As you’ve probably heard, there was quite a stir across the pond last month when two British medical journals got into a verbal war over statins. Hostilities began when The Lancet published a study claiming that by gosh, statins are indeed wunnerful, wunnerful drugs — which means that people who raise doubts about them are killing babies and should perhaps be silenced.
No wait, let me check my notes … okay, slight correction: The Lancet suggested that statin skeptics are killing adults, not babies. Sorry for the confusion, but when The Anointed trot out the “we must shut you up because your skeptical opinions could kill the planet—er, we mean people” line, I sometimes get brain-lock.
Anyway, The Lancet specifically warned that those who question the effectiveness and safety of statins might be killing adults with heart-disease risk factors (defined in such a way as to include almost every adult with a pulse) by scaring them away from statins.
Here are some quotes from a U.K. Guardian article that appeared after The Lancet published its pro-statin study:
Statins to lower cholesterol prevent 80,000 heart attacks and strokes every year in the UK, far outweighing the harm from rare side-effects, according to a review of the evidence which aims to put a heated controversy to rest and reassure the public that statins are safe.
The review is published by the Lancet medical journal, whose editor, Richard Horton, likened the harm done to public confidence by the critics of statins to that caused by the paper his journal published on the MMR (measles, mumps and rubella) vaccine in 1998.
“Controversy over the safety and efficacy of statins has harmed the health of potentially thousands of people in the UK,” he wrote in a comment published with the review. In six months after the publication of “disputed research and tendentious opinion” on the side-effects of statins in 2013, a study estimated that over 200,000 patients stopped taking a statin. It predicted there would be 2,000 extra heart attacks and strokes over the next decade as a result.
“Disputed research and tendentious opinion” means there are scientists and doctors out there who – egads! – dared to examine the research and conclude that The Anointed are wrong. Worse yet, those researchers have managed to catch the ear of the public through books, blog posts, documentaries and even some articles in major media outlets.
The Anointed don’t take kindly to being questioned, which is why The Lancet’s editorial included this gem:
Some research papers are more high risk to public health than others. Those papers deserve extra vigilance. They should be subjected to rigorous and extensive challenge during peer review. The risk of publication should be explicitly discussed and evaluated. If publication is agreed, it should be managed with exquisite care.
Let me interpret that gobbledygook: Research papers that suggest We The Anointed are wrong should be squashed – for the sake of public health, of course. We can’t have the little people doubting us.
What we’re seeing here is a ramping up of the Save The Statins Campaign – which is very much like the Save The Grains campaign. Both are a reaction to the fact that people are deciding those wunnerful, wunnerful products they’ve been told to consume might not be so wunnerful after all – a result of the Wisdom of Crowds effect, which actually is wunnerful. The Anointed are fighting back with articles that say, in effect, “Damnit, people! Those negative effects you think you’re experiencing are all in your tiny little heads! Stop listening to people who disagree with us! We’re The Anointed, and we know what’s best for you!”
The British Medical Journal has been critical of the statins-for-everyone position taken by The Lancet. So after The Lancet slammed the critics of statins, the British Medical Journal chimed in to slam The Lancet. This is almost as much fun as a good football game. (I’m talking about the kind of football where wide receivers make acrobatic catches, running backs collide with linebackers and touchdowns are scored, not the kind where men in shorts run around for two hours, during which perhaps one goal is scored.)
Let’s have the U.K. Daily Mail pick coverage of the game – er, the controversy from there:
Patients who take statins were plunged deeper into confusion last night after the country’s two leading medical journals went to war over the safety of the drug.
The row was triggered by a major review in The Lancet last week that concluded the pills are safe and their benefits far outweigh any harm. It was the biggest ever review into their use, but now the rival journal The BMJ has cast doubt on the assertions by claiming ‘adverse’ side effects are far more common than the study implied.
Professor Rory Collins, lead author of the Lancet review undertaken by a team of Oxford researchers, concluded the pills were so beneficial that six million more adults should be taking them.
Collins and his cohorts, by the way, receive a ton of research money from the pharmaceutical industry. I’m sure that doesn’t surprise you.
The Lancet’s editor, Richard Horton, also launched a strong attack on research published in The BMJ that had warned of the possible side effects of the pills. He said two studies that had appeared in the journal in 2013 resulted in 200,000 patients stopping their statins, potentially harming their health.
Or potentially avoiding diabetes, joint pain, permanently damaged muscles, liver damage and memory loss.
But last night The BMJ defended this research and questioned The Lancet’s claims that the pills are safe and effective.
Writing for the journal, Dr Richard Lehman, a retired GP and Oxford University academic, said muscle pain and fatigue were ‘prevalent’ and ‘recurrent’ in many patients on statins. And Professor Harlan Krumholz, a cardiologist at Yale University in the US, said many scientists still had ‘persistent concerns’. Also writing for the journal, he added there was a ‘lack of good evidence’ for the pills’ benefits in elderly patients.
Health experts urged the two journals to resolve their differences so they could work together to uncover the truth about statins. Tam Fry, of the National Obesity Forum, said: ‘I find it unbelievable that the medical establishment should be at loggerheads over whether they are worthwhile or not.
Say what? I find it entirely believable that there’s an ongoing battle over statins. It’s believable for the same reason that the Save The Grains Campaign will fail and the Save The Statins Campaign will fail: once people know something, it’s impossible to persuade them to not-know it – especially when it comes to their own well-being.
I’ve mentioned that I have a co-worker whose wife suffered from migraines for years. She went from doctor to doctor looking for relief. One prescription pill after another failed to provide that relief. Back in the dark ages of, say, the 1990s, that’s where the story would have ended: with her suffering from migraines and hoping for the magic pill to come along someday. That’s because in the dark ages, access to information was limited and it generally flowed from the top down.
But we’re not in those dark ages anymore. Thanks to the internet, the average person has access to almost endless information, and that information flows in every direction. So here’s how the story ended: at a dinner party one night, a friend-of-a-friend mentioned that some people have gotten relief from migraines by giving up grains. He knew this because he’d done some online research on migraines. So my co-worker’s wife stopped eating grains as an experiment and – voila! – the migraines went away.
She now knows that giving up grains put a stop to her migraines. She’ll never not-know it – no matter how many pro-grain articles the Save The Grains Campaign manages to place in media outlets. Likewise, I’ll never not-know that after giving up grains, I waved goodbye to psoriasis, arthritis in my shoulder, a mild case of asthma and frequent belly aches.
The promoters of the Save The Grains Campaign and the Save The Statins Campaign apparently haven’t figured out how the game works now. They still think it’s the old game, where most people only know what the officially-sanctioned experts decide they should know. That’s how we ended up with pretty much everyone believing low-fat diets prevent heart disease. Several prominent researchers disagreed, but the arterycloggingsaturatedfat! crowd won the war and became the information gatekeepers.
That strategy doesn’t work anymore because the gates are gone. Yes, there are still official proclamations handed down from on high, but those proclamations are easily undermined by the Wisdom of Crowds effect. If you suffer from migraines and someone who’s done a bit of research online suggests that giving up grains might cure them, you’ll probably give it a try. If the migraines go away, you’re not going to be persuaded to eat grains again because a researcher funded by the Save The Grains Campaign releases An Official Study saying grains don’t cause migraines. You know your migraines went away when you dumped the grains, and you can’t not-know it.
That’s why the Save The Statins campaign will fail. We may be outraged when journals like The Lancet insist side-effects are rare (I saw plenty of outrage on the internet), but seriously, it’s no big deal. Let the industry-funded hacks at The Lancet and elsewhere publish all the b.s. studies they want. It won’t make any difference.
My mom dutifully took her statin despite the muscle and joint pains for only one reason: she didn’t know the statin was the cause of the pains. But once she knew statins were the cause (because I told her), she couldn’t not-know it. In fact, I didn’t have to convince her that statins were absolutely, positively the cause of her muscle pains. I just had to convince her they were a likely culprit. Going off the statin and experiencing the happy result was the final convincer. Hundreds of thousands of people are being similarly convinced.
The Save The Statins Campaign is already a failure – although the hacks at The Lancet may choose to not-know it for some time.