Lessons from the 20-year statin experience

2. November 2011 William Davis (0)
Readers of the Heart Scan Blog know that, while I recognize that statins are useful in a small segment of the population with genetically-determined disorders, they are wildly overused, misused, and abused. In my view, the majority of people taking statins have no business doing so and could, in fact, obtain superior results by following some of the strategies advocated in these pages.

Nonetheless, the 30-year long statin experience has taught us some important lessons. Statin drugs have enjoyed more "research" than any other class of drugs ever conceived. They have received more media attention and embraced by more physicians than any other class of drugs. Combine these social phenomena and I believe that several lessons can be learned:

Tags :

Add comment

Loading
Are you using bogus supplements?

Are you using bogus supplements?

16. April 2006 William Davis (0)
I consider nutritional supplements an important, many times a critical,part of a coronary plaque control program.

But use the wrong brand or use it in the wrong way, and you can obtain no benefit. Occasionally, you can even suffer adverse effects.

Take coenzyme Q10, for instance. (Track Your Plaque Members: A full, in-depth Special Report on coenzyme Q10 will be on the website in the next couple of weeks.) Take the wrong brand to minimize the likelihood of statin-related muscle aches, and you may find taking Lipitor, Zocor, Crestor, etc. intolerable or impossible. However, take a 100 mg preparation from a trusted manufacturer in an oil-based capsule, and you are far more likely to avoid the inevitable muscle aches. (Though, of course, consult with your doctor, for all it's worth, if you develop muscle aches on any of these prescription agents.)

Unfortunately, you and I often don't truly know for a fact if a bottle from the shelf of a health food store or drugstore is accurately labeled, pure, free of contaminants, and efficacious.

One really great service for people serious about supplements is the www.consumerlab.com website. They are a membership website (with dues very reasonable) started by a physician interested in ensuring supplement quality. Consumer Lab tests nutritional supplements to determine whether it 1) contains what the label claims, and 2) is free of contamination. (I have no reason to pitch this or any other site; it's just a great service.) They recently found a supplement with Dr. Andrew Weil's name on it to have excess quantities of lead!

What Consumer Lab does not do is determine efficacy. In other words, they do a responsible job of reporting on what clinical studies have been performed to support the use of a specific supplement. However, true claims of efficacy of supplement X to treat symptom or disease Y can only come with FDA approval. Supplements rarely will be put through the financial rigors of this process.

If you're not a serious supplement user, but just need a reliable source, we've had good experiences with:

--GNC--the national chain
--Vitamin Shoppe--also a national chain
--www.lifeextension.com or www.lef.org--A great and low-priced source, but they do charge a $75 annual membership that comes with a subscription to their magazine, Life Extension (which I frequently write for) and several free supplements that you may or may not need. Again, I'm not pitching them; they are simply a good source.
--Solgar--a major manufacturer
--Vitamin World
--Nature's Bounty
--Sundown

There are many others, as well. Unfortunately, it's only the occasional manufacturer or distributor that permits unnacceptable contamination with lead or other poisons, or inaccurately labels their supplement (e.g., contains 1000 mg of glucosamine when it really contains 200 mg). I have not come across any manufacturer/distributor who has systemtically marketed uniformly bad products.
Tags :

Add comment

Loading
"Get regressive"

"Get regressive"

6. May 2009 William Davis (0)
This caught my eye:



Niaspan, prescription niacin, now sold by Abbott Laboratories, is now promoting its advantages in regressing coronary plaque:



In patients with a history of coronary artery disease (CAD) and hypercholesetgerolemia, Niaspan (niacin), in combination with a bile acid-binding resin, is indicated to slow progression or promote regression of atherosclerotic disease.



And the new slogan: "Get regressive."



Interestingly, the new marketing campaign is based on relatively old data. They base this new claim on 3 studies:



1) Cholesterol-Lowering Atherosclerosis Study (CLAS)--a 1987
Tags :

Add comment

Loading
Digging for the truth

Digging for the truth

15. July 2007 William Davis (9)
I remain continually amazed how difficult it can be to gain an understanding of what is true and what is not true. I am particularly worried about the messages provided by agencies that stand to make enormous gains by persuading us to believe their version of the "truth".

For a moment, let's strip away the charitable covers of some financially-motivated organizations and see what they really look like:


Hospitals: The dream of hospitals is to shift the proportion of patients towards those with the most profitable diseases in well-insured patients. Heart disease is among the best paying diseases. HOSPITALS WANT YOU TO HAVE HEART DISEASE.

Doctors: Many (though not all) want to deal with diseases that pay well. Implanting a stent can pay several thousand dollars. Putting in a defibrillator can likewise pay handsomely, even better than stents. DOCTORS WANT TO STEER YOU TOWARDS PROCEDURES THAT REIMBURSE GENEROUSLY. Talk is cheap and pays poorly. Heart scans? Useless, since they're cheap. CT angiography? Now we're talking! $1800 dollars is a lot more interesting than $200 or so for a simple heart scan. CT angiograms also lead to catheterization, stents, hospitalizations.

Drug manufacturers: The holy grail for drug manufacturers is a chronic condition that is present in large numbers of people. An antibiotic, for instance, is a drug manufacturers waste of time: Short courses of treatment in relatively few people. Cholesterol drugs, blood pressure drugs, drugs to modify personality or some aspect of behavior--these you take for years, decades, or a lifetime, and millions are persuaded they need them. DRUG COMPANIES WANT CHRONIC CONDITIONS (WHETHER OR NOT THEY'RE DISEASES) IN PEOPLE WHO SURVIVE FOR A LONG TIME, NOT SICK PEOPLE.

Supplement manufacturers: What don't we need in the eyes of sellers of nutritional supplement? While a program like Track Your Plaque makes liberal use of supplements in a focused and, I believe, rational way, supplement sellers want you to take dozens or preparations of dubious value: milk thistle, hawthorne, ribose, hoodia, silymarin, hydroxycitric acid . . . Unlike the larger ambitions and bigger money of the pharmaceutical industry, the supplement industry is often driven by the momentary craze and the quick payoff. THE SUPPLEMENT INDUSTRY IS LOOKING FOR SUCKERS.

Food manufacturers: The holy grail for the food industry are foods that have high markups, are convenient (e.g., eaten right out of the box or package), and are purchased repeatedly. Even better, if a health claim can be added, it can ride the current wave of the public's health consciousness. Thus, Cocoa Puffs can be labeled "Heart Healthy". How about foods that have addictive potential and virtually ensure repeat sales? Eat some and you want more within 2-4 hours! As nutritionist Marion Nestle says, the mantra of the foods industry is "Eat More". It is my firm conviction that the epidemic of obesity in the U.S. is not due to laziness, video games, and computers. It is the fault of food manufacturers. FOOD MANUFACTURERS WANT US FAT AND HUNGRY AND WANT US TO STAY THAT WAY. What pays better, a 110 lb vegetarian woman who shops at the farmer's market and buys locally produced foods, or the 260 lb glutenous and always-hungry woman who fills her supermarket shopping cart with 15 cents worth of flour and sugar priced at $4.59 (cleverly disguised as a healthy breakfast cereal), instant mixes, convenient meals, energy bars, and chips?

Government agencies: User fees for the FDA paid by drug companies have caused the FDA to be beholden to drug company pressures. The USDA, charged with crafting the food pyramid, was created to support the farm industry and distributors of their products, not to disseminate public health. The food pyramid is the watered down end result of food industry lobbying and threats, not the scientific advice of nutritionists. GOVERNMENT AGENCIES SERVE INDUSTRY FIRST, THE PUBLIC SECOND.

Health websites: Read popular websites like WebMD for information and the conversation quickly steers towards drugs. "Natural treatments for cholesterol" talks about reducing saturated fat and then gushes about the wonders of statin drugs. Guess where 80% of WebMD's revenues come from? Yup, the drug industry. The same goes for many magazines, TV shows, and other media. MEDIA IS OFTEN THE TOOL OF BIG INDUSTRY.



I'm sounding like a conspiracy theorist. I don't believe that I am, but I am skeptical of the messages we often receive from the media, advertisements, news reports, websites, etc. It's left to you and me to use our judgment and decide what is truth and what is someone's version of a message crafted towards their hidden agenda.

I am hoping that the real truth will grow through a wiki-like phenomena driven and supervised by a collective knowledge that we all contribute towards. That will happen, most likely, on the internet. Just as Wikipedia overtook the revered Encylopedia Britannica in the blink of an eye at far less cost yet with greater depth and equivalent accuracy, so will it happen in health information. I'm uncertain of the eventual form this health-wiki will take, but it will shatter many smug and deeply-entrenched powers that at present continue to profit from mis-information.
Tags :

Comments (9) -

  • JT

    7/15/2007 4:29:00 PM |

    Unfortunately you don't sound like a conspiracy theorist.  I even know of an example of a fortune 500 company receiving air time for one of their products by "respected" news agencies.  

    Back in the summer of 1999 or 00 one would have thought the supplement SAMe was the cure all for depression and arthritis.  Magazines Time, & Newsweek ran articles on it.  My memory isn't so good anymore but I believe one of them even placed SAMe on the front cover.  The nightly news NBC, CBS, and ABC all ran gushing reports on SAMe and its natural curing abilities.    

    I'd like to say that the news reporting was done because SAMe is truly a wonder supplement.  That is not the case.  It is a fine product I suppose but not the kind of product that deserves the enormous press coverage that it did.  The reason it received so much press is because the large multi national company asked them to do so.

  • Rich

    7/15/2007 9:41:00 PM |

    Dr. Davis, these comments are a huge inspiration.

    As a b-school prof, I know that pharma and hospitals are not intentionally exploitative, but the profit motive inexorably works its effects in all aspects of the decision process, and ethical standards are gradually stretched to the minimum limits of acceptability.

    I recently did a casual analysis of the ads in Reader's Digest. About 80% of the ads are for prescription drugs to treat lifestyle-inflicted illnesses, such as high BP, type 2 diabetes, and inability to sleep, as wells other highly questionable illnesses such as "restless leg syndrome, or RLS." Daytime TV is about the same. You may notice that the ads now say "talk to your prescriber" instead of "talk to your doctor" -- in other words, they don't care who prescribes it, only that it gets prescribed.

    THESE ADS ARE THE REVENUE SOURCES FOR THE MEDIA, WHICH MUST CATER TO THE ADVERTISERS IN ORDER TO STAY IN BUSINESS. PHARMA PAYS FOR THE RESEARCH IN UNIVERSITIES, AS WELL.

    People don't bite the hand that feeds them!

  • Dr. Davis

    7/16/2007 12:30:00 AM |

    Wow! I wasn't aware of that.

    Would you know who the company was?

  • Dr. Davis

    7/16/2007 12:36:00 AM |

    Rich--

    I had no idea that the proportion of pharmaceutical ads had grown to such an extraordinary number. The drug industry is not stupid--their direct-to-consumer advertising must be working in a big way.

  • JT

    7/16/2007 12:48:00 AM |

    Yeah, maybe I'm too cautious, but giving the companies name shouldn't be a problem in this case.  The SAMe pills were made by an Italian firm that had/has a contract with BASF.  (They could be a division of BASF.)  

    I was told by a BASF employee that their press department is very good and persuasive.  They wanted to create a buzz for the product.  70% of sales for health foods are generated on new products.  People like to rush out and try the new thing.

  • Anne

    7/17/2007 11:33:00 AM |

    Don't forget to include the "non-profits". Back in the 1950's my father, a physician, told me that the American Cancer Society did not really want to find a cure for cancer. From some of the things the American Heart Associaton promotes, I don't think they really want to stop heart disease.
    Anne

  • Dr. Davis

    7/17/2007 12:00:00 PM |

    I couldn't agree more.

  • Anonymous

    7/17/2007 5:42:00 PM |

    Thank goodness we have someone like you, Dr. Davis, who can help us sort through all these industries who are looking for "suckers".

  • Anonymous

    11/19/2008 3:07:00 AM |

    There is a very interesting 6 part documentary on youtube about marketing and the pharmaceutical industry. "Big Bucks, Big Pharma"
    Here is the link to part 6.

    http://www.youtube.com/watch?v=IVDTo8Rm1rE&feature=related

Add comment

Loading
Test your own thyroid

Test your own thyroid

7. September 2009 William Davis (15)
134 people responded to the latest Heart Scan Blog poll:


When I ask my doctor to test my thyroid, he/she:

Accommodates me without question 45 (33%)

Questions why, but orders the tests 49 (36%)

Refuses because you seem "healthy" 20 (14%)

Refuses without explanation 4 (2%)

Ridicules your request 16 (11%)



That's better than I anticipated: 69% of physicians complied with this small request. After all, you're not asking for major surgery. You're just asking for a very basic test, as basic as a blood count or electrolytes. 36% of respondents said that their doctor asked why, but still complied; this is simply practicing good medicine--If there is a problem, your doctor would like to know about it.

However, the remainder--31%--were refused in one way or another. Incredibly, 11% were ridiculed.

Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.

Let's say you're tired. Ever since last summer, you've suffered a gradual decline in energy.

So you ask your doctor to assess your thyroid. He refuses. "You're just fine! There's nothing wrong with you."

You disagree. In fact, you are quite convinced that there is something physically wrong. What do you do?

You could:

--Drink more coffee
--Exercise more in the hopes that it will snap you out of your lethargy
--Sleep more
--Take stimulants of various sorts

Or, you could get your thyroid assessed and settle the issue. But how can you get this done when your doctor won't accommodate you, even though you have perfectly fine health insurance and are simply interested in feeling better and preserving your health?

You could test your thyroid yourself. This is why we're making self-testing kits available. Test kits are available here.

This is yet another facet of the powerful revolution that is emerging: Self-directed health.
Tags :

Comments (15) -

  • Tom

    9/7/2009 2:47:55 PM |

    In addition to home kits we might create drop in health shops where healthy people are given a quick set of automated tests/scans and the results made available to them online.

  • Lincolnb

    9/7/2009 3:26:27 PM |

    This is a great tool as many of my clients mention their thyroids and wonder if there was a way to monitor it.  When will this be available in the UK?

  • Anna

    9/7/2009 4:11:56 PM |

    I'm not sure getting tested is as big of an issue as getting a proper diagnosis and treatment.  I know lots of women who have their their thyroids tested (at least minimally with a TSH) but the results are not properly interpreted or treated.   Usually they end up with anti-depressant meds or are told to eat less and exercise more (or both).

    My thyroid was tested for about ten years (mostly with just the TSH and total T4, not the full complement of thyroid tests) for more than ten years because of two infertility investigations and later, symptoms of fatigue, etc.  I didn't ask for these tests; they were routine as part of a panel or the doctor specified them.  

    My HMO network doctors failed to see that my TSH was slowly slowly rising in that decade because they only looked at the recent result and not the trend (and there was a faster rate of increase after 7-8 years of testing).  They also missed that my results  were always in the "upper end" of the reference range (in late 2002 at least two national medical boards said the upper range was suspicious of development of mild hypothyroidism and the range should be adjusted downward).  Last year when I brought these AACE and NACL recommendations to the attention of the local HMO network lab supervisor, he was unaware of of the new range recommendations and promised to look into it.  I was pleased to note the ref range was somewhat adjusted down a few months later.

    So for me, the lab tests were less an issue; I had numerous TSH and total T4 tests while my symptoms progressively increased, but with little good.  

    The biggest difficulty was getting a correct diagnosis and the proper treatment, instead of attempts to suppress symptoms with other meds (I felt in my gut this was the wrong approach and I mostly resisted it).  

    The best treatment I've tried to date has been desiccated thyroid hormone (I'm now taking 1 grain of Nature-throid daily); to get to this it took a full three years with a continual search to find a local doctor who would use and correctly interpret the right lab tests *and* take into account my symptoms.   I hear similar stories from other hypothyroid people.

  • Dr. William Davis

    9/7/2009 8:43:28 PM |

    Yes, absolutely correct, Anna. Getting tested is just the first step.

    Once tested, understanding what they mean is the next step. But at least you know where you start. It's certainly better than not having any data at all.

    Next hurdle: Getting treatment when you need it. A topic for future discussion!

    Lincolb--It is available in the U.K. by ordering.

  • Daddy

    9/7/2009 10:02:24 PM |

    I guess that's how CA and NY can justify putting restrictions on their sale.  Sheesh!  Reminds me of when CA was on the brink of criminalizing home-schooling.

  • Hot Cover Girls Central

    9/8/2009 1:28:17 AM |

    That's great! I will recommend that to my sister and friend who were always complaining that they might have thyroid problem.
    See yah!

    Cathy Young
    http://fashionhotcelebs.blogspot.com/

  • pooklaroux

    9/8/2009 3:18:20 PM |

    I have also been able to get my doctors to do TSH tests, but since my labs ate at the upper end of normal, they also pooh pooh my suggestion  that treating the thyroid might positively impact other issues they care about, like my cholesterol levels and my asthma.  But they would rather give me statins (which I refuse to take) and advair (which I take only because I have to be able to function.)  I think they have it in my notes that I am hypochondriac and uncompliant. So much for being proactive for my own health care! Now they think I am a nutcase!

  • Laura in Arizona

    9/8/2009 3:38:35 PM |

    I agree with Anna. My doc has routinely tested TSH for years. This past check up I told her I wanted more info on the thryoid because of my lack of energy and other symptoms. She ordered T3 and T4 along with TSH but nothing else. My TSH came in at 4.5 on a scale going to 4.5 which is a full point jump since my last test. My T3 is almost abnormal on the low end. However since they are within the lab's normal range, she says I am fine. I am making an appointment with doc #2 in my search for someone that knows what they are doing. I sure hope it does not take the 3 years to find him/her it took Anna!

  • Anna

    9/8/2009 4:06:54 PM |

    Laura,

    I'd also like to add that much of that 3 years looking for better care was also spent educating myself (I must have read every book available on hypothyroidism to get a sense of all the perspectives), so developed a sense of when to seek out another doctor's care and when to settle for "good enough for now".  

    For me, the hardest part was early on -  summoning the inner strength to get over my reluctance to find new care and thyroid hormone options.  I was acutely aware that my tactic might be viewed as "doctor-shopping" or hypochondria.   Each step wasn't always very far forward, but it was still progress in some way and far more therapeutic than stagnating (it didn't always feel like progress at the time, though).

    Good luck in your quest for better care and more thorough assessment of your thyroid function.  Be sure to get tested for anti-thyroid antibodies.

  • Anonymous

    9/8/2009 4:39:45 PM |

    Regular Doctors are always a crap shoot. If you don't mind switching Doctors, it is better to seek out a Doctor that you know will probably be receptive to alternative therapies right from the get go. Life Extension has a list of "Innovative Doctors" here:

    http://www.lef.org/Health-Wellness/InnovativeDoctors/

    Another good source for Doctors that would probably be receptive to taking a patients thyroid concerns more seriously can be found at the A4M site:

    http://www.worldhealth.net/pages/directory

    Likewise, if lipid disorders are your concern, you can find a Lipidologist at the following site:

    http://www.learnyourlipids.com/resources.php

    Hope this helps.

    John M.

  • kris

    9/8/2009 8:13:44 PM |

    here is the site to find thyroid hormones friendly doctors.
    http://www.armourthyroid.com/con_phLocator.aspx

    Dr Davis, I don't think that you are on there? LOL

  • Dennis Mangan

    9/9/2009 4:10:23 PM |

    Another option when faced with uncooperative doctors: order thyroid from an overseas pharmacy.

  • Anonymous

    9/19/2009 5:22:14 PM |

    You forgot the option of saying you look Healthy so the test is unnecessary and Ridiculing you -- but finally ordering the tests, because you wouldn't leave the room till he patronizingly agreed (hey, whatever works)... and it turns out I have multi-nodule goiter!!

  • Anonymous

    1/2/2010 10:25:33 PM |

    Your blog keeps getting better and better! Your older articles are not as good as newer ones you have a lot more creativity and originality now keep it up!

  • buy jeans

    11/3/2010 2:31:15 PM |

    Although this was not asked in the poll, I believe that it is a safe assumption that you asked with good reason: you're abnormally fatigued, you have been gaining weight for no apparent reason or can't lose weight despite substantial effort, or you feel cold at inappropriate times.

Add comment

Loading