cholesterol

Taking Drugs for Cholesterol Issues? Maybe Medication Started the Problem

October 31, 2015 by James Bogash

Cholesterol myth — Your microbiome and your cholesterol

Cholesterol lowering drugs seem to have lost some of their luster. Can’t say I’m disappointed about that little tidbit.

Due to staggeringly successful marketing efforts on the part of the drug companies (most notably Pfizer for Lipitor), drugs to lower cholesterol became one of the most successful drugs ever produced. Unfortunately, this had little effect on patient health because of the truly dismal benefits of the statin class of drugs.

One percent improvement. Yup. That’s about all you can expect from taking a statin drug to lower your cholesterol. Pretty much sucks no matter how you look at it.

The cholesterol story has become quite interesting in the past few years. It took some very large studies to put the minimal benefits of statin drugs into perspective, especially in light of the risk of diabetes from this class of drugs.

I think the findings that statins increased the risk of diabetes (ironically, especially in those who were at lower risk in the first place) has finally opened medicine to the idea that this class of drugs is not the miracle drug we once thought it was.

To see how far it’s come, the most recent cardiovascular disease prevention guidelines do NOT include cholesterol as a risk factor nor are there recommendations to limit dietary cholesterol intake.

My how far we’ve come.

Still frustrating, however, when you consider that these recommendations NEVER should’ve been present in the first place. It’s like medicine is just now waking up to the idea that the “statins to lower high cholesterol” approach is just not a good idea.

I’m not saying that high cholesterol is a goal we should shoot for. Quite the opposite. It’s just that cholesterol is just one risk factor among many and putting on blinders to look just at total cholesterol is a bad idea. To give you an idea of how crazy the idea of using a drug to single-mindedly lower cholesterol is, this particular study should do the trick. You see, cholesterol levels are merely a reflection of the health of the body. That means that literally hundreds of factors will work together to create the numbers that you see on your blood test.

These numbers can include total cholesterol, LDL cholesterol (generally “bad”), HDL cholesterol (generally “good”), triglycerides (lower is better), Lp (a) (lower is better), Apo B (lower is better) and VLDL (lower is better). Diet, exercise, stress levels, supplements and environmental exposures can all affect your lipids levels. But according to the results of this study, there may be another factor affecting your levels that your doctor is likely not aware of.

The bacteria in your gut.

Yup. As if we didn’t already link the bacteria in your gut to pretty much every other aspect of health. Now we can chalk up your lipid levels on the list. Here’s the specifics of the study:

The gut bacteria was evaluated in 893 subjects, with an average 238 different types of bacteria per individual (ranged from 44 to 355).
As seen in just about every other study looking at the microbiome, higher diversity (as measured by Shannon’s diversity index) led to better lipid values.
Higher diversity was linked to lower BMI.
Higher diversity was linked to lower trigylcerides.
High diversity was linked to higher HDL levels.

The study went into FAR more detail than this as far as the relationship between specific bacterial species, BMI and lipids, but suffice it to say that the results were consistent with prior studies on this same subject.

So what does this mean? It means that someone, somewhere is going to try to financially capitalize on this relationship. You can bet this will be along the lines of fecal transplants (and now for the collective “yuck…”), which is already well on its way to being an acceptable treatment for C. diff infections.

To me, this means that diversity is key. I have said this time and time again and always relate it back to antibiotic use in all but the most life-threatening situations.

Antibiotics WIPE OUT DIVERSITY and it takes years to recover, if ever. IF EVER. I can not state this more strongly—if you are the type of person who runs out and gets an antibiotic prescription for acne, sinus infections, urinary tract infections, sore throats, ear infections or upper respiratory tract infections (ALL of these have very little evidence of effectiveness and can be better managed naturally), even if it is only once every few years, you are absolutely, positively, destroying the diversity in your gut and with it, your long term health.

Thinking that you are OK after antibiotics by just following up with probiotics for a week or two is old school. Taking probiotics is just the first 100 yards of a marathon. But if you can point me to a probiotic with 200+ strains that will survive through to GI tract to the lower regions of the intestines, I’ll revise my thinking on this issue.

Until then, avoid antibiotics unless you are on your deathbed with a fever of 106.

Think You’re Not at Risk for Heart Disease? Take This Test and Find Out

April 13, 2015 by James Bogash

Heart disease is not something that we need to educate the public on. Everyone’s got ideas on how to prevent heart disease.

But, apparently, there’s some massive disconnect between what we need to do and what we are doing. A recently study revealed that not a single person out of 1,731 were living a lifestyle that included Life’s Simple 7 established by the American Heart Association. Not a single one.

But I’m confident that not a single person out of the 1,731 actually wanted to have a heart attack or leave his or her family with the untimely death of a loved one.

So why the disconnect? This particular study may help give you some insight as to why YOU haven’t adopted at least the Simple 7.

In it, researchers looked at a group of 5,863 patients and asked about his or her individual perception of risk of heart disease based on established risk factors. The patient’s perceived risk was then compared to his or her ACTUAL risk based on established risk factors.

Individuals were asked to rate his or her heart disease risk for the next years as low, intermediate or high. Based on these responses, they were classified as hypo-perceivers (the patient’s perceived his or her risk of heart disease as lower than it actually was) and normo-perceivers (the patient’s perceived risk was on par with his or her actual risk). Here’s what they found:

Cardiovascular risk was intermediate in 45.7% and high in 54.3% of individuals as estimated by the Lifetime Risk Score (LRS).
Shockingly, 83.9% were hypo-perceivers, thinking that they were at a lower risk than they actually were.
A mere 16.1% estimated their risk correctly.

Talk about a massive disconnect. First of all, EVERYONE in the study had at least an intermediate risk for heart disease. This is a sad reflection on the overall state of health. But how could so many of these patients be so unaware at how great his or her risk is??

The rest of the study may give us some insight into just how much our “take a pill to fix it” society has screwed up our perceptions:

Smokers were 204% more likely to underestimate their risk.
Those with cholesterol problems were 121% more likely to underestimate risk.
Sedentary people were 167% more likely.
Those who took meds? A whopping 350% more likely to underestimate his or her risk.
On the flip side, those with a higher BMI (64%), high blood pressure (43%), depression (54%) and stress (60%) were at a lower risk of hypo-perception.

I have said this time and time and time again. Taking medications to “fix” your problems does no such thing. In almost every situation, medications give you a false sense of security. Even though your blood pressure, cholesterol or blood sugar has gotten better on the meds, it translates very weakly into actually changing your risk of the things you are really worried about like heart attacks, stroke or death.

In other words, you will die with better numbers, but you WILL STILL DIE.

While this is a strong statement, we have seen it play out over and over in the medical literature. This study just reinforces the fact that our drug-oriented medical approach is creating a society that BELIEVES it is at a lower risk for heart disease, when in reality, it is not. There is a very high likelihood that you have some degree of risk for heart disease, unless you have adopted at least Life’s Simple 7 (click here for more info on the Simple 7 and see where you stand….personally I’m at a 9.4/10 because my BMI suggests I should lose 4 pounds, but my actual body fat percentage is where I want it to be).

Take the test yourself and let me know how you scored in the comments section!

Cholesterol Lowering Drugs and Nerve Damage

April 2, 2015 by James Bogash

statins and nerve damage — decade3d / Dollar Photo Club

Ok. I’ll admit it. I am completely stumped as to why drugs to lower cholesterol are among the most successful drugs that drug companies manufacture.

The evidence for their effectiveness pretty much sucks. Out of 100 people who are prescribed statins over the course of 5 years, only a single person will actually benefit. Not quite as rare as winning the lottery, but very few people have side effects from buying a lottery ticket.

Not so with statins. The list of side effects in far longer than you probably realize. At the top of the known list is muscle problems. From microscopic damage all the way up to fatal reactions from muscles literally melting (fatal rhabdomyolysis). It would not be unreasonable to say that almost everyone who takes a statin drug to lower cholesterol will suffer some type of muscle damage, even if it’s only on the microscopic level.

But what about your nervous system? Could your brain and the nerves going into your feet and hands be affected just as much as the muscles? And if so, why didn’t your doctor mention this side effect potential?

Here’s a little tidbit. When it comes to clinical studies on statins, the odds are stacked against you and your doctor for finding out just how common many of the side effects are. In both the muscle and nervous system lists of side effects, there are some 10-11 separate categories. So, when the reports of a study done on drugs that lower cholesterol are released, the risks are deemed “uncommon.” However, if you grouped all of the “nervous system” or “muscle” side effects into a single category, the rates of these side effects for EACH CATEGORY approached that 10% or higher level.

Considering that only 1 in 100 will benefit from the drug, 1 in 10 having significant side effects is a BIG deal.

As for just how common nerve damage may be, I’d like to point out this particular study. Normally, I review current research that has been published in the past month or so, but this one of those “oldie but a goody” studies from 2002. It is even more important in the context of recent recommendations to give practically every living being over 5 years of age who knew someone who had chest pains or lived in the same zip code as someone with heart disease a statin.

These researchers looked at cases of nerve damage (polyneuropathy) to see how likely statin use was related to the nerve damage. Because of the way that the data was retrieved, the diagnosis of polyneuropathy was limited to definitive, probable or possible. (Definitive = tested for all previously listed exclusion diagnoses and conditions, and where no apparent cause for the neuropathy had been established. Probable = only sufficient information existed to rule out alcohol over-use, diabetes, and renal insufficiency. Possible = information available was not sufficient to ascertain the presence or absence of any of the above-mentioned exclusion criteria.)

Here’s the specifics of this study:

Overall, statin users had a 370% higher risk of suffering from polyneuropathy.
However, for those who had definitive nerve damage, this risk skyrocketed to 1,420%.
When looking at current statin users, these were 460% for any diagnosis of polyneuropathy and 1610% for the definite cases.
If patients had been taking statins for 2+ years the risk of a diagnosis of definite idiopathic polyneuropathy topped the charts at 2,640%.

These aren’t exactly small relationships. If the drug manufacturers get their way and there is a massive increase in prescriptions for statin drugs, the number of cases of permanent nerve damage caused by statins are going to go through the roof.

And for what? So a single patient out of a hundred suffer one less heart attack?

Cholesterol Lowering Drug (Jupiter) Trial Shenanigans

March 17, 2015 by James Bogash

ARE THE DATA FROM ASTRAZENICA, CRESTOR JUPITER TRIAL ON STATINS LOOKING FISHY?

Wow. I really think if most of the American public knew the real story of what goes behind some of these trials we’d all be sickened. In it’s essence, the Jupiter trial looked at the prevention of heart disease in patients who had NORMAL cholesterol, but elevated inflammation. Essential understanding that the “cholesterol blame game” was going away and they needed to find a new lab value that they could use the drug for.

The study was stopped early and declared a rousing success. Much fanfare was heard and the medical journals and editorials sung it’s praise. Oops. A little too soon. A closer look at the data raises some serious suspicions. Basically, the trial was stopped early when predetermined events occurred just 2 yrs into the trial.

Furthermore, when you look at a population, certain statistics are expected. Here’s the quick details:

The study found that statin drugs did NOT protect against deaths from heart attack and stroke.
In the general population, cardiovascular deaths account for about 40% of the total number of deaths. Of these heart attacks, around 50% of these are fatal.

But in the Jupiter trial? Apparently miracles occurred. Cardiovascular mortality accounted for under 20% (instead of 50%) of the deaths, and the fatality rate of these heart attacks was very low (instead of the expected 50%). This raises serious questions about the validity of the data and suggests that funding of the trial may have had a strong influence on the interpretation of the data.

Statins and Your First Heart Attack

March 10, 2015 by James Bogash

IS THIS THE BEGINNING OF THE END OF STATINS (LIPITOR, CRESTOR, ZOCOR, VYTORIN, etc…)?

It should come as no surprise to regular readers of my posts that the research just does not support the use of statins to prevent a first heart attack. The data is very, very weak. Which would be fine if it didn’t cost the US alone some $20 BILLION per year. Talk about money wasted. And not a shred of evidence to suggest that they help prevent a heart attack, and plenty to suggest they harm. But, despite the evidence, our country and medical system is absolutely convinced that statins are the savior for heart disease.

This meta analysis, reviewing over 65,000 patients over 11 studies with patients at a HIGH RISK of heart disease (forget those with only elevated cholesterol…), found NO EVIDENCE FOR THEIR USE IN PREVENTING THAT FIRST HEART ATTACK!!! Seriously. What more information do we need? Any why do I have to spend hours educating patients that the drug they are taking is worthless to them? Help!!

Cholesterol Lowering Drugs and Diabetes: Just How Bad is It?

February 28, 2015 by James Bogash

aspirin to protect your heart — Sergey Yarochkin/Dollar Photo Club

It is now clear that cholesterol lowering drugs cause diabetes. But the proponents have clearly stated that the risk was in those already at risk.

Ironically, pretty much everyone with cholesterol issues is, to some degree, already on his or her way to developing diabetes. Giving a drug that is now proven to push patients along this pathway faster just seems a wee bit on the crazy side.

This article is not about the fact that statins suck at preventing heart disease. Because they do. Across the board statins pretty much lower your risk of having a heart attack by a paltry, sad 1%. High cholesterol, low cholesterol high CRP….doesn’t matter. One percent is the magic number. Your protection from heart disease will really not go above this level of protection.

Patients will respond by saying that the cholesterol drug he or she is taking lowered his or her cholesterol. Big deal. Do you REALLY care what your cholesterol is??? No. You just don’t want to have a heart attack or stroke. Well guess what—your cholesterol level dropping has very little to do with whether or not you are going to have a heart attack.

THAT is the big problem with statins. This delusional idea that artificially lowering your cholesterol with a drug (as opposed to lifestyle changes) will protect the heart is dangerous.

For those of you who would like to know more, I elaborate quite a bit in my Cholesterol Lowering eBook that can be found on Amazon by clicking here.

Back to this particular study. In it, researchers looked at the statin / diabetes link in greater detail. They looked at 4,645 patients who already had vascular disease but no diabetes. Of this group, 3,057 of them were taking statins at the beginning of the study, and 1,608 of these were on high-doses (intensive statin therapy–statin therapy theoretically lowering LDL cholesterol more than 40%).

Here’s what they found:

Statin use increased the risk of developing diabetes by 63%.
Those on intensive statin therapy had an even higher 22% risk of developing diabetes.
Here’s the shocker: the increase in risk had NO relationship to whether or not the statin user was already at risk for diabetes or not.
As a matter of fact, the greatest risk was in those patients who were LESS likely to on their way to diabetes (baseline glucose levels less than <120 mg/dl or 5.6 mmol/L).

Less just review this a second. People with elevated cholesterol are, in almost all cases, already on the way to developing diabetes. These patients are then put on drugs to lower cholesterol levels but do almost nothing to actually prevent a heart attack or stroke (which, BTW, is the main reason that diabetics leave this planet).

These drugs will then, paradoxically, further increase the risk of diabetes that the patient already had.

But, if you’re one of the luckier ones who was NOT on your way to diabetes but had high cholesterol, the drug you are put on will now pretty much ensure that you ARE on your way to diabetes.

Umm…am I the only one who seems to think this is a problem? Especially considering that the new ACC/AHA guidelines will drastically increase the number of patients who will be given prescriptions for statins.

No wonder heart disease is still the #1 killer in the industrialized world.

Cholesterol Lowering Drugs & Your Good Cholesterol–Bad News

February 20, 2015 by James Bogash

Despite all the less-than-stellar research on cholesterol lowering drugs, the powers-that-be want us to take even more of it.

The latest “cholesterol guidelines” released late in 2013 have drastically increased the number of patients who would potentially be given a statin. They have finally dropped the fallacy that total cholesterol has any value (you know–total cholesterol–that lab value that you were taught to pay attention to so doctors would know when to put you on a cholesterol lowering medication..) and basically state that you should be given a statin if your doctor THINKS you might be at risk for a heart attack.

I have certainly been a vocal opponent of the statin class of drugs because the numbers just don’t make any sense. Treat 1,000 people for 5 years to prevent 11 heart attacks (instead of 22 people who would’ve had heart attackes without the drugs), while at the same time causing diabetes in 8 more. A net gain of 3. Out of a thousand. In 5 years.

That just sucks in my book.

And “they” think we should use it more on more patients. None of this takes into account the very long list of side effects from this class of drugs (other then the already mentioned increased risk of diabetes).

And, as we treat more and more patients with cholesterol lowering drugs, the amount of people experiencing side effects is just going to skyrocket. But at least they are not going to have a heart attack because of the statin drugs.

Right?

I guess that all depends.

This particular study looks at one of those little-known secrets about drugs to lower cholesterol. While they all lower cholesterol levels (for whatever that is worth), in some individuals the drugs also lower HDL (the “good”) cholesterol. This is generally not a good thing. Specifically, researchers looked at 724 patients who had just started treatment with statins after having a heart attack and followed for 6 to 9 months.

Eighty-six percent (620) of these patients had his or her HDL-C level increase during the course of the study, while 14% (104) of patients had his or her HDL cholesterol go down. Here’s what the researchers found when they looked closer at the group that had HDL levels drop:

Both groups had their LDL cholesterol levels drop below 100 mg/dl.
Adverse cardiovascular events (including death from all causes, heart attacks and stroke) happened more frequently in the decreased HDL group.
To be precise, this lower HDL group had these events at over TWICE the rate (15.4% vs 7.1%).
Overall, those who had lowered HDL as a result of the statin drugs (to protect the heart, I might add) were 95% more likely to have a cardiac event.

Let’s get this straight. A drug given to lower cholesterol levels actually lowered good cholesterol levels in 14% of those patients taking them. In this 14%, they were 95% MORE likely to have a cardiac event??

THIS is the wonder drug that seemingly all of medicine is hanging their hats on to save the world from heart disease? I‘ll take lifestyle changes, thank you.

Diabetes and Drugs to Lower Cholesterol

February 15, 2015 by James Bogash

DO THE DRUGS THAT LOWER CHOLESTEROL ACTUALLY MAKE THE CONDITION WORSE?

It is a sad state that most cases of elevated cholesterol are actually due to being pre-diabetic. How do we know? Look for lowered HDL and elevated triglycerides. Clear sign. So, enter mainstream medicine and respond with knee-jerk reaction. Give statins. Numbers look better. Doctor is very happy. Patient is deluded into thinking everything is OK. Numbers great, no need for lifestyle changes. Everyone’s happy. Including the OTHER drug company that makes diabetic drugs, because more evidence is mounting that statins INCREASE THE RISK OF DIABETES, WHICH IS WHAT WAS WRONG IN THE FIRST PLACE!!!!!!! UGH!!! This, more than anything, is one of the most frustrating “fixes” in mainstream medicine to me. And stay tuned for the next update, which finally begins to admit that statins do nothing to protect against that first heart attack..