As a doc you may appreciate this bit of biochemical analysis by Dr.
Malcolm Kendrick. <http://thincs.org/Malcolm.choltheory.htm>
or this one regarding heart disease, statins and total mortality
titled "Thank God He Didn't Die of Heart Disease Doctor".
<http://thincs.org/Malcolm3.htm#march24>
Kendrick can be very irreverent at times... which I think is called for.
Finally, a more rational hypothesis regarding the cause of heart
disease. One that actually accounts for the known data.
<http://mercola.fileburst.com/PDF/Ravnskov%20McCully%20Vulnerable%20plaque%20formation.pdf>
Chuck Norcutt
Charles Geilfuss wrote:
> Thanks for posting the links Chuck, those are great food for thought (pun
> intended). I've always felt there is a lot of shenanigans in the drug trial
> business and far too much drug company money chasing doctors (alas I'm not
> one of them). And don't get me started on TV ads for prescription drugs that
> drive sales for dubious new products. Big Pharma is famous for making a
> slight chemical change to a drug whose patent is about to expire, claim
> wondrous new benefits (usually marginal at best) on TV ads and then patients
> demand them and hop from Doc to Doc to get them.
> This cholesterol business has been getting personal of late. Mine has been
> creeping up the last ten years and my internist had been leaning on me to
> begin a statin. My total is about 250 mg/dl with an LDL of 185 and HDL of
> 45. Triglycerides are normal. I'll be 56 this year and since I started
> parenting late my youngest is 11 years. I decided to not play doctor on
> myself and take her advice and began Simvistatin 20mg. Everything went fine
> for three weeks when out of the blue, as if someone had flipped a switch, I
> became completely impotent. WTF! I've never had this problem. Turns out to
> be an uncommon but well described side effect. I stopped the statin and all
> returned to normal within a few weeks. My physician wants me to wait a month
> and try a different statin but I think not. In my gut I no longer trust that
> class of drug.
> Time to re-think. My mother lived to 82 and died with no heart disease;
> my Dad is a healthy 82 with no heart disease. His cholesterol is about the
> same as mine and was pressured by his doctor to go on a statin as well. He
> told him to take a hike. As for me I weigh 150 lbs, never smoked, exercise
> regularly and eat a well balanced diet with lots of fruit, vegies and nuts
> (love 'em). I have a normal EKG, a very low C-reactive protein (measure of
> systemic inflammation), low Lipoprotein A (<5 mg/dl) and a cardiac calcium
> score of 0. Fuck it! I'm taking my chances with the high LDL. And if the guy
> whose link you posted is right it may explain why I rarely get sick (haven't
> missed a day of work in 30 years).
>
> Charlie
>
> On Fri, Jun 25, 2010 at 8:34 AM, Chuck Norcutt <
> chucknorcutt@xxxxxxxxxxxxxxxx> wrote:
>
>> The docs are so exercised about cholesterol (and statin drugs in
>> particular) since the only sources of information for most of them are
>> the drug company reps that visit them incessantly and the heavily biased
>> drug trials in our corrupt medical journals. Even if they read the
>> journals all most ever read is the abstract. Almost all drug research
>> in the US and Europe is today funded totally by the drug companies who
>> always manage to get the results they desire. Richard Smith, former
>> editor of the British Medical Journal tells how it is done here.
>> <http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020138
>> A summary here:
>> -------------------------------------------------------
>> Examples of Methods for Pharmaceutical Companies to Get the Results They
>> Want from Clinical Trials
>>
>> Conduct a trial of your drug against a treatment known to be
>> inferior.
>>
>> Trial your drugs against too low a dose of a competitor drug.
>>
>> Conduct a trial of your drug against too high a dose of a
>> competitor drug (making your drug seem less toxic).
>>
>> Conduct trials that are too small to show differences from
>> competitor drugs.
>>
>> Use multiple endpoints in the trial and select for publication
>> those that give favourable results.
>>
>> Do multicentre trials and select for publication results from
>> centres that are favourable.
>>
>> Conduct subgroup analyses and select for publication those that
>> are favourable.
>>
>> Present results that are most likely to impress—for example,
>> reduction in relative rather than absolute risk.
>> ---------------------------------------------------------
>>
>> Smith left the BMJ because of the corrupting influence the drug
>> companies were having on his publication. He also commented that the
>> American journals were much worse.
>>
>> Cholesterol and statin drug research is particularly hard for the docs
>> to understand even if they read the full journal articles. Cholesterol
>> research it totally based on epidemiological evidence. There is no
>> medicine involved as there is no credible biological explanation for why
>> cholesterol causes heart disease. The epidemiological evidence is, of
>> course, purely statistical using simply awful methods such as
>> unjustified use of single tail vs. two-tail tests of significance. Even
>> then the correlations are extremely weak. To be fair, statin drugs do
>> reduce the incidence of heart attack and stroke. However, they work
>> equally well whether you have high or low cholesterol. The most likely
>> reason that they work at all is that they also have an anti-inflammatory
>> effect. But the effect is no more effective than an aspirin or fish oil
>> in the diet and those have little or no adverse effects.
>>
>> I've tried to educate my own doc (whose office is always filled with
>> drug reps) but his eyes just glass over when we get to the statistics.
>> Not part of his education and he just quietly says "very interesting".
>>
>> Using the studies from U of Hawaii and others having to do with
>> cholesterol and the elderly I did manage to convince my 89 year old
>> father's doc not to put him on cholesterol lowering drugs. There are
>> still some researchers that are independent of drug money but they are
>> few and far between.
>>
>> If you're really interested in this subject your eyes will be opened by
>> reading at this site: <http://www.thincs.org/> The primary mover here
>> is a Swedish physician, Uffe Ravnskov, well published in the Lancet and
>> elsewhere. I got into this years ago by accidentally picking up his
>> book "The Cholesterol Myths". In it he speaks of the problem of drug
>> company influence and of docs only reading the abstracts of papers. He
>> states that often these papers make claims in the abstracts that are not
>> actually supported by the data in the paper. I thought this was
>> preposterous. This is "peer reviewed" science. I was ready to throw
>> his book in the trash. But before doing that I decided to check for
>> myself. I located two small (3 pages) papers on PubMed
>> <http://www.ncbi.nlm.nih.gov/pubmed/> that were small enough and
>> sufficiently statistical (vs medical) that I could understand them
>> without much difficulty. Apart from my selection criteria the selection
>> was random. To my utter horror I discovered that both of these small
>> papers made claims not actually supported by the data. But these claims
>> were not different from the more general cholesterol hysteria and would
>> not be picked up or even suspected without careful examination of the
>> actual data in the papers.
>>
>> Unfortunately, "peer reviewed" in some circles has come to mean "buddy
>> approved".
>>
>> Chuck Norcutt
>>
>>
>>
>>
>>
>>
>> Moose wrote:
>>> On 6/19/2010 5:45 AM, Chuck Norcutt wrote:
>>>> 'tis a matter of opinion. High cholesterol (by research at U of
>>>> Hawaii and u of California at San Diego) has been shown to be
>>>> protective in the elderly. Above the age of 65-70 the higher your
>>>> cholesterol the longer you live.
>>> Never heard that.
>>>
>>>> In fact, there is no association whatsoever between cholesterol and
>>>> heart disease in men over the age of 50 and in women of any age.
>>>> None. Never has been.
>>>>
>>> So why are the docs so exercised about it?
>>>
>>> I've completely ignored my cholesterol for well over ten years now,
>>> and don't plan to start monitoring it to see if I can get it up any
>>> more than I did to keep it down.
>>>
>>> When I was in a heart study, they did measure it, but I paid little
>>> attention.
>>>
>>> Moose
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