More Cholesterol Follies

      182 Comments on More Cholesterol Follies

“It’s no accident that we’re drug oriented, really. The drug companies got us that way and they’d like to keep us that way.  It’s a simple thing. They start you early with the oral habit. Little orange flavored aspirin for children. (pop, pop) Two in the mouth, son. Something wrong with your head? (pop, pop) Two in the mouth. Remember that:  head, mouth. (pop, pop) These are orange; there’ll be other colors later on.”
– George Carlin

I’m wondering what color the drug companies will choose for children’s statins.  Maybe they’ll produce cherry-flavored pills shaped like the American Heart Association’s logo.  Two in the mouth, son.

I was hoping against hope the anti-cholesterol hysterics would never be foolish enough prescribe statins for kids, but a recent news article suggests that’s where we’re headed:

More children should be screened for high cholesterol before puberty, beyond those with a family history of problems, according to wide-ranging new guidelines expected from government-appointed experts who are trying to prevent heart disease later in life.

Any call for wider screening is likely to raise concern about overdiagnosing a condition that may not cause problems for decades, if ever. Yet studies suggest that half of children with high cholesterol will also have it as adults, and it’s one of the best-known causes of clogged arteries that can lead to heart attacks.

High cholesterol is one of the best-known causes of clogged arteries?  Well, in that case, obviously most people who suffer heart attacks must have high cholesterol.  We’ll come back to that.

About a third of U.S. children and teens are obese or overweight. And government studies estimate that about 10 to 13 percent of children and teens have high cholesterol — defined as a score above 200.

Yup, that’s how high cholesterol is defined, all right.  It was defined that way for an important scientific reason:   the average cholesterol level among (non-statinated) adults is around 220.  By defining a normal cholesterol level as high, the National Cholesterol Education Program (whose members nearly all had consulting contracts with statin-makers) turned millions of adults into instant patients.  Now the statin-makers want to tap the kiddie market too.

A key change will be more aggressive recommendations for cholesterol screening and treatment in children, including a change in “the age at which we feel we can safely use statins,” said Dr. Reginald Washington, a pediatric heart specialist in Denver and member of the panel.

I wasn’t aware that the safety of statins for children was based on feelings.  I was thinking perhaps there should be some hard evidence involved.

The pediatrics academy already advises that some children as young as 8 can safely use these cholesterol-lowering medicines, sold as Lipitor, Zocor and in generic form. They are known to prevent heart disease and deaths in adults and are approved for use in children.

Statins are known to prevent heart disease and deaths in adults?  Let’s see what the science has to say on that.  Here’s the conclusion of a meta-analysis on the usefulness of statins for primary prevention – that is, preventing heart attacks in people who don’t already have heart disease:

A new meta-analysis of statins in the primary prevention of heart disease has not shown a significant reduction in all-cause mortality.

Here’s the conclusion of a similar study:

In patients without CV disease, statin therapy decreases the incidence of major coronary and cerebrovascular events and revascularizations, but not coronary heart disease or overall mortality.

Statins may slightly reduce your chances of having a heart attack (if you already have several known risk factors), but they don’t reduce heart disease or overall mortality.  So when a journalist tells you statins are known to prevent heart disease and deaths in adults, the journalist is making a statement that simply isn’t true.

Statins are worthless for primary prevention.  So at best, the kids would be taking a powerful drug they don’t need.  At worst (and I expect the worst), the statins would starve their brains of cholesterol and destroy the mitochondria in their muscles – at exactly the time when their brains and muscles are developing rapidly.  This is a disaster waiting to happen.  With their brain development stunted at an early age, the only career paths open to these kids will be running for Congress or working for the FDA.

But there aren’t big studies showing that using them in children will prevent heart attacks years or decades later.

Well then, by all means, let’s start giving statins to kids based on nothing more than anti-cholesterol hysteria  — and our feelings.  We needn’t bother waiting for those big studies.  To paraphrase George McGovern, we don’t have time to wait for every last shred of evidence to come in.

I said earlier that we’d come back to the statement that high cholesterol being one of the best-known causes of clogged arteries.  If that’s true, then we’d expect most heart-attack victims to have high cholesterol.  But that simply isn’t the case.  Several months ago, I posted about a study showing that nearly three-quarters of heart-attack victims have normal or even low LDL levels – and course, it’s LDL that statins beat into submission.

If you look at heart disease rates and cholesterol levels around the world, you won’t find any correlation whatsoever.  The French and the Swiss both have average cholesterol levels over 230.  They also have the first and second lowest rates of heart disease among industrialized nations.  Russians have an average cholesterol level of 190 – below that magic number of 200.  Russians also have the highest rate of heart disease in Europe.

In another recent news story warning that (eek!) up to one-fifth of people with heart disease aren’t being good little patients and taking their statins, the truth about cholesterol and heart disease slips out again  — although that wasn’t the intention of the article:

More than one in five people with heart disease aren’t getting life-saving statin drugs despite guidelines saying they should, a new study shows.  Researchers looked at nearly 39,000 people who had experienced a heart attack or undergone heart surgery, and found about 8,600 people weren’t prescribed the cholesterol-lowering medications.

Notice the reporter couldn’t resist referring to statins as “life-saving.”  Bias?  What bias?  We don’t see any bias.

Now for the paragraph where the truth slips out:

“Our study shows that half of untreated patients had low LDL levels,” said Dr. Suzanne Arnold of Saint Luke’s Mid America Heart Institute in Kansas City, who worked on the new findings. “This supports the assumption that some doctors may not think patients with low LDL levels need lipid-lowering medication,” she told Reuters Health.

The patients in this study were people who already had a heart attack – and half of them had low LDL levels.  If high cholesterol is one of the best-known causes of clogged arteries, then how the @#$% do we explain away the fact that at least half of the people who suffer heart attacks don’t have high cholesterol?  And how on earth do we justify giving statins to kids just because they have “high” cholesterol?

But even in people with low LDL cholesterol, statins can provide a benefit, according to Arnold. “Statins do more than just lower cholesterol,” she said. “They also play a role in reducing plaque and inflammation in arteries. That benefits people regardless of their cholesterol levels.”

Here’s a crazy idea, Dr. Arnold:  Given what you just said, perhaps high cholesterol isn’t the problem.   Perhaps inflammation is the problem, and the only reason statins provide any benefit at all is that they lower inflammation.    We don’t need drugs to reduce inflammation.  We can do that with a proper diet.  Beating down our cholesterol levels isn’t a benefit of statins; it’s a nasty side-effect.

In some people, statins can cause muscle pain and stomach problems such as nausea, gas, diarrhea or constipation. And their long-term effect on muscle tissue is unknown.

Yes, determining the long-term effect of statins on muscle tissue is tricky, especially since so many older people take statins.  As my mom discovered, if you’re a senior citizen who takes statins and you complain to your doctor about muscle pain, your doctor will probably attribute the pain to old age.

So here’s what we need to do:  Let’s prescribe statins to a whole generation of kids.  In just 20 years or so, we’ll finally know the long-term effects of statins on muscle tissue.  I’m sure all those 30-year-olds in wheelchairs will be glad to know they contributed to medical science.


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182 thoughts on “More Cholesterol Follies

  1. Jason Sandeman

    I just read (over at Dr Mercola’s site) about how a study showed that overuse of statins actually increase your odds of developing type 2 diabetes. Great – that way a person is on the hooks for statins, an for the BIGGEST Pharma business of all – diabetes supplies. Oh, joy!

    That has shown up in the literature lately. As someone on THINCS asked, how may side effects do they need to find before they decide the dangers outweigh the supposed benefits?

    Reply
  2. Debbie C.

    Scary to think about kids on statins. Well to me it’s scary to think about *anyone* on statins, though a woman on the low carb group I hang out at, who does take statins, insists: “If you do some research, you will see plenty of studies that show a reduction in heart disease and fatalities in older diabetic women (like me)[when taking statins], including studies done overseas with no big pharma funding”.

    I just don’t know which studies those are.

    Ask for references.

    Reply
  3. Laura A

    Debbie C – Actually a lot of studies show that statins and low chloesterol do absolutely no good for older women. I know that The Cholesterol Con, GBGC for a couple I can think have have references to those studies.
    I too would be interested to see what studies you friend is talking about. If they were in Europe I would think that the Thinc group would have seen and commented.

    Reply
  4. Laura A

    Debbie C – Actually a lot of studies show that statins and low chloesterol do absolutely no good for older women. I know that The Cholesterol Con, GBGC for a couple I can think have have references to those studies.
    I too would be interested to see what studies you friend is talking about. If they were in Europe I would think that the Thinc group would have seen and commented.

    Reply
  5. Caveman Doctor

    Great article. I recently gave a talk on a similar topic to other doctors and some nutritionists and watched as veins were popping out of their heads. Yet, they had no evidence to argue with me…

    I’m sure many doctors don’t like hearing that they’ve been giving out bad advice.

    Reply
  6. Caveman Doctor

    Great article. I recently gave a talk on a similar topic to other doctors and some nutritionists and watched as veins were popping out of their heads. Yet, they had no evidence to argue with me…

    I’m sure many doctors don’t like hearing that they’ve been giving out bad advice.

    Reply
  7. Walter B

    TN: “I’m sure many doctors don’t like hearing that they’ve been giving out bad advice.”

    No one does. But when being wrong means you’ve been maiming , mentally decapitating[1] and killing people; most people find it hard to take. People desperately want to maintain a good opinion of themselves. This desire is a major cause of suffering in the world. Consider the case of Ignaz Philipp Semmelweis.

    Then there is Mr. Taubes with his summation, “It’s trash; I haven’t read it.”

    Reply
  8. Walter B

    TN: “I’m sure many doctors don’t like hearing that they’ve been giving out bad advice.”

    No one does. But when being wrong means you’ve been maiming , mentally decapitating[1] and killing people; most people find it hard to take. People desperately want to maintain a good opinion of themselves. This desire is a major cause of suffering in the world. Consider the case of Ignaz Philipp Semmelweis.

    Then there is Mr. Taubes with his summation, “It’s trash; I haven’t read it.”

    Reply
  9. Chris Sadowski

    If I may quote another great scientific philosopher, Chris Rock, in regards to Big Pharm – “there’s no money in the cure, only in the ‘comeback'”. You take the healthy number for cholesterol for millennia in humans and say it is 20-30 points too high, you call Dr. Eric Oliver’s at 6’, 190 overweight, and have a pill to help them curb their appetite, which screws up their healthy processes and gives them more illnesses for them (and our govt) to help fix. Then you have where we are now as a society.

    There’s an important middle step too: you define a problem, then declare it’s been severely under-reported for decades.

    Reply
  10. Chris Sadowski

    If I may quote another great scientific philosopher, Chris Rock, in regards to Big Pharm – “there’s no money in the cure, only in the ‘comeback'”. You take the healthy number for cholesterol for millennia in humans and say it is 20-30 points too high, you call Dr. Eric Oliver’s at 6’, 190 overweight, and have a pill to help them curb their appetite, which screws up their healthy processes and gives them more illnesses for them (and our govt) to help fix. Then you have where we are now as a society.

    There’s an important middle step too: you define a problem, then declare it’s been severely under-reported for decades.

    Reply
  11. m

    i have a friend who makes 4 times more cholesterol in his body, unrelated to dietary cholesterol intake. so far i understand about dietary cholesterol being harmless etc, what about when his body makes loads of it? is it safe to take statin in this case then?

    Reply
    1. Tom Naughton

      Your friend apparently has hyperlipidemia, an inherited condition. If it were me, I still wouldn’t take the statin.

      Reply
  12. m

    i have a friend who makes 4 times more cholesterol in his body, unrelated to dietary cholesterol intake. so far i understand about dietary cholesterol being harmless etc, what about when his body makes loads of it? is it safe to take statin in this case then?

    Reply
    1. Tom Naughton Post author

      Your friend apparently has hyperlipidemia, an inherited condition. If it were me, I still wouldn’t take the statin.

      Reply
    1. Tom Naughton

      Dr. Davis says people with hyperlipidemia are perhaps the only group that need statins. Given the side-effects (which I saw in my parents), I’d never take statins, period. But here’s what Dr. Davis recommends:

      “While I believe that statins are miserably oversold, overprescribed, overhyped, and overused in the general population, I believe that the one clear-cut beneficial application is in your condition, familial heterozygous hypercholesterolemia. However, statins alone do not cut it. You have already taken the extra steps that I would have advocated: reduce carbohydrate exposure, especially wheat, sugars, and fructose to maintain small LDL to a minimum; vitamin D normalization; fish oil. One of the common pitfalls in FHH is people take a statin but follow a low-fat diet that increases the proportion of small LDL that then gets underestimated by Friedewald LDL. Also, be mindful of thyroid status. At the very least, being sure you get iodine is helpful. It would take very little thyroid dysfunction for me to advise thyroid replacement, since LDL drops like a stone when you do this.”

      Reply
      1. Bob Niland

        And if someone does decide to take a statin, they almost certainly need to be taking CoQ10 along with it. If their doctor “neglected” to mention this, they also need to find a real doctor.

        Reply
        1. Tom Naughton

          I’ve seen CoQ10 advertised that way: if you take statins, you need CoQ10. I say take the CoQ10 anyway, but skip the statins.

          Reply
      2. m

        thank u, i hope the friend sees this reply and decides to take a chance. his biggest fear is something bad happens to him when he stops statin, and i totally get his fears, given that he isnt sure which school of thought to believe

        Reply
    1. Tom Naughton Post author

      Dr. Davis says people with hyperlipidemia are perhaps the only group that need statins. Given the side-effects (which I saw in my parents), I’d never take statins, period. But here’s what Dr. Davis recommends:

      “While I believe that statins are miserably oversold, overprescribed, overhyped, and overused in the general population, I believe that the one clear-cut beneficial application is in your condition, familial heterozygous hypercholesterolemia. However, statins alone do not cut it. You have already taken the extra steps that I would have advocated: reduce carbohydrate exposure, especially wheat, sugars, and fructose to maintain small LDL to a minimum; vitamin D normalization; fish oil. One of the common pitfalls in FHH is people take a statin but follow a low-fat diet that increases the proportion of small LDL that then gets underestimated by Friedewald LDL. Also, be mindful of thyroid status. At the very least, being sure you get iodine is helpful. It would take very little thyroid dysfunction for me to advise thyroid replacement, since LDL drops like a stone when you do this.”

      Reply
      1. Bob Niland

        And if someone does decide to take a statin, they almost certainly need to be taking CoQ10 along with it. If their doctor “neglected” to mention this, they also need to find a real doctor.

        Reply
        1. Tom Naughton Post author

          I’ve seen CoQ10 advertised that way: if you take statins, you need CoQ10. I say take the CoQ10 anyway, but skip the statins.

          Reply
          1. Bob Niland

            Merck actually earned two patents circa 1990 (US4929437 and US4933165) for a statin compounded with CoQ10. They never brought them to market.

            The story I heard was there wasn’t then enough CoQ10 production capacity in the world to support compounding all the statins expected to be sold.

            The corporate lawyers may have advised Merck to sell zero safer statins, rather than just some safer statins, and indeed it would have made it harder for idiot MDs to ignore the patient reports of side effects from the straight statins.

            In any event, the patent pretty much prevented anyone else from selling a compounded statin until 2010 or so. I don’t know what their excuse is today.

            Reply
            1. Tom Naughton Post author

              I believe I read somewhere that statin-makers considered including CoQ10 with statins, but decided they’d rather not alert that public that statins deplete CoQ10.

      2. m

        thank u, i hope the friend sees this reply and decides to take a chance. his biggest fear is something bad happens to him when he stops statin, and i totally get his fears, given that he isnt sure which school of thought to believe

        Reply
  13. Mom

    This makes my stomach hurt, a virtual statin side effect…
    Ouch! Very disturbing for you all there in America. I hope this nonsense stops eventually, with all you educators doing your fine job!

    best wishes: mom from European small country

    We’re doing our best.

    Reply
  14. AndreaLynnette

    Michele, there’s not a lot you can do. I really recommend looking for a naturopath in your area, but most states don’t let naturopaths practice medicine, despite the fact that they’re better trained. And remember that a doctor is not God, he can be wrong. If your husband knows he shouldn’t take statins, he should just NOT take them and to heck with what the doctor says about it.

    Some states have outlawed naturopaths — to protect the public, of course.

    Reply

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