As someone who considers myself to be a scientist, I thought I should present another view to you on statins. This piece (a transcript of a talk) can be seen on Medscacpe1.
Please read on, and see what you think of his arguments:
I am Dr. Frank Veith, Professor of Surgery at New York University Medical Center and the Cleveland Clinic. Today I am going to talk about what I call the “statin witch hunt” and why, despite it, we should give more patients statin drugs.
The question of whether to give statins to more healthy patients is one of considerable interest to the public and considerable debate in both the medical community and the lay press. In November, the American College of Cardiology (ACC) and the American Heart Association (AHA) released their long-awaited new guidelines on the treatment of blood cholesterol to reduce the risk for adult atherosclerosis. T
This guideline, among other recommendations, guided physicians to expand the number of patients being treated with statin drugs. The guideline was greeted with many objections in both the medical community and the lay press. Most notable was a November 14 New York Times op-ed by 2 respected experts, Drs. John Abramson and Rita Redberg, titled “Don’t Give More Patients Statins.”
Other New York Times articles about Drs. Paul Ridker and Nancy Cook, and another by Gina Kolata, expressed similar reservations about the ACC/AHA guideline recommendation to broaden statin administration. All three of these New York Times articles were part of what I call the “statin witch hunt” which has generated much confusion among the public.
The op-ed by Drs. Abramson and Redberg makes the case that the recent ACC/AHA cholesterol guideline is incorrect to advocate the expansion of statin usage to more patients because such expansion “will benefit the pharmaceutical industry more than anyone else.” They state that the guideline’s authors were not “free of conflict of interest.” In addition, they claim that “18% or more” of statin recipients “experience side effects” and that the increase in statin administration will largely be in “healthy people” who do not benefit and who would be better served by an improved diet and lifestyle.
Although the latter is true for everyone, Drs. Abramson and Redberg convey the wrong message. Statins are the miracle drug of our era. They have proven repeatedly and dramatically to lower the disabling and common consequences of arteriosclerosis — most prominently heart attacks, strokes, and deaths in patients at risk. Statins avoid these vascular catastrophes not only by lowering bad blood lipids but also by a number of other beneficial effects that stabilize arterial plaques.
They have minimal side effects, most of which are benign. In several controlled studies, the patients who did not receive statins had an incidence of side effects equal to those who received them. Serious side effects are rare and manageable. Moreover, healthy patients are only healthy until they get sick. Many individuals over the age of 40 take a daily aspirin.
Statins are far more effective than aspirin in preventing the heart attacks and strokes that often occur unexpectedly in previously “healthy people.” Clearly it would be worthwhile for such healthy people to take a daily statin pill with few side effects, if it would lower their risk for such vascular catastrophes and premature death.
In contrast to what is implied in the Abramson-Redberg article, these drugs are an easy way for people to live longer and better, and statins cannot be replaced with a healthy lifestyle and diet — although combining the latter with statins is a good thing.
Lastly, with respect to the comments about the pharmaceutical industry benefiting from statin prescriptions, and the guideline authors’ conflicts of interest, both are less important than patient benefit, which has been demonstrated dramatically and consistently in many excellent and well-controlled statin trials. Moreover, most statins are now generic, so the cost for obtaining these miraculous drugs need not be prohibitive, and the guideline’s authors are experts who are eminently qualified to write them.
The statin witch hunt is a bad thing, and more patients should be on statin medication. I am Dr. Frank Veith, and that is my opinion.
1: http://www.medscape.com/viewarticle/822145?nlid=51963_1985&src=wnl_edit_medn_card&spon=2
(You will need to subscribe to Medscape to see the talk, and transcript. It is fairly straightforward to gain access. The site is www.medscape.com It is one of the biggest medical websites.)
I though you should know if Frank Veith has any conflicts of interest. He works at the Cleveland Clinic, so he probably doesn’t, as most of the medical experts who work there state that they give all of their income from working with the pharmaceutical industry to charity. Steven Nissen, a man of whom you may have heard me speak on a regular basis, is the chairman of Cardiovascular medicine at the Cleveland Clinic.
Here, for example, is Steven Nissens conflict of interest statement
Dr Steven Nissen
Medical Director
Cleveland Clinic Cardiovascular Coordinating Center
Dr. Nissen has received grant/research support from AstraZeneca Pharmaceuticals, Atherogenics; Eli Lilly and Co., Lipid Sciences, Pfizer Labs, Sankyo Pharma, sanofi-aventis, and Takeda Pharmaceuticals North America with all reimbursement directed to the Cleveland Clinic Cardiovascular Coordinating Center; and has been a consultant for Abbott Laboratories, AstraZeneca Pharmaceuticals, Atherogenics, Bayer Corp., Eli Lilly and Co., Forbes Medi-tech, GlaxoSmithKline Pharmaceuticals, Haptogard, Hoffman-LaRoche, Isis Pharmaceuticals, Kemia, KOS Pharmaceuticals, Kowa Optimed, Lipid Sciences, Merck/Schering Plough, Novartis Pharmaceuticals Corp., Novo-Nordisk, Pfizer Labs, Protevia, Roche Pharmaceuticals, Sankyo Pharma, sanofi-aventis, Takeda Pharmaceuticals North America, Vasogenix, Vascular Biogenics, Viron Therapeutics, and Wyeth Pharmaceuticals, all fees are paid directly to charity with no reimbursement paid to Dr. Nissen; and has served on the speakers’ bureaus of AstraZeneca Pharmaceuticals and Pfizer Labs, all fees are paid directly to charity with no reimbursement paid to Dr. Nissen.
Cleveland Clinic physicians and scientists may collaborate with the pharmaceutical or medical device industries to help develop medical breakthroughs or provide medical education about recent trends. The collaborations are reviewed as part of the Cleveland Clinic’s procedures. The Cleveland Clinic publicly discloses payments to its physicians and scientists for speaking and consulting of $5,000 or more per year, and any equity, royalties, and fiduciary relationships in companies with which they collaborate. The Cleveland Clinic requires its doctors to approve the public disclosures of their scientific collaborations with industry. As of 3/21/2014 the review process regarding Dr. Veith’s disclosure had not been completed. Patients should feel free to contact their doctor about any of the relationships and how the relationships are overseen by the Cleveland Clinic. To learn more about the Cleveland Clinic’s policies on collaborations with industry and innovation management, go to our Integrity in Innovation page.
Dr. Malcolm Kendrick 
Veith says “They have minimal side effects, most of which are benign.”
That just isn’t true so what credence should I give to anything else he says? Zilch.
TC
…I might have a headache next week, so i’ll take an asprin today – just in case.
http://www.theguardian.com/society/2014/mar/21/-sp-doctors-fears-over-statins-may-cost-lives-says-top-medical-researcher There’s all this in the media this morning too. I’d like to see some proper, unbiased scientific proof that A/ high cholesterol causes heart disease B/ That statins significantly reduce heart disease C/ the benefits outweigh the adverse effects. Even then, I dont think I could be persuaded. I only take medication if I’m unwell – and even then, only if its something that my natural defenses couldnt fight on their own
The HPS study did show that there was a significant reduction in deaths but it required group sizes of over 10,000 to show it. The actual difference was an estimated 156 fewer deaths in statin group (10,269 = N) over 5 years. That is 3/1000 per year or an NNT >300 or the probability for individual benefit of p = 0.003, significant but in short very unlikely.
This study went to great trouble to exclude statin intolerants and potential intolerants and consequently had a very low level of adverse reactions (the official term). To then extrapolate this finding to those excluded on grounds of intolerance and potential intolerance is scientifically outrageous – apparently worth a Knighthood.
Great post! Thanks for being you and doing what you do. Really helps those of us that are working hard to stay healthy without big pharmas help!
There is a lot of similar content in today’s papers. I think one can only read as much as possible, get informed, and then make a decision for yourself with respect to your own health. A year ago I made the decision not to take a statin. Two years ago I made a decision to follow a LCHF lifestyle. At the moment I still feel comfortable, and well, with those decisions, but I guess only time will tell. You cannot rely on anyone else to improve your health, you can only listen to advice from the medical profession and decide what to do with that advice. BTW, I have many instances of accepting advice from doctors too!
If I wanted an opinion on an electrical problem, I wouldn’t ask a plumber. It is ludicrous that a surgeon should see fit to pronounce on an area outside his expertise and expect to be heeded!
In this case I would agree. This surgeon’s unsubstantiated puffing of Statin potions is just like the appeal to authority by Prof Rory Collins in yesterday’s press and today’s news feeds. The correct response to such puffery is to adopt Paxman’s maxim and ask “Why is this lying bastard lying to me”
The cracks opening in the case for the mass medication of the public with Statins have clearly produced a coordinated response.
Let us hope those with the evidence come forward to dispute their vapid assertions.
In another case though, a cardiac surgeon described his damascene conversion from the recommendation of statins after finding no correlation between arterial plaques in his patients and their cholesterol levels.
So no conflict of interest there then. 😉
Yes, it is the same song my GP sang to me 6 years ago….” No matter what you do with your diet it will not reduce your cholesterol levels…you MUST continue with these statins” and me being a silly-billy, took the explanation board! (But why should I reduce my cholesterol? …well, you just HAVE to!)
Well, maybe, just maybe, my bloods were up the spout because I was following the ridiculous high carb diet the GP prescribed for type 2!
Give me strength! The diabetes spiralled out of control….the triglycerides were dicing with death, the B/P was not responding as the script ordered. Oh, and the debilitating pains and tiredness….all in the head, you know! Any suggestions as to combat all this disruption to my bad state? Well, how about doubling all the meds……..
Have you ever heard such a daft story, and I can now see how me and many more round the globe have been drawn into this massive mistake for mankind….we have listened too closely to high-fallutin-sounding scientists who fail to listen to real people, but navel-gaze in collaboration with the drug producers.
Dr Kendrick,
It is remarkably fair minded of you to publish Dr. Veith’s that alternative point of view.
However, it would be more interesting if he had actually engaged with your numerical estimates of the benefits of statins – based on actual studies, and presented in your book and in some of your articles here. Does he challenge them?
On one point I think he is clearly wrong:
“They have minimal side effects, most of which are benign. In several controlled studies, the patients who did not receive statins had an incidence of side effects equal to those who received them. Serious side effects are rare and manageable. ”
My side effects could hardly have been described that way, but more to the point, I have spoken to so many people (privately – not on the internet) who have reported nasty problems. If Dr Veith were correct, the probability of that happening would be very low indeed.
Since you seem to think Dr. Veith’s views are not tainted by big pharma, it would be fascinating if you could persuade him to debate the issues with you – either on this blog or in video format.
Has he read “The Great Cholesterol Con”?
The one and only time I had my cholesterol checked was 10 years ago. I’d been LCHF for a year then. Anyway, my GP phoned me with my results, stating that my numbers were too low!!!!! and that low cholesterol was a marker for cancer!?!?!?
JoJo – I want YOUR doctor! 🙂
I’ve read about this cancer correlation elsewhere.
And for those of you interested in reducing all-cause mortality (dead is dead, right?), there is an interesting 2005 graph reprinted at
http://highsteaks.com/cholesterol/
that will make you feel mygoshgood if your cholesterol numbers fall between 200 and 240 mg/dL.
: ))
Oh! I get it…it’s a bit early in the day for me 🙂 But, how does Dr. Nissen afford to live if all of his fees are paid to charity, unless that is his wife’s name.
I recently wrote to my MP recommending two books and suggesting that a researcher, for the Health Minister, read them before NICE makes a decision on widespread preventive use of Statins and to set up an INDEPENDENT body to research the whole question of statins and their efficacy.He passed it on and sent me back this response. It may just move things along if all readers of such blogs do the same and involve their MP; there is certainly an increasing amount of background noise against Stains use …and it may just get some action. What Government wants to be in power when the full story behind Statins is finally revealed as a Big Pharma con . The Books ?…Drs. M.Kendrick & D.Graveline.
NB. The PDF response will not paste into this reply so will sent it to Dr.K bye e-mail.
I find it very difficult to accept analysis of any product objective, when the environment the person works in, has so many links with an industry that produces it. The bigger problem though is that, no matter what science backs up the truth about it, as long as there are enough specialists repeating the same untruth over and over again, for whatever reason, there will be enough people thinking and reasoning, Well, my cardiologist is a nice man, he sounds like he knows his business and if he thinks it is better to be safe than sorry, and since my health insurance is paying for it, I might as well.
You see Malcolm, your battle, the battle of all the people that know the real story, will likely last for many, many more distressing years. I think it is up to all of us who know better to plug away at blogs, Facebook, social gatherings etc. etc. Not to behave like Jehova witnesses to convert, but making sure we have our facts straight and preferably some studies, articles to refer to.
The issue is medication in the absence of diagnostic criteria.
Does any combination of BP, BG & Lipoprotein readings diagnose “Pre-CHD” with the accuracy (97%) of this for Pancreatic Cancer ?
“Researchers at The Sahlgrenska Academy, University of Gothenburg, have now developed a method which can predict with 97 percent certainty which pancreatic cysts constitute precursors to cancer. With this method, which detects the presence of mucus protein, mucins, in the cystic fluid, the researchers were able to reach the correct diagnosis in 77 of 79 cysts that were examined.
“This is an exceptionally good result for a diagnostic test, and we are very hopeful that the method will enable more instances of early discovery of pancreatic cancer, at a stage when the cancer can be treated or prevented. This approach may also minimize the risk of unnecessary operations on non-malignant cysts,” said Karolina Jabbar, PhD student at The Sahlgrenska Academy and physician at The Sahlgrenska University Hospital.
The method which has been used in the study is called proteomics, which means the analysis of the protein content of a tissue or fluid with the help of mass spectrometry.”
See http://www.sciencedaily.com/releases/2014/03/140321101603.htm
Sláinte
I’d be interested in how they got the fluid from the pancreatic cysts in the first place. Sounds kind of invasive to me and not – perhaps – a brilliant screening test. In answer to your other question, accuracy for CVD screening is very poor. So poor that if you use the Framingham data, and try to use them in France, you have to divide the risk by 4. If you use them in Aboriginal women, you need to multiply by 30.
Dr Malcolm
It was a rhetorical flourish directed at Veith.
And, yes, the report stated that this test needed 2% the fluid volume of another diagnostic, without describing method of collection.
Sláinte
What do I think of Dr. Vieth’s arguments? There’s no data there. It’s a bunch of assertions.
You may be able to think what I make of his assertions. Still, nice to know what others are thinking.
I think that the data are very clear. Let us assume that the statin trials, run by the drug companies, are completely unbiased and acccurate. According to that data, if you are a male with CVD and take a statin drug for five years, you have reduced your risk of dying by less than 2%. How, exactly, does that make statins “wonder drugs?” The results may be statistically significant, but not clinically significant, therefore pretty useless. Of course, we all know that the data should be “dismissed as garbage.”
He is totally covinced of the cholesterol-CVD link therefore he would naturally assume that statins were a good thing. He ends with this is my opinion, it is his opinion that he accepts and conveys the opinion of someone else.
Whereas you, I’d be interested as to how you embarked down this rocky road, have come to researched and evaluated conclusions to form your opinion.
The problem is most science is conducted on the lines of consensus it is often not the facts that are important but the standing of the originator.
The problem with science is no progress can be made within the constraints of consensus but getting funding outside of it is near impossible and especially so if it’s going to damage someone’s gravy train.
By accident. I am by nature, more of an bon viveur than a heroic battler against for truth (I think, maybe I have too little insight). I just started to look at the research with as open a mind as possible, and it just did not make sense. No part of it. When I first tried a bit of questioning, I got absolutely nowhere, and certainly did not get any answer that satisfied my curiosity. So I embarked on a quest that I have found constantly stimulating. Without that stimulation I could not have carried on. Now it all fascinates me. Most of all what fascinates me is the process of scientific thought itself. Or, at least, how few people are capable of dispassionate thought. Especially medical researchers who only seem interested in ‘Eureka’ and not ‘that’s funny.’ The only thing that interests me is ‘that’s funny…..I wonder why that happens.’
I thought it may have been a paticular patient experience.
Bon viveur, I wish. I’m more of a “beware expert opinion as the principal beneficiary is often the expert” type. I can’t accept opinion, it goes way beyond medicine, I have to research almost everything, not an easy path to tread. Moving on,
Last weeks interesting observation:
We visited some family friends of many years, she 73, he 75. over the last couple of years she, names omitted, has declined in personality and mental capacity, easily confused, indecisive, semi reclusive etc, her mum had completely lost it to dementia at 77 years ago. We naturally assumed that she was destined to follow the same path. Not so it would seem, the old “she” was back to her previous self, not just a little but remarkably. My daughter had visited them a few days earlier and remarked to my wife the old “she” is back.
As you do in conversation with older folk medication was discussed, look how many tablets I’m on type of thing, a bit like a veteran displays his medals. I asked her if she was on statins, yes she said proudly but the funny thing is the doctor halved my dosage a couple of months ago !!!
Then you have the best sort of drive, sir.
I recognise that. I’d guess that as a child your parents were bombarded with “why this, why that, what’s this for?” Pain in the neck for parents, but Good for humanity!
Since we are relating how we got to mistrust statins and the lipid hypothesis, here goes my story. Until some years ago I trusted implicitly everything that the doctors recommended, I ate very low fat which was easy for me since I crave mostly carbohydrates so I could spend days eating only fruits and such and I felt very healthy overall. So when I was diagnosed with gallstones I asked the doctor what caused them, her answer was that she didn’t know but it was the result of sedimentation of the bile. After the Cholecystectomy I researched what was the purpose of the gallbladder and found out that it was for digesting fats, that immediately rang a bell, we have an organ specifically built for digesting fats. Looking for it I found a medical trial where they subjected women with no prior gallstones or sedimentation to low fat diets and monitored their gallbladders. They had to cut the trial short as most of the subjects in the low fat arm started to develop sediments in their gallbladders. That told me that not eating fats regularly is actually very dangerous. There was something really wrong with the nutritional recommendations for a low fat diet. Further internet research led me to your articles Dr Kendrick which opened my eyes specially because of the clear cut logic with which you dissected the medical papers data and conclusions.
Considering the calamity that statins have on the mevalonate pathway, Occam’s Razor would *predict* the very side effects that so many claim. So the many reports of such side-effects online are not some mad nocebo cherry-picking, but a rational null-hypothesis expectation!
It is thus up to those who would deny the prevalence of these side effects to explain what exactly prevents them from happening. After all, the mechanism of statins predicts them!
The Cleveland Clinic are heavily involved with multiple drug companies, who apparently fund Steven Nissen, he in turn giving the money to the Cleveland Clinic Cardiology Centre. Is this how they get round the conflicts of Interest issue? Impartial, my eye.
Succinctly put.
The first part of his speech makes the case for not taking statins. The rest of his speech is just opinion without any references to studies to back up his opinion. I’m not convinced by his speech.
I took statins for a couple of years until my calf muscles started to hurt, then my doctor took me off statins. Now when I take a blood test, I think it’s my liver enzymes that are high and they ask me if I’m on statins or drink. I’m not on statins nor do I drink because I don’t like the taste of alchohol. I wonder if statins permanently damaged my liver.
I think that”s one of the side effects, Dr Kendrick you can spell it better than me, it starts with “R”
The language choices being used by Dr Veitch and Professor Collins in the Guardian article are interesting. They don’t discredit the arguments of those who question the widespread use of statins by analysing and disproving their arguments. Instead they rely on emotive language -“witch hunt” (what witch hunt? where?) “Serious disservice to British and international medicine” . Studies which don’t support their views are dismissed without explanation as “flawed”, but they don’t address the detail in the critiques of their own studies. In other words, they seem unprepared to argue their case on the basis of substance.
I started reading up on statins in January of this year with a completely open mind – I was actually more interested in the subject of the role of dietary fats in relation to brain health and maintaining cognitive function. It was the quality of the challenges to the orthodox wisdom on cholesterol – the close analysis of the data – that drew my attention. It’s a pity that the proponents of widespread statin use don’t bring the same quality to their arguments. Perhaps they can’t?
We are the “Confused Public”. Intelligent and informed exposition would obviously be wasted on us. Such a bother.
Two points:
When I kicked statins into touch, in 2000, I asked my GP to yellow card the muscle pain and his response was that it was so well know that it wasn’t worth bothering. I didn’t know then that the brain rot was caused by that as well. I was keeping very quiet about that since I didn’t want to be diagnosed with early dementia. It cleared – I don’t think dementia of the real sort can do that. So I can swear on oath that the stats are wrong by one person.
I see a “leading researcher” has had another little canter on the Beeb today. They are all busy popping up to tell the same story. It is, in it’s way, heartening – they still can’t prove what they would have us believe, but the very fact that they keep hammering it,shows they are beginning to be on the back foot.
Courage, mes compagnons!
Arguably death is a manageable side effect Dr Veith! You just cremate the corpse, point to those lovely and of course completely unbiased studies the pharmaceutical industry provides so selflessly thus absolving yourself of any scientific/ethical/medical responsibility, shrug and write the whole nasty affair off as natural causes. And after you’ve done that we can all go and get our heads reburied in nice, dark, warm sand. Progress!
As an infrequent consumer of medical advice, I find it easiest to make decisions based on who has skin in the game and who’s funding these studies. 98% of “environmental scientists” believe in AGW because none of them have a job without it.
In one, but it’s accross the board, in all areas. We are being systematically lied to by vested interests. One of my favourite quotes, despite it’s provenance:
“If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.” Joseph Goebbels
Though this phenomenon is outside Malcolm’s sphere of interest, I sincerely laud him for his efforts, The statin question is the tip of a monumental iceberg but hey, one step at a time eh.
If you want to further your brain damage look into GM food, it has nothing whatever to do with feeding the world, it’s objective is to cartelise agribusiness. Our seed or no seed. Don’t be saving any to replant as you’ll be in breach of contract, we’ll sue and ruin you.
Sorry Malcolm, way off topic.
I could say the same about the climate change deniers. Vested interest can be a useful indicator, but it’s not always the whole story.
While you ‘could say’ that, it wouldn’t really be true. Research labs get enormous sums of money to study CAGW (not least NASA!), and scientists who question this cash cow are not exactly welcome in their institutions. The ‘climate deniers’ are pushing against the tide or are retired.
Even the energy companies are making a mint out of CAGW!
I can’t imagine how to do it, but it is really essential to decouple much of science from funds that are in any way associated with large corporations.
I am sure many ‘scam’s such as CAGW and statins, would be better described as muddled confusion created out of the process of doing research partially directed by money depending on shrill messages of doom, or equally shrill messages about miracle drugs!
Ultimately we all depend on science, and if we let it crumble, the consequences will not be pleasant
Dr Veith must be nudging 80, so I’m sure he will have been taking his statins for many years now; that could be an explanation…
It’s a shame that this global debate is about medication and not about nutrition and lifestyle. extremist views such as Dr Veiths certainly don’t help. Medication is not a solution. Is Dr Veith an expert biochemist – probably not! Is Peter Attia an expert? Yes. Is Chris Masterjohn? Yes. Now who should I believe?
As a geochemist I understand some of the similarities between blood and geothermal water. In geothermal colloidal solutions it is zeta potential that limits silica deposition along with pipeline surface roughness, boundary layer effects etc. Has our food changed to the extent that we no longer (possibly) enhance blood zeta potentials by consuming colloidal substances in fresh foods strikes me as one of the “What’s gone wrong?” questions. It probably has considering the mineral depletion of croplands. Dr Sinatra’s (Obels) grounding effects on blood zeta potentials may also be a factor.
Why are these, and related issues not being pursued with the same vigour as the statin debate?
What an empty exercise in the “I can assure you that …” school of discussion. Bollocks: show me.
Dr Frank Veith would be more plausible if he mentioned in his comments how long he has been taking a statin drug, this also apply s to Dr Nissan. If they believe their own advice it would be a simple matter to “walk the talk” and prescribe themselves a statin drug as a “preventative” measure, and after say, twelve months tell us what their advice is. I , like many others have been there and, after three years getting rid of the side effects, have no intention of going there again.
Does Frank Veith take statins himself?
I wouldnt otherwise explain to my self his writings…
“…the patients who did not receive statins had an incidence of side effects equal to those who received them.”
Did they receive a placebo? If so, what was in the placebo that caused all the side effects? Was it really a placebo? Or did they really give statins to everyone? Am I too cynical?
Neither Dr Veith nor Dr Nissan could possibly take statins – their heads’ are far too entrenched up where the sun don’t shine. If there isn’t any room left up there for logic, there certainly isn’t any room left for a statin tablet.
I am often horrified to find my nursing home patients on statins, they are largely debilitated and weak and no one seems to make the connection. That said, I placed my brother in law on a very low carb diet and his facial hypercholesterolemia was cured. No kidding, he had previously been on Crestor and had serious side effects including weakness, depression and muscle pain. His lipid profile was completely transform on a VLC diet, his HDL climbed to 82 from a previous 45.
By the way, the plaque heart attack association is not valid for 50% of myocardial infarction. So, again how does a stain help those people? Better to give them a VLC diet and exercise program. It works for my patients.
That was Famial Hypercholesterolemia, sorry.
Ah, the dreaded spellchecker strikes again. I kind of guessed it was.
Lauren,
I also worry about the number of people who may be battling horrendous symptoms while still taking their statins!
When I developed problems with simvastatin, I thought I had Post Polio Syndrome (because the pain was confined to that part of my body), and my doctor agreed, and sent me to a specialist. Fortunately, and only at my suggestion, we agreed that stopping the simvastatin for a bit might be a useful precaution. I think it was mainly because the symptoms were decreasing when I saw the specialist, that I didn’t get diagnosed with PPS.
I think at the very least, doctors should be ‘advised’ to check anyone on a statin (for however long – my problem took 3 years to develop) with new, odd symptoms (rephrased in more medical terms!) because muscle/joint problems and memory problems are so common in the statin age group!
Yes, sadly the muscle soreness is missed. My BIL’s major problem was really depression. He was treated for refractory depression after trying multiple SSRIs. After the VLC diet and statin cessation, the depression cleared. Thankfully. I wonder how bad it would have been for my sister’s marriage if the depression had continued.
Lauren,
One statin distortion is to talk about “muscle soreness”.
I used to assume if I got a reaction to the statin, it would feel as though I had just done a stiff hike! The reality was more like I felt the affected muscles were packing up in a most painful way. For example, putting my socks on in the morning had to be done very gingerly, otherwise my leg would cramp extremely painfully. Other people talk about difficulties going upstairs!
The increasing “side affects” of aging do seem to be a real issue for anyone over a certain age taking statins. I meet so many older people who have been put on statins. I also see this group exhibiting memory and muscle problems, which they dismiss as aging. So frustrating, as they seem to accept that’s just how it is.
To me, the most telling sentence of this article is: ‘Healthy patients are only healthy until they get sick’. That means, if you start to think about it, two things. First that everybody is a patient, either a healthy patient or a sick patient. And second, that health is just a state of being ‘not yet sick’.
The logic of this is absolutely blinding: Living patients are only alive until they die. A sunny day is only sunny until it starts to rain. If it is true that laughing is good for your health, I am a very healthy patient now – until I get sick, of course. LOL
It is my favorite health category….and yes, it exists. ‘Temporarily able.’ i.e. anyone who is not yet ill.
The commonality between all classes of patient is they can and have to be monetised.
Plus, along with statins, to be even more pro-active, we could follow Tom McNaughton’s suggestion (FatHead) and take chemo before cancer even gets started, or Izoniazid because hey, you just don’t know when you will breath in some T.B. bacillus!
Has Tom become an honorary Scotsman? I always his enjoy his stuff, he makes me laugh
Speaking of “few and insignificant side effects”, Dr Veight repeats without any proof but an appeal to authority (I’m a doctor so I’m right) the same party line all the industry-sponsored physicians use. It is very interesting that Dr Veight – like all his colleagues receiving “research” money from the industry seems to have become suddenly blind when he read Dr Abramson’s paper titled “should people at low risk of cardiovascular disease take a statin”. In this very interesting paper, Dr Abramson and his colleagues explained some of the many ways the industry can cheat to make side effects disappear:
1. exclude from the trials people with known health issues likely to be exacerbated by statins or signal susceptibility to statin side effects (e.g. liver, kidney and muscle disease)
2. Use a pre-randomization run-in” period before the official study starts to detect and exclude individuals who have serious side effects or do not tolerate statins (the industry explains this is so that patients are comfirtable on the study)
3. Forget to report the reason for patients dropping out of the study (so called “lost data”
4. No assessment or monitoring of side effects (why clutter our great study with petty negative data?)
5. Under report or no reporting of side effects, conveniently forgotten.
I could add: volontarily choose the most severe presentation of a side effect ( rhabdomyalysis versus the much more common myalgia for example).
In my physician experience with statins, side effects are much more frequent than stated by the industry and industry-sponsered “experts”. Myalgias can be debilitating and much more severe conditions (heart failure for example, due to the destruction of ubiquinol) are not even reported because physicians do not make the link with statins. Yet this type of failure is entirely reversible by stopping the statin and giving supplemental ubiquinol at high doses. Most physicians’ knowledge of basic biochemistry is so poor that they have no clue as to what exactly statins do in the body and their knowledge of biostats and epidemiology is so abysmal that they are fooled by “relative risk” while knowing nithing about NNT (number needed to treat) and NNH (number needed to harm). It is much more comfotable to repeat the part trues and lies of the industry, passed on by pharmaceutical representatives than read with a critical eye the numerous articles and doing the analysis themselves.
As pointed out by many people including Dr Mckendrick, the basis of the cholesterol hypothesis has been proven false over and over again. It is, simply put: eating saturated fat increases cholesterol, which in turn increases heart disease. The last 10 years of research have proven beyond the shadow of a doubt that eating saturated fat, though increasing cholesterol (mainly HDL and big, fluffy harmless LDL particles), do absolutely nothing to heart disease. No increase in resk. Nothing at all. Yes, it does increase some cholesterol fraction. So what?
And finally, cardiac death is only one of the causes of death on this planet. And all studies – including industry-sponsered ones, have shown that the link between cholesterol levels and “all cause death” is a J curve for every patient: young, old, man, woman, of any ethnic origin.
Good post. I even forgive you calling me Dr McKendrick (somehow this got stuck in WordPress and I have no idea how to get rid of it).
Malcolm–
Have you considered changing your surname to McKendrick to make it conform to WordPress mistake?
Hoots mon. When Scotland votes for Independence I shall claim dual nationality.
Thanks for forgiving me. Maybe because you are Scottish and to us Foreigners, nearly all Scotts are either Mac or Mc. Won’t do it again, I promise. Love your blog by the way. Like minded opinions I guess.
Francois Melancon, MD, MPH, MACN (alphabet soup)
Oops! Sorry, I meant Tom Naughton as you know!
The whole “the drug is now available as a generic so the pharmaceutical companies make no money out of it” argument is a bunch of BS. The same doctors that are pushing it are pushing the statins are pushing the non-generic version. They spout a bunch of crap about generics having a low tolerance to scare you when it’s actually the exact same tolerance as the non-generics (at least in the US): http://www.fda.gov/Drugs/ResourcesForYou/Consumers/QuestionsAnswers/ucm100100.htm
Maybe the drug companies are happy for doctors to prescribe the generic versions because of all of the other drugs the patients will need to combat the side effects.
Malcolm, when the NHS prescribes statins do they prescribe generic on non-generic versions of the drug?
Generic.
Dr Kendrick
I hope you give your view on this. I’m sending increasing numbers of people to this blog for some informed views on statins and cholesterol. Some have limited internet access. Some have limited education and little confidence in their own ability to assess reports of medical research. It would be a pity if they took this post as a strong endorsement by you of statins.
Thanks for your continued patience and hard work for patient health and care.
I wondered a bit about that too, as bizarrely I find the science easier to follow than the tortuous and tricky money train involved with this topic.
I notice that because of the way this blog is organised, it doesn’t seem obvious how to get at Dr Kendrick’s earlier essays, where he discussed statins in detail. However, his book, “The Great Cholesterol Con”, which is available very cheaply on Kindle if you wish, will tell you everything you need to know! The important point is that he describes the various studies that have been done, the results, and how these have been manipulated to say what they don’t obviously say!
Our marvelous brains are cholesterol. It is the most common organic molecule in the brain. The most common compound is water. The brain is only 2% of the body mass, but contains 25% of all the cholesterol. The cholesterol covering of an individual’s axons, combined, if stretched out, would wrap around the earth 4 times.
Gordon Love, et, al. published an article about proto-cholesterol compounds detected in pre-animal evolution 3/4 of a BILLION years ago. We are cholesterol. It’s been very good to us. The big difference between plants and animals, and why we move and think and they don’t so much- is we are the way we are today because of……… CHOLESTEROL.
Thank you Luigi for reminding me about zeta potentials. Very timely and important. I thank cholesterol and lots of other lovely phenomena, like zetas and Good Doc Kendrick, every day.
Defeat cholesterol with a statin, enriching Big Pharma and their shills by taking toxic sludge brain and heart and vessels rotting poison and in combination with a diet of lots of carbs and glyphosate Big Ag soaked ‘healthywholegrains’? No thanks.
Watching telly right now? 23rd April 2014, about 10:40a.m.
Dr Chris on “This Morning” was talking about total memory loss caused by statins, and I quote : “… but this is not serious medically”.
Do we have a smiley for brave and stupid but not brave or honest enough?
I’ll immediately seize your rss feed as I can not find your email
subscription hyperlink or e-newsletter service.
Do you’ve any? Kindly let me realize so that I could subscribe.
Thanks.