Statins: Overused or Essential? What Most People Don’t Know About Cholesterol Drugs

Few health topics are as wrapped in controversy and mythology as cholesterol and the drugs used to lower it: statins. If you’re over 50—or closing in—you’ve no doubt heard of statins and may even take one yourself. Yet, as Alan Ogden shares in his recent podcast episode, the story behind these medications, the shifting guidelines for their use, and the gender-specific risks and benefits are far more nuanced than what most of us hear in a doctor’s office. Let’s unpack what Alan describes as the real history, rationale, efficacy, and sometimes overlooked side effects of statin drugs—especially when it comes to differences between men and women.

Changing Guidelines and Their Impact

The Evolution of Cholesterol Thinking

Alan begins by taking us back to the origins of the cholesterol panic: “It was such a big emphasis on cholesterol back in the 70s, 80s, and so on. The question is why and how has the field of knowledge around that dreaded topic evolved over the years?” He recalls that this fear coincided with a major public push to get fat out of food—only to have it replaced with sugar, which he identifies as more damaging than the fat or cholesterol itself.

The original research… on cholesterol and the guidelines… was very suspect of the whole research because… this doctor that was being elevated as the new expert in cholesterol had done a meta-analysis… he had cherry-picked just a few studies. He didn’t look at all of the research, he just cherry-picked a few studies and then they came up with these guidelines that if you are over a certain level of LDL cholesterol, then you needed therapy.

Alan’s university experience gave him a first-hand account of how the guidelines used today were built on questionable foundations. He stresses that at the time, high cholesterol’s risk was tied to a very niche population: people with genetic issues, like those producing high levels of apolipoprotein A, which is highly inflammatory and notoriously difficult to control through lifestyle changes.

Genetics vs. General Guidelines

From Alan’s perspective, the original intent for cholesterol-lowering drugs was very focused: “You had to be a male, you’d had to have already had a heart attack, they would start you on a statin drug, or you had to have genetically high cholesterol.” That foundation was later pushed to encompass a much broader population, largely driven by selective research interpretations rather than comprehensive data.

The levels, allowable levels, pre sort of therapy have dropped. They continue to drop. So when I was… in the 1978, 80s, there were certain levels, there was very few people that met them. And the statin drugs were approved for these people that had high apolipo-A protein from genetics. And then a very small study had been done on preventing secondary heart attacks in men. So there was no original research done on women with statin drugs.

Alan argues that the expansion of statin use far beyond those with clear genetic risk has led to overmedication and potential side effects for many whose only “risk factor” is a number on a blood test.

Statin Controversies

The Origins of the Low-Fat, Low-Cholesterol Craze

Alan credits the “fat is bad” movement to this same period, noting, “We went through this whole process of removing fat from food. And if you look at those foods, what replaced it was sugar. And we now know that that… is devastating.” This replacement, he suggests, had more negative health impacts than the original cholesterol issue the guidelines aimed to manage.

Why Do We Even Need Cholesterol?

An important point Alan stresses is that cholesterol itself is essential—an upstream molecule in many of the body’s most crucial functions:

Cholesterol is necessary to make vitamin D.
It’s the source material for hormones like insulin, testosterone, estrogen, and progesterone.

When we start interrupting that pattern, then we are going to get downstream effects from cholesterol.

This means that when statin drugs suppress cholesterol production, there can be ripple effects, including some of the most talked-about statin side effects: muscle pain, hormonal imbalances, or even cognitive and emotional changes.

Who Truly Needs Statins?

“There are some people, and I want to say this clearly, there are some people that statin therapy is a requirement for because of the genetics,” Alan says. He points out that situations exist—due to genetics or inability to change diet—where medical intervention is warranted. But, for the vast majority, he advocates for a more thorough, stepwise approach.

Stepwise Treatment: Alan’s Approach to High Cholesterol

Testing Beyond the Basics

Alan walks listeners through the comprehensive process he uses before considering statins:

Genetic testing: Looking at the genes that affect cholesterol production and metabolism.
Fasting blood panel: Standard tests for LDL, HDL, and triglycerides.
Dietary review: Evaluating saturated fat intake and overall dietary patterns.
Liver and kidney function: Since the liver produces and breaks down cholesterol, and both organs play a role in cholesterol balance, their health is assessed.
Bowel function: The ability of the intestinal tract—especially the gut microbiome—to process and eliminate fats is an often-overlooked factor.

Only when these areas have been explored does Alan consider pharmacological intervention. And even then, he emphasizes the need for advanced lipid and genetic testing.

Advanced Tests for Personalized Risk

According to Alan, the basic cholesterol panel used by most doctors—HDL, LDL, and triglycerides—doesn’t tell the whole story. “We do a further panel which is called a lipoprotein panel. That lipoprotein panel is looking at the triglycerides… very low-density lipoproteins… and smaller molecules that have another name. These are the ones that we’ve now identified that actually are doing the damage in our cardiovascular system.”

Women and Statins: A Unique Perspective

One of the most significant oversights Alan spotlights is the lack of original statin research on women. He explains:

All the original tests were done on males. And one of the things that why women were excluded at the time was it was pretty well known that as women go through menopause and they become postmenopausal, their LDL cholesterol naturally rises.

This natural LDL rise post-menopause led to widespread statin prescribing for women, yet Alan states that, historically, “many [women] who’ve lived into their 80s and 90s and never had cardiovascular disease… yet they had this LDL cholesterol.” He notes that female bodies seem to have a cardioprotective mechanism, likely linked to hormonal cycles pre-menopause, which complicates the risk equation and makes direct extrapolation from male studies unreliable.

A Real-World Example

Alan describes his own approach with his wife Donna, whose standard cholesterol numbers were high by conventional thresholds. Rather than start statins, Alan insisted on a deeper lipoprotein analysis, which “came back very good.” That meant Donna’s LDL, though elevated in number, wasn’t actually damaging. By adjusting her diet and using a natural product called Stericol—a treatment permitted by Health Canada for certain cholesterol issues—they were able to handle her cholesterol without prescription drugs.

The Hidden Side Effects and the Influence of Big Pharma

Underrated Downsides of Statins

Alan reminds us that, because cholesterol underpins so many bodily systems, artificially lowering it can lead to side effects. These include:

Muscle aches and weakness (a common complaint)
Possible interference with hormone production
Potential impacts on vitamin D metabolism
Unintended metabolic changes

Though these aren’t always experienced by every user, Alan encourages listeners to recognize the broad reach of cholesterol’s role, and to seek individualized answers instead of accepting blanket prescriptions.

The Power of the Statin Industry

The other thing we have to remember is we’re fighting a $35 billion a year industry right now in cholesterol, right? So there’s a high…

Alan’s point is that, with so much money on the line, messages around “normal” cholesterol levels and the need for statins have been shaped as much by business as by unbiased science. This is why independent interpretation and a more nuanced understanding are so vital.

Conclusion: Personalizing Cholesterol Care

As Alan explains, the world of cholesterol management is not a one-size-fits-all affair. While statins remain an essential therapy for a subset of patients—especially those with clear genetic predispositions and certain high-risk profiles—their widespread use, especially based on outdated or oversimplified criteria, can bring more harm than good. Side effects are real, particularly given how deeply cholesterol is entwined with energy, hormone, and even mental health.

If you find yourself facing a statin prescription based solely on a single LDL number, consider a more holistic assessment—one that includes genetics, advanced lipoprotein analysis, and a careful review of lifestyle factors, as Alan Ogden advocates. Statin side effects and individualized risk deserve thoughtful attention.

Ready to take charge of your cholesterol story? Ask your healthcare provider about advanced testing and share this approach with others in your life. If you liked Alan’s insights, subscribe to the Your Second 50 podcast for more episodes that demystify the intersection between genetics, lifestyle, and vibrant aging.