Lowering cholesterol – an urgent Christmas appeal

A reader of this blog sent me this e-mail message that she had just received:

This is a special Cholesterol e-News Bulletin asking for your help to draw your urgent attention to a recent decision by NICE that is of great concern to us.

There has been significant progress in the management and treatment of cardiovascular disease (CVD) over the past two decades, which has resulted in an overall decline in CVD deaths in the UK. Heart disease still remains one of the UK’s biggest killers. Over half of all UK adults have raised cholesterol increasing their risk of cardiovascular disease; leading to heart attacks and strokes. Not only does it have a devastating impact on patients and their families, but it also places significant burden on our health service and wider economy.

Innovative new medicines, such as PCSK9 inhibitors, are an exciting development in the treatment of cholesterol, with little known side effects and very good scientific evidence that they work to significantly reduce the levels of bad cholesterol in those at high risk of CVD.

NICE reviewed the first of these PCSK9 medicines and recommended that it should not be available for NHS patients.

HEART UK is concerned by NICE’s recent decision to turn down the use of the first of the PCSK9 medicines. This means patients will not have access to the best possible treatment options to help lower the levels of bad cholesterol, particularly those at high risk such as people with an inherited high cholesterol condition called Familial Hypercholesterolaemia.

NICE are conducting a second round of consultation, closing on Tuesday 8th December, before issuing final guidance. On behalf of the patients in England adversely affected by this decision, please join HEART UK’s efforts to reverse this decision and allow PCSK9 inhibitors to be more freely available for NHS patients.”

NICE = The National institute for Care and Health Excellence. Let us not dwell for too long upon that self-aggrandizing title. NICE was set up in the UK, initially to look at whether or not various healthcare interventions represented good value for money, or poor value for money.

For reasons beyond the understanding of man, they plucked a figure from the sky one day (well not a figure, a range) from £20 – £30K ($33 – $48K) per year. If the intervention cost more than £20 – £30K/year to provide one added year of full quality life, then they turned it down. [One year of full quality life = 1 QALY (quality adjusted life year)]. And breathe.

Of course, NICE make all sorts of exceptions (all cancer drugs get funded no matter how much they cost, or how useless they are – go figure) and the way NICE words out how much interventions actually cost/ per QALY is complete nonsense in many cases. Be that as it may, they do make an effort to say ‘How much!’ ‘You must be joking,’ Reject…bong!

If NICE do say, reject, bong! This basically means that the drug will not be prescribed to anyone in the UK. In addition, such is the influence of NICE that many other countries use their decisions as an important guide for what they will do with regard to funding. So if NICE turn a drug down, this is very bad news from the manufactures or said drugs.

Now, when it comes to the new cholesterol lowering agents (PSCK-9 inhibitors) the manufacturers have a problem. Which is that they cost around £4 – £8K ($6.4 – $12.8) per year, per patient. Now, at those sort of costs, you are going to have to have some seriously impressive benefits. At present, however, the manufacturers have no data on mortality, or morbidity. Which makes the current cost per QALY = infinity. Just slightly above the NICE thresholds.

For those who read my blog you will know that I wrote the following in ‘Changing the definition of Familial Hypercholesterolaemia.’

At present I would think that the response of NICE (to PCSK-9 inhibitors) would be ‘Are you out of your tiny little minds. Why the [[…] insert swear work of choice here], would we fund this?’ At least I would certainly hope this would be their response. Imagine if everyone on statins in the UK, around seven million, changed to PCSK9 inhibitors This would cost £56 billion pounds [$80Bn] a year. A tidy little sum. Half of the entire NHS budget.

As it turns out NICE did turn down the first PCSK9-inhbitor, no surprise there. And this is where HEART UK comes in….

Before going any further I should state that there are, currently, two PCSK9-Inhibtors launched/launching. They are Repatha ‘evolocumab’ made by Amgen. And Praluent ‘alirocumab’ to be co-marketed by Sanofi and Regeneron. They are, to all intents and purposes, identical drugs doing identical things. Remember the names Amgen and Sanofi. Amgen and Sanofi….

Now HEART UK states that it is a charity. HEART UK – The Cholesterol Charity – campaigns to increase general public and policy makers’ awareness of raised cholesterol as a major public health concern. We campaign to keep action on cholesterol at the forefront of the health debate.’ 1

Where do HEART UK get their funding from. Difficult to tell precisely. They claim to get money from public donation… how much? It’s a secret. What I do know is that they receive a very large amount of funding from companies that have cholesterol lowering products. So, for example Nestle, who make Shredded Wheat, pay HEART UK money, and HEART UK says stuff like

‘HEART UK dietician Linda Main said: “Shredded Wheat and Shredded Wheat Bitesize are low in saturated fat and can play an important role in a heart healthy diet and HEART UK is delighted that these products are supporting National Cholesterol Month and the Great Cholesterol Challenge.’2


Of course, when it comes to cholesterol lowering PCSK9-Inhibitors are the big daddies, with the big, big, budgets. So, you would expect that Amgen and Sanofi would be very, very, close to HEART UK. Well, if you expected that, you would be right. If you want to visit the HEART UK website, and look at the sponsors of their conference we have3:

Sanofi:                     Exclusive conference sponsor

Amgen:                   Sponsored symposia 1

Sanofi:                    Sponsored symposia 2

Amgen:                   Privileged sponsor…etc.

And now, to bring the two strands of this little tale together. NICE have just turned down the first PCSK9-inhbitor and so we have HEART UK reaching out to everyone that they know, or have contact with, to plead with them to sign a petition ‘On behalf of the patients in England adversely affected by this decision, please join HEART UK’s efforts to reverse this decision and allow PCSK9 inhibitors to be more freely available for NHS patients.’ Sob. But what about Tiny Tim?

Some people, were they to be truly cynical, would allege that HEART UK may not be trying to get NICE to reverse their decision on PCSK9 – inhibitors, for the great good of humankind. But because they are being paid large sums of money by the manufacturers of PCSK9-inhbitors. Shame on anyone for thinking such a thing. With Christmas coming this should be a time of peace and happiness. Such cynicism has no place in my thoughts. No sirree.

[And for my Christmas quiz the reader with the best answer to the following question will have it published on my blog. ‘What is a health charity, and should they be allowed to accept sponsorship from pharmaceutical companies?’]

1: http://heartuk.org.uk/policy-and-public-affairs

2: http://heartuk.org.uk/latest-news/article/press-release-shredded-wheat-to-support-heart-uks-national-cholesterol-mont

3: http://heartuk.org.uk/news-and-events/meetings-conferences/heart_uk_annual_conference/sponsors

143 thoughts on “Lowering cholesterol – an urgent Christmas appeal

  1. Tom Welsh

    I suppose the £20K-30K represents the approximate range of pay for an individual in the UK, and there may be some vague belief that the average expenditure per person should be close to their contribution to GDP. Or some such.

  2. thefatemperor

    Health Charity: “…an incorporated structure mandated to funnel funding from multiple corporate sponsors into promotional campaigns, with the implicit understanding that the sponsors will in turn be it’s primary beneficiaries.” Should they be allowed to accept sponsorship? Of course – this is clearly requisite to fulfill their mandate.

  3. Gerry Gabel

    Good article on the drug companies behind the organizations promotong health and well being. “Follow the money” is always informative. But what is your position on the new PCSK9-inhbitors for those with Familial Hypercholesterolaemia? I have a low LDL and high HDL (thanks to niacin in my opinion) but my Lp(a) is still very high. I have been diagnosed with CAD but have had no stents or bypasses.

  4. Gerry Gabel

    Update to my previous comment: I found your article on familial-hypercholesterolaemia and PCSK-9 inhibitors so I think I have my answer – too early to tell if this drug has positive outcomes. Thanks for your helpful contrarian articles that refute the drug company claims and those of the organizations they fund.

  5. Trish

    Mmmmmm…….. Why am I ‘NOT’ surprised!

    What ‘DOES’ surprise me is that when you mention the info & evidence about statins to statin takers in your family & friends they, plus their nearest & dearest vehemently defend the need to take them & that anything contrary is *bollocks* (anatomical term, so safe to say I think?). This blind opposition has shocked me… Intelligent people with total blindness to investigate for themselves & make their own choices.
    My husband says I’m a conspiracy theorist, I hold my arms to the sky & say “Thank God!” 😊

    1. John U

      Yes I have the same experience and I have tried to find an answer to the same question – why don’t they just start investigating for themselves?. I suspect that a lot of people do not have enough education in the sciences to feel confident about their decisions to take or not take medications. Therefore their default position is to follow their MD’s advice. Even though I am well educated in science, until about 3 years ago I was still believing all that was written in the media about nutrition. Even when my son was providing me some contrarian information he obtained, I tended to discount it as not probable. How could all these medical professionals be wrong?. It was not until reading the Gary Taubes’ book did I start to question and research for myself. So it is not surprising that most lay people do not understant enough to disregard their MD’s advice and judge for themselves. I think the establishment counts on this weakness. Shame on them.

      1. Graham Jones

        People would be crazy to think their doctor’s advice is always to be questioned especially when backed up by every TV documentary “expert” and Daily Express Headline!

        Those who write books and propose a different view are perceived as con-men in it for the money

        Its only when you really study the evidence in detail you can form your own view but most people are not so enquiring

    2. bevlockwoodBev

      I too am a conspiracy theorist – according to my family! The way people blindly take whatever they are prescribed without doing even the basic investigation, both frightens me and makes me angry.

  6. ellifeld

    ‘What is a health charity, and should they be allowed to accept sponsorship from pharmaceutical companies?’ The definition of a health charity is a charity that receives funds strictly from pharmacetical companies. In fact no other funding will be accepted. If an individual does want to contribute they must do so through their favorite pharmaceutical company. All funds raised in these charities MUST be used to market pharmaceuticals, with the exception of the salaries of the employees of such charities which should be limited to no more than 75% of the funds the charities receive.

  7. celia

    Surely a charity by definition should not have business interests. Wouldn’t that make it a business? By my definition Heart UK are not a charity, they are a business. Who are they working for? The public or their sponsors? The answer must be – their sponsors; therefore they are not a charity. They were also highly misleading in their suggestion that PCSK9 inhibitors have little known side effects and that there is scientific evidence of their benefits. Well, I guess they do lower cholesterol and nobody yet knows the potential side effects. I hope the government are not fooled by this shameful marketing ploy, although I fear many of the public will be.

    1. Stephen T

      I think the side effects might well be the same as statins, but happen a lot quicker. That might help to expose them. When people can’t walk or remember what day it is, the media will see a story.

    2. SJ

      I sincerely hope your comment was in jest, otherwise it’s extremely myopic; you’re reading a blog written by the UK’s foremost and most vocal critic of the diet-heart hypothesis. Lowering cholesterol is a VERY BAD THING (even in cases of familial hypercholesterolaemia, which I’m sceptical is a thing that exists, given that Homo sapiens is an omnivorous carnivore, and has always had a cholesterol-producing liver. If FHCA DOES exist, what caused the mutation…? Humans have always had cholesterol, but they’ve not always had FHCA, so what happened…? Anything that is designed to reduce cholesterol is, directly or indirectly, fuggering about with the liver’s own production and regulation, and the end result is going to be a completely fuggered liver, and you’ll end up literally dropping dead like my dad’s best mate).

      As for medical ‘charitable’ organisations, I have a very simple rule: I don’t trust those with names in the format UK. Those beginning with ‘British’ are something of a grey area, but I’m inclined to lump ’em all together, makes things easier all round.

  8. thelastfurlong

    Reblogged this on The Last Furlong and commented:
    A Health Charity is a new kind of parasitic industry that has sprung up in my lifetime (I’m seventy +). It feeds off the Governments it infects and can be found worldwide because it is so profitable. It sustains itself by promoting fear, whether the fear is justified or not. The directors and workers get well-paid by siphoning off (via Government subsidies), our taxes. However, because many Health Charities are “fronts” peddling products, and their directors are also directors, or board members of the Corporations whose wares they promote, any logical person, would be suspicious of their pronouncements, their “scientific” promulgations, their “sponsors” and their motives. It’s REALLY rarely about health. It’s about profit. Pity the workers in Health Charities who truly believe in their nobility. Pity the public, who are taken in by it all. And shame on Governments that allow them such power.
    And thank you Dr Kendrick for another excellent post!

    1. Frederica Huxley

      Which is why I refuse to give anything to any of the big ‘health’ charities, and I also will not be blackmailed into contributing to events, such as fun runs. Out of curiosity, I have delved deep into the websites of a number of the big charities, and have been appalled by the meagre amount of donor’s money that actually assists patients, not to mention the fact that most of the charities are blatantly marketing their pharma donor’s wares.

    2. Anonymous

      Malcolm, this one gets my vote. I once worked for a charity for 10 years. I went in with noble objectives, came out with a very different perspective.

  9. Adriaan Keij

    Malcolm, are you related to Jane Kendrick, Executive PA/Office Manager to CEO at Heart UK? Hope not, would be bad for family relations…

  10. Anne

    I too received that email from HEART UK asking me to click a link in support of their submission to NICE. I not only did not click their link but I wrote an email to Heart UK as follows (quoting some of what you had written in your previous blog Dr Kendrick – hope that was in order):


    “I am concerned that you did not have an option in your email for people to click that they do NOT support your campaign to get NICE to give PCSK9 inhibitors on the NHS.

    “My reasons for not wanting PCSK9 inhibitors on the NHS are as follows:

    “Whilst PCSK9 inhibitors will lower LDL, there is no data on their effect on cardiovascular mortality, or any other form of mortality.

    “I understand that PCSK9 is an enzyme that degrades/destroys LDL receptors so cells cannot absorb so much LDL. Without PCSK9, beta-cells in the pancreas will absorb too much LDL. In tests these LDL ‘overfilled’ beta cells were found to be malformed, dying and inflamed. Mice without PCSK9 which had these ‘overfilled’ beta-cells were also glucose intolerant, did not produce enough insulin and were hyperglycaemic, so they were diabetic.

    “There appear to be a lot of risks with the PCSK9 inhibitors and not enough testing on them yet to really assess whether they are helpful in lowering cardiovascular mortality.

    with regards,”

    I have not received a reply from Heart UK,

    1. mikecawdery

      A very appropriate answer but in the same way official institutions and Big Pharma (BP) and Big Business (BB) never answer awkward questions so Big Charities, dependent on BP and BB will never answer questions. Read Risen, James Pay Any Price: Greed, Power, and Endless War for a general picture

  11. Ian Munro

    well don I was only on statins for four years and had terrible and numerous side effects and am running a local campaign encouraging friends aND RELATIVEs TO STOP THEIR USE .i TOLD ONE CONSULTANT AND SUBSEQUENTLY MY GP THAT WOULD NOT TAKE ANY MORE AND THEY BOTH PROMPTLY IGNORED MY DECISION and issued prescriptions for the drug without further discussion with me. Even in a recent ten day hos[ital stay caused by damage done to my heart by statins a junior doctor tried to encourage me to take them again. I informed him to read my records and if he persisted in this way I would sue the hospital and advised him to read the recently update NHS report on the side effect of simvastatin. My previous GP denied that there were any problems with the drug and was unaware of the report and tts instructions of what action or routine checks to take if you had leg muscle cramps etc. The reply was sorry cant do anything about it. Arrant nonsense ignorance bigoted attitude. The NHS policy of NO BLAME MUST BE URGENTLY REVIEWED AND THIS STUPIDITY WOULD SOON STOP. IF EVERYONE READ THE PATIENTS CHARTER AND STOPPED the doctors in their ill informed tracks and started suing for damages ..

    1. Lucy

      I went in to see my doctor because I had a raging ear infection. I tried not to go I really tried. The minute I walked in she started nagging me about statins. I got really sick on statins(muscle problems) and my brother has permanent liver damage. Then she nagged me that I need a mammogram and a colonscopy I finally told her I am not coming for routine mammograms and colonoscopy. If you read the data, mammogram doesn’t extend your life at all, but it does cause a lot of false positives and over treatment. My friend has had 4 biopsies in the past 4 years. I am still being relentlessly spammed with letters and robocalls to come in for all this stuff. It’s all very depressing Anyway, sorry this is happening to you. I thought the U.S. was the only country doing this.

      1. Susan

        I’m with you, Lucy. I have given up on mammograms and am steadfastly refusing the colonoscopy that is routinely offered, if not urged. I figure why go looking for trouble. I’ve been down the false positive mammogram road and don’t plan to go there again. And as for the colonoscopy, I’m pretty sure that at my age (65), they’d be sure to find at least one “abnormality” that would put me on the merry–go-round of a colonoscopy every 3 to 5 years. No thanks.

        Have you seen the latest study that concluded having a false positive mammogram finding should be considered a risk factor for developing breast cancer down the road? News reports made it sound like an important risk factor, but the researchers admitted it was a relatively modest one, like an extra 1 of every 100 women who had a false positive mammogram went on to develop breast cancer. Wonder if they factored in the extra radiation involved in all the follow up mammograms?

  12. Stephen Rhodes

    an organization set up to provide help and raise money for those in need.
    “the charity provides practical help for homeless people”
    synonyms: non-profit-making organization, non-profit organization, not-for-profit organization, voluntary organization, charitable institution; More
    the body of organizations viewed collectively as the object of fundraising or of donations.
    “the proceeds of the sale will go to charity”
    the voluntary giving of help, typically in the form of money, to those in need.
    “the care of the poor must not be left to private charity”
    synonyms: financial assistance, aid, welfare, relief, financial relief, funding;

    I fail to see the connection between ‘those in need’ and large pharmaceutical companies.

    Presumably they would claim that they are providing help and support to those in need of ‘health’, in which case they have to justify the efficacy of their remedies and nostrums. Without this they are just another member of the tinfoil hat brigade that seeks to push their faulty-science based ideas on the public at the expense of the public purse (tax reclaimed on charitable receipts).

    Maybe a referral to the Charities Commission is in order?

  13. Ash Simmonds

    “Charity bestowed upon those who are worthy of it is like good seed sown on a good soil that yields an abundance of fruits. But alms given to those who are yet under the tyrannical yoke of the passions are like seed deposited in a bad soil. The passions of the receiver of the alms choke, as it were, the growth of merits.” ~ The Gospel Of Buddha

    But really, Charity is the name of my favourite stripper – for all the good it does throwing money at her.

  14. mo79uk

    Just as there are opposing groups that get funding from interested parties re climate change, it would be fair if a competitor to Heart UK was allowed to exist and accept money from, say, the meat industry. And then people can look at both and use their grey matter than be herded in one direction.

  15. Lorna

    Shakespeare has an image that might be applied here: ‘look like the flower, but be the serpent under it’. An aspiration to be a convincing hypocrite seems more relevant than ever to the definition of ‘health charity’ in the case of ‘Heart UK’.

  16. tabitca cope

    A charity is an organization set up to provide help and raise money for those in need.If we then use the general definition of health as the state of being free from illness or injury then a health charity should be promoting that aim and raising funds for that aim.

    The Charities Act says that a ‘charity’ is an institution which is established for charitable purposes only . It cannot have some purposes that are charitable and some that are not and must be for the public benefit.The Legal requirement for this to satisfy the ‘benefit aspect’ of public benefit,a purpose must be beneficial ,any detriment or harm that results from the purpose must not outweigh the benefit
    A charity must not have a political purpose such as securing or opposing a change in the policy or decisions of central government or local authorities or other public bodies, whether in the UK or overseas .
    I would argue that if this charity is trying to change NICE’s decision on a new drug it is breaking the political purpose rule. Therefore it cannot be a charity.It also breaks the rule on having some purposes that are charitable and some that are not because it is promoting a drug manufactured by it’s sponsors so it is not purely beneficial in purpose.
    Which is why sponsorship should be transparent and should not be allowed to dictate what a charity does or impinge on it’s purpose.Any sponsorship should be given freely and be stipulated that it cannot be used to benefit the sponsors. I presume charities can be investigated by the commission if they fail to fulfill the criteria set down.

  17. Gary

    Health charity? I nominate the humble soup kitchen. Should they accept money from Pharma? Yes, but they won’t get any. Saving the homeless from starvation will only net them a meager return. One thing that is both astonishing and routine, is that they have data only for a surrogate end point: cholesterol lowering; no trial data for a real end point, such as reduced CV events has been published.

  18. Marcia Davis

    Surely a health charity is a charity concerned primarily with the healthy amount of money it can raise (known in the states as the “bottom line”) and that money must, if it’s to remain healthy, be plowed back into the charity that raised it – primarily the administration of said charity. As an interesting side note, the medical profession reportedly uses the caduceus as its symbol – a symbol that, according to sources that cannot be named, has associations with trade, eloquence, trickery, and negotiation; Heart UK is clearly closely associated with all those “meanings” but for its symbol it currently has a heart (naturally) with a rather lousy EKG reading going off from either side. I think it should just go for it and adopt the caduceus as its formal symbol. Then we’d all know exactly what they stand for, no? (As an historical footnote, the caduceus, embarrassingly, has come into modern use as a symbol of medicine because the United States established it for that purpose in the late 19th and early 20th century as a result of documented mistakes, misunderstandings and confusion. Heart UK deserves it . . .)

  19. Martin Edmundson

    Crocodile Tears for Heart UK, but they should keep up with the times.
    Even the American Heart ‘people’ are getting equivocal about CVD with the statement that “cholesterol may or may not have an effect on CVD”.
    Was that the bottom falling out of a market I just heard, and this the market trying to hide the fact from us poor patients, (pun intended).
    I’m lucky I’ve got a medical practice that ‘listens’ and I’ve managed to negotiate my Statin dose ‘down’ to a level where ‘Victor Meldrew’ has disappeared and my last blood readings were still ‘acceptable’ !

    Please continue to keep us informed Dr K.

    1. Stephen T

      Martin, I’m intrigued that you’d take even a small amount of statin if you reject the cholesterol is harmful theory? Is that what we call an each way bet?

    2. celia

      Martin, if you’re taking any statin dose at all I hope you’re also taking ubiquinol (coQ10). I wish I’d known about it while I was still taking statins.

    3. Anna

      I always find it odd when people speak of their prescriptions as if they have no choice in the matter. There is a patient’s bill of rights, you know.

  20. Soul

    I believe a health charity is a reflection of our current health care system. It is anything it wants to be. It’s is based on the agreed upon latest health cure. It’s a group with the best story to tell, that is able to obtain the most people to support it’s ideas, often providing perceived prestige. Some charity groups do some good I feel, and others, as mentioned in your post much less so.

    Personally I Imagine it would be nearly impossible to remove money from drug firms out of the charity system. A similar problem has been seen in politics here in the US, with many schemes created to remove money out of the system, but none successful. Probably the best way to fight the problem is with sunshine, highlighting as best as possible potential conflicts of interest.

    It’s kind of funny with the internet age. When I have been critical of charity groups in the past, March of Dimes, American Heart Health, American Cancer Soceity, etc. typically a few days later I received a letter asking for donations! Oh, as I type the American Heart association just called, funny that.

    The other day I was mentioning to some others about our American President’s trip to India in January, in which the President lobbied the Indian government to stop the manufacturing of inexpensive drugs. Many top charity groups were up in arms over this. Urgent letters were sent off mentioning their great disappointment. In some respects I sympathized with their plight. On the other hand much of what the charity groups wrote about is wanting the continuation of inexpensive AIDS medications to be sent to Africa and else where in Asia. I’m more in the camp of Peter Duesberg, Kary Mullis, even nobel prize winner Luc Montagnier who mentioned HIV was a harmless passenger virus and felt other reasons could account for peoples immune system being conpromsed leading to different disease infections. In theory if medications for AIDs became more expensive in poorer countries, placing a strain on health care costs, as happened in the past in South Africa more questions could be asked about the cause of AIDs. Then again another American President might step up, make a big speech to Congress saying we Americans need to be more charitable in the world and spend billions fighting AIDS in Africa, by sending life saving medications, much as GW Bush did in the later 2000’s.

  21. HotScot

    Do any of us remember Quango’s? Yep, the bonfires of, and all that.

    As far as I understand, charities are the new Quango’s. The government realised eliminating non-accountable bodies was a good election platform. They also knew they were losing key ‘independent’ organisations largely supporting the government of the moment, because they were being paid.

    Step up the charities. Now who in their right mind could possibly claim a charity was a bad organisation, after all they exist to help people, don’t they? Well that would be true if they relied on public donations however, other than a few well-established organisations, few could exist without government funding. But, as universally respected organisations, if their survival can be perpetuated by government funding, providing the correct messages are delivered, way hey, result! As far as the government is concerned it’s a cheap quango.

    And if you’ll forgive me Doc. I’ll make a little point here. I mentioned our national obsession with climate change the other night and was upvoted by one, downvoted by another. Fair enough, however, I realised I had missed an important point. Man’s contribution to global CO2 is estimated to be around 3%, paltry really, but, and this is a big but. CO2 forms around 0.04 of all atmospheric gases, of which there are Nitrogen (76.55%), Oxygen (20.54%), Water vapour (1.95%) Argon (0.91%) with misc. gases (0.01%). We are basing the future of the human race on our CO2 contribution of 3% of 0.04%, which is (I think) 0.0012% of all the gases that make up our atmosphere.

    We are also at the coldest time in 300 Million years, on the verge of another ice age, and people don’t want the planet to warm up? Not that CO2 has anything to do with global warming but it has a huge amount to do with plantlife, more, more, more, I say. We need CO2 in it’s 1,000’s PPM so we can feed a growing population.

    Or am I missing something?

    The public opinion machine grinds on through charities, we must accept statins, fluoride in our water (which does my dogs no good whatsoever) climate change armageddon, and geriatricy (made up word) the ultimate goal. We must all live forever! Providing NICE deems it’s financially viable. Isn’t funding for Homeopathy being cut? No drug money support I guess, a molecule in a gallon isn’t worth bothering about.

    But wait, a molecule in a bucket is grounds for healthcare contempt, but it’s good enough for the Global Warming argument?

    1. Hugh Mannity

      “But wait, a molecule in a bucket is grounds for healthcare contempt, but it’s good enough for the Global Warming argument?”

      What a great summation. I’ve been arguing for years that the climate is not so sensitive that a compound that makes up 0.04% of it is capable of completely destabilising it if it gets to 0.05%.

      Of course, if there was science involved instead of politics and fairy dust. We’d have a consistent critique.

  22. Ali

    I wonder who decided not to include the H and why it isn’t called NICHE…..? Surely that name would be far more appropriate. Oh yes, of course, why sully a NICE name with something as unimportant as Health…….?

  23. Ali

    Ocean Robbins recently stated (on Ty Bollinger’s very enlightening Quest for a Cure series) that ‘the ‘Health’ Industry is not interested in food, and the ‘Food’ Industry is not interested in health’. Great, and very true statement.

    But, however, as Industries they are very interested in each other – especially when they have very itchy backs…….

  24. jmcefalas

    In conversation with a cancer research specialist recently, was somewhat appalled but not surprised to hear the bewailing of the “open secret” within cancer research that most if not all that they do is pointless and money driven and that they do not seriously expect ever to be able to cure (any? all?) cancer. The despair at staring into a moral void was palpable. Having advanced so far down a career path how does one turn aside and avoid becoming part of the problem? How when and where to jump off the merry go round and do something smaller, less well funded but more likely to contribute to the sum total of human good? My sole observation was that if you were talking wasted money the sums consumed as of now in Syria, let alone Iraq et al, on war and armaments would dwarf the expenditure but that didn’t seem to help much.

    1. Stephen T

      An increasing number of people in cancer research are beginning to quietly acknowledge that they’ve been barking up the wrong tree with the genetic abnormality theory. Except for some blood cancers, astonishing little progress has been made since President Nixon declared war on cancer about forty years ago. Since then roughly $200 Billion dollars has been spent in America, with a similar amount in the rest of the world, achieving very little. That’s why the National Institute for Health in the US finally approached a British physicist, Professor Paul Davies, to take a fresh look. He believes cancer is a metabolic diseases rather than genetic.

      As your friend knows, they’re making no progress in cancer research because they’re almost certainly looking in the wrong place. Your friend is one of thousands of people with good jobs in science that rely on continuing to look in the wrong place. A whole industry would collapse if the new theory was accepted and proved. A whole range of largely useless drugs would be obsolete.

      I no longer contribute to cancer charities, or most health charities, because it’s money wasted. If anyone is interested this short fifteen minute talk by Professor Thomas Seyfried on Youtube is a good place to start.

      1. Fergus

        Sorry Stephen but Paul Davies is a physicist opining on essentially a biological phenomenon. Not a bad idea as you can get a different view.

        However you need to get certain basic facts correct and Paul Davies’ ideas can be knocked back quite easily as he doesn’t get the basics right.

      2. Dr. Göran Sjöberg

        After having read his book, the sincerity and the depth of understanding of which no-one can deny having read it, I strongly believe that it is a very good idea to refrain from all carbs and optimally arrive at the highest possible keton state in your body together with lowest possible blood sugar levels. This might work to defeat your cancer – to me there is a metabolic logic in this if you don’t choose to stick to the official dogma about the origin of cancer. I would try it myself if I got a diagnose even if it is a tough treat to avoid all sweet stuff offered.

      3. Nate

        Great video! Professor Seyfried said something like the current policies governing cancer treatment have now turned into granite and are thus next to impossible to knock down. It reminded me of when I would take my wife in for surgery to remove lumps in her breast. The surgery was done in a brand new wing of a well established hospital, which of course made construction very difficult. The new wing was huge and had an awe inspiring atrium made of glass and steel. The cost of that new wing made the hospital, doctors and everyone financially connected to the hospital indebted to the methods used in the new wing to treat cancer. Any mention of a free way to treat cancer must be very scary. Fortunately, glass and steel are more easily broken and eroded than granite. So, maybe with the help of the internet, the new wing and the policy against ketogenic diets will not survive as long as an old wing made of granite.
        Now, Matthew’s Friends promotes the use of ketogenis registered charity.

    2. mikecawdery

      I agree. Patients numbers “surviving (for 5 years)” are increasing, but mortality is also going up – How is this happening? A celebrity who had “survived” recently died of, guess what, the cancer. Medical claims, particularly, when supported by a battery of Hazard Ratios (without the basic four numbers) should be treated with extreme caution.

      1. Stephen T

        Mike, we diagnose cancer earlier so five year survival is improving for that reason. Nothing’s really changed.

        Fergus, the current paradigm has failed abysmally despite truck loads of money. I’d prefer to see something else given a chance. If Professor Davies is so clearly wrong, it’s strange that the NIH have such faith in him and Professor Seyfried’s getting such good results. We’ve invested vast amounts in the status quo and failure for forty years. Enough is enough. This is tax payer’s money and it isn’t there to keep people in cosy jobs, saying the same things, it’s there to make some progress. Deliver or change.

      2. mikecawdery


        Yes I know but it seems that the oncologists and cancer “charities” are unaware of this and continue to pretend that it wholly due to their chemical creations. One does wonder sometimes about the basic IQ of these “experts”

      3. Catherine Reynolds

        My husband was diagnosed with male breast cancer earlier this year, and had surgery to remove the tumour and several lymph nodes under his left arm. The surgeon was more than confident that all the cancer had been removed, and indeed, scans showed that there had not been any spread (thank goodness). Then came “precautionary” treatment. Of course, he was told he would have chemotherapy and radiotherapy, both incredibly strong and debilitating treatments. Neither of us wanted him to have, in particular, chemo, because of the very well-known side effects, and we questioned this option long and hard. The oncology unit at our local hospital moved heaven and earth to persuade him to have the chemo, but he continually asked “why is it necessary for me to have it?” and they honestly couldn’t answer this with anything other than “what if the cancer returns?”. That isn’t an answer to his question at all. His oncologist was more down to earth about things, and said that he didn’t “have” to have chemo. In the end, he had a three week course of radiotherapy, and has Tamoxifen in tablet form – even that was specifically developed with women in mind, so the poor man suffers hot flushes now! From this whole experience, I get the distinct feeling that more often than not, everything currently available is thrown at cancer, regardless of whether it will actually be effective for that person – my husband was not actually showing any signs of feeling ill, it was only him finding the lump that sent him to our GP. We knew that chemo would make him ill though, and neither of us wanted that, despite the oncology staff going on about it being “worth it in the end”. Really? The radiotherapy certainly wasn’t a walk in the park, either, but at least he didn’t have awful sickness and he didn’t lose his hair. I feel the same is true of “treatments” such as statins, and these PCSK things – lowering cholesterol has unfortunately become ingrained – our bodies make the stuff because they actually need it – do all the so-called experts really think that our bodies would make something that was out to kill us? Various GPs have tried to persuade my poor husband that he “needs” to take statins – even the after effects of radiotherapy weren’t as debilitating as the side effects from Simvastatin that he suffered a few years ago, yet still the drug companies try telling us that side effects are “rare” and even “minimal”. Bah, humbug!

  25. John Wright

    Malcolm, how about rebranding Heart UK as a charity for companies like Sanofi, who have staked everything on Cholesterol treatments.
    After all with B’s$$$$ wasted on research, there will be many companies, executives and researchers that will have to forgo the traditional, New swimming pool bonus!

    1. Fergus

      Paul Davies basis his theories on Ernst Haeckel’s ideas that during embriogenesis organisms go through stages that hark back to ancestral times by replaying their evolutionary history. This was a good theory at the time because it fitted certain observations. Haekel’s theories have been shown to be wrong however as our knowledge of genetics, genes, and molecular biology has improved. As Davies’s theories are based on a misconception I don’t believe he has found the answer to what is a tremendously complicated question.

  26. labaum22

    To my mind, Heart UK have nothing to do with charity and should not be allowed to describe their company as such, it is misleading the public. They are paid advertisers for drug companies who will say almost anything to promote their products.

  27. David Bailey

    “[And for my Christmas quiz the reader with the best answer to the following question will have it published on my blog. ‘What is a health charity, and should they be allowed to accept sponsorship from pharmaceutical companies?’]”

    The answer is obvious – bloggers such as yourself, who save people from being harmed by the very people they trust with their well-being!

    If I am certain of one thing, it is that you don’t accept sponsorship from the pharmaceutical companies (!!) – so add a DONATE button if you need money to keep this website afloat, or if you know of genuinely deserving places where the money will be used for people’s health.

      1. Dr. Göran Sjöberg

        Isn’t it in Switzerland they have a ‘charity’ dog who carry malt whisky to those in bad need? I keep a keen eye on all big dogs passing my house nowadays.

        Today, in our present rough rainstorm in Sweden, I tried to addressed the owner with three big dogs but she didn’t seem to be interested in any kind of charity although I pointed out how really bad the weather was.

      2. Anne Michna

        For all the good work you are doing I think you should enjoy a glass (or two) of malt. Cheers, and thank you.

      3. maryl@2015

        Dr. Kendrick, hope your malt whiskey find “overfloweth” . Look statins are for wimps and PCSK-9 s are for cowards.

  28. Sylvia

    I am just so surprised at how many health charities there are and that there is an organisation called Association of medical research charities. AMRC. Do the health charities belong to this association. Will our beleaguered NHS eventually become a health charity with church and volunteer groups attending the sick.

  29. Leigh

    This information is directed towards all males who are vertically challenged . ‘Sophisticated statistical analysis’ (Uh, Oh!) conducted by researchers at the Universities of Leicester, Cambridge and other institutes and funded by the British Heart Foundation, UK National Institute for Health Research, the European Union (Uh, Oh!) and the Leducq Foundation (Huh?) have discovered those of us closer to 5 feet than 6 feet in height have a 32% greater risk of developing CHD (percentage lessening the taller you are). Quick, get out those cuban heels! No, what those researchers failed to realise is that those of us of shorter stature undergo massive gravitational waves originating from the Earth’s core, which makes our hearts work harder, which causes a build up of cholesterol, which causes CHD, and an increased desire to dine on statins, rhubarb, rhubarb, rhubarb. ‘Only two things are infinite; the Universe and human stupidity….and I’m not sure about the former’ (Albert Einstein). The mind boggles at it all. By the way, is HEART short for Has Everybody Absorbed Rhubarb Today?

    1. Sylvia

      A beauffont hairstyle can add an inch or so. My husband is 6 ft, I am 5ft, my sons are in between, alas one has male pattern baldness. You certainly make people think outside the box dr Kendrick.

  30. Deborah Walker

    > What is a health charity, and should they be allowed to accept sponsorship from pharmaceutical companies? >

    The whole point of sponsorship is to promote their brand, they only give that money for a reason, and there is little room for unconditional sponsorship. The problem comes when that sponsor becomes such a big sponsor that the charity then starts to allow them to be more influential in decision making and their focus, it’s like any sponsorship that happens, look at advertising on the TV, those biggest sponsors are pandered to. Printed media ensure that big advertisers are not upset with any negative press about their own products. The media bosses fear the loss of those big sponsors, or advertisers and do little to upset them, and then, those big sponsors place caveats on their sponsorship, as any company would do in many respects. These caveats then start to place more control on these charities, and it’s tailored for them. So I believe what is happening in charity is just a reflection of what is happening on a wider scale with companies who choose to either ‘advertise’ or ‘sponsor’.

    Sadly Malcolm, I believe the current Tory Party are setting the standard, with their revolving door of MP’s moving into the private sector, even whilst working as an MP one was advising a health care company, and then they have these key companies sitting on their committees, advising how government should move forward.

    Most health charities from my perspective are a con, they are set up to influence society, and government to follow one health care system, they collect money to fund research that these pharmaceutical giants then benefit from, and then those who are paying taxes pay for it all yet again when the product is sold back to us. So in effect many people pay twice to companies whose sole focus is to make a profit for their shareholders, so yes they should be able to sponsor but in reality it’s just advertising, and people need to realise that rarely is anything given unconditionally, it’s all to influence your choice, and they want you to choose them.



    1. Nate

      Reading your comment made me realize the importance of an internet that provides equal speed to all bloggers and commenters. Greedy McMogul’s like Martin Shkreli would love to get more control over our access to unfiltered information.

  31. Malcolm

    A Health Charity is a new species of organisation that has evolved to fill the gap between public awareness and corporate greed. Since the government vacated this space kind-hearted board members of pharmaceutical companies (which find it hard to sell directly to the public) have donated their spare time and expertise to create friendly sounding charitable groups to do their selling for them.

    But spreading the good word and writing impartial honest scientific reports with which to educate the public is not cheap. And with no one else willing to subsidise this essential role we should thank the philanthropic drugs companies for stepping in and footing the bill; with no strings attached, ever.

    Always with our best health at heart and never making a profit. Health charities are our fairy godmothers!

  32. Robert Dyson

    When computer viruses appeared about 1990 I realized that this behaviour was probably not just restricted to computers, in any area there would be people who wanted to do anonymous harm. I know that has changed a bit into malicious code for profit. In the same way it seems so many producers of products will misrepresent to gain sales. I expect we will now hear a gentle trickle of negative stories about those wonder-drugs, statins, as the push for the more expensive PCSK9 – inhibitors by lobbyists gets going.
    My question is how did humans evolve for millions of years to be such a dominant species without the support of statins; indeed evolving with the PCSK9 enzyme that clearly needs to be repressed?
    M.K. – keep up the with the informed truth, it gives me hope.

  33. Jenni

    Just wondering can Cholesterol actually be too low WITHOUT taking Statins?
    Our son aged 40 very slim, fit, as far as I know healthy, recently had a Health Check at a local supermarket. His Total Cholesterol was 3.9. He was delighted, as mine is at the opposite end of the scale, (probably double his actually!!) and I couldn’t care less.
    But I’m worried his is too low?

    1. Dr. Göran Sjöberg


      In my view our ability to balance whatever happens in our bodies, our homeostasis as it is called, is a wonderful devise to keep us as healthy as possible given the external and internal circumstances including any hereditary factors.

      If your body needs some extra cholesterol somewhere for whatever reason (an infection somewhere ?) you will probably produce some more to be distributed through our amazing blood system. My guess is thus that your son is in a marvellous health condition and don’t need so much of this good stuff we call cholesterol.

      By the way , why don’t you feed him a lot o cholesterol by giving him ten egg yolks omelette and see what happens. Usually, though, the body ignores such external cholesterol boosts.

      1. Sylvia

        Homeostasis, of course, why don’t we listen to our body. It so makes more sense to me now. My health scare earlier in the year was a scary transient global amnesia, TGA. It makes sense that my LDL levels were raised because my brain would need more. That the consultant wished me to have statins is just crazy. Waiting for repeat blood results. In 30 years nursing had never heard of TGA, neither had my GP. My niece a nursing sister, sees it on her acute admissions ward.

      2. Ali

        Yes, it seems the body will only produce cholesterol as needed. Eat more cholesterol-laden foods it will produce less, eat less cholesterol-laden food it will produce more. Contrary to popular opinion, our bodies are beautifully designed, and far from stupid. They know exactly what they are doing, and why they are doing it at any given time.

        If our bodies are sick – it’s because WE have made them so…….

        1. Dr. Malcolm Kendrick Post author

          Indeed. Only in the world of ‘cholesterol science’ does eating once substance – saturated fat – cause the body to lose control of another substance – cholesterol. Something seen nowhere else in nature. But if your underlying hypothesis is nonsense, the only way you can sustain it is with equal and opposite nonsense.

    2. Stephen T

      Jenni, mine was 4.9 before I abandoned the low fat diet. I don’t know what it is now and I don’t much care. I did feel much better when I stopped starving my body and brain of natural fats, so it depends what your son’s eating. If he’s a strict follower of the ‘healthy’ low-fat, then I’d want to get some eggs and natural fats into him. The first step for me was looking at the evidence and accepting that eating fat has nothing to do with heart disease. I then felt free to change my diet. As Goran says, the body largely self regulates but we need to give it a helping hand with some decent fuel.

      1. Jenni

        Well sadly he is very much in the ‘healthy diet’ camp, which for him, or should I say ‘them’ (as he’s married with two children) is ‘Low Fat’, plenty of grains and pulses, chickpeas, small amounts of meat.
        You can almost hear his eyes rolling in his head when they visit us and he sees me putting cream in my coffee and butter on my vegetables!!
        And he works for the dear old NHS too, in a senior professional position. He’s a bright boy but he thinks I’m bonkers!!!!

      2. BobM

        Jenni, maybe you can give him Dr. Kendrick’s book (The Great Cholesterol Con)? If he’d read it, it could enlighten him.

      3. John U

        Jenni, I too was slim and fit in by mid 40’s (maybe 10kg heavier than I was when I was in my 20’s ) and ate a good “healthy” diet of veggies and meat and grains (raw oats every morning) and orange juice, etc. I was convinced that my diet was excellent. I believe all the hype about saturated fats and low salt, etc. This went on until I was 67, still fit and trim and no sign of illness, and I read Gary Taubes book “The Diet Delusion” (in the UK, I believe) and was utterly transformed by the total logic of the science. I experimented on myself and lost 8kg in a very short time and noticibly improved blood work. Like most readers here, 3 years later I am still eating LCHF and can’t understand why anyone, who takes the time to educated themselves (and that is a big condition) who would not do exactly as I have done. I found the science so compelling that is I was willing to put my health on the line to try it. I was rewarded. Maybe you need to give your son the book to read. Also Malcolm’s “Doctoring Data” is great and serves as a reinforcement book to explain why otherwise intelligent people get fooled by the media and the establishment propaganda and continue doing what they have been doing for decades.

  34. Joyce

    I was “invited” to partipate in a trial for this new “wonder drug” earlier this year, (a couple of months after suffering a cardiac arrest, and having a stent fitted). Answer was a definite NO THANK YOU! Even if we could afford the cost, is anyone aware that not only do you have to inject yourself every two weeks with “the magic bullet”, you MUST contine taking the statins too. This is not a replacement for statins, it’s a “buddy”. At least that way, I suppose you would never know which was killing or curing you! ;o)

    1. David Bailey


      I applaud your brave decision. I imagine that after having a brush with death, it would be all too easy to accept the illusory comfort of doing exactly what the medical profession recommend – however absurd!

      1. Joyce

        You’re right! However, I had to learn the lesson the hard way! After being “statinated” for approx three months, with no symptoms other than dark urine, I was found to have LFT’S (liver function tests) of 1300(yes, 1300!!) Apparently normal is about 45! Suffice to say I was told to stop the statins immediately,and hospitalised. It took MONTHS to get back to an acceptable level. Never again.

  35. Jenni

    Our Son aged 40, very slim, fit , recently had a ‘ Health Check’ at a local supermarket.
    He was ‘delighted’ to tell me his Total Cholesterol was 3.9, I say delighted because he knows that mine is probably at least double his . Not that I’m concerned with mine at all.
    He’s been ‘brainwashed’ into thinking lower is better, but actually I’m more concerned about his low levels not my higher ones!

  36. Virginia

    There is no such thing as “health charity”. What we call a health care system is not anything to do with health and prevention of disease; we have disease management. Pharmas make their money on disease management. Promoting health and preventing disease cost pharmaceutical cos. a lot of profits.

  37. Sean Coyne

    I am disappoint. I didn’t get a Chrissy message from HEART UK. Now I can’t throw it in the same rubbish bin I threw my statins in years ago (*runs off sobbing*).

    No wait, I can still run, because my leg muscles work, plus I can remember where the bin is, which I probably couldn’t do if I was on statins, or indeed this new bullshit drug. Yay me! Just cheered myself up. 🙂

    Now to the serious business of coming up with a good answer to your quiz question regarding health “charities”. More later!

  38. Barry

    Heart UK – The Cholesterol Charity. Title implies that they support cholesterol but, as in many things, the truth is the polar opposite of what is stated.

    To distribute propaganda and lies under a seemingly innocent “charity” is a well-worn method that Big Pharma employs to advance their agenda. Heart UK list of sponsors should provide more than sufficient cause for doubt as to the validity of their advice http://heartuk.org.uk/partners/our-partners. Conflict of interest anyone?

    “Innovative new medicines, such as PCSK9 inhibitors, are an exciting development in the treatment of cholesterol, with little known side effects and very good scientific evidence that they work to significantly reduce the levels of bad cholesterol in those at high risk of CVD.”

    Let’s reword that:
    Innovate new drugs, such as PCSK9 inhibitors, are likely to provide vast profits by unnecessarily lowering cholesterol. We’ll try and hide the side effects that we know about http://www.ncbi.nlm.nih.gov/pubmed/16893422 and hide any trials that reflect badly upon these drugs. We know that they lower cholesterol very effectively and by doing so will create a raft of medical issues that will result in even more medication and thus further enhance profits.

    We, at least those who follow Dr Kendrick’s blog, are well aware that the whole cholesterol /diet hypothesis only survives due to constant support of the drug and food companies plus all those supposedly non-biased researchers and organisations that have and continue to profit from this fraudulent scam. The flight of fantasy that these people are on routinely avoids the bright landing lights leading to airport of Evidence and continues to the twinned airports of Dogma and Corruption.

    I see no end to this situation until such time as research funds are provided by the taxpayer to avoid the obvious bias and conflict of interest that is almost impossible to avoid with industry funded research. If we stopped drug companies funding trials, which we indirectly pay for, stopped the freebies plus other direct and indirect enticements that are provided to various people and organisations then we might start seeing the truth. Will it happen? I doubt it, as the whole system is corrupt from the politicians that have allowed the current situation to develop to all those that benefit at our expense. Our only hope is for sufficient people to become aware of the lies and to put such pressure on the politicians that they will act to save their careers. The politicians are the ones who can pass laws that will bring an end to the fraud. Enforcing such laws will require clean lawyers and judges (another problem) with draconian fines and jail sentences such that the ones perpetuating the scams will realize that they are not going to get away with it.

    1. mikecawdery

      Following your Pubmed link I came across the following:

      Specific knockdown of zebrafish NARC-1/PCSK9 mRNA resulted in a general disorganization of cerebellar neurons and loss of hindbrain-midbrain boundaries, leading to embryonic death at approximately 96 h after fertilization. These data support a novel role for NARC-1/PCSK9 in CNS development, distinct from that in cholesterogenic organs such as liver.

      Just what I DO NOT want – interference with my “cerebellar neurons and loss of hindbrain-midbrain boundaries”

  39. mikecawdery

    HEART UK is concerned by NICE’s recent decision to turn down the use of the first of the PCSK9 medicines”.
    My immediate reaction to the Heart-UK statement was that given the conflictions it is not surprising their first reactions as drug-pushers is just that. Furthermore, they are clearly unconcerned at the huge increase in cost to the already overburdened NHS.

    To quote from the blog:
    If NICE do say, reject, bong! This basically means that the drug will not be prescribed to anyone in the UK. In addition, such is the influence of NICE that many other countries use their decisions as an important guide for what they will do with regard to funding. So if NICE turn a drug down, this is very bad news from the manufactures or said drugs.
    This sums it up very nicely and hence the seriously conflicted Heart-UK rush to change NICE’s assessment.
    Big Pharma dependents to the rescue

    There has been significant progress in the management and treatment of cardiovascular disease (CVD) over the past two decades, which has resulted in an overall decline in CVD deaths in the UK.

    Incredibly there has been little valid evidence that this is due to cholesterol lowering drugs while the benefits of general medical therapies plus stenting and CABG (coronary by-pass surgery) are totally ignored. No one has yet demonstrated a credible life extension following cholesterol lowering. Indeed high national cholesterol levels are associated with higher national life expectancy ( WHO/BHF data) and a WHO figure that shows that a TC level of 5.8 mmol/L is associated the lowest all-cause mortality ( I have figure fir anyone interested but I need an email address. I have yet to find a way to put it on this blog. Along with other items that highlight “medical erors and flaws” this has been removed from the internet)

    Innovative new medicines, such as PCSK9 inhibitors, are an exciting development in the treatment of cholesterol, with little known side effects and very good scientific evidence that they work to significantly reduce the levels of bad cholesterol in those at high risk of CVD.

    Rather than waffling in this way, why does Heart-UK not present data that demonstrates clearly the actual real numbers of those benefiting compared to the numbers treated? I suspect that the usual medical trick of hiding the truth in a welter of hazard ratios is being used to confuse and deceive!.

    The use of 1 QALY (quality adjusted life year) is another example of pure, unadulterated fudge. Precisely what does this mean – the facility to play golf (or anything) as a 40 year-old or to sit in a chair with oxygen available? And needing daily and continuous human assistance. Definitely a statement for the “brain-washed herd”

    Incidentally, did I hear that AMGEN has recently been absorbed by Pfizer?

    Your last para says it all and I am definitely and totally cynical

  40. Sean Coyne

    ‘What is a health charity, and should they be allowed to accept sponsorship from pharmaceutical companies?’

    My answer?

    A health charity is either a fund for helping those with a specific medical condition, by such means as education and bankrolling research, or a scam. Any acceptance of sponsorship from pharmaceutical companies allows us to be sure it’s at the very least compromised, if not an outright con.

  41. Nate

    ‘How to Increase Your Drug Company’s Bottom Line’ by Greedy McMogul
    Lesson #32 – Change the name of your Advertising Department to Health Charity. Besides directly increasing profits, a side benefit is that the salaries paid to the department are tax deductible.

  42. vjadams2014

    Malcolm, one of the things that makes your blog so interesting and a delight to read is that it consistently demonstrates critical thinking – Who says x? Why are they saying it? Who benefits from them saying it? In a totally different context, I’ve seen it argued quite persuasively that one of the dangers of scientific education is that we don’t teach science students this kind of critical thinking – scientist are taught on the Grandgrind principle of facts and more facts. Answers are right or wrong and proof resides in the past experiments/work of eminent authorities who are to be revered, not challenged. It strikes me that whatever work you do in disseminating a critical approach to thinking about medical practice is at east as important as the work you do in questioning the cholestero/heart disease link.

    1. mikecawdery

      You are incredibly right. Over 60 years in research, this is becoming more and more evident as the years go by. I find it terribly depressing – for those in training DO NOT CHALLENGE the professor – it is the quickest way to disaster.

  43. Lucy

    I live in the U.S. and the AHA (American heart association ) has the heart check label on all sorts of barely food items: you know , fruit juices that are loaded with fructose, and sugary flavored oatmeal, mystery synthetic “butter”. Cheerios cereal used to be something resembling a plant. The AHA is playing radio spots touting canola oil, soy bean oil and safflower oil. All stuff that is barely food. It wouldn’t surprise me if nondairy creamer had the heart check label on it. Nobody is quite sure what is in non dairy creamer. It could be plastic. ? Abestos? $$$$

    1. David Bailey

      We often take holidays in the US, and gradually we have learned to avoid as much of that sort of junk as possible. A good rule of thumb is to avoid anything that says ‘healthy’ on it! Opting for a continental breakfast is also dodgy because sometimes all the cereals on offer are sweetened, and the fruit comes out of a can and is sweetened as well.
      Even the fuss about salt seems to be based on little evidence:

      1. mikecawdery

        Thanks David,

        I have known this for some time and have papers by Alderman and Elliot and others that demonstrate the benefit of salt. It is just another example of promoting what is, or might be, a “benefit” to those who have serious kidney condition, to all and sundry on the “idea” of some person trying to promote himself. This is all too common in medicine.

        That a basically non-professional journal can write such an article just highlights the professional inadequacies.

        Please remember that there are some conditions (not BP in the healthy) in which reduced salt intake can be of value but this does not validate whole sale salt reduction in the entire population.
        As I remember Dr Kendrick wrote a blog on this subject.

    2. mikecawdery

      Appaparently in the US HFCS has been renamed because of the bad press. It is now called “fructose”

      Incidentally, an American cardiologist told me that the AHA had “sold out” to Big Pharma as, unfortunately, have other professional associations.

    3. Jean Humphreys

      Scrolling down I passed your last comment “non dairy creamer. It could be plastic.” You speak the truth in that – in China it was plastic – to be precise, melamine in baby formula milk.

  44. Kathy S

    A question – why are beta blockers prescribed after a heart event (stent, whatever) so that your heart doesn’t work too hard? Wouldn’t it make more sense to let your heart work hard, such as with aerobic exercise so that it strengthens? I’ve seen these prescribed for those that do not have high blood pressure to begin with – including myself, but I refused the offer. Anyway, just curious. Thanks

    1. goransjoberg2015


      I for one, after my serious, almost ‘final’, “blow” 1999, was prescribed a “number” of heart drugs, one of which was a beta blocker. The beta blockers are for sure very efficient psychopharmacological drugs and they worked amazingly well in turning me into a kind of zombie – I never got upset. To get rid of zombies it is a well known fact that you have to behead them 🙂

      Anyway, doing my research homework this convinced me to skip all the medication after half a year of ‘treatment’ and the by-pass offer as well and instead address the actual cause of my CVD disease.

      A scientific approach which suits my natural science research mind and an approach that still seems to work incredibly well in my case after 17 years. And of course physical exercise is an important part of my present approach.

      1. Kathy S

        thanks for your reply. So much of what is now prescribed does not make sense to me and I am one that has chosen not to take the beta blockers or statins. I’m on the blood thinner for a year as that does make sense to me and isn’t something I have to take forever. I have never had high blood pressure and when in the hospital for my first ‘go round’ with the stents I coded twice – blood pressure crashed. Although we have figured out the reason why this might have happened – I questioned why in the world would I want to lower my blood pressure any further. Of course the big pharma’s have convinced the medical community that we now should all have even lower blood pressure and lower cholesterol levels. Don’t care, not going to do it.
        I too am concentrating on living and being healthy. All the best on your own health.

      2. BobM

        Kathy, they may not have given you beta blockers to lower your blood pressure. They also reduce the speed at which your heart beats and supposedly reduce certain arrhythmias. I have idiopathic dilated cardiomyopathy and have to take a beta blocker and an ACE inhibitor daily, but they aren’t given to me to reduce blood pressure (which was never that “high”).

        1. Kathy S

          Bob, I think the problem I had with the beta blocker was that not only do I not have high blood pressure but don’t have any problems with my heart. The only issue I had was with that darn blocked artery and thank God for collateral vessels which I attribute to me not having a heart attack considering that artery was 95% blocked. I understand there must be reasons, such as yours, that having your heart not work so hard is necessary but for others like myself, why would that be important?

  45. Dr. Göran Sjöberg

    I just received an encouraging mail from BMJ papers administration telling that BMJ has accepted my offer to become a patient reviewer.

    Stating my special interest in statins and cholesterol evidently didn’t refrain them from accepting me.

    Interesting activity for me on my present eternal vacation.

    1. mikecawdery

      Delighted to hear that you have been accepted as a patient reviewer but you should have added diabetes to your competences.

    2. John U

      Congratulations and I wish you lots of joy in doing this task. I think it is a great way to provide some serious feedback. I will be interested in your comments after you have had a chance to do some reviews.

      1. David Bailey

        Unfortunately (but reasonably) I think the reviews are supposed to be confidential. I am still awaiting news of whether I have been accepted for the same process.

      2. mikecawdery

        David Bailey
        Yes the reviews are confidential but at least the authors see them and one does get to see the “professional reviews” as well and they see yours. Reminds them that there are real people, not just a “herd”.

    3. Dr. Göran Sjöberg


      Thank you for your always appropriate remarks!

      Especially: “Reminds them that there are real people, not just a “herd”.” appealed to me.

      For me being an ‘atypical’ (?) anecdote within the ‘CVD-herd’ I tend to be disgusted by cardiology experts who don’t even have the courage to take a serious discussion within their own field of ‘expertise’ with a well read ‘anecdote’ but instead feel threatened.

      For me, in my own field of expertise, super alloy metallurgy, I couldn’t even imagine not being able to face any competent remarks from an ‘outsider’.

      All this tells me something about absence of science within the field of medicine.

      For sure this BMJ-reviewing will be an interesting exercise for me but of course confidential by nature and necessity.

      1. Marcia Davis

        “All this tells me something about absence of science within the field of medicine.”
        Perhaps that’s why they stick to the idea of the “art” of healing? It lets them off the hook with the science responsibility. Mind, I do NOT agree with them. It’s just plain sad to see patients in waiting rooms with their bags of prescription drugs – or to see them standing in the lines at places like the CVS pharmacy (where the pharmacy part is either on the second floor or way in the back of the store so one first has to go by – and is tempted to buy – all the candy and junk food this “drugstore” stocks) because you know the patients’ symptoms, by and large, are what’s being treated by drugs – not their real problems/diseases. You and Dr. Kendrick are wonderful – keep up the good work!!

      2. Dr. Göran Sjöberg


        Thank you for your encouraging esteem but frankly don’t deserve since I couldn’t not possibly be put on par with Dr. Kendricks.

        The main reason for not qualifying is that I am professionally outside the medical field and thsu don’t risk anything. A second reason is of course that Dr. Kendrick is far more read in the medical literature.

        Basically I am ‘only’ an ‘anecdote’ though perhaps of a well read kind 🙂

        By the way, an interesting remark relating to the pharmacy as a market place for junk food – I have made the same observation.

      3. Dr. Göran Sjöberg

        I find the field of medicine so amazingly fascinating as being an ‘anecdote’ and as an adherent of the strongest core of the natural science, i.e. the inorganic physical-chemistry; with all the thermodynamics involved. Although just the ‘understanding’ of the chemical bonding in the inorganic field of chemistry easily turns into an overwhelming task it is still ‘peanuts’ in comparison what is involved in the organic part of the same discipline but which still follows the same fundamental physical laws of the thermodynamics.

        With this fascination as a driver, I have now, since a couple of years, also plunged into the discipline of the molecular biology of the cell to try to better understand the fundamentals of organic life and of our physiology but is now basically stunned in my amazement of the complexity involved in all what we happen to call ‘life’.

        The higher up I reach in my climb to ‘master’ how it is possible to live and ‘keep my health’, i.e. to enter into the ‘heaven’ (or hell?) of medicine the more I get convinced that there is, as I have stated many times before, just a religion there which today and to my dismay serves mostly the evil forces involved if we by such forces mean the greed without care for life.

        In medicine today I (as Malcolm?) just see the abuse of the natural science I have been ‘in love with’ since my childhood and a science which I think should be better used for ‘love and care’ instead of serving the destruction of mankind.

        So, finally I have arrived at the Hippocratic insights “First of all don’t harm!”, which I see so abandoned today, and of course ‘Let food be thy medicine and medicine be thy food.’

  46. mikecawdery

    Following my review of Kristensen ML,et al BMJ Open 2015;5:e007118. doi:10.1136/bmjopen-2014-007118 an OPEN ACCESS article, their Table 1 provided useful data on the results of primary and secondary prevention of all cause mortality. Overall everything points to the probability of individual NO BENEFIT from statin use approaching certainty.

    It would also appear that primary prevention is basically ineffective as their estimation of life extension of 3.2 days would suggest. In the case of secondary prevention while the estimated life extension of 4.1 days is probably significant its relevance is doubtful.

    In these circumstances, without clinical evidence of benefit in terms of all cause mortality, it would seem highly inappropriate for the “charity” Heart-UK to engage in promoting a commercial product with no better evidence than that claimed by various plant stanol spreads.

  47. mikecawdery

    It is incredible that Heart-UK should officially support this drug given that Amgen admits “The effect of Repatha™ on cardiovascular morbidity and mortality has not been determined.


    The effect of Repatha™ on cardiovascular morbidity and mortality has not been determined. Please see full Prescribing Information.” Is this not the reason we are supposed to be taking this drug, for its unknown Cardiovascular Morbidity and Mortality? (Christopher Wunsch on facebook)

  48. Soul

    Wow, I know Dr. Kendrick had a quick mention of the book earlier, but I’ve been reading Peter Gotzsche’s book “Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare”.
    I knew there was a good deal of corruption and fraud in the health care industry, from regulatory agencies, to pharmaceutical companies, the press, and charity groups, but if all he says is true, it’s far disturbingly worse than I expected. Recommended reading for all. Peter Gotzsche, while not giving details, at least so far in what I’ve read, makes a good case for doing what one can to stay healthy as best as possible with diet and exercise and placing less faith in the health care system to honestly solve problems.

    “Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare”


    1. mikecawdery

      The more one digs and checks the research, the worse it gets and the more necessary it is to support Dr Kendrick and his colleagues that support changes. They really deserve our support as the GMC tends to be vindictive against those who challenge the “approved” medical paradigms.

  49. Maureen Berry

    A few years ago a friend of ours dropped dead from a cardiac arrest. He already had heart disease and was an absolute believer in mainstream medical advice. On his death his widow asked for donations to Heart-UK in his memory. I had a quick glance at the website and felt unable to make a donation – as they were clearly promoting rubbish! It is very scary how many intelligent, otherwise savvy people are totally taken in by the nonsense that is the mass medication of the population, with no proven benefits.
    Only yesterday a good friend told me how he would have died years ago, were it not for the wonder drugs, Statins. I could have choked on my red wine!
    Sometimes, because of the various blogs, Facebook pages etc, that I tend to read all the time, I kid myself into believing that we are making headway, that the tide is turning, both in terms of dietary advice and in terms of over medication, but I fear this is not the case, we have a long way to go!

    1. Stephen Rhodes

      And it is likely to get much worse.
      There is a petition on the web to require a Parliamentary debate on the compulsory re-testing of drivers who reach 70 years of age, rather than the current self-certification process.
      There are good reasons that some re-testing sanction should be available to the Police if they suspect that the driver is unfit to drive through age or infirmity, but…..
      debate around the petition also calls for a ‘medical’ as part of the ‘fitness to drive’ part of the re-testing.
      Having opted out of the current NICE practice of mass testing and mass medication, as many of those posting here have also done, I do not trust the medical ‘authorities’ to allow GPs to only test for ‘medical fitness’ as it is a perfect opportunity to force those who are well and over 70 to subject themselves to a battery of spurious tests, the result of which will be multiple prescriptions for drugs designed to destabilise a carefully won homeostasis and create another member of the medical ‘cash cow’ herd.
      Failure to conform will result in no license renewal and social isolation for many.

  50. financialfundi

    Hi Dr Kendrick
    What do you make of the mortality statistics produced by Dr J Revill.?
    Is there a possibility that the reduction in mortality was due more to factors other than the
    lowering of TCh, such as a reduction in smoking and a lowering of BP, for example.
    Is it possible you could obtain a comprehensive account of the data behind the mortality stats in the link below?

    1. Bil

      Death from heart disease is falling mostly, it would seem due to better mechanical intervention (e.g stenting) and I would suggest better public awareness of what a heart attack or angina is. This ‘study’ says nothing about the overall level of heart disease at his practice. There were some 5000 non- bypass coronary interventions in the UK in 1991. In 2012 there 95,000. This seems to co-incide nicely with the start of Revill’s ‘study’ into statination and the reduction in deaths from heart disease. Also no info regarding side effects caused by the aggressive intervention.

    2. goransjoberg2015

      These figures seem convincing about the benefits with ‘cardiological clinical interventions’ including statination and I now wonder why I have not seen such staggering figures highlighted before – they definitely contradict most of what I presently believe to be true regarding CVD and the treatments.

      From what I myself have learnt during my many years as a successful anecdote and sceptic is that almost all interventions in the long run turns out to be contra-productive. So I really get very confused seeing these ‘happy’ curves. Are they as myself “anecdotical” or is there an overwhelming generic knowledge I have missed, kind of a tip of an hidden iceberg of truth, I now wonder.

      There must be more to learn here!

      I am excited!

      1. financialfundi

        i too was confused by this info produced by Dr Revill’s clinic, until that is i put my 71 yr old thinking cap on and realised that without total mortality stats the charts are next to worthless to me.

      2. Bil

        I got the numbers from the BHF web site following a google search. Anyways, what I thought, subsequently was, where does this leave statination? Surely, if it works so well then, well, er almost no one would need an ‘intervention’. By the way I had a stent fitted 12 years ago but after the initial round of beta blockers, Clopidergol ( not sure thats the correct spelling) and aspirin I was left with statins. So, when I had my angina attacks I was 50, I was a long distant runner and had a cholesterol reading of 5. ‘We need to get this down’ was the mantra. I gave up running after having a bad fall in an ice running competition in Montana (US). So my cholesterol reading rose to 6.5 or thereabouts. I discovered LCHF through the Eades in 1996 and have used it on and off since then- now totally on. The reason, I think I had angina was because I went 35 years not being diagnosed with a very, very, underactive thyroid. I have taken 225ug of Thyroxin for the last 20 years. For many years prior to this I was a low fat person, not sure it helped at all though. I gave up statins when I lost my endurance,when running, the feeling in my left calf and episodes of TGA. My initial dose was 20mg of Simvastatin this didn’t seem to bad, I was then moved to 40mg and that is where the issues started. I think its a matter of ‘poison is in the dose’ with these drugs, I haven’t taken them for 8 years now, eat HFLC, drink like a fish and well, I feel fine.

        These days we run a small hotel. A fair number of our guests are ‘older’ people (60+). I can usually tell when they are on high dose statins and sometimes bring it up in conversation. Generally they comment on joint pains (often being ‘treated’ as arthritis) and all complain of memory loss. Interestingly they always put it down to age and that the medication is saving their lives. What utter tosh, I do my best to steer them in a better direction. I’m not sure any of them take any heed- after all I’m not a doctor ( no offence Malcolm)

        1. Kathy S

          Maybe you should leave a few of Dr. K’s books around that hotel of yours. You might just save a life or two. I keep extras that I buy used, although they are like brand new, and give them away.

  51. Andrew Larwood

    Hi Malcolm,

    Season’s Greetings!

    I too received the “NEWS ALERT – Managing cholesterol in primary care: the challenge continues” from the PCCJ Plus http://www.pccj.eu/ on behalf of Heart UK and was completely incensed at the audacity of this “charity” to use an educational journal for the benefit of the pharmaceutical companies that I wrote to Stuart Andrew, Chair of the All Party Parliamentary Group for Heart Disease and my local MP, Damian Hinds, about such behaviour by Heart UK.
    The upshot of my communication with these MP’s was a) from the chair Stuart Andrew, “I will continue to raise the issue of preventative heart care and treatment within Parliament, both with regards to cholesterol and heart disease, and hope to make real progress on an issue that impacts so many people. Thank you again for your correspondence, and please feel free to respond with any further concerns.” and b) from Damian Hinds, “Thank you for alerting me to your concerns. I have written today to my colleague, George Freeman, to bring this campaign to his attention. He is the Minister who leads on NICE within the Department of Health’s ministerial team. I will also make sure Stuart Andrew is aware. With respect to the appropriateness of Heart UK’s conduct, your concerns are best addressed to the Charities Commission; it is the regulator and has the necessary investigatory powers and resources, which I am afraid I do not.”

    For more on the APPGHD visit: https://www.politicshome.com/health-and-care/articles/opinion/heart-uk-and-benecol/stuart-andrew-mp-keeping-cholesterol-public

    Also for those interested in more on PCSK9 visit http://www.pcsk9forum.org/ to see who the sponsors are for this “independent resource on PCSK9 science and its translation into critically important new treatments to lower low density lipoprotein cholesterol (LDL-C), which promise to transform the prognosis of millions of patients with hypercholesterolaemia (cholesterol disorders), accelerated atherosclerotic vascular heart disease and a high risk of premature cardiovascular (CV) death and disability.”
    A Happy New Year to all!!

  52. Anne Mutch

    Dear Malcolm,
    Long may you continue to put the record straight! We must always question the relationship between the medical community, and now charities, and the pharmaceutical industry.

  53. Jackie

    ‘…an exciting development in the treatment of cholesterol, with little known side effects…’ What??! They are actually ADMITTING that this has some little known side effects and they STILL want to get it approved? Argh. They can’t even write proper English (that is, if they were trying to say ‘ with FEW known side effects’, but maybe they weren’t, maybe they are admitting they don’t know anything about the side effects yet)

  54. Bob Niland

    The HOPE-3 (7-year statin trial) results are out:
    LDL (presumably -C) driven down by an impressive 30% or so.
    All-cause mortality driven down by a not-so impressive ¼ of 1%.
    And this is an industry-funded study.

    Paper and supporting material is open-access on NEJM:

    If you happen to correspond with any of the investigators, please ask them what the placebos were (it’s not in the paper or any supplements).


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