LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

cholesterol

STATINS PRODUCE MORE HARM THAN GOOD

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It should come as no big shock that I am certainly not an advocate of the statin class of drugs to lower cholesterol.  There are many reasons why I am so vehemently opposed to the use of this drugs.  How could this be, when it cuts the risk of a cardiac event by 50%??

For primary prevention (meaning we are trying to prevent a first heart attack), in almost all studies I’ve read, regardless of what value you look at (cholesterol, hsCRP, LDL), a statin will cut the RELATIVE RISK down by 50%.  If you are a physician that does not understand research and take the drug company’s headline as gospel, this seems like a godsend.  Every patient walking through the door is going to get their blood pressure checked and get a prescription for a statin, thinking that you are doing wonders for your patients.

However, before we jump up and down in excitement, we need to understand relative vs absolute risk.  In most of the studies, the numbers are pretty consistent.  Treat 100 people for 3 years and, instead of 2 people having a heart attack, only 1 does.  The RELATIVE drop from 2 to 1 is a 50% reduction and sounds great.  But since the overall risk is pretty low in this population (typically referred to as a 10 yr risk), the absolute risk reduction is a paltry 1%.  This flat out sucks.

There are some lifestyle interventions or supplements that fall into the same category.  The relative risk reductions may appear more powerful than if you put it into absolute risk reductions.  Here’s the difference.  Statins are very expensive (although with the loss of the patent on Lipitor the prices will drop substantially) and have a long list of side effects.  Muscle damage (the damage is present even if someone taking statins does not have muscle pain).  Depletion of CoQ10.  Probably the greatest scare is the increased risk of diabetes.

But, the biggest, staring you right in the face, answer is that I have NEVER not had a patient bring their cholesterol levels in line with the right lifestyle choices.  This is and will always be the only appropriate way to handle lipid issues.  The vast majority of patients with lipid (total cholesterol, triglycerides, HDL, VLDL) problems are pre-diabetic.  So giving these patients a drug that will worsen the physiological state that is making the number off kilter is just plain bad medicine.

http://jama.ama-assn.org/content/305/24/2556.abstract

April 5, 2000 Research Update

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Here is yet another example of the poor quality of many nutritional products…

Among 25 major brands of supplements containing glucosamine and/or chondroitin used for treating osteoarthritis, nearly one third were found not to contain all labeled ingredients. These results were reported by ConsumerLab .com, which conducts the largest independent analysis of dietary supplements sold in the United States. More alarming, almost half (6 of 13) of the glucosamine-chondroitin combination products tested did not pass — all due to low chondroitin levels. Similarly, the 2 chondroitin-only products tested did not pass. In contrast, all 10 of the glucosamine-only products tested passed. One possible explanation for the low pass rate for chondroitin-containing products is economic — chondroitin costs manufacturers approximately 4 times as much as glucosamine.

A drug used for Crohn’s and Ulcerative colitis may be strong cause of birth defects when taken by the male. If only these parents knew that there are many non-pharmaceutical methods to handle these diseases.

Paternal use of 6-mercaptopurine shortly before conception may be linked to the development of “startling” congenital deformities, according to findings reported in the March issue of the American Journal of Gastroenterology.

New vaccine for pneumococcal disease, including ear infections. Now, before you go run out and get your little one vaccinated, consider how many drugs and vaccines are pulled off the market for safety reasons in their first few years. Let someone else be the guinea pigs..

A study published in the March issue of The Pediatric Infectious Disease Journal confirms that a newly approved vaccine is at least 90% effective in preventing invasive pneumococcal disease in young children. The study also shows that the vaccine, Prevnar, reduced common ear infections by 7%, multiple ear infections by 23%, and the need for ear tubes by 20%.

Major increases in asthma in our children. Could it be the poor diets? The poor quality air? The extensive use of antibiotics when they are not needed?

The prevalence of asthma-associated disability in US children has more than doubled since 1969, according to a report in the March issue of the Archives of Pediatric and Adolescent Medicine. They found that the prevalence of disabling asthma in children has risen 232% since 1969.

Or maybe it’s Tylenol use?? Thorax — Abstracts: Shaheen et al. 55 (4): 266

Yet another marker for heart disease that will go unnoticed for DECADES before someone decides it may be a good idea. Cholesterol levels is not becoming outdated, they ARE ALREADY outdated.

Our current study disclosed that RLP-C (remnant-like particle cholesterol) levels are strongly associated with coronary artery disease, especially in patients with normal total cholesterol levels. Moreover, RLP-C/HDL-C ratio may be even more significantly associated with the presence of coronary artery stenosis in normocholesterolemic patients. Am Heart J 139(2):305-310, 2000.

 

Research Update (April 2, 2000)

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Yogurt as a health food that can stimulate the immune system? There is very strong evidence that the probiotics in yogurt have numerous health effects. AJCN — Abstracts: Meydani and Ha 71 (4): 861

Soy can lower cholesterol. Not new news, but always nice to see further evidence backing it up. Watch out for the side effects, though: lower risk of breast cancer, endometrial cancer, prostate cancer, eases menopausal symptoms, may help with osteoporosis… AJCN — Abstracts: Normén et al. 71 (4): 908

Another study showing that whole grains can protect against diabetes. Won’t see this evidence from Dr. Atkins book… AJCN — Abstracts: Meyer et al. 71 (4): 921

Silica may prevent aluminum absorption, and aluminum has been linked to many health problems, including Alzheimer’s. AJCN — Abstracts: Jugdaohsingh et al. 71 (4): 944

Some people worry about the caffeine and tannins in tea effecting calcium absorption. My advice is usually not to worry about it because somehow things work out because nature somehow puts everything together right. Here’s evidence of tea protecting against osteoporosis. AJCN — Abstracts: Hegarty et al. 71 (4): 1003

This is scary…the incidence of diabetes is increasing in kids. The name “adult onset” has been dropped because too many kids are getting the disease. This is definately a result of kids eating such processed foods with no nutrition.

Diabetes Care 23(3):381-389, 2000 If the incidence and prevalence of type 2 diabetes in children are increasing and if this increase cannot be reversed, our society will face major challenges. That is, the burden of diabetes and its complications will affect many more individuals than currently anticipated, and the cost of diabetes to our society will cause us to consume enormous resources. Also, many more Americans will be taking potent medications, which have attendant risks, for most of their lives.

More bad news. It is becoming increasingly evident that the drugs commonly used to treat diabetes MAY ACTUALLY PROMOTE THE DISEASE. The reason? Certain drugs stimulate the pancreas to produce insulin (secretagogues), but it also produces a protein called amyloid, which can damage the pancreas itself. But don’t worry, they suggest using a relatively new drug called troglitazone (Rezulin).

South Med J 93(1): 24-28, 2000. We may wish to rethink our current methods of treating type 2 diabetes. We must ask whether we should allow this hyperinsulinemia/hyperamylinemia state to continue or even complicate matters by using insulin secretagogues, thus increasing endogenous insulin and amylin.

Oops… that new drug they’re recommending? The FDA pulled it because it has some strong links to liver failure… But never fear, nature to the rescue. Troglitazone is a PPAR agonist. So is congugated linoleic acid (CLA), an essential fatty acid with no side effects.

The diabetes drug troglitazone (Rezulin) was withdrawn from the market on Tuesday following a request from the US Food and Drug Administration (FDA). The drug, which lowers blood sugar in diabetics, has been linked to potentially life-threatening liver failure in some patients. An FDA spokesperson said that the drug has been linked to 63 deaths and 90 confirmed cases of liver failure. The drug has been on the US market since mid-1997, but soon after its launch, reports of liver failure emerged among patients taking the drug.

YOU KNOW YOUR CHOLESTEROL, BUT DO YOU KNOW THIS LEVEL?

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In today’s health environment, thanks to aggressive marketing by the pharmaceutical companies promoting the near godlike power of the statins to lower levels, most everyone knows where their cholesterol sits.  The reality is that total cholesterol, as a risk factor for heart attacks and cardiovascular mortality, is just short of worthless.  The more important value, however, is not known by most people.

Triglycerides have long been known to be a major player in heart disease risk.  The relationship between triglycerides and HDL (“good”) cholesterol is a key factor to look at in evaluating your risk.  Ideally, a ratio of 2:1 or less is desirable.  There are only a handful of patients I have seen where the triglycerides are close to or even lower than the HDL levels.

There reason these levels are so important is that they are driven by our relationship between our insulin and our cells (i.e. prediabetes).  Since prediabetes and diabetes absolutely destroy our cardiovascular system you can see why this ratio is so important.

This particular study further reinforces this, finding that non-fasting levels of triglycerides were the strongest predictor of total mortality.  While non-fasting cholesterol levels were associated with risk of heart attack, the risks of high non-fasting triglycerides were much more severe.   Levels above 443 (normal fasting values should be well under 150) increased the risk of heart attack by 420% and risk of death overall by 50%.  THIS is why you need to know your numbers.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2010.02333.x/abstract