The Metabolic Classroom with Dr. Ben Bikman

The Truth About Statins & Women’s Health: Can They Harm More Than They Help?

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Sep 7, 2025

Dr. Bikman dives into the surprising effects of statins on women's health, revealing how they might actually worsen metabolic conditions rather than help. He highlights that traditional markers like LDL cholesterol don’t effectively predict cardiovascular risk for women. Instead, he emphasizes insulin resistance as a true red flag. The discussion also covers potential side effects unique to women, such as muscle pain and brain fog. Lastly, he advocates for lifestyle changes, including exercise and diet, as safer alternatives to statin use.

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INSIGHT

Lipids Are Weak Predictors In Women

LDL cholesterol and ApoB are weak predictors of cardiovascular events in women compared with metabolic markers.
Statins lower LDL but may not meaningfully reduce mortality for women in primary prevention.

INSIGHT

Metabolic Risk Dominates Lipids

Metabolic markers like type 2 diabetes and metabolic syndrome predict cardiovascular risk far more strongly than LDL or ApoB in women.
Diabetes raised risk by over tenfold while metabolic syndrome and LPIR carried multiple-fold risks.

INSIGHT

Statins May Trade Risks

Statins lower LDL yet can increase insulin resistance, potentially trading a weakly predictive marker for a strong one.
This irony is particularly relevant in primary prevention for women who haven't had cardiac events.

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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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