"Lipitor Paradox"

[Dawg52]

I pay $10 for a 90 supply of Mevacor. One of the older versions, but my numbers are great.

When I applied for an individual health policy a few years ago, I was afraid this might go against me on my application. But when I had my phone interview with BCBS, they told me my numbers were good and to continue doing whatever I was doing. I told them I love my meds.

 

[eytonxav]

Well, for one thing, if you accept possible efficacy in the absence of evidence, it is logical and consistent to assume a level of long-term undocumented risk as well. MIlions of people on such inadequately tested drugs could spell disaster. Remember Tryptophan? It was a "'supplement" for insomnia manufactured by an Asian pharmaceutical company and a contaminant killed patients before it was discovered. Risk for benefit is rational, but risk in the absence of demonstrated benefit makes no sense to me.

In addition, COq10 is rather expensive, esp over decades.

It may turn out that it is safe and effective with further research. Or not.

I have advised it in special circumstances with the patient at high risk and with full understanding of the issues -- rarely.

I found a link that does a good job in presenting both viewpoints of CoQ10 and makes some comments on safety: Coenzyme Q10: A therapy for hypertension and statin-induced myalgia?

Regarding your comments on safety, to be totally fair, I believe there have been FDA approved drugs over the years that were extensively tested but later pulled due to problems. So just because something has been clincially trialed/approved doesn't mean it won't turn out to be a safety problem/risk (ugh, look at all the disclaimers). Therefore, you could draw that conclusion for almost anything (drug, supplement, food, air, etc), so should that prevent one from using a supplement?

Personally, I trust in Dr Oz and Dr Weils advice and tend to follow many of their recommendations, and in my opinion they know a lot more about these things than my own physician. I also take fish oil and D3 (USP cert), aspirin and simvastatin. Boy am I in trouble

 

[braumeister]

If Oz and Weil recommend it, that's more than enough reason for me to be extremely skeptical of it.

 

[kcowan]

Does anyone else remember VIOXX? I was in NY visiting friends when it was withdrawn. One of them was on it and really POd...

 

[nun]

The real drug problem isn't illegal drugs it's the over prescription of legal lifestyle drugs. There are situations where statins are warranted, but changes in diet and excersise would be more beneficial in most cases. If drug companies were purely philanthropic organizations I might be more prone to believing the hype and advertising, but as they are in it for money I take the studies and marketing with a big pinch of salt

 

[ERD50]

Regarding your comments on safety, to be totally fair, I believe there have been FDA approved drugs over the years that were extensively tested but later pulled due to problems. So just because something has been clincially trialed/approved doesn't mean it won't turn out to be a safety problem/risk (ugh, look at all the disclaimers). Therefore, you could draw that conclusion for almost anything (drug, supplement, food, air, etc), so should that prevent one from using a supplement?

Maybe Rich can comment more fully, but I'd agree that FDA testing is not a complete assurance. The sample sizes are too small to catch everything, but there is (as I understand) this follow up monitoring to catch problems like VIOXX.

But your logic doesn't follow that NO testing is as good as SOME testing. Or that old phrase, "Perfect is the enemy of good".

Does anyone else remember VIOXX? I was in NY visiting friends when it was withdrawn. One of them was on it and really POd...

He would have been happier if it wasn't pulled?

-ERD50

 

[nun]

I have much less faith in doctors and medical science than I used to, and there's no convenient replacement. That is, even if I had time for exhaustive research on a topic, it's difficult for me to evaluate all the different studies (and I started my career as a scientist in a biological field).

I started my career in physics and now I'm working in molecular biology and it frightens me the ad hoc way a lot of medicine is practiced. I'm impressed by the researchers that I work with, but some of the doctors are pretty dumb. It's sort of funny to see their egos deflate when they get out of their comfort zone of bossing patients around.

 

[eytonxav]

The real drug problem isn't illegal drugs it's the over prescription of legal lifestyle drugs. There are situations where statins are warranted, but changes in diet and excersise would be more beneficial in most cases. If drug companies were purely philanthropic organizations I might be more prone to believing the hype and advertising, but as they are in it for money I take the studies and marketing with a big pinch of salt

Nun, I totally agree with you, but the biggest problem is most people are unwilling to adopt good nutrition and exercise.

 

[HFWR]

If Oz and Weil recommend it, that's more than enough reason for me to be extremely skeptical of it.

I worry about the "new-agey" aspect of both of these guys. Granted, conventional wisdom often isn't, but I'd prefer to keep my BS detector on max sensitivity.

 

[haha]

Nun, I totally agree with you, but the biggest problem is most people are unwilling to adopt good nutrition and exercise.

Well, they have been given useless or flat out counterproductive and contradictory advice for so long a lot of people more or less think that all the doctor knows is whatever he's been told, and that is likely to be wrong or self-serving.

If medicine hadn't so often gone down the wrong road at full speed, loudly telling everyone what they had to do if they didn't want to die soon, medicine would have more credibility today.

Ha

 

[eytonxav]

Maybe Rich can comment more fully, but I'd agree that FDA testing is not a complete assurance. The sample sizes are too small to catch everything, but there is (as I understand) this follow up monitoring to catch problems like VIOXX.

But your logic doesn't follow that NO testing is as good as SOME testing. Or that old phrase, "Perfect is the enemy of good".



-ERD50

ERD50,

I am not trying to get into an arguement with you over my logic, however, several of those links showed that some testing was done, however, as Rich pointed out, there has been no conclusive/definitive evidence to prove or dis-prove CoQ10. That said, there have been several small trials done that seem to confirm its benefits along with many experts drawing a conclusion that it is helpful.

 

[GregLee]

There are situations where statins are warranted, but changes in diet and excersise would be more beneficial in most cases.

Yes, and the article Martha referenced says this:

No one doubts that it would be best if every patient had a healthy diet and weight and exercised regularly. Some argue that statins should be reserved for those who fail these lifestyle interventions, or who have genetically high cholesterol refractory to diet and exercise. The reality is that it is very difficult to get individual patients to change their behavior. Science-Based Medicine » Statins – The Cochrane Review

It doesn't seem fair to criticize drug companies and doctors for not depending on diet/exercise when they know that their patients are by and large not going to do it. As patients, though, we have a different slant on this, since we know whether we're doing good diet and exercise.

 

[TromboneAl]

For Dr. Oz, the following quote is appropriate:

The most important thing in this job is sincerity. Once you can fake that, you've go it made.​

 

[kcowan]

Re Vioxx:
He would have been happier if it wasn't pulled?

-ERD50

He would have been exctatic if the FDA had not approved it and then found out that it increased the risk of death from the very disease that was the reason he was taking it! Silly man trusted the FDA!

Fortunately he lived to talk about it, but many did not!

 

[Zoocat]

Well, they have been given useless or flat out counterproductive and contradictory advice for so long a lot of people more or less think that all the doctor knows is whatever he's been told, and that is likely to be wrong or self-serving.

If medicine hadn't so often gone down the wrong road at full speed, loudly telling everyone what they had to do if they didn't want to die soon, medicine would have more credibility today.

Ha

Well, applause for that statement.