I have now finished my book, to be called ‘Doctoring Data.’ It has taken a long time to write, mainly because I had to bring together hundreds of different strands of thinking and research. Each strand seemed to get longer and longer as I attempted to pursue them to the end. In many cases I never really found the end.
Some ideas just keep stretching away forever and I had to give up, or else the book would have become a million pages long. And I was told three hundred and ten was to be my limit – or something like that. As if my genius could be contained to a mere hundred thousand words, or so.
Anyway, the main purpose of the book was to look at medical research and data, and try to make some sense of it for those who are interested in looking beyond a medical headline. The book was, at least in part, inspired by a paper written by John Ionnadis.
It was entitled ‘Why most published research findings are false.’ You can easily find it on the internet by searching the title. It is currently the most downloaded paper in recent medical scientific literature
The shortest summary of his paper is, as follows:
‘Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias.’ J Ionnadis.
How can it be, you may think, that most published research is false? Surely research is the one area of human endeavour where bias and dogma are ruthlessly hunted down and destroyed. A scientific finding is a scientific finding….is it not? Did Francis Bacon die in vain?
As Dogbert might say. Hahahahahahahahahahaha!
Or you might be best to pay attention to the quote from Friedrich Nietzsche. ‘There are no facts, only interpretations.’ Of course, he was a bit bonkers, but there is an awful lot of truth to what he said. Especially in medical research. Facts are the most tricky little blighters to get hold of. Interpretation, however, that is stated as fact all over the place
Surely, though, we have ways to ensure that research is pure and objective, such as peer-review. A system of using respected ‘experts’ to check and approve papers before publication. This will weed out papers that are flawed, will it not. Well, here is what Richard Horton (editor of the Lancet) has to say on peer-review:
‘The mistake, of course, is to have thought that peer review was any more than a crude means of discovering the acceptability — not the validity — of a new finding. Editors and scientists alike insist on the pivotal importance of peer review. We portray peer review to the public as a quasi-sacred process that helps to make science our most objective truth teller. But we know that the system of peer review is biased, unjust, unaccountable, incomplete, easily fixed, often insulting, usually ignorant, occasionally foolish, and frequently wrong.’
There we are, nice and reassuring to know that peer-review is such a fabulous system. As for the quality of published research itself, here is one of my favourite quotes by Drummond Rennie, at the time the Deputy Editor of the Journal of the American Medical Association.:
‘There seems to be no study too fragmented, no hypothesis too trivial, no literature citation too biased or too egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory, no analysis too selfserving, no argument too circular, no conclusions too trifling or too unjustified, and no grammar and syntax too offensive for a paper to end up in print.’
A view supported from a slightly different angle by Dr Marcia Agnell, who was the editor of the New England Journal of Medicine for two decades. This was, and remains, the single most powerful and influential medical journal in the world. At least it is, when it comes to citations and impact factor:
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” Dr Marcia Agnell
Here is a further view on the issue by Richard Smith, editor of the BMJ for many years. He wrote this in his blog:
‘Twenty years ago this week the statistician Doug Altman published an editorial in the BMJ arguing that much medical research was of poor quality and misleading. In his editorial entitled, “The Scandal of Poor Medical Research,” Altman wrote that much research was “seriously flawed through the use of inappropriate designs, unrepresentative samples, small samples, incorrect methods of analysis, and faulty interpretation.” Twenty years later I fear that things are not better but worse…
…The poor quality of much medical research is widely acknowledged,” wrote Altman, “yet disturbingly the leaders of the medical profession seem only minimally concerned about the problem and make no apparent efforts to find a solution.”
Altman’s conclusion was: “We need less research, better research, and research done for the right reasons. Abandoning using the number of publications as a measure of ability would be a start.”
Sadly, the BMJ could publish this editorial almost unchanged again this week. Small changes might be that ethics committees are now better equipped to detect scientific weakness and more journals employ statisticians. These quality assurance methods don’t, however, seem to be working as much of what is published continues to be misleading and of low quality. Indeed, we now understand that the problem doesn’t arise from amateurs dabbling in research but rather from career researchers.’
So, Ionnadis states that most research findings may often be simply accurate measures of the prevailing bias. Current and past editors of the three most respected and powerful medical journals in the world confirm that medical research is warped, biased and flawed and, in many cases simply not believable.
Would this be very evidence used by NICE* to tell us which drugs to use – for example. Why, yes it would be. So be afraid, be very afraid. For an idiotic politician (sorry for the tautology) recently made this announcement1.
‘A Labour government could reduce variation in access to drugs and procedures by making it mandatory for commissioners to follow national clinical guidelines, Andy Burnham has revealed.’ Andy Burnham was, at one time Secretary of State for Health. His is now shadow secretary of state for health. So, if the UK votes for Labour, it will mandatory for all doctors to follow the guidelines based on the evidence that comes from clinical trials.
Oh Joy.
*NICE stands for the National Institute for Care and Health Excellence. It is supposed to review all evidence for various healthcare areas and decree what is best practice. What NICE says tends to get taken up in many, many, other countries as their views are widely respected and acted upon.
1: http://www.hsj.co.uk/news/exclusive-labour-could-make-nice-guidance-mandatory/5076286.article
Dr. Malcolm Kendrick 
Dr Kendrick….than you for your tenacity on this subject…as a former Critical Care RN, I fell for these “data” hook, line and sinker…until I was disabled by Lipitor…Cholesterol heart disease…I can believe I fell for it!!! As so many others are still believing it! Absurd…Keep up the good work!! So many of us need real science!
I was recently reading the following article http://www.badscience.net/2014/03/statins-have-no-side-effects-what-our-study-really-found-its-fixable-flaws-and-why-trials-transparency-matters-again/comment-page-1/#comment-84309 thought Id share it with you!
“‘The mistake, of course, is to have thought that peer review was any more than a crude means of discovering the acceptability — not the validity — of a new finding.”
There’s the essence, right there, acceptability! If it’s sounds good and it’s what people want to hear, it is good and the acceptance is a forgone conclusion. I’ve said it before and I will reiterate: It all works the same. If it’s a fluffy persective it will be accepted.
I can heartily recommend the prevoius work, ” the geat cholesterol con” an essential read, what is required is a link to purchase the new work.
If it soungs too good to be true it usually is, it isn’t truth that drives any of it, it’s the potential acceptance and the acceptance is down to how the statement is framed. It all works the same.
Everything we know about cholesterol is wrong? Statins? Saturated fat? The low-fat diet? The low-carb diet? Say it ain’t so Kendrick! 🙂
Amen, Jonathon!!!
I look forward to reading your new book. Ironic that you announce it on the same day that we find (believable to be sure, to be sure) that simvastatin + ezetimibe really (yes, really) does improve outcomes or the value of Vytorin or something like that… At least, that’s what the American Heart Association is trumpeting today…
Hat ready to be eaten, but not yet. The amazing coincidence that just as PSCK-9 inhibitors are trying to launch it is found that cholesterol lowering protects against CHD after all. So, no need for nasty long lasting ouctome trials. Just launch, launch, launch. Billions upon billions are at stake here. I shall do what I can to try and review that data, although I know that much of it will be kept top secret, not to be viewed by anyone other than the pharmaceutical company running the trial….. yes, you couldn’t make it up.
Hi Malcolm,
Thanks for writing your new book. I look forward to reading it.
Regarding cholesterol and statins, would we trust a financial audit if companies could do their own? Would we trust reviews if they were all written by the manufacturer? So, why would we trust pharmaceutical companies when there are so many issues in their studies, the presentation of the results and the massive financial motive to declare success?
It may be true that the new drugs are effective but, statins, thalidomide, the flu vaccine of a couple of years ago and others all tell us to await longer-term outcomes before jumping on the band wagon.
Chances are your hat is safe.
You are doing a great service by raising awareness. Irrespective of trials outcomes, the conflicts of interest are real. To me, it feels a lot like the emperors clothes.
Take heart.
With gratitude,
Steve
Thanks Steve. I think I blew my chance at a knighthood years ago. I feel a great sense of freedom to write what I truly think. Maybe I am wrong about a number of things, but hopefully people can trust that my only desire is to try and get at the truth – as far as that may be possible.
You’re welcome Malcom,
Intent is very important. Many would say that it’s more important than being right. I certainly would.
I’ve read a summary here:
http://www.forbes.com/sites/larryhusten/2014/11/17/improve-it-meets-endpoint-and-demonstrates-real-but-modest-clinical-benefit-for-ezetimibe/
First of all, if there is indeed a second class of drug that both lowers (LDL) cholesterol, and does the heart good, that does indeed make the lipid hypothesis more plausible: not conclusive but confidence-building. But, but, but…
There’s only a 6.4% reduction in risk accompanying the 24% reduction in LDL. Moreover “There was no difference between the groups in overall deaths, coronary deaths, or cardiovascular deaths” so it doesn’t seem to extend lives, though it may make them better (which is not to be sneezed at): significant reductions in MI (13%), stroke (14%), and ischemic stroke (21%). Mind you “The investigators calculated that 50 patients would need to be treated for seven years to prevent one event” which means that it’s no super-drug. Put more explicitly: because the effect is so small, I’d need to have an awful lot of faith in the competence and honesty of every person who worked on this project before I acted on its published results: a a yearly NNT of 350 does not scream “use me, use me”.
I further note “The results came about even though 42% of patients in each arm discontinued taking the study drug before the end of the trial.” Hello, hello. Now, however carefully the experimental group and the control group were matched to begin with, can one be confident that they were well-matched throughout? You certainly can’t simply trust that whatever randomisation was used initially was still in effect at the end, though I suppose you can look for evidence of the 58% of “survivors” being well matched. (Hence presumably “A secondary analysis, presenting the results of only the patients who stayed on the study drug, is scheduled for presentation on Tuesday.”) But what if the drop-outs were well-matched only in total, but not well-matched year-by-year? Could such a subtle (conjectured) imbalance matter? The smaller the claimed benefit of the drug, the more exposed the trial is to subtleties such as that – and many others, I suppose, that might occur to people skilled in the art.
Controlled trials and statistical analyses are grand things: but the smaller the effect measured, the more exposed the conclusion is to the underlying assumptions not being met. That point is general.
The trial was also failing to meet end its end-points, so the study population was doubled in size half way through.
The actual report’s reference is:
Am Heart J. 2014 Aug;168(2):205-12.e1. doi: 10.1016/j.ahj.2014.05.004. Epub 2014 May 15.
Evaluating cardiovascular event reduction with ezetimibe as an adjunct to simvastatin in 18,144 patients after acute coronary syndromes: final baseline characteristics of the IMPROVE-IT study population.
Abstract on Pubmed. Full paper Open ACCESS.
This study has been subject to other doubtful reports
A sample of conflicts of interests:
Dr Blazing has served as an advisory board member forMerck, has consulted for AstraZeneca and Novartis, andhas received grant support from Merck (to the DukeClinical Research Institute). Dr Giugliano has receivedgrant support from Amgen, Daiichi-Sankyo, and Merck (tothe Thrombolysis in Myocardial Infarction [TIMI] StudyGroup) and honoraria from Amgen, Beckman-Coulter,Bristol-Myers Squibb, Daiichi-Sankyo, Janssen, Lexicon,Merck, Regeneron, and Sanofi. Dr Cannon has received research grants and support from Accumetrics, Arisaph,AstraZeneca, Boehringer-Ingelheim, CSL Behring, Essentialis,GlaxoSmithKline, Janssen, Merck, Regeneron,Sanofi, and Takeda and has served on an advisory boardfor Bristol-Myers Squibb, Lipimedix, and Pfizer.Drs Musliner and Tershakovec are employees andstockholders of Merck.etc.
I searched in the NYT story about the trial but could not find any reference to a control group that received neither treatment. Is that correct? Personally, I find it difficult to trust clinical trials that do not have a control group receiving a placebo. And it is shocking to see how many clinical trials eliminate this vital step.
Old Fogey. You would not be allowed to do a placebo arm in a ‘high risk’ group as it would be unethical to withhold these ‘life saving’ drugs from anyone. Yes…. Catch 22.
No treatment groups are not generally used in human medicine; I presume they are considered unethical though surprisingly it is apparently considered “ethical” to treat healthy individuals and expose them to adverse reactions because a small minority might benefit. In animals I have always included a no treatment group but then one assumes that a placebo or nocebo effect does not exist.
Thank you, Drs. Kendrick and Cawdry, for your kind replies. It is rather scary to think that drugs such as these are never tested against the body’s natural defenses. Catch-22 indeed – or an unstated unwillingness to see if indeed they are “life-saving drugs.” In any case, many thanks for your blog, Dr. Kendrick, and your new book is already noted on my Amazon wish list here in New York.
Thank you but I am a geriatric research vet DSc but not MD
I have heard it said (I don’t know on what authority) that muscle problems from statins are most common in physically fit people. If that is so, then the large numbers of dropouts probably included more of those who were in better condition!
This doesn’t directly explain the final result but it certainly adds another complication.
Does anyone know if the combination therapy used the same dose of statin?
David
Physically fit and physically ACTIVE. and what about the heart? Far more mitochondria than skeletal muscle producing ROS that is not properly deactivated by reduced CoQ10? leading to an epidemic of congestive heart failure (CHF) as claimed by both the US CDC and NHBLI but which suddenly disappeared while on the rise from their websites. Never explained but according to a US cardiologist to me the epidemic is progressing well (from Big Pharma’s point of view)
________________________________
Dr. Kendrick, as the launch of Vytorin was reported on the news lately, I forgot to add that immediately the reporter stated that the Vytorin trials were funded by the drug company manufacturer. That report also included an interview with our beloved Dr. Peter Langsjoen, who stated with absolute certainty how statin side effects are so under reported. It was a proud day for me and should be for all here. Finally, there was a news cast that exposed something of the truth. I hope people take heed!!
Dr. Kendrick, thanks for your new book. I am anxiously awaiting it. I will buy a hard copy as I love the feel and smell of a book and will add it to my collection. I shall cherish it for the rest of my life.
You are our hero!
Dr. K
If you were, in the very unlikely event, ever offered any kind of gong, I, as a staunch republican, would go from trust to mistrust, overnight.
Honours system, my arse! They get given out like sweets at Hallowe’en! I do not trust anyone who’s been so dishonoured, seems they’re given to undesirables as a means to gild over their guilt (Savile, Cyril Smith, Rolf Harris, Muggeridge, Esther Rantzen, Terry Leahy, and so on, and so forth).
To be gonged is to be gagged; as far as I would be concerned, you’d have been bought and then I’d not be able to trust a single character you typed EVER AGAIN!
I think there is little danger of that happening
Yes Kevin, I saw this bit on the news yesterday. The reporter hastened to say that Vytorin studies were of a six year duration and were funded by the drug company manufacturer. So, here we go again!!! Do they think by now people are really that stupid? I would not touch any combination of poisons they made (particularly with Simvastatin) with a ten foot pole. Game Over!!!
Well done! when will your book be available, please? I hope Santa puts one in my stocking.
I am so sorry to have to admit that it never occurred to me that stuff I was taught during my two NHS careers, (diagnostic radiography and Nursing), was anything less than gospel. How trusting I have been, failing to question concepts more closely. It seems as potty as actually believing the slogan “a Mars a day helps you work, rest and play”….yes….I believed that too.
I am almost afraid to read your exposures……….
All that “advice” I passed on, believing it was correct.
All those medication rounds I did, believing I was dishing out fully tested drugs.
All the ‘lifestyle’ changes I was expected to promote, in the name of progress.
The mind boggles, in anticipation of what your book may reveal.
@Jennifer…I know how you feel! When Dr Beatrice Golomb called to inform me the results of the UCSD Statin Effects Study, I was in, she informed me that after thorough review, and discussion with Dr Doug Wallace of UC @ Irvine (Mitochondria Expert) it was their opinion that my use of lipitor was the causal contributor to the Mitochondrial Anomolies as well as the Neuronal Apoptosis (holes in my brain)…yet the rocket scientists at UW Madison, discharge me after 28 days inpatient, Brain biopsy revealing holes in my brain and electron microscopy revealing Mitochondrial abnormalities, most similar to MELAS…I was like an advanced alzheimers patient, couldnt walk not speak coherently, I was incontinent of bowel and bladder, couldnt feed myself, was completely disoriented, muscle biopsy corroborated the MELAS suspicion, I did not improve until I was evaluated by a visiting professor who suggested a mitochondrial cocktail, which was initiated and within 2 days I was no longer nursing home bound..The key ingredient in the Cocktail was Ubiquinol – CoQ10….why these rocket scientists couldnt have figured it out is beyond me..When I worked in the ER, a physician I worked with once told me, if you have a patient come in and has strange symptoms, unexpected test results, you must consider a chemical cause, whether street drug, over the counter drug or prescription, that needs to be considered…
In response to 1999 (is it Andrew?).
I have read and re-read your most unpleasant experiences today, and am so sorry that you have endured such awful conditions. I do wish you better health from now on.
I suspect that pro-statin supporters would suggest that you fall into a minority, and thus discount your suffering as being an extreme and rare reaction. ( for that read—-“it is all your own fault”). Indeed, we frequently read that GPs dismiss symptoms as ‘trivial side effects’ of statins, (and for that read “complaining wimp, making it all up.)
Either way……someone like you is affected dreadfully at one end of the continuum, and someone else shows at the other end. The Statinators will never accept either as being fair assessments of their lucrative, beloved drugs…..and the likes of us in the Anti-Statin League, will be accused of bias the other way, because we see nothing but evil in them.
We are in a dire state of affairs where we have lost faith in most research findings, ( and how do we distinguish between good and bad?), and I remain fearful for the future a humanity.
Oh, well, back to the knitting, where I ought to have something constructive to show for my efforts….. until the day comes when ‘researchers’ undermine my skills, in much the same way that humanity has had its skills demolished regarding how to intuitively care for and feed its offspring safely.
An extreme analogy….but I think folks will get my meaning.
Thanks for your comments, Jennifer..Actually I should change my username, Andrew is my son, Im Chris…I too have become so skewed to ANY and ALL medical research produced, first I seek financial disclosure statements, then I look at the study itself and how the data is presented, whether Absolute or Relative risk reductions.. After dealing with this blow in my life, I wake up every day, and thank God, despite the constaint pain I may have, the profound fatigue I may endure, I am thankful to wake up every day and be a dad, and a husband…thats one think Statins did not take from me! You are correct about the pharma parroting doctors I have had…”you need to take this drug, I dont want to see you die at 40 of a heart attack” blah, blah blah…I have a wonderful GP now who knows my history, she is aware of the causal relationship between what I have and my use of lipitor, and she has told me, ” I will never ask you take a drug you do not want to take.” My neurologist told me at my last visit in August, that he does not prescribe Statins to his stroke patients, due to the overwhelming lack of hard evidence…I have had to seek physicians like this for the past 12 years, and finally found them. Perseverance, I guess…
Great blog Malcolm, I totally agree. I have been on a similar journey to you, regarding depression and “mental I’ll Essex” “chemical balances”. Best of luck with your book, I will certainly get it. My next book on the myth of brain chem imbalances out early 2015. Keep up the great work-and questioning.
Oops that was supposed to be “mental illnesses”, not Essex!!
As someone wanting to go to medical school, how can one, with any scruples whatsoever, enter a profession that is so (for want of a better word) corrupt? I’m really confused and upset about the state of affairs.
What is the future? Who can one believe? How can one toe the “NICE” line when the foundations upon which they build their recommendations are themselves, built upon sand?
My personal belief is that most modern ailments come from eating and drinking the crap that passes today as a “balanced diet”. I truly believe that the foundations for ill health may even start pre-birth with mum’s nutrition. Carb heavy, nutrient poor crap = in many people, chronic ill health, or at best, sub-prime health. A pharma pill or potion can only mask the symptoms, until that is, the symptoms become overwhelming.
Can a doctor, once qualified, survive outside of this matrix, without getting struck off?
Mark. Yup, you just need a bit of fancy footwork and never, ever, give specific medical advice to someone over the Internet – that you have not met first. Your role, as a doctor, is to advise the best treatment – as you see it. Provide balance, state that your view may not be the same as the mainstream – and here are the mainstream views. The patient is the one who decides.
Dr Kendrick
In my searching through the literature I have found that iatrogenic deaths in the US are competing with heart deaths and cancers for top place in the cause of deaths (John T. James PhD, J Patient Saf 2013;9: 122-128). I suspect that a similar situation exists in the UK but I have been unable to find published information. Do you know of such data?
No, I do not. But it would be interesting if it existed.
Mike Cawdery (or Malcolm),
Can you clarify something for me. In order for a death to be classed as iatrogenic, does it have to be a treatment for something non normally life-threatening? I mean if a cancer patient dies of complications caused by the treatment, does that count in the figures?
Yes
As I understand it iatrogenic deaths are caused by drugs, care or medical interventions etc.,. A useful reference is John T. James PhD, J Patient Saf 2013;9: 122-128. However, there are many others in journals such as JAMA, NEJM, Arch. Intern, Med., Pharmacotherapy and others.
Doesn’t that make the concept of iatrogenic deaths a bit meaningless? I mean, if someone is operated on for advanced cancer, and they die on the operating table, that isn’t necessarily anyone’s fault.
David, Medical statistics are often very difficult to interpret – for reasons such as the one you state. If you want to make sense of things you need to dig quite deep and grind rather fine.
And I should add that medicine is a fantastic career. It is stimulating, frustrating, emotionally draining at times. But if people like you don’t go in to try to make things better, why then, nothing will get better. However critical I may sound, I still think that Western medicine is (despite its many flaws) one of mankind’s greatest achievements. If not the greatest. I just want to make the bad bits better.
Good advice for Mark. I still believe in the inherent goodness of mankind and the medical profession. It may be flawed…but it is the best, I agree with Dr. Kendrick. I do hope Mark does not become disenchanted to the point where he would not use his wonderful mind and enthusiasm to make our world better. A little tweaking here and there, but that is life!!
Mark, Please, please take Dr Kendrick’s advice and encouragement and carry on with your chosen career. We need people like you who care enough to get it right. Don’t leave it to the ‘others’. Learn the fancy footwork!!!
I totally agree with Sue Richardson’s comments to Mark. Just take Dr Kendrick’s advice and go for it. We need people like you Mark.
I agree about the evils of our “Food-Like modern diet. But it’s not just mum’s health – it looks like the boys might be implicated as well…
“My personal belief is that most modern ailments come from eating and drinking the crap that passes today as a “balanced diet”. I truly believe that the foundations for ill health may even start pre-birth with mum’s nutrition.”
I am happy to hear that young people like you have taken the same Hippocratic attitude as have turned many previously ill adherents, including myself, in Sweden into reasonably healthy individuals. To the frustration of medical authorities in Sweden we are doing exactly the opposite to the nutritional ‘health advice’ they are advocation by cutting the carbs and increasing the ‘villainous’ saturated fat (LCHF) which has been shown to increase the equally ‘villainous’ cholesterol. Basically they are stunned by the evident successes the reluctantly admit so the cholesterol seems to be their last line of defence. The authorities have lately also approved the LCHF as a medical acceptable procedure for obese and diabetic subjects since there did not seem to be any scientific evidence against the treatment.
Sometimes I wish that I could turn my clock back 50 years.
So good luck with your career and the ambition to contribute to our health as Dr. Kendrick has done.
Now, I just wonder when we can order and read Malcolm’s new book.
It will be coming out early 2015. Launching before Christmas is not good, as I would be competing with the world of celebrity biographies, cook books, and suchlike. This will seriously hamper sales, despite being the greatest book ever written in the history of mankind, by far. Anyway, that is my humble opinion.
Mark, I would encourage you to continue with your venture to Medical School…Just remember to investigate everything for yourself…dont just blindly accept information as Gospel truth until you have analyzed and reviewed the information….We need open minded physicians/nurses….perhaps you could encourage your colleagues to do the same…
Your analysis of the crudity and ignorance of far too many reviewers for original papers is bang on the mark. I, Prof Rudolf Hoermann, Prof J Dietrich and coworkers believe that we have developed a significantly new concept in thyroidology which implies the all-embracing direct effects of TSH on both the thyroid gland itself and the whole body together in a complex feedback/feed forward process. This strongly implies the diagnostic value of FT3 measurement, certainly in the case of those on T4 monotherapy or T4/T3 combined therapy or NDT, and it supplies a rationale as to why some do not prosper on T4 alone. Every paper but one when submitted has been subjected to a series of the most shallow, loftily dismissive reviewing I have ever encountered in my scientific career, requiring repeated submissions to different journals until finally one succeeds. Even as I write, we are still pounding uphill against the most uninformed opposition one could imagine. Objectivity in medical studies is in my opinion a forlorn waif in the chaos of prejudice. Ordinary papers simply repeating what everyone believes get a much easier passage.
In current medical research new ideas or ones that challenge the “gospel” according to the KOL dominated medical establishment are not welcome. This is one reason why Ioannidis has condemned them.
As an aside in your studies on the thyroid, what do you consider the role of selenium is in its role in seleno-proteins, many of which, if memory serves, are involved with thyroid metabolism
I believe that if you do not eat sufficient vegetables (fresh) then one could become somewhat selenium deficient. You don’t need much to put it right – chemist shop selenium tabs will do all that’s required – I take one every two days. But not too much – you smell like a goat and have no friends!
Dr Kendrick
Thank you for writing this article. I hope your new book ‘Doctoring Data.’ is soon on the market and hopefully on Kindle. I like kindle because I can comment on it and rapidly access research reports.
You certainly confirm my own limited research on this subject. When specific published research studies are examined in detail and serious flaws can be demonstrated, one can only conclude that current medical drug research is simply designed to promote drugs, irrespective of their real, if any, benefit. An example that I use relates to the HPS study. It was designed as a 2×2 factorial (Int J Clin Pract. 2002 Jan-Feb;56(1):53-6.) but no statistical analysis based on this design has ever been published. This, surely, is a breach of standard practice and of the protocol itself! WHY? I suspect that the statin treatment was not significant as was the vitamin treatment. But what about the interaction? Probably “just” negative (say, p> 0.05 but <0.1) allowing the combination of the “statin only” and the “statin+vitamin” groups to give the REQUIRED positive result in the subsequent report (Lancet 2003; 361: 2005–16 ). Another example of the “Smoke and Mirrors” approach of current medical drug research!
May I suggest that this is due to the dominance of commercial interests in drug research and the dominance of experts with serious conflicts of interests in the various “allopathic medical establishment” committees which issue DIRECTIVES (in the guise of “guidelines) to the extent that the total emphasis is on commercial drugs which often require huge studies to demonstrate trivial benefits over a sugar pill.
I have almost reached the point where I don’t believe any research any more. The problems is, what do you do when you have reached that point?
Indeed, what does one do. I came to this conclusion some time ago. Where I cannot find support for the advice, I do the opposite on the basis that if the advice is wrong, the opposite may well be better
“I have almost reached the point where I don’t believe any research any more”
I guess I am already there if you mean medical papers where some seem to me to be close to criminal documents.
Still I believe in fundamental natural science and to this realm I count not only my own field of metallurgy, but closer to ‘medicine’, also the molecular biology – a lot of chemistry there which tends to be my favourite subject since childhood.
THE texbook on this subject is as far as I understand it Alberts et al. the “Molecular Biology of THE CELL”. My fifth edition copy wears its signs of heavy reading and I am now eagerly waiting for my already ordered copy of the sixth edition which is due by December 15. Evidently you avoid the competition in my heart during christmas with that ‘tome’ by now letting your book in January.
I agree! I do not believe any research either anymore or the tainted guidelines that are produced by the so-called research. When are more doctors going to wise up, start questioning everything and really look out for their patients rather than themselves?
I also find it hard to believe any modern scientific work by now.
I know people ‘correct’ their data to make it say the ‘right’ thing. Of course, they should specify any corrections before collecting the data.
I know people trawl for correlations – ignoring the Bonferroni statistical corrections – so I don’t believe in all the reports of dangers from minute traces of environmental chemicals.
I know people use selective reporting – for example whatever is happening to the Arctic ice, Antarctica has had record levels of ice this year! For this, and many other reasons, I don’t believe in CAGW.
There is an interesting book called “The Higgs Fake”, that gives some pretty good reasons not to believe in the output from the LHC and similar accelerators.
A friend who is a statistical expert describes a number of scenarios where he was called in to give advice on experiments, and he concluded that the results had no statistical significance – but they published anyway.
This same friend advised one researcher to test an assay kit to see if it gave results of the stated accuracy. It did not, but since the postgraduate was distraught that her PhD was in peril, he pointed out that she could use the manufacturer’s quoted accuracy, and publish anyway! She went away delighted!
The BBC discovered that cancer researchers were not ensuring that their cell lines were uncontaminated – thus invalidating the research paid for by donations:
http://news.bbc.co.uk/1/hi/programmes/file_on_4/7098882.stm
(To explain, these cell lines can get contaminated by a faster growing type of cell. Because the colony of cells is kept over many generations, this means that the faster growing cells dominate the culture.)
They revisited this issue some years later, and found that the problem had not been fully dealt with. To me, it also seemed remarkable that nobody noticed that they were performing experiments on the wrong kind of cells!
That is before we get to explicit fraud!
I feel that people are becoming more and more aware of this problem, and science will have to go through a period of profound scandal before long.
This may interest you.
In the face of the following I simply do not believe it:
I found this early report of the HPS statin study by Collins et al (Int J Clin Pract. 2002 Jan-Feb;56(1):53-6. Two interesting points: first to quote the summary “Among high-risk patients in this western population (with a minimum total cholesterol [TC] < or = 3.5 mmol/l at entry) there appears to be NO THRESHOLD CHOLESTEROL VALUE below which statin therapy is not associated with benefit; even among those with pre-treatment cholesterol levels below current national recommended targets”.
In short from a top researcher lowering cholesterol has no benefit
They think people will not notice. The reality is that the only people who do notice don’t get listened to. Another reality is that the medico-pharmaceutical industry can crush logic beneath under its tracks and move on as if nothing has happened.
Dr Kendrick
How true. I have, as a vet, great admiration for the medical profession as represented by GPs and consultants but virtually none for the medical establishment. Dr James LeFanu, in his book “the Rise and Fall og Modern Medicine” outlines the rise very well but fails to point out that were the researchers in the 1930s and 40s under the same regime of Directives as today, the findings on antibiotics and cortisone would never have been made. Independent researchers testing their ideas are simply not allowed to do so now.
MIke, in the same vein, no pun intended, If one were to find a blanket natural and unpatentable cure for cancer one would either be dead or sworn, with menaces into anonymity with no disclosure, and be very rich by weekend.
I read the remark as having just the opposite meaning from the one you draw.
I am surprised! It did not matter at what level cholesterol was at, high or low. Surely this means that other actions were at work; that low or high cholesterol was irrelevant to the benefit?
In short, the benefit of using simvastatin HAD NOTHING TO DO WITH BLOOD TC LEVELS.
This possibly explains why in a subsequent report (Lancet 2003; 361: 2005–16 ) the phrases “cholesterol lowering” and “heart protection” in the title suggests/implies that cholesterol lowering, of itself, is responsible for the small benefit demonstrated in this study (15 deaths/1000 treated over 5 years) for which NO EVIDENCE (of cholesterol lowering) was provided; the authors already knew that there was no evidence of benefit BUT DID NOT WANT TO ALLUDE TO THAT FACT! Thus the apparent claim “cholesterol lowering protects the heart” clearly is flawed.
No. What he’s saying is that whatever level your cholesterol was originally, you get a benefit from taking statins. It seems implausible to me that his claim is true, but that’s what he’s claiming.
I guess the obvious question is how could it be possible to lower people’s cholesterol to arbitrarily low levels, when it is required for other vital functions?
Also, unless the patients were eating a diet containing no cholesterol, wouldn’t the liver simply make up the difference?
I didn’t notice any reference to an actual publication. Are you two busy trying to explore the details?
And a very good question too. But my own GP told me that cholesterol can never be too low, as part of his failed campaign to get me to take the stuff.
Int J Clin Pract. 2002 Jan-Feb;56(1):53-6. Not open access – abstract only and Lancet 2003; 361: 2005–16 Downloadable (or was?).
See previous comments..
Neither of these papers addressed the real issue of the claim that lowering cholesterol was the cause of the reduced death rate.
Also on the subject of Vytorin, this drug is a combination of statin and ezetimibe. Its claimed effects are those of simvastatin. Ezetimibe, along with plant sterols, has never been shown to have a clinical effect (other than lowering cholesterol) on any condition.
Funny that once cholesterol goes under 200 the all-cause mortality rate absolutely skyrockets (especially malnutrition-related deaths which are completely absent from 220):
–> http://highsteaks.com/cholesterol/#mortalitychart
*Ioannidis
🙂
Thank you for another great post and especially for writing the book. Despite warnings for some years now from editors and meta-researchers, the severity of the ‘bad research’ problem in health sciences is not at all clear until all the information is put together.
Dr Kendrick, I love your work. But it has left me in a dilemma. I suspect I am not alone. My GP seems genuinely concerned, considerate, committed, hard-working – but he is so misinformed it is scary. And if he is misinformed about cholesterol / statins – what about everything else?
My sister has just visited me for a fortnight, she brought with her the documentation from the NHS about a drug called Humira, she has Crohn’s disease. Now, if the research is so poor / biased and the information given to patients is so inaccurate for statins, is it the same for other highly profitable drugs? Are the advantages overstated and the side effects understated? What do you believe? Who do you believe? I have to say I read this stuff and thought, “I wouldn’t touch it with a barge-pole,” but then it’s not my life and I don’t have this dreadful debilitating condition.
And what do I do when I get ill, as I surely will, eventually. So what are your thoughts on this? Any idea how to get treatment we can trust from anybody, these days?
My wife has crohns also, for some 30 plus years. The sad conclusion I have come to is the only people who know anything about this insideous condition are the drug companies. They have a vested interest to control it with expesive and ongoing drug therapy there is no incentive to research a cure. My wifes drug therapy costs in the region of £100 per month.
The experts in this condition have been told by the companies what to know and how to treat it with their products. Sadly I think this model is prevelant in an awful lot of conditions.
All GPs are in this unfortunate position, In almost every condition the knowledge that is sought is generated by a vested interest.
This enduring situation, to me, is responsible for up and comming antibiotic crisis, the impetus is on the development of drugs that generate an income for the entire lifespan of the patient not a short course of drugs that would effect a cure.
Uncontrolled Crohn’s disease certainly carries its own risks. While it’s never “good” to be on biologic drugs, they often do give people their lives back and very few of them experience bad infections and I don’t know anyone who has gotten cancer from it. I do keep in contact with a lot of people with IBD because I have ulcerative colitis myself and am going on a biologic for it very soon.
Sometimes you just have to take risks with debilitating chronic illnesses. It’s the cards we were dealt. I’ve seen a lot of people get their lives back with biologics and a select few get worse, but if you do get worse, you can always stop them.
Yes, when I read that statement it seems to be saying that there is a benefit. Could Dr. Kendrick or MikeCawdery comment. I keep trying to understand it, but it still says to me that there is a benefit. Is it too wordy maybe?
In an earlier reply to “dearieme”, I have extended my explanation. The cholesterol level had nothing to do with the trivial benefit (3 lives saved per 1000 treated p.a.). It was clearly other pleiotrophic effects (e.g.,anti-inflammatory,etc) that were responsible.
Your original statement “In short from a top researcher lowering cholesterol has no benefit” is plain wrong. Collins’ claim is that whatever your original level of cholesterol, you’d benefit by taking statins. He claimed, in effect, that there’s no such thing as too low a level of cholesterol. (Since he believes that statins work by reducing cholesterol, which is, in his view, a (or perhaps the) cause of heart attacks. I’m no biologist, but the claim sounds loopy to me. But it’s what he claimed.
My point exactly. Whatever the cholesterol level statins will benefit the “lucky” patient (3 in 1000 p.a.). This seems to me that irrespective of the cholesterol lowering ability of the statin, a beneficial effect will follow. In a latter study with combined groups (from the original design of a 2×2 factorial) there are three sub-groups to each treatment group, namely no-event, non-fatal event and fatal event. Comparison of these within and between treatment groups would, if cholesterol level was relevant, have proved the association one way or the other.
This was never done. They already knew the answer which was not wanted.
As I commented elsewhere:
“Out of the mouths of experts, the truth sometimes slips”.
I would be interested to read your thoughts about the latest advice, which is to adopt a Mediterranean type diet, also derived from research.
If someone can tell me what a Mediterranean type diet I might consider the evidence. Do they mean France? Or Egypt, or Israel, or Italy, or Crete, or Croatia, or Sardinia (longest life expectancy in the Med), Spain, Turkey, Albania, Libya, Syria, or what? France has the lowest rate of CHD in Europe/the Med? Highest saturated fat consumption. High red meat consumption etc.
It is just, I am afraid, meaningless at present. It seems to mean whatever people take it to mean.
Dr de Lorgeril the principal researcher on the Lyons study outlines his view of the Mediterranean diet in his book
“Cholesterol and statins: Sham science and bad medicine”
It does not mention saturated fat concentrating on olive oil. But from the EU-WHO-Monica study “A View of the European Cardiovascular Disease Statistics – Report 2005 ” the data provided for saturated fats was significantly but negatively correlated with heart disease as you pointed out years ago in your book. In subsequent reports saturated fats were removed from the study.
I think the phrase “Mediterranean” diet is a useful way to muddy the issue that we have all been encouraged to eat the wrong types of food for years. Here is a typical article:
http://www.bbc.co.uk/news/health-29929403
After discussing this diet, we then get this statement:
“Government advice is to eat plenty of bread, rice, potatoes, pasta and other starchy foods, plenty of fruit and vegetables; and some milk and dairy products, meat, fish, eggs, beans and other sources of non-dairy protein”
Nobody who read the article without some awareness of the row behind the scenes would know what to eat, or what it really meant! It is confused as to whether the article is actually talking about a change in recommendations or not!
Malcolm, do you have any idea how long it will take for your book to appear?
Yeah, and no bread or pasta preferably. Very Mediterranean!
The French I know (Cajun people of Louisiana) are people my father admired so much for their live and let live mentality. They could ALWAYS laugh at themselves and love to Laissez les bon temp rouler (let the good times roll). Maybe it is attitude as well as diet. I am not afraid of saturated fats. When I was, I got sick. Now that I am not eating like this AT ALL, I feel so much better, but it is complicated. The point we all want to learn is why statins are so widely prescribed with so little effect and so many side effects. I think that is what concerns us all. When I see a cash cow…I always get suspicious!! All this money spent and where are we in terms of effectiveness? The means just don’t justify the ends. So, now they are going to sucker punch a bunch of poor innocents by adding another drug to a statin. It is kind of like putting perfume on a hog…it is still a damn hog!!
A Mediterranean diet is just a lot of olive oil and goat cheese, is it not? I am still not sure about what that is myself. Can’t wait to see your new book, and I like the title. It appears it will encompass more than just the statin issue…correct?
Dr. Kendrick. Don’t the members of THINCS have a lobbying arm? Someone has to stand up for the people. I would hope that someone or many people (in the U.S.) would testify before the Congress about the safety issue of this “stuff” called statins. For God sake, let’s do something!!!
That is what I want to do. My father was a Lobbyist. He was one of the really good guys. He was one of those stalwarts who pounded the floor or the state and National Congress for the good of the people. It started when an innocent man applied for a job and was killed! He was only 24. That was when he had enough!! And he set about to fulfill his destiny!! Is there no one out there willing to do the same? No one, but no one can be successful without governmental intervention. You can best believe the statinators do!!! He had a motto, ” DON’T LIE, STICK WITH YOUR FRIENDS…AND COUNT THE VOTES”! He still remembered the time when a man’s word and a firm handshake meant something! And…he read his bible every day. He personified the character traits described in the poem “If” by Rudyard Kipling. That is why today, it is my favorite poem. Sorry Dr. Kendrick, but when I saw your Eulogy, I thought of my own father. Your father knows what your destiny is…and you are fulfilling it. Now, will the rest of you take the challenge to DO?
A Mediterranean is diet is certainly a load of something.
My book is an attempt to make people aware that medical research is not the objective search for the truth you some may wish it were.
Some studies do actually quantify it, for eg in this study:
Effect of ketogenic mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees – http://www.nutritionj.com/content/10/1/112/abstract
John,
After reading “The Big Fat Surprise” by Nina Teicholz, (well worth reading), I have grave doubts about the supposed research backing advice to adopt a “Mediterranean” diet. Read the book and make up your own mind on the subject.
Celia Have you read Dr de Lorgeril’s Lyons study or his book “Cholesterol and statins: Sham science and bad medicine”?
The Lyons study is the only study that I have found that actually demonstrated a cardiac benefit BUT WITHOUT AFFECTING CHOLESTEROL LEVELS. In both treatment groups the TC levels were virtually identical.
________________________________
Celia, Nina’s book is mind boggling! I highly recommend it.
I became fearful of statins after reading Dr Kendrick’s book, but it took me years to pluck up the courage to eliminate Simvastatin 40mg. I am so thankful that, eventually, I disregarded all advice warning me not to stop it.
Having fully accepted Dr Lustig’s take on sugar and fructose, my health improved considerably when I reduced their consumption. This, too, was contrary to the stupidity of the ‘balanced’ diet being pushed at me from all directions.
I took on board Wheat Belly’s and Dr Perlmutter’s concerns regarding the deleterious effects on our general physiology and brains by eating modern grains. I drastically minimised consumption of all grains, and in particular wheat; once again going against advice given to me as a type 2 diabetic, who ‘ought to consume a 55% CHO diet’.
I read Barry Groves’ book ‘Trick or Treat’ about fats, with gusto, praying that it would be safe for me to re-introduce butter, cream, dripping and lard into my tiresome, low fat regime that had been promoted all my adult years. ( no, I would not be informing my GP of that either).So I was certainly heading for an immediate demise if I took on board all these new findings, especially being diabetic, hypertensive, overweight, with ever rising triglyceride levels, and cholesterol readings well outside ‘acceptable’ parameters. But continuing as I had been, wasn’t exactly life enhancing, anyway…..I had little to lose by changing my whole regime, and did so over a 12 month period……on my own, with no medical support…..very scary, I can tell you. But why was I worried? ..I was improving week on week, month on month.
Nina’s book has now confirmed that Barry’s tried and tested high saturated fat intake, was absolutely well founded.
I no longer see any need to consume large volumes of fruit, veg, bread, pulses etc. (in fact, as low CHO as reasonably possible). I now accept that quality proteins in moderate amounts, and relatively copious quantities of saturated, natural fats of animal origin, is what I need to be a healthy individual, devoid of any extraneous, superficial, medications or manufactured nutritional supplements.
It is up to the individual to find what is correct for them, but this feeling of liberation is beyond words. Life is just great.
I think a mediterranean diet is just eating real, unprocessed food.
What Jennifer is describing is basically a palaeo diet, the Mediterranean diet (as I understand it) still contains plenty of processed food (bread, pasta, other things made with grains, stuff made with pulses and legumes).
@Jennifer (if you ever see this, I realise that I’m commenting on a blog entry that’s 4 months old, but I can’t seem to get WordPress to play nice with iOS, so I have to borrow the laptop as and when I can, meaning that I don’t get to read Dr. K as often as I’d like. I can read but, if I read, I have a compelling urge to comment, so I don’t read, because commenting is just too frustrating) DON’T be scared of saturated fat, it really is a superfood.
Talking of superfoods, have you considered using extra virgin coconut oil (EVCO) and red palm oil (RPO)? DON’T confuse RPO with the evil stuff that’s in most processed junk these days (I won’t bestow it with the word ‘food’, because it ain’t, all here would agree on that, I’m certain), RPO is raw, unprocessed, and harvested sustainably (no orang-utans are ever harmed in its harvesting!), and adding it to EVCO raises the smoke-point of the latter, meaning you can cook with it and it won’t turn ‘rancid’ (meaning that you’ve destroyed most – or all – of its health benefits).
There’s an excellent article here – http://www.marksdailyapple.com/healthy-oils/#axzz3UwanB3iZ – regarding the evils of the oils the NHS would have us believe are (heart) healthy; unless, your GP is truly tuned into the truth, they’ll probably balk at EVCO and RPO due to them being almost 100% saturated. It’s an excellent blog all-round, once you get past Sisson’s constant promos of his own line of supplements, whey powders and books, very American, though.
Chris Kresser is another blogger I’d strongly recommend you read (he blogs at http://www.chriskresser.com – again, he’s another who likes to push his own products at you, but the blog itself really does contain some very useful articles (he, like Sisson – and, obviously, our very own Dr. K – is extremely outspoken on the subject of salt).
Finally, there’s Dr. Andreas Eenfeldt – http://www.dietdoctor.com – I think I learnt of the existence of Malcolm’s blog via his – a very informative read and, like Malcolm (I do feel funny calling Dr. K by his first name, no idea why, I’m sure he doesn’t mind) he doesn’t pull his punches!
I don’t know whether it’s because of my autism, but I’ve always been a very cynical, mistrusting sort, and I refuse to believe anything unless I’ve checked and verified it myself at least twice; I have, in the past, been labelled a conspiracy theorist for my vociferous distrust and mistrust of the NHS but my main problem with a state-run health service is that it’s a form of control; if the populace is too fat and/or too sick to do anything but be good little sheep, then they’re not suddenly going to rise up and overthrow the government, are they? I lay a large part of the blame for my current poor health firmly at the door of the NHS for feeding me bollocks for most of my life (I was grossly obese and Type II and, because I didn’t know any better back then, I did everything the NHS told me with the result I simply became fatter and fatter, at one point they reduced my TOTAL fat intake to just 20g a day). I also partly blame myself because, when I found that LCHF palaeo caused me to lose weight, I dropped the carbs too low, too quickly, and tried to fast for too long, too soon, ignoring the advice to begin with between 9 and 12hrs, and then lengthen in increments of 3hrs, sometimes my stubbornness can be a bad thing.
Finally, because I forgot to mention it earlier, there’s MCT (medium-chain triglyceride) oil, which is derived by superheating EVCO and skimming off the resulting ‘precipitate’. I used to do a lot of my primal fitness sessions (see Mark Sisson’s blog) fasted, but after a black coffee ‘laced’ with MCT oil (here I’m duty-bound to issue a WARNING:Due to the way MCT oil is metabolised, and it’s metabolised EXTREMELY RAPIDLY – caution is advised when dosing for the first time, as nausea and/or diarrhoea can result from taking too much, too soon. It’s best to begin with 0.25-0.5tsp, and gradually increase the dose, until you reach the dose which makes you sick, then scale it back to the previous one. Over time, you may find you can increase it again with no ill-effects. I found that i was able to tolerate a couple of tablespoons over time. Why the coffee? Because the caffeine enhances the fat-burning effect of the oil by raising the metabolism slightly).
Furthermore, there has been research undertaken which has shown MCT oil to be efficacious in reducing – or even reversing – dementia (including Alzheimer’s and Parkinson’s) if it’s given in the early stages; problem is, it was independent research so, obviously, Big Pharma has now trampled all over it. Can I find the fecking link when I want it? Can I fecking bollocks! I thought I’d learnt of it via Andreas’s blog, but I couldn’t find it again when I searched, so perhaps it wasn’t him who posted it. Perhaps Malcolm knows of it?
In summary, I believe that every species has a unique evolutionary and genetic dietary blueprint and that disease occurs when this is strayed from, or not adhered to strictly enough. If all of human evolutionary history was condensed into a single 24-hour period, then we’ve only been cultivating all those things the NHS would have us believe to be healthy for about the last 2.5 minutes, how can we POSSIBLY have evolved to digest them properly in such an infinitesimally short timespan? How can wheat, for example, be though a good thing for anyone to consume, if it causes coeliac disease in some? Surely, as we’re all the same species, nobody would suffer any kind of a reaction? That’s the basis of my philosophy; if something causes severe allergy in a certain group of people, then I avoid it myself, although when it comes to eggs, I believe the allergic reaction is not to the egg itself, but to whatever crap the hens were fed. If eggs from hens allowed to eat a 100% natural diet (hens are omnivorous, eating a similar diet to most passerine-type birds), then fewer – if any – people would be allergic. Seafood is more tricky, although the shit we dump in the sea is a prime candidate for culpability, if wild-caught, or growth-enhancers (if farmed). People shouldn’t be having allergic reactions to foods we’ve been eating since the day dot (well, almost), although I do concede there could be some rare genetic abnormalities which could mean someone can’t eat something.
And, there, another essay! Sorry, Dr. K!
Thank you for your thoughtful contribution.
Dearieme
“The investigators calculated that 50 patients would need to be treated for seven years to prevent one event” which means that it’s no super-drug.”
This refers to a population, a herd, but not an individual.
This is equivalent to an NNT of 350 p.a.. This is a probability = 0.0029 that you, as an individual, will benefit. Conversely, the probability of ,NO BENEFIT is p = 0.997, a near certainty. Even over seven years the probability No Benefit = 0.98: not inspiring.
John E Midgley
Does not answer the question. Selenium deficiency occurs in various soils round the world and can be a serious problem in animals and man; Keshan disease, a cardiomyopathy in man is an example. In animals it causes a myopathy. And like most deficiency conditions it is a distribution, though only extreme deficiencies seem to be acknowledged.
Small probabilities are also more likely to be a consequence of artefacts of various sorts – deliberate or otherwise.
Incidentally the NNT of 350 is very similar to the NNT from Collins paper (Lancet 2003; 361: 2005–16) where 156 lives were saved in the treatment group of 10,269. = 15.2 per 1000 deaths in 5 years or 3.04/1000 p.a. equivalent to an NNT of 329 which is remarkably similar to the NNT found in the IMPROVE-IT study.
De Lorgeril in his book is highly critical of this study including the “peaking” before termination. To quote:
In agreement with the findings of 4D and AURORA, SHARP confirms that cholesterol -lowering is neither effective nor useful in patients with chronic kidney diseases. Saying the opposite is nothing but a lie! The “scientific fraud ” is easy to detect in SHARP where things are quite clear.
Reference: de Lorgeril, Michel (2014-03-05). Cholesterol and statins: Sham science and bad medicine (Kindle Locations 4622-4624).
“This is a probability = 0.0029 that you, as an individual, will benefit.” That’s true IF you are a representative member of the herd. But you won’t know if you are. Was there any effect of age, sex, and race, for example? Maybe Dr K can help us with that.
Here’s another way of looking at things: “No deaths were prevented. … Researchers … said in a press release that 50 patients had to be treated to prevent a heart attack or stroke – an impressive figure. But that’s over seven years. … It would cost $880,000 to prevent that heart attack or stroke.”
Whereas many people would be very keen to spend $880,000 of someone else’s money to avoid a heart attack, how many would be keen to spend that much of their own? It seems to me to be a huge bill for avoiding a non-fatal heart attack. As for strokes, I have no idea whether they are talking about, say, “mini-strokes” of mild effect, or major strokes of life-ruining effect. Maybe Dr K can help us with that too.
http://www.forbes.com/sites/matthewherper/2014/11/17/surprise-vytorin-works-here-are-five-things-you-should-know/
I don’t know, and cannot reply. All we have so far is an abstract from a conference. Difficult to do a critique when you have sod all information to go on.
Absolutely true. The probability does depend on the particular herd selected for the study. In an email to NICE I suggested that if they wished to reduce the incidence of adverse reactions to statins they should follow the inclusion/exclusion criteria used in the HPS study. A major criterion in this study was tolerance to the statin. They even ran a prior study by treating patients and selecting those who proved tolerant…
But please remember that a probability of benefit must also be examined in the light of the probability of No Benefit and also in the light of final cause of death. Reducing one cause of death, increases the probability of another; cancer is the next common cause with, if US data is to be believed, iatrogenic death a common cause.
The problem was and is that the findings on adverse reactions in the HPS was extrapolated to the entire population including those EXCLUDED on tolerance, non-compliance, etc. This is in my opinion an extrapolation too far.
“This is in my opinion an extrapolation too far.” In my little corner of science we might be blunter: it was crooked.
As a longtime researcher I am generally quite polite though on the subject of statins I am sorely pressed to remain so. Your assessment is probably correct but knights get away with lts of things.
Looks like Stephanie Seneff has been covering some of the same ground in a series of lectures in Indianapolis 7-10 Nov 2014 – http://people.csail.mit.edu/seneff/Indianapolis/Drugs.pdf
Wow! Just read through Seneff’s long series of slides. Amazing how many studies she cites, both older and more recent, that call into question the use of statins and other commonly prescribed drugs. And yet, what gets reported by the press is this new study that says Vytorin is wonderful after all!
As for Mary’s question above, do they think we’re stupid, if you’ve been paying attention to the US political scene lately, clearly, those in charge do think the lowly people are too stupid to know what’s best for them, so the “smart” ones with the power are going to just go right ahead and do it no matter what we think.
The Mediterranean diet is an American invention by Harvard’s Walter Willet that does not exist in real life. Nina Teicholz’ The Big Fat Surprise is a very good X-mas gift.
Excellent. Once again I have to lead you to the whole debacle of the PACE Trial for sufferers of ME/ CFS. I’m unsurprised by your Horton quote as it’s clear The Lancet cares very little about the logic of the papers it chooses to publish. here is a link to a BMJ e-letter by Alan Mattees:
http://www.bmj.com/content/347/bmj.f5963?tab=responses “”
Couldn’t make it up!
It Ain’t Necessarily So: Why Much of the Medical Literature Is
Wrong
Christopher Labos, MD CM, MSc, FRCPC
From what I could make out in a small news item on the “Mediterranean Diet” theory, they were proposing an Italian diet rather like the one that would be eaten in that famous, in-bred, village where everyone has the genes for longevity and no heart disease. When any “expert” mentions eating like an Italian to me, I can’t resist coming back with “Great, pounds of butter” – because that’s one of the elements.
I have just realised what a brilliant title you chose for your new book – far better than your previous title, which I have forgotten!
It is good, isn’t it? I suppose a vet with the same views could write “Vetting Data”, but it would have less punch. An engineer who wrote “Fabricating Data” might have a title with too much punch.
On which subject (sort of) how do statins do on our furry and feathered friends?
Actually, the drug companies tried to get vets in the US to start testing cholesterol in dogs some years ago. (“Great new and huge market there!”) That one did NOT fly!! Too bad, people docs are so trusting of the drug companies…
I sincerely hope that they are never used!
Wonderful: “Do you feel good? One woof for yes, two woofs for no.”
Judging from the various cats we have had over the years, getting a pill inside them is a tough job! I can’t imagine many people opting to give their pet a pill every day, just on the off-chance it might help.
We humans are just too good at taking medicine!
Indeed. And the “Stupid” virus is apparently quite common.
http://www.pnas.org/content/111/45/16106.abstract
Chlorovirus ATCV-1 is part of the human oropharyngeal virome and is associated with changes in cognitive functions in humans and mice
Back in 1984 ( now that sounds like a good book title) I wrote a paper entitled “Iatrogenesis”, for which I was given a pass mark of 98%.( I wonder which aspect of the topic I missed out?).
I must therefore have done a fairly decent job at researching the subject from scratch, because until then the word had never been part of my Geordie vocabulary. I genuinely thought it was a purely academic exercise, and certainly far removed from the cutting edge of medical care at the nice, top-notch establishments I was associated with.
I reckon my paper equates well with Orwell’s 35 year fictional projection into the future, ( as he wrote Nineteen Eighy-Four in 1949).
My ( crystal ball) masterpiece of 30 years ago was not meant to be fictional, but little did I think it was, is and will surely be an accurate reflection of the Medical World…..now where is the darned thing….likely stuffed in my loft….could I possibly publish?
It would indeed be interesting to compare it with todays findings.
Loft has been decluttered….but to no avail, I am afraid.
I seem to recall I wrote about the potentials of ……cross infection on wards, poor nutrition, slips and trips, surgical mishaps, drug errors and such like. In other words, procedural inaccuracies caused by sheer accidents, or lack of attention to detail or pure slovenliness. In today’s culture of supposed ‘transparency”, these matters are being discussed, quite correctly, by all and sundry, so that improvements ought to be implemented accordingly.
Our problem today is that research regarding statin administration (and possibly other treatments), is being hidden from the general public, (typical BBC debates….on the one hand…on the other hand!), stifled by medics afraid to raise their concerns and by those in the know being ostracised and silenced. This is resulting in an iatrogenic scenario at least equal to, and likely worse than, anything I documented 30 years ago.
At least I am now fit enough to tidy the loft…..a job never contemplated whilst under the influence of the dreaded statins.
Jennifer – sounds like an interesting paper you wrote for me at least.
I have from somewhere had a number that about a third of all death should be due to medical ‘treatments’ – reasonable?
Many years ago I read a book that you might have been aware of, “Medical Nemesis” written 1975 by the author Ivan Illich who was a philosopher and a social critics. That book is to my opinion a book that gives a great perspective on how medicine had ‘gone wrong’ already at that time. By coincidence I actually pulled that book from the shelf about a week ago with the intention of reading it once more although it now tends to fall apart as old paper backs tend to with time. It is on my night table waiting now.
Prof,
The following may help. There are many refs from mainline journals.
In the US it is clear that iatrogenic deaths are a major cause of death (John T. James PhD, J Patient Saf 2013;9: 122-128; Gary Null et al, http://orthomolecular.org/library/jom/2005/pdf/2005-v20n01-p021.pdf ; Dean MD ND, C. “Death by Modern Medicine: Seeking Safe Solutions” and others).
Thanks for the link, Mike.
Just read the excellent article re:- iatrogenesis in USA……so….once again, how come these stats don’t reach the public?
Any sugestions as to whom these papers ought to be directed at?
Medics?
Managers of medical institutions?
Politicians?
Big business?
The Media?
Universities?
Questions, questions, questions……and the answers are there all the time, apparently gathering dust in an old cupboard, a bit like my humble, hand-written manuscript from 1984, which gained merit, but got filed away under “interesting”, then conveniently ignored, even by yours truly, I might add!
Jennifer,
Dr Dean’s book “Death by Modern Medicine” delves even more deeply into the subject.
You ask why these numbers do not reach the public. Simple, the snake oil manufacturers (SOM aka Big Pharma) do not want anyone to know and they have the money and influence, as Dr K has pointed out, to smother \nything they do not like. As an example, where would the Oxford CSTU be without the £hundreds of millions provided by BIg Pharma?
Incidentally, I suspect that the real number is somewhere between the 700,000+ and 200,000 and in the UK it will be proportionally the same. But the numbers will be carefully hidden.
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Professor Sjoberg.
I am spending all day reading my way through Illich once again, after a 25 year gap. My husband is mesmerised by it, (he is reading it too), and keeps saying….”Jennifer, you always said this/that….” …”Jennifer, you have harped on for years about the medicalisation of pregnancy and labour”….”Jennifer, Illich described your worries about the institutionalisation and undermining of life-skills”.
I can now see that my views were moulded by encountering his work, which has obviously had a profound, subliminal influence on my thinking, because prior to your recommendation, I could hardly remember much about Medical Nemesis. And I thought I was the brains behind all my way-out, controversial ramblings! But, credit where credit is due!
So, it seems that I have be regurgitating Illich’s views of 40 years ago. It is proving a magnificent read, especially as I can look back over my years in the NHS, and with the experiences gleaned from being a wife and mother, together with the points of view witnessed as a political animal. The book could have been written last week, as his perceptions remain utterly pertinent to today’s world.
Jennifer – thank you for your enthusiasm!
I am actually experiencing the same thing now re-opening the book with my wife in the background watching some sheets falling out of the book to the ground. Truly amazing reading even if you have already lost all your confidence in medicine and were the statins may be viewed as the tip of one of many icebergs.
My own infernal personal journey started with my heart illness and my stepping out of the whole medical system after the very serious heart attack 15 years ago. My profound natural science research background helped a lot to unveil the religious character of medicine. Treating myself, as advocated by Illich, my health just swell today but my body i as slim as when I was twenty – down 20 kg by eating saturated fat and like – no carbs. An anecdote to be openly ridiculed by the last ignorant cardiologist I met about a year ago. “May God forgive him for his arrogant stupidness!”
During the years, I must say that, I have read ‘a lot’ not least about the theory of scientific knowledge. That have brought me deep into philosophy, now reading Plato’s complete works with great interest. In Plato’s work I found recently a ‘pearl’ on dogmatic medicine (in “Statesman”) stating that by dogmatic attitudes – by rigidly following the rules – any system is ‘doomed’ in the long run and will never recover! Clever thoughts 2 500 years ago!
One corner stone at the beginning of my journey was here Thomas Kuhn with his “The Structure of Scientific Revolutions – a great classic reading on this subject. In his book he, as you, fully admitted his early ignorance of another very early (1935) treatise arriving at the same thoughts of paradigm shifts in science as Kuhn himself had arrived at but now specifically related to medicine. That book was “Genesis and Development o a Scientific Fact” by the German Ludwik Fleck and was about how the view of syphilis developed over the centuries. The book is no reissued with a foreword of Thomas Kuhn. Excellent reading!
From a slightly different perspective Susan Sontag sheds light on this subject in her book “Illness as Metaphor”. Also good reading to my opinion.
Professor Sjoberg.
Thankyou so much for reminding me of the excellent work of Ivan Illich, and I do hope you enjoy re-reading your copy. I had written my paper 5 years before his work was recommended to me. I needed to contact The British Library (pre-Amazon days), in order to obtain a copy of Medical Nemesis and the dog-eared copy I received was only available on a short term loan.
I have found the full text on-line, and so will now re-read it at leisure; the contents list alone reminds me of what an important piece of work it still is. As we have strayed onto the touchy topic of iatrogenesis, it is an excellent, appropriate read, as relevant today as it was in 1975, I am sorry to say.
Thank you so much.
Prof Sjoberg.
Once again, I must thank you for the links to other authors, and will endeavour to read their work.
There are wonderful works out there, but who is reading them? Just because they are ancient, does not detract from their relevance.
I feel that not much changes in human nature, and I like the thought that research ( for that I mean…inquisitiveness) has a place in modern society. There are elements of dishonesty in all walks of life (as Illich points out), so we must keep abreast of issues, and I thank you for pointing me towards other good works.
In North country parlance…..there’s nowt in telly….so better I read Plato.
Jennifer,
North country parlance – Scottish?
“…..there’s nowt in telly….” something I realised about twenty years ago when I throw my TV-set out.
Plato is though ‘heavy reading’ if you are not an addict to philosophy which to my opinion though might easily happen with age, an inquisitive mind plus ample ‘free’ time.
I agree that Plato is likely to be a hard read alongside all the other things I am interested in. I am fortunate in having one of the last printed editions of Britannica (2002), which will enable me to find the items of interest to me, in an easy(ish) way.
I am Geordie, (using the true, tight definition of ” born on the banks of the River Tyne), and after many years have become an adopted Yorkshire lass…. I have been around a bit…..worked in big and small institutions ( mainly hospitals ), across the North and South of England, spent time in politics, and holidayed frequently in lovely Scotland. I feel almost as competent as the next person to voice my opinion on big topics, and put this down to my proud Geordie upbringing and education. I am so delighted to have found this blog where like-minded people, such as yourself, are striving to educate those of us who maybe missed out on some aspects of a rounded education. For instance, I was never formally taught anything about Classics or Politics. My education has been wholely ‘practical’ or ‘vocational’ stuff, as was pushed on the masses in order to serve others by working for a living. No lounging in reference libraries for me, with Daddy paying a generous, regular, dependable allowance in the bank. You get my meaning?
So, I am thankful that I have safely reached retirement years, and as such, can devote much time to academic readings. But my working class background will never leave me, and my practical skills in household management, are now being supported by the wonderful topics discussed on the internet..e.g. ..a better understanding of nutrition, and the ability to research important aspects of life.
What a great 3rd Age I am enjoying!
I really like the premise of the book, but the idea that all research is useless seems pretty extreme to me. Surely a good portion of it is useful if you still believe Western Medicine is one of mankind’s greatest accomplishments.
That being said, i’m always a skeptic, very much looking forward to the book.
I think that the skepticism is mostly for Big Pharma sponsored drugs, not all medical research. Though I must admit that I am pretty skeptical of much of the findings from many epidemiological studies that show, for example, that eggs are good, bad, good,…….. etc. Prof Bradford-Hill pointed out decades ago that findings had to be coherent and consistent; something that seems to be ignored today. Meta-analyses too are suspect; studies are selected, ie., not random. A serious flaw in my opinion as the selection criteria can be used to provide the “required” answer.
I think the point is that if research is heavily corrupted with biassed or poor quality information, it is extremely hard to know what research to believe. After watching the saturated fat, cholesterol, and salt hypotheses fall, it is hard to feel much confidence!
A potential cure for an acute illness such as EBOLA has to work, but dietary advice has to be suspect. OK sugar is bad, but is there definite evidence that trans fats are bad – I don’t know, because who knows if another Ancel Keys collated the evidence!
Corruption in research is fantastically corrosive.
Dr Mary Enig has researched this issue of trans-fats and has published widely. The FDA took 20 years to finally accept the fact that trans-fats resulting from heating of unstable polyunsaturated oil was dangerous. A pubmed search will provide data. Dr Enig’s book “KNOW YOUR FATS” gives details
Mike,
What I am trying to point out, is that once you realise just how unreliable medical science has been, it is awfully hard to know which research to accept and which to ignore! I am not arguing specifically for trans fats – just using them as a relevant example.
Trans fats are mainly artificial – which is certainly a point against them – but I imagine that assessing people’s level of intake of TF’s in actual epidemiological studies must be fraught with difficulty. In the abstract of one paper I read, this was performed using a survey technique, but if, say, people consumed most of their TF’s from takeaway food, it might be that people who took care of themselves in other ways ate less takeaways – which would skew the results.
Before I got into all this, I assumed that researchers had powerful ways to disentangle such effects and their results were real – but now…….!
David,
The FDA has finally, after some 20 years, come out against trans-fats. Certainly the food industry, supported by the USDA, tried very hard to block research on trans-fats, but now in the US actually claim on labels “no trans-fats”.
The problem of course relates to heating the unstable, polyunsaturated (note the poly-) oils so commonly used for frying.
“for heart-healthy patients, statins will not increase longevity, prevent a fatal heart attack, or avoid a life-ending stroke.” from Sat. Eve. Post, Sharon Begley about “Dr. Nortin Hadler refuses to let anyone measure his cholesterol.”
A quote from Stephanie Seneff
“Statin drugs may prevent small heart attacks but they make the big ones more deadly. No study on women of any age has ever shown a benefit for statin drugs. Most experts agree that statins don’t prevent heart attacks by lowering cholesterol. In fact, lowering cholesterol can be viewed as a nasty side effect of statin drugs. Statins make you grow older faster (hair loss, hearing loss, cataracts, diabetes, arthritis, neuropathy, muscle pain and weakness, brain fog are all side effects of statin drugs).”
But statins are recommended like candy and foisted upon the healthy, the young, women, and the elderly who have no other ‘symptoms’ besides age. This is ‘SOYLENT GREEN’-like of Big Pharma.
Dr. Gotzsche of the Cochrane Collaboration, and “Deadly Medicines and Organized Crime” reminds that 21st century medicine morphed into NO and NOT ‘health maintenance’ BUT the ever increasing and MUCH more lucrative ‘disease-maintenance’.
I do wish we could get rid of that fantastic euphemism – “muscle pain”. When I originally read that on the leaflet in my first packet of Simvastatin, I imagined something like I might feel after a stiff hike!
The reality isn’t ‘muscle pain’ it is is muscle cramps and weakness, and joint pain, and sheer disability! Remember that some of the people who post here, haven’t even recovered from their brush with statins – I was lucky in that respect!
I would prefer it if the euphemism “side effects” was properly defined as “Adverse Effects” as described in EMA directives
But that would scare the h*ll out of patients and seriously affect sales
Mary, thanks for your reply. Believe me, I don’t think of myself as lowly. That was more my reflection of what the elite apparently think of all the peons that they are taking care of by massaging — or doctoring, if you will — the data. Be it political or medical, to me, it’s all pages out of the same book. They know better — or at least they think so — than we do, and all the data doctoring they do is only designed to take care of us since we’re incapable of knowing what’s right.
So true, Susan. However, when was the last time you contacted a state or local government representative? Have you ever made an appointment with one and sat in front of them. Are you afraid to shake his or her hand and look them in the eye? When was the last time you attended a “town hall” meeting or wrote to your Congressman to make your voice heard. And…do you vote? I think the fact that the House and Senate have a newly more conservative electorate tells you that people’s voices are being heard at the polls. They are tired of the tyranny of this government. You are not going to like everything your government says or does. But if you only sit in your living room and shake your fist at the T.V. or if you just blog your feelings without taking action…are you really making a difference? It is very empowering to do just that no matter who you are. Believe me, when you do make that appointment, and look those people in the eye and ask WHY…they remember you! They have to fight for a job every 4-6 years, so they owe it to you to listen. You the people are paying their wages and you have God given right to complain or to extol their virtue or corruption. That is all I am saying! I have now sat before more than one by now and have told them of my plight, and I tell them where to find the information and ask them to keep an open mind and protect the innocent. Do that, and come back and tell us how it went!!! Because it is simple…nothing changed…nothing changes.
As for those who say…I have read all the studies and don’t know what to believe anymore? Well each piece of that evidence is embedded in your subconscious memory. And each of you knows what you need to do to get better or to make the lives of others better! And if you think you only have a vague idea…do it and tell us how you feel afterward!!! Use common sense when all else fails you!! Have any of you ever written to your governmental representatives and sent a link to Statin Nation or Dr. Graveline or Kendrick’s books? If you have not, then it is time to do so.
And that’s all I have to say about that!
Thanks to Mary Richard, Sue Richardson, Celia, Crandreww1999 and of course Dr K for your kind words of encouragement.
I really want to pursue my dreams and would agree that western medicine is amazing in its treatment of acute and emergency conditions, surgical interventions etc.
It’s in the treatment of some “everyday” ailments where I believe we seem to have got bogged down. Maybe our expectations are too high and still riding on the belief that a tablet can cure everything, whereas even bacteria have been fighting back from the very first day that that “other” Scottish doctor first discovered the Penicillium Notatum mould almost one hundred years ago.
@ Maureen Berry, Flyinthesky and Kamran re Chrohn’s. A friend was diagnosed with this horrible condition about 18 months ago. He desperately didn’t want to go on a lifetime of meds with no guarantee of eventual surgery and a colostomy bag. I told him to delay any drug intervention because I was sure I’d read some research regarding healing of leaky gut / tight junctions and the microbiome, all / any one of which may be the background to developing Crohn’s / IBD / UC etc. His consultant was open to dietary modification but the nutritionist was aghast at what was proposed: a diet rich in natural saturated fats, butter, coconut, fatty meats, absolutely zero grains, homemade yoghurt made with specific bacterial cultures, specific vegetables etc. Within a couple of weeks his condition had improved. Within two or three months it had gone. At his follow up meeting with his consultant at 3 months the doctor couldn’t believe the turnaround but told him to carry on doing what he was doing. The nurse couldn’t believe he was on zero meds. And the nutritionist wouldn’t speak or return his phone calls when the diet sheet he completed revealed that his diet consisted of at least 60% fat but yet, his blood markers were “textbook”. The nutritionist had previously warned that his cholesterol levels would be “sky high”. And as a bonus, he lost about 30lbs without even trying or feeling hungry.
Admittedly this is a sample of n=1, but how many others have unnecessarily had colostomy surgery when a relatively simple dietary modification would have had them live symptom and pain free lives whilst allowing their guts to heal – drug free? The research exists but is there any money in following it…? And why don’t mainstream doctors, consultants etc suggest such an approach? If the dietary intervention fails, the meds / surgery will after all, still be there.
Mark, are you sure you have not already graduated medical school? What a scholarly example as well as a sensitive and gentlemanly answer. I recall that as a child, we ran around bare footed all day. We only went to the doctor when we had to have shots to get into school. Our parents or grandparents nursed us back to health when we had colds or the flu. We swam in the water when the streets flooded. And I have only touched on a few examples of how we put ourselves in harm’s way as children. Yet, surprisingly we were healthy. Our bodies learned to fight infections. I was never sick until just 10 years ago. I had a pretty good go of it and I can tell you what mistakes I made as an adult that I would not make again. One of the many was to start on statins rather than be proactive and take control of my health.
You are welcome! And, stay the course!
Mark,
I know people who were prescribed statins after suffering some CVD. As you know, I am extremely wary of statins, both from my own experience, and various things I have read. However, I am not a medical doctor – any more than you are yet, so I tread very gingerly – pointing out things they might want to read, and suggesting that they should watch out for peculiar muscle symptoms, and describing my own experience – always stopping short of actually giving medical advice.
It is very difficult nowadays, when it is clear that doctors don’t always know best!
David, you really helped me the other day. I get tired sometime of all the exercising but I know that for me…it is the only way. And, you made me think. Prior to statins, I never had any real back problems or pain. But, I would get soreness. That is part of aging and I can deal with that the way I always have. But, constant unabated pain is something altogether different. It is scary and you are right in that any possible vulnerable spot, will get worse with statins. It is amazing to me that just taking Ubiquinol has helped. I have increased it as well, but my energy is so much better. I take an anti inflammatory (otc) before the exercise and it has helped my endurance.
At night, I eat fresh raw vegetables for a snack. I actually crave those things now. I soak them in vinegar and water to rinse them. I hope I am doing the right thing. My elderly aunt who is 88 and very healthy swears by it. It feels good to feel that your diet is working for you. I think I will get Dr. Natasha’s books as well. I listened to her on Statin Nation and found her so credible. Her body language is amazing. She never misses a beat, does she?
So glad to see you all trying to do the best you can for your health. It is great to be in healthy company. I feel encouraged!
Mary,
I am glad my approach of exercising muscles that are damaged by statins seems to be working for you, and I hope you do get totally better. The raw vegetables in vinegar diet certainly didn’t come from me! After realising that neither salt, nor saturated fat is bad for you, I have adopted a rigorous “eat what you like” diet 🙂
Perhaps I should just correct my slightly flippant remark (above) about diet. I definitely try to avoid eating sugar – other than that, I eat what I like.
Mark,
You would surely love the Swedish LCHF (Low Carb High Fat) grass root movement though eagerly ridiculed by the medical establishment – “it will blow your cholesterol!”. Talking about leaky gut I read the book “GAPS” by Natasha Campbell-McBride with interest – sounds like your friend, diagnosed CD, might have read that book.
Professor and Mark, I so agree. I actually tried the high fat, low carb diet, both in the 80’s and the 90’s. Those were times I had the best of health. I stopped statins about a year and a few months ago. It has been an uphill battle. I believe that Dr. Natasha knows what she is talking about, since that diet or lifestyle is not dissimilar to the one I grew up with. I have heard her say that her grandmother used to wipe her pots out with the animal fat in them. They were okay to use that way since she believes that saturated fats are not vulnerable to oxidation. I tried years ago to buy new iron skillets like my grandmothers did and oil them and heat them up to season them. Each time I took them out of the cabinet to use, they smelled rancid. We scratched our heads wondering how our mothers and grandmothers used these same black iron skillets and they did not stink. I now believe it was probably because we tried to use vegetable oils not knowing they would not work like animal fats. Live and learn. I guess I did my own home experiment! I am on that diet now or actually lifestyle and we eat wonderful tasty food. I am feeling better today than I did 10 years ago. My pain is subsiding, I am exercising. I have PAD. However, on my latest exam, my ABI was within normal limits and pedal pulses are strong. There is no significant atherosclerotic plaque in the carotid arteries. I have to wonder. And, I sure am thankful.
Hi Mark, Thank you for your considerations. My wife has enjoyed many years of no drug interventions between periods of having to. Her greatest savour has been daily intakes of slippery elm powder mixed with live yoghurt, alas her failing has been grain and starch intake. She enjoys bread and cakes and it took many years for me to convince her that was the main culprit. She now enjoys the same but to a lesser degree but only the gluten free varieties.
The other problem is being a lady, girl, she is always mindful of her figure so restricts herself on fats, saturated or otherwise. I haven’t the heart to tell her this is contributory to her condition.
The essence is, any sort of dietary consideration and self help, however effective, isn’t patentable so any research will not be undertaken.
Malcolm is an anomaly, sadly, He tends to question accepted wisdoms.
I was diagnosed with terminal cancer in 2007, reserved place in hospice and all, I’m still here!
The point is, of all the consultants on my case, 20+, I was only ever seen by one “doctor”, a person interested in me and my perspective, the rest were transmitters of their own importance.
I’m tending to think that doctoring is as much of an art as a qualification, you can guide an artist on technique but you can’t teach one.
Judging your comments, go paint a picture.
Having just re read your comment re nutritionalists, you don’t get to retain your position if you want to buck the consensus. they’re all on message. Low fat low sugar high fibre etc, if they don’t they’re out of a job. It isn’t wisdom it’s acceptance of someone elses. It’s like politics, it isn’t a question of mending prevailing situations, it becomes a desire to retain a place in the game.
We are being lied to, accross the board, once your perspective is recognised and becomes a threat you’re out of the game. It all works the same.
Flyinthesky
“The point is, of all the consultants on my case, 20+, I was only ever seen by one “doctor”, a person interested in me and my perspective, the rest were transmitters of their own importance.”
This is something that bothers me. Current medical diagnosis seems to be based on RISK to the HERD; as a vet this has been the direction of most of my research and work over nearly 60 years (2015 makes it 60). While this is obviously valid for some conditions that can be protected against with an EFFECTIVE vaccine, daily chemoprophylaxis with drugs that have serious adverse reactions is something else; particularly when the incidence of the disease is very small and that the efficacy of drug is very poor. In the HPS study some 83% died despite treatment and cholesterol lowering. One is tempted to call it snake oil!
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Mike, I don’t think it’s herd protection, I think a lot of it is percieved financial liability reduction for the government.
Statins are the prime example, let’s not get ahead of ourselves thinking the government cares about the people, they just care how much we cost.
The cost of statinising the population, many millions. The government have been persuaded that this money is well spent as it will lead to an overall reduction in their liability by preventing cardiac events. If one took the “published” data at face value it would appear to be a good call.
It has been a slick presentation by the pharma giants omitting the contrary data.
The problem we have with modern governments is most ministers are not up to their brief, they are selected, not for area expertise but potential party line compliance. This situation leaves them vulnerable as they have to consult, often vested interest, experts to formulate policy.
Flyinthesky While I agree with most of what you say, epidemiology and its techniques only deal with populations, NOT INDIVIDUALS. I use “herd” to draw attention to the fact that individuals are now being ignored with these algorithmic diagnostics procedures and “risk” estimates.
Finance is certainly involved – again using herd characteristics to imply that “savings will be made”. Example of course is heart attacks which kills a large percentage of sufferers – no treatment costs; or kept alive to die of cancer (substantial costs), COPD (substantial costs), Alzheimers (substantial costs) etc., but the costs of these are always left out. The efficacy rate in the HPS was about 17% (156 “saved”); 83% (781) died of CHD despite lowered cholesterol and statin treatment. A classical example of emphasizing the trivial at the expense of the truth.
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There’s my essence, right there “these algorithmic diagnostics procedures and “risk” estimates.”
I don’t want to be part of an algorithmic expression I want to be returned to my individual status, by doing so not only would we all be better off and less fearful, better quality of life etc, it would cost less by a large margin. Problem is that takes a lot of skins out of the game, so it’s not going to happen.
Wonderful for your friend, really! Crohn’s is such a difficult condition that it is great he has found relief without any meds. However, I have interacted with enough people to know that what works for one person when it comes to IBD may fail terribly in the next. Many I know, including myself, have tried the dietary route to no avail. I have an eating disorder that I’m trying to recover from as well, so major dietary modification is not a good plan for me. That goes back to each treatment being individual.
I see a few swear by diet and not be on any meds, I’ve seen people give many diets honest shots and the only thing that gives relief is meds, I’ve seen people enter remission through fecal transplants, and I’ve seen people get horribly ill after fecal transplants. It’s the nature of the beast, it seems incredibly individual for all of us that deal with it. I see stories like your friends often enough to know that they haven’t found the answer for all of us, but they definitely know what works for them. That is still a great feat.
The problem with the dietary route is it can be a very long game and it requires huge amounts of self discipline, a quality few have. Lets take a pill and carry on as we are.
You have to be mindful that some of the longest livers on the planet have a diet of whole grain rice and a few vegetables, my wife returns to this when in difficulty.
Eating, care of, again, vested interests, has now evolved into a leisure activity, far away from the design parameters. Food is fuel for the organism any pleasure derived is a bonus.
It’s good for the people who can tolerate vitually anything they eat. I have been out for meals with my wife where she has been reduced to tears, literally, because there is nothing on the menu she can tolerate. As well as having crohns for over 30 years she is hyper gluten intolerant.
Even a miniscule amount will trigger a flare up.
Getting control of it in a natural way is a very hard route, most opt for medication.
I have the greatest sympathy for your position, we’ve been there and done that.
Mark, what a wonderful story. Thank you for sharing it.
Celia
Try reading this FDA recommendation arrived today
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm423082.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
It is again the old story – nothing learnt – all contradictory data ignored at the behest of Big Grain.
The very organizations set up to protect the public are conniving at providing commercial advice that is contrary to public health just as Lustig claimed. Just yesterday in a diabetic journal there was a recipe containing two table spoons of sunflower oil in a recipe. This oil contains very little omega3 but a huge amount of omega6 , thus contributing to a bad omeg3/omega6 ratio. Some advice!
Thanks Mary!
Thanks also Richard – point noted. Sometimes my exuberance takes control but isn’t it amazing when dietary advice and specifically and essentially dietary advice which is really all about eating real food can now be construed to be “medical advice”! Take that pill to manage thy symptoms but woe betide the person who “dares” to eat real food to potentially cure themselves! No money for big pharma there or even worse, the Emperor may begin to look increasingly bare…!
Thank you Professor Göran Sjöberg for your recommendation – just bought Dr Natasha’s Gut and Psychology Syndrome (GAPS) book and also “Put Your Heart in Your Mouth”. Both look interesting! And looking forward to Dr K’s new book in the new year!
I would agree Kamran, that any form of IBD or for that matter, any autoimmune disease has trigger(s) which are likely specific to that individual, (even though there are probably a few common ones). I also suspect that my friend was in the “fortunate” position of being diagnosed with Crohn’s and then beginning his dietary modification within a matter of days. In other words, he didn’t have years or possibly a decade or two of damage to his gut to heal (apart from that time of damage prior to the official diagnosis). Also something to bear in mind is that I told him that he had to be absolutely scrupulous when it came to what passed between his lips. Not even the slightest, miniscule (not even a nanogram!) trace of gluten for example. Equally, not the slightest trace of sugar or vegetable oil or milk etc. The list was quite long! He had to be absolutely strict and scrupulously so. The slightest trace of any forbidden item could make the exercise futile and frustrating. I also had him supplement with, amongst other things, 5,000IUs of vitamin D a day, the deficiency of which seems implicated in a variety of autoimmune conditions. Plus, he was deficient, but then again just about everyone likely is for most of the year in the northern hemisphere…
Interestingly, my next step for him is to suggest faecal transplants. From what I’ve read there is lots of merit in the idea but the gut has to be ready and the donor suitable. Even though my friend’s been symptom free for well over a year, from what I’ve researched I doubt his gut will be fully healed for at least another year.
It’s a shame that serious money isn’t thrown at following what works for whom and when in this regard. It seems logical that the earlier the dietary / probiotic / faecel intervention the better. I truly hope that you manage to find a lasting, healing relief to your condition. Any form of serious IBD strikes me as being a very nasty and pernicious disease.
None of the above is intended to be medical (or dietary advice) but simply the story of one person managing to overcome the symptoms of Crohn’s disease and the abridged way he managed to do it.
I too have looked at this concept: “Interestingly, my next step for him is to suggest faecal transplants. From what I’ve read there is lots of merit in the idea but the gut has to be ready and the donor suitable.”
There is, to me, a connection between a lot of AI diseases and prior history of antibiotic use.
There again you can come up against the same wall. Any research in this area has with it the potential of litigation so would be avoided as much as possible. It would be a brave scientist that took this route.
I don’t know how specific advanced antibiotics are now but a lot of earlier ones were broad spectrum indiscriminate bacteria killers. The role of beneficial bacteria in our bodies , in my opinion, is not yet a complete and settled science.
If one were to take Helicabacter pylori as an example: it was only found to exist by a lab tech’ forgetting to remove a sample from the incubator. No one was looking for it, it just appeared. How many more are there? As a pointer we should look at nature, a bear awakening from hibernation, the first order of business, no pun intended, is to seek out some faecal matter to replenish and reinvigourate the intestinal flora.
Here we go again, back on the magic roundabout. Does any drug company want to find a cure for auto immune diseases when they are making fortunes out of controlling them. I think not.
Another potential area for investigation is sanitation, there is no doubt that improving standards of sanitation has contributed greatly to our life span expectations. Conversely, fear inspired, hyper sanitation, as promoted by various vested interests, anti bac sprays, washing up liquids et al are having the opposite to the inferred benefit. You can’t hide from all bacteria, the more successful you are at hiding from it the more it will batter you when it finds you and short of bubble dwelling it will. The immune system is like a muscle if you don’t use it you lose it.
A point to ponder. If the current Directives (aka Guidelines) were in place in the 1930s-40s whould the sulphonamides, penicillins and cortisone ever been identified? After all, these days docs are not allowed to use “alternative” remedies under pain of legal charges.
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I understand the alternative remedy issue but in years gone by people would sort a lot of health issues out with said themselves. Any sort of self intervention has now become frowned upon and actively discouraged.
We can’t have people treating themselves for depression with St Johns wort now can we when we have a patented and expensive formula to do the same thing.
We can’t have people taking to their beds with a whisky and hot lemon and honey when we can sell them night nurse.
You could fill pages with simmilar instances.
The entire problem with the NHS is it’s created a fear inspired need, to benefit various vested interests, that it can’t, and never will be able to, service. Often for dubious benefit.
Problem is the fear is out of the bag, you can’t put it back and too many factions want a slice of the action.
If it saves one life is the meme, the fact that it ruins a million others isn’t a considered issue.
Flyinthesky
I only wish that the medical establishment would open its eyes and look at the facts as you have so clearly expressed them. When I trained at the LSH&TM scientific integrity was paramount; now money and status are of prime importance. The case off Dr Poldermans in the Netherlands is an example of this change in emphasis.
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Depressing isn’t it. It doesn’t matter what opinions I hold, I, don’t have the relative qualifications for them to be considered.
I fell out with the medical profession circa 1980, sorry Malcolm no offence intended or inferred, I went to the GP and had to endure a five minute dressing down, what was my heinious crime, I had the temerity to tell him what was wrong with me.
When I phone the vet with a problem with my dog, it’s a cavalier king charles so it’s not infrequent, I get an appointment the same day and pay a modest amount for a resolution. What I don’t get from the vet is constant summoning from them to investigate what may be wrong with it. A good model for the NHS I would have thought.
Flyinthesky
For goodness sake keep having your opinions. Are they as wrong as some so-called experts? I suspect no.
As to vets. Well many people tell me that they get a good service which is nice. Unlike GPs though, they are actually are allowed to get on and practice their medicine and surgery for which they were trained. Personally, I pity the average GP who sits in an office all day having to see people who really do not require a doctor and acting as sorting house for those who do to see a specialist and a NHS form-filler. I would think a depressing experience. Dr James LeFanu has commented on professional dissatisfaction. May be the veterinary model would indeed be a step forward for the NHS.
Mike, I think I am possibly being hard on our GPs. The big problem today is that families are so remote from their immediate relations, that the Dr has to fill the gap….and his tools of trade are medicines. My belief is that Nursing ought to be seen as a separate discipline, whereby ‘care and support’ are the name of the game. But the public have lost confidence in Nurses too; they are seem as little more than subservient handmaidens. I see Practice Nurses who are no more than ticky-box fillers-in, wheres I was trained, and expected to be, the patients’ advocate, in other words, speak up on their behalf, when bamboozled by pompous docs. I am so sorry to put this in a blog by a very caring Dr K, and I hope he is not offended by this.
Leave medicine to the doctors, and put practical management back into the hands of the Nurses, where it belongs. Nurses are as capable as the next person to use equipment and new fangled whizzies…..but that is not their remit…….care and support should be lauded as their mantra in the absence of Mam and Granny.
Flyinthesky. I keep meaning to stop getting into discussion with all the marvelous responses I read on this blog, but I entirely agree with your comments. At the moment I am keeping abreast of the work by Dr Atul Gawande, in particular his Reith Lectures, the 1st of which was on BBC Radio 4 this morning. He is a good example of explaining the complexities of iatrogenesis in modern medicine, and well worth a listen to.
I do not wish to live in the past, but I have gone on and on for years about the way we are conditioned to believe that all that comes out of a factory must be better than any real food or treatments which our forefathers have used. I have had some wonderful pharmacy teachers….yes, Radiographers and Nurses were/are taught pharmacology…..who explained the futility of cough medicine, mouth washes, etc, and the sheer danger of some common meds such as paracetamol, aspirin etc, which actually offer no quick fix for common ailments. Indeed, honey is an excellent example for sore throats with lemon as a cleanser. OK, I know that anaestheitic medications have allowed life saving interventions to take place….but come on you docs…..admit that there are many situations whereby granny knows best. But society has become all too-dependent on the Welfare State….ooohh…and me a life long Socialist!
Mike, I have a mantra, one of many: beware expert opinion as the principal beneficiary is often the expert, it’s served me well but it’s a hard path to tread. On the vetinary situation, sorry again Malcolm, I find my vet talks to me, my doctor talks at me. Because there’s no money changing hands on the day it invokes an entirely different concept as to who is in control. Do they want to help or dictate. To help is to infer altruism to dictate is to confer power.
Jennifer, They don’t want us to have the complete picture, it’s disempowering, sorry again Malcolm. There are a lot of “health care professionals” who are as culpable as the big pharmas.
Going to medical school makes you qualified but not necessarily a doctor.
I too follow a lot of different perspctives but too much power has been granted, too many pockets have been filled neither of which will readily be relinquished. I’m not optimisic of any change within my lifespan.
I’m sorry, all round, if it comes off as cynical, that’s me. It’s a far easier route that most people take, the experts know best, believe and accept everything. I can’t.
Flyinthesky
My sentiments exactly. I personally find that working medics (GPs, consultants, nurses et al) are genuinely concerned and helpful. My gripe is the medical establishment that is attempting to dominate and dictate to both the profession itself and the general public to elevate their own sense of importance and status to say nothing about the MONEY.
It docs like Drs Kendrick, Briffa, Ravnskov, Graveline and others who, through their books, writings, etc., uphold the Hippocratic principle of “First do no Harm”, are the redeeming feature of true medicine.
Here here Fly. Right you are. Everywhere you go, there are hand sanitizers. My goodness, it is no wonder our children and older adults get every bug that comes along. They are constantly trying to get me to take a yearly flu shot. I refuse. I have not had the flu in 24 years. No thanks. Unless I get some strange strain I cannot fight myself, then…maybe. I do all the normal things. I wash after toileting and before I touch food in the kitchen, take a bath daily…the usual. However, we are germaphobes these days and our children catch everything that comes around. It has not done a whole lot of good or maybe too much of a good thing. And Jennifer, I so agree with you about nursing and doctors. They do the work of our families now days. I never considered that fact but it is true. They are failing, then.
It is late now. Today is Thanksgiving day in America. The greatest thing our friends across the pond gave us is, in fact, America. With all its flaws, I still consider ourselves to be a most blessed country. I am sure you all do as well. Today our family stood around our dinner table, held hands and gave thanks for the many blessings we have; among them, the most precious of which is…Freedom. I count Love way up there, too. How long it will last is anyone’s guess (the freedom part). But, like Western medicine, I feel it is the best we have and I still kiss the ground I walk on today.
God Bless America. Hope you don’t mind my being a little off topic.
Thanks for letting me blog here. I appreciate Dr. Kendrick and all of you, too.
Mary, this is my 2nd attempt today to reply to you.
This morning I was in a rant regarding the flu jab, and in my temper….my i-pad decided I ought to wait until I calmed down….and froze dead!
What got me into a rage, was that I heard a report on BBC saying that toddlers between 2 and 4 years must have the flu jab. ( I wish my GP would get the message…NO, I will not be having the jab….ever) Reasons given for youngsters needing immunity? Well…..they are “super-spreaders” of the virus, because they are “touch feely”..(yes, we still manage to cuddle the poppits, for the time being!)…..and they cover us with “snot” …. ( a good BBC word, to be encouraged in polite company!).
Oh I do feel enraged.
So, little Freddie’s mammy decides she doesn’t want him herded….(the term used for mass vaccination, I believe), so will he be prevented from entering nursery school?
And if mammy abstains from putting refined carbs in his lunch box, (should it be deemed safe for him to mix with other kids), will she be fined by the authorites to pay for the toxic crackers they insist he eats, as part of a ‘balanced diet’?
I can tell you, it is 30 years ago since I complained to the Head that my teenage children were witnessing their peers eating 5/6 doughnuts chosen from the self-serve counter at lunch time. The head said I was being alarmist…..what did I know about “proper food”?
I needed to replace the loo seat last month……I was offered anti-bacterial plastics.
I went shopping with a colleague, ….every where we went, she smeared her hands with antiseptic gel….(how has she made it to 65, I ponder?)
I saw a lovely bag of apples……reduced to coppers, because they were on their final day for eating! Must let the pigs know not to indulge in them there orchards.
And as for “antiseptic feminine hygiene products”…. Well, I reckon I must be a miracle walking, having never indulged…..or is that too much information for a public blog? Yes, I have finally confessed to my husband of 47 years, that I have probably put him at risk of catching something nasty from me, having relied on good old soap and water for my intimate ablutions.
It is just getting sillier and sillier, isn’t it. The world is turning upside down.
Off now to disinfect the non-disposable crockery and cutlery for our next meal…prepared on my anti-microbial chopping board,…. wearing my blue rubber gloves to serve the food..and with my hair tucked safely under my surgical cap…..I think not!
You have to recognise it as what it is, every edict is a potential earner……. for someone.
Fear inspired everything.
It’s all a bit catch 22, you have the right not to accept these doctrines, for now. However if you choose to reject, your child will be excluded from school, second tier, you will be prosecuted for not sending your child to school, it may be protracted but you will comply, we know best.
Your child is your own, until you disagree with the state, then it’s illustrated who is really in control.
Democracy, self determination, only in your wildest dreams.
Indeed
Are you sure you are a nurse? I am so proud of how open minded you are!! One thing I know for certain, is that if I were ever able to work again, I would get fired immediately for telling my patients to spit out the pills I was giving them…
Jennifer
Over the past 50 years I probably have had ~40 vaccinations. The outfit I worked for thought they would reduce days work lost to flu. They didn’t! In my own case, 4-6 months after vaccination I got a “virus” infection 2-3 times every year. I have a paper direct from DoH that showed on average 40-60% (lower confidence interval 7-10%) of patients would benefit.
I and my wife (both octogenarians) have not had a “virus” infection in the last 5 years which I attribute to high Vit D (5,000 IU/day) and high Vit C (+ 1.5g/day). No proof indeed but even the UK CMO has drawn attention to Vit D deficiency/insufficiency in the elderly but the “conflicted” medical establishment considers vitamins as “snakeoil”; better to take their promoted products.
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Thanks for sharing, Mark! I have a feeling that if fecal transplants can be turned into an exact science for IBD, they can be potentially curative. Some people get lucky and are absolutely symptom free. Others can have very bad reactions. This only seems to apply to IBD, however. It seems universally safe for most other conditions provided the donor is parasite-free.
But thanks for the well wishes, and I hope your friend keeps on improving!
Kamran – FYI – the current issue of The New Yorker has a well-written piece on fecal transplants that you might enjoy reading. Apparently quite a few physicians in the U.S. are signing up to get permission from the medical establishment to oversee the process. (I continually am amazed at how restricted physicians are in practicing medicine.) Meanwhile many people are self-medicating by using youtube instructions. I don’t think knowledge of this procedure can be contained by the establishment now that people realize they can do it themselves, provided a friend or family member is willing to provide the “means.”
I think the tide is turning. I have seen recently where many of your GP’s in the UK are refusing to follow the NICE guidelines. Now, there is a reason for this. I believe you will see a lot of such people turning away from statins as the evidence mounts. In the USA, they are the number one prescriptions written in America today in terms of cost. Interesting. Our new electorate will possibly be more open to hearing the devastating effects of these poisons. I think more people will prevail upon the oversight committees for Food and Drug Safety to stop the insanity. This is our government and we have a right to visit those committee members and urge them to take note of this insanity.
*Throwing cash at the screen for the book and screaming, “Take my money!” The stress of anticipation is probably going to give me a heart attack.
Death by Prescription – Terence H. Young
I totally agree with this statement (November 26th):
“It docs like Drs Kendrick, Briffa, Ravnskov, Graveline and others who, through their books, writings, etc., uphold the Hippocratic principle of “First do no Harm”, are the redeeming feature of true medicine.”
During the last eleven years (since my father was drugged and my mother “statinated”) I have read a lot of books and patient stories. I have googled certain expressions and found one interesting book after the other.
Now, I am reading “Death by Prescription” which I would like to recommend.
It´s written by a Canadian, Terence H. Young. His 15 year old daugther Vanessa felt bloated and was put on Prepulsid (=ciscapride?) Vanessa died suddenly from heart stop This happened in the year 2000.
It`s a compelling, well written story. It`s about Vanessa, about research, the intricate relationships between the pharmaceutical industries and the regulatory bodies of government, the medical profession and the tragic concequences for the public.
What Terence H. Young describes goes on in many countries and I am sure it`s the same story in America and. many EU-nations.
P.S. Google his name for more information.
I discovered the book while looking at a videoclip on u-tube.
Marie
Thank you for the lead to another book on Death by Medicine. All these authors cannot be wrong
but the following article is truly frightening:
http://news.yahoo.com/elderly-cholesterol-lowering-statins-us-study-143822771.html;_ylt=AwrBEiFWV3dUbCoALxPQtDMD
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The bright side of that report is that the bolder and greedier big pharma becomes, the closer comes the day of reckoning. Younger, healthier populations are less likely to take the poisonous effects of statins as just part of growing older. Wait till they zap a powerful politician with the stuff!
Thanks Mike,
Swedish guidelines
Läkemedelsverket included new guidelines for prevention of heart disease with drugs in “Information från Läkemedelsverket” (No 5/2014).
Läkemedelsverket = the Swedish version of FDA.
Below, I have made a free interpretation of a very small part of the text.
According to this information, Sweden has decided not to have national screening, but LMV suggests something called “opportunistic screening”
According to the text, most middle aged people pay a visit to their doctor once every two years and the doctor can, then, take the “opportunity” to check blood pressure, cholesterol, blood sugar, BMI etc. and inform. . .
They also write that it`s important that the patient is aware of the benefits of continued lipid lowering treatment, the treatment targets to be achieved, which adverse effects that are common and important to notice, how often blood tests should be done and where to turn with questions.
Then they add – it`s important that the patient is fully aware of this and is motivated to continue the treatment as many patients stop their treatment within one to two years for unknown reasons.
How come – no-one seems interested in those “unknown reasons” ?
My guess is that many patients stop because of adverse effects.
P.S.
In Sweden, the package inserts for Zocor/simvastatin (all brands) only list the following frequences of adverse effects: rare, very rare and unknown frequency
When it comes to Lipitor/atorvastatin it`s different – the whole range (common, less common etc….).
How is it in other countries?
Thanks for the Swedish info
take the “opportunity” to check blood pressure, cholesterol, blood sugar, BMI etc.
For travel insurance there is a question on “cholesterol” If you have had it measured and it > circa 4.5 mmol/L, you will often be lumbered with an increased charge. Best not have it done!
many patients stop their treatment within one to two years for unknown reasons.
And the “reason” is never investigated! Why? Because they do not want to know! Their guess would be adverse reactions and that information is a NO-NO
David, my fear is that they already have zapped powerful politicians with the stuff. God help us!
Judy, I agree. As I see it, many of them are zapped. It appears as though the Congressional aids, staff, and interns are running the country. Nothing gets done!! God help us all is right!!
Surely there has to be someone on the hill with some sense!! We shall see! It is scary. To my way of thinking, Republican or Democrat, no matter what they tell the public, it is all about power and money. Even those who do try to do the right thing, are fighting an uphill battle. I have seen more and more on paid TV that our food supply is poisoned. So, whatever dose of that poison you get, you will easily find it at your neighborhood pharmacy and/or grocery chain.
Chris/(Andrew), indeed I am a Nurse, and a Radiographer. I learned my professionalism as a youngster, and it has got me into bother some times, especially with dinosaur Consultants!
Indeed, with the knowledge I have gained in recent years, it would be impossible to tow the line…..so thank goodness for my £79 per month NHS pension…..yes….£79 per month, after practicing up to ‘G’ level!
David and friends,
I have located the appropriate Drug safety committees in both the House and Senate in the U.S. Congress. Trying to anything now would be of no use since there will be many new Congressmen who take office after the first of the year. After our run-off elections, I and a group of our like mind statin damaged friends intend to make some noise. I am not going to be satisfied with writing letters that won’t get answered. Instead…I am going to pick a fight! It is time someone stood up for doing the right thing. And…if I suffer for it, I would rather suffer for doing right rather than wrong.
Good on you! I have had a go at UK organizations such as NICE, MHRA, my MP, Dept of Health and others without much success. All these are very quick to promote a treatment using committees with a large proportion of seriously conflicted “experts” (ie Big Pharma KOLs) but v..e..r..y, v..e..r..y s..l..o..w to investigate the risks consequent on that treatment.
Jennifer
Thanks for your most interesting post. I had to chuckle. Some things are so ridiculous, you have to laugh to keep from crying. As a young woman on the verge of marriage, I was given birth control pills. I was so deathly ill that I had to stop them. Then the doctor gave me an IUD, stating you won’t even know it is there. Well…I knew it alright. I think the thing bit my husband, but that is a story I dare not share here. I had it removed pretty quickly. Suffice it to say that it is not nice to fool mother nature. Many of my contemporaries who were on “the pill” had terrible problems getting and staying pregnant. I always thought it had to have something to do with all these fake hormones. I think I am right. Sometimes we have to listen to our intuition when all else fails. At times when that little voice sounded loud and I did not listen, I got myself in trouble. And so it goes also with the soap and water debate. Your body has its own cleansing system and there is no need to spend money on something that will wash away the good bacteria.
And I think I have said before that my youngest was absolutely addicted to McDonalds hamburgers and fries. He would not touch any vegetables or fruits. His weight began to soar. It seemed every summer it got worse. His father was the “enabler” allowing him pizza, pasta and burgers since that is all he would eat. I began to feverishly research our options. I signed him up for a health camp in Florida when he was 13. It was like summer camp for overweight kids. I could see the handwriting on the wall. Although he was not terribly over weight, he was heading in that direction quickly. This child needed nutrition boot camp or rehab, if you will. He would be away from home for quite some time, but I was desperate to see him succeed. When he completed that session, I could not wait to pick him up at the airport!! When he came down the runway, he looked like a million dollars and was as handsome a boy as I had ever seen. He lost 30lbs, learned to love salads, fruits and vegetables and learned to cook. He also was instructed on exercise and its importance. To this day, he keeps his weight down by exercise and watching what he eats. Had I not intervened, his life might have been very different. It was one of the best decisions and the most difficult I had made up to that point. A.C. graduates next semester from college and has a great deal of confidence. I see very good things for his future. There is a growing trend in the U.S. where our very young are obese. The foods available at most schools fall very short of the mark. Many have advocated putting these youngsters on statins. That is utterly ridiculous. It is up to the parents to do whatever they need to in order to get between their child and drugs, food, or anything else that takes over his or her life. Statinating the young is foolhardy to say the least! But, if we as parents do not do what we know is right by our kids, they will end up as unhealthy a lot as those of us who are over prescribed and expect a pill to solve our health issues. It is more than just a statin issue these days. Health and good health have to be learned at home. And both parents have to be a united front in that effort.
Interesting that this has come up again. Medical research on drugs should be thoroughly and HONESTLY reviewed.
Dr Marcia Angell in her book “The Truth about Drug Companies……….) and more recently, Dr Goldacre in his book “Bad Pharma……”. Concepts such as “The New Genetics” and “The Social Theory” have been well reviewed by Dr. Lefanu in his book “The Rise and Fall of Modern Medicine”. Regarding “The Social Theory” I am, having been trained for research in epidemiology of parsitology at the LSH&TM, amazed at its misuse, even abuse, in attributing causation to factors without further evidence; something that the late Prof. Bradford-Hill specifically warned against. But back in those days (late 50s) scientific integrity was paramount. The degradation started when the “a-ethical money men” took over the pharmaceutical companies with the sole purpose of making money – truth went out by the door and spin came in.
To add to this, there is the work of Prof. R.L. Smith, who in books (Diet, blood cholesterol and coronary heart disease: a critical review of the literature. Vector Enterprises Inc., Vol 1, 1989; Vol 2, 1991. The Cholesterol Conspiracy: Warren H. Green Inc, St Louis 1991 and American Clinical Laboratory, Nov. 1989 pp.26-33) was highly critical of the work on cholesterol, to quote “It is virtually impossible not to recognize that many researchers routinely manipulate and/or interpret their data to fit preconceived hypotheses, rather than manipulate hypotheses to fit their data. Much of the literature, therefore, is nothing less than an affront to the discipline of science”.
Dr John Ioannidis has, some years later confirmed this view with his finding that many medical research reports are flawed through study design, selection of data, misuse or misinterpretation of statistics, or bias (JAMA. 2005;294:218-228; PLoS Med 2(8): e 124; Arch Gen Psychiatry. 2011 Apr 4.; J Clin Epidemiol. 2011 Mar 29). Prof. P. Gotzsche’s book “Deadly Medicine and Organised Crime….” also itemizes the problems. These examples are a serious indictment which is confirmed by some of the massive fines imposed by the FDA on Big Pharma companies BUT THE FINES WERE NOT CONSIDERED TO BE CONVICTIONS. HAD THEY BEEN THE COMPANIES CONCERNED WOULD NOT, BY US LAW, BE ALLOWED TO SELL TO MEDICARE AND MEDICAID and that could not be allowed to happen; in short Big Pharma is above the law.