Right or Wrong?

You said:
“When two physicians give you two different answers to the same question, one of them is right and one of them is wrong. In these situations, what do you do? Blindly accept the advice of one or the other?”
Only two doctors? Only two opinions? And are you sure either is right?
I tend to have severe side-effects to many medications, and I usually stop taking them very quickly. Then, my doctors typically ignore my complaints, and they call me non-compliant, at which point I look for another doctor.
Interestingly, after a long series of different doctors, I’ve noticed that each doctor can look at the same lab results and come up with entirely different diagnoses and prescriptions.
They can’t all be right.
But they dan sure can all be wrong.

Hello all,
I think part of the problem is not asking the correct questions. Instead of judging the bodies actions in raising blood cholesterol or its transporters, why not ask why the underlying process is taking place? Maybe that person is needing more cholesterol in their cell membranes due to oxidative or other types of damage. I have read this increase occurs naturally with age and that people who artificially or naturally have low cholesterol levels are in higher mortality groups (Ravnskoff and/or Masterjohn I think).
Another is blood pressure. As people age, arteries get stiffer over time. When trying to push a liquid (blood) through a less pliable tube, the heart needs to exert greater pumping pressure to deliver the blood to all parts of the body. Pathologically high BP? In my opinion it is just the body adapting to its current physiological status. Are all BP meds bad? I don’t believe so. When writing an Rx, are all the right questions asked or all causes considered, I don’t believe so.
In health
Brandon Schultz,D.C.

First, there is no need to lower cholesterol almost no matter what your level is. It is a false risk factor. The evidence that high cholesterol is a sign of heart disease is weak at best.
Who are statins good for? Research indicates a small group of men who have already had an event. Who are they bad for? Everyone who takes them.
Women derive ZERO benefit. Show me the research where it indicates the opposite. And no – observational studies don’t count. Let’s not forget HRT – all based on ob studies.
My mother in law is FAR FAR better off without statins in her life. She is already experiencing muscle weakness and liver # issues. At 78 muscle weakness is a BAD thing.
Statins do not protect people from CVD. That is the bottom line. They never have.
http://www.westonaprice.org/moderndiseases/statin.html
I think it would behoove you to read The Great Cholesterol Con by Malcolm Kendrick MD. If you like that book, you’ll go searching for others. Visit http://www.thincs.org as well.
Thanks for reading my blog.

You sound angry – and you are terribly misinformed. One doctor? Did you go to http://www.thincs.org? Please do so before commenting back.

Forget it.. I’ll baby you.
http://stmarysresident.org/NEJM%202004%20350(15).pdf
That’s the link to;
Cannon, C.P. et al. 2004.,
Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes,
The NewEngland Journal of Medicine,
Vol 350, No 215, p.1495-1504
That particular article has been cited 1452x in 5 years. For pretty much any article that’s absolutely unprescidented. It points to how well the work was done, and how impactful it was.
How well cited is your friend’s book?
You’ll also notice that Cannon, C.P. et al. 2004 has 7 M.D’s, 2 Phd’s, and one MD/Phd authors.

Sorry.. you believe you don’t do super slow. You call it ’slow burn’ right?
My bad.. they are so clearly different techniques of working out with the purpose of developing feeble lifters who blame genetics for their weakness.

1. Your club has zero publications. At best the ‘members’ can claim publications of their own, but to say the publications are a part of that club is a stretch.
They do however have dozens of unpublished letters and articles. Gee.. I wonder what that could mean?
2. You asked for scientific evidence and not self reporting.
Let me quote;
“Show me the research where it indicates the opposite. And no – observational studies don’t count.”
I have.. with a single 11 page article which has been cited ~1450x by other researchers that have also been published in peer reviewed journals.
You have yet to comment at all about this excellent article explaining how somehow your totally unpublished club trumps it, or the reserchers who cited Cannon, C.P. et al. 2004.

John,
Opposing views make for excellent discussion, so as a reader I appreciate your additions to Fred’s post. However, I don’t understand your rudeness?? You muddle your points by berating Fred without warrant. If your citation/points are strong, they’ll stand up. No need to behave like a child.
Joe

Fred,
That was an epic chutzpa if I have ever seen one.
Your whole original post is a claim that statins are not benificial. So if we are to play by your rules then I don’t have to prove anything, you do. But then we just keep playing hot potato.
Look, your first claim is that LDL and VLDL play no part in CHD.
That’s just flatly wrong.
Evidence:
Journal of the American Heart Association
Ehara, S. et al. 2001, 103;1955-1960
Elevated Levels of Oxidized Low Density Lipoprotein Show a Positive Relationship With the Severity of Acute Coronary Syndromes
You then say that since LDL and VLDL have nothing to do with CHD, therefore statins are bad because all their side effects are their only effects.
I only cited a single article showing the correlation between LDL/ox-LDL with CHD. I won’t cite any more until you go beyond the Dean Esmay approach of telling me to go to some totally unreviewed organization (Dean would suggest Adiposity 101) and read all their literature that is also totally unreviewed.
What that sort of suggestion translates to is; “I have nothing substantive to rebut you with.. therefore I will send you to a bottomless pit of unorganized, unreviewed literature in the hopes you never come back.”

John,
You’re not reading the research critically. You are merely reporting the abstracts.
And you are constructing straw man arguments. I said nothing about LDL and VLDL in this blog post.
DO you know what a VAP test is? Do you know the difference between the different LDL particles?
My blog was written to suggest that there are 2 sides to the statin story and not knowing all the players is a recipe for disaster.
Big money is made on statins – perhaps this influences the research? Are you aware who funds over 90% of the research on statins? Are you really that naive?
Read more. A lot more. Then come back. If you keep up the BS I’ll ban you.

Fred: “Big money is made on statins – perhaps this influences the research? Are you aware who funds over 90% of the research on statins? Are you really that naive?”
Are you kidding me? So you’re a conspiracy theorist too?
Everyone has their motivations. I do, you do. Mine just happen to have nothing to do with promoting statins. I work with cancer therapeutics in a university. Avoiding personal skewing motivation is the whole point of reading peer reviewed, proper scientific articles that have been referenced over and over (which is why I mentioned how many times each article I referenced was cited). If the articles I had cited were BS it would be abundantly clear by this point. All the articles that referenced them would point to that fact (unless you’re now trying to argue there are thousands of intertwined groups citing each other for some over arching Pharma conspiracy. If that’s the case.. god help the people who follow your advice.)
However, if you actually read these other articles that cite the ones I referenced you’ll see that they point to them because they make a point and not because they’re flawed.

Isn’t there a difference between demonizing LDL and oxidized LDL? Doesn’t the oxidized LDL go along with the larger picture of “oxidative stress” on the cellular makeup of the body, particularly the DNA? Isn’t this part of the whole idea of avoiding oxidizing and inflammatory foods such as grains and refined sugar and emphasizing fresh fruit and veggies and a grass-based meat intake? Isn’t that what is supported on this site?
Nasty post, sorry to see such exchanges.
In health
Brandon Schultz, D.C.

Hi Brandon,
The difference between LDL and ox-LDL is, like you’ve said, ox is the oxidized form. This has less to do with DNA damage as it has to do with arteriosclerotic plaques. When macrophages take up LDL or VLDL in the plaques (which are localized to arterial walls) they also oxidize the LDL. In the process the macrophages turn into foam cells, and in late stages of arteriosclerosis rupture the plaque. This, in many cases results in a stroke. Not exactly something you want.
So the purpose of statins, which inhibit an enzyme that feeds into cholesterol biosynthesis (HMG-CoA Reductase), is to reduce cholesterol amounts, which will reduce LDL and VLDL levels, and the associated bad effects of them on coronary health.
Regarding your concerns of publications having alternative motives; Authors are absolutely required in reputable journals to completely disclose competing interests (ie. trademarks, patents, enterprise motives). This will appear at the very beginning, or in many cases at the end of an article after the conclusion and it will take the simple form of “The authors disclose competing interests.” You can also get this information from the disclosure of where the fundings that support the research came from.
However, what Fred has done here has just said ‘do you know who funds 90% of the research?’ and accused me of being naive without showing me where the competing interests in ANY of my articles are.

Hi John,
Thank you for the reply. I have read articles pointing to the role of a chronic imbalance of omega3:6 ratio, which deposits excessive omega 6 (and 3 and some saturated fat) into the walls of the arteries, not directly into the lumen, and these deposits cause a disruption of the arterial lumen, thus attracting cholesterol and other cells forming plaques within the lumen. This would seem to imply the real cause is chronic overconsumption of omega 6 oils, thus setting the stage for plaque buildup, oxidation, etc. What is your take?
Also, which is just my speculation, when people consume large amounts of omega 3s to offset this imbalance, they are also consuming more antioxidants (such as vit. e, c, rosemary oil, etc.) found in the oils. Would this be part of the reason why people are seeing benefits from fish oil (omega 3) supplementation in heart health? Could the combination of a healthier omega3:6 and a higher consumption of antioxidants help decrease this oxidized LDL formation?
In health
Brandon Schultz, D.C.

I think what I’ll do is an entire blog dedicated to the misunderstanding, misuse and misapplications of statins as well as their benefits and their dangers just for our polite friend John.
Brandon, John is a hot head. He reads my posts in an attempt to find fault, not to understand. Clearly this is the case given his many almost instant responses.
You are correct – if a company creates a drug and funds the research, that is a conflict of interest and you have to take the results with several grains of salt.
John is painfully naive WRT the research on statins. He reads abstracts, not the actual studies and if he does, he does not read them critically.
John you said:
“If the articles I had cited were BS it would be abundantly clear by this point. All the articles that referenced them would point to that fact.”
Not necessarily.
I mentioned the adherer effect before. Here is a piece by Dr. Eades on the adherer effect which you probably won’t read (but at least I tried):
http://www.proteinpower.com/drmike/statins/more-statin-madness/
From the study mentioned in the aforementioned blog post:
“A pooled analysis of 8 randomized trials in primary prevention populations showed that statins did not reduce overall mortality, indicating that lipid-lowering therapy with statins should not be prescribed for true primary prevention in women of any age or in men older than 69 years.”
And while your at it, take a look at this abstract:
http://content.nejm.org/cgi/content/abstract/303/18/1038
And this:
http://www.proteinpower.com/drmike/cardiovascular-disease/1853/#more-1853
These I hope will help you John to evaluate whether or not you are reading the statin literature critically enough.
As for this statement:
“My bad.. they are so clearly different techniques of working out with the purpose of developing feeble lifters who blame genetics for their weakness.”
Though this comment is childish and rude, I’ll address it for the benefit of others. Genetics are responsible for many aspects of physical prowess. If it wasn’t you and I could train and become as fast as the fastest men in the world, as strong as the strongest and as muscular and the most muscular. We can’t.
However, we can ALL become strongER, fastER and more muscular by training. Training using heavy weights (for the individual) and using proper form and a slow and controlled repetition tempo will create great strength and added muscle IF you eat right, sleep right, etc.
I have a picture of what this type of training has done for me here:
http://seriousstrength.yuku.com/topic/1267?page=2

The time it would take me to answer the entirety of your last post is not worth my time. You are not reading what I am saying critically. You’re just spouting – fuming more like it. I’ll at least address a few points:
You said:
“So Dr. Mike is trying to argue that ‘adherers’ (whatever that means)…”
You don’t know what the word ‘adherer’ means? C’mon. He explains it quite thoroughly in the blog post. “People who take their medications religiously…” Perhaps you need to actually read the entire post. Clearly you didn’t.
Read closely and slowly: There is no research proving that statins, by lowering LDL cholesterol alone, improve CVD health leading to less CVD events. None whatsoever. The study you cited that has been cited 1500 times or so does not indicate that if your cholesterol is elevated, taking a statin will decrease the chance that you will have a CVD event. They DO seem to protect a very small group of men (although at a cost in side effects), and the evidence is good that they extend the life of certain men who take them typically men at high risk who have had a CV event.
The issue is HOW they protect some men from CVD. Do they do it by lowering cholesterol or LDL or do they do it via mechanisms that are identical to restricting carbs (without the added side effects) by lowering VLDL and so LDL and triglycerides, raising HDL, maybe selectively removing small dense LDL or lowering the total number of LDL particles, reducing inflammation, etc.
If a statin reduces your total cholesterol, because cholesterol is considered a risk factor, you now have a lower risk.
But a high cholesterol level isn’t a risk factor at all. There is no science indicating such which all of the books I mentioned (which you haven’t read and more than likely won’t read) discuss – all of which are heavily referenced.
Statins it is now believed lower inflammation and it is this aspect of statins that appears to be beneficial – in men who have already had a CVD event and in no one else. It has nothing to do with cholesterol levels as fully half of the people in this country who experience a CVD event have normal cholesterol numbers. And there are many other ways to decrease inflammation than by taking liver damaging, muscle wasting drugs that cost a small fortune.
You also said:
“You (Fred) and Dr. Mike are not at all empowering anyone by your Stick it to The Man mentality.”
You are quite wrong about that. The dozen or more people I have convinced to flush their statins down the toilet and adopt a low carb diet have all markedly improved their blood profiles and lost their muscle pain and weakness. For Mike it is probably exponentially more.
And:
“Seriously man.. the ONE citation that kinda, sorta looked like a decent thing to read wasn’t even the same drug class that we are discussing here. Now who needs to read more literature? And by literature I don’t mean Muscle Magazines, or http://www.proteinpower.com.”
The point of adding that citation was not to discuss statins. But again you sidestep the point. Interesting how you side-stepped this:
“A pooled analysis of 8 randomized trials in primary prevention populations showed that statins did not reduce overall mortality, indicating that lipid-lowering therapy with statins should not be prescribed for true primary prevention in women of any age or in men older than 69 years.”
I said:
“…if the doctor bothered to read a smattering of the scientific literature on cholesterol and women, she would know that statins are useless and cause everyone who takes them liver and neuromuscular harm.”
This was the crux of my blog and I am correct. They are useless in women and cause everyone who tkaes them harm.

Again Fred.. YOU seem to miss the point that patient compliance with a drug regime is not anything new, and it is not limited to statins. Neither you, nor Dr. Mike have shown how some innate quality of what you term ‘adherers’ lets them live longer, and how this innate quality has nothing to do with the use of statins.
Again, you simply quote OPINION.

Look.. I’ll walk you through the whole process of how statins work;
They’re a class of molecules that interact with the enzyme named HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase (HMGCoAR). Their action on this enzyme is to inhibit it’s function. What HMGCoAR does is catalyze a single step in the biosynthesis of isoprene units. Isoprenes are then used to synthesize a whole wack of compounds like fatty acids, cholesterol, hormones etc.
The mechanism of statin inhibition of HMGCoAR is well documented. A fantastic article published in Science on this topic is;
Science 11 May 2001:
Vol. 292. no. 5519, pp. 1160 – 1164
Structural Mechanism for Statin Inhibition of HMG-CoA Reductase
Eva S. Istvan, Johann Deisenhofer
I assure you I have read this article. It’s only 4 pages and it’s absolutely fascinating.
Now that the ‘where do statins act?’ question is answered, the next question is ‘do they act?’ As in, do they decrease cholesterol, LDL and VLDL proteins. Do they improve cardiovascular health? This is where we are butting heads. You believe they don’t act in vivo even though much of the scientific literature would beg to differ.
For example;
Jan 2006, n engl j med, 352;1
Statin Therapy, LDL Cholesterol,
C-Reactive Protein, and Coronary Artery Disease
Nissen, S., et al.
That whole article was dedicated to measuring the effects of statins on a number of blood serum components including cholesterol, LDL, triglicerides etc. It also discussed other effects related to arterial health. So clearly statins work in vivo.
Now the question is ’so what? what’s the consequence on people’s health?’ I believe this question was answered with my first citation that had been referenced over 1400x. Statins prolonged peoples lives who were at risk of CHD. To suggest that statins do nothing, and it’s rather a function of a person’s ‘adherence’ predisposition is to pull the blinders down and plug your ears. If it were merely an innate predisposition that is protecting groups from CHD then it’s an amazing coincidence that these predisposed people happen to fall in statin test groups over and over again.
If you want to argue that patient compliance with drug regiments will make the whole issue moot, then why bother advocating anything. Compliance is never 100%. The point is to improve people’s health status. Statins do that for many people.
Look.. the bottom line is you are basing your opinion on what and Dr. Mike says, and he doesn’t even know what to think about statins. In a single article he will claim that statin’s do nothing;
Dr. Mike: “… those who stuck with them are adherers and have what ever quality it is that adherers have that makes them live longer. And, if this is the case in this study as in the others, the statins don’t really do anything at all.”
While 3 sentences later admit they reduce LDL proteins, and mortality!;
Dr. Mike: “What they’re saying here is that statins have been shown to reduce mortality from heart disease in those who have elevated LDL, which is true.”
Dr. Mike also admits 2 sentences later that Statins do in fact help prevent Heart Disease. Hey! But since you’re going to die of cancer down the road it’s a moot point (something I’ve strongly disagreed with. Extending someone’s life is never moot).
Dr. Mike: “But this decrease in deaths from heart disease is compensated for by an increase in deaths from cancer and other causes, so there really isn’t a gain. You’re still dead. Just maybe not from heart disease, but what difference does it make. Are you going to spend $200 per month for the rest of your life and stay on medications that may make you feel lousy and lose your memory just so you can die of something other than heart disease?”
So you’re the one who suggested being the ‘gumshoe.’ It’s time to do some ‘gumshoe’n’ of your own and stop plaigarizing the opinions of a confused person who tries to pass himself off as a doctor.

Cite a peer reviewed research article and I’ll read it.
I’m not side stepping anything. You’re putting out a quote that could be completely out of context.
Here.. I’ll give you some homework;
1. CITE exactly where these quotes are coming from.
2. READ the articles I have cited and criticize them or provide adequate rebuttal as to why they are not valid.
3. stop wasting my time with out of context quotes that don’t deal with the issue at hand.. which is STATINS have been well established to have a biological function in lowering cholesterol, LDL, VLDL, triglicerides and have a protective effect against CHD.

It is you who are confused, rude and angry. You are not worth my time. Enjoy living with your ignorance.

I didn’t delete your last post John. Why would I? I’ve answered you each and every time. Maybe you didn’t type in the security code before hitting enter? I have no idea.
You said:
“Secondly I’m glad you couldn’t even be bothered to cite where you obtained this quote you keep throwing at me. That alone makes it abundantly clear that you make it a habit to plagiarize people’s work, pervert it for your own purpose, and completely ignore it’s context.”
Do you know what the word plagiarize means? I think not since you didn’t know what the word adherer meant either. To plagiarize is to pass of someone elses work as your own. I clearly indicated that the info I pasted was from Dr. Eades blog and you clearly knew that using his name many time in your posts.
Given that you don’t know the meaning of basic words in the English language, I diubt you are who you say you are and simply cut and paste the information on statins in your post from Wiki or some other site. That’s plagiarism.
Yes, you’ve asked for the citation many times. To not embarrass you I stayed silent. The paper it was cited from was at the top of the blogpost from Dr. Eades in full-blown view. In the first paragraph there is a link to the abstract
http://archinte.ama-assn.org/cgi/content/abstract/169/3/260
You never read the post did you? Here it is again. You’ll see the study right in front of your face:
http://www.proteinpower.com/drmike/statins/more-statin-madness/
And this snippet from the post is what supports my position. It’s not Dr. Eades opinion – it is what’s so about the study and statins. If you could read critically rather than accept the conclusions of the researchers you’d understand that:
“First, the study authors admit that there is no gold standard, randomized controlled study data showing that statins are of benefit in preventing death except for one group of people (and they even get that wrong).
The beneficial effects on cardiovascular mortality of treatment with statins to decrease levels of low-density lipoprotein cholesterol (LDL-C) have been established in several long-term, placebo-controlled trials.
The value of primary prevention with statin therapy in the reduction of overall mortality has recently been questioned.
A pooled analysis of 8 randomized trials in primary prevention populations showed that statins did not reduce overall mortality, indicating that lipid-lowering therapy with statins should not be prescribed for true primary prevention in women of any age or in men older than 69 years.
What they’re saying here is that statins have been shown to reduce mortality from heart disease in those who have elevated LDL, which is true. But this decrease in deaths from heart disease is compensated for by an increase in deaths from cancer and other causes, so there really isn’t a gain. You’re still dead. Just maybe not from heart disease, but what difference does it make. Are you going to spend $200 per month for the rest of your life and stay on medications that may make you feel lousy and lose your memory just so you can die of something other than heart disease?
In the last paragraph in the quote above, the authors confess that the data from actual randomized control trials show that statins confer no all-cause mortality benefits to women of any age and to men over 69. They are playing a little fast and loose with the truth here because as I have posted before, the gold standard trials have shown no benefit for women and no benefit to men over 65 or to men under 65 who have never had heart disease.”
And this study is an observational study. Ob studies cannot and do not prove casue and effect. Association does not equal causation. From the blog:
“Don’t fall for the false promise of this or any other version of an observational study. These kinds of studies do not prove causality. Nor do they prove that a drug regimen works. The patients in this study who religiously took their statins had better all-cause mortality than those who didn’t. But, as we saw above, adherers always have better all-cause mortality than non-adherers. In this case, was it that the adherers lived longer or was it that statins conferred some sort of benefit. We can’t tell. But we do know that in the real studies, the randomized control trials, statins didn’t do squat, so my vote would be that what we’re seeing here is an adherer effect and not a statin effect.
My advice is to continue to regard statins with a jaundiced eye. So far, we haven’t seen any evidence that justifies the expense and the side effects of these drugs.”
Mike Eades is considered to be one of the most brilliant doctors in his field. You bash him without knowing that and this proves you are completely out of touch with the field. Before you go around insulting people and bashing them perhaps you should know something about them, no?
And I’ve published 2 books. You?

FYI.. Books aren’t necessarily peer reviewed, or reflect any sort of honest/objective representation of whatever field they aim to address.
For example the Atkins diet solutions. You moan about statins being bad for people. Atkins is by far the worst fad diet. Oddly enough your buddy Dr. Mike ripped it off, gave it a new name and you call him ‘brilliant’. Hell he couldn’t even come up with a cool new catch term. He even stole ‘metabolic advantage’ as a coin phrase.

Wasn’t there a study within the last year showing long term comparison of low-carb(Atkins-like), Mediterranean and low fat diets and found the low-carb showing positive health indicators (overall lipoprotein profile, weight loss and others), and even being superior to the other two types of diets?
Why is Atkins the “worst fad diet”? The act of telling people to eliminate useless calories in the form of simple sugars and overly starch-dense foods is seen as bad does not make sense to me.
As Fred mentioned earlier, isn’t there studies showing a lower carb intake improve blood lipid profiles in the same manner that statin drug intake purports to help decrease overall death and further CVD incidents?
In health
Brandon Schultz, D.C.

Also, in terms of judgements in libel cases they go to determine the worth of an individual’s reputation. Just googling Dr. Mike Eades name will yield a number of negative reports on his work, his publications, his interpretations of scientific literature and of course his diets. The 3rd hit (1st non-proteinpower.com hit) is a 100% negative critique of Dr. Mike.
Libel judgements also determine what damage was done to the person’s reputation as to assign value. I hardly think my statements, in the comment section of your site (even if determined to be libel.. I contend they are not since I believe them to be true and could defend them as they’re personal opinion) would hardly expose Dr. Mike to any actual harm to his reputation. Before I showed up here 2 days ago nobody had commented on this thread for almost a week. And since I came here it’s been mainly you and me with occasionally Mr. Shultz.
So flatly, if you think what I’ve done is libel.. then so has;
http://www.anthonycolpo.com/Eades_Admits_Anthony_Colpo_Was_Right_On_Calories.html

Anyway Fred I’ll stop taking up your space here. While I’m sure you don’t agree, it’s been good discussing statins with you. I know I come across as being a complete dick (trust me it’s just the media.. hah.. not the person). I know a little more today than I did 2 days ago because I had to go re-read articles I haven’t looked at since undergrad, and I have read some newer ones (and yes.. including the ones you have suggested.. just not the books.. I dont have time to read 400 page books right now).
Regarding the Dr. Mike stuff, if you truely think anything is libel, or close to libel then just delete it. This is your blog after all and you have control over it. I can’t even edit any of my posts which I can clearly see have spelling errors and grammatical errors.
Anything I have posted is my personal opinion, and since I am hardly an authority on the topic of dieting (particularly highprotein diets… I simply eat well.. exercise etc..) my opinion should be taken with a grain of salt.
cheers