Popular herbal supplement could make some statins ‘far less effective’

Statins: How the drug prevents heart attacks and strokes

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Dietary supplements have seen a major boom in their popularity during the last century. Worryingly, a growing body of evidence points to the pitfalls of taking herbal supplements in conjunction with certain medicines. Statins also belong to this category.

Designed to bust high cholesterol levels, statins work by inhibiting an enzyme called HMG-CoA reductase, which is needed to produce the pesky fatty substance.

While your medicine and supplement regimen might feel like second nature to you, Dr Deborah Lee, from Dr Fox Pharmacy, prompts you to think again about the products you’re taking together.

The NHS explains that some medications can affect the way certain statins work and increase your chances of serious side effects, such as muscle damage.

One popular herbal product could make simvastatin and atorvastatin “far less effective”, according to the doctor.

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The supplement in question is known as St John’s wort, which describes a herbal remedy taken for a whole host of problems, ranging from depression to perimenopause.

Dr Lee said: “Many people are under the illusion that because something is natural it must be healthy. 

“In fact, little is known about the interactions between herbal medicines and cardiovascular drugs.”

The doctor explained that St John’s wort contains two active ingredients –hyperforin and hypericin – that are partly responsible for the interactions.

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Dr Lee said: “Hyperforin stimulates liver enzymes called cytochrome P450 3A4, and hypericin activates P-glycoprotein (P-gp) – an intestinal transporter.

“Simvastatin and atorvastatin are metabolised by the cytochrome P450 system.

“Hence if St John’s wort is taken at the same time, this speeds up their breakdown, and less of the statin reaches the bloodstream.

“As a result, there are less favourable effects on lowering cholesterol.”

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Furthermore, research, published in the Scandinavian Journal of Primary Health Care, also backs the doctor’s warning against mixing St John’s wort with some statins.

Looking at 24 patients, the study observed the effects of taking 300mg of St John’s wort a day alongside simvastatin.

After four weeks, the participants’ ‘bad’ cholesterol levels were significantly increased.

The study concluded: “Products containing St John’s Wort should not be given to patients with hypercholesterolemia [high cholesterol] who are on treatment with simvastatin.”

Dr Lee added: “If you have raised cholesterol, and have decided to take statins, it makes no sense to take St John’s wort with the statin. 

“This will make the statin far less effective. 

“If you have a good reason to need St John’s wort, discuss this with your GP. It might be an option to take fluvastatin or pravastatin.”

The good news is that other statins might not counteract with St John’s wort but always remember to speak to your doctor before mixing supplements and medicines.

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