Pros and Cons of Taking Statins Preventively

[James L]

Apparently many, if not most, cardiologists take statins preventively to reduce the probability that they will experience a heart attack. And yet it appears that many members of this discussion forum do not favor taking statins.

Do any of you have strong opinions (hopefully backed up by strong facts) one way or the other on this issue?

[concup]

James,

I was placed on statins 12 months ago (lipitor)due to a bad "Cholesterol ratio"and unfortunately had a bad reaction to them.My doctor explained I was one of "very few" of his patients who had adverse reaction.He suggested I could either reduce the dosage or stop them completely.
(Turns out I was one of many who had complained of nasty side effects)
Given this,I began to research statins and the whole cholesterol/CHD theory.I spent many,many hours both on the net,as well as research via my local library.
If you want information provided by a totally unbaised researcher (i.e. he has no connection to the medical profession and the drugs barons)who has studied virtually every medical test ever done on the role of cholesterol and CHD then may I recommend you take a look at the web page below

www.theomnivore.com (http://www.theomnivore.com)

This man,Anthony Coplo completly changed my life and I want to yell his name from every clifftop I can find.He has now published a book that should be compulsary reading for every cardiologist in the world.I actually purchased a copy for my own cardiologist...and he had the courtesy to phone me a week later to say that although he is not totally convinced on what Anthony states in his book,he will certainly be looking at the research quoted in the book (over 70 pages of documented medical study references quoted) and if what Anthony has said is correct then he will take it further....I think he was totally "blown away" by the findings.

However I do accept we are all different...unique even,so I will leave you to make up your own mind here.However,you did ask.......

[bluejay111]

Here is an interesting article.

The Cholesterol Myth from Low Carb Luxuary Magazine Jan 2007

"Cholesterol." What images come to mind when you see this word? Is it positive or negative? Is it health, or is it heart disease?
If what came to mind was negative — as something to avoid — as well as heart disease, then the pharmaceutical companies food industries have been successful in getting you to believe a fabricated myth!

According to George V. Mann, M.D., professor of Medicine and Biochemistry at Vanderbilt University, "Saturated fat and cholesterol in the diet are not the cause of coronary heart disease. That myth is the greatest scientific deception of this century, perhaps of any century."

Russell L. Smith, Ph.D. is the author of the book, The Cholesterol Conspiracy. Dr. Smith states that "Both the public and clinical physicians have simultaneously been swamped by an ever-growing tidal wave of exaggerations, distortions and even fabrications of the facts."

Here's the truth. Cholesterol is good! It is a necessary part of every cell in your body and is essential in virtually all aspects of metabolism. Without it, we would die. That?s not the impression you got from the advertisers, is it!

Cholesterol is necessary for the brain, nervous system, hormones, digestion, liver function, heart muscle contraction, calcium metabolism and bone structure and skin. Cholesterol forms 50 percent of the nervous system and serves as the conductor of nerve impulses. It is so important that your body produces four to seven times as much as you ingest and reduces its production to accommodate cholesterol intake from the food you eat.

A deficiency of cholesterol results in obesity, emotional disturbances, fatigue, impotency, and many more imbalances.

How the Scam Begun

In the early 1900's, experiments were done in which rabbits were given extremely high amounts of dietary cholesterol. Their blood cholesterol rose twenty fold and a soft plaque like disease formed on the coronary arteries. But the cholesterol levels returned to normal and the plaque disappeared when the feeding was stopped. This formed the basis of the theory that cholesterol caused coronary heart disease in humans.

Here are the flaws. The rabbits were given a synthetic form of cholesterol that easily oxidized when exposed to air (which made it toxic). Rabbits also do not metabolize cholesterol as do humans. Humans and other animals like dogs and rats do not develop atherosclerosis-like disease as do rabbits when given dietary cholesterol. And finally, humans do not develop soft plaque as did the rabbits; humans develop hard plaque which does not reverse, and it is not caused by dietary cholesterol.

Eggs and Cholesterol

One of the many foods we are warned about is eggs. In one study, seventy men were divided into three groups which ate either 3, 7, or 14 eggs a week for five months. They all had similar cholesterol levels in the beginning. The total cholesterol, LDL and HDL cholesterol and triglycerides did not change during the study for any of the groups.

An 88 year old man consumed 20 to 30 eggs a day for more than 15 years, yet maintained normal blood cholesterol levels of 150 to 200.



Cholesterol occurs only in animal foods. Yet the consumption of animal fat since 1909 actually decreased by 10%, whereas vegetable fat increased by over 200%. The increase of heart attacks has paralleled the increased use of margarine, homogenized milk, and processed foods such as sugar, and worse — high fructose corn syrup.

According to Judith DeCava, in her book, Cholesterol, Facts and Fantasies, in one study, almost half of the patients had total cholesterol levels under 200, which is supposed to be safe. Yet half of this group had coronary heart disease. Of the almost 1200 who did have heart disease, one third had cholesterol levels under 200. Dr. Michael DeBakey, the famous heart surgeon, reports that 30 percent of patients who have a coronary bypass have "normal" cholesterol levels...

The Real Culprit

Here's what is clearly linked to heart disease: sugar. Judith DeCava states, "John Yudkin analyzed the refined sugar consumed by men with atherosclerosis. The men who had heart attacks ate almost twice as much sugar as those who not having heart attacks. In fact, in persons with coronary heart disease, the degree of atherosclerosis was proportional to the amount of refined sugar consumed." (The Lancet 1964); 2 (7349):6-8.

As further evidence of this is the fact that the consumption of fat in the Caribbean countries is very low, but the use of sugar is very high. Cuba has one of the highest levels of sugar use, and has a higher death rate from heart attacks in men between ages 55 and 64 than the U.S.!

The Fox Guarding the Hen House

So what's perpetuating this campaign of misinformation? It's the money from the drug companies who want you to buy their cholesterol reducing drugs (that have serious side affects) and from the food industries that benefit from this scam.

Here are some examples. The American Medical Association's Executive Vice-President, Dr. James Sammons, promised physicians in 1988 of their financial rewards by stating, "...the AMA's campaign against cholesterol will bring both old and new patients to you for necessary testing, counseling and care."

One researcher who later became a director of the National Institutes of Health bought stock in a pharmaceutical company just before announcing the results of a study favorable to the drug's effects. The editor of the AMA's publication, Circulation, also received stock options on the same drug company.

Jane Heimlich began doing extensive research on this cholesterol issue in 1989. In her book, What Your Doctor Won't Tell You, she concludes, "There is no question that the cholesterol program benefits three powerful groups in our society to the tune of billions of dollars. These three are the medical profession, the pharmaceutical industry, and the food companies."

[James L]

concup and bluejay,

thanks for your replies. I know that Malcolm (mcsblues) is also a great fan of Anthony's, and I did check his Web site a couple of months ago. Although I haven't read his book.

Gary Taubes, who wrote a New York Times Magazine article in 2002 about low-carb diets, is also publishing a book with lots of references. Although here is some counterpoint on Taubes from Michael Fumento (http://www.reason.com/news/show/28715.html) of the Hudson Institute.

Until I read the Feb 2007 article in National Geographic I just didn't realize that so many cardiologists considered taking statins to be something of a "routine" preventative measure for heart health.

I still go primarily by the ratio of fasting triglycerides/HDL, since I haven't seen any evidence to convince me that the research done by J. Michael Gaziano, et al., is in some way flawed (Circulation 1997).

[mcsblues]

Cardiologists more than any branch of the medical profession are probably the most likely to have fallen heavily for the lipid hypothesis ... or perhaps they know that statins, when they do 'work' (and ignoring the appalling side effects that some suffer) do so by reducing inflammation (the benefits, such as they are are seen independently of cholesterol lowering) - and that is their reason? I doubt it somehow. Remember these same cardiologists will almost invariably prescribe a low fat, high carb (inflammatory) diet for CHD prevention or post operative care.

As 'we' know there are much more benign ways of controlling inflammation through diet and supplements such as fish/krill oil - just as 'we' also know that lowering blood sugar, insulin and triglycerides has a direct relationship with prolonging good health - the same cannot be said for cholesterol lowering (quite the reverse if you look at The Framingham study for example).

Reading AC's book (cheap ebook downloads now available of the book and highlights from the old site) would be a good start or you could pick up Malcolm Kendricks' new offering (http://www.amazon.com/Great-Cholesterol-Lie-Really-Disease/dp/1844543609) which may or may not have the same title!

Extract here (http://www.thisislondon.co.uk/news/article-23382714-details/Have+we+been+conned+about+cholesterol/article.do)

And of course there is plenty of ammunition on the THINCS (http://www.thincs.org/) site.

Oh and I agree with Taubes (and can't wait for his book) ... the Fumento rant really doesn't require a response ... but he got very detailed one anyway!

[Ottawa]

Do any of you have strong opinions (hopefully backed up by strong facts) one way or the other on this issue?

I was on Statins (Lipitor) for almost 4 days after a 5 minute visit with a walkin GP. He mentioned nothing about side effects but to come back in 3 months to have blood work done.
I cannot fathom the reason why Cardiologists would endorse such a product other than the methodology used by the medical industry which is often lead by pharmaceutical research/dollars.

In my case the side effects began showing on the second day as I was talking with a client. A nose bleed, which meant little on it's own but I rarely have them. I had another driving home. Upon arrival at work the next day (my third day) another, along with the beginnings of joint tenderness. By the end of that day two more and I was beginning to get worried but had not associated the cause. The morning of the fourth day I began looking for side effects of Lipitor after a biologist/client at work suggested the connection. My joints were quite tender at this time and I stopped the medication and made an appointment with the MD who had prescribed it.

He said that we could fix that problem for a few dollars. "Get a pill splitter and go with a half dose for the fist few weeks. Many of my patients have some type of side affect and it takes their bodies a while to get used to this drug."

The on line research included muscle and joint soreness, deterioration of muscle tissue, including the heart, and nose bleeds or hemorrhaging.

That was the turning point in getting a new doctor and getting blood tests done on a regular basis. I had been on PP for 6 months at that point and my blood work had already shown improvement, and has continued. My HDL/CHOL ratio is very good and shows low risk leading me to affirm that lower triglycerides have a direct bearing on Lipid Profile. A year later I began a regular exercise program which increased HDL dramaticly and further strengthened my commitment that food choices and exercise are an effective way for most people to improve their lipid profile.

I am a firm believer in taking control of your own health based on all the facts.
http://www.lastoutpost.com/ProteinPower/RMLipid.JPG
Slightly modified from "Red Meat" by Max Cannon.

[Dodger]

I was a statin taker about 5 years ago. At the time I was a firm believer in low-fat eating. I also believed that having low cholesterol was a great health benefit. All the literature that I came across told me how great low-fat eating and taking statins was. I had no noticeable side effects from the pills, but I never felt right. I always have been an exerciser, but my HDL was barely over 40. The more that I reduced my fat intake, the heavier I became. My blood pressure was slowing increasing and my blood glucose/insulin response was at the almost diabetic level.

Luckily, my doctor became convince that low-carb was much better than low-fat and eventually talked me into giving Atkins a try. He gave me a copy of Taubes' NY Times article and I began doing some actual research of medical publications and low-carb diets (including the wonderful books by the Eades) and found that the scare stories that I had heard about low-carb eating were just urban legends.

After two months of low-carb eating, I quit the statins and other drugs and my next blood tests came back great. My HDL increased 50% from increasing the fat in my diet. My triglycerides dropped to under 100 and I don't care what the LDL is as my research has lead me to believe that the LDL value by itself is meaningless.

It's been over 4 years now and I am at a health weight, my blood chemistry is great and I have more energy than I did when I was younger. I can exercise harder and longer.

I still have half a bottle of Lipitor in the medicine cabinet. I don't want to pollute the environment by dumping it.

[mcsblues]

If you don't regularly follow them, Mike's latest blog (http://www.proteinpower.com/drmike/?p=494) covers the pros and cons (and the reasons why the supposed pros are still mainstream) extensively.

[Ottawa]

Thanks for the pointer Malcolm. It is definitely an amazing read and yet this just goes on and on.
Two good friends just started on Statins. They already knew my concerns and were hesitent but the one proceeded when his doctor told him that his Lipid profile was mainly caused by heredity and this was his best option (the Statin).

[bluejay111]

I took Lipitor for almost 2 years.For about the last 6 months of that time my calves hurt even though I was walking every day. I said something to my doctor after three months of the pain and he just blew it off. Then I heard on TV about a CK blood test to see if the statins were attacking my muscles. I as asked my doctor for this test and the levels came back elevated. Also my liver enzimes were slightly elevated. He told me to quit taking the Lipitor right away. After a while the pain in my calves went away. Even though I have had quadruple bypass surgery I refuse to take cholesterol lowering drugs. I want to keep my muscles and liver in tact. There seems to be an increase of the incidence of liver cancer among statin users.

[James L]

Thank you, everyone, for your replies. (Seems like I should have titled this thread, "The Cons of Taking Statins.")

concup, it's gratifying to know that your cardiologist is taking time to read some of what Anthony has to say and to read some of the references he has listed. I spoke with a cardiologist recently and he had no familiarity with the Gaziano research or the use of the fasting triglycerides/HDL ratio.

Malcolm, thanks for all the great links. Dr. Mike's blog entry is very timely regarding this thread topic.

I think I'll just continue on with my "Eades/Gaziano" experiment, using the trig/HDL ratio as my key indicator of heart attack risk, and skip the "Statins" experiment. And also focus on increasing the amount of exercise that I do. I'm still not up to any respectable hunter-gatherer standard. :)

[Billie]

James I certainly don't have any scientific data sitting in front of me but just a thought as I read this. With all that we do know, all the possibile side effects etc., it wouldn't seem to prudent to me to take something on the side of prevention when we know we can control it (most of the time) by what we eat and how we exercise.

I too have dear family members who wouldn't listen, Gabe even sent them scientific journal articles to read but the words of the doctor were too strong for them.

Are you feeling that statins would help your overall quality of health?

[Gaelen]

James, you asked us for 'strong opinions (hopefully backed up by strong facts)' on this issue.

I'm going to turn this question around...on what actual facts do you base this statement?

Apparently many, if not most, cardiologists take statins preventively to reduce the probability that they will experience a heart attack.

I mean, did some reputable scientific polling organization do a poll or conduct an actual honest to goddess study? Is this the famous marketing '3 out of 4 practicing cardiologists' tagline, or do you have some actual documented research that conclusively indicates that a substantial percentage of cardiologists do indeed take statins preventatively. Is 'many' more than 10%? More than 30% but less than 50%? More than 50% but less than 75%? While 'one' and 'a couple' and trios, quartets, and even 'nearly all' are quantifiable, 'many' is a pretty subjective amount that probably should be placed in context before we all react to it...so what, exactly, constitutes 'many' and what documented research do you have that supports your first statement?

I mean, before everyone goes off on the cholesterol myth, the evil drug companies, the idocy of health practices in standardized medicine, etc. ... how 'many' is defined might be a good question to ask. :cool:

[mcsblues]

Well yes ... but who cares? ;)

I think we can agree that statins are widely prescribed - by GPs (largely in the misguided hope of prevention) and cardiologists (one would imagine more often than not post operatively) Now surely we would have to delve even deeper into the evil drug company conspiracy/myth theory if these doctors were prescribing for their patients ... but not for themselves? Or are you saying that as most cardiologist would not see patients before some form of CHD had become apparent - their views and practices concerning prevention cannot be established? ... and if they knew GPs were prescribing (and presumably using) just for 'prevention', they would be horrified?? :lol: I don't think so do you?

[James L]

Billie, the cardiologist I spoke with appears to think that my total cholesterol number is too high and that statins would lower that number. He didn't prescribe statins for me, but he does take them himself and seems to think that I should give them a try. As I said, I think I'll skip the "statins" experiment.

Gaelen, good points. In response, I'll refer you to Jennifer Kahn, the author of the National Geographic article cited in the Mending Broken Hearts thread. Her terminology is, "Like almost every cardiologist I've talked to ...." So obviously, we're dealing with small-sample statistics. Although, the Geographic does claim that, "Kahn has had her work selected for the 2003, 2004, and 2005 editions of Best American Science Writing. Since the Geographic has a large circulation and is a somewhat influential magazine, you may want to consider writing a letter to the editor. The article also contains zero information about the potential beneficial effects of a PP nutritional approach for heart health.

[Grandma Moe]

When my sister had 4 heart attacks in one year her cardioligist put her on statins. She said she would have these deep pains in her chest that she figured were a result of the attacks. I asked her to read up on statins and she just refused. She bragged about how good her Dr. was and so I let it drop, (just like I would want someone to leave me alone if I felt I already was satisfied with what I was doing).

Several months passed and she began to just think it might have something to do with the statins she was taking, but her Dr. assuered her that she should trust him and told her that the real culprit was that she was one of those unusual people who could not so much as eat a single M&M or she could have a heart attack. (?) So she stopped eating any candy but the pains continued.

She went in for her annual physical and her bone mass had changed from the year before from that of a 40 year old, (she was 58) to the bone mass of a 75 year old. Her family Dr. asked her what she was taking and said he believed that the statins had caused an accelaration of bone loss in her that was so extreme that he told her he recommended discontinuing them.

She quit taking them. She had noticed that she seemed to be developing arthritis and was finding it almost impossible to get in and out of a car without help since her heart attacks began.

When she stopped taking the statins she noticed that the pain of her "arthritis" went away and she stopped having the deep chest pains.

She started eating more raw vegetables but doesn't seem to understand the need for protien in her diet. She was always a heavy meat eater before her first heart attack but my dad died of a heart attack when he was 64 and she has made some connection in her brain about it and his heavy meat consumption. FYI-- My dad was a heavy meat eater and a huge fan of mashed potatoes and gravey and pie. He loved a buffet style breakfast and my mother cooked one for him every morning. Three plates of pancakes, hashbrowns, sausage, eggs and bacon with biscuits and gravey, and mush were typical. He ate huge amounts of carbohydrates with every meal and loved to snack on almond roca. I never saw him ever resist a treat or think about what he put in his mouth. He consumed lots of trans fats from chips and doughnuts and bakery goods from the grocery store. He weighed over 300 lbs. when he died.

I worry about her, but it is her life and she has to make the decisions for herself that she feels are the best for her.

I'm just glad I "get" what it does to you if you do not get enough protein or fat in your diet.

My total cholesterol numbers since returning to PP have dropped from 282 to 192.

As my friends age who were avid low fat dieters, I see a lot of osteoporosis, even where it was not a family trait before. BTW-- my bone density is that of a 20 year old and I will be 51 this month.

[James L]

Moe, thank you for the information. I think I'll have another cup of coffee! :)

[ares]

Even though my doctor wants to put me on Statins I have heard enough evidence of Cons that I believe they would cause me more harm than good. One alternative 'drug' therapy that the Eades also recommend to persons with dangerously high cholesterol is Niacin.

Right now I'm in the process of finding out all I can about this approach as the Eades only mention it briefly in PPLP. If anyone has any input or experience on this type of treatment I'd love to hear it. I did just finish reading a book by William B. Parsons Jr., called Cholesterol Control Without Diet! The Niacin Solution., which I would recommend to anyone considering taking Niacin. I think it has given me a good start in my quest to find out if Niacin is right for me.

A couple of things that immediately stand out in the Parsons book;

A) The type of Niacin that I had already started taking - No Flush Niacin - from Inositol Hexanicotinate is ineffective and will do nothing to lower cholesterol. What you want is Plain Niacin or a Time Release Niacin.

B) The cost of taking Niacin vs Statins is extremely less expensive.

C) Parsons claims there is no significant liver damage, only some temporary elevations in liver enzymes that return to normal when Niacin is discontinued. His position on this contradicts some others medical opinions so this is something I'm trying to find out more about. In any case Parsons says its important to monitor liver enzymes while taking Niacin.

Forgive me if I hijacked this thread. Didn't mean to.

[James L]

Here's the small-sample statistic, from the Mending Broken Hearts article, on which I based my initial post in this thread:
Of eight cardiologists I spoke with, all but one were taking the medication [Lipitor].

FWIW.

[Gaelen]

Here's the small-sample statistic, from the Mending Broken Hearts article, on which I based my initial post in this thread: "Of eight cardiologists I spoke with, all but one were taking the medication [Lipitor]."
FWIW.

James, sorry I wasn't able to get back to this thread before today...but I'm sure you'll agree that 8 cardiologists interviewed out of hundreds, if not thousands of cardiologists in North America is no real 'sample' at all. It's 8 people the author knew--and who knows if they were 'selected' because they'd give her the slant she chose to present. I don't care how many awards she's won...if Jennifer Kahn is presenting an eight-person sample as 'many, if not most cardiologists,' then that is sloppy research, bad journalism and overstatement to the 10th power. If a reader infers 'many, if not most' from her article, knowing that she only interviewed eight people, then it's the reader who is guilty of leaping to conclusions no matter what the writer said in the article.

Malcolm, after I turned the question around to ask James on what facts he based the 'many, if not most' statement, you posted:
Well yes ... but who cares?

Well, obviously, I do. ;)

See, the thing is, internet discussions are notorious for people dragging out the heavy artillery based on statements that can't really be supported by...ummm...facts. ;) As James points out, the interview sample for the article on which he based his statement was a whopping eight cardiologists, which is, IMO, so small a sample as to be statistically insignificant. This board, another case in point, has fewer than 2000 members, and less than have of those are 'active.' There are a higher percentage of people on this board likely to have blood value/lipid profile issues because I think it's safe to say that more than half of us, if not a higher percentage, came to this board looking for support for a low carb WOE because we already HAD health issues. So we're not a 'representative sample' of what a typical doc's office patient load might be, either...we're heavily weighted (pun intended) towards people who might be likely to have had health issues. So before everyone leaps fully armed into the kind of heat this type of discussion can generate, I think it IS important to recognize that you may be firing up the full force of argument over a statement that's little more informed than the kind of casual comment you'd overhear on public transportation. Frankly, I'd put more stock in that kind of conversation relative to a sporting event than to health issues, but that's just me. ;)

I think we can agree that statins are widely prescribed - by GPs (largely in the misguided hope of prevention) and cardiologists (one would imagine more often than not post operatively) Now surely we would have to delve even deeper into the evil drug company conspiracy/myth theory if these doctors were prescribing for their patients ... but not for themselves?

I do agree that statins are often prescribed, and that it's usually based on blood value guidelines which don't consider the whole picture, or post operatively in the presence of heart disease at some level. But prescribed 'just because,' without the presence of blood values which exceed the guidelines, flawed as they are, or without the presence of disease that would be indicated by needing an operation? Ummm...I don't know how insurance works in Oz, Malcolm, but in the states docs don't prescribe drugs when the patient doesn't exceed the blood value guidelines or have disease/family/personal history present. Why? Well, because the evil insurance companies won't pay for them. ;) Seriously. I'm not saying statins should be prescribed as frequently as they are...but they wouldn't BE prescribed unless the patient met the insurance company's guidelines for paying for the drug...unless the doc or the patient was willing to make a stink about getting the drug covered. Getting an insurance company to cover various durgs and treatments is something I've lived through first-hand...trust me, nobody on typical insurance gets drugs or treatments outside of established guidelines without a fight. Knowing that, I find it very hard to believe that any doc is doing much prescribing of statins outside of the guidelines for the drugs which have been established as reimbursible. They couldn't afford to stay in practice if they did.

Or are you saying that as most cardiologist would not see patients before some form of CHD had become apparent - their views and practices concerning prevention cannot be established? ... and if they knew GPs were prescribing (and presumably using) just for 'prevention', they would be horrified?? I don't think so do you?

Actually, I DO think cardiologists wouldn't be in favor of preventative dispensing of statins outside of a patient who exceeds the blood value guidelines (again...flawed guidelines...I totally agree). But despite what people might want to believe, there ARE treatment guidelines for heart disease, and if you don't meet them, you don't get drugs prophylactically (sp.) If you did, you'd have to pay for them yourself, because your insurance wouldn't cover them, and the doc wouldn't get reimbursed for treating you for a non-existent condition.

I don't like the system...but if it has an 'up' side, then it's that it is very difficult to get insurance coverage on treatment and meds for non-existent physical (or mental) conditions. People often have trouble getting coverage if they DO fit a treatment profile but are too young, or too old. An example...you often have to fight to get a colonoscopy if you're under the recommended age (50) and have a family history of CRC, unless you also have compelling/emergent symptoms. There may be some people who score...the system isn't perfect by a long shot...but despite what you may have heard about US healthcare, every doc's office isn't a wholesale statin dispensary. Remember, the people you see posting here are also a very small sample of the thousands of patients out there. They aren't all getting statins...although my 401K would probably be doing a whole lot better if they were. ;)

[bluejay111]

Gaelen,

I think the health insurance companies are becoming a little more leinient about paying for statin drugs. I know of at least two people who were perscribed statin drugs although their cholesterol was below the current numbers being used as upper limits. They were told that it was a preventive measure. It seems that more and more medical personel are buying into the cholesterol myth.

The life insurance companies also seem to be buying into the cholesterol myth. My son had a total cholesterol reading of 208 when he applied for a life insurance policy. Because it was over 200 he had to pay an extra $5 a month on his premium or they wouldn't give him the policy. Just another way to make more money.

Bluejay111

[mcsblues]

Gaelen, I'm still half asleep but all I can really respond to there (as far as I can see!!) is the insurance bit, In Australia, AFAIK if a doctor prescribes a drug, or admits you or keeps you in hospital (all of which may on occasion be unnecessary) the insurance company pays their % (there is normally a 'gap' for treatment - but this is independent of the treatment option). There is a distinction for some drugs that are not approved in the government funded ummm drug subsidizing scheme (forget what its called) ... but as statins are so mainstream now I'm sure they would be included. Our much vaunted health care system was once much admired ... hmm don't know if I should mention her here but Hilary Clinton:eek:'s failed attempt to reform your health care system was loosely based on ours. These days other countries are still trying to emulate what we used to have, while those ever so wise here :rolleyes: want to move ever closer to what you have now.:confused:

Coming back to statins! - are you really suggesting that doctors (of whatever colour) are prescribing (given the billions made through sales, I think we can agree there must be a hell of a lot of them doing so - and doing so, on the basis of drug company funded research guidelines) but not taking the statins themselves?? And if that is your suggestion (remember I'm still asleep!) ... where is your evidence!!:D Even if it was a money question (which I really doubt) I find it hard to imagine a doctor not drowning in free samples.

[Gaelen]

Gaelen, I think the health insurance companies are becoming a little more leinient about paying for statin drugs. I know of at least two people who were perscribed statin drugs although their cholesterol was below the current numbers being used as upper limits. They were told that it was a preventive measure. It seems that more and more medical personel are buying into the cholesterol myth.

Bluejay, some physicians do prescribe statins to people whose total cholesterol numbers are lower than 200 if they also have other predispositions to, or family or personal history of heart disease. Not saying that's right...just noting that it happens. In that case, it's not a question of the insurance companies getting more lenient; blood values are not the only criteria for the prescription. As for insurers getting more lenient about prescriptions, all I can say is that hasn't been my experience with one of the variants of Blue Cross/Blue Shield. :frown:

[Gaelen]

In Australia, AFAIK if a doctor prescribes a drug, or admits you or keeps you in hospital (all of which may on occasion be unnecessary) the insurance company pays their % (there is normally a 'gap' for treatment - but this is independent of the treatment option).

Here, unfortunately, payment ultimately depends on your insurance, especially if any kind of managed health care is involved. Doesn't matter if your doctor thinks you need (fill in the blank...). You can fight, and win in cases where the care can be demonstrated to be necessary--but I have a stack of 'denials of claim' that fills a file cabinet drawer! And these were not new drugs or experimental procedures...these were things like the charge for the bit of tubing that rotates in the infusion pump. Now, of course, the whole works (IV bag of drug, tubing to the pump, tubing from the pump and needle into the infusion port) were all charged separately, and paid for--but the 6 inches of special tubing that makes the pump do its job was denied as 'not necessary.' Perhaps they were hoping osmosis would deliver the medication... :rolleyes:

Coming back to statins! - are you really suggesting that doctors ... are prescribing ... but not taking the statins themselves??

Malcolm, I'm suggesting that if a doctor doesn't meet the blood value or family/personal history or presence of disease, why would he prescribe statins for himself--even if they were free samples?

Seriously.

The original statement made it seem as though docs are taking statins as if they were some sort of supplement, like Vitamin C or echinacea, whether they had health conditions for which they'd give a patient statins or not. That is the theory I asked be further investigated. I know a few docs, too...around a dozen+ in my rolodex who I've seen more than once in the last 18 months. None of them recommend that I take any kind of pills, including vitamins and supplements, 'just in case' if I clearly don't have any physical reason to do so. Granted, those are the kinds of docs I prefer, so my sample (like J. Kahn's) is guilty of my personal bias. ;) But granting that it's a personal and biased sample, and so no more representative of 'all docs' as the sample that started this discussion, why would I have any reason to believe, based on my dozen+ sample, that a doctor would take statins if he didn't have any evidence of the medical condition(s) that qualify someone as a candidate for statins?

Yes, there is tons of statin marketing out there.
Yes, patients and docs are bombarded with the option of statins.
And yes, people (docs and patients both) want an easy way out--and often, taking a pill is perceived as easier than changing lifestyles. Hell, it IS easier. ;)

That said, I don't think it's fair or accurate to portray all doctors as statin dispensary machines for everyone who walks in the door, including themselves, especially when the person doesn't have any of the qualifiers that make him/her a statin candidate. None of my docs has a statin bubble gum machine in his waiting room (3 pills for a quarter... ;) ). What was alluded to in James' post simply hasn't been my experience. YMMV.

[James L]

1. Regarding cardiologists taking statins as a preventative measure.
Malcolm, I'm suggesting that if a doctor doesn't meet the blood value or family/personal history or presence of disease, why would he prescribe statins for himself--even if they were free samples?
Gaelen, I think that Malcolm's reasoning about the thinking of cardiologists on this issue is plausible (it's obviously consistent with the small sample of 8). Here's another quote from the Geographic article:
[Cardiologist] Nissen is an advocate of lowering cholesterol by any means necessary. Does he take a statin? "You bet!" he says. "I have no intention of dying of the disease I treat."
I would be surprised if that same thought has not occurred to "many, if not most," cardiologists. I grant you that we currently have no accurate way of determining exactly how many of them are actually taking statins as a result of that thinking. But thoughts frequently determine behavior.

2. Regarding anyone taking statins as a preventative measure. If statins do significantly lower the risk of heart disease, then it may be worthwhile for people to take them even if they have to pay for the drugs themselves. When I asked a cardiologist how much statins cost, he gave me an approximate figure and then stated that some (all?) statins would be going generic after the end of this year (exact timing?), so the cost would be even less in the near future.

[bluejay111]

JamesL
A friend of mine who has to meet a deductable before his insurance picks up a co-pay just paid $100 for a months supply of Lipitor. I don't believe all statins will be going generic. It's too big of a cash cow for big pharma. They are already combining a statin with blood pressure medicine. This will give them the patent security they want.

[Mitra]

In the UK you can buy a 12 month supply of Zocor (simvastatin) over the counter for about £75 (that was just the first one that came up on the google search), which is much less than I spend on various supplements, and not a price that would be much of a barrier to anyone who thought it was going to protect them from heart disease.

[phecksel]

I return after too long an absence, and get a soft ball pitch like statins? A few years ago, started looking at statins, mainly because my physician described them, and insisted I NOT listen to the idiots on the web and actually read the research studies. Well I did, fired my doc and created this web page
http://www.hecksel.com/statin%20dangers.htm

The one thing that disturbs me most is the mixing of absolute and relative statistics. You've heard that statins decrease the risk of heart disease by 25% (or more), but what they don't tell you is they compared the number of people that had heart attacks while on placebo to those on statins. That is an unrealistic statistic. Looking at the total population of the study, it literally only decreases the risk of heart attack 1-2%. Now they claim the risk of side effects have only a risk of a few percentage points, but in this case they compare the entire population of the study. Using the same calculation as the benefit side, it increases the risk from a few percentage points to 50-75%. They're playing fast and loose with statistics. There are some people that will benefit from statins, but very few. There was a study of Japanese men, evaluating the life expectancy vs their cholesterol level. I can't remember the exact number, but it's something like maximum life was achieved at a level of 245. One final thought and I'll let you read the page and the dozens of links... The one statistic they don't share with you, and actually bury, if you have a heart attack while on statins, your risk of dying is substantially increased.

[James L]

So ya want some numbers, do ya Sparky? Well, here are a few stinkin' numbers for ya to chew on!

I had blood work done (lipid panel analysis) in late October 2006 and again in mid-January 2007, with the following results:

Total cholesterol dropped from 267 to 178.
Fasting triglycerides/HDL ratio dropped from 2.38 to 1.2

(I'm not going to post all the other numbers, although LDL dropped below 100. Triglycerides also decreased and HDL increased.)

"How can that be?", you ask.
"How can that be?", I asked.
"Did you send a surrogate for the January blood draw?", my doctor asked. (Jokingly, I think!)

Needless to say, I was very satisfied with the January results. But what accounts for this significant improvement in the lipid panel analysis over such a short time span? What changes were involved? As far as I can tell, there were only three changes of any potential significance.

1. One lab performed the October analysis and a different lab performed the January analysis.
2. For the six weeks preceding the January blood draw, I had supplemented my diet with four 600 mg capsules of red yeast rice daily (with no noticeable side effects).
3. I resumed taking 100 mg daily of coQ10 (I had earlier been trying to simplify and reduce the number of supplements that I take).

This is my assessment of these three factors:

1. My primary care physician (PCP) and I are both of the opinion that the results from the lab that performed the October analysis are suspect. In fact, my PCP stated that he does not intend to use that lab again in the future. (I had been a bit puzzled by the October results, since I've had better numbers in the past. I exercise and try to keep my protein, fiber, and water intake up and my carb intake down; although I probably follow PP at the Dilettante/Hedonist level much of the time.)
2. My PCP had suggested taking the red yeast rice after he reviewed the October results. He knew that I took other supplements and that I was uninterested in taking prescription drugs, such as statins, unless it was absolutely necessary. I think that the red yeast rice may have been a factor in the improved lipid panel numbers.
3. I'm not convinced that the coQ10 had any major influence, although I intend to keep taking it, since the available evidence seems to indicate that it has beneficial effects.

I am posting this information primarily because of the concern I have seen some board members express about "high" total cholesterol values and the concerns that other members have expressed about taking prescription statins. Based on my recent experience, I would suggest that:

1. You might want to consider trying a different lab for the lipid analysis and see if you get comparable results from the two different labs.
2. You might want to consider supplementing your diet with 2.4 grams daily of red yeast rice. However, please consult with your physician before you try this, since liver enzymes should be monitored to ensure that there is no impairment of normal liver function.

FWIW and YMMV.

[Caveman]

The irony in all of this is that statins are only partially successful in reversing artherosclerosis. Read this article from Forbes magazine: http://www.forbes.com/lifestyle/health/feeds/hscout/2006/03/13/hscout531506.html

In this article: Aggressive Statin Therapy May Reverse Atherosclerosis the author states that "Intensive cholesterol-lowering therapy using Crestor -- a powerful (and controversial) member of the statin family of drugs -- not only reduced LDL or "bad" cholesterol levels but actually reversed atherosclerosis, better known as hardening of the arteries." However, on the down side, the article also states: "Crestor has an acknowledged higher rate of adverse events, including kidney failure, than other statins. The consumer advocacy group Public Citizen has petitioned the U.S. Food and Drug Administration to take the drug off the market."

Is this the tradeoff we want? I may not die of a heart attack, but my kidneys will stop working? No thanks.

On top of that, a new statin being developed by Pfizer promised to raise HDLs while lowering LDLs. Well, the drug did all of that, but it also made peoples blood pressure rise and it did nothing to reduce the plaque in arteries! Read the facts here: http://www.nytimes.com/2007/03/27/health/27drug.html

So, what is the safe alternative? Well, pure and simple, it's water soluble fiber. Some examples of water soluble fiber (WSF) include oat bran, psyllium, guar gum, pectin, grapefruit fiber, glucomannan, etc.

How does soluble fiber work?

Soluble fiber is the only known food component that will lower blood cholesterol when you add more to your diet. Foods high in soluble fiber help prevent sugar from rising too high after meals by keeping food in the stomach longer. Sugar is absorbed more slowly, preventing free fatty acids and triglycerides from rising too high after meals. Free fatty acids bind to insulin receptors and prevent insulin from doing its job of driving sugar from the bloodstream into cells. In addition, soluble fiber does the following:
It binds to fat in the intestines, preventing some fat absorption.
It dissolves fluids in the large intestine and forms a gel that binds with bile acids in the intestines. As a result, the liver converts more cholesterol to bile acids, and blood cholesterol levels are reduced.
It slows digestion and the absorption of nutrients, resulting in a slow and steady release of glucose from accompanying carbohydrates.
It soaks up excess bile acids found in the intestinal tract - the same acids that are converted into blood cholesterol.
It delays stomach emptying, triggering satiety (a feeling of fullness) that can be helpful in people with type 2 diabetes trying to achieve weight loss goals.Numerous studies have been done showing that WSF not only reduces cholesterol but it also reverses atherosclerosis. You can verify this yourself by googling fiber + atherosclerosis. For example, here is a link from the unversity of Oregon discussing the advantages of fiber: http://lpi.oregonstate.edu/infocenter/phytochemicals/fiber/

Finally, we are all reluctant to add carbs in our life, so how can we add extra fiber? I personally use the fiber compound developed at the University of Florida Medical School called ProFibe (http://www.profibe.com). You will find the clinical studies of fiber done at the school, plus case studies, and the story behind the development of ProFibe.

Another popular fiber is glucomannan, and I love the noodles made from this fiber as they have ZERO carbs (http://www.konjacfoods.com/).

HTH, FWIW, YMMV
The Caveman

[Gaelen]

The irony in all of this is that statins are only partially successful in reversing artherosclerosis.

Welcome, Caveman.
Actually, you can make the same statement (above) for nearly everything. For instance "the irony of water-soluble fiber is that it is only partially successful in reducing cholesterol levels and reducing atherosclerosis and coronary artery narrowing." From the abstract of one of the articles to which you linked:

Inhibition of Atherosclerosis by Dietary Pectin in Microswine With Sustained Hypercholesterolemia

James J. Cerda, MD; Signurd J. Normann, MD, PhD; Michael P. Sullivan, MS; Charles W. Burgin; Frank L. Robbins, BS; Sohini Vathada, MD; Paisan Leelachaikul, MD

Abstract "Sustained hypercholesterolemia is a known risk factor for development of atherosclerosis. ... In animals with established hypercholesterolemia, pectin did not lower their cholesterol levels. ... The mean surface area covered by atherosclerosis in the aorta was 13.6% in the group that did not receive pectin compared with 5.3% in the group that did receive pectin. The mean coronary artery narrowing was 45% without pectin and 24% with pectin. We conclude that pectin may have a direct beneficial effect on atherosclerosis by a mechanism independent of cholesterol levels". (Circulation. 1994;89:1247-1253.)


Since they had mean numbers, results varied (or whoever ran their stats had an interesting equation in play...) And since there was some level of atherosclerosis reported, and some continued coronary artery narrowing, even in the group receiving the test article (pectin), that article could easily have been interpreted by media (such as Forbes or the NYT) as being only partially successful.

So, what is the safe alternative? Well, pure and simple, it's water soluble fiber.

Ummm...not quite so fast. ;)
For anyone with an altered gastrointestinal tract (IBS, UC, CRC) or anyone who has had gastrointestinal surgery which has left them (intentionally or not) with altered GI tracts such as ostomy, lap-banding, gastric bypass surgeries and/or scarring from any of the above surgeries or illnesses, they should only add fiber, of any type, with caution and under medical supervision.

I had a permanent ostomy placed over two years ago, and liver resection a year ago in March due to advanced CRC. I can still only tolerate small amounts of fiber because my GI tract and my liver have been permanently altered. And there are a heckuva lot more people with altered GI tracts out here in the world than you may think.

Fiber is not manna from heaven. It is neither the road to hell nor the path to heaven. It's one component of our diets, and for some of us it must be very carefully monitored and consumed with care, if not caution. (note to self: I don't care HOW good it looks, do NOT eat the asparagus! or the broccoli! ;))

And BTW, in the 'mileage varies' category, while the powdered fiber you linked may be fine, and shiritaki noodles made from glucomannan are cool if you can tolerate them, the ingredients list for the Profibe bars is no healthier than any other highly processed bar trying to pass itself off as health food. Here's the list for the peanut butter bar (the chocolate covered one is worse!):

INGREDIENTS:
ProFibe (Soy, Guar Gum, Citrus Pectin), Corn Syrup, Chocolate Coating (Contains: Turbinado Sugar, Fractionated Vegetable Oils, Non-Fat Dry Milk, Cocoa, Soy Lecithin, and Salt), Granola (Contains: Rolled Oats, Wheat, Barley Flakes, Crisp Rice, Cinnamon, and Vanilla), Malt Barley Syrup, Crisp Rice, Raisins, Date Paste, Peanut Paste (Contains: Fructose, Maltodextrin, Peanuts, Water, Food Starch, Salt, Carrageenan, Lecithin, and Natural Flavors), Peanut Flour, Natural Flavors, Vitamin and Mineral Blend (Contains: Dicalcium Phosphate, Magnesium Oxide, Vitamin A Palmitate, Ascorbic Acid, Vitamin E Acetate, Niacinamide, Ferrous Fumarate, Zinc Oxide, Pantothenic Acid, Pyridoxine Hydrochloride, Copper Gluconate, Cholecalciferol, Riboflavin, Thiamine Mononitrate, Folic Acid, Biotin, Potassium Iodide, and Cyanocobalamin).

Each contains over 20g of sugar, and a scant 6g of Protein.

Unless you have nut allergies, it seems like you'd be better off to shell a handful of nuts if you'd like some fiber, good fats and protein without all the 'extras'. But then again, YMMV.

[James L]

I am reactivating this thread because it contains information that may be of interest to people who are concerned about the use of statins.

[Conniems]

Thanks James. I'm glad you did. After getting almost all the way through it, I realized it was "old".
So, I have a question now that I know I am not taking the Zocor any longer. (I took it for about 2 weeks). My LDL IS very high at 203. Do I need to be doing something to try to get it down to normal other than what I am already doing ~ eating vlc and walking? I will be losing more weight and I will be going on the Eades new 6w plan in just a few weeks to help w/ that goal. My lipid numbers are in the thread just below this one.
I know I need to concentrate on my BS. However, that LDL number is a little scary to me.
Malcolm, Frank, and Carol have given me great advice. I just still have this one lingering question.

[James L]

Hi, Connie. I don't have a specific answer to your question. However, as a general comment, you may want to consider taking red yeast rice (see/search my RYR posts for details). It's a non-prescription supplement that appears to function as a low-dosage statin. I started with 2.4 g/dy, the amount used in UCLA's 1999 double-blind research study. But I later reduced the dosage to 1.2 g/dy and I still get satisfactory results. (I use Nature's Plus, a "prescription-quality" brand recommended by my PCP.) YMMV.

[CindySue54]

you may want to consider taking red yeast rice (see/search my RYR posts for details). It's a non-prescription supplement that appears to function as a low-dosage statin.

Yes...and it carries all the same dangers!! If anything, I'd try Niacin, but RYR is no different than a statin just weaker.

[gitfiddle]

Connie, I came across a note I made from PPLP last time I read it:

Glucagon suppresses cholesterol-making activity in the cells, requiring more LDL receptors to pull cholesterol from the blood. Exactly like a statin only without the side effects and expense. Just keep your insulin production low by carb reduction.

Sorry I can't tell you what page. My notes are always fuzzy. :rolleyes:

[mcsblues]

Connie all I can say is your LDL is only "very high" if you believe the current guidelines. These guidelines have been effectively set by drug companies ... for whom statins are a multi billion dollar business (statins are their biggest 'cash cow' by far). I know it is hard but try to just relax for a few months at least.

And yes sorry James, but I second Cindy's note on RYR.

[mcsblues]

My notes are always fuzzy. :rolleyes:

And why would that be?:p

As someone once explained it to me it goes something like this;

The body has a feedback system which efficiently regulates cholesterol levels BUT the sensors are located within the cells, meaning there is no direct regulation of bloodstream cholesterol. Most cells can produce their own cholesterol (and supply it to others) or they get it from the liver (via the bloodstream) So if you can lower the amount produced in the cells they will automatically compensate by taking what they need from the blood - (which will reduce your serum cholesterol reading).

AND ... you control the level of cellular cholesterol production by lowering INSULIN levels - because insulin and its 'counter hormone' glucagon affect the activity of a rate limiting enzyme. (If you really want to impress your friends, tell them you have improved your glucagon/insulin ratio to inhibit HMG-CoA reductase which in turn will upregulate cellular LDL receptors in order to induce a reduction of LDL-cholesterol in your plasma! http://www.empowerfoods.com.au/forums/images/smiles/icon_razz.gif http://www.empowerfoods.com.au/forums/images/smiles/icon_biggrin.gif )

AND how do you reduce insulin levels?? .. you eat a low carb diet of course. (You knew that bit ;) ).

[gitfiddle]

And why would that be?:p Because I take notes with just the high points and promptly forget the very information they're supposed to resurrect.

(If you really want to impress your friends, tell them you have improved your glucagon/insulin ratio to inhibit HMG-CoA reductase which in turn will upregulate cellular LDL receptors in order to induce a reduction of LDL-cholesterol in your plasma! http://www.empowerfoods.com.au/forums/images/smiles/icon_razz.gif http://www.empowerfoods.com.au/forums/images/smiles/icon_biggrin.gif )
I'm going to memorize that! How elegant! I hope my doctor has one more try at handing me a statin prescription! :nod:

[Roadstr]

Gaelen set me straight on what cells produce cholesterol... without trying to explain you can read Gaelen's post here (http://proteinpower.com/forum/showpost.php?p=89108&postcount=7). She was also good enough to provide a link to explain it.
I did not have the opportunity to discuss it further because the facts are facts, I was wrong and the thread was closed. I haven't approached the subject since, because I didn't want to get banned from the forum :eek:, but glad you brought it up. Your explination is still my understanding of the cholesterol production and regulation. :)

[mcsblues]

Gaelen set me straight on what cells produce cholesterol... without trying to explain you can read Gaelen's post here (http://proteinpower.com/forum/showpost.php?p=89108&postcount=7). She was also good enough to provide a link to explain it.
I did not have the opportunity to discuss it further because the facts are facts, I was wrong and the thread was closed. I haven't approached the subject since, because I didn't want to get banned from the forum :eek:, but glad you brought it up. Your explination is still my understanding of the cholesterol production and regulation. :)

Not sure why Gaelen appears to be saying cholesterol is only produced in the liver - but apart from that I agree with her. Red Yeast Rice, Oat Bran Muffins and every time I go to the supermarket these days I cringe at the margarine they are desperately trying to sell (seems to be on a endlessly repeating soundtrack) - which is so full of plant sterols that are just the bees knees for cholesterol re-absorption:rolleyes::rolleyes::mad: (I hate supermarket shopping at the best of times!). I wouldn't touch any of them!!

[Roadstr]

I'm in agreement with Gaelen as well, apart from the part saying cholesterol is only produce in the liver as well.

When I heard about the possibility of plant sterols being absorbed through the intestine I stopped taking them. What I had read is that the plant sterols would fill receptors for animal type sterols and then release... not always the case, it was possible to get into the body and cause problems. Plant sterols work very well, but there is a greater risk to some than others.

[James L]

Yes...and it carries all the same dangers!! If anything, I'd try Niacin, but RYR is no different than a statin just weaker.
...
And yes sorry James, but I second Cindy's note on RYR.
Cindy and Malcolm,

Perhaps, but I have not had any problems with RYR. It has lowered my total cholesterol and LDL and improved my Trig/HDL ratio. So I intend to continue taking it. I also take niacin, BTW.

[James L]

... If you really want to impress your friends, tell them you have improved your glucagon/insulin ratio to inhibit HMG-CoA reductase which in turn will upregulate cellular LDL receptors in order to induce a reduction of LDL-cholesterol in your plasma! ....Malcolm, that is impressive! Have you run that by your doctor? If not, do so and let us know how he/she responds. (Most physicians could use some post-graduate education, particularly in nutrition and its effects on the human body.)

[mcsblues]

Cindy and Malcolm,

Perhaps, but I have not had any problems with RYR. It has lowered my total cholesterol and LDL and improved my Trig/HDL ratio. So I intend to continue taking it. I also take niacin, BTW.

How do you know? Not being smart ... but that's what low carb does for most people - especially so for triglicerides.

[mcsblues]

Malcolm, that is impressive! Have you run that by your doctor? If not, do so and let us know how he/she responds. (Most physicians could use some post-graduate education, particularly in nutrition and its effects on the human body.)

Can't say I have had the opportunity - last time I had my cholesterol chacked was about 10 years ago. My then doctor said it was fine - gave me a single number :rolleyes: - and said I didn't need to get it checked again unless I changed my diet ...

Guess what doc? :p

[James L]

How do you know? Not being smart ... but that's what low carb does for most people - especially so for triglicerides.I've been on the PP nutritional program since 1996. And I keep records of my blood test results. PP did produce significant positive improvements. But, the addition of the RYR did additionally improve the items that I mentioned.

So, at the moment, I consider RYR to be a beneficial supplement, for me, at the 1.2g/dy level. I remain open to proof to the contrary, and I am ready to discontinue taking it if such proof emerges.

(Optimal human nutrition? Hopefully we will some day soon know exactly [or mostly] what constitutes O.H.N.)

[mcsblues]

Do you take CoQ10? (to replace that depleted by the statin)

[Conniems]

Whew ~ you guys and gals are impressive in your depth of knowledge. I hardly know how to respond to all of this, so won't. I think that I will try the YRY and Niacin to see if it is helpful. I've been concerned about side effects so have stayed away. However, I understand there is a different form of Niacin that doesn't cause flushing. Also that ASA taken before the dose will help. James, how much niacin do you take?

I have gotten a direct LDL added to the bloodwork I will be getting done in November so I'm hoping that will also be a better number. According to Dr. Mike, it should be.

Today, I am dealing w/ intense bloating and I have no idea what it is from. I went out for dinner last night and had steak, salad and green beans. That's more vegetables than I normally have. Maybe that did it. I just don't know. I'm anxious to get home and change my clothes!

I need to reread all of this and see what I can absorb from it. Thanks.

[Conniems]

I am submitting another, meaningless reply because I forgot to subscribe to this thread. :eek:

[mcsblues]

I think that I will try the YRY ...

If you mean RYR then as I mentioned to James you should also take CoQ10 - which statins deplete - regardless as to whether they are naturally occurring statins (like many drugs, they were found originally in nature) or not.

[Conniems]

Thanks, Malcolm. I already take CoQ10. I've taken it for years. Yes, I meant RYR ~ typing too fast. :o

[CindySue54]

However, I understand there is a different form of Niacin that doesn't cause flushing.

"However, I understand there is a different form of Niacin that doesn't cause flushing."

Don't waste your money!! Take the plain niacin that can cause flushing....it's not bad and the non-flush kind is apparently useless. I take Niacin and occasionally get the flushing, not all the time, and drinking ice water makes it go away a little faster....but it only lasts a few minutes at worst!

Dr Davis on fkush-free niacin: http://heartscanblog.blogspot.com/2008/11/flush-free-niacin-kills.html

Link to all Dr Davis's articles on Niacin:
http://heartscanblog.blogspot.com/search/label/Niacin

[mcsblues]

Good thinking Cindy - buck passing!:p

Bill Davis on RYR (http://heartscanblog.blogspot.com/search?q=red+yeast+rice) - it would be nice to know what you are actually consuming!

[Frank Hagan]

Whew ~ you guys and gals are impressive in your depth of knowledge. I hardly know how to respond to all of this, so won't. I think that I will try the YRY and Niacin to see if it is helpful. I've been concerned about side effects so have stayed away. However, I understand there is a different form of Niacin that doesn't cause flushing. Also that ASA taken before the dose will help. James, how much niacin do you take?


Niacin causes flushing with me, but the Slo-Niacin brand, available at Costco, minimizes it. I barely notice anymore. I've read that the flushing is genetically based, so if you have it, you have it. Therapeutic dose is 1000 to 1500 mg (not too much more benefit from taking 1500 mg, according to some studies).

Tricks to minimize the flushing: Take a regular aspirin 30 minutes before taking 1000 to 1500 mg of the Slo-Niacin and you will minimize the flushing. This one works for me. Another trick that works for others, but not so much for me, is to drink 16 ounces of water when the flushing first starts. Some like to take it at bedtime, with the idea that they will sleep through the flushing ... but that never worked with me.

Fish oil rich in omega-3 also works to lower triglycerides for some people. I read where Karol uses the same fish oil as I do, Carlson's Very Finest Fish Oil - Lemon Flavor, available from Amazon.com for about $23 (shipped by Vitamin Shoppe). The cost of the stuff at Whole Foods and Lassen's was about double that, so I order it online. I've been taking 1600 to 3200 mg, a level I read was necessary to lower triglycerides. A couple of teaspoons of Carlson's provides 3200mg of the "good stuff", as much as in 11 fish oil capsules.

[James L]

Do you take CoQ10? (to replace that depleted by the statin)Of course! . :)

[James L]

... James, how much niacin do you take? ...I was taking 500mg am and 250 mg pm, but lately I've reduced that somewhat.

I actually like the flushing. First of all, my body adapts to it and it is minimal. Secondly, it lets me know that it's doing something!

Be careful with the non-flushing niacin; some of those supplements can have deleterious effects. (Google will probably tell you what I can't remember.)

[James L]

... Bill Davis on RYR (http://heartscanblog.blogspot.com/search?q=red+yeast+rice) - it would be nice to know what you are actually consuming!Malcolm, thanks for that link.

1. I will trust UCLA before I will trust Consumer Lab for unbiased research information.

2. I would definitely use the Nature's Plus "prescription quality" brand (recommended by my PCP). I believe that is the product that was used in the UCLA study, and as far as I know Nature's Plus has not received any letter from the FDA complaining that their RYR product contains lovastatin.

[James L]

The full text of the 1999 UCLA research study, Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement, by D. Heber, et al., is now available free at this Web site (http://www.ajcn.org/cgi/content/abstract/69/2/231?ijkey=511efd498bc73b717bf4211323c2e3e6badaad70&keytype2=tf_ipsecsha). The Web site contains the abstract and the upper right corner contains the link to the .pdf version of the article.

Conclusions: Red yeast rice significantly reduces total cholesterol, LDL cholesterol, and total triacylglycerol concentrations compared with placebo and provides a new, novel, food-based approach to lowering cholesterol in the general population.BTW, my earlier post was incorrect; Cholestin was the proprietary supplement used in that study.

Malcolm, thanks for mentioning the need for CoQ-10; I should have included that information myself.

[mcsblues]

I don't think anyone is doubting that RYR reduces cholesterol, just as they are not doubting that drug based statins do the same. The question still remains why would you want to. In Framingham, those that did increased their risk of CHD and all cause mortality ...

[mcsblues]

Malcolm, thanks for that link.

1. I will trust UCLA before I will trust Consumer Lab for unbiased research information.

2. I would definitely use the Nature's Plus "prescription quality" brand (recommended by my PCP). I believe that is the product that was used in the UCLA study, and as far as I know Nature's Plus has not received any letter from the FDA complaining that their RYR product contains lovastatin.

It will 'contain' lovastatin because that is the naturally occurring statin that occurs in RYR . The question is whether some purveyors of RYR are boosting its potency by adding extra.

[James L]

I don't think anyone is doubting that RYR reduces cholesterol, just as they are not doubting that drug based statins do the same. The question still remains why would you want to. In Framingham, those that did increased their risk of CHD and all cause mortality ...Apparently my PCP is ignorant of Framingham; he's the one who recommended the RYR. And he really wanted me to stay at the 2.4 g/dy level, although I think he has accepted the fact that 1.2 g/dy works well enough for me.

Apparently UCLA is also ignorant of Framingham, although that is somewhat hard to believe.

What's your Framingham reference?

[mcsblues]

James as I see it you have found one study done at UCLA (?) which showed RYR lowers cholesterol. No one is disputing this. They make no findings as to whether or not this is a good thing - but they do quote a handful of studies which they would have you believe, make this self evident. I don't have time to check them all but I seem to recall the Scottish one is highly suspect - again from memory was that the one that had more smokers in the control group?

Anyway - while it is possible your PCP is ignorant of a lot of things - I'm sure the UCLA researchers have heard of Framingham (as Mike keeps telling us it is the big daddy of observational studies - still ongoing after 60 odd years) The fact that they don't quote it or a huge number of other studies doesn't necessarily say they are ignorant - just that they wanted to cite a few studies to reinforce what they see as being widely accepted - ie the lipid hypothesis.

I am thinking you wouldn't have been doing PP for as long as you have if you agreed with them - so in effect you know they are ignorant!

The much quoted Framingham result comes from here;

http://jama.ama-assn.org/cgi/content/abstract/257/16/2176

"There is a direct association between falling cholesterol levels over the first 14 years of the study and mortality over the following 18 years. 11% overall and 14% CVD death rate increase per 1mg/dl per year drop in cholesterol levels"

Mike has written about Framingham quite a bit - notably about the contortions performed by some of those involved to escape the obvious conclusions here (http://www.proteinpower.com/drmike/cardiovascular-disease/framingham-follies/) and here (http://www.proteinpower.com/drmike/uncategorized/framingham-flip-flop/) are just examples - and I don't remember exactly but I'd be surprised if it didn't get a mention in the PP books.

Have I read all the papers? No. But I have read quite a bit from those that have - Kendrick, Ravnskov, Colpo, Taubes and again some guy called Eades and I respect and agree with their conclusions - which is why I wouldn't even consider taking a statin, natural or otherwise.

[James L]

Malcolm, thank you for taking the time to compose that detailed reply. I haven't read all the links, but I did read the blog entry about the $80 news clipping.

Research is just that - research. Clear, unambiguous answers are few and far between (and sometimes seemingly non-existent).... Anyway - while it is possible your PCP is ignorant of a lot of things - I'm sure the UCLA researchers have heard of Framingham ...I am thinking you wouldn't have been doing PP for as long as you have if you agreed with them - so in effect you know they are ignorant! ...They better not be totally ignorant. Because if they are, I want some of my state tax dollars back! :)

(BTW, in an earlier post I misstated that I started PP in 1996. Instead, I started in 1998, shortly after I purchased a paperback copy of Protein Power.)

How do you reconcile the Framingham results with the results of the Gaziano, et al., research (Circulation 1997 (http://www.circ.ahajournals.org/cgi/content/full/96/8/2520)), Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction? Gaziano was cited favorably by the Drs. Eades in PPLP (hardcover edn, pp. 96 and 109). Instead, your best assessment of risk [of a heart attack] comes from your triglycerides and your "good" HDL cholesterol. (p. 109) More specifically, the lower your ratio of fasting triglycerides to HDL the better.

So ya want some numbers, do ya Sparky? Well, here are a few stinkin' numbers for ya to chew on!

I had blood work done (lipid panel analysis) in late October 2006 and again in mid-January 2007, with the following results:

Total cholesterol dropped from 267 to 178.
Fasting triglycerides/HDL ratio dropped from 2.38 to 1.2

(I'm not going to post all the other numbers, although LDL dropped below 100. Triglycerides also decreased and HDL increased.) ...That was after taking RYR at the 2.4 g/dy level.

My quoted post does state some qualifications. However, I have continued taking RYR at the 1.2 g/dy level and my most recent lipid panel has my Trig/HDL ratio at 0.95!

Faced with that evidence, I think I will continue taking red yeast rice as a dietary supplement. YMMV.

[Conniems]

So, I've just spent considerable time reading and digesting these recent posts. In a way, I feel more confused than ever. However, the more I read, the more I sense it all makes ~ if that makes any sense. I'm not sure who said it, but one thought that stood out for me is that why would Dr. Mike think RYR is a good thing if what makes it work on lipid numbers is lovastatin in it? Now, I think I also read here that there should not be any lovastatin in it which would mean that is not the ingredient in it that makes it work. Hmmmmm........... (Now, THAT'S confusing.)

Do any of you have an opinion on using niacin alone? Also, I'm really counting on the 6w plan of the Eades' to bring my weight down. If it does, as I think it will, my numbers should come down, too. I'll be starting that plan 2 weeks from tomorrow when my vacation is over.

I just said things seem more clear but I remain confused as to what to do. I also get that there is a body of work saying that reducing cholesterol lead to higher mortality & CVD in a group of people. My goodness!!

[mcsblues]

So, I've just spent considerable time reading and digesting these recent posts. In a way, I feel more confused than ever. However, the more I read, the more I sense it all makes ~ if that makes any sense. I'm not sure who said it, but one thought that stood out for me is that why would Dr. Mike think RYR is a good thing if what makes it work on lipid numbers is lovastatin in it? Now, I think I also read here that there should not be any lovastatin in it which would mean that is not the ingredient in it that makes it work.

1. I'm pretty sure Mike has never said that RYR (or any other source of statins) is a good thing.

2. Lovastatin is certainly one of, if not the only active naturally occurring components of RYR - there have been suggestions that some RYR preparations contain added lovastatin - presumably to boost its potency.

[Frank Hagan]

Re: niacin -- I'm still taking 1,000 mg a day. My doctor recommended 1,500 mg per day to reduce my triglycerides (over 440 at that point). I did reduce them, after a year or so, to about 344. When I added 1600 mg of EPA/DHA in fish oil AND started LC, I dropped my triglycerides to 106 in about 6 weeks. After my next blood test, I intend to discontinue them and see what happens to my triglyceride levels. (I don't know if the combination of all three approaches ... niacin, fish oil and low carb ... is the reason for the rapid decline, or if its just the two regimens I added just before the drop).

Here's my thought on the "longevity studies" ... all of these studies are useful for people with particular risk factors. My risk factors were pointing toward diabetes (family history, more than three of the markers for "metabolic syndrome", etc.) I don't have a family history of heart disease, with both sides of the family living to ripe old ages (most in their late 80s or 90s). No one in my family has died of a heart attack, on either side.

So my work is to reduce my personal risk factors, not engage in a society wide effort to reduce coronary heart disease. The longevity study you mention, that shows people with higher total cholesterol live longer than people with lower cholesterol, helps me focus on eating a relatively high fat, high protein, low carb diet.

My wife has a family history of heart disease, was diagnosed with pulmonary hypertension (erroneously), and probably has a small hole in the septum that closes at birth when the baby starts breathing air and needs the oxygenated blood from the lungs. Her goals are to focus on those risk factors and work to reduce blood pressure and LDL cholesterol. Her diet is different than mine.

Grand, society-wide health goals ignore the individual in the quest for easy-to-explain guidelines and could end up shortening the lives of some individuals. If less people die that way its counted as a success (except by the dead people, of course.) Eventually we may get to a point where individuals are seen as individuals and not as part of "grand plans."

[James L]

Re: niacin -- I'm still taking 1,000 mg a day. My doctor recommended 1,500 mg per day to reduce my triglycerides (over 440 at that point). I did reduce them, after a year or so, to about 344. When I added 1600 mg of EPA/DHA in fish oil AND started LC, I dropped my triglycerides to 106 in about 6 weeks. ...

... but that's what low carb does for most people - especially so for triglicerides.As Malcolm points out, LC is usually very effective at reducing triglycerides.

[Frank Hagan]

As Malcolm points out, LC is usually very effective at reducing triglycerides.

Yes, and so is fish oil, and niacin is also successful much of the time. I'll eliminate the niacin when I run out, and then see what my next blood test shows. I probably will keep the fish oil in the diet because of other benefits.

[arnieb]

I have personally been prescribed both lipitor and crestor in the past. I know that they work for many people and actually did lower my numbers. Conversely, I know that they cause a litany of side-effects for many people, (including me). When weighing my options, I would much rather try to get my numbers under control through exercise, diet, and a natural alternative. Therefore, that's exactly what I did. I feel great and have dropped numbers dramatically. If you insist on taking some sort of medication, I highly recommend a natural supplement called CholestProtect, or you can simply google natural cholesterol lowering supplements and take your pick, there are a other options out there. Good luck...