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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