Hippies and Pharma face off in cholesterol debate
I am up in arms about a new study being reported - which I initially heard on NPR this morning.
Huffington Post reports: People with low cholesterol and no big risk (emphasis added) for heart disease had dramatically lower rates of heart attacks, death and stroke if they took the cholesterol pill Crestor, a large study found.
But half of all heart attacks occur in people with normal or low cholesterol, so doctors have been testing other ways to predict who is at risk.
One is high-sensitivity C-reactive protein, or CRP for short. It is a measure of inflammation, which can mean clogged arteries as well as less serious problems, such as an infection or injury.
...and actually this idea of the "inflammation effect" is a phenomenon that hippies, natropaths and healthy foodists have been talking about for years now. If you had a granola mom that fed you fish oil and a low sugar diet, she may have been a part of this "you are what you eat" propaganda at the bottom of this all.
But in today's day and age - the hippies have gone high tech and are beginning to explain the chemistry behind it all.
Even the PhD's are slowly buying in... and promoted by Oprah
...funny how the idea becomes main stream out of concern for how the body looks when it ages. I find it curious that at this point the whole notion gets hooked to the mass marketing machine.
The Huffington post article continues...
Doctors said the study might lead as many as 7 million more Americans to consider taking cholesterol-lowering statin drugs, sold as Crestor, Lipitor, Zocor or in generic form.
-- Though the radio program I was first listening to that reported on this study mentioned specifically that the scientists involved were not sure if the generics will have the same effect. Crestor is the strongest statin drug on the market.
Should this notion of finding the cure before identifying the problem become a popular notion with the drug companies (as it often does)... the pharmaceutical companies stand to make a large sum of money just off the diagnostic kits to determine if you should take the drug in the first place. Doctors check CRP with a blood test that costs about $80 to have done.
Another point the radio program noted specifically, is that once you are on the drug, you would need to be on the drug for life.
Crestor costs $3.45 a day versus less than a dollar for generic drugs.
The HP artice notes.... Crestor gave clear benefit in the study, but so few heart attacks and deaths occurred among these low-risk people that treating everyone like them in the United States could cost up to $9 billion a year and prevent about 30,000 heart attacks, strokes or deaths, they calculate.
AstraZeneca (a pharmeceutical company) paid for the study, and Ridker (a cutting edge Harvard doctor that is credited for finding the link between inflammation response and heart attacks)and other authors have consulted for the company and other statin makers. (parenthetical notes added)
The scientists quoted on NPR also cautioned that the 2 year study does not indicate the possible long-term effects or side effects of this group of people taking the drug for a lifetime (20 years or more).
HP reports that this ground breaking study was initially supposed to last 5 years, but was stopped after they found that "those taking Crestor were faring better than others".
Doesn't that sound suspicious to anyone? This factiod was not mentioned on NPR - but I gather it was reported in HP to show just how effective, just how fast "what a panacea this is"... it sounds like a commercial.
And then in trying to sort this whole jumble out did not find much time to uncover a nicely documented source giving some very distinct possible reasons why for this abrupt halt-- in an article written and posted 4+ years ago (14 Jun 2004) -- some excerpts provided:
Tahoe City resident Doug Peterson developed slurred speech, balance problems and severe fatigue after three years on Lipitor--for two and a half years, he had no side effects at all.5
Taking statins for one year raised the risk of nerve damage by about 15 percent--about one case for every 2,200 patients. For those who took statins for two or more years, the additional risk rose to 26 percent.
In every study with rodents to date, statins have caused cancer.25 Why have we not seen such a dramatic correlation in human studies? Because cancer takes a long time to develop and most of the statin trials do not go on longer than two or three years. Still, in one trial, the CARE trial, breast cancer rates of those taking a statin went up 1500 percent.26 In the Heart Protection Study, non-melanoma skin cancer occurred in 243 patients treated with simvastatin compared with 202 cases in the control group.27
Manufacturers of statin drugs have recognized the fact that statins depress the immune system, an effect that can lead to cancer and infectious disease, recommending statin use for inflammatory arthritis and as an immune suppressor for transplant patients.28
According to the research of Dr. Golomb, nerve problems are a common side effect from statin use; patients who use statins for two or more years are at a four to 14-fold increased risk of developing idiopathic polyneuropathy compared to controls.11
She reports that in many cases, patients told her they had complained to their doctors about neurological problems, only to be assured that their symptoms could not be related to cholesterol-lowering medications.
The damage is often irreversible. People who take large doses for a long time may be left with permanent nerve damage, even after they stop taking the drug.
>>> I guess the bottom line is that you can't prove a causal connection if in the bigger studies you don't allow the symptoms to manifest.
The HP article notes "One concern": More people in the Crestor group saw blood-sugar levels rise or were newly diagnosed with diabetes.
According to the Weston A. Price Foundation website - it's easy to see the connection to this issue simply by looking at how cholesterol functions in the human body:
Statin drugs work by inhibiting this enzyme--hence the formal name of HMG-CoA reductase inhibitors. Herein lies the potential for numerous side effects, because statin drugs inhibit not just the production of cholesterol, but a whole family of intermediary substances, many if not all of which have important biochemical functions in their own right.
Finally, cholesterol is the precursor to all the hormones produced in the adrenal cortex including glucocorticoids, which regulate blood sugar levels, and mineralocorticoids, which regulate mineral balance. Corticoids are the cholesterol-based adrenal hormones that the body uses in response to stress of various types; it promotes healing and balances the tendency to inflammation. The adrenal cortex also produces sex hormones, including testosterone, estrogen and progesterone, out of cholesterol. Thus, low cholesterol--whether due to an innate error of metabolism or induced by cholesterol-lowering diets and drugs--can be expected to disrupt the production of adrenal hormones and lead to blood sugar problems, edema, mineral deficiencies, chronic inflammation, difficulty in healing, allergies, asthma, reduced libido, infertility and various reproductive problems.
More alarming is a suggestive long term trend:
Cholesterol is one of three end products in the mevalonate chain. The two others are ubiquinone and dilochol. Ubiquinone or Co-Enzyme Q10 is a critical cellular nutrient biosynthesized in the mitochondria. It plays a role in ATP production in the cells and functions as an electron carrier to cytochrome oxidase, our main respiratory enzyme. The heart requires high levels of Co-Q10. A form of Co-Q10 called ubiquinone is found in all cell membranes where it plays a role in maintaining membrane integrity so critical to nerve conduction and muscle integrity. Co-Q10 is also vital to the formation of elastin and collagen. Side effects of Co-Q10 deficiency include muscle wasting leading to weakness and severe back pain, heart failure (the heart is a muscle!), neuropathy and inflammation of the tendons and ligaments, often leading to rupture.
Deaths attributed to heart failure more than doubled from 1989 to 1997.13 (Statins were first given pre-market approval in 1987.) Interference with production of Co-Q10 by statin drugs is the most likely explanation. The heart is a muscle and it cannot work when deprived of Co-Q10.
Researchers in Hull, UK followed 114 heart failure patients for at least 12 months.16 Survival was 78 percent at 12 months and 56 percent at 36 months. They found that for every point of decrease in serum cholesterol, there was a 36 percent increase in the risk of death within 3 years.
The HP article briefly mentions -- Crestor also has the highest rate among statins of a rare but serious muscle problem, so there are probably safer and cheaper ways to get the same benefits, said Dr. Sidney Wolfe of the consumer group Public Citizen.
Researchers do not know whether the benefits seen in the study were due to reducing CRP or cholesterol, since Crestor did both.
Whether you believe Dr. Ridker or a doctor with naturopathic leanings -- the trend becoming evident seems to corroborate the findings of the Westin A. Price Foundation which purports that Hypercholesterolemia (or the health problems associated with "high cholesterol") is an invented disease.
My cynical marketing mind perceives that an incredible amount of money can be made creating drugs that only fix certain symptoms of a complex health problem for awhile until they create a new problem - that guess what? - takes more medicine to correct.
The HP closes with what sounds like a market research statement:
This study and two other government-sponsored ones reported on Sunday "provide the strongest evidence to date" for testing C-reactive protein, and adding it to traditional risk measures could identify millions more people who would benefit from treatment, Nabel's statement says.
U.S. Crestor prescriptions totaled $420 million in the third quarter of this year, up 23 percent from a year earlier. In the rest of the world, third quarter sales were $520 million, up 33 percent.
Sales have been rising even though two statins _ Zocor and Pravachol _ are now available in generic form.
I love Hippocrates
"Let food be your medicine!"
I really wish I knew how we could steer America towards preventative medicine - starting at the nutritional level. There's enough chemistry and research why momma was right all these years.
Eat "whole grains, fruits, vegetables and nuts"
Exercise 1/2 hour a day.
Realize that if you haven't done this for years you will most likely have to work to reverse a condition - but take each day as it comes, be encouraged by the progress you make and keep at it before it becomes something worse.
I've come to learn that you don't rely on the conventional doctors alone. They are the emergency patch up crew. Conventional medicine does not train in Hippocrates style nutrition concepts. Dieticians are more aligned with government standards of nutrition which are as much based on politics as they are based on after the fact research with limited traceability.
The risk assessment process for regulating food once served to allow the American people to keep goverment from impinging upon their food choices. Today, however, corporations have changed the landscape through both promoting reliance upon pharmacopia, but also by the industrialization of our food supply. Unfortunately the cheapest foods are no longer the "whole grains, fruits, vegetables and nuts" but the empty processed shells of them. Food may be cheaper - but it is cheaper in every sense of the word.
Accredited naturopathic doctors exist - who are schooled in science - not in hokum pokum, but they are not recognized as valid doctors by the government - nor are their prescriptions allowed as tax deductions in the same way pharmaceutical prescriptions are.
Every time I see some prescription medicine "craze" or hype on t.v. it makes me sad to think of what looms on the horizion as far as the health of the American people. Marketing and medicine do not belong together.
Re: "Let Food be Your Medicine"
I heard a great call-in talk show with Dr. Mark Hyman while I was on my commute yesterday. Dr. Hyman was talking a lot about inflammation as cause in illnesses--for instance as a cause behind autism. I found what he was saying really exciting with far-reaching implications. (The guy interviewing him, though, sometimes seemed to have an "attitude" toward the callers.)
Dr. Hyman is the editor of "Alternative Therapies in Health and Medicine" and the founder/director of the UltraWellness Center which is out in the western part of Massachusetts. And he's the author of The Ultramind Solution.
Here's an excerpt from a description of the book that gives a sense of his approach: "Conventional treatments don't help, or provide only slight benefit, because they just manage symptoms rather than deal with -- and heal -- the underlying problem....Our ancient genes interact with our environment to create systemic imbalances that affect our brains. Correct those imbalances -- most caused by nutritional deficiencies, allergens, infections, toxins, and stress -- and you can achieve optimum mental health without drugs or psychotherapy."
Among the things he talked about with people calling in were the role of wheat allergy in schizophrenia and the role of artificial colors (especially red dyes) in ADD/ADHD.
He drew a distinction with one caller who was calling in about depression between what he called "green medicine" and what he's proposing which he calls "functional medicine"--the woman was talking about St. John's Wort not having worked for her. And he was saying that replacing a drug with an herb isn't really an entirely holisitc approach. Genetics, lifestyle, diet, environment all have to be looked at--in depression, or in any symptom being treated (he also mentioned diabetes in this context--so it's not just about the effects on the brain--that just happened to be the focus of this program.) In fact one thing he talked about with someone calling in about cardiovascular health was that it is sugar more than fat that seems to be implicated in arterial health and that will affect not just the heart of course, but also the brain. He said that some doctors are beginning to refer to Alzheimers as Type 3 diabetes. And that sugar/insulin levels are implicated in dementia and depression.
Here's a link to the radio show: Vox Pop, Medical Monday.
Statins and Cholesterol
I had read an article in the paper today reporting the same findings of statin use in people with low cholesterol and low risk. A warning flag went up went I read that AstraZeneca funded the study. I didn't realize all these other things about Statin use--at the most basic, that once one started using you had to continue to use. The "make a drug to fix a symptom which creates a new problem which leads to another drug"--that's how a consumer culture approaches healthcare, right?
How do people who don't consume fish get omega 3 do you know? Is omega 3 found in nuts too, or is that just 6?
Omega 3 for vegetarians
To simplify the issue a tad - the focus of your fatty acid intake should be to balance the intake of Omega 3's to Omega 6 in the diet.
(Omega 9 is not considered an essential fatty acid, though known to have beneficial effects.)
Vegans and vegetarians are less likely to be deficient in Omega 3. Part of the reason is that animal foods and processed foods inhibit the conversion of Omega 3 to 6 fats in the body. Because of vegetable oils (such as sunflower and corn oils) used in processing goods we tend to have an greater amount of Omega 6 in the American diet. So if you can avoid processed foods you're already a step ahead.
But another reason vegetarians might have a better time of things, is that their diet is more likely to contain rich souces of Omega 3. Nuts & seeds (flax, walnuts, hemp, pumpkin), algae, olive oil, rapeseed (canola) oil, soy and green vegetables are all sources of Omega 3.
So - some nuts are better than others at supplying Omega 3.
Flax apparently is the most used vegetarian source for supplements.
Here are a couple of the articles I looked at if you want to review in more depth:
http://vegetariancuisine.suite101.com/article.cfm/vegetarian_omega3_sources
http://www.vegsoc.org/info/omega3.html
http://www.vegetarian-dha-epa.co.uk/
http://www.womentowomen.com/nutritionandweightloss/veganepadha.aspx
Beyond Statins
An article in the Health section of the paper today just backing up the idea that nutrition is a better option than taking drugs for lowering inflammation:
Blood vessel health beyond statins