Medications and debate about Statins and Cholesterol
More about medications and alternatives
Basically, take them or not?
If I only had T2 diabetes I would be very comfortable with where I am, despite a badgering from both GP and nurse to take Metformin and a statin. But I have P.A.D. too which is where the waters are muddied rather.
Regarding T2 initially........
Metformin is only one of a number of drugs that help treat T2 diabetes, but it is the most common.
It works in a number of ways: by helping diabetics respond better to their own insulin, lower the amount of sugar created by the liver, and decreasing the amount of sugar absorbed by the intestines. It is recommended for use in conjunction with exercise.
Sounds good.
BUT, it can cause side-effects. These include lactic acidosis (which can be very serious) diarrhoea, nausea and upset stomach.
Metformin is taken by many, many people and it can definitely help in many cases.
Some people take it long term, others initially, then find they can come off it when life-style changes start to improve their condition – in other words when blood sugars are stabilized.
Many T2s take Metformin, most without side-effects, and it can literally be a life-saver.
Professional medical advice required with this. (It's only available on prescription anyway I believe).
As I have said previously, it's not a one-solution fix for everyone.
Metformin is a good drug and helps lots of people.
Statins are another thing altogether.
A statin is prescribed to help reduce cholesterol.
Cholesterol, particularly in diabetics, is believed to increase the risk of complications, including CVD, Cardio Vascular Disease.
BUT, once again statins have well-documented side-effects, here's plenty of them, some very unpleasant and occasionally irreversible.
One known side-effect is T2 diabetes!
Others include muscle pain or damage, liver damage, neurological damage.
BUT, many people take them without side-effects.
I've decided to stay off then for now.
Statins are a multi-billion pound industry.
Millions of people take them - And they do benefit some people - I'll explain later.
They are aggressively marketed in America, and elsewhere, and this marketing appears to 'benefit' from some very spurious statistics.
'Big Pharma' as the huge pharmaceutical companies are known make eye-watering profits so it's in their interests to sell as many as possible.
The cynic may say it pays to keep people sick.
Some medics are furious that statins are so aggressively promoted and so widely prescribed on the back of apparently limited benefits. And they are prepared to stand up and say so.
Conversely some doctors swear by them, particularly cardiologists and more particularly for patients who have already had one cardiac event and are aiming to prevent a second.
What is less easy to fathom out is whether Statins' greatest advocates have vested interests.
To give you on example of why some people are 'suspicious'........
…..just try and follow this!!
One advert for the statin Lipitor (otherwise known as Atorvastatin) says:
“Lipitor reduces the risk of heart attack by 36%”. (36% is written in BIG letters.)
(Lipitor funded a study and this resulting claim went on to make the company 100 billion dollars in revenue!)
Blimey, 36% that sounds bloody brilliant!
Till you look at how they actually arrive at that figure.
In the study they studied people with no history of cardio vascular disease.
Half were put on Lipitor and half on a placebo.
They results looked for people who DID NOT HAVE a coronary event.
There was a 1.1% difference.
98.1% of those on Lipitor didn't die – 97% of those on the placebo didn't die. 36% ?????
Bear in mid that the study was on men and women in the 50 – 75 year-old age range, probably the prime age range for heart trouble.
Look at those figures another way - 2% of people on Lipitor died, 3% on the placebo died.
The 2% / 3% figures were actually written on the advert itself - in small blue font on a blue background down at the bottom. Perhaps the lawyers suggested that!
Now, that's a mortality difference of only 1% - BUT at the same time a 36% difference!
3% to 2%. See what they did?!
Not fraudulent but spurious eh?
Imagine if your financial advisor made 2% one year and 3% the next.
Not great, but nevertheless they can claim to have done 36% (aprox.) better!
So, statins, it is claimed, reduce coronary deaths by whatever amount they want to fudge.
They do this, in people without a history of CHD, primarily by reducing cholesterol.
Now we come on to the next bit which is also subject to massive debate.
Is raised cholesterol truly bad for you?
No, says much of the new thinking, unless levels are very high indeed.
The fact is we need cholesterol, it is in every cell in our bodies, it helps digestion and helps us make various hormones. It also helps produce vital vitamin D. Plus it contains things that help bile digest fats in our food.
Put simply, we need it. Without it we're dead.
We have, as many people know, good and bad cholesterol, known as HDL and LDL, High density Lipoproteins and Low Density Lipoproteins, although neither of these are actually cholesterol at all!
These lipoproteins are the vessels (boats) that transport actual cholesterol around our bodies.
Cholesterol is an oily chemical that is non water-soluble, as such it won't absorb into our water-based blood – so it needs a transport system.
One interesting fact is that our bodies produce around 80% of our cholesterol (75% - 85% depending where you look), mainly in the liver.
Vis, only about 20% comes from what we eat.
To expand a bit, we've actually got VLDL, IDL, HDL, LDL and sLDL
The first letters stand respectively for: Very, Intermediate, High, Low, and small low.
We all 'know' LDL to be the evil one - don't we? But, I understand that the naughty one is actually sLDL. But even sLDL is not really bad, it's only when it gets glycated or oxidised that it can cause problems. This is partly because LDL normally only stays in the blood for a week or two before going back to the liver. Oxidized sLDL stays in the blood longer. In effect it's been corrupted and can no longer do it's job of distributing things we need around our bodies. Its also very small and can get into our artery walls.
Gets a bit complicated now so I'll back off.
Here are a three links that back up what I say and help explain things more fully.
These are just 4 of hundreds of videos, studies, articles etc. from all corners of the globe:
The Great Cholesterol Con (A book by Scottish doctor, Malcolm Kendrick)
Most of us have only ever heard of HDL and LDL, me too, but there is a lot more to it.
So why are we still continually told that high cholesterol is bad for us.
National guidlines, that's why. Many believe they will change, but it will take time for our super tanker to turn round again.
Meanwhile we may all be getting duff advice.
What is interesting, according to many studies that look at all-cause mortality in relation to cholesterol, is that high cholesterol actually appears to help you live longer while low cholesterol is linked with earlier mortality!
This the exact reverse of what most people believe and what we have been told for years and years.
So, if cholesterol isn't bad for us after all, there's no need to take a side-effect laden statin to counteract it!
Having said all that, I have a dilemma.
Despite the statement above, there does appear to be a good case for someone who either has already had a coronary event to help prevent a second, OR someone with arterial / vascular disease, to take a statin. That's me (I think).
Nobody understands why they help, it's not cholesterol based, but apparently they do.
What I have decided to do is wait until I get my results from the vascular surgeon before I make up my mind. Hopefully he will find time to talk and explain things to me. Can't wait!
But, it may well result in me having to start on statins.
Blimey!
Read on........So, how am I getting on so far?