Statins

The whole history of the “rat science” behind the modern push for statin drugs is extremely shaky…and more a lesson in successful sales of pharmaceutical drugs than saving any lives. “Normal” levels of cholesterol have been lowered over the years to bring new patients into the statin business.
You are dead wrong.

 
I agree that you should absolutely listen to your Dr., however from what I have been told by my new Dr. there is an alternative to Statins.
I told my personal reaction to them on here for informational purposes only, not to stop you but to give you an insight on what could possibly happen.
 
You are dead wrong.

Actually, no I’m alive and very healthy lol. Many who have taken statins are now dead wrong however. The “science” behind statin research reads like a bad horror story…studies on rats not replicated in dogs, serious side effects shutting down studies, etc. There is no proof statins have saved anyone…but they have made a lot of people rich.
 
Statins get an undeserved bad rap. Most of the listed side effects are questionable (you see no statistical difference in placebo controlled trials for things like liver damage, muscle aches and pains, Etc).

So, the real things that are well verified.
-About 1 out of 10 people with prediabetes will progress to full blown diabetes sooner if placed on a statin. However, so long as diabetes is managed, people who continue to take the statin will live longer and be healthier on everage than those who stop it. Note, this is people with prediabetes, if you have that, you should be cleaning up your diet and exercising as otherwise it will progress to diabetes.
-1 in 100,000 people will have a trues muscular fibrosis response, this is rare, but can happen. There are ways to reduce the risk.

Statins are not associated with dementia and lowering cholesterol actually reduces the risk of dementia. However, for some people they do cause memory issues. These issues resolved with stopping the statin, and a statin vacation (1-6 weeks al of not taking it) will provide a clear answer. One statin will cause this issue for someone, while a different one does not. So, just because one causes an issue doesn't mean a different one will.

Statins have a very strong nocebo effect. This is basically the evil twin of the placebo effect. There are ways to manage this, primary being giving to person taking the statin some control over dosing.

Statins are about risk reduction, no one has a crystal ball, but you are more likely to live longer and be healthier if you take one, then if you don't. This is supported be multiple large, long term, data sets in humans (one of the benefits of old meds that have been around for over 35 years, along with being cheap). It really sucks if you turn out to have a bad side effect, but not being able to predict the future, all a health care provider can do is recommended the lowest risk option.

Now, on balance, statins are pretty safe with a very small risk of significant adverse effects. Probably safer than taking ibuprofen (which can cause kidney failure, heart attacks, life threatening bleeding, and all your skin to fall off and you basically die from the equivalent of 3rd degree burns which is called SJS). Additionally, unlike ibuprofen, statins have a pretty significant benefit profile.

There was a time when there was concern that lowering cholesterol too much could cause issues, as science has proven this to be false and in large human datasets shown that further reduction in cholesterol reduces risk further, the case for more aggressive treatment has become stronger. The benefits of lower cholesterol shows up over years of lowering. Just like you can't start walking at 60 and expect the health benefits of a life long athlete.

The rather ill informed idea of revenue generation always gets brought up, so lets address that.

The way to make money is to tell people not to take them. If I Rx a statin to someone for 10 years, and assume they only need an annual visit for a refill, our office brings in about $3500 and you can assume drug companies make about $800 over that 10 years. Assuming current guidelines are used to guide starting treatment, I need to treat 10 people to prevent one heart attack in that 10 years. So, $35,000 + 8,000, for $43,000 in 10 years.

Compare that to the best case without prescribing any statins, the person develops angina, I see them in the office, get them a stress test and echo, then send them for a heart cath and they get a stent, my employer would net about $18,000 more when all is said and done as opposed to treating 10 people with statins. But, in the worst case, we are talking hundreds of thousands in addition revenue for the medical industry that is lost by preventing a single heart attack.

Some of the older intervention cardiologists remember 20+ years ago having partners that didn't believe in prescribing statins, those guys had a steady rotation of the same people getting stents every few years. Great business model, flat out shit way to treat people though.

I do find it amusing how people actually drive up medical expenses by avoiding good preventative care in the name of not enriching big pharma.
 
Have you had a coronary calcium score lately?

To understand a coronary artery calcium score and how to use it, we first must take a step back and discuss physiology (a little simplified). Plaque starts as an irritation in the artery lining, this attracts some cholesterol to it, then, based on simple chemistry (Le Châtelier's principle) more cholesterol is attracted to this at a rate determined largely by the concentration in the blood (this is the same reason poring grease down your drain tends to lead to a clog in one spot and not evenly distribute through the entire pipe). This leads to a soft, faty plaque that is unstable, which the body doesn't like. Over time osteoblasts (cells that build bone) migrate to these plaques and lay calcium down to form a stable cap.

A CAC score detects the calcium, not the plaque. A young person can have a CAC of zero and yest have severe multi vessel disease that needs a bypass. Some people will rapidly build plaques that need intervention but are not calcified.

On the other hand, endurance athletes tend to have high levels of coronary calcification, but no significant plaque burden. Statins also stabilize plaques and long term statin use results in elevated CAC scores, but lower total plaque burden and lower risk of heart attacks and strokes.

So, a CAC is not a diagnostic test, rather for someone who is borderline on if they need a statin or not, it provides additional information. If your risk factors are such that a statin is clearly recommended, a CAC of zero doesn't mean you don't need a statin. You would need a heart cath or a coronary CT angiogram to rule out coronary disease, but even if an angio is clean, you are on shaky ground using that to recommend discontinuation of a statin in a high risk individual.
 
Actually, no I’m alive and very healthy lol. Many who have taken statins are now dead wrong however. The “science” behind statin research reads like a bad horror story…studies on rats not replicated in dogs, serious side effects shutting down studies, etc. There is no proof statins have saved anyone…but they have made a lot of people rich.
Again. Dead wrong.
 
One thing for sure. We have a pill for everything in health care today. 100 years ago healthcare was infection and trauma.

There was no systemic illness. If you had Autoimmune disorders or diabetes you were in a book. If you were fat, you were in the circus. Now, just go to walmart for all the above.

I have patients who have had heart attack With ldl of 90, statin naive and no other risk factors.

I have a bushel basket full of 90+ yo patients with LDL of 180+ and never been on a statin. There is a direct correlation between longevity and elevated LDL.

Now if you are obese, sedentary and diabetic you better be on a statin . (Diabetes is the biggest risk for cardiovascular disease).

Again, metabolic function/dysfunction causes disease. Period.


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One thing for sure. We have a pill for everything in health care today. 100 years ago healthcare was infection and trauma.

There was no systemic illness. If you had Autoimmune disorders or diabetes you were in a book. If you were fat, you were in the circus. Now, just go to walmart for all the above.

I have patients who have had heart attack With ldl of 90, statin naive and no other risk factors.

I have a bushel basket full of 90+ yo patients with LDL of 180+ and never been on a statin. There is a direct correlation between longevity and elevated LDL.

Now if you are obese, sedentary and diabetic you better be on a statin . (Diabetes is the biggest risk for cardiovascular disease).

Again, metabolic function/dysfunction causes disease. Period.


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Life expectancy in 1925 was about 59 years old. I’m glad we have those pills.
 
There is a direct correlation between longevity and elevated LDL.
Direct correlation?

So why is it that Homozygous Familial Hypercholesterolemia patients with LDLs over 900 have a life expectancy of less than 30 years without treatment?

But people with Benign Heterozygous Familial Hypobetalipoproteinaemia causing abnormally low LDLs of 20-50 frequently live past 85 years?

Direct correlation? Certainly not. Even an argument for a J curve has little support, especially as with newer medication we can get some people to undetectable LDL levels and the suggestion in the data (which continues to grow stronger as we get more data) points towards additional benefits, though the return for effort diminishes. There certainly is not a signature for harm in the currently available data.

I have patients who have had heart attack With ldl of 90, statin naive and no other risk factors.
Check an LP(a) level on them. This is commonly very elevated in patients with low to normal LDLs and early MIs. No approved meds currently, but PCSK9i's will reduce it. And, some people are just vasculopaths and we haven't found why yet. Just like some people have longevity despite bad habits, look at Winston Churchill who died at 90, yet we don't recommend smoking, drinking, and being obese to patients.

Risk factors are not destiny. Some people will speed every day of their life and never wear a seatbelt, but die of old age without any injuries from an MVC, that doesn't make it a good idea. It does mean that telling someone they will die from doing that is a dishonest overstatement. Equally, many people will do well not modifying risk factors, but can you authoritatively identify them prospectively? What factors make it okay for me to go back to stuffing a third a can of cope in my lip while smoking a pack a day?
 
I went down the cholesterol/statin rabbit hole several years ago when my doc started trying to scare me into taking the drugs because my total cholesterol number was above 200. I remembered in the past that they said 240 was good. In fact, 50 years ago 300 was considered normal and healthy. So I was skeptical. I looked into it myself. I learned a lot. Cholesterol doesn't cause heart disease. Statins don't extend life expectancy, but they do cause lots of bad side effects. They're highly profitable for big pharma. That's why they've gaslit doctors and the rest of us about cholesterol. Pharma owns conventional medicine. They pay for literally EVERYTHING in the system from the research to medical schools to media reports, so they control it all - for profit. Clearly, we (docs included) should take everything pharma says with a grain of salt.

Here's a playlist full of info on cholesterol and statins, mostly from cardiologists and other doctors who have stepped outside the dogma of the system and thought for themselves.



I have since stopped going to that conventional medicine doctor, even though he is a friend of mine. He's a good man. We're in a small group together at our church. And, by the way, I'm fitter and healthier than he is. But after heavily researching this and several other things for myself over the last several years, it's clear to me that the conventional allopathic medical system is badly misguided in it's thinking about chronic disease and general health and nutrition. Conventional medicine is great for acute care. But its recommendations for general health, nutrition, and chronic disease are demonstrably counterproductive. I've since found a functional/integrative medicine doc for when I need a doc to sign an annual wellness exam for insurance, etc. I'm healthier now at age 59 than I was at age 45, thanks to learning about proper nutrition and lifestyle. There are lots of good people in the conventional medicine industry. They're doing their best to help people. I just believe their training is very wrong in lots of ways.
 
You can try Red Yeast Rice as a natural (OTC and very cheap) Statin and then recheck after 3 months.
My Dr recommended it and my cholesterol dropped from 210 to 185. I stopped taking it for awhile and my levels shot back up., So, I'm on it again.
 
So, there are medications that raise HDL (good cholesterol), none of these are available because people who take them have more problems, not less (turns out very high HDL is also bad).

So, if pharma controls everything and can gaslight us all, why did these drugs never make it to market? Why do more drugs fail in development than get marketed despite massive development costs?

The insurance industry has way more control than the pharmaceutical industry and better prophet margins. They don't really pay for stuff unless it saves them money in the long run and are frequently behind on adopting proven treatments by several years.

Ever wonder what the supplement industry makes?

Red yeast rice in a cheap brand at Walmart would cost me $144 a year at the typical recommended dosing of 2400 mg in two divided doses daily. Rosuvastatin 10 mg, paying completely out of pocket, would cost me $80 a year locally. One certainly lines pockets more than the other. Don't forget, supplement sellers don't have to invest anything proving results.

The other side of it is numbers like cholesterol are just a guide, the goal is never just a pretty number, but rather live longer and be healthier. Not everything that moves the number accomplishes the actual goal. So, I will always take something with a large dataset supporting improved long term outcomes over something only proven to alter a marker.
 
Wondering who on here takes a statin? And how it affects you? 10yrs ago my dad got on a statin. He was 53yrs old, 5'9" and 170lbs. He was at 260 on his cholesterol.

I went and got my bloodwork done for the first time in 8yrs. Last time mine was 185. This time it was 210. Dr. told me that its time I get on some cholesterol medication. She prescribed me advorstatin. Last night I got to looking it up on the internet. Some things really stood out to me on the side affects list. Memory loss and and type 2 diabetes. My dad isn't a sugar eater and never has been. 3yrs ago he started to not be able to see very good. Went to the eye Dr. and got told that he needed to go to his regular Dr. instead. So he did and has diabetes. So they put him on a medication for that. And me and my brother have noticed for the past 1yr-1.5yr that his memory is getting BAD. Bad enough that we are/were thinking maybe something more than just being a little forgetful.



Maybe they aren't related at all. But I am going to call in tomorrow and tell the Dr. my concerns and get her opinion before I start taking them. I know that I probably need to do something to get my cholesterol down. But making me a diabetic and not remembering much isn't very appealing either.
I am not a medical professional. My advise is listen to your doctor. If you don't trust your doctor get a different one. I was placed on Advorstatin along with other meds while in the hospital in 2020. As time went on my muscles got progressively weaker and more sore. To the point it became difficult to do some things including maintain good balance. My primary care doctor of 25 years retired. Got a new Doc. I mentioned my soreness and he immediately switched me to Rostuvastatin. Within a few weeks my soreness was gone. I had never mentioned my issue to my old doctor. So I am not saying what statin to take but that you should report any and all changes with your body after you go on any new meds. People have different side effects from meds.
 
Totally agree with Boarmaster about communicating with physicians, and firing doctors when needed. If you live in an extremely rural area, your choices are likely limited.

The challenge is most of us don't have the education or training to know the available treatment choices for a particular ailment, we blindly trust the doc we see, or the docs only use the tools (meds and tests) they know which can lead to needless suffering for some Pts. I learned that the hard way and have fired docs to find ones that i trust more, and were not threatened with technical questions challenging their suggested treatment choices.

Also consider APRNs (nurse practitioners) as a PCP because it seems to me they have less ego involved and listen better then many docs.

Speaking as a licensed professional, just because a person has a license to practice doesn't mean they are any good at what they do. The same goes for any field or any type of work. That being said, there are some good docs out there. If you have a nurse or other medical professional in your circle, ask them for advice on who to see. They usually know who to avoid and may have some good suggestions.

Some medical problems really are just bad luck...however many chronic medical conditions are not, and are preventable or risk reducible with exercise, healthy eating, good sleep, and reduced stress.

I encourage all to think about healthspan vs lifespan. What quality of life do you want to have as you get older?

The better our health as we age, the longer we will likely enjoy life.

Sorry for the rant :)
 
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