Statins and cancer

(Ho hum, not again)

A number of people have written to me pointing out an outbreak of mass hysteria in the UK press about statins protecting against cancer. I suspect this hysteria has been repeated around the world. Here are the headlines from the eponymous Daily Mail

Statins slash risk of death by cancer: They slow tumour growth

by up to 50% reveal major studies

Experts say there is ‘overwhelming’ evidence that statins can treat cancer

Study showed they cut death rates for bone cancer patients by 55 per cent

GPs should make patients aware of pills’ new benefits, researchers say

I have been aware of claims that statins protect against cancer for many years. They pop up on a pretty regular basis. I have tended to ignore them on the basis that, anyone who is stupid enough to believe such research, deserves all the statins they can get.

However, such is the overblown hype this time, that I feel the need to rouse myself from my slumber, and explain why this is just complete rubbish. I don’t need to read the original studies to do this. I have read enough of these over the years. I hope this does not sound too arrogant, but I will happily apologise if any single thing I write here proves to be wrong.

Not randomised controlled studies

The studies quoted will not have been randomised and controlled. By which I mean they did not take, say, forty thousand people and split them into two, randomised, groups. One group to take statins the other to take a placebo. Then wait, say, five years to see what difference there was.

These studies will have been observational. By which I mean you look at people taking statins and see what happens to them vs. people who do not take statins. Such studies can show associations between two variables. But they cannot prove causality. (They cannot provide ‘overwhelming’ evidence of anything either). This is basic science, page one, paragraph one.

Just to provide one example of this. In 1987 a major observational study showed that women taking HRT had a more than forty per cent reduction in heart disease. At which point it was recommended that women took HRT to protect themselves against heart disease. This was, in fact, written into the guidelines of the American College of Physicians. To fail to prescribe HRT was considered medical malpractice in the USA.1

Some years later came the Women’s Health Initiative (WHI) study. The first randomised primary prevention trial to use HRT, and 17,000 women were involved.

‘Analysis of hazard ratios showed that after 5.2 years, there was a 29% increase in coronary heart disease risk, including an 18% risk of coronary heart disease mortality and a 32% increase risk of nonfatal myocardial infarction. There was a 20% increase in risk of fatal stroke and 50% increase in the risk of non fatal stroke in women assigned to HRT.2

So, a 42% reduction in heart disease turned into a 18% risk of dying of heart disease. In short, observational studies are hopelessly unreliable and often turn out to be complete nonsense. And there is a specific reason why I know these statins studies will be complete rubbish, which I will get to.

Relative not absolute risk

Once again, in these studies, we run into the distorting use of relative, not absolute risk. A fifty per cent reduction in risk can mean something, or nothing very much. It depends what the underlying risk was in the first place. In my book Doctoring Data I covered the use/misuse of relative risk in some depth.

Let us just say that if your underling risk of dying in the next five years is 50%, reducing that risk by 50% is a big deal. If the risk of dying in the next five years is 0.1%, then reducing that risk by 50% is five hundred times less of a big deal.

As for slowing tumour growth by 50%. Well, that could mean almost anything. Did you reduce tumour growth by 1%, 50% or some other number. And does reducing tumour growth actually reduce the risk of dying? Of course, you will always find some super rare cancer e.g. bone cancer, where death rates are cut by 55%.

I would imagine this meant about three deaths verses seven in bone cancer. Basically, however small the absolute figures can be to get to a relative risk reduction of 55%. I would guess there will be no statistical significance figure attached to this reduction. Many questions, almost none of them well be answered, you will find.

The elephant in the room (raised cholesterol protects against cancer)

Here, however, is the big issue. People with higher cholesterol levels are far less likely to die of cancer. Add this to the fact that people with higher cholesterol levels are far more likely be prescribed statins, and you start off with the most gigantic built in bias that it is possible to find.

In 1992 (before statins were being prescribed to more than a select few) a conference was held to look at low blood cholesterol and associations with mortality3. Going back this far in time is important. After this, statin prescribing makes it very difficult to disentangle those with naturally low, or high, cholesterol levels vs. those who were taking statins.

All the major studies of the time were reviewed, with nearly one million participants. As you can see from my little graph, reproduced from the figures in the paper, as cholesterol levels rise, the risk of cancer falls. For women, if your cholesterol level is below four, the risk of dying of cancer is 38% higher than if your cholesterol level is above 6.2mmol/l. In men we are looking at a 27% greater risk with low cholesterol levels. {See chart)

CL-vs-CR

Thus any observational study on lowering cholesterol with statins starts off with a massive inbuilt bias in the two populations. You are looking at one group of people who have a much lower risk of cancer to start with, then giving them statins, then declaring that statins protect against cancer….. just the most absolute unscientific codswallop.

As final warning. Be careful about lowering cholesterol too far. A very large Japanese study (that you will never have heard of, because it was not very supportive of statins) looked at prescribing statins to over forty seven thousand people over six years. As they found:

‘The patients with an exceptionally low TC (total cholesterol) concentration, the so-called ‘hyper-responders’ to simvastatin, had a higher relative risk of death from malignancy than in the other patient groups.’4

In fact, the rate of death from cancer in those whose cholesterol fell the most dramatically was increased by three hundred and thirty per cent (relative risk, apologies for doing this, but I do not know the absolute risk). The authors added this warning:

‘Further analysis is necessary to elucidate why the hyper-responders had an increased risk of death; their baseline characteristics will be described and discussed in detail in the future. Nevertheless, the health of patients who show a remarkable decrease in TC or LDL-C concentration with low-dose statin therapy should be monitored closely.’

Can I return to my slumbers on this issue now?

 

References

1: American College of Phyisicians. Guidelines for Counselling Post-Menopausal Women about Preventative Hormone Therapy. Ann Intern Med. 117:1038-41. (1992)

2: Writing group for the Women’s Health Initiative Investigators. ‘Risks and benefits of oestrogen plus progestin in healthy postmenopausal women. Principal results from the Women’s Health Initiative Randomized controlled Trials’ JAMA (2002)

3: Jabobs et al: Conference on Low Blood Cholesterol and Mortality: Circulation Vol 86, No 3 September 1992

4: Matsuzaki M et al: Large Scale Cohort Study of the Relationship Between Serum Cholesterol Concentration and Coronary Events With Low-Dose Simvastatin Therapy in Japanese Patients With Hypercholesterolemia Primary Prevention Cohort Study of the Japan Lipid Intervention Trial (J-LIT). Circ J 2002; 66: 1087 –1095

104 thoughts on “Statins and cancer

  1. dearieme

    I’ve decided to combine statins with homeopathy. I’ll grind up one pill, scatter it on the potato patch, and consume it with my tatties. Or should I scatter it under the apple tree? Which do you recommend, doc?

    Reply
    1. Eric

      Oh no. Homoepathy won’t work without ritual dillution in water. You should dissolve one tablet in a bathtub filled to about two inches, drain to about one glassful and repeat a couple of times. The more often you repeat the more potent the preparation.

      Reply
  2. michael lightfoot

    Thank you, once more, for your characteristic wit, wisdom and good science in bringing to the fore, once more, this key public health issue which is so hopelessly mired in the myths imaginations and mythology of Big Pharma. I celebrate your bold heresy !

    Reply
  3. Rapunzel

    All big pharma is sweating to do is find a new home for the discredited (Hoorah qv) statins ppl will refuse to take to lower their cholesterol…when they wake up. Very cruel stories about cancer this week in other news, when the required two fold drugs are likely to cost in excess of £100K / year / patient.

    Reply
  4. Carol

    In my view this press release is about getting patients to demand statins from their GP. Thus enforcing the NICE guidelines in the face of recent opposition.

    Reply
  5. Mark Johnson

    Look, you’re all approaching this in totally the wrong way, including you Dr Kendrick.

    The correct way to approach this is as follows:
    The answer is a statin. Now what’s the question?

    Taken from page one, paragraph one of the Cholesterol Treatment Trialists Collaboration (allegedly). 😉

    Reply
  6. CB

    I read your book ‘Doctoring Data’. Thank you for educating me and helping me confirm my suspicions about medical research. When I heard this headline I immediately thought of you and knew it was probably observational and that it was 50% of a small percentage.

    Reply
    1. Anne

      I have to admit that I saw the headline and immediately dismissed it – guess I haven’t passed just yet 🙂

      Reply
  7. rockingbass

    yes Dr Kendrick you are spot on again.about satins.
    May I humbly suggest some bed time reading?
    My wife has written two books
    Uncle Wolfi’s Secret by Valerie Bracken,
    My Life Without Bread (Dr Lutz at 90) also by Valerie Bracken
    published by Just Perhaps.co.uk

    Reply
  8. Catherine Reynolds

    I yelled at the TV this morning when this cropped up on the news! My husband was recently diagnosed with male breast cancer, and has already undergone surgery in this regard, and is due to have precautionary radio and chemo therapies. Having been a devotee of your wonderful blog, Dr Malcolm, for some time, I was really hoping you would have put something in writing about this total nonsense, so thank you very much. My first thought was that the drug companies are seriously worried that statins are beginning to lose popularity or at least that thinking is beginning to change (albeit far too slowly for our liking), and that they’ve decided to come at us all with what is arguably an even more frightening prospect than heart disease. After all, who wouldn’t want to try and fend off cancer in any way they could? It is shameful, that’s what it is.

    Reply
    1. BobM

      Catherine, there is some evidence a low carbohydrate diet with ketosis will limit cancer growth. See, eg, the following:

      Healing Brain Cancer with a Zero Carb Ketogenic Diet by Andrew Scarborough

      This is an N= 1 account. Does it work for all cancers? It’s unknown. I’ve also read studies with multiple patients that did not have as good results.

      Nonetheless, I think it’s reasonable that a low carbohydrate diet with ketosis could affect cancer. It’s something to consider for your husband.

      Reply
      1. Catherine Reynolds

        Hello, Bob! Yes, I have heard of this, and I have given my husband several lots of information on the ketogenic diet. Persuading him that it might well be worth a try is an uphill struggle, as he feels that the doctors treating him must know best, and know what they’re doing and why. I’m not a doctor, of course! It’s the sort of thing that would not actually harm him, whereas the thought of him having chemotherapy, and actually becoming “ill” bothers me a great deal. Thank you for the links – I, at least, will look at them with great interest.

        Reply
      2. Leaview

        Check out 2 groups in facebook practical keto and cancerucan, lots of people discussing diet there x

        Reply
    2. Linda

      Hi Catherine, you could simply begin making meals that follow ketogenic principles and you’ll be doing your husband and even yourself a huge favour! Have a look at a website keto diet app. It’s full of fabulous recipes and info. Best wishes Linda

      Reply
      1. Catherine Reynolds

        Hi, Linda – I shall certainly look at that! I’m still trying to persuade him on this – he is a breadaholic and a ChineseCurryaholic, and weaning him off those two things is tantamount to torture, in his opinion!! I’ve suggested that he has the latter as a once-a-month treat only, and he’s considering that at the moment. I’ve been trying hard to follow at least a low-carb diet for a few weeks now, hoping to encourage him, but he is unfortunately still of the opinion that calories are all that matters, and that therefore, fat is B.A.D. I soldier on…..

        Reply
  9. Flyinthesky

    I must confess when I read it I did, near instantly, wonder where you were going to go with it.
    My own gut feeling was this is a response to a hypothesis in it’s dying throes that’s in dire need of replacing with another. And here we have it.
    The disconcerting thing to me is this is going to stick as tight and for as long as it’s predecessor. Further, I see the potential of enhancing these new founded cancer treating properties to increase the perceived value of the product. The war’s far from won, the big boys are now pushing on two fronts.
    Statins, the new wonder drugs to combat cancer with the added bonus of reducing cholesterol levels.

    Reply
    1. Dr. Malcolm Kendrick Post author

      Statins do not make any money any more (at least not the multi-billions) as they are almost all off patent. However, when the PCSK9 inhibitors launch (with no outcome data), they are going to have to fend off a lot of pretty horrible data. This is where it starts.

      Reply
      1. David Bailey

        Can you expand that a bit? Won’t horrible statin data help to sell PCSK9 inhibitors? Also, they surely can’t be claiming that statins prevent cancer by lowering cholesterol – for the very reasons you have given!

        Reply
  10. DCreadsalot

    Don’t read the Daily Express today either its got statins causing breast cancer !! Described as “doubling” the risk !!

    Reply
      1. Joan

        The study about statins in reducing breast cancer was “observational.” I have Dr. Kendrick’s book so know what that means. So if you were to believe the articles, which as stated are only two weeks apart, then statins both reduce and cause breast cancer, thus canceling out any benefit or risk. Problem solved, absolutely no point in taking a statin!

        Reply
      1. maryl@2015

        What in God’s name is happening. Dr. Kendrick, I read a lot. I see some people saying the GMO’s are causing cancers, auto-immune, and neurological disorders (I have seen a huge increase in Autism and outright behavioral problems with children in the last 20 years) and the list goes on. Then we have the issue of Glyphosate which many are saying is also causing all these aforementioned problems. There is a huge outcry to limit or get rid of statins for all the reasons we have see well documented in these studies, not to mention what we have learned in your previous blogs. So which is it? I cannot figure what came first…the chicken or the egg? We have basically all eaten poorly then when you consider all the “toxins” purported to be in our environment and agricultural products. I am confused and don’t know what to believe.

        Reply
        1. Dr. Malcolm Kendrick Post author

          I think that financial considerations have begun to completely override objective scientific truth. This makes it very difficult to know what is true, and what is not. Which is an uncomfortable situation for all of us. The great problem, as always, is to know what is science and what is nonsense. Are GMO foods potentially deadly. I have to say, at present, I think this unlikely. Do vaccines have a role in increasing the prevalence of autism. I think this likely, and in need of urgent research. Is glycophosphate highly damaging? I think my personal jury is out on this one. Do statins do more harm than good. I am virtually certain about this. My own view is fairly straightforward. Steer clear of things that you don’t need in your body, that might prove horribly damaging at some point in the future. Eat local produce and organic produce when available, avoid highly processed foods.

          Reply
      2. Jacob

        Although Wikipedia says “citation needed” this doesn’t look like much fun:

        “A possible side effect of the monoclonal antibody might be irritation at the injection site. Before the infusions, participants received oral corticosteroids, histamine receptor blockers, and acetaminophen to reduce the risk of infusion-related reactions, which by themselves will cause several side effects”

        and this:

        “Preliminary studies have been released for each and phase 3 trials are underway. In September 2014 results were announced that alirocumab cut roughly in half the number of heart attacks and strokes. The result is not conclusive, because the analysis was done retrospectively. The drugs could reach the market next year”

        Reply
        1. Dr. Malcolm Kendrick Post author

          Personally, I think all the medical/scientific arguments will be as naught compared to the potential cost. I cannot see these drugs getting approval anywhere in Europe. Some rich people maybe will pay for them, otherwise any healthcare organisation will see the cost as a massive barrier.

          Reply
  11. mikecawdery

    Dr Kendrick

    Once again you have hit the nail (misinfo???) on the head with a very large hammer. Thank you.

    May I add another rarely cited research report? All drugs in their early stages of development have to go through a series of tests for carcinogenicity. Statins have been so tested.
    JAMA. 1996 Jan 3;275(1):55-60.
    Carcinogenicity of lipid-lowering drugs.
    Newman TB1, Hulley SB.

    The following is an extract:

    All members of the two most popular classes of lipid-lowering drugs (the fibrates and the statins) cause cancer in rodents, in some cases at levels of animal exposure close to those prescribed to humans. In contrast, few of the antihypertensive drugs have been found to be carcinogenic in rodents. Evidence of carcinogenicity of lipid-lowering drugs from clinical trials in humans is inconclusive because of inconsistent results and insufficient duration of follow-up.

    My Comment: “inconsistent results and insufficient duration of follow-up” This raises the question of data manipulation and/or data hiding – anything to obfuscate the real facts!

    CONCLUSIONS:

    Extrapolation of this evidence of carcinogenesis from rodents to humans is an uncertain process. Longer-term clinical trials and careful postmarketing surveillance during the next several decades are needed to determine whether cholesterol-lowering drugs cause cancer in humans. In the meantime, the results of experiments in animals and humans suggest that lipid-lowering drug treatment, especially with the fibrates and statins, should be avoided except in patients at high short-term risk of coronary heart disease.

    RTECS outlines the overall toxicity etc for drugs and many other chemicals. Unfortunately I no longer have access. May be you can through the BMA?

    Reply
  12. Stephen Town

    There is a huge problem with science reporting, as I think Ben Goldacre has complained. I read about this in today’s Times and hoped there’d be an item here. Two thoughts struck me straight away after reading this site for a few months: 1) it’s an association study. 2) Four out of five association studies later turn out to be wrong.

    I wonder if they’re trying to squeeze the last bit of profit from statins or just trying to combat recent bad publicity. There never seems to be a lack of willing collaborators doing and reporting dodgy research. The newspapers should club together and pay one or two scientists to scrutinise and write health and science articles. The problem is that most articles would go in the bin and that’s a lot of missing front pages stories.

    Reply
  13. Joan Kohnke

    At the beginning of the Daily Mail article it says “while the drugs do not seem to prevent cancer in the first place…..” but then somewhere else in the article it says two studies suggest they may prevent cancer. Seems contradictory. Presume they mean that if you are taking statins and you happen to get some kind of cancer, it slows the cancer down?? That would not be preventative. A very good friend of mine, a physician, took statins for years at the urging of her own doctor and now tragically she has Alzheimer’s so it seems statins did not work for her certainly. So much will be made of these findings, I can imagine everyone’s next visit with their doctor where there will be a prescription for statins waiting. Why not make it a worldwide law that every adult take a statin? Why stop there though, maybe statins from birth onwards! Scary stuff. The old saying here I think stands true “if it seems too good to be true, it probably is.” Probably not too good to be true for the drug companies though. Also, can imagine oncologist having fits with the thought that a cheap drug is as effective as chemo, especially here in the U.S. where apparently the oncology practices buy chemo drugs and then jack the price up dramatically for their patients. I am in my 60s, very active and pain free, while some of my contemporaries are complaining of muscle pain and memory issues, on statins, but of course according to their doctors, symptoms are nothing whatsoever due to the drugs.

    Reply
  14. Penny Irving

    Tony, you should digest this article including the Q and Answers
    This is the fantastic Dr Kendrick – as radical as Dr. Durant-peat field, and in all our views
    He’s right.
    You don’t have to act on it, just absolve it.

    Sent from my iPad

    >

    Reply
  15. Jo

    Once it’s on the BBC it gets sold all around the world. Their coverage was on the tv here in NZ. Also an article in all the local papers, which these days pretty much rely on overseas content anyway.

    Thanks for the analysis. I figured it was a load of hooey, but like to have someone more skilled to tell me why.

    Reply
  16. Jennifer

    Well I shall certainly sleep well tonight!
    Yesterday I happened to come across the notes I gave to my GP over 2 years ago, questioning what I considered to be over medicalisation for a female aged 65 at the time.
    I thought any mathematicians out there might be able to help me work out the morbidity of the combination that I was ingesting daily. Of course I was just THE PATIENT, but my concerns were dismissed out of hand by the GP, as no one had ever presented at the surgery with any of the senarios I gleaned from the pamphlets inside each box.

    PIOGLITAZONE 30mg….increased risk of urinary bladder cancer ( no figure given).
    also, …10 in 100 females ….increased risk of bone fracture….already an increased risk factor for elderly females.
    also….weight gain affects 10 in 100, due in increased appetite.
    also…..anaemia ( did not specify type), affects up to 10 in 100.

    JANUVIA 100mg….increased risk of pancreatitis ( no figure given)
    also……bowel irregularities in more than 10 per 100 users.
    also …..ankle swelling when combined with a glitazone,.as above.

    AMIAS 30mg…..for a person with White Coat Hypertension.(heck)

    METFORMIN 2,000 mg….for BMs less than 8mmol, with the threat of insulin just round the corner.

    But, do not worry…..with Simvastatin fluctuating between 40mg and 80mg, and a nice healthy total cholesterol of 3.4mmol… I had absolutely nothing to worry about….the statins would be my saviour…or so the Daily Rags now confirm.
    Yes, The GP was presumably right all along.

    I thought long and hard…..the best way for me to proceed, was to clear out every last pill….including the statins, and in hindsight, little realising the risk I was taking in discontinuing the wonder drug, now shown to have been the guardian angel protecting me….silly me.
    I would laugh if the whole darned thing wasn’t so serious. But in reality it is a crying shame…..and I am relieved to have found this blog, along with LCHF…..my life is well and truly back on track.
    Today’s newspapers? Tomorrow’s fish and chip papers…..no…..I wouldn’t contaminate good food with them!

    Reply
  17. Suzanne Looms

    I think you’ve trained us well. I read the headline in a paper and IMMEDIATELY thought of the early post about absolute/relative risk and the underlying numbers in a study. Many thanks for your efforts.

    Reply
  18. jvikse58

    It has been suggested that one of the reasons statins do reduce CVD (albeit minor) is due to anti inflammatory effect.
    Cancer might also be due to inflammation. Thoughts on this ?

    Reply
    1. Dr. Malcolm Kendrick Post author

      Broken ankles are due to inflammation. Insect bites are due to inflammation. Or perhaps it is the other way around? I am not a great believer in the spontaneous inflammation theory of disease.

      Reply
      1. Spokes

        It doesn’t make a lot of sense does it? If inflammation is the body’s response to injury of some kind, it makes more sense to say chronic injury is likely to lead to something nasty(er). I don’t know though.

        Reply
      2. Steve (UK)

        Hi Dr. Kendrick,
        I wouldn’t describe it as ‘spontaneous’ – there are literally dozens of well-known mechanisms – all of which cause or exacerbate what is described medically as ‘inflammation and which fully explain what is happening in Cancer.

        Would be happy to discuss – but, perhaps it’s a little off subject.

        Reply
    2. Steve (UK)

      Hi jvikse58,

      I’ve done a considerable amount of (amateur) research on this and IMHO Cancer is caused by inflammation or more specifically what causes Cancer also causes inflammation – I would be happy to discuss and provide supporting evidence if you are interested.

      I don’t want to hijack Dr. M’s blog – is there a safe way to get an email address to you?

      Reply
  19. Jennifer

    As an aside……good to see that there are well over 2,000 following Dr Kendrick’s blog. Nice that momentum is gathering at a time when the press are going barmey with stupid pseudo science reports.

    Reply
  20. Leigh gold

    1. “Don’t believe everything you read in newspapers”
    2. “Lies, damn lies, and statistics”
    Great quotes.
    Nuff said?

    Reply
  21. Fergus

    Observational studies are on the whole a complete waste of time. Too many confounders. It’s why I don’t take notice of food studies eg red meat kills, bluberries save etc.

    Reply
  22. Anne

    is it just me or is there some confusing between ‘risk of developing cancer’ and ‘treating cancer’? The Daily Mail talks of ‘treating’ cancer with statins – a different ballgame from disease prevention.

    Reply
      1. maryl@2015

        Today I went to my GP. I had sent one of the studies quoted by you that doctors diminish patient complaints about statins. The last time I saw him, he said the had reduced the statins he gives patients to 3 times weekly. I tried to explain to him that the dietary guidelines world wide were changing. He laid back in his chair and said “I am the man around here who knows the most about statins”. I gave him two recent blogs on this website. I also gifted him your latest book. As I tried to explain that the pain I feel is from statins, he told me that people don’t suffer longer effects from statins. I said “yes, they do.” He said “Well I don’t have time to read all theses studies”. So, he is the “Go to” physician when it comes to statins, but does not have time to read studies? Makes no sense to me. However, I chose my battles as wisely as I can. I said once again. Well, if you are the “Go to” man for statins, you will find Dr. Kendrick’s book an eye opener. I suggest you read it for the future as things are about to change drastically. He thanked me for the book and said he will read it. Don’t know if he will. But I see him again in October and if he has not read your book, I am going to get it back!!!!!! You know, I was among the first of that practice’s person (this is a highly regarded teaching hospital) to give my GP a copy of “Statin Nation” and and spacedoc.net to encourage her to ponder whether statins cause damage. She placed in my file that I was “statin intolerant”, which tells me she finally believed me and others. She has retired because her husband has heart problems. He (my new doctor mentioned above) took her place and now is the expert in the practice on statins even though he admits to not having time to read studies. Hmmmmm! Every single person you touch and provide information to is a feather in one’s cap so to speak. I certainly have made contact with everyone I can think of in a position of authority to read and keep an open mind about statin damage. I beg those in the U.S. to do so as well. I have written to my Congressional leaders, many of whom I know quite well. I am doing my part in the U.S. I can only school others on the legislative process on a National level and local level. I know how our Congress works and that is my contribution. And, if I turn out to be wrong, I will say Sorry, but I doubt I will have to do that on this issue. I refuse to give up!!

        Reply
      1. David Bailey

        Maryl,

        It isn’t easy arguing with a doctor, and I think you did very well – much better than I did! I have wondered about offering a copy of “The great Cholesterol Con”.

        Dr. Kendrick, let me ask you – have you ever been offered a medical book (or paper) by a patient, and did you read it!

        Reply
  23. Graham Hilder

    Hi Dr Kendrick, just finished reading Doctoring data, I really enjoyed it,in your opinion is it possible that statins are in any way responsible for the apparent rise in cases of Alzheimer’s bearing I mind cholesterol is so important to brain function?

    Reply
    1. mikecawdery

      Ash:
      Yes if you are:
      1) statin tolerant,
      2) prepared to accept the probability of avoiding a fatal heart attack at 0.003 (i.e 3 chances in a 1000 p.a. – direct quote from Collins) or conversely the probability of NO BENEFIT = 0.997, rounded to decimal places = 1.00 – near certainty of no benefit and
      3) a probability of having an adverse reaction of one in five (p = 0.2).

      People do win the lottery but to stake your life on it?

      Reply
      1. David Bailey

        Plus you may be like me, and tolerate statins well for 3 years, and then have serious problems. This poses a real danger that doctors don’t realise that the statins are responsible.

        Also, if you read some accounts here or on sites devoted to statin side effects, you learn that not everyone does recover properly from the damage statins can cause.

        Reply
      2. Mark Johnson

        I’m not sure that “tolerant” is the right word to use when discussing an individual’s possible reaction to them. There can be no doubt that cell death occurs in each and every person who takes a statin for any length of time. That is a stain’s modus operandi. I use the term deliberately because just like a murderer, statins are killing you, just very slowly, one cell at a time. It’s the chemistry of the drug – they do what they do. Have a look at any of the Yoseph books on the topic.

        Reply
    2. mikecawdery

      Dement Geriatr Cogn Disord 2009;28:75–80
      DOI: 10.1159/000231980 Can be downloaded in full.
      Midlife Serum Cholesterol and Increased Risk of Alzheimer’s and Vascular Dementia Three Decades Later
      Alina Solomon et al. Yes

      I came across this paper first on the WebMD site in 2009. Not properly referenced therein and I enquired from both WebMD and WebMD-BOOTS (UK version) about this use of statins and my comments Both declined to answer.

      In Tables 2-4 change row titles from TC levels to US Guideline treatment. Provides evidence of association of statins with increased incidence of Alzheimer’s. This paper is very rarely cited yet I believe that it could easily be repeated WITH TREATMENT details in many NHS TRUSTS. It won’t be! It could bankrupt Big Pharma in US class action trrials.

      Reply
      1. DBchris

        Checked the paper, not sure I get your point but probably dumbness on my part.Seems they are convinced high TC is the road to hell,albeit LDL accounts for most of it (and we still are unsure of those lttle hard beauties).

        Reply
      2. mikecawdery

        DBchris
        Re: Solomon’s paper on high TC

        I have included two URLs that provide statistical calculations to confirm results

        1) Assume that medical insurance companies will treat high TC with cholesterol lowering drugs which from the late 1980s the preference would be statins.
        2) Assume that patients tolerant to statins (80%+ and up to 99%{Collins}) would keep taking them “to save their lives” for decades.
        3) Subsequent cholesterol levels were ignored.
        4) Just assume for argument sake that the medical insurance company did not want endanger its relationship with Big Pharma and therefore withheld treatment data.

        Analyze a 2×2 contingency table
        Outcome 1 Outcome 2 Total
        Group 1 136 2545 2681
        Group 2 460 6703 7163
        Total 596 9248 9844

        Hazard ratios plus CI Using: https://www.easycalculation.com/statistics/odds-ratio.php

        AD & VaD No dementia Total incidence

        NO TREAT (200 mg/dl) 460 6703 7163 6.86

        Total 596 9248 9844

        Result

        Odds ratio 0.77869

        95% confidence interval from 0.63966 to 0.94793

        ChiSquare

        using: http://www.graphpad.com/quickcalcs/contingency1/
        Chi-square with Yates correction
        Chi squared equals 6.008 with 1 degrees of freedom.
        The two-tailed P value equals 0.0142

        The association between rows (groups) and columns (outcomes)
        is considered to be statistically significant.

        In short those PROBABLY treated with cholesterol lowering drugs for 2-3 decades have a significantly higher incidence of Alzheimer’s and VaD than those not treated
        Real difference is small but numbers are large

        Reply
    3. Stephen Town

      Graham, I believe Stephanie Seneff from MIT in the U.S. regards statins and the low fat diet as the most likely causes of Alzheimer’s.

      Reply
      1. mikecawdery

        Throw in glyphoshate (Roundup) as well because of the ever increasing rates of usage due to the increasing levels of resistance in weeds. Check her web site.

        Reply
    4. Anne

      I also feel that statins may be in some way responsible for the onset of Alzheimer’s… every person I know who takes them also has at least some level of memory issues

      Reply
    5. maryl@2015

      The fact that it is happening more frequently to those younger and younger is a cause for deep concern! That is not a good sign!!

      Reply
  24. Cstckdvd

    There is an interesting opinion in the Daily Telegraph of 4 June in which Karol Sikora gives his views as a cancer specialist with 35 years experience. These stories of imminent cures for cancer appear annually coincident with the Chicago meeting of oncologists “…placed by smart marketing execs on behalf of the pharmaceutical industry.” Who’d have thought it…

    It can be found by searching the Telegraph website with his name. The title is “Miracle-cure hype fuels the modern quest for immortality”

    Reply
  25. Dr Robin Willcourt

    With the PCSK9 drugs about to get approval this year in the US, it is interesting to see the laudatory comments made about them: “The consistent and dramatic reduction in LDL and impressive reduction in cardiovascular risk should continue to cement investor confidence in PCSK9 drugs as a class in treating atherosclerosis,” one analyst wrote for investors.

    “Unprecedented” is how Dr. Steven Nissen of the Cleveland Clinic characterizes PCSK9 inhibitors’ ability to lower LDL-C, adding: “We have not seen any evidence in emerging trials that the LDL-C levels achieved are producing any harm. Even the very, very low levels appear to be safe.” The actual reduction in a cardiovascular event was, in fact 1%. This was in a group of over 4,000 patients.Stunningly successful! They are given sc every 2 to 4 weeks. Lots of injections and doctor visits.
    http://consultqd.clevelandclinic.org/2015/02/pcsk9-inhibitors-with-likely-approval-imminent-what-should-we-make-of-them/

    Reply
    1. David Bailey

      I notice in the section about side effects, it admits, “There have been limited reports of myalgia and creatine kinase elevation signals”

      That sounds remarkably like statin muscle problems! I wonder if the truth is that statin muscle problems are simply a side effect of unnaturally lowering the levels of cholesterol/LDL and thus are an inevitable consequence of lipid lowering treatments.

      I really can’t see many patients going for an injection every 2 to 4 weeks just on a preventative basis.

      Reply
      1. Dr. Malcolm Kendrick Post author

        I can, if someone else pays e.g. the NHS. A few rich people will do anything they perceive to be a risk. Frankly, I don’t think any major payors will fund these drugs. Thousands of dollars/pounds per year, per patient. These drugs, if widely taken up, would bankrupt every healthcare system in the world.

        Reply
  26. Adam Staines

    Farnesol has proven anti-cancer properties and apart from natural sources is also produced in the body as part of the cholesterol biosynthesis pathway. Statins knock this out so at least on one level taking statins revoves on anti-cancer compound from the body!

    Reply
  27. mario

    Dr. Kendrick, Had the patents system never existed, or applied to drugs, could we have avoided all this scientific stupidity and all the medical/pharmaceutical terrorism?

    Reply
      1. maryl@2015

        Dr. Kendrick, we need industries. I am not averse to business and industry. I love free enterprise and promote businesses. However, if they are producing known carcinogens, then things are dark, indeed. We need change to come about so that these industries are lead by good, honest people. These changes can and must come to pass. I would hate to see a full world economic collapse based on what we observe and believe to be toxic. We must have a plan B so to speak. I believe these things will change. Time is going to do just that. If done properly, all of us can benefits including business and industry. Just think if both sides of the slavery, states rights issues, and taxation issues could have been solved with a plan to implement these things through proper channels, we would not ever have had a Civil War in the South which devastated both sides. We lost so many good boys who would have sired other good people. Instead, bloodshed ensued and the South was left in a state of grinding poverty which took years to recover from. And those black slaves had no one to protect them and give them some kind of plan once they were free men and women. It was a disaster. Just listen, make a difference and slowly change these things through the proper channels. We must negotiate these differences and have a plan B to address those changes.

        Reply
    1. David Bailey

      My feeling is that a drug is not really a ‘product’. What I mean is that if a company devises a new computer chip (say), and early testers report problems, these can be fixed. However as I understand it, if you tweak a molecule – adding so much as a methyl group – the rules stipulate that the testing starts again from scratch. From the perspective of a drug company, that is like Russian Roulette!

      I think somehow money should be provided for basic research itself, but nobody should end up with a patent. Then the NHS could simply buy the drug at cost price – possibly from a different company.

      The NHS (in Britain) ends up paying for the research anyway – either directly, or through inflated drug prices, and campaigns to sell more drugs than are necessary, phoney diseases etc etc.

      Reply
      1. Mario

        Maryl, politics is not about finding an optimal solution, but about the total obliteration of your enemies. Nothing to do with justice, freedom, rights, law, religion or economy. All of these are excuses to justify destruction. And many things about medicine and insdutries are just politics.

        Industries can do good, and commerce is a great thing, but all about production, marketing and research must be as far from political power as possible. But most people are blinded because of education and journalistic propaganda, and believe that politicians must control research and medicine, when it is quite clear that politicians knowingly create oportunities for making up and disseminating scientific lies and abhorrent medical treatments.

        What I’m saying may seem harsh, but I don’t think I’m exaggerating one bit.

        Medical freedom now!

        Reply
        1. Jennifer

          Mario, in 1986, the first words uttered by the Nurse Tutor to his new cohort of NHS Student Nurses was “Nursing is Politics”.
          I suspect it was not the sort of thing they were expecting to hear, because the vocational aspects of their chosen career would no doubt have been uppermost in their minds.
          Nearly 30 years later, I should imagine they have realised it was the most pertinent phrase of their studentship.

          Reply
  28. mikecawdery

    The following is an abstract of a paper sent me by Dr Stephanie Seneff.

    Sennef – Statin Use and the Risk of Incident Dementia

    Background: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular risk through mechanisms that might affect the development of dementia.
    Objective: To evaluate whether statin use is associated with a lower risk of dementia compared with never use of lipid-lowering agents (LLAs).
    Design: Cohort study of community-dwelling adults 65 years and older. The analysis included 2798 participants free of dementia at baseline.
    Main Outcome Measures: Using Cox proportional hazards regression analysis, we estimated the risk of incident all-cause and type-specific dementia associated with time-dependent statin therapy compared with never use of LLAs. The primary analyses incorporated a 1-year lag between exposure and outcome. Secondary analyses included the final year of exposure and modeled statin use as current use vs nonuse to simulate a case-control approach.
    Results: Compared with never use of LLAs, ever use of statins was not associated with the risk of all-cause dementia (multivariable-adjusted hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.77-1.52), Alzheimer disease alone (HR, 1.21; 95% CI, 0.76-1.91), mixed Alzheimer disease and vascular dementia (HR, 0.87; 95% CI, 0.44-1.72), or vascular dementia alone (HR, 1.36; 95% CI, 0.61-3.06). In contrast, in secondary analyses, current use of statins compared with nonuse of LLAs was associated with HRs of 0.69 (95% CI, 0.46-1.02) for allcause dementia and 0.56 (95% CI, 0.35-0.92) for any Alzheimer disease.
    Conclusions: In this cohort study, statin therapy was not associated with a decreased risk of dementia. Methodological differences may explain why results of this cohort investigation differ from those of prior casecontrol studies. Additional investigation is needed to determine whether and for whom statin use may affect dementia risk.
    Arch Neurol. 2005;62:1047-1051

    Seneff’s comment:

    See Table 2 in the attached paper:

    FORMER use of statins is associated with 2.5 fold increased risk to
    Alzheimer’s disease.

    This is because the first thing they probably do when they detect memory
    problems is take you off the statin.

    And notice that this important point was omitted from the abstract.

    More “fudging” as usual

    Reply
  29. Joan

    Interesting article in the New York Times today (June 9th) about PCSK9 inhibitors. Probably they will be approved before clinical trials are back showing if they are effective or not in preventing heart attacks or strokes. No side effects apparently compared with placebo! Oh, and cost about 10 thousand dollars a year. What would that do to our health insurance premiums here in U.S.??? Hefty copays for people choosing to take them and what about Medicare which is supposedly going bankrupt? Would the NHS pay out that much? I am a Scot living in the U.S. so interested in what the difference will be.

    Reply
  30. fiona405f

    Dr Kendrick – love all you write – above you state: “Are GMO foods potentially deadly. I have to say, at present, I think this unlikely.”

    Have you considered this? Plants have an inbuilt defence mechanism against bugs, the BT toxin injected into the plants is adding to those toxins. We are experiencing increasing problems with human gut related problems as carbohydrate intake has increased over the decades of low fat advice. There are also reports now coming in that the root worms are now becoming resistent to the BT toxin injected into GM corn…so maybe this GM technology is only another short term solution driven by high profit potential with no long term sustainability?

    Reply
    1. Professor Göran Sjöberg

      Funny!

      For me it seems as whatever I critically dig into, it may be heart disease, diabetics or cancer but basically it all started with the statins and the cholesterol, my old views are turned upside down.

      A couple of years ago I wouldn’t have given our agriculture much thought but when I started doing ‘some digging’, I was ‘converted’ here as well and a month ago I did what I could not have dreamed of two years ago, I participated as one of 300 in the “March against Monsanto” in Gothenburg as one of the 600 cities participating around the world at the same time.

      As with statins I now believe that the pesticides in our food are ‘slow killers’.

      We grassroots seem to be really concerned today about our health and future – not the authorities who constantly claim the safety of everything on the market and closing there eyes to what science tells them. In the grocery stores there is now a 30 % increase of the organic food sales in just one year and at the wine stores in Sweden there has been a 100 % increase of organic wine during the same period of time.

      Tells you something!

      Reply
      1. Flyinthesky

        “Slow Killers” Indeed, there are a lot of sites in the USA dedicated to illustrate the harm or possible harm to the human organism. It has similarities with the statin question. Some people maybe able to tolerate the increased toxin levels and maybe affected sub clinically whereas others the consumption can have marked and sometimes debilitating effects.
        Whereas the pharmaceutical industry may have a responsibility for hundreds of thousands of deaths and debilitations, messing around with the fundamentals of food crops for short term gain may have multi decadal unforeseen consequences and may indeed kill billions.
        Soylent green anyone.

        Reply
        1. Dr. Malcolm Kendrick Post author

          Yes, absolutely. I think that if you messing about with the food chain, the requirement to prove long-term safety should be extremely stringent. We don’t really want comments in the future such as: ‘Oh, you mean the entire human race has just become sterile… we never expected that to be the result of GM crop genes entering the human genome.’

          Reply
    2. Flyinthesky

      It’s the same with antibiotic resistant bacteria, nature finds a way.
      G.M.O. is sold on the emotive feed the world ticket where it is in actuality an ongoing project to cartelise all agribusiness. The culmination of which we be our seeds or no seeds.

      Reply
      1. Professor Göran Sjöberg

        “G.M.O. is sold on the emotive feed the world ticket where it is in actuality an ongoing project to cartelise all agribusiness. ”

        Agree!

        As with the statins what is disgusting to me is the ethic or rather moral part of the whole business. It is the sunday school ‘kindness’ from these corporate guys that is up my throat just now.

        Reply
    3. chris c

      I think GM is something of a red herring. “Normal” plant breeding techniques have been used to increase pest and disease resistance.
      Animals defend themselves with teeth and claws or by running away. Plants defend themselves with toxins. We have evolved to detoxify many of them, and even use them as drugs and dietary supplements. Pretty much by definition, increasing pest and disease resistance means making the plants more toxic. Unfortunately they are not told that humans are NOT pests!
      The other side of the coin is that they are bred for things like appearance and shelf life, which tends to reduce levels of micronutrients (and taste). GM is basically the icing on a cake that has been being baked for decades. A neighbour grows old fashioned wheat for thatching straw and it looks like a completely different species from the modern wheat in his next field – as recently as my childhood all wheat was like that, which ties in with William Davis and David Perlmutter’s theories. Likewise but less distinctive are the differences between “heritage/heirloom” vegetables and fruit and modern varieties: again these changes took place over my lifetime and were driven by normal plant breeding techniques until the last decade or two.
      Much the same can be said for animals – Friesian cows and the later American variant, Holsteins – are bred to be milk making machines such that they have difficulty maintaining their own bodies, unlike older, less productive breeds, and they produce milk with a different protein variant.
      I’m very tempted to believe that we’ve also spent decades trying to breed the carbohydrate intolerant out of the human population in a similar way. This hasn’t worked yet because people are still breeding before they die prematurely. Maybe the huge increases (pun intended) in childhood obesity, diabetes (both types) asthma, allergies etc. will have the desired effect.

      Reply
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  32. Stephen Town

    The ‘heresy’ trial of Professor Tim Noakes has been adjourned until November. Noakes committed the sin of tweeting advice on a low carb diet in response to a request from a mother of a young child. The amount of time spent on this tweet is astonishing. The case was adjourned after Noakes’ legal team objected to a person sitting in judgment who has voiced criticism of a low-carb diet and is a member of the same dieticians organisation whose president made the complaint. Are they totally incompetent? I predicted that they’d find a way to drop this case but it hasn’t happened yet.

    The attached link is a recent debate in South Africa between a traditional dietician and Prof. Noakes. She gives the usual high-carb view, but does concede the benefits of a low carb diet for diabetics. Most of the dieticians in the NHS can’t seem to understand that simple point. I think it’s game, set and match to Noakes.

    Reply
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  34. Oliver

    I realise this is a year later now, but I just wanted to ask about the high cholesterol/cancer protection thing. The study you cite is itself a collection of observational (cohort) studies, which you’ve mentioned the issues of. Specifically, the observed cholesterol/cancer association could well be due to reverse causality (I found this post because I’m looking into Mendelian randomisation studies – for a small and inconclusive, yet still interesting study finding no such protective association see http://aje.oxfordjournals.org/content/170/11/1415.long).

    I’m by no means saying this in order to advocate for statins as protection against cancer, but I do wonder if you might be jumping the gun on saying cholesterol is protective too.

    Reply
    1. Dr. Malcolm Kendrick Post author

      Oliver. Thanks for your post. I don’t think I have ever said that cholesterol is protective against cancer – although I may have implied it rather strongly. My own view is that a low cholesterol level is a general sign of ill-health – and a falling cholesterol even more so. Thus it is difficult to disentangle correlation and causation.

      Reply

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