A useful summary of one of the many sordid scams in Big Medicine.
2023-02-24. Emphasis added.
Malcolm Kendrick, whose talk was hilarious as always, showed how outright fraudulent were the studies on a couple of the newer, very expensive, LDL-lowering drugs. Since statins have all pretty much gone generic, Big Pharma has to continue to exploit the LDL fear they have thrown over us all like a blanket.
Just a couple of days ago, I got an email from an old friend who used to be quite hefty. I badgered him about diet, but it all fell on deaf ears. Then, out of the blue, he decided to go full low-carb. He started dropping weight, and as happens with many folks on low-carb diets, he spontaneously started exercising. This all happened without my knowledge, and when I saw him a year or so later, I was stunned. He was almost unrecognizable.
He is still thin, still exercising, still on LCHF. But he went to his doc, who found my friend’s total cholesterol to be 301, up from 296 almost three years ago. Of course, the doctor panicked. I’m sure just seeing it over 300 was a fright for him. He, of course, began to badger my friend about statins fairly vigorously. Scared the crap out of him. So, he went home and emailed all this to me.
When I looked at his lab report, I couldn’t believe it. His total cholesterol was indeed 301 mg/dl. But his frigging triglycerides were 78. And even more stunning, his HDL was 84! For a man over the age of 65, this is astonishing. I would have thought it a lab error, except on his last lab it was 99!
Since total cholesterol is made up of all the different fractions of cholesterol, a big part of why his total is so high, is that HDL, the good cholesterol, is so high.
If you’re going to look at lipids, probably the best estimate of risk—for a number of reasons—is the triglyceride figure divided by HDL. If it’s under 3, your in pretty good shape. His was under 1 (78/84)! Which is terrific.
It beggars belief that anyone would hound him to go on a drug.
But he was hounded. Here’s what I wrote back to him explaining why?
Don’t take them. I can send you any number of papers, but your doctor will be too stupid to understand them. You’ve got to understand how the system works. It is totally corrupt. The drug companies pay many millions of dollars to big name docs, who have all the academic merit badges. These same big name docs always end up getting on the committees that write the guidelines for various specialties. The guidelines they write are the definition of Standard of Care. All the non big named docs, i.e., your local doc, try to follow the Standard of Care as outlined by his/her specialty. If the doc follows these SOC guidelines, he/she won’t get sued if the patient turns to shit as a consequence. "Your Honor, I was simply following the current Standard of Care guidelines as promulgated by the American Association of Cardiologists [or whatever group it is].” Statins are recommended for elevated LDL in virtually all of the SOC protocols. If docs give them, and the patient has a heart attack or a bad reaction to the drugs (not uncommon), the doc is protected because of the SOC. If he/she does NOT recommend the drugs and something goes bad, then he/she has no protection because the SOC wasn’t followed. That’s why they push these drugs so hard.
Sadly, that’s how it works. Statins have been the bestselling drugs in history. They’ve made more money for the pharmaceutical industry than any other drug ever made. Now they’ve gone generic, so Big Pharma isn’t making nearly as much. But they’ve got new cholesterol-lowering drugs that cost anywhere from $8,000 to $10,000 per year. A number of people do not get their LDL levels low enough (to an unnatural state, really) on statins, so now they can go to these other vastly more expensive injectable drugs that will finish the job.
The reality is that the evidence shows that the older you get a higher cholesterol level is associated with greater longevity. The only real studies on statins—the randomized, controlled trials—showed that only a small group of people got any improvement in all-cause mortality while taking the drug. That group was men under the age of 65 who had actually had a heart attack. Not men under 65 who had so-called risk factors for heart disease, but those who had actually had a heart attack. If you’re not in that group—and you’re not—statins are worthless. Based on the evidence, they should never be given to women of any age and never to men who aren’t in this under 65 age group who had had a heart attack. Even in that group, their improvement is so modest that public health officials question their use in terms of how much money has to be spent to save one person.
I went back and reread what I wrote above. When I said Big Pharma pays big named docs millions of dollars, it isn’t that blatant. They don’t offer it as an out-and-out bribe. That would be unlawful. What they do is fund their labs (most big named docs are academics) and pay them to fly to glamorous spots around the world to give talks, for which Big Pharma pays generously. As Upton Sinclair commented long ago “It is difficult to get a man to understand something, when his salary depends on his not understanding it.” These big named docs don’t want to give up the gravy train, so they don’t look too carefully at the scientific literature. And if they do look at it, the literature is full of shitty epidemiological papers that appear to show a benefit to statins, but are really worthless. Worthless because epidemiological studies are worthless except for generating hypotheses that need to be tested by randomized, controlled studies. But re statins, these have already been done. Multiple times. And have shown what I described above.
This is why science needs to be fixed.
WIND: summarizes it well.
Personal experience on cholesterol, statins, doctors
I can attest to the situation as summarized: most doctors and especially cardiologists are not on your side; they are on their own side and that means paint-by-numbers medicine allowed by their employer, “treatment” that is likely to at best not damage you. My last cardiologist (never again!) had never even heard of Dr Malcom Kendrick. How can you claim to understand a field (any field) if you have zero knowledge of the counterargument and counter-evidence and its main proponent? Such doctors are financial and intellectual crooks. I was lied to about coming in (“multiple very serious conditions”, a grotesque falsehood), and suckered out of $840 in fees for which I learned nothing useful, and which raised my BP 30 points by a doctor clearly out of date with the factual evidence, an incompetent communicator and as frozen an intellectual as I have yet encountered. A caricature of a thinking mind, one plodding arrogantly painting by numbers until retirement—next patient please!
BTW, I have high cholesterol and my HDL ranges from 84 to 110, the leaner I am the higher the HDL mapping linearly (inversely) to ~1 point HDL per pound of excess body fat, varying slightly by fitness level. I’ve proven this year after year, with my doctors dismissing it as a flight of fancy.
Furthermore, being under duress from infection (eg EBV or Long COVID) raises cholesterol; the body needs it for repair and related functions. It too my regular doctor a few years to finally agree with me.
My mother is 81, my father 83. Neither has had a stroke or heart attack. My mother has had very high cholesterol for 40 years (eg 260 - 340 range). She still uses a Ryobi hedge trimmer @AMAZON to clear trails at 8000' elevation at her cabin.
Note: numbers from 2020 onwards were in the throes of extreme Long-Haul COVID symptoms, later years screwed up from EBV and thyroid issues and high blood lead, and carrying an excess 20 pounds of body fat and not being able to exercise normally. The body naturally increase cholesterol when faced with an infection or other physical damage. This can be seen directly in this graph starting with the August 2020 figures, preceeded by many years of stable figures.