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The problem is that "your doctor" is not competent to understand the complex issues
All too often true. In that case we should all seek out a doctor who makes judicious use of an expert system to crunch the numbers of your own tests and at least come up with a risks vs benefit analysis.
In my case, the results are (currently) in the negative for statin medication.
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Keep taking cholesterol meds: experts
from Clifford Fram, AAP National Medical Writer - AAP - November 01, 2013 11:39AMPEOPLE with high cholesterol should keep taking their medication despite controversial claims in an ABC television program, the Heart Foundation says.
Foundation CEO Dr Lyn Roberts says an ABC Catalyst program has caused confusion by questioning whether cholesterol is an important risk factor for heart disease and saying the benefits of cholesterol-lowering statins are overstated.
"Patients are already contacting their GPs on the basis of the program".
you betcha! :-)
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The good thing is, people are now seeking answers and asking questions as well as looking at alternatives, whereas before the program they were not even aware there may be problems. Good luck Goanna with your decision, hope it works best for you.
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@ goanna
I am one consumer who spends $41.50 a month on statins, hoping they will keep me healthy. The statins cause me muscle pain on top of the wallet pain. 15 years ago, my mother's doctor stopped taking his statins. Last year, my own doctor stopped as well.
My mother was prescribed statins for years. She became irritable, had lots of muscle pains, and sometimes she could hardly work and was so tired. She described her problems to the doctor; he looked it up and said: there's nothing in the computer relating statins to your muscle pain, so it must be something else -- menopause.
My mother simply stopped taking the statins but didn't tell her doctor. After a few weeks, she was her old self again.
I've seen TV programs that relate the same story over and over, but nothing changes. It's government policy to give these "preventive" medicine in the Netherlands. So almost everybody are given statins because the percentage of people with "high" cholesterol is high. These drugs are causing people harm; they are supposed to give people less likelyhood of getting heart disease, but in the meantime people become wrecks. It's not even known for sure what cholesterol does and if high cholesterol is bad -- I once read a research paper that stated high cholesterol in the elderly might have a reason, I don't remember what exactly, but it had something to do with the body's natural defenses.
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I hope your mother is doing well; eating and exercising right while we all wait for a real solution to the inflammation/cholesterol syndrome mystery. A lot of the message of what we've learned in the last two weeks comes down to the medical adage: "First, Do No Harm."
The statin manufacturers will no doubt seek protection from any claims of statin damage by pointing to the product leaflet's, "See your doctor if.." clauses. Quite often, public awareness followed by threat of further class action will persuade an industry to change its tune.
Belief in statins' power over cardio-vascular disorder had become a religion. In that respect, I'll be calling myself an agnostic.
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I'm not convinced at all. The statin manufacturers will not only seek protection against damages, but also perpetuate the science that supports a multi-billion dollar industry.
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The ABC documentary, although much derided by industry, is not a solitary voice.
Sep 24, 2013 :
FDA Expands Advice on Statin Risks
If you’re one of the millions of Americans who take statins to prevent heart disease, the Food and Drug Administration (FDA) has important new safety information on these cholesterol-lowering medications.
FDA is advising consumers and health care professionals that: Routine monitoring of liver enzymes in the blood, once considered standard procedure for statin users, is no longer needed. Such monitoring has not been found to be effective in predicting or preventing the rare occurrences of serious liver injury associated with statin use.
Cognitive (brain-related) impairment, such as memory loss, forgetfulness and confusion, has been reported by some statin users.
People being treated with statins may have an increased risk of raised blood sugar levels and the development of Type 2 diabetes. Some medications interact with lovastatin (brand names include Mevacor) and can increase the risk of muscle damage.
And much more (from February 27, 2012):
Liver Injury Called Rare
Reports of Memory Loss
The Risk of Diabetes
The Potential for Muscle Damage
http://www.fda.gov/forconsumers/consumerupdates/ucm293330.htm
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Part 2 VODCAST is now available for download:
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TV ratings: quality programming wins out
from Glenn Dyer | Nov 01, 2013 12:41PM | Crikey,com
ABC’s Catalyst smashed the competition last night with the second part of its investigation of cholesterol and heart medication.
Despite the presence in last night’s schedule of the TV pap programs like Beauty and The Geek Australia and Big Brother, the most-watched program across the country last night was a good, old-fashioned ABC effort with traditional values — Catalyst, which reports on science and other issues considered too “difficult” by most TV executives for Australian audiences.
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Nothing sweet about this debate
from Amy Corderoy| November 2, 2013 - 12:00AM| Sydney Morning Herald
University of Melbourne media ethicist Dr Denis Muller says it's important programs like Catalyst discuss areas of medical debate and controversy. "But there is a duty on the reporter to be fair about the quality of the science it's based on."
It's the kind of vitriol usually reserved for climate science. But it's not the future of the planet that's at stake but the future of what we put in our mouths. ... Most experts in the field say there are huge holes in this thesis. Somehow, among the tribal online world, the debate has turned into one where you are either with the argument, or against it.
But could both sugar and fat contribute to heart disease? The National Heart Foundation says excess sugar consumption causing problems does not rule out high cholesterol as a danger.
"Heart disease is multifactorial," chief executive Dr Lyn Roberts says. "You have to look at a range of risk factors to know your risk for heart disease."
The weight of evidence shows cholesterol medications are effective and their benefits outweigh harms in people at moderate to high risk of heart disease.
The risks of side effects from the medication are real. Many users report muscle cramping, while the US Food and Drug Administration warns patients could experience impairments to thinking and memory and an increased risk of diabetes. .... Little is known about how many Australians at low-risk of heart disease are inappropriately prescribed statins but evidence from the AusHEART study indicates it could be up to 30 per cent.
Head of the school of public health at the University of Sydney Professor Glenn Salkeld says part of the answer will lie in developing better decision aids where people can input their risk factors (such as weight) and preferences (such as not to take medication). In the end, he says people must also get the message that prevention is better than cure. "We pay a high price, many billions of dollars, for not heeding this advice. Some people will benefit from taking a prescription drug and others will not. All compelling reasons to . . . start exercising and switch to a diet rich in fruit, vegetables and healthy fats, like the Mediterranean diet."
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Things to consider:
- What some people need is a better cholesterol-reducing drug (statin family or other);
- Strange that this story should come to light only after Pfizer's patent expired;
- Strange that this story should come to light only after Pfizer announce success with a new statin-adjunct drug.
Back mid-2012, when Pfizer were still making ridiculously minor changes to Lipitor in attempts to extend its patent, their army of lawyers would have stopped this kind of criticism in its tracks.
I'm still kind of surprised they seemed to have called the dogs off this time. Is this debate somehow playing into their hands?
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"Pfizer calling off the dogs"
Well, the FDA has put a lot more strictures in place on what a PhRMA member can say publicly, and since the FDA has determined there are problems, Pfizer cannot say there are not. I am sure that behind the scenes that there is increased pressure being brought upon the physicians, reassuring them that 'science' says it is best to prescribe the statin, just to be sure the patient is protected from himself...
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Patients swamp GPs in heart pill confusion
Cathy O'Leary Medical Editor, The West Australian November 2, 2013
WA doctors are being inundated with patients asking if they should dump their anti-cholesterol drugs after a television documentary suggested the pills were overprescribed and doing more harm than good.
Experts are furious by claims in the ABC medical science program Catalyst that cholesterol is a heart disease myth and the drugs statins have few benefits and significant side effects.
The program was a rating success, with almost one million capital-city viewers tuning in to the series on the past two Thursdays.
There is now speculation the ABC has left itself open to litigation after reports of worried patients taking themselves off the drugs without telling their doctor.
Some critics claim the program was heavily biased to the views of several hand-picked US doctors, nutritionists and "suntanned charismatics" who played down the role of cholesterol and saturated fats in heart disease.
Australian Medical Association WA president Richard Choong said one in five patients he had seen at his Port Kennedy practice in the past two days came because they were worried about their prescribed statins.
"I've reassured them there is good evidence of the benefits of statins but also made the point that cholesterol does need to be kept in perspective and isn't the only factor," Dr Choong said.
Heart Foundation national chief executive Lyn Roberts said home care nurses visiting patients had discovered some people had stopped taking their pills.
"That's of concern because some of these people actually have heart disease, so to go off their medication is very dangerous," Dr Roberts said. "We are shocked by the program's disregard of the strong medical evidence and are considering our next course of action once we've got through the next few days."
Despite a backlash after the first episode, the ABC maintained the program was fair but added a disclaimer saying it was not intended as medical advice.
Heart Foundation WA chief executive Maurice Swanson said each episode should have started with a strong health warning rather than having a weak disclaimer "tacked on".
This is looking more and more like a social-media phenomenon - where science now has to combat popular belief. In its place, disbelief, disillusion and mistrust of rogue drug marketers are taking on a dangerously un-scientific, dissuasive role.
I think one day soon the pharmaceutical industry might just be forced to adopt a level of transparency which it finds very unfamiliar!
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Hmm. Most probably corporations already have right solution, that is "only 40% more price" :-)
TV owners usually are good friends with corporations. -
Chelesterol is really a non issue. It's not an essential nutrient, so no need to consume it. The problem is most people like their animal foods, so they rather eat foods that slowly kill them + pills to try to control the side-effects. All they need to do is eat a healthy diet, youd be off the meds in no time...
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How Catalyst Effectively Exploded The Cholesterol Myth With These 13 Facts About Fat
*From BUSINESS INSIDER's Peter Farquhar 1st October 2013One of the most cherished health assumptions of the modern era – that high cholesterol levels and saturated fat consumption lead to heart disease and death – may be fundamentally based on a single dodgy chart from the 1950s.
The ABC made it clear that the report was not intended as any form of medical advice.
But it was undeniably riveting. Here’s a breakdown of the key points:
1) Cholesterol is essential for life.It's a major component of brain and nerve tissue, and central for hormone production. Virtually every cell in your body makes it.
2) Eating fat causes heart disease. The idea that saturated fat clogs your arteries by raising cholesterol was first kicked around in the '50s by American nutritionist Ancel Keys. He noted soaring rates of heart disease after World War II and compared the rates of heart disease and fat consumption in six countries. Result? The more fat people ate, the higher the rates of heart disease. Except, there was just one problem.
3)Keys withheld data for 16 other countries.
... Soon all Americans over the age of two were being told to go on low-fat diets.
4) Follow-up trials couldn't replicate Keys'result. ..Later, another two trials, costing over $250 million and involving hundreds of thousands of patients, failed to prove that lowering saturated fat could lower your risk of dying from heart attack.
5) Even Australia's National Heart Foundation admits evidence is 'limited'.They could only cite one study to Dr Demasi which showed only certain types of saturated fat could raise bad cholesterol. But it also raised good cholesterol.
6) Diet has very little influence on your blood cholesterol in the long term. Cardiologist Ernest Curtis says the reason for that is that your body manufactures 80% to 90% of your cholesterol. Very little of it comes from the diet. And if somebody cuts all the cholesterol out of their diet, their body will simply start making a little bit more to bring it back up into the range.
7) The longest study on heart disease began in 1948. It's still going. But 30 years later, researchers found that by the time residents reached their late 40s, there was no correlation between cholesterol levels and heart disease.
8) In fact, after the age of 47, high cholesterol was shown to be probably protective.
9) Then there's the Lyon Diet Heart Study. .. two groups of dieters. After several years, it emerged that those on the Mediterranean diet had a whopping 76% less deaths from heart attacks. But their cholesterol levels didn't budge. Both groups had the same cholesterol levels, except one group just stopped dying.
10) THEORY - Fat and cholesterol block arteries.Contrary to popular belief (and advertising), neither saturated fat or cholesterol deposit on the artery wall like sludge in a pipe. If an artery wall is damaged, the body responds by building a cap over the plaque. The plaque often contains cholesterol, along with bacteria and calcium. If it bursts, a clot can form. Hence when doctors study the clot, they often find cholesterol. Cardiologist Stephen Sinatra says blaming cholesterol for causing plaques is like blaming firemen for causing fires, just because they're always at the scene.
11) THEORY - The real cause of arterial damage is inflammation. More and more doctors are now coming around to the fact that sugar is the real enemy.
12) The other cause of inflammation. Omega-6 oils. Margarine is the perfect example. Polyunsaturated fats such as vegetable oils are inflammatory because they're very prone to free radical attack - oxidation. Oxidised cholesterol is the cholesterol often referred to as “the bad cholesterol”. Saturated fats, like butter, are inert fats. When you cook with them, they don’t pick up free radicals.
13) Why the Mediterranean diet worked. Because of the high omega-3 content in seafood. Omega-3s are thought to counter the inflammatory effects of omega-6s. Hence fish with a high oil content, such as salmon, are recommended as an essential part of a healthy heart diet.
http://www.businessinsider.com.au/how-catalyst-effectively-exploded-the-cholesterol-myth-with-these-13-facts-about-fat-2013-11#Catalyst and the Cholesterol Myth
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@Gamer_s "All they need to do is eat a healthy diet, youd be off the meds in no time..." Future philosophy students will enjoy dissecting statements they find in the Internet archive, and comparing it with the knowledge that actually emerges as time goes by :)
ABC put disclaimers at the beginning and end of their show - "ask your Doctor." Why? What information do Doctors have about this issue that is superior to the knowledge of the experts who were interviewed? One Catalyst topic was that the very bloodwork values upon which Doctors make their decisions have been artificially altered to make diagnosis of hypercholesterolemia even more difficult. The dice have been loaded.
@goanna_BusinessInsider: Points 12 and 13 are not supportable by science. They are conjecture which 'sound right' to the writer, but only 'sound right' if one accepts the same shaky level of 'evidence' as was used to vilify cholesterol. Nobody knows which direction to move forward, and they do a disservice by simplifying the problem (which is indeed 'inflammation') down to something under an individual's control - one's diet.
If anybody could live longer and healthier from eating a 'perfect' diet, or by having the 'right' amount of exercise, we would see populations of people around the world who are exceptional. We don't see that. It is hard to find healthy centenarians. Most are in wheelchairs, partly deaf and blind. Mankind doesn't have the answer yet. Mankind needs to face the music, instead of looking to industries which offer hope, but few long-term solutions.
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@trevmar well, the few docs that actually help patients with lifestylechanges sure think it's that easy, as do the patients they're treating, but I guess you're privy to information on why they are all wrong.
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Unlike many other media outlets, science reporting has a solid history at the ABC. How, then, can its flagship science program create such widespread controversy?
It’s hard to know what to believe in the reporting of science. As the Catalyst controversy shows, both sides need to do a better job, writes biologist and science communicator Upulie Divisekera.
(a stinger for respected, investigative paid-news site Crikey.com
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The impact of an ABC Catalyst program questioning the benefits of statins is already being felt by pharmacists
..a number of their patients had admitted ceasing their medication in the week since the first of the two-part Catalyst series looking into cardiovascular disease and statins aired.
“I have already had a couple of patients who, during a Home Medication Review, admitted to discontinuing statin therapy as a result of this program,” the Pharmacy News reader said. “Fortunately this was picked up early and few doses were missed. [These people are] high risk cardiovascular patients... It was very dangerous reporting to say the least.”
The pharmacists possibly don't talk to their patients enough: people most often stop taking statins because of pain. Pain which can be relentless.. some people "don't want to go on" with such pain. They learn that after stopping statins for 3 weeks, the pain subsides and they can resume living normally.
Some comments from the feedback sections for Part 1 and Part 2 of Catalyst's website:
"after being put on Statins at 51 for high Cholesterol, after a few weeks I was suffering severe muscle pain so stopped taking them"
" I ceased taking the drug Lipitor because not only did I suffer constant joint and muscle pains and extreme tiredness, I could no longer climb stairs. "
"about a year later I was convinced give statins another go on half the original dose - 10mg of Simvastatin - the leg pains returned within 2 weeks even though I wasn't running"
"Not only was every day a struggle in a range of ways from muscle pain to an unclear head, my hair was falling out (an apparently uncommon side effect). My cardiologist suggested I get a wig or wear a hat!"
My boss, a maths HOD retired unnecessarily because of mental confusion probably as result of statins. I gave them up myself because of joint pain which precluded me from running which I figured was better for me than the vague promises of lower cholesterol."
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@goanna Wow they are really giving ABC a hard time. I looked over both the programs in detail. ABC sought out competent experts, and presented both sides of the argument. Beatrice Golomb, for example, has spent much of her career studying statin side effects. I have discussed this issue with her. She knows the topic inside out.
I think the problem was that the science came out as being extremely one-sided. The lack of scientific support for the cholesterol dogma is the problem the cholesterol folk ought to be addressing, not ABC's reporting.
But as Vitaliy commented above, the Business of Medicine is a really big business, and has performed well in delivering promises, while hiding failures behind a veneer of respectability. Just as the ABC demonstrated, many of the studies performed these days are really not worth the paper they are printed on. Drugs are commonly approved with a 16% improvement in a single biomarker. What use is this measure to a patient threatened by a deadly disease? Why don't they measure the patient's actual response, rather than the easier biomarker? Why are life extensions for cancer patients measured in months, not years? However, one day the public will figure it out. If not on this issue, maybe on the next...
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(A little off-topic, but just to raise morale a bit) , there is indeed some hope in sight - and it's not too far from the approach seemingly suggested by @trevmar.
I've been Communicating with Associate Professor David Sullivan from the Lipid Clinic at Royal Prince Alfred Hospital in Sydney, who's running the Fourier trials in Australia.
AMG 145 is an investigational human monoclonal antibody that inhibits PCSK9, a protein that reduces the liver's ability to remove LDL-C from the blood. Amgen presented the data at the ESC Congress 2013, organized by the European Society of Cardiology, in Amsterdam.
from http://www.amgen.com/media/media_pr_detail.jsp?year=2013&releaseID=1851078
As David Sullivan describes this monthly injection process, it seems to work by an antibody, re-setting the body's misfunctioning abiility to dispose of excess cholesterol.
At a high success rate, participants' cholesterol profile has been observed to revert to that as observed in persons with genetically low cholesterol.
-And no, I was unable to participate. I live too far from the city and they'd need to see me every three weeks :-(
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Wow they are really giving ABC a hard time.
from http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/
The strange thing is, people are quite prepared to defend statins against the odds: the aura of respectability hangs around. (After all, we all want statins to work). They don't, and they can be harmful. "But", we say to ourselves, "without statins, we have nothing". - Which seems to me like a textbook case of denial.
I'm hoping sometime soon, the Catalyst crew will make a public statement - and I'd like to think they'll stick to their guns.
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The big pharma companies will stop at nothing to convince the medical profession that "drugs are good" the reps will be out in force talking to doctors & pharmacists with glossy pamphlets which show the 'truth' of the situation. Auntie can't compete with big business and big money
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ABC gets [only] 22 complaints over Catalyst’s statins series
from Pharmacy News
The ABC has received an “overwhelmingly positive” response to Catalyst’s controversial two-part series questioning the link between cholesterol and heart disease, and the benefits of statins, a spokesperson claims.
The national broadcaster revealed it has received 22 complaints about the claims aired over the two episodes, despite widespread criticism of the program, including from Dr Norman Swan the presenter of the ABC’s Health Report, The Australian reported.
“The program was looking into a controversial issue and was always going to be a catalyst for debate,” the spokesperson said.
“The fact that it is a robust internal, as well as external, discussion shows that the ABC is examining the matter from a variety of perspectives.”
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