'Statins' - nothing but slow poison?

ElMondoHummus said:
Unfortunately, that seems to be a huge part of your problem: It looks like you haven't looked at this well enough or with a reasonable degree of thoroughness. You've not provided citations, references, or anything above and beyond assertion for what you've posted, the quote I questioned above being one example.

The questions are partly to see where you're coming from, and partly to see if the "place" you're coming from is valid to begin with. Frankly, without support for your arguments, it cannot be determined that it is. And given that the current medical standard of care disagrees, we're forced to conclude that it does not. That's why we ask these questions: Not to bury you in a dogpile of citations, but to discover why you're making the argument. That helps us figure out our responses.
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Because the evidence points at not only the correlation, but a mechanism for the causation. And your post above demonstrates that you may be suffering under a misapprehension regarding the causation.

If you want to walk away from the discussion, fine. But your point gets nowhere without you providing supporting arguments. Bare assertion doesn't cut it, and yes, your post above was bare assertion.
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And that's the final misapprehension you suffer under: The apparent belief that we haven't already thought about it. That's not only unsupported, it's contradicted by the detail in some of the responses, and the questions we've directed back at you. We have thought about it; it's that thought and research that led us to where we are today. Using myself as an example: My late father and late maternal grandmother both had cardiovascular issues, and I'm on statins myself as a preventative against further problems. I personally am affected by this, and am by no means acting blindly. That's the same for some here, and for others, they're on the other side of the fence as care providers.

But in contrast, you are coming at this as if you only recently noticed the potential issue; your statement about only posting "in the first place a day or two after I discovered that someone I know" gives weight to that. Telling those of us who've been dealing with this for years when you yourself have only been dealing with it for a few days is a bit presumptuous. So the question in return is: Have you thought about it? Or are you merely reacting to what you saw in your friends cases?

I'm sorry, but without support for your basic presumptions - support that's missing, given that you've gone on at length from those basic presumptions but have not given support for them - it's hard to agree with you or even give your posts any credence. Again, it's your right to walk away from the discussion, but without anything other than a "Google for..." pointer, your arguments fail due to lack of support, and your point goes nowhere.

I'm sorry, but there it is. It's your choice whether to provide support for your basic presumptions or not.
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Eloquently put :)

Yuri
 
Supernaut said:
a reminder – I posted in the first place a day or two after I discovered that someone I know, who is showing a pronounced physical degeneration that seems incongruous given his age and history (55, tall and formally athletic, climber etc’) turned out to be taking Lipitor (I can't know what effect if any it may have had on his mental faculties, because it seems that he’s been taking them since before I met him).

I’m not here to crusade or push any agenda. Period. I just feel that the issue is not being discussed in the MSM as it should, notwithstanding the odd piece voicing misgivings in the press, usually to the effect that older statin users should urgently consider taking a CQ10 supplement.

I really don’t have the time or resources to devote myself to arguing and citing interminably.

For the time being I’ll leave you with this;

I cannot fathom how so many allow themselves to be convinced that "high cholesterol" is a "disease" (or even a symptom of a disease) for which the solution is to dose people in their millions pre-emptively and (presumably) for the rest of their lives with a "medicine".

Please. Just. Think. About. It
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Please. Just. Think. About. This.

It could be vascular dementia
it could be extended alcohol use
it could be a transient ischemic attack
it could be a host of things, such as street drugs, high blood pressure, diabetes , etc...

And you just focus on the Lipitor, have you ever done a mental health assesment, do you even know how to take a medical history........

There is a complaint of hearning noises and insomnia, suspect the Evil Statinator without a single thought to at least five other issues, the correct response. Get the person to the ED, in case they are having a TIA...migrane...psychosis...heart attack... etc...

Not that there aren't ten more things that could and should be checked for...


But nooooo, it has to be Lipitor... "the most malevolent con ever pulled by the drug companies"
 
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Dancing David said:
But have there been huge data based studies that link serum cholesterol and heart disease risk, yes.
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Yes but how many of those use studies been via statins? Mightn't there be an unexpected side effect to the statins, besides the claimed benefit of the lower cholesterol? Well, hell yes, per my link above some where, where in statins are shown to prevent clots, lessen inflammation, and help stabilize plaques.

A few years ago I did learn this tid bit: Cholesterol level is actually the #5 risk factor for heart disease. Risk factors are (from memory, might be in wrong order):

#1 Age, obviously
#2 Genes, relatives who had heart disease at young age
#3 Weight, probably a lot of conflation with diabetes
#4 Height, but nobody says I should cut 2" out of my femurs to prevent disease
THEN comes cholesterol level at #5

Hey, shouldn't hypertension be in there too? Lower than #5 I assume?

But, if there are four groups above cholesterol, then cholesterol can not mathematically be a risk factor bigger than 20%. And could be very minor, like only single digit?

Though it may be the risk factor with the best rate of treatment. For instance, the only way to prevent aging is death, so lowering cholesterol sure beats that.

Yet even in my morning visit to the cardiologist today, he seems to think that lowering cholesterol level will prevent any further troubles for ever. In my own lexicon, I think 'prevent' means "never happen". But the studies really only show a "lesser relative rate" actually, which is actually a 'delay'. Said delay happens in a small percent of people. Hey, 60% of people die from something else that statins have no benefit for. Cancer, pulmonary disease, brain hemorrhage, ulcers,,,
 
Anectdotal stories on going crazy from statins aside, there's a far greater problem with them (and antihypertensive drugs, for that part): If large studies show a beneficial effect of lowered serum lipid levels, it's very easy, especially for centrally managed state-run healthcare systems such as the one I work in, to gradually lower the bar for what levels of cholesterol (or blood pressure) should be treated. In the worst case scenario, large numbers of otherwhise healthy persons end up consuming "preventative" medications with a huge NNT due only to blood test results aquired during routine exams.
 
Sawbones79 said:
Anectdotal stories on going crazy from statins aside, there's a far greater problem with them (and antihypertensive drugs, for that part): If large studies show a beneficial effect of lowered serum lipid levels, it's very easy, especially for centrally managed state-run healthcare systems such as the one I work in, to gradually lower the bar for what levels of cholesterol (or blood pressure) should be treated. In the worst case scenario, large numbers of otherwhise healthy persons end up consuming "preventative" medications with a huge NNT due only to blood test results aquired during routine exams.
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So you don't consider extending one's life span a 'healthy' goal?
 
SG, the studies show that statins do nothing for 2/3s of heart patient. And 60% die of something else anyhow. So do the math, that means they help 13.3%.

Now that 13% don't become immortal, the drug merely delays the disease. How long? About 1/3 as long as they take the drug.

So for 86.7% of the population statins do nothing. For the rest, life extension may be a couple years. Not exactly a great panacea.

So I take my aspirin, get 80% of the benefits of statins with much lesser side effects. For 1/2¢ per day.
 
Skeptic Ginger said:
So you don't consider extending one's life span a 'healthy' goal?
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Certainly I do, and I don't oppose either statins, antihypertensive drugs or salicylic acid. I was just trying to state how expanding indications IS an issue in a socialised medical system, and how many of my patients say to me "I take these, these and these but I'm not sure what they're for". I sometimes see a backlash reaction where people state thay since medications are prescribed so offhandedly, how important can they be?
 
Sawbones79 said:
Certainly I do, and I don't oppose either statins, antihypertensive drugs or salicylic acid. I was just trying to state how expanding indications IS an issue in a socialised medical system, and how many of my patients say to me "I take these, these and these but I'm not sure what they're for". I sometimes see a backlash reaction where people state thay since medications are prescribed so offhandedly, how important can they be?
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I can't comment about the aspects of socialized medicine, since I'm in the US. But isn't it possible that what some of your patients are saying is inaccurate?

I've seen that as a vet. A client will make a statement like that (or something similar) about another vet; yet the medical records indicate their account is far from accurate. And if I question them carefully, I'll see them retract the statement as I probe for information.

Even with friends who make such statements about their MDs and the meds prescribed-- I'll often ask questions, and find they were given information about the medication--which they may have either not understood, or didn't remember.

I don't doubt that some MDs prescribe meds as you stated. I've seen MDs that were reluctant to answer my simple, but pertinent questions, with flippant, short or nonsense answers. They are, of course, ex-MDs of mine. ;)
 
Sawbones79 said:
Certainly I do, and I don't oppose either statins, antihypertensive drugs or salicylic acid. I was just trying to state how expanding indications IS an issue in a socialised medical system, and how many of my patients say to me "I take these, these and these but I'm not sure what they're for". I sometimes see a backlash reaction where people state thay since medications are prescribed so offhandedly, how important can they be?
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Personally, I haven't found that drugs are prescribed offhandedly. My doctors have always explained why they are prescribing me drugs. Additionally, they have (where appropriate) got me to try lifestyle changes first. Even for a condition that evidently needed treatment a while back I was told "I'd like to try you on this first", but also told about alternatives.

Before I was started on statins I was asked to try diet and more exercise for a few months. In fact, the first time a blood test came back with a cholesterol level higher than desirable the advice was "it's about the same as mine. Try not eating cheese more than once a week. Have you considered taking up something like tennis?"
 
I think it was at TAM4 or TAM5 that there was a rather heated debate between Marshall Deutsch & a very switched on woman whose name eludes me for the moment about statins. Deutsch struck me as an eccentric, but did seem to have an interesting take on statins - IIRC, his argument wasn't that they were detrimental to one's health but that they were unnecessary - lack of collaboration of evidence that cholesterol was a major contributing factor to heart attacks? I should re-watch those TAM DVDs to see if the discussion was recorded.

It was an interesting debate - I don't think I would pronounce Marshall the 'winner' of the debate, but he had some interesting points of view.

I'm pushing 40, and the doctor has suggested to me that I consider Lipitor and a blood pressure pill. I asked for 6 months to get my dietary regimen straightened out to see if I can avoid going on such 'old man' medicines, at least for awhile. Dropped 20 lbs, and have taken some smarter eating decisions of late, we'll see where my numbers come in on the retests.

Certainly, I don't ascribe to any big pharma CT - my personal view is to medicate only when necessary.
 
casebro said:
SG, the studies show that statins do nothing for 2/3s of heart patient. And 60% die of something else anyhow. So do the math, that means they help 13.3%.

Now that 13% don't become immortal, the drug merely delays the disease. How long? About 1/3 as long as they take the drug.

So for 86.7% of the population statins do nothing. For the rest, life extension may be a couple years. Not exactly a great panacea.

So I take my aspirin, get 80% of the benefits of statins with much lesser side effects. For 1/2¢ per day.
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Once again you assert your conclusions without sources. Surely by now you know not many of us (if any) take your word for anything?

I am familiar with the studies including the risk benefit analyses.
 
Antiquehunter said:
I think it was at TAM4 or TAM5 that there was a rather heated debate between Marshall Deutsch & a very switched on woman whose name eludes me for the moment about statins. Deutsch struck me as an eccentric, but did seem to have an interesting take on statins - IIRC, his argument wasn't that they were detrimental to one's health but that they were unnecessary - lack of collaboration of evidence that cholesterol was a major contributing factor to heart attacks? I should re-watch those TAM DVDs to see if the discussion was recorded.

It was an interesting debate - I don't think I would pronounce Marshall the 'winner' of the debate, but he had some interesting points of view.

I'm pushing 40, and the doctor has suggested to me that I consider Lipitor and a blood pressure pill. I asked for 6 months to get my dietary regimen straightened out to see if I can avoid going on such 'old man' medicines, at least for awhile. Dropped 20 lbs, and have taken some smarter eating decisions of late, we'll see where my numbers come in on the retests.

Certainly, I don't ascribe to any big pharma CT - my personal view is to medicate only when necessary.
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I'm guessing that woman was the Skep Doc, Harriet Hall.

Here's a link on Science Based Medicine on the subject: Cholesterol Skeptics Strike Again, Published by Harriet Hall

I find Hall clearly discredits Deutsch with evidence vs his unsupported recollections.
 
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Sawbones79 said:
Certainly I do, and I don't oppose either statins, antihypertensive drugs or salicylic acid. I was just trying to state how expanding indications IS an issue in a socialised medical system, and how many of my patients say to me "I take these, these and these but I'm not sure what they're for". I sometimes see a backlash reaction where people state thay since medications are prescribed so offhandedly, how important can they be?
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Socialized medicine vs medical insurance companies limit medicine in different ways but both are confined by limited resources. There's a big misconception that profit driven medicine unleashes all the care people can afford to buy. Trouble is, everyone can't afford all the medicine available. Neither system offers unlimited care.

Socialized medicine offers an opportunity to decrease medical costs by keeping a population healthier. If a statin daily for many years is less costly than treating a heart attack and other vascular diseases, the cost benefit analysis will show that. It's a reasonable basis for health care resource decisions.

Private insurers in the recent past have instead saved costs by denying coverage. While pharmaceutical manufacturers might be marketing drugs of limited value, it does not automatically follow that insurers will cover the drugs.


But back to the "expanding indications", creating an indication for profit doesn't mean providers and third party payers are going to ignore cost/risk benefit analyses. It seems you are oversimplifying the decision making processes in medicine.


As for your poorly informed patients, what else is new?
 
Skeptic Ginger said:
Once again you assert your conclusions without sources. Surely by now you know not many of us (if any) take your word for anything?

I am familiar with the studies including the risk benefit analyses.
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So your conclusions don't agree with my conclusions. They are MY conclusions.

Feel free to site/cite any arguments that prove me conceptually wrong.

Even Hall agrees that the NNT is very large for statins. And that diet has little efficacy towards lowering serum numbers. (I scanned your link. I didn't think Deutch's and Hall''s opinions are mutually exclusive. And by extension, neither are mine)

Even you can't argue that most of us die from diseases NOT related to clogged arteries. Or that stains only help minority of those who do. (The relative risk in NOT zero, it is 70%, +/-)

And I don't think you want to claim that taking statins means NEVER having a heart attack.

And I do think I hinted that cholesterol may be the most controllable risk factor.

So tell me, what are you dissing me about?
 
Skeptic Ginger said:
Socialized medicine vs medical insurance companies limit medicine in different ways but both are confined by limited resources. There's a big misconception that profit driven medicine unleashes all the care people can afford to buy. Trouble is, everyone can't afford all the medicine available. Neither system offers unlimited care.

Socialized medicine offers an opportunity to decrease medical costs by keeping a population healthier. If a statin daily for many years is less costly than treating a heart attack and other vascular diseases, the cost benefit analysis will show that. It's a reasonable basis for health care resource decisions.

Private insurers in the recent past have instead saved costs by denying coverage. While pharmaceutical manufacturers might be marketing drugs of limited value, it does not automatically follow that insurers will cover the drugs.


But back to the "expanding indications", creating an indication for profit doesn't mean providers and third party payers are going to ignore cost/risk benefit analyses. It seems you are oversimplifying the decision making processes in medicine.


As for your poorly informed patients, what else is new?
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There are lots of things, good and bad, to be said about socialised medicine, but that's a huge can of worms likely to derail the thread so I'll try to limit my arguments a little. Cost-benefit analysis is generally performed on a national level in Sweden, but indications and choice of drug used is definitely affected by local tradition and the interaction between doctor and patient on an individual level. IMHO your view seems a little optimistic as to how well centrally made decisions are applicable in day-to-day patient work.
 
Sawbones79 said:
There are lots of things, good and bad, to be said about socialised medicine, but that's a huge can of worms likely to derail the thread so I'll try to limit my arguments a little. Cost-benefit analysis is generally performed on a national level in Sweden, but indications and choice of drug used is definitely affected by local tradition and the interaction between doctor and patient on an individual level. IMHO your view seems a little optimistic as to how well centrally made decisions are applicable in day-to-day patient work.
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You're right, too off topic.
 
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