Statin Wars - British Style!

[mvoo]

Most if not all can avoid statins

It’s actually pretty clear science, once you get past the incorrect headlines and misleading articles. First, the need for statins in generally is based on false premise that cholesterol in general is problem. This has been pretty well understood now to be debunked. Most now look to, among other factors, the particle size and count of LDL cholesterol, and Statins have no impact on this....but can be controlled by diet (as can another factor, the level of HDL cholesterol). As an aside, it’s the higher fat and lower appropriate carbohydrate diets that give most people the best blood profile.
Statins however have multiple downsides, as the way most work is to block certain chemical pathways in the liver that create other necessary elements — most notably coenzyme Q10 which is utilized by every cell in the body to facilitate energy production. Hence one symptom of statin use is muscle weakness.
Also, for almost everyone except one very specific subgroup, there are no science based study conclusion that demonstrate the effectiveness of statin use on affecting the end points of the respective study, and in fact, there are some that show all cause mortality increasing. It’s not an accident that every cell in your body uses and needs cholesterol. Punchline I guess is learn proper (don’t rely on the government or medical associations) nutrition, and avoid statins at all costs unless you’re in the specific subgroup. (I don’t want to be specific, as that’s not my job — so go do the research yourself)

 

[eytonxav]

I don't think there's a way to be 100% certain, but I know of 3 tests which will give you a good idea:

Coronary artery calcification score (CAC) indicates the level of plaque in your arteries. A low CAC score means you're pretty safe. If your score is high, look up Dr. William Davis for tips on improving your score.

Homocysteine is an amino acid that either causes inflammation or is a marker for inflammation. You can lower homocysteine with B vitamins (B6, B12, and folate).

Total or LDL cholesterol are weak markers for risk. HDL is better. The best marker is the triglyceride/HDL ratio. If TG/HDL is less than 2, you're pretty well off. Exercise raises HDL and lowers triglycerides, so this may be a marker for fitness. Saturated fat raises HDL and sugar raises triglycerides, so this may also be a marker for diet.

Thanks for that info. I did a CAC test about 10 years ago and it was negligible. My big bugaboo is HDL. I exercise a lot, but can never seem to get my HDL beyond 40, it more typically stays between 36-38. Makes me think there is a genetic component to this that predisposes some people to low HDL levels, although I suppose the statin also lowers HDL. On the ratio, I am 2.08 which does not seem too bad, but again, I am on a statin and I doubt the ratio would be as favorable without it.

 

[Rianne]

Thanks for that info. I did a CAC test about 10 years ago and it was negligible. My big bugaboo is HDL. I exercise a lot, but can never seem to get my HDL beyond 40, it more typically stays between 36-38. Makes me think there is a genetic component to this that predisposes some people to low HDL levels, although I suppose the statin also lowers HDL. On the ratio, I am 2.08 which does not seem too bad, but again, I am on a statin and I doubt the ratio would be as favorable without it.

The most important issue is, you and your Dr. came to this conclusion and you are comfortable on the statin...bottom line!
My DH HDL is around 40 and he said (won't let me see his numbers from tests) his ratio is @ 3. DH HDL, never in his memory, was more than 40 and knows it's genetic because his DS and DB and DM all had numbers like that and No heart disease. He refuses to take statins.

 

[Rianne]

It’s actually pretty clear science, once you get past the incorrect headlines and misleading articles. First, the need for statins in generally is based on false premise that cholesterol in general is problem. This has been pretty well understood now to be debunked. Most now look to, among other factors, the particle size and count of LDL cholesterol, and Statins have no impact on this....but can be controlled by diet (as can another factor, the level of HDL cholesterol). As an aside, it’s the higher fat and lower appropriate carbohydrate diets that give most people the best blood profile.
Statins however have multiple downsides, as the way most work is to block certain chemical pathways in the liver that create other necessary elements — most notably coenzyme Q10 which is utilized by every cell in the body to facilitate energy production. Hence one symptom of statin use is muscle weakness.
Also, for almost everyone except one very specific subgroup, there are no science based study conclusion that demonstrate the effectiveness of statin use on affecting the end points of the respective study, and in fact, there are some that show all cause mortality increasing. It’s not an accident that every cell in your body uses and needs cholesterol. Punchline I guess is learn proper (don’t rely on the government or medical associations) nutrition, and avoid statins at all costs unless you’re in the specific subgroup. (I don’t want to be specific, as that’s not my job — so go do the research yourself)

BTW, thank you...DH is Phd in food science and he agrees with you 100% about govnmt., medical associations and studies that leave out too many factors to be conclusive. DH is not obese or diabetic or has any other risk factor (no familial history of heart disease). His nutrition is good, not as good as mine, but good.

 

[travelover]

Apart from demonstrating a poor grasp of common courtesy in both this and your previous post, you cited a link that shows no response to my question. Quoted from your link:


I have to conclude that it's not worth my time engaging with you, so I won't post in this thread again.

Yup.

 

[threegoofs]

Apart from demonstrating a poor grasp of common courtesy in both this and your previous post, you cited a link that shows no response to my question. Quoted from your link:





I have to conclude that it's not worth my time engaging with you, so I won't post in this thread again.

LOL.

Bar moves from ‘anyone’, to ‘primary prevention’ to ‘primary prevention in low risk patients’.

 

[zedd]

Bar moves from ‘anyone’, to ‘primary prevention’ to ‘primary prevention in low risk patients’.

I would truly suck as a clinition because I have no idea what that means

 

[Nemo2]

I would truly suck as a clinition because I have no idea what that means

A progressive narrowing of the field...in order to better coincide with the data?

 

[6miths]

It's an interesting discussion. There is no doubt about statins in people with previous cardiovascular disease and those at high risk I would venture. The controversy is in those that are low risk - however that is defined. Definitely no CVS disease and good risk factor profile. No matter how you slice it, it is a battle. The definitive review group in the world is the Cochrane Group which took some heat in 2013 when they suggested use in low risk individuals was warranted. A small reduction in all-cause mortality (from 2.6% to 2.1% over 5 years I believe) and less non-fatal CVS events with minimal side effects. An informed objection to the change in recommendations was made here. An academic discussion between the two groups occurred here. It is fairly dense. Another useful source is the NNT site but not in the same league as Cochrane.

So the debate rages. There are definitely risks of side effects but given the available evidence (likely on the basis of statins ability to stabilize plaques and make them less prone to rupture and cause vessel occluding clots - but possibly by some other mechanism) some decide to take the statin for the hoped primary prevention benefit. If side effects occur then perhaps not worth it. Between you and your MD but ultimately up to you. I definitely wouldn't be trying to dissuade anyone from taking statins - perhaps just be skeptical and informed as always.

To make things interesting, in the US, the most authoritative bodies would be the American College of Cardiology and the American Heart Association, their Calculator suggests no statin in people with a 10-year CVS risk of less than 7.5% and no low dose ASA in those with 10-year risk <10%. Clear as mud!

 

[Winemaker]

This is an interesting thread to read while snacking on hard boiled eggs and baby aspirin each night. And wash it down with red wine, this week.

 

[Easy Rider]

When i used to get yearly blood tests and had a new doctor about 10 years ago - i thought it was very strange that he told me to expect to take statins. He actually was 'grooming' me to get on the statin bandwagon - all right after drawing blood. I felt that used car dealer attitude - it was so blantent. I'm not sure how they get money for prescribing the meds - but what a creep.

My blood tests came back perfect then - he did send them in the mail and wrote on them 'good results'. Still a creep - the doctor left that practice soon afterwards.

Just amazing how he was pushing statins as his regular talk to a new patient at the time.

 

[Chuckanut]

Most authoritative bodies would be the American College of Cardiology and the American Heart Association, their Calculator suggests no statin in people with a 10-year CVS risk of less than 7.5% and no low dose ASA in those with 10-year risk <10%. Clear as mud!

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IMHO, their calculator is a big part of the problem. It certainly made me suspicious that the statins are being excessively pushed to the healthy population. Note: I say this as a person who after lots of personal study of the issue decided that a low-dose statin is overall beneficial for me.

When I first put my numbers in, the calculator recommended I take a statin. Just for fun I tried lowering bad cholesterol numbers to see how low I needed to go to be free of a statin. Basically, there was no level of total cholesterol I could have that did not require me to take a statin. Apparently, my gender and age were the driving force.

IOW, with normal BP, and total cholesterol of 130 and HDL of 70 and being a non smoker, no diabetes, I needed a moderate to high intensity statin. Really?

 

[Koolau]

This is an interesting thread to read while snacking on hard boiled eggs and baby aspirin each night. And wash it down with red wine, this week.

Heh, heh, I JUST saw a news clip last night which indicated an aspirin a day (81mg) has NOT shown any benefit. Supposedly, this is NOW the new paradigm. What's next? Maybe red wine is now BAD for you. Say it isn't so! YMMV

 

[Chuckanut]

Most authoritative bodies would be the American College of Cardiology and the American Heart Association, their Calculator suggests no statin in people with a 10-year CVS risk of less than 7.5% and no low dose ASA in those with 10-year risk <10%. Clear as mud!

IMHO, their calculator is a big part of the problem. It certainly made me suspicious that the statins are being excessively pushed to the healthy population.

When I first put my numbers in, the calculator recommended I take a statin. Just for fun I tried lowering cholesterol numbers to see how low I needed to go to be free of a statin. I found that a 64 yo male with normal BP, and total cholesterol of 130 and HDL of 70 and being a non smoker, and no diabetes, is still told he needs a statin. This makes me very suspicious.

Note: I say this as a person who after lots of personal study of the issue decided that a low-dose statin is overall beneficial for me.

 

[mpeirce]

Heh, heh, I JUST saw a news clip last night which indicated an aspirin a day (81mg) has NOT shown any benefit.

I believe they were referring to cardiovascular benefits (still debatable), but aspirin continues to be touted as being helpful for other things:

In the United States, tens of millions of adults take aspirin to reduce their risk of heart attack or stroke. But studies over the last two decades have suggested that regular use of aspirin may have another important benefit: decreasing the risk of developing or dying from some types of cancer.

And hey, it still fixes my occasional headaches better than acetaminophen and ibuprofen for me.

 

[6miths]

IMHO, their calculator is a big part of the problem. It certainly made me suspicious that the statins are being excessively pushed to the healthy population.

When I first put my numbers in, the calculator recommended I take a statin. Just for fun I tried lowering cholesterol numbers to see how low I needed to go to be free of a statin. I found that a 64 yo male with normal BP, and total cholesterol of 130 and HDL of 70 and being a non smoker, and no diabetes, is still told he needs a statin. This makes me very suspicious.

Note: I say this as a person who after lots of personal study of the issue decided that a low-dose statin is overall beneficial for me.

Yes I think it is reasonable to be skeptical and always question what the motivations are and where the conflicts lie. Upthread there was talk of why anyone would be doing research to advance science if there was not money to be made... to an outside observer this is one of the core problems with American medical care. The primary objective in every endeavor should not be to make a profit IMHO.

 

[JoeWras]

Yes I think it is reasonable to be skeptical and always question what the motivations are and where the conflicts lie. Upthread there was talk of why anyone would be doing research to advance science if there was not money to be made... to an outside observer this is one of the core problems with American medical care. The primary objective in every endeavor should not be to make a profit IMHO.

So... With Atorvastatin (nee: Lipitor) now reaching a price of zero, yes $0, in America, yes, in America, what is the incentive for docs to be pushers? Is the investment in generic companies that lucrative? Is "big generic" the next big thing? Mylan's stock price has been terrible over the last 5 years. Mylan is a huge maker of atorvastatin.

Now add Rosuvastatin to the mix (nee: Crestor). Another generic costing the price of a latte for 1 month supply.

I'm missing the kickback or incentive being talked about in this thread. Help me out.

 

[sengsational]

I think it's less of a kickback driven thing and more of a cognitive dissonance thing; if a doctor got on board with early (and later proven wrong) LDL-C theory of CVD, they're finding it hard to jump off that horse and find another one to ride. They've treated thousands of patients, they are smart and good, and dammit, they were right then and they're still right now.

 

[threegoofs]

So... With Atorvastatin (nee: Lipitor) now reaching a price of zero, yes $0, in America, yes, in America, what is the incentive for docs to be pushers? Is the investment in generic companies that lucrative? Is "big generic" the next big thing? Mylan's stock price has been terrible over the last 5 years. Mylan is a huge maker of atorvastatin.

Now add Rosuvastatin to the mix (nee: Crestor). Another generic costing the price of a latte for 1 month supply.

I'm missing the kickback or incentive being talked about in this thread. Help me out.

There is no kickback or incentive to use statins for anyone.

It’s just that the main toxicity of statins used to be financial... and now that they are essentially free, its a bit tough to see why they would be withheld in most patients at risk of CVD.... and frankly, virtually everyone who lives in the US is at some risk for CV disease.

Yes, side effects happen, but they are quite rare and usually reversible when the statin is stopped, and the more common ones are still quite uncommon and mild.

Realistically, in some aspects, the question is why WOULDNT you take a statin?

I know many, many primary care docs and cardiologists who take statins starting in their 30s for primary prevention, with little risk of CVD. They are treating themselves for prevention 30-50 years from now. It’s not supported by evidence, but its got a lot of indirect evidence to suggest that these drugs might modify disease (unlike, say, aspirin).

 

[Winemaker]

Since doctors are paid based on patients outcomes, it would make sense that they would follow the most favorable protocol.

 

[Chuckanut]

So... With Atorvastatin (nee: Lipitor) now reaching a price of zero, yes $0, in America, yes, in America, what is the incentive for docs to be pushers? Is the investment in generic companies that lucrative? Is "big generic" the next big thing? Mylan's stock price has been terrible over the last 5 years. Mylan is a huge maker of atorvastatin.

Now add Rosuvastatin to the mix (nee: Crestor). Another generic costing the price of a latte for 1 month supply.

I'm missing the kickback or incentive being talked about in this thread. Help me out.

Obviously, you need a PK9 inhibitor.

https://www.drugs.com/slideshow/pcsk9-inhibitors-a-new-option-in-cholesterol-treatment-1166

The PCSK9 inhibitors are a class of injectable drugs approved in 2015 that have been shown to dramatically lower LDL cholesterol levels

Bye the way, what happened to the Brits in this discussion?

 

[zedd]

So... With Atorvastatin (nee: Lipitor) now reaching a price of zero, yes $0, in America, yes, in America, what is the incentive for docs to be pushers? Is the investment in generic companies that lucrative? Is "big generic" the next big thing? Mylan's stock price has been terrible over the last 5 years. Mylan is a huge maker of atorvastatin.

Now add Rosuvastatin to the mix (nee: Crestor). Another generic costing the price of a latte for 1 month supply.

I'm missing the kickback or incentive being talked about in this thread. Help me out.

Well perhaps not unlike the example of Facebook, if you dont see what the product being marketed is, then YOU, are the product.

Here's one example:

https://www.forbes.com/sites/kalevl...nd-pharmacies-commercialize-our-medical-data/

"Even if you’ve never stepped foot in Facebook’s walled garden or know anyone who has, there are myriad companies out there that are buying and selling your information every day that you likely had no idea existed. For example, did you know that if you fill a drug prescription at Walgreens, the company has the right to commercialize your medical information by charging clinical research companies and pharmaceutical manufacturers to send mailers to you on their behalf based on your medical condition? Or that there is an entire industry of companies that sell mailing lists of people with every imaginable disease, all available for pennies per name, monetizing your misery?"

 

[zedd]

Here's another. I cant make this stuff up

https://newrepublic.com/article/84056/health-

"How Drug Reps Know Which Doctors to Target
For years Dr. Peter Klementowicz suspected that pharmaceutical sales representatives knew more about the prescriptions he was writing than they let on. Klementowicz, a cardiologist in Nashua, New Hampshire, would occasionally hear curious statements from drug reps, such as, “you’re one of my targets.” His suspicion peaked when a friend told him she overheard a group of reps at a local Panera Bread discussing ways to induce Klementowicz to prescribe their drugs. How did they know he wasn’t already prescribing their drugs? It wasn’t until last year, after Klementowicz’s wife stumbled upon a two-year-old newspaper article, that he learned what more and more doctors are also just discovering: Drug companies know almost everything about which physicians prescribe which drugs and how often."

 

[zedd]

Okay one more then I'm gonna grab a Kirkland brand knock off of a Haagen Dazs bar. Let my cholesterol be damned:

https://www.scientificamerican.com/article/how-data-brokers-make-money-off-your-medical

"At present, the system is so opaque that many doctors, nurses and patients are unaware that the information they record or divulge in an electronic health record or the results from lab tests they request or consent to may be anonymized and sold. But they will not remain in the dark about these practices forever. In researching the medical-data-trading business for an upcoming book, I have found growing unease about the ever expanding sale of our medical information not just among privacy advocates but among health industry insiders as well.

The entire health care system depends on patients trusting that their information will be kept confidential. When they learn that others have insights into what happens between them and their medical providers, they may be less forthcoming in describing their conditions or in seeking help. More and more health care experts believe that it is time to adopt measures that give patients more control over their data."

 

[bmcgonig]

IMHO, their calculator is a big part of the problem. It certainly made me suspicious that the statins are being excessively pushed to the healthy population.

When I first put my numbers in, the calculator recommended I take a statin. Just for fun I tried lowering cholesterol numbers to see how low I needed to go to be free of a statin. I found that a 64 yo male with normal BP, and total cholesterol of 130 and HDL of 70 and being a non smoker, and no diabetes, is still told he needs a statin. This makes me very suspicious.

Note: I say this as a person who after lots of personal study of the issue decided that a low-dose statin is overall beneficial for me.

Why did you decide that a strain was beneficial for you personally? Just curious.