causes of neuropathy, including injury to the nerves caused for example by an accident or various diseases like diabetes and kidney problems. The occurrence of toxic or poisonous substances in the body is another one of the ways neuropathy occurs.

There are over 100 types of neuropathy, each with its own cluster of symptoms that can be diagnosed by a neurologist. For susceptible individuals, the use of a statin drug can interfere with proper functioning of the peripheral nerves. Researchers assume that the build-up of statins in the body causes neuropathy in some individuals.

Muscle weakness is frequently a symptom of neuropathy and the muscle weakness may develop in a matter of days or may slowly progress over weeks or months. Individuals may simply not recognize the progressive muscle weakness and excuse the symptoms away as the result of being tired, overdoing or just getting older. For those who take statins, keep muscle weakness in mind as it “could be a sign of a rare but serious side effect.”

Other symptoms of neuropathy include: numbness, tingling, and pricking sensations; burning pain (especially at night); and/or sensitivity to touch. If left undiagnosed, neuropathy can lead to deterioration of the muscles and paralysis. Remember that we all need throat muscles to swallow, chest muscles to breathe, and that the heart is a muscle. In the extreme, severe neuropathy as a side effect to statin use can lead to death.

Some researchers estimate the 1 in 10 people who take statin drugs will experience a mild form of neuropathy where the symptoms may be a feeling of tiredness, difficulty in arising from a low chair or getting out of bed, shortness of breath or difficulty walking.

Small countries like Demark or Iceland are great for studying medical conditions. Because the population is genetically similar as opposed to the vast melting pot of the United States, it is easier to conduct a controlled study. A famous Danish study of neuropathy as a side effect to statin use concluded that an individual who is a long-term user of statin drugs has anywhere from 4 to 14 times greater risk of developing peripheral neuropathy than a person who does not take statin drugs. Typically, long-term use of statins is defined as 2 years or more but neuropathy can occur even after just a few days of use in a susceptible individual.
Memory Loss

Some people experience memory loss, report an inability to concentrate as well, and feel that they are developing Alzheimer’s disease when taking statin drugs. (Conincidentally, a new study suggests that simvastatin (Zocor) actually lowers the risk of Parkinson's and Alzheimer’s diseases.) This memory loss may be so extreme as to be amnesia that lasts for 6 to 12 hours. These types of problems are known as cognitive defects. Other people claim to experience mood swings and other behavioral changes when taking statins. These differences in behavior are not just subjective feelings on the part of the individual but tend to be corroborated by family members.

There are cases of cognitive difficulty that have been reported to the FDA as adverse side effects to statins. A systematic review of the cases reported to the FDA determined that approximately half of the memory loss problems occurred within 60 days of starting on statin therapy, although memory problems were reported after taking a statin drug for just 5 days. Fortunately most people return to normal after discontinuing the statin drug. The time until recovery appears to be related to the amount of time before the cognitive symptoms appeared; that is, the longer it took for the symptoms to appear, the longer it took for the person to recover. However, a small group may continue to suffer with cognitive problems, perhaps indefinitely.

The risk of experiencing memory problems while taking statins did show up in the first clinical trials of statins but memory loss occurred in less than half of one percent of the people in the clinical trials. Meanwhile, about 2 percent of the cases of side effects of statins reported to the FDA at the time these cases were studied concerned cognitive problems including memory loss.

There are two other points to consider. One is that amnesia used to be a rare phenomenon, especially transient global amnesia (TGA) where individuals can forget major details of their lives for hours only to return to normal until the next episode. Yet TGA is occurring with increased frequency. At the other end of the spectrum, it may be impossible to measure how many people who are taking statins simply ignore smaller lapses of memory or lack of attention. At this point in time, current research does not have an estimate of the incidence of memory loss associated with statin use in the general population.

A recent study raises the possibility that statins increase the risk of delerium in patients after surgery. Researchers at the University of Toronto looked at data from 284,000 people after surgery. Delerium is known to be underdiagnosed in these cases, but the researchers estimated that it occurs after 10% of all surgical procedures, and after 13% of procedures in people taking statins. Because delerium can reduce recovery time, this is an area of concern. The hypothesis is that the statins cause blood flow to the brain to reduce in favor of flow to the heart, although there is no firm evidence that this is happening. The researchers admitted that more work is needed to answer questions regarding surgery and statins, and they did not recommend stopping statins before surgery until more is known.

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The info below was from a friend who works in the industry.He makes some interesting points. My father has also been on these drugs for 15 years on high doses with no sides.



All product information for the statins have myopathy, myalgia and rhabdomyolosis are possible side effects from statin use.

I got severe myalgia from simvastatin use. Doubled up in back spasms within 48 hours of starting use. I didn't get it from atorvastatin (interesting, as both are fat soluble statins). I work for the company that make simvastatin (Zocor)/ezetrol and vytorin (all cholesterol lowering drugs)

Permanent muscle damage is very rare (1 in 1,000,000). You will have plenty of warning as you start to feel lethargic and crampy very quickly upon initiation of statins if this was to be the case (or on titration).

Yes, Crestor was once withdrawn from the US and European markets due to myopathy and rhabdomyolosis cases. Back then, they used higher doses than are recommended now.

We have strong data on Zocor (15 years use), and Lipitor (10+ years use) - (I use to work for Pfizer as well during the launch phase of Lipitor).

The fact your dad is on 80mg Lipitor, tells me he may have had a myocardial infarction (heart attack). If this is the case, there may be a reason for you to go to Lipitor 40mg or Zocor 40/80mg (both have great event reduction data).

There are no studies that look particularly at sport-people or BB. Looking at the MOA (mode of action),and what enzymes it interrupts (statins are HMG-Co reductase inhibitors), and that P-450 is the primary metabolic pathway, there is no biochemical reason not to take it.

There is some evidence (this needs to be put into context) of statins lowering testosterone. Test is produced form lipids, and the trial that showed this was in men over the age of 80 (and with low numbers) who had very low natural testosterone. This is irreverent when our (exogenous and endogenous) testosterone is higher than normal. If there was a reduction for us, it wouldn't be measurable by normal pathology (eg: blooooody small).

Should you switch from Crestor? If you are on 5 or 10mg and getting LDL control and your total cholesterol level is below 4mmol/L, you should OK to stay on it.

If you are at high risk because of family history, I would be prone to switch to a statin that has multiple data showing event reduction (Lipitor/Zocor/Pravachol). There is no extra benefit on HDL or triglycerides with Crestor, and regardless of their new trial data, still does not have solid end-point-data looking at reduction of events in CHD.

Not knowing any history makes it harder (current lipid levels, risk levels) to make a definite comment.


If it was my family:
Diabetic - it has to be Zocor.
Family history of CHD and Total-cholesterol level above 4mmol?l (with no diabetes), I'd rather be on Lipitor.

Hope this helps. Let me know if you need any extra info

[liftsiron]

I'm glad that your father does well on the drugs, however I have known a number of people who had to quit statins because of severe muscle and bone pain. The point that I was trying to make is that we require very little cholesterol for proper function and sex hormone production, the majority of which is naturally produced by our liver. Eggs btw are a very good food as they are nature's second highest source of lecithin, nature's cholesterol emulsifier.
Good thought provoking thread btw. It's very refreshing to see someone doing
research in to various alternatives which most of us take for granted.

Also your article make some good points especially in regard to lipid levels and 17aa's.

[NYCmitch25]

Interesting read(s) none the less...

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I'm glad that your father does well on the drugs, however I have known a number of people who had to quit statins because of severe muscle and bone pain. The point that I was trying to make is that we require very little cholesterol for proper function and sex hormone production, the majority of which is naturally produced by our liver. Eggs btw are a very good food as they are nature's second highest source of lecithin, nature's cholesterol emulsifier.
Good thought provoking thread btw. It's very refreshing to see someone doing
research in to various alternatives which most of us take for granted.

Also your article make some good points especially in regard to lipid levels and 17aa's.

Usually if people are having muscle pain they can change over to a different statin. Just like with any medication.They all work differently. Its the same with steroids, you dont believe all the bullshit docters and the media feed us. We know better because we are the ones who having been using the stuff for years.