Hello...I have high LDL

[HubbleRules]

Your cholesterol numbers are to be admired - in my humble opinion. Your HDL/LDL ratio is EXCELLENT, as are your triglyceride levels. I wish my numbers were half as good as yours are!!!

Before anyone talks you into taking cholesterol meds (probably statins) - do some research on your own. Your doctor will most likely tell you only of the benefits of statins - but there are also real risks - which are largely played down by doctors and drug companies. Do an internet search on "+statins +risks" - you'll be amazed at what comes back.

If you do go on statins, make sure you're in the one group that studies show will benefit from them - white, middle-aged males with high-risk factors for CHD. If you fall into this group, I'd say try the statins - and be watchful for side effects.

Here is an article from an interview with Dr. Beatrice Golomb, a cardiovascular epidemiologist at the Univ of Calif. San Diego... She is doing an independent study of the side effects of statins. There is scant evidence of statin-related risks, because no one is really studying them other than Dr. Golomb. After all, there's no profit in besmerching a group of drugs with +$25Billion/year sales.

HubbleRules
============== interview follows ==========================

THE TROUBLE WITH STATINS: Although statin drugs are highly effective at lowering cholesterol, they still pose risks. Beatrice Golomb, M.D., Ph.D., from the University of California, San Diego, heads up one of the largest study of its kind to look at the side effects of statin drugs. Dr. Golomb is particularly looking at the way studies that confirm the safety of statins are set up. She says: “Problems arise when, having excluded the population at risk of having harm, people interpret absence of evidence of harm as evidence of absence of harm. In fact, the populations that tend to enroll in clinical trials are very small, non-representative, more robust, healthier subsets of the population. And it's quite routine to find that rates of adverse effects and quote ‘observational studies’ where you follow people who are actually put on drugs tend to be much higher than they are in clinical trials because of the selection issue.”

NOT ENOUGH STUDY: Dr. Golomb also says side effects of the drugs have not been extensively studied. She says: “The question is how much have these adverse effects been studied? Well, very little. There certainly isn’t any interest group who wants to invest lots of money looking at harms of drugs because there really isn’t any financial gain behind that.”

WHAT ARE THE SIDE EFFECTS: Some studies suggest the use of statins is linked to:
• Memory loss
• Muscle weakness
• Nerve damage
• Cancer
• Insomnia
• Personality and behavior changes
• Gastrointestinal problems

Dr. Golomb is worried doctors aren’t telling their patients about these risks. She says, “Physicians have heard so many of the wonderful things about statins and so little about the potential downsides that the physicians are persuaded that the statins can’t possibly be related, and then the individuals stay on the drug, and the problem progresses and becomes very severe and debilitating.”

WHO SHOULD TAKE THEM? According to Dr. Golomb only white, middle-aged men who have or are at high risk for heart disease should take statins. That contradicts current guidelines set by the National Institutes of Health. Dr. Golomb says, “People who are female, even if they are at high risk of heart disease, people who are middle-aged males if they’re at low risk, or people who are elderly, even if they are male and high risk, none of those groups receive survival benefit with assignment to statins compared to placebo. So there’s really not evidence that the benefits exceed the harms for women, for elderly or for men who aren’t at high risk … I don’t believe that the current evidence supports elements of the current guidelines.”

PANEL OPPOSES OVER-THE-COUNTER USE: In January 2005, members of an FDA panel opposed a proposition to sell statins over-the-counter. They cited numerous side effects and also said the drugs can pose serious birth defects when taken during the first trimester of pregnancy. Dr. Golomb agrees that statins should not be sold over-the-counter. She says: “What I fear is what I see everyday, which are people contacting us who develop problems, many of whom actually spoke with their physician about whether statins could be related to these problems. I worry that there will continue to be patients who wouldn’t necessarily be getting benefit from these drugs in the first place who will be experiencing severe quality of life-impairing adverse effects and won’t have a source of information to let them know that this is one possible consideration that should be taken into account.”

For More Information, Contact:

John McGraw
Department of Medicine
University of California, San Diego
(858) 558-4950

[Lenin]

Hi ARIZONA,

We were out all day doing Theater/Dinner and then came home and watched a movie...nice day.
So I put in some late 'puter time to make sure I didn't go into CPU Withdrawal.
But you're right, that was a break from my routine!

Hubble,
The little respect I had for these FDA panels was dashed on the rocks when the news hit that 10 of the 32 people on the board to determine the fate of the COX-2 inhibitors, some of which were KILLING people, had been in the pay of Pfizer, Merck or Adventis. Nine of the 10 doctors voted in FAVOR of the drugs. Had these 10 recused themselves, the drugs would have been pulled from the pharmacy shelves...but now they can continue to be prescribed.
I think the same hypocrisy exists with the statin panel that basically said these drugs are dangerous UNLESS WE CONTINUE TO PRESCRIBE THEM. I wonder what the decision would have been with ZERO doctors on the board who after all do a GOODLY portion of their "trade" by prescribing statins rather willy-nilly.
Perhaps an OTC status with an included flyer listing study results and frequency of side effects might actually be MORE informative than the doctor who says "Take these, they are perfectly safe," which is more often the rule than the exception.

If a "drug panel" had its way, probably a wonderful drug like aspirin would be available only after paying $125 to spend 10 minutes with a guy with a prescripotion pad.
It's ALL business...and probably the biggest in the U.S.

No prescription needed in England for statins and probably British statin use is less than U.S. use (just a stab in the dark there.)

[ARIZONA73]

I don't think there's any question that these drugs are being recklessly prescribed by far too many doctors nowadays. They should only be prescribed to a select group of high risk patients, and not just anyone.

The claims being made for these drugs list the incidence of side effects as being somewhere in the 2% range. I have always found this very hard to believe. I think it's much higher than that. In fact, Joel M. Kauffman, Ph.D, wrote the following in his paper "Statin Drugs-A Critical Review of the Risk/Benefit Clinical Research":

"Besides cancer, the other side effects of statins listed were incomplete, and should have included constipation, myalgia, myopathy, polyneuropathy, liver and kidney damage, congestive heart failure and amnesia. Side effects are usually said to affect 2-6% of patients. In fact, a recent meta-analysis noted side effects in 20% of patients above the placebo rate (65% vs. 45%), and no change whatever in the all-cause death rate for altorvastatin. The PROSPER trial on pravastatin showed no change in the all-cause death rate, and increased cancer and stroke rates. Statins are commonly used at a dose to lower TC to <160mg/dL, a level noted in the report of a NHLBI conference to be associated with higher cancer rates."

[Lenin]

ARIZONA,
In all honesty, I know LOTS of people on statins and I know LOTS of people on antihypertensives. I can tell you truly that these people have FAR more problems with the BP meds than the statins.
Shall we talk about antidepressives and their risk of suicide, or the bizarre results of the Ritalin plague in schools.

As far as side effects go, just read the side-effects in the PDR on virtually ANY drug...see if the list isn't every bit as long as the list for Lipitor!
I just got done with reading Cozaar because of the screetching pain in my knee after taking ONE after a 2 month hiatus...YEP, myalgia, myositis, KNEE PAIN, all there amidst a nearly full page of horrors. And this from a classs that most people agree has perhaps the fewest side effects of any of those commonly prescribed.

How's this comparison: take Lipitor to avoid a heart attack and risk some aches and pains or take a Cox-2 inhibitor for aches and pains and risk death from a heart attack. THose choices seem VERY dissimilar to me.

And poor Johnny, he got over his depression where he couldn't do ANYTHING with his life. He took Paxil and FINALLY got off his rear...and HANGED himself!

Drugs have side effects and all present Cost/benefit and Risk/benefit ratios. People have overwhelmingly chosen in favor of statins; they have been judged NOT an unsafe class of drug by the tens of millions who take them. The benefit denominator has apparently been judged to be SO high as to overwhelm the high cost ...and LOW risk.

Guess the drug:

Damage to the lining of your stomach, prolonged bleeding time, wheezing, breathlessness, ringing in the ears, hearing loss, chronic catarrh & runny nose, headache, confusion, nausea, vomiting, GI upset, GI bleeding, ulcers, rash, allergic reactions, hives, bruising, abnormal liver function tests, liver damage, and hepatitis. If you take too much, the toxic effect is Kidney Damage, severe metabolic derangements, respiratory and central nervous system effects, strokes, fatal hemorrhages of the brain, spleen, liver, intestines & lungs and
DEATH
300 to 500 reported deaths per year: (taken as directed)

Yep. aspirin. No prescription needed.

[HubbleRules]

Lenin,

I know - I heard about that 10 panel members on the VIOXX vote had financial ties to the drug industry - they cast 95% of their votes that day in favor of the drug companies. From what I've been reading, the financial conflicts of interest between the drug companies and those monitoring drugs for safety (FDA) is extensive. What's worse, the new-drug-certification branch of the FDA is almost totally funded by the drug companies. If you were a department head of this unit, would you give the drug companies a hard time and see your budget slashed? Or would you play along and not fuss too much about patient safety?

Anyhow, I also agree with you that for the great majority of statin users, the drugs do more good than harm. I do think though, that the only group for which there is documented proof of benefit is 'white, middled-aged males with high-risk for CHD'. Other groups do not seem to benefit from the drugs. They may die less frequently from heard attacks, but die more often from other causes, such that there is almost no effect on longevity...

I, by the way, fall into the above group, but I know that my body cannot tolerate the statins any longer, and have sought alternative therapies.

Take care,

HubbleRules