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In this important Metabolic Classroom lecture, Dr. Bikman examines the use of statins in women, particularly for primary prevention of cardiovascular disease.

While statins are widely prescribed to lower LDL cholesterol and ApoB levels, Ben highlights research showing that these markers are weak predictors of cardiovascular risk in women. In contrast, metabolic markers like insulin resistance and type 2 diabetes are far more predictive—often increasing cardiovascular risk by up to 10-fold.

He discusses how statins may ironically worsen metabolic health by impairing insulin sensitivity, increasing type 2 diabetes risk (especially in postmenopausal women), and altering the gut microbiome in a way that reduces GLP-1 production. He also notes statin-induced side effects that disproportionately affect women, such as muscle pain, brain fog, and even potential risks during pregnancy. While statins may have limited value for secondary prevention, their risks—especially in women who haven’t had a cardiovascular event—warrant serious caution.

In the final portion of the lecture, Dr. Bikman outlines practical, lifestyle-based strategies to improve metabolic health without the need for statins. These include resistance training, a smart-carb diet, and stress/sleep management. He also shares evidence-based supplements like CoQ10, omega-3s, magnesium, and alpha-lipoic acid that may help mitigate some of statins’ side effects if they are used.

Show Notes/References:

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