Cholesterol and Statins

[Bogie]

In my humble view medicating people unnecessarily for something that they are little to no risk from is malpractice.
Whether it's medication or any other procedure. Usually at the root there is a financial incentive which makes it even worse. Many doctors appear to have forgotten their oath of "first do no harm", especially as all drugs come with the risk of side effects.

I do not understand the "financial incentive" part of your comment. Cost in Canada, in Ontario, for 90 Rosuvastatin 10 mg is only $13.16 plus a small dispensing fee ... and that is a 3 month supply. Where would there be any financial incentive for the Endocrinologist and my GP that I am a patient with? Unlike the US medical system, there are statutes in Canada that make financial incentives, kickbacks, and commissions to doctors illegal.

I have discussed the use of statins with both my Endocrinologist (highly respected and in a Diabetes specialist clinic), and GP, and they both disagree about discontinuing statins. Lack of continuing education may be part of the problem, if valid.

New drug prescription regulations about to take effect in Ontario (the Canadian province I reside in) that will allow pharmacists to prescribe medication for certain ailments/conditions (I think starting as a pilot program). It is part of a transition from doctors doing both diagnosis and treatments but leaving some medication prescribing to pharmacists who are way more educated in medications/drugs than doctors are ... this has been a long time coming as a lot of drug "education" for doctors seems to come from pharmaceutical reps extolling their company's drug offerings along with lots of samples. It takes about the same amount of time to become a pharmacist as it is to become a general practitioner doctor. I have had pharmacists disagree with a doctor's prescription but couldn't change it without consulting and explaining 'why' to the doctor involved - most times the doctor would agree with the pharmacist (but not always as each has their medical specialty, knowledge, and reasoning).

Note, I am not defending statins, and do well-understand the "first do no harm" in regards to treatment and drugs, but, again, what are the possible side effects of statins besides possibly psychological? Are statins doing harm or basically a placebo with none of the intended and claimed effects?

I have seen the psychological effect of medications for Diabetics. One friend I had (no longer with us as he died from Diabetes) would eat anything he wanted as long as he took more Metformin. He thought it was a magic pill. Overweight (his whole family) and eventually his legs were turning black. One of his daughters died from Diabetes at a young age (in her 30s).

I am not affected by any psychological aspect but focus on facts and evidence. All of the posted videos and research seem to show that statins are not needed and do not do what they are purported to do. One of my quirks that bug some people I know, in both personal beliefs and in business, is that I always want to know "Why?". In other words, "What are ALL the facts - pro and con?". Just like the well-known phrase from the old 1950/60's police show "Dragnet", "Just the facts, ma'am!". I don't know if that program was broadcasted or popular in the UK, but still an old re-run favourite of mine.

 

[lucylocket61]

I do not understand the "financial incentive" part of your comment.

thats because you are in Canada.

 

[bulkbiker]

Where would there be any financial incentive for the Endocrinologist and my GP that I am a patient with? U

In Canada not sure, but there are certain metrics in the UK where doctors surgeries are financially rewarded for getting certain percentages of patients on certain medications.
Statins for people with T2 diabetes is one of those.
So there is a financial incentive to prescribe statins to T2's .

 

[Bogie]

thats because you are in Canada.

While I am not totally familiar with the system in the UK, it is mostly similar to Canada ... same as Australia (I have a brother that lives there). We each have some variances but basically a "free" healthcare system with some differences. As I have been on this forum for some time now I have read of certain challenges in the UK system compared to here. The system in Canada is supposed to be universal in each province but there are a few differences as each province has some control of how it is managed. Federal $$ for healthcare flows to each province and has basically been unaudited until recent calls by the Federal gov't for more oversight and possible audits and proof of how the money is spent in healthcare. A few of our provinces that are run by Conservative governments have been trying to introduce a split system of public and private healthcare ... but private healthcare is contrary to our guaranteed right, by our Constitution, for "free" healthcare.

This does not mean free drugs/medications for all, although seniors, handicapped, and some other social assistance demographics do have drugs 100% paid for by the province they live in. Each person in the specified groups do see on their receipt how much each medication does actually cost even though it is not paid for by the individual except for the pharmacy dispensing fee (depends on the province - about $4-$8 on average and even that is exempt for those who are handicapped or on social assistance of some kind). I am a senior so I only pay the dispensing fee and must pay for certain (very few - like Imovane/Zoplicone) "exception" drugs that are not covered by our provincial drug plan but still low cost.

Interesting how we are so similar but also different in some ways.

 

[bulkbiker]

what are the possible side effects of statins

There's a long and fairly detailed thread on it here.
Go back to page 1 and start some of the videos.

 

[Antje77]

Besides the possible psychological affect of using statins (thinking that you can eat anything and it won't raise your cholesterol levels

Just out of interest, what exactly are the foods that raise your cholesterol levels to your thinking? I was made to believe it's dietary fats, but this is what happened when I upped the fats (yes, saturated as well) and reduced the carbs, so it looks like it's not the fats I need to watch for my cholesterol.
(Mind, the sharp drop in 2017 was statins, I quit them within two months after starting.)

 

[AndBreathe]

Interestingly, I've just had a full panel done, so these are my lipids.

The first reading is at diagnosis, with carbs being trimmed in the following months. The May 2014 results are from a lab in the WIndies, reported in the US format, so "translated" for indicative purposes.

I was very surprised to see my lipids drop this time around.

Having taken part in some research into people living with T2 and heart failure (I don't have it), my full results were reviewed by a cardiologist and a specialist in cardiac imaging who reviewed my CTs and MRI scans. No recommendation was made for statins. Indeed, I was told there was no indication they should be recommended for me, at this time. It would differ had I a history CV disease or events.

Frankly, I find the whole lipids things a total mess, coupled with a scandal.

 

[johneee]

High cholesterol food - HEART UK try this it might help

 

[zand]

High cholesterol food - HEART UK try this it might help

I know those are the official guidelines but I have a big problem with them. My blood tests don't agree with them, so for me personally the guidelines are wrong. When I was eating a low fat diet my total cholesterol was 7.8. When I switched to a diet high in saturated fats but low in carbs my TC level dropped over 2 whole points. It has remained in the 5s for 11 years.
I think you will find this true for many others too. The official guidelines do appear to be great for statin manufacturers though.

 

[Oldvatr]

High cholesterol food - HEART UK try this it might help

This article contains generalisations and statements such as"So, eating saturated fats can raise your blood cholesterol." which has not been proven yet. in fact, our bodies prefer satfats since they are more dense and allows the body to store energy in a more dense form. Our body actually combines fats to increase SFA, so denser fat reduces the LDL not increases it. Even vegans have SFA in their system.

Also studies on FH have indeed found that high cholesterol levels are not associated with atherosclerosis or incereased morbidity, so it is possible to live happily with high cholesterol.

 

[Oldvatr]

The other point to make is that LDL carries lipoproteins, i.e. a mixture of fats and protein materials, so not just fatty acids, but also aminoacids. These are the lego bricks of our construction. Ergo eating a high protein meal will also increase LDL, so it is not surprising if eating animal products increases LDL. It is not just the satfat, but all the fat and the denser protein content.

 

[johneee]

All these points are valid, just had a quick look at pros and cons, I was very reluctant to take Atorvastatin at first, but was finally persuaded, been on them a few years now, and I still wonder about the benefits, and as some of you have said, it does not seem to be all it claims

 

[bulkbiker]

I still wonder about the benefits

Indeed as they seem to have been shown to be of minimal benefit at best and possibly harmful at worst.

 

[Oldvatr]

Question - why do we not get plaque buildup in veins, that carry the same blood components and cholesterol? The theory appears to be that arterial plaques form because LDL attaches to the cell walls, and the body responds by sending white cells to shift it. This causes inflammation that makes the plaque worse, and eventually the body covers the inflamed section with a cap that is made up of calcium and varius bits of blood debris like dead cells etc. This theory is rubbish.

Firstly white cells will not attack LDL since the ingredients within the bubble have been passed for use by the liver processing it prior to releasing it, and so it is not going to be recognised as being alien. White cells repel invaders not allies. secondly, cholesterol bubble is formed from choline and glycerol and given identifying markers at the chemical level to identify it as being part of us, so even an empty LDL bubble is not alien or hostile.

Now arteries may suffer damage from other causes (glucose is a large and heavy molecule) and at high pressure, So if damage occurs then it makes sense that the body will try to repair the damage. What does the body require in the first aid kit? Well, lipoproteins for a start, and some choline to repair the ethelium cells What would carry the components for the repair, why its LDL of couse since many of the repair components are fats that do not travel well in blood. What supplies the energy for the repair, its minerals like calcium, potassium and phosphate to make ATP in the replacement cells and fire them up.

So in arterial plaque we see evidence of possible repair and evidence that LDL may be being used to supply the repair kit. A large proportion of plaque is calcium, which has nothing to do with cholesterol. We talk from of old of hardened arteries and calcined arteries, long before we understood cholesterol. So the question should be why do we see calcium play such a major role in plaque? Why not magnesium since that too is a similar blood borne mineral? Or Selenium?

 

[Bogie]

Thanks to all who have rebutted the use of Statins and "Why". The purpose of being a Devil's Advocate is to stimulate a conversation, whether via thorough fact-based research or due to personal opinions based on "whatever".

Personally I had quit using statins twice of the past 8-10 years, based on limited research at that time. Many years of the medical community stating that fat-based diets create cardiovascular cholesterol blockages has created an atmosphere of "that is the way it is", while much current research contradicts that and change is hard to swallow for many medical professionals who have touted this as doctrine.

Unlike the financial incentives in the UK (and possibly in other countries - except Canada) for medical professionals to promote Statins, and most likely other drug-involved treatments, this is not a factor or advantage in Canada. For that I am grateful. If I can find enough time I will stimulate conversation here in Canada about Statins and see how many feathers I can ruffle. You have to be a s**t disturber to garnish enough attention to create a meaningful discussion. Tough to do right now with so much still going on with the seemingly non-ending pandemic.

BTW, during the last pandemic (1969-71) I was a Medical Research Lab Technician (Jr) in Microbiology and Immunology at a leading Canadian University, so my mind is stimulated by topics such as this. Drives me for answers and solutions

Reminds me of the time (until recent years) that drinking milk was a way to reduce or eliminate various intestinal tract ulcers while the opposite has been proven true. Until my twenties I drank more milk than water LOL. I am keenly aware of this chain of events as I did have 2 ulcers at the same time (duodenal and gastric along with a hiatal hernia) and the pain over those early years was almost unbearable. Then the revelation of what really caused them followed by a course of 2 strong antibiotics that work together to eliminate the condition. Scars and damage remain, due to a long-delayed effective treatment, and reminder to follow a fact-based diet, but the debilitating pain and discomfort are mostly gone.

That said, I am now off statins, again, and I simply have muted any discussions with my doctors involved as they are too "pro statin" to expect agreement. How many doctors will admit "I was wrong!"? I will monitor my cholesterols over the next year to document the results.

A side note: ALL and ANY medications can have one or more side-effects. It is a matter of balancing the pros and cons of each.

"♪♫ What doesn't kill you makes you stronger ♫♪ " ... Kelly Clarkson

 

[bulkbiker]

Definitely worth a watch.. not only about cholesterol and statins but they do feature.
I met Tony at the PHC conference in 2018 ...what a great guy.

 

[bulkbiker]

This is a new one on me....

Just found it on my medical records.. I have asked the Practise Managing Partner exactly why it's a "problem"

 

[Rachox]

This appeared on my record earlier this year…

I’ve never taken a statin, so I assume they mean I’m intolerant to the idea of taking statins!

 

[pixie1]

In Canada not sure, but there are certain metrics in the UK where doctors surgeries are financially rewarded for getting certain percentages of patients on certain medications.
Statins for people with T2 diabetes is one of those.
So there is a financial incentive to prescribe statins to T2's .

could be why I was asked to take statins after 4 years not seeing a doctor. I returned to try to lower my Bp, back on hypertensive meds.

 

[bulkbiker]

Do you really think your doctor wants you to take a statin just because their surgery might get a few pounds added to their budget from the nhs if they get enough of their diabetic patients to take statins ? Or because the doctor thinks it might do you some good .....

No reason why both couldn't be in play?
Statins, the most profitable drug ever invented, have an enormous marketing budget even today.
The doctor may think that they do some good and the surgery will get some bucks.
What's not to like (providing you aren't the patient of course)?