Bad News For Statins Is Good News

      121 Comments on Bad News For Statins Is Good News

Let’s hope this is the beginning of the end for statins. The so-called wonder drugs have been a cash cow for pharmaceutical companies for decades now, mostly because doctors bought into the idea that high cholesterol causes heart disease, therefore any drug that reduces cholesterol must also reduce heart disease. I’ve lost count of the people I know who don’t have atherosclerosis, but were prescribed statins simply because their cholesterol was above the supposedly magic number of 200. Their doctors weren’t treating heart disease; they were treating a cholesterol score.

While researching Fat Head, I became aware of quite a few doctors who insist that giving statins to people who don’t already have heart disease simply to beat down their cholesterol is worse than worthless … Al Sears, Mike and Mary Dan Eades, Uffe Ravnskov, Malcolm Kendrick, etc. I found the evidence they presented quite convincing. Unfortunately, the medical establishment and the media have tended to either ignore the anti-statin doctors or write them off as a bunch of kooks.

Not anymore … at least I hope not. A new meta-analysis of the effectiveness of statins (and lack thereof) was just released by the Cochrane Collaboration, and it’s bad news for the statin-makers — partly because the analysis itself isn’t flattering, and partly because the Cochrane Collaboration is a highly-respected organization whose work is considered both thorough and unbiased. Consequently, their report has generated quite a bit of media coverage. I’ve already read articles in the UK Telegraph (two), TIME’s online version, the Los Angeles Times, Miller McCune, and Reuter’s Health, among others.

If we piece together quotes from the articles, we end up with a nice summary of the statin story. Let’s start with how and why they became the best-selling drugs of all time:

Back in 1975, Henry Gadsden, the chief executive of the drug company Merck, expressed his frustration that the market for his company’s products was limited to those with some treatable illness. Ideally, he said, he would like to “sell to everyone”.

Three decades later, his dream would seem to have come true – epitomised by the most profitable class of drugs ever discovered, the cholesterol-lowering statins that are taken by an estimated seven million people in Britain, and tens of millions worldwide.

Yup, Merck and the other pharmaceuticals wanted to sell drugs to healthy people, and by gosh, they finally figured out how to do it.

The story starts with the arrival of “cholesterol consciousness”: the thesis that those indulging in (for example) bacon and eggs for breakfast boosted the cholesterol level in the blood, causing the arteries to become narrow, and making a heart attack more likely.

Although this idea has its critics, there is no doubt that the small proportion of the population with a genetic predisposition towards high cholesterol levels are at greater risk of circulatory disorders. Encouraging them to switch to a healthy diet had failed to lower that risk – so the idea gained ground that cholesterol-lowering drugs might be the answer.

The small proportion of the population with a genetic predisposition are those with familial hyperlipidemia. Their LDL is extraordinarily high because their LDL receptors don’t work and therefore don’t remove LDL from the bloodstream. Cholesterol-lowering drugs were shown to reduce their rate of heart disease by a teeny, tiny bit. From that result, the medical community decided cholesterol is a killer and we should all stop eating bacon and eggs — even though low-fat diets didn’t do diddly for the people with hyperlipidemia. Go figure.

An even more important factor, especially in the US, was the drive to establish “clinical practice guidelines”, under which panels would set the optimal treatment for any given condition. Successive guidelines have forced the “normal” level of cholesterol ever lower, resulting in leaps in the numbers deemed eligible for treatment. In the US, the figure went from 15 million to 40 million.

That’s how you sell drugs to healthy people: redefine normal cholesterol levels as dangerous. Among the un-medicated population, average total cholesterol was around 220 a few decades ago. Doctors rarely warned patients about heart disease unless their cholesterol was 250 or higher. But if 220 was the average, how did the new “normal” end up being 200?

After it was pointed out that those responsible for the most recent guidelines had failed to declare any potential conflicts of interest, it subsequently emerged that most of them had received research grants or consultancy fees from the drug companies involved in manufacturing statins.

That’s how. By declaring 200 to be the target level for cholesterol, the researchers (ahem, ahem) who wrote the guidelines guaranteed their paymasters millions of new customers.

Not surprisingly, quite a few clinical studies eventually concluded that statins prevent heart disease. I say “not surprisingly” because nearly all the studies were funded and conducted by the pharmaceutical companies. According to the Cochrane review, the studies might’ve been (surprise!) skewed to exaggerate the benefits and minimize the side effects:

In particular, while all the studies focused on benefits, only half provided information on the side effects of the drugs, said Dr. Shah Ebrahim, whose group’s findings are published by the Cochrane Collaboration, an international organization that evaluates medical research.

“There is evidence that the reports cherry-picked the best outcomes for presentation,” he added, “which will tend to inflate apparent benefits of treatment.”

While there appeared to be no difference in side effects between trials participants taking dummy pills and statins, the researchers say those results aren’t credible.

“Any appraisal we can make of adverse events is biased by failure to report these events,” Ebrahim said in an e-mail to Reuters Health. “We believe that trial funders, investigators and journal editors have failed to provide adequate information to doctors and their patients to assess the benefits and harms of statins in primary prevention.”

The good news is that while Merck and Pfizer may not report on negative side effects, more media outlets are:

Dr. Greg Burns (not his real name) is a 72-year-old retired radiologist living in Connecticut. Until early last year, he ran with his dog at canine agility meets, skied, ice skated and played 18 holes of golf. He is now unable to walk and is taking a course of medication that will postpone, by a few months, his death.

Burns’ rapid decline began in December 2007 when he suffered a short-acting stroke from which he fully recovered. His cholesterol level was elevated and so as a preventative measure his doctor prescribed a 20mg daily dose of Crestor, a cholesterol-lowering drug in the “statin” class.

A few months after beginning Crestor, Burns developed muscle cramps. He was assured by his doctors that these were not serious side effects of taking the drug. But in December 2008 when tests showed that his creatine phosphokinase – an enzyme that is released into the blood stream when muscle cells are damaged – was elevated, Dr. Burns stopped taking Crestor. When his enzyme levels returned to normal, he began taking Pravachol, another statin drug. He quickly developed weakness in his lower legs and a right foot drop.

Mayo Clinic cardiologists acknowledge that the side effects of statin drugs can include muscle pain, extreme fatigue, liver damage, digestive problems and neurological damage including memory loss.

Of course, not everyone who takes statins will experience side effects, so it’s a question of balancing benefits and risks, just like with any other drug. So let’s look at the supposed benefits.

If you’ve seen Lipitor ads on TV (and if you haven’t, it means you don’t watch TV), you know Pfizer claims Lipitor reduces the rate of heart attacks by 36%. As I’ve explained in previous posts, that figure may sound impressive, but basically it means that during the clinical trials, three out of every 100 men who took a placebo had a heart attack, while slightly less than two out of every 100 men who took Lipitor had a heart attack. So for every 100 men treated for ten years, we’re preventing (in theory) one heart attack.  That’s one heart attack, not necessarily one death. 

But even those unimpressive results were found only among with men with existing heart disease or multiple risk factors for heart disease — not among women, and not among otherwise healthy people who happen to have high cholesterol.

But of course, statins didn’t become the most profitable drugs in history by being prescribed solely to men with existing heart disease. Nope, statins became a cash cow when doctors started prescribing them to pretty much everybody whose cholesterol is above 200.  (In the UK, you can even buy your future muscle or memory problems over the counter — yippee!)

The theory, of course, was that statins could prevent heart disease from developing in the first place, otherwise known as “primary prevention.”  The Cochrane report casts more than a little doubt on that theory, as several media articles pointed out:

An authoritative review shows there is little evidence that the cholesterol-lowering drugs protect people who are not already at a high risk of heart disease.

Experts who advocate the use of statins say they have helped prolong thousands of lives by preventing heart attacks and other cardiovascular events. But a wide-ranging review of previous studies, published today in the journal The Cochrane Library, urges “caution” among GPs who prescribe them. It concludes that there is no “strong evidence” to suggest that statins reduce coronary heart disease deaths among those who have not suffered a heart attack or other cardiovascular event in the past.

Shah Ebrahim, a professor of public health at the London School of Hygiene and Tropical Medicine, who co-wrote the report, called on doctors to stop giving patients the drugs unnecessarily.

Just one life is currently saved for every 1,000 people who take them each year, the report says.

Great … so to prevent (in theory) one fatal heart attack among every 1,000 people who take statins, we’ve created lord-only-knows-how-many cases of muscle degeneration, memory loss, kidney failure, erectile dysfunction and liver damage. Of course, that works out well for Big Pharma — they sell drugs to treat those conditions, too.

I’ve said it before, and I’ll say it again: statins are some of the worst drugs ever. I’m just happy to see more people in the news media are catching on.


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121 thoughts on “Bad News For Statins Is Good News

  1. Neil

    I hope that there is a change starting to happen, some people (hello to you all) are starting to wake up and see the light. But there are many millions more that are still suffering in the dark of outdated information. Apparently it took two generations before people finally accepted that the world was not flat after Columbus found the US.

    Seven years ago I was diagnosed with very high blood pressure and was told that I had to go on a diet of Statins and beta-blockers for the rest of my life.
    I reluctantly took the drugs, but was adamant that I was going to get off them. I was very overweight (123 Kg) and unfit. I hit the Internet looking for a diet and found so much conflicting information. Finally found one that I felt made sense to me. It was high protien, low carb. At the time I had no idea what that ment.
    I made a deal with my doctor stating that if I could get my blood pressure down to normal levels he would let me come off the drugs.
    6 months later I went back and he tested me. I was back to normal. It took some real effort though. He then said that I could come off the drugs, that’s when I told him that I had been off them for over three months.

    Thanks to documentaries like Tom’s I now understand a lot more about my body and how it functions.

    Maybe in 20 or 30 years doctors will look back at these times and wonder why they could not see the truth, much like doctors do now on cigarette smoking. Years ago here in New Zealand doctors would prescribe smoking to mothers to calm the down during pregnancy. Doctors like any of us are only taught what to do. It is now up to all of us to re-educate our doctors with facts that they cannot dispute.

    Keep up the amazing work Tom.

    It’s amazing how many ailments the proper diet can cure. Let’s hope more and more people come to realize that instead of popping pills.

    Reply
  2. Lori

    @Larry, re: mental outlook, I noticed I became more upbeat on a low-carb, high-fat diet also. So did my mother. Part of the answer could be improved blood sugars (but my blood sugars were already normal, and my mom’s are still fairly high), part of it could be improved critical thinking to solve problems and curb bad mental habits (but my mom hasn’t worked on this). It’s not higher cholesterol, since mine went from 135 to 140. (Yes, I eat a lot of cholesterol and saturated fat, thank you.) That leaves a VLC diet–and not eating wheat.

    You might recall that in Fathead, Tom and one of the doctors got depressed on the low-fat Pritikin Diet, if memory serves. Dr. Michael Eades mentioned seeing lots of books on depression during the low-fat craze of the 90s.

    @Your Older Bro: Just because you’re paranoid doesn’t mean they’re not out to get you.

    Reply
  3. Walter

    If you’re not paranoid, it means you’re not paying attention.

    I find that my life works best when I’m as paranoid as Dick Nixon. If you’re thinking “wait a minute, Joe Stalin is the gold standard for paranoia” remember, for a goal to be achievable, it must be believable.

    Reply
  4. Sweet Tart

    Even better than your doctor prescribing statins, how about your insurance agent!

    Several years ago my husband had a blood test for life insurance and his total cholesterol was slightly above 200, but his HDL was high and his triglycerides were low. He got a call from our insurance agent telling him that with those numbers he would have to pay a higher rate. Our agent suggested that he take a statin to lower his cholesterol to get a better rate on life insurance. Needless to say, my husband declined the suggestion and decided to pay the higher rate.

    Good grief …

    Reply
  5. Mike

    @Lori – re: depression

    I had mild depression and slight fatigue for many years. I always felt like my mind ran a bit slower than it ought to – slower than it did when I was in college. Six days on a near-zero-carb diet changed all that. Suddenly (overnight) I felt normal, or as normal as I can be :o).

    I had a lot of cravings the first several times I tried the low-carb diet. It took years to figure out I was deficient in magnesium and overloading on calcium. With supplemental magnesium I no longer crave chocolate. Magnesium also helped with the fatigue and depression. I’m still dealing with the effects of long-term calcium overload from eating too much canned salmon.

    Tom,
    This info on statins came at just the right time. My 72-year-old mom is on Lipitor, and I needed some ammo to convince her to stop it. She’s already doubtful of the wisdom of her doctor, so it may not be a hard sell. I sent her a link to “Fat Head” on Hulu. Now I need to make sure she watched it.

    If she’s doubting her doctor, she’s halfway there.

    Reply
  6. Sweet Tart

    Even better than your doctor prescribing statins, how about your insurance agent!

    Several years ago my husband had a blood test for life insurance and his total cholesterol was slightly above 200, but his HDL was high and his triglycerides were low. He got a call from our insurance agent telling him that with those numbers he would have to pay a higher rate. Our agent suggested that he take a statin to lower his cholesterol to get a better rate on life insurance. Needless to say, my husband declined the suggestion and decided to pay the higher rate.

    Good grief …

    Reply
  7. Anastasia

    Not to defend the ignorance of medical profession, but you have to remember that we are taught very little nutrition in medical school. The majority of teaching is geared towards disease pathophysiology, treatments and prescribing medications. When we were told in lectures that statins were shown to decrease cardiovascular risk and improve mortality in randomized controlled trials, we had no reason to doubt it. I am in my final year of med school and like most of my colleagues, I would prescribe a medication to my patients if I thought it was going to save their life. Most doctors are not stupid, or malicious, or in league with pharmaceutical companies. They are just naive and too busy to sift through tons of primary evidence. (there’s always an exception of course). So next time you encounter a stubborn physician who is hell-bent on prescribing you statins, don’t fly off the handle and accuse them of conspiring with the Big Pharma :). Show them the evidence.

    I don’t believe most doctors are in cahoots with Big Pharma. I just wish more of them would get away from the “pill for everything” mentality and question what they’re taught.

    Reply
  8. Mike

    @Lori – re: depression

    I had mild depression and slight fatigue for many years. I always felt like my mind ran a bit slower than it ought to – slower than it did when I was in college. Six days on a near-zero-carb diet changed all that. Suddenly (overnight) I felt normal, or as normal as I can be :o).

    I had a lot of cravings the first several times I tried the low-carb diet. It took years to figure out I was deficient in magnesium and overloading on calcium. With supplemental magnesium I no longer crave chocolate. Magnesium also helped with the fatigue and depression. I’m still dealing with the effects of long-term calcium overload from eating too much canned salmon.

    Tom,
    This info on statins came at just the right time. My 72-year-old mom is on Lipitor, and I needed some ammo to convince her to stop it. She’s already doubtful of the wisdom of her doctor, so it may not be a hard sell. I sent her a link to “Fat Head” on Hulu. Now I need to make sure she watched it.

    If she’s doubting her doctor, she’s halfway there.

    Reply
  9. Anastasia

    Not to defend the ignorance of medical profession, but you have to remember that we are taught very little nutrition in medical school. The majority of teaching is geared towards disease pathophysiology, treatments and prescribing medications. When we were told in lectures that statins were shown to decrease cardiovascular risk and improve mortality in randomized controlled trials, we had no reason to doubt it. I am in my final year of med school and like most of my colleagues, I would prescribe a medication to my patients if I thought it was going to save their life. Most doctors are not stupid, or malicious, or in league with pharmaceutical companies. They are just naive and too busy to sift through tons of primary evidence. (there’s always an exception of course). So next time you encounter a stubborn physician who is hell-bent on prescribing you statins, don’t fly off the handle and accuse them of conspiring with the Big Pharma :). Show them the evidence.

    I don’t believe most doctors are in cahoots with Big Pharma. I just wish more of them would get away from the “pill for everything” mentality and question what they’re taught.

    Reply
  10. Laurie

    From the recent ‘Reuters’ report about cautioning people to think twice about taking statins, is the following quote:
    “In a review of the medical literature, they found the drugs did appear to slash deaths ever so slightly in patients at low risk of heart disease.”
    I only bring this up because I don’t think the writer even noticed the insidious nature and the pernicious effect that statins already have on us collectively that resulted in that unfortunate, salacious wording. This is what I’m trying to point out. One definition of ‘slash’ is to ‘reduce sharply’. Does reduce sharply really fit well with ‘ever so slightly’? And statins’ purported absolute decrease of risk of heart attacks is a measly 2%. Does that translate into ‘slash deaths’? Really? Words matter; actions have consequences. Big Pharma’s advertising phrases and their actions- get profitable statins into as many people as possible- have had unintended consequences galore.

    I’m with you. When you modify “slash” with “ever so slightly,” the verb was the wrong choice.

    Reply
  11. Laurie

    From the recent ‘Reuters’ report about cautioning people to think twice about taking statins, is the following quote:
    “In a review of the medical literature, they found the drugs did appear to slash deaths ever so slightly in patients at low risk of heart disease.”
    I only bring this up because I don’t think the writer even noticed the insidious nature and the pernicious effect that statins already have on us collectively that resulted in that unfortunate, salacious wording. This is what I’m trying to point out. One definition of ‘slash’ is to ‘reduce sharply’. Does reduce sharply really fit well with ‘ever so slightly’? And statins’ purported absolute decrease of risk of heart attacks is a measly 2%. Does that translate into ‘slash deaths’? Really? Words matter; actions have consequences. Big Pharma’s advertising phrases and their actions- get profitable statins into as many people as possible- have had unintended consequences galore.

    I’m with you. When you modify “slash” with “ever so slightly,” the verb was the wrong choice.

    Reply
  12. Jerry

    Yet another ijit who thinks that big business is evil. Grow up. There are loads of healthcare professionals in the pharma industry, and we wouldn’t be there unless we believed that we were helping people. The Cochrane Review also stated:

    “All cause mortality. coronary heart disease and stroke events were reduced with the use of statins as was the need for revascularisations. Statin treatment reduced blood cholesterol. Taking statins did not increase the risk of adverse effects such as cancer. and few trials reported on costs or quality of life.”

    It’s blindingly obvious that these drugs save lives, and prevent CV disease. Cholesterol is a valid biomarker for CV disease. Just because it’s not naturally found in birdsh*t, doesn’t mean that it’s toxic.

    Keep passing the open windows…

    Since the Cochrane report specifically stated there’s no conclusive evidence that statins work for primary prevention, would you care to explain how it’s “blindingly obvious” that statins prevent CV? I must’ve missed something. Since many studies funded by the statin makers didn’t include all-cause mortality figures, would you care to explain how it’s “blindingly obvious” that statins save lives? Did the statin-makers find impressive reductions in all-cause mortality and just decide they wouldn’t bother to report this fabulous news?

    You may want to take a course in reading and comprehension. When the Cochrane report stated that few studies reported on cost or quality of life, that wasn’t a compliment. The authors also were quite clear that they don’t trust the “adverse event” data reported by the industry-funded studies.

    As for me being yet another ijit who thinks big business is evil, I’m going to assume you’ve never seen the film or read any other posts on either of my blogs.

    Reply
  13. Jerry

    Yet another ijit who thinks that big business is evil. Grow up. There are loads of healthcare professionals in the pharma industry, and we wouldn’t be there unless we believed that we were helping people. The Cochrane Review also stated:

    “All cause mortality. coronary heart disease and stroke events were reduced with the use of statins as was the need for revascularisations. Statin treatment reduced blood cholesterol. Taking statins did not increase the risk of adverse effects such as cancer. and few trials reported on costs or quality of life.”

    It’s blindingly obvious that these drugs save lives, and prevent CV disease. Cholesterol is a valid biomarker for CV disease. Just because it’s not naturally found in birdsh*t, doesn’t mean that it’s toxic.

    Keep passing the open windows…

    Since the Cochrane report specifically stated there’s no conclusive evidence that statins work for primary prevention, would you care to explain how it’s “blindingly obvious” that statins prevent CV? I must’ve missed something. Since many studies funded by the statin makers didn’t include all-cause mortality figures, would you care to explain how it’s “blindingly obvious” that statins save lives? Did the statin-makers find impressive reductions in all-cause mortality and just decide they wouldn’t bother to report this fabulous news?

    You may want to take a course in reading and comprehension. When the Cochrane report stated that few studies reported on cost or quality of life, that wasn’t a compliment. The authors also were quite clear that they don’t trust the “adverse event” data reported by the industry-funded studies.

    As for me being yet another ijit who thinks big business is evil, I’m going to assume you’ve never seen the film or read any other posts on either of my blogs.

    Reply
  14. Ellen

    Last summer, I saw Dr. Peter Langsjoen, a cardiologist who is an expert on statins and CoQ10, speak at a conference, and this is what he said about statins:

    “Statins are the worst drugs ever made, and if you are taking them, you should throw them in the garbage, or give them to someone you don’t like.”

    I agree. Let’s give them to the all of the drug company CEOs and hope THEY have memory loss and kidney failure.

    Can we clone Dr. Langsjoen?

    Reply
  15. Marilyn

    Unfortunately, the side effects thing is cyclical:

    Since so many of the side effects are easily attributed by both patients and doctors to “old age,” they are not reported to the drug companies.

    Since the side effects are not reported to the drug companies, they don’t show up in the drug books. So doctors see no reason to connect statins to the side effects when patients complain of them.

    Like most people, doctors don’t see what they’re not looking for.

    Reply
  16. Dana Carpender

    My doctor and I have an agreement: If she ever wants to stop being my doctor, she’ll try to get me to take statins.

    Fortunately, I’ve found a doctor that doesn’t treat me like I’m stupid. She mentioned that my LDL was just a teeny bit above the so-called “healthy” range, and I pointed out that my triglycerides were in the 40s. “I could lower my LDL by raising my triglycerides.” She laughed and said “Bad idea.”

    (For those who don’t know, LDL isn’t directly measured, but calculated with something called the Friedewald equation. This equation is: Total Cholesterol – HDL + (triglycerides/5). It’s apparently reasonably accurate if your trigs are over 100. But with the low trigs low carbers run, it’s misleading, to say the least.)

    That’s right; the Friedewald equation nearly always over-estimates LDL for people with low triglycerides. And if your LDL is large and fluffy (which is likely is when triglycerides are low), who the heck cares? Fluffy LDL is good for you.

    Reply
  17. Dana

    Check out WebMD’s incredible defense of statins on the grounds that risk of diabetes is lower than risk of heart attack without them.

    http://www.webmd.com/cholesterol-management/news/20100217/statins-may-be-linked-to-diabetes-risk

    Funny though, they’ll prescribe statins on the basis of a risk that tiny but they’ll dismiss diabetes, and never mind that if you get diabetes you’re at risk of a lot more problems than you would be if you suffered but survived a heart attack.

    My dad’s diabetic and is on a statin for his cholesterol. He’s never had a heart attack and he turns sixty in November. Diabetes is a risk factor for kidney problems. Statins are a risk for kidney problems. On top of that he’s had at least two episodes of anemia requiring hospitalization for a blood transfusion. I don’t know if it’s been any more than that because he lives several states away and he doesn’t tell me about this stuff til six months after or more. But both statins and diabetes are risk factors for anemia, as well.

    I wish I were living with him again, I’d try to transition him over to low carb if I could. I think he’d really enjoy it–the notion that he could still eat meat and fat for the sake of health would be quite novel to him. But from here I really can’t do anything because I can’t monitor him at all.

    On top of that he’s a problem drinker, has been for most of his life, and of course any problems he has will be blamed on that. Can’t be the sainted statins, no way!

    Believe me, I wish I could go back in time and give my dad some advice. He probably wouldn’t have Alzheimer’s today.

    Reply
  18. Dana

    Oh, someone mentioned mental health issues vs. low carb. Here’s my experience so far. Low carb does indeed help my mental status–and I had been taking Lexapro there for a while. (They even prescribe it to pregnant women, can you believe that?) I’d have these wicked mood swings and impulses to seek conflict and all manner of crazy stuff. On low-carb I evened out a LOT. And since then I have found that as long as I’m getting a good amount of saturated fat in my diet, regardless of the carb content of my overall diet, I stay relatively sane. The one thing that seems to make a difference now is the amount of wheat I eat. Been something of an addict where that is concerned. The more wheat I eat, the stranger things my brain does–still functional, but not *me.* Nevertheless, it seems the effects of the saturated fat sort of blunt that a little bit.

    I’d be curious to look into the mental status of people who try to do low carb with little to no saturated fat. That’d really cinch it.

    Reply
  19. Anastasia

    I wasn’t making a comment at you directly, Tom. You are one of the people that I wish was giving us lectures on metabolism! Sometimes people from the low-carb/paleo community go a bit over the top. As for me, I feel embarassed to be part of the profession whose job description got reduced to writing scripts. We need people like you to keep challenging us and questioning the myths that are considered dogma.

    I didn’t take it personally. I’m glad you’re in the profession. We need more like you.

    Reply
  20. Lori

    Anastasia said, “Most doctors are not stupid, or malicious, or in league with pharmaceutical companies. They are just naive and too busy to sift through tons of primary evidence. (there’s always an exception of course).”

    I don’t think most doctors are stupid, malicious or conspirators, either. But naive–yes. Hanging out one’s shingle and simply reciting recommendations is sheer intellectual laziness. Considering the consequences of badly controlled illnesses like diabetes and heart problems–amputation, blindness, heart attack, stroke, death–it’s irresponsible.

    I’m thinking of a doctor I had an online conversation with several months ago. She had a subspecialty in diabetes, yet recommended her diabetic patients eat at least 130 grams of carbohydrate per day. Why? Because the ADA said so. At that level of education, a doctor shouldn’t need to sift through tons of primary evidence to know that carb raises blood sugar, that high blood sugars cause organ and tissue damage, and the liver can make glucose out of protein. That should take nothing but a review of the textbook. It takes nothing but a curious mind to wonder why people who don’t eat anything close to 130 grams of carb don’t get hypos and question how much carb people really need, and wonder how it can be that the high-fat diet most humans lived on for two million years is so bad for us.

    If doctors are just reciting official recommendations, what good are they? Patients can look up guidelines for themselves, and in the UK, they can buy statins OTC. In most states, people can order a variety of medical tests–no doctor needed. If their doctor knows less about treating their condition than they do, why not?

    Reply
  21. Heada Spinning

    Thanks for this article; I’m glad I found it along with the links to the Cochrane report you gave. I’m an under 40 y.o. woman, 5′ 9″, 140#, pretty fit. Unfortunately, my mom has HBP and high LDL and mine came back at 296. ALL my other #s are great– triglycerides, HDL, etc. I talked my doc into giving me a few months to work on diet and other changes to bring the LDL down. She wants to put me on a statin if my # is still high. I’m slightly confused, though. Do I fall into a high risk category or no? Or are all the statins “high risk” enough by themselves? I appreciate your replying personally to most of these posts, Tom : )

    The best predictor of heart disease is Triglycerides/HDL. If that ratio is below 2.0, your LDL is most likely the large, fluffy type that isn’t harmful and may in fact protect against cancer and infections. If your doctor insists, ask her which studies show statins prevent heart disease in women when given as a primary intervention.

    Reply
  22. Ellen

    Last summer, I saw Dr. Peter Langsjoen, a cardiologist who is an expert on statins and CoQ10, speak at a conference, and this is what he said about statins:

    “Statins are the worst drugs ever made, and if you are taking them, you should throw them in the garbage, or give them to someone you don’t like.”

    I agree. Let’s give them to the all of the drug company CEOs and hope THEY have memory loss and kidney failure.

    Can we clone Dr. Langsjoen?

    Reply
  23. Lori

    Tom, did you mean to write “triglycerides/HDL” in response to Heada Spinning? I’m thinking HDL of 40 and triglycerides of 200 would be under 2.0, yet not a good thing.

    Headsmack. Yes, thanks for the catch. I’ll fix it.

    Reply
  24. Doug Stables

    Well said Ellen, Dr. Langsjoen, a Cardiologist, that recommends

    supplementation of Co enzyme Q10, especially if one is taking

    Statin drugs, but be careful when purchasing Q10, you must go for

    quality fermented Q10 which takes 9 months, to reach it’s maximum

    strenght, the cheaper inferior brands are filled with preservatives oils etc.

    and are ready in 24 hours or so, but because of this procedure,

    then oxidises, then it’s useless, fermented Q10 remains unoxidised,

    therefore it works.

    Reply
  25. Marilyn

    Unfortunately, the side effects thing is cyclical:

    Since so many of the side effects are easily attributed by both patients and doctors to “old age,” they are not reported to the drug companies.

    Since the side effects are not reported to the drug companies, they don’t show up in the drug books. So doctors see no reason to connect statins to the side effects when patients complain of them.

    Like most people, doctors don’t see what they’re not looking for.

    Reply
  26. Dana Carpender

    My doctor and I have an agreement: If she ever wants to stop being my doctor, she’ll try to get me to take statins.

    Fortunately, I’ve found a doctor that doesn’t treat me like I’m stupid. She mentioned that my LDL was just a teeny bit above the so-called “healthy” range, and I pointed out that my triglycerides were in the 40s. “I could lower my LDL by raising my triglycerides.” She laughed and said “Bad idea.”

    (For those who don’t know, LDL isn’t directly measured, but calculated with something called the Friedewald equation. This equation is: Total Cholesterol – HDL + (triglycerides/5). It’s apparently reasonably accurate if your trigs are over 100. But with the low trigs low carbers run, it’s misleading, to say the least.)

    That’s right; the Friedewald equation nearly always over-estimates LDL for people with low triglycerides. And if your LDL is large and fluffy (which is likely is when triglycerides are low), who the heck cares? Fluffy LDL is good for you.

    Reply
  27. Dana

    Check out WebMD’s incredible defense of statins on the grounds that risk of diabetes is lower than risk of heart attack without them.

    http://www.webmd.com/cholesterol-management/news/20100217/statins-may-be-linked-to-diabetes-risk

    Funny though, they’ll prescribe statins on the basis of a risk that tiny but they’ll dismiss diabetes, and never mind that if you get diabetes you’re at risk of a lot more problems than you would be if you suffered but survived a heart attack.

    My dad’s diabetic and is on a statin for his cholesterol. He’s never had a heart attack and he turns sixty in November. Diabetes is a risk factor for kidney problems. Statins are a risk for kidney problems. On top of that he’s had at least two episodes of anemia requiring hospitalization for a blood transfusion. I don’t know if it’s been any more than that because he lives several states away and he doesn’t tell me about this stuff til six months after or more. But both statins and diabetes are risk factors for anemia, as well.

    I wish I were living with him again, I’d try to transition him over to low carb if I could. I think he’d really enjoy it–the notion that he could still eat meat and fat for the sake of health would be quite novel to him. But from here I really can’t do anything because I can’t monitor him at all.

    On top of that he’s a problem drinker, has been for most of his life, and of course any problems he has will be blamed on that. Can’t be the sainted statins, no way!

    Believe me, I wish I could go back in time and give my dad some advice. He probably wouldn’t have Alzheimer’s today.

    Reply
  28. Dana

    Oh, someone mentioned mental health issues vs. low carb. Here’s my experience so far. Low carb does indeed help my mental status–and I had been taking Lexapro there for a while. (They even prescribe it to pregnant women, can you believe that?) I’d have these wicked mood swings and impulses to seek conflict and all manner of crazy stuff. On low-carb I evened out a LOT. And since then I have found that as long as I’m getting a good amount of saturated fat in my diet, regardless of the carb content of my overall diet, I stay relatively sane. The one thing that seems to make a difference now is the amount of wheat I eat. Been something of an addict where that is concerned. The more wheat I eat, the stranger things my brain does–still functional, but not *me.* Nevertheless, it seems the effects of the saturated fat sort of blunt that a little bit.

    I’d be curious to look into the mental status of people who try to do low carb with little to no saturated fat. That’d really cinch it.

    Reply
  29. Anastasia

    I wasn’t making a comment at you directly, Tom. You are one of the people that I wish was giving us lectures on metabolism! Sometimes people from the low-carb/paleo community go a bit over the top. As for me, I feel embarassed to be part of the profession whose job description got reduced to writing scripts. We need people like you to keep challenging us and questioning the myths that are considered dogma.

    I didn’t take it personally. I’m glad you’re in the profession. We need more like you.

    Reply
  30. PeggySu

    I took Lipitor for about a year 5 years ago when I was 65. I was a wreck with pains everywhere, shoulders were the worst. Like others, I thought at first it was just age.

    My 97-yr old (mentally healthy) father had open heart surgery a few years back and his cardio doctor put him on Zocor. Under those circumstances I’m not going to try to talk him out of statins. However last summer I finally got him to start taking CoQ10 (his doc said it “couldn’t hurt”) and within a few weeks his back pain and other muscle pains just stopped. He’s thrilled. So if you can’t get someone off statins, at least get them on CoQ10.

    Good advice on your part. Statins deplete CoQ10. I wouldn’t take a statin, but I’d certainly urge those who do to add a CoQ10 supplement.

    Reply
  31. Lori

    Anastasia said, “Most doctors are not stupid, or malicious, or in league with pharmaceutical companies. They are just naive and too busy to sift through tons of primary evidence. (there’s always an exception of course).”

    I don’t think most doctors are stupid, malicious or conspirators, either. But naive–yes. Hanging out one’s shingle and simply reciting recommendations is sheer intellectual laziness. Considering the consequences of badly controlled illnesses like diabetes and heart problems–amputation, blindness, heart attack, stroke, death–it’s irresponsible.

    I’m thinking of a doctor I had an online conversation with several months ago. She had a subspecialty in diabetes, yet recommended her diabetic patients eat at least 130 grams of carbohydrate per day. Why? Because the ADA said so. At that level of education, a doctor shouldn’t need to sift through tons of primary evidence to know that carb raises blood sugar, that high blood sugars cause organ and tissue damage, and the liver can make glucose out of protein. That should take nothing but a review of the textbook. It takes nothing but a curious mind to wonder why people who don’t eat anything close to 130 grams of carb don’t get hypos and question how much carb people really need, and wonder how it can be that the high-fat diet most humans lived on for two million years is so bad for us.

    If doctors are just reciting official recommendations, what good are they? Patients can look up guidelines for themselves, and in the UK, they can buy statins OTC. In most states, people can order a variety of medical tests–no doctor needed. If their doctor knows less about treating their condition than they do, why not?

    Reply
  32. Heada Spinning

    Thanks for this article; I’m glad I found it along with the links to the Cochrane report you gave. I’m an under 40 y.o. woman, 5′ 9″, 140#, pretty fit. Unfortunately, my mom has HBP and high LDL and mine came back at 296. ALL my other #s are great– triglycerides, HDL, etc. I talked my doc into giving me a few months to work on diet and other changes to bring the LDL down. She wants to put me on a statin if my # is still high. I’m slightly confused, though. Do I fall into a high risk category or no? Or are all the statins “high risk” enough by themselves? I appreciate your replying personally to most of these posts, Tom : )

    The best predictor of heart disease is Triglycerides/HDL. If that ratio is below 2.0, your LDL is most likely the large, fluffy type that isn’t harmful and may in fact protect against cancer and infections. If your doctor insists, ask her which studies show statins prevent heart disease in women when given as a primary intervention.

    Reply
  33. Lori

    Tom, did you mean to write “triglycerides/HDL” in response to Heada Spinning? I’m thinking HDL of 40 and triglycerides of 200 would be under 2.0, yet not a good thing.

    Headsmack. Yes, thanks for the catch. I’ll fix it.

    Reply
  34. Doug Stables

    Well said Ellen, Dr. Langsjoen, a Cardiologist, that recommends

    supplementation of Co enzyme Q10, especially if one is taking

    Statin drugs, but be careful when purchasing Q10, you must go for

    quality fermented Q10 which takes 9 months, to reach it’s maximum

    strenght, the cheaper inferior brands are filled with preservatives oils etc.

    and are ready in 24 hours or so, but because of this procedure,

    then oxidises, then it’s useless, fermented Q10 remains unoxidised,

    therefore it works.

    Reply
  35. PeggySu

    I took Lipitor for about a year 5 years ago when I was 65. I was a wreck with pains everywhere, shoulders were the worst. Like others, I thought at first it was just age.

    My 97-yr old (mentally healthy) father had open heart surgery a few years back and his cardio doctor put him on Zocor. Under those circumstances I’m not going to try to talk him out of statins. However last summer I finally got him to start taking CoQ10 (his doc said it “couldn’t hurt”) and within a few weeks his back pain and other muscle pains just stopped. He’s thrilled. So if you can’t get someone off statins, at least get them on CoQ10.

    Good advice on your part. Statins deplete CoQ10. I wouldn’t take a statin, but I’d certainly urge those who do to add a CoQ10 supplement.

    Reply
  36. Theresa

    Thanks for the good info, I love reading your site. I am so torn with this issue! Every time I read this stuff I say “Yes, I agree, but what about people with the genetic form of high cholesterol?” My husband has been on Lipitor for years. He has inherited high cholesterol along with his brother and father who both had heart attacks in their 30’s and 40’s. Now two of our children have been diagnosed. They are 5 and 6. When they are 10 we will be pressured to put them on Lipitor too. I’m so tired of the info that our docs give us (take Lipitor and eat low fat) I’m reading Good calories, bad calories right now and loving it. Do you have any good resources for people with this genetic condition? Are there people who SHOULD take Lipitor? Are they any different than the guy next door who has eaten his way to high cholesterol? I want to do the best for my family but it’s a struggle to know the truth.

    Dr. Duane Graveline, who is opposed to statins in most cases, still supports them for a select few, but only at low doses. His site is:

    http://www.SpaceDoc.net

    Reply
  37. Theresa

    Thanks for the good info, I love reading your site. I am so torn with this issue! Every time I read this stuff I say “Yes, I agree, but what about people with the genetic form of high cholesterol?” My husband has been on Lipitor for years. He has inherited high cholesterol along with his brother and father who both had heart attacks in their 30’s and 40’s. Now two of our children have been diagnosed. They are 5 and 6. When they are 10 we will be pressured to put them on Lipitor too. I’m so tired of the info that our docs give us (take Lipitor and eat low fat) I’m reading Good calories, bad calories right now and loving it. Do you have any good resources for people with this genetic condition? Are there people who SHOULD take Lipitor? Are they any different than the guy next door who has eaten his way to high cholesterol? I want to do the best for my family but it’s a struggle to know the truth.

    Dr. Duane Graveline, who is opposed to statins in most cases, still supports them for a select few, but only at low doses. His site is:

    http://www.SpaceDoc.net

    Reply
  38. PHK

    My friend, due to a genetic condition, needed a heart valve replacement.

    after surgery, despite his “low” cholesterol of 180, he was put on statin, along with a 4 or 5 other drugs (beta blocker, 2 types of antibiotics)

    anyway, he ballooned to 300 lbs due to the fluid retention.

    in his case, the muscles that were weakened happened to be his heart muscles.

    so at the end, he was suffering heart failure.

    at first the medics were in denial but when it was proven that it was his heart, they pulled him off statin. (methink he got luck that he suffered no lasting side effect)

    regards,

    Statins can damage muscles. The heart is a muscle. That’s why I’d never go on a statin.

    Reply
  39. PHK

    My friend, due to a genetic condition, needed a heart valve replacement.

    after surgery, despite his “low” cholesterol of 180, he was put on statin, along with a 4 or 5 other drugs (beta blocker, 2 types of antibiotics)

    anyway, he ballooned to 300 lbs due to the fluid retention.

    in his case, the muscles that were weakened happened to be his heart muscles.

    so at the end, he was suffering heart failure.

    at first the medics were in denial but when it was proven that it was his heart, they pulled him off statin. (methink he got luck that he suffered no lasting side effect)

    regards,

    Statins can damage muscles. The heart is a muscle. That’s why I’d never go on a statin.

    Reply
  40. Clark

    To tell you the truth, Tom, I think the people who promote these Statins are either seriously misguided, selfish, or just psychos.

    Reply
  41. Clark

    To tell you the truth, Tom, I think the people who promote these Statins are either seriously misguided, selfish, or just psychos.

    Reply
  42. Geoff G.

    How’s this for a title to an article….”Would You Like Statins With Your Burger?”
    Check this link out: http://www.gizmag.com/statin-drugs-at-fast-food-restaurant/17701/?utm_source=Gizmag+Subscribers&utm_campaign=f164fe421d-UA-2235360-4&utm_medium=email

    Tom, look at this article. What will they think of next!!! IJITS all of them!!

    That same goof is at it again, I see. I wrote about him and his suggestion in this post:

    http://www.fathead-movie.com/index.php/2010/08/12/would-you-like-some-mcstatins-with-that/

    Reply
  43. Geoff G.

    How’s this for a title to an article….”Would You Like Statins With Your Burger?”
    Check this link out: http://www.gizmag.com/statin-drugs-at-fast-food-restaurant/17701/?utm_source=Gizmag+Subscribers&utm_campaign=f164fe421d-UA-2235360-4&utm_medium=email

    Tom, look at this article. What will they think of next!!! IJITS all of them!!

    That same goof is at it again, I see. I wrote about him and his suggestion in this post:

    http://www.fathead-movie.com/index.php/2010/08/12/would-you-like-some-mcstatins-with-that/

    Reply
  44. John W.

    I enjoyed reading about this particular brand of bologna! My wife has MS and is being told to take CRAB drugs to reduce her immunity since MS is an auto-immune disorder. These drugs cost $2500 a month which my insurance company pays out. The drug company claims that these expensive drugs are 30% effective, but real data says they are only 17% effective. Why take a drug that is mostly ineffective anyway? Another drug, Low Dose Naltrexone has been shown to be beneficial in many cases, and my wife finds that inexpensive drug ($50 a month) to be good for her. But LDN is not accepted as a treatment for MS and my insurance company will not pay for it. The drug is cheap and cannot be co-opted by Big Pharma, so no one wants to put the money into doing formal research. So, we only have insurance paying for the expensive CRABS drugs, some of which cause fatal brain infections, and an almost permanent nausea. To make matters worse, a new approach to treating MS involving something called CCSVI is being opposed by the MS Society as well as almost any neurologist who specializes in MS. Treating CCSVI as a means to treat MS is being represented (recently even on NPR) as a kind of snake oil medicine and a dangerous procedure. Basically, it involves doing an angioplasty on MS patients. Of the 15,000 people treated so far, only two have died. A couple more have had some serious complications. Well, my wife had her first angioplasty today, and she feels great. Many of her MS symptoms are gone. A blind spot on one of her eyes has disappeared…she can see out of it now. We have yet to see more results, but we don’t need doctors to throw more expensive and dangerous medicines at us. We need results. Big Pharma tweaks the numbers and falsifies their reports. That is not giving us results. Don’t even get me started on Prozac because doctors have no idea what that drug does to a person’s brain, but they continue to prescribe it….as well as other anti-depressant snake oil meds.

    Thanks for this report on statins. I will keep reading more about them as my blood pressure has been up lately, and my family has no real history of heart disease. I’m going to see what I really need to do so that I live longer.

    Sorry to hear about your wife’s condition. I presume you already know to try removing all grains from her diet to see if that helps.

    Reply
  45. John W.

    I enjoyed reading about this particular brand of bologna! My wife has MS and is being told to take CRAB drugs to reduce her immunity since MS is an auto-immune disorder. These drugs cost $2500 a month which my insurance company pays out. The drug company claims that these expensive drugs are 30% effective, but real data says they are only 17% effective. Why take a drug that is mostly ineffective anyway? Another drug, Low Dose Naltrexone has been shown to be beneficial in many cases, and my wife finds that inexpensive drug ($50 a month) to be good for her. But LDN is not accepted as a treatment for MS and my insurance company will not pay for it. The drug is cheap and cannot be co-opted by Big Pharma, so no one wants to put the money into doing formal research. So, we only have insurance paying for the expensive CRABS drugs, some of which cause fatal brain infections, and an almost permanent nausea. To make matters worse, a new approach to treating MS involving something called CCSVI is being opposed by the MS Society as well as almost any neurologist who specializes in MS. Treating CCSVI as a means to treat MS is being represented (recently even on NPR) as a kind of snake oil medicine and a dangerous procedure. Basically, it involves doing an angioplasty on MS patients. Of the 15,000 people treated so far, only two have died. A couple more have had some serious complications. Well, my wife had her first angioplasty today, and she feels great. Many of her MS symptoms are gone. A blind spot on one of her eyes has disappeared…she can see out of it now. We have yet to see more results, but we don’t need doctors to throw more expensive and dangerous medicines at us. We need results. Big Pharma tweaks the numbers and falsifies their reports. That is not giving us results. Don’t even get me started on Prozac because doctors have no idea what that drug does to a person’s brain, but they continue to prescribe it….as well as other anti-depressant snake oil meds.

    Thanks for this report on statins. I will keep reading more about them as my blood pressure has been up lately, and my family has no real history of heart disease. I’m going to see what I really need to do so that I live longer.

    Sorry to hear about your wife’s condition. I presume you already know to try removing all grains from her diet to see if that helps.

    Reply
  46. me

    I was told to take lipitor in 2000 due to elevated cholesterol values around 180. After three months, my liver values were through the roof and my Dr suggested stopping for a while. 10 years later, my liver values are still extremely high. Morale: stay away from this stuff, it’s dangerous.

    You were prescribed Lipitor for cholesterol of 180?! That’s just nuts.

    Reply
  47. me

    I was told to take lipitor in 2000 due to elevated cholesterol values around 180. After three months, my liver values were through the roof and my Dr suggested stopping for a while. 10 years later, my liver values are still extremely high. Morale: stay away from this stuff, it’s dangerous.

    You were prescribed Lipitor for cholesterol of 180?! That’s just nuts.

    Reply
  48. Marilyn

    John W., I’m sorry to hear about your wife’s MS situation. I’m an MSer, too, but the primary progressive kind, so I’ve never been offered any of those nasty drugs. Frankly, I’m still not convinced about the whole “auto immune” explanation for so many of these diseases. I try to keep my immune system in as good shape as possible, thank you very much. And you’re right, for all the side effects of the CRABs, and the very poor rate of improvement they offer, they really aren’t a very good option. Get rid of the grains, as Tom suggests, especially the gluten ones. I’m not convinced it’s necessary to get rid of dairy as a lot of sites recommend; I certainly haven’t. Rest is vitally important . . . and I should listen to my own preaching here. . . I’ve recently wondered, since cholesterol is a component of the myelin sheath (do a Google search for the two words “myelin” and “cholesterol”), if my ultra-low fat diet at the time this thing got rolling didn’t contribute to it. Just yesterday, I turned up a slip with my cholesterol reading at the time and it was 164 — on no drugs.

    Reply

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