Dangers Associated With Cholesterol Drugs

[JustinSmith]

Hi brum,

With respect, I have many years experience as a health practitioner besides my degree in engineering. I do strongly feel that the scientific background has helped me to evaluate in particular, the numerical aspects of research and to put risk reductions into proper context.

I totally agree with you about the interpretation of statistics but the fact is that the headlines and statistics have been so heavily exaggerated in favour of statins. The statistics that reach the headlines are the misleading relative percentages ? drug companies issue a press release to the media that highlights these exaggerated benefits, the media just copies this directly and thats what the general public gets. The real statistics I have quoted do not ever get into the headlines because journalists do not read the actually study itself but they rely on the press release directly from the drug company. I have documented evidence of this. In fact anyone can see this process taking place if they take the trouble to look.

[JustinSmith]

Huguenot,

Your comments are typical and highly predictable. You have chosen to attempt to discredit me personally even though you have never met me or know anything about me. This approach is always used by those who do not have any scientific argument and those who wish to hide the facts.

I am most certainly not ?advising members of this forum to ignore the advice of their doctors? or take my advice instead, as you have put it. This is a fabrication in your own mind sir. If you look back at my posts will will see that I have stated time and again that I wish to present the facts on this subject so that people can make their own informed decision. I have not once suggested that anyone should not take the advice of their doctor.

Excuse me, but what has Gillian McKeith, lemon juice, AIDS and climate change got to do with this discussion? Your use of the word ?denialist? is also very telling since this word is only used by people who are afraid of entering into scientific debate.

The scientific process at the core involves challenging a hypothesis. This is how progress is made. I am tempted to use the word dogma here to describe the cholesterol hypothesis. I challenge you sir to present a scientific argument.

If you have any scientific contribution to make to the discussion then I welcome that but your personal attack directed at me has so far only highlighted a deficiency of knowledge on your part.

I will state again that absolutely everything I have said can very easily be verified by anyone who wishes to know the facts.

[brum]

Thanks, Justin, though my main point is that I choose to place my trust in my GP, who knows a darn sight more than I do. Just as I chose to allow my daughter to receive the MMR vaccine, based on the advice of my GP versus 'headline' statistics which turned out to be inaccurate.

I don't wish to under-value your experience and expertise in this area, but I will continue to take the advice from my GP unless I am convinced the advice is wrong. I have yet to see any justification to not taking statins. You have said there is evidence that statins can increase the risk of type 2 diabetes and suggested that there is an increased risk of cancer, but where's the evidence?

[daizie]

Oh come on , the government will never admit to a national cock up

[brum]

What has the government got to do with it daizie? Have I missed something?

[jollybaby]

Justin - I have quoted the absolute percentages as well if you read my post properly. You quoted a single percentage out of context with no mention of the population it referred to in your initial post which is far more misleading.

I agree there needs to be more long term data on statin use (as I'm sure there needs to be on metabolic typing)

[Peckhamgatecrasher]

Brum - I did some research on statins a few years' ago when I was prescribed them. I vaguely recall that there was an increased chance of gall bladder cancer (I used BMJ to look at published papers). However my memory is pretty rubbish, so you might want to look up the arguments yourself.

[This post does not indicate that I am buying into OP's stance wholeheartedly!]

[JustinSmith]

Hi brum,

I understood that your main point was that you choose to accept the view of your GP. I did not comment on this because I fully respect your personal choice.

The issue of statins and type 2 diabetes can be illustrated through a discussion of a clinical trial known as JUPITER (N Engl J Med, 2008; 359: 2195?2207):

http://content.nejm.org/cgi/content/full/NEJMoa0807646

When the results of the JUPITER trial were published it was widely reported in the media that the statin used in this trial reduced the risk of serious cardiovascular events (such as a heart attack) by 44 percent. However, this again was a relative percentage reduction. If we look at what has been referred to as ?hard cardiac events? (heart attack, stroke, or death from cardiovascular causes), 1.8 percent of the people in the placebo group suffered these events compared with 0.9 percent in the statin group (N Engl J Med, 2008; 359: 2280?2282):

http://content.nejm.org/cgi/content/full/NEJMe0808320

So, in fact there was only a 0.9 percent absolute risk reduction, but this sounds much less impressive than 44 percent.

The reporting of the misleading 44 percent suited both the media (sensationalism) and the drug companies.

At the end of the day, the most important thing to look at is deaths from all causes. Since, there is not much point in taking an expensive medication if the risk for one disease is reduced at the cost of increasing the risk for another disease within the same time period. In the JUPITER trial, the statin reduced the overal risk of dying by about 0.5 percent.

Now, JUPITER also found an increase in type 2 diabetes amongst the people who took the statin. This increased risk for diabetes was 0.6%.

So the increased risk for developing diabetes was around the same as the reduced risk of dying. However the authors of the trial report chose to dismiss the increased risk for diabetes as a chance finding without justifying this and at the same time they exaggerated the 'benefits' of the statin.

It is often difficult for us to imagine risk as a percentage - if we imagine a theatre containing 1000 people who all take the statin for the next two years ? around 5 people will have their life extended and around the same number will develop diabetes as a direct result of the drug. These are the facts from the JUPITER study, which incidentally is now being used as an excuse to put millions more people onto statins.

The problem of course, is that an individual person has no idea if they will be one of the few people who have their life extended or one of the people who develop diabetes.

Researchers tried to answer this question about statins and type 2 diabetes. A meta-analysis was published in the journal Diabetes Care (Diabetes Care, 2009; 32:1924-1929):

http://care.diabetesjournals.org/content/32/10/1924.abstract

This meta-analysis confirmed that statins increase the risk for type 2 diabetes. The researchers state that this increased risk is reduced if the WOSCOPS study is included in the analysis, but WOSCOPS was so different in characterists that there is a strong argument for it not being included in the analysis -as explained in this editorial:

http://care.diabetesjournals.org/content/32/10/1941.full#ref-8

Some researchers may indicate that the increased risk for type 2 diabetes (associated with statins) is a slight risk. However, it is important to realise that the suggested 'benefits' of statins are of a similar magnitude. Given the other additional risks associated with medications, individual people may choose not to take the drugs when the facts are presented to them accurately.

This should cause concern because diabetes drastically increases the risk for heart disease, but this increased risk would not be seen during the three or six year duration of a statin clinical trial ? the full extent of the increased risks associated with diabetes develop over a much longer period of time.

There are other studies to show the link between statins and diabetes but I feel that this post is already getting too long.

I will discuss statins and cancer in my next post....

[mockney piers]

I must say that I've been Reading for years that not everyone is convinced by the simplistic correlations between cholesterol and ill health. The Japanese and southern French have very healthy hearts despite diets with high levels of cholesterol.

I agree with PR that it's about sensible eating, which to answer your question at a very lay but common sense level is all things in moderation (ok not rat poison).

However targetting the high cholesterol items in out diet in this country seems to be an eminently sensible thing to do as we eat far too much processed food, fast food, pizzas and burgers dripping in fat, and nowhere near enough fresh or steamed veg, White fish, oily fish etc etc.

Likewise salt, too much in our diet for sure but we'd die without any.

Huguenot* is being a tad unfair, especially as a new scientist subscriber he will have read the same articles questioning this orthodoxy as I. But we do get some strange folk on here advertising their services of strange ideas and practices, and starting off with 'here's my book' will understandably get people wondering what motives are (and tbh selling more books still seems like the most likely candidate for startig this thread however noble your intentions regarding the subject matter).

*his referneces to climate hange denial and gillian mckeith are about bad science, I guess a cursory look at your site he felt you may be pushing it. In fairness connections to metabolic typing do also ring alarm bells.

[JustinSmith]

jollybaby,

I could have written the facts in two different ways:

During a mean follow-up of 4.1 years, 5.7 percent of participants died in the placebo group compared with 5.1 percent in the statin group (BMJ 2009; 338:b2376).

or:

During a mean follow-up of 4.1 years, there was a 0.6 percentage reduction in the risk of dying (BMJ 2009; 338:b2376).

Both statements mean the same thing and the point is that if patients are informed about this meagre 0.6 percent reduction in mortality, they may think twice about taking a statin every day for the rest of their lives.

[daizie]

LegalEagle-ish Wrote:

-------------------------------------------------------

> brum Wrote:

> --------------------------------------------------

> -----

> > Are you suggesting we've all been duped -

> > including most in the medical profession? If

> that

> > is the case, is the motivation purely driven by

> > profit, at the expense of patient's health?

>

>

> If so, it wouldn't be a first.

>

> Thalidomide anyone?

brum, legal's already said it .

[Ladymuck]

Slightly off topic but Thalidomide is still being used...on sufferers of leprosy.

[JustinSmith]

Hi mockney piers and welcome to the discussion.

Please, if you want to talk about bad science there is more than enough of it within the subject of cholesterol. I maintain that people start to look for ways to discredit others only when they cannot contribute to the scientific discussion. If you are interested in discussing Gillian Mckeith why not start a separate thread to do that ? I will certainly not contribute to that because I have no interest in the women.

I feel that Metabolic Typing should also be discussed in a separate thread. There is more than enough to deal with here in terms of cholesterol and statins. I'll not be drawn away from the important task of bringing the facts about cholesterol to the general public.

In fairness, please stick to the subject here so that people can asess the facts for themselves!

You are however absolutely correct that there is no connection between cholesterol and ill-health. I have attached an article that I had published last year to provide people with some additional references.

I only wish that some of your suspicion of me be directed toward an extremely powerful pharmaceutical industry who's motives are to generate business growth and not to improve heath.

My motives are to communicate the facts. My original post was for a seminar that is most likely to be free of charge. No one has to buy my book to get the facts on this subject. I have already provided the link to a 60min interview of myself that anyone can download for free. That combined with the information on my website, the posts I have taken the time to write here, and the article I have attached to this message should be more than enough for people to decide for themselves if they are being misled by the idea that cholesterol causes heart disease.

[brum]

Thanks PGC.

There are side-effects in all drugs, so its a case of analysing the risk versus the benefit. This is where the expert judgement of the GP comes in to help you. I'm not saying that a doctor's opinion is always right - they are only human - but, sometimes, we have to place our trust other people.

Heavily edited since the thread has moved on significantly since I started to write it...!

[Tarot]

Justin what exactly are you selling?,

[mockney piers]

I'm not necessarily suspicious of you justin, I sought only to help defuse the thread from becoming argumentative and allow people to address the points. I thought huguenot could come in a little less full on, but thought that it might help to explain to you why people might be suspicious. I wasn't intending to subvert debate towards any particular topic and lord knows I'd happily avoid ever discussing ms mckeith again.

On a minor aside before i pop off, and while I understand you wanting the intentions of thread adhered to and respected, house rules do say that the lounge is pretty much anything goes and debate is often irrevernt and prone to offtopication.

If you want to start a debate about the science of cholestorol free of that sort of thing then the drawing room has stricter rules and guidelines about how debates are adhered to.

[JustinSmith]

I was requested in a previous post to provide some information about statins and cancer. I have stated previously that there are unanswered questions concerning this.

Within the medical literature, there is a well documented connection between low cholesterol levels and increased deaths due to cancer. At least eleven studies have confirmed that low cholesterol levels are associated with increased cancer mortality:

Rose G, Blackburn H, Keys A, Taylor HL, Kannel WB, Paul O, et al. Colon cancer and blood-cholesterol. Lancet 1974;1:181?3

Rose G, Shipley MJ. Plasma lipids and mortality: a source of error. Lancet 1980;1:523?6.

Cambien F, Ducimetiere P, Richard J. Total serum cholesterol and cancer mortality in a middle-aged male population. Am J Epidemiol 1980;112:388?94.

Beaglehole R, Foulkes MA, Prior IA, Eyles EF. Cholesterol and mortality in New Zealand Maoris. Br Med J 1980;280:285?7.

Kagan A, McGee DL, Yano K, Rhoads GG, Nomura A. Serum cholesterol and mortality in a Japanese-American population: the Honolulu Heart program. Am J Epidemiol 1981;114:11?20.

Garcia-Palmieri MR, Sorlie PD, Costas R, Jr., Havlik RJ. An apparent inverse relationship between serum cholesterol and cancer mortality in Puerto Rico. Am J Epidemiol 1981;114:29?40.

Peterson B, Trell E. Premature mortality in middle-aged men: serum cholesterol as risk factor. Wien Klin Wochenschr 1983;61:795?801.

Sorlie PD, Fienleib M. The serum cholesterol-cancer relationship: an analysis of time trends in the Framingham Study. J Natl Cancer Inst 1982;69:989?96.

International Collaborative Group. Circulating cholesterol level and risk of death from cancer in men aged 40 to 69 years. JAMA 1982;248:2853?9.

Morris DL, Borhani NO, Fitzsimons E, Hardy RJ, Hawkins CM, Kraus JF, et al. Serum cholesterol and cancer in the Hypertension Detection and Follow-up Program. Cancer 1983;52:1754?9.

Sherwin RW, Wentworth DN, Cutler JA, Hulley SB, Kuller LH, Stamler J. Serum cholesterol levels and cancer mortality in 361,662 men screened for the Multiple Risk Factor Intervention Trial. JAMA 1987;257:943?8.

Stain drug manufacturers have been very keen to dismiss any idea that their products increase the risk for cancer ? they have suggested that cancer itself causes the reduction in cholesterol (reverse causation) but we do not know if this is this case.

As with diabetes, statin trials are too short in duration to properly assess these increased risks for developing cancer.

At a finer level of detail there are other pieces of evidence to show that statins increase the risk for cancer but these issues are best discussed in the form of a presentation.

[Huguenot]

I have picked up on the debate regarding cholesterol and big pharma, and have not read sufficiently into the subject to have formed an opinion. That was not my point.

To have a commercial practitioner of non-evidence based hocus pocus peddling snake oil and building up a core customer base off the back of criticising real science is completely disingenuous.

He intends to get rich by exchanging real medical treatments for his own juju. He claims valid criticism, but is not declaring his interest.

This is not a proposal for a 'study group',it's a transparent attempt to estalish a new revenue base in his new residential district. Cynical.

To accuse me of failing to communicate the facts? Debate?

That's hilarious.

Justin, where are the "2 to 6 year" controlled tests on metabolic typing, hair mineral analysis, neurotransmitter balancing, and detoxification protocols?

Apparently these are not long enough, so Justin where are your decade long tests on balanced neurotransmitters?

Where are the proven statistics in peer reviewed publications discussing similar statistical differentials to the ones you use to justify your attacks on real medicine?

You seem quite comfortable using scientific research studies to demonstrate the lack of absolutes in real medical science. What you replace it with is faith based medicine and quasi-religious study groups. It's like a blinking madrassa.

Your 'treatements' in common with homeopathy reject any testing, because like religion, if you put faith to the test you ensure that it won't deliver.

You want debate? Let's see your own silly ideas under the same microscope as you're putting statins?

Big pharma may well be sick, but at least they're honest criminals.

[JustinSmith]

Hi mockney piers,

Thank you for your reply.

I did actually start this thread in the drawing room - i agree with you that that would be a better place. However it was moved out of there into 'the lounge' for some reason??

[Huguenot]

And I know I'm a bit full-on, because I perceive Justin to be cynically playing with people's health for commercial profit.

Maybe I'm too cynical, but even so Justin could recognise the comedy in putting pharma under such scrutiny whilst plugging solutions which support no such honesty.

I think that's really naughty ;-)

[mockney piers]

I'd avoid mentioning your book though, the chair may frown if you do.

[mockney piers]

Ah, enough said then ;-)

Huguent, you had me on 'peer reviews journals' ;)

[JustinSmith]

Huguenot,

Your post has brightened up my day! You start by saying that you have ?not read sufficiently into the subject to have formed an opinion?. Consider that as you read back to yourself the personal insults that you have thrown at me.

Your post reads like a standard cut and paste job that you send to anyone who raises issues with mainstream medicine.

You say that you ?perceive Justin to be cynically playing with people's health for commercial profit?. I must say, you perceive and assume a lot from a small paragraph on my website.

What commercial profit? Oh you must be referring to the cholesterol-lowering industry that is now worth tens of billions of dollars.

Why are you so defensive of the pharmaceutical industry? Do you have any connections here that you are not mentioning and is that why you feel so personally offended by the mere facts that I have presented?

The techniques I use as a practitioner are based on good science but there is not much point in discussing this with you because I'm sure (as with cholesterol) you have already made up your mind without any knowledge or reading of the subjects.

And now you are talking about homeopathy, where will the list end? I too know nothing about homeopathy so there at least we may experience a metaphorical meeting of minds.

Thank you for the entertainment but I will not waste any more time on your comments until you have read at least something about cholesterol, statins or heart disease. I look forward to further amusing comments from you once you have done that.....

[PeckhamRose]

Come on kids, he just said don't believe the pharma hype.

Leave it there. SO what if he is plugging his book. He said he had written a book about it and was up front.

And he said he'd like to do a discussion for free if we can get a free room.

Move on. But move on quickly so that we can exercise more.

[Huguenot]

It's entirely predictable that you'll refuse to discuss your own treatments.

I actually don't think you're specifically interested in cholesterol or statins either are you Justin, there's another agenda to this entire thread.

It's entirely predictable that you'll use an attack on science to attract a focus group of individuals predisposed against science as a thinly veiled commercial seeding bed.

From this evangelical base you can sell your book and sell your treatments.

It's textbook stuff.

I'm not interested in pharma, I'm interested in your denial of clmate science on another thread, and your denial of medical science on this one.

Then I realise your call for focus groups has all the honesty of an alpha course.

An engineering graduate such as yourself is clearly clever enough to see the link, and you choose to exploit it.

Boo hiss, as they say in pantomimes.