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Message
re: Lipitor side effects
Posted on 8/8/18 at 3:03 pm to Roger Klarvin
Posted on 8/8/18 at 3:03 pm to Roger Klarvin
So statins have the ability to stop plaque from breaking off? Good to know
0
Posted on 8/8/18 at 3:33 pm to Roger Klarvin
I am not an MD, but I have participated in treating heart disease in over 8000 patients using interventional cardiology. We are great at treating it, but not so much preventing it. What we are treating is just risk factors, and while statins do treat those so-called risk factors, it doesn’t translate into a proportionate reduced rate of cardiovascular events. I just want people to stop acting like they know what causes heart disease, and if you do, come get your Nobel peace prize. Most of the cardiologist I work with reflect your sentiment, but I am skeptical. For every study that you can show me that statins reduce risks, or a Dr or scientist that can lecture on the subject, I can show you another that says the opposite.
Studies are so convoluted, they will have a statin group that shows 6% have an event, while a placebo group had 8% that had an event, and they will call that a 18% reduction on CV events. And that might just be in one age group that is over 75.
There is a new PCSk9 inhibitor that will drop ldl 60% but only reduces heart attack by 1 person out of 100, yet they call that 27% reduction, the same amount of people died with the drug vs placebo.
Why is all cause mortality not valuable? It can’t be that many people getting killed by a bus when crossing the street? That’s the main goal, not to die right?
Studies are so convoluted, they will have a statin group that shows 6% have an event, while a placebo group had 8% that had an event, and they will call that a 18% reduction on CV events. And that might just be in one age group that is over 75.
There is a new PCSk9 inhibitor that will drop ldl 60% but only reduces heart attack by 1 person out of 100, yet they call that 27% reduction, the same amount of people died with the drug vs placebo.
Why is all cause mortality not valuable? It can’t be that many people getting killed by a bus when crossing the street? That’s the main goal, not to die right?
This post was edited on 8/8/18 at 3:41 pm
Posted on 8/8/18 at 3:54 pm to treyk89
quote:You should avoid being on Lipitor if at all possible. My reasons:
So my doctor has started me on Lipitor. I’m only 36 but have battled high cholesterol for a while now. Unfortunately, a restricted diet, taking supplements and etc didn’t lower it. I’ve heard numerous people over the years complain about muscle pain as a side effect. I’m just curious to see if anyone here can speak to that; what are your experiences with it or similar drugs?
--you have "high cholesterol": I'd be interested in seeing what they even mean by this. It's likely that high cholesterol is actually good for you and not bad. But either way, the headline LDL number they give you (which I'm guessing is the impetus for Lipitor) is basically entirely irrelevant.
--"restricted diet" - I'd be curious to see what shite shot of low fat and high carb they have you on that is supposedly helping you, but which will be, in fact, harming you.
Posted on 8/8/18 at 3:56 pm to Roger Klarvin
quote:Absolute, complete horseshite. Essentially all actual clinical studies attempting to show the effect of cholesterol on all-cause mortality show it having a POSITIVE effect.
All-cause mortality
The cardiovascular mortality reduction is undeniable and one of the most well established premises in all of medicine.
Posted on 8/8/18 at 3:57 pm to cici
quote:Yes, cholesterol is vital - particularly to your brain function. You basically can't have too much.
but unfortunately my body produces too much.
quote:Well, bread is certainly terrible for your CV health.
I could eat just bread and water and my levels would be to high
Posted on 8/8/18 at 3:57 pm to Roger Klarvin
quote:So the problem in actually adopting the correct science is Medicare won't pay for it? I don't deny practical limits, but that doesn't mean you should still keep spouting nonsense.
The problem is they generally aren't covered by insurances or Medicare and are cost prohibitive to most patient demographics.
Posted on 8/8/18 at 4:00 pm to Rust Cohle
quote:Heart disease is caused by ingested carbohydrate. That's it. (see edit below) Prior, to, say, 1910, CVD essentially didn't show up in the entire medical history of humanity. It was invented by us when sugar consumption went from x to 150x in 150 years.
they know what causes heart disease, and if you do
I grew up just thinking "you get old, you die of a heart attack". I was stunned to learn in the past several years that this simply isn't true. There really is no mystery here. Carbs cause CVD (and cancer and diabetes and dementia, etc. etc.)
ETA: Also caused by the migration to "vegetable oils" (which is in and of itself a misnomer. should be called seed and/or nut oils.) Switching from butter to margarine and from lard/tallow to Crisco has had a devastating impact on human CV health in the 20th century.
This post was edited on 8/13/18 at 3:31 pm
Posted on 8/8/18 at 4:14 pm to Big Scrub TX
quote:
All-cause mortality The cardiovascular mortality reduction is undeniable and one of the most well established premises in all of medicine. Absolute, complete horse shite. Essentially all actual clinical studies attempting to show the effect of cholesterol on all-cause mortality show it having a POSITIVE effect.
That’s why he added cardiovascular in there, because it does reduce deaths from heart attack and I, and I believe it does have some plaque stabilization affect, but it may have even less benefit to someone without progressive heart disease.
And I am with you on the processed carbs, but even the American College of cardiology has papers saying the diabetes is not caused by excess sugar, but excess calories. A low carb high fat diet is undeniably the best diet to manipulate your lipid panel to best case scenario’s. As more people are adopting a low-carb, and carnivore diet we will soon see if there is a decrease in heart disease.
This post was edited on 8/8/18 at 4:21 pm
Posted on 8/8/18 at 4:14 pm to Big Scrub TX
quote:
Carbs cause CVD (and cancer and diabetes and dementia, etc. etc.)
I agree that excessive carbohydrate are terrible for overall health and longevity. You may find the second link on my post above of interest as it gives credence to your post.
I have CAD. If you get a calcium score of anyting other than 0, you have CAD according to the medical establishment. I was in the lower range but still had plaque in my LAD. My LDL particle size was small in size and great in number which was alamring to my older doctor. He told me to watch Forks Over Knives and told me that I could never go on a ketogenic diet again because it was genetic that fats would cause more plaque in my arteries. I am still uncertain as to the correlation between diet, genetics, and CAD.
I have researched and read and run the gauntlet of arguments about statins, fats, plaque, etc. and still find it all a bit jumbled. I am not sure how much diet affects hereditary markers for plaque buildup in the long run.
This post was edited on 8/8/18 at 4:16 pm
Posted on 8/8/18 at 4:30 pm to Farkwad
There are still doctors out there prescribing statins for elevated total cholesterol, and anyone who is up-to-date in medicine knows that is antiquated practice. A target healthy HDL often show total cholesterol numbers that are “high”
I always tell people that blaming cholesterol for heart disease is like blaming a fireman for a house fire. Just because there at the scene doesn’t mean that they did it. We will die without cholesterol, so much so that her body makes it, it is vital to our joints in your eyes and our brains. I totally believe that cholesterol deposits are a result of repairing inflammation in arteries. A lot of the patients we see have lots of calcium lining the arteries, and make balloons and stents very difficult to pass, but nobody is suggesting we stop ingesting calcium.
I always tell people that blaming cholesterol for heart disease is like blaming a fireman for a house fire. Just because there at the scene doesn’t mean that they did it. We will die without cholesterol, so much so that her body makes it, it is vital to our joints in your eyes and our brains. I totally believe that cholesterol deposits are a result of repairing inflammation in arteries. A lot of the patients we see have lots of calcium lining the arteries, and make balloons and stents very difficult to pass, but nobody is suggesting we stop ingesting calcium.
This post was edited on 8/8/18 at 4:48 pm
Posted on 8/8/18 at 4:33 pm to Farkwad
quote:
He told me to watch Forks Over Knives
Yikes.
Posted on 8/8/18 at 5:48 pm to Big Scrub TX
Low fat, high carb diets are antiquited and objectively bad for you. Depending on the fats being eaten, so is a high fat, low carb diet.
The reality is that the "healthiest" diet is a near vegetarian diet that limits any meat intake to seafood and skinless chicken on occasion. Both simple carbohydrates and trans/saturated fats are very pro-inflammatory, increase insulin resistance/obesity, lower HDL, etc.
LDL alone is not particularly meaningful, though it is very rare for someone with a high proportion of large LDL particles to have LDL levels >190. In people with extremely high LDL, it is safe to assume it is largely the unhealthy small, dense LSL that likes to deposit in your vessel walls.
Ideally everyone would get a LDL-profile but again, most patients can't afford it and virtually nobody covers it. I'd order it on all patients as part of their lipid profile if I could.
High HDL improves all cause mortality. High LDL does not increase all cause mortality but does increase CV mortality though not proportional to the level until the levels get VERY high (for the reasons discussed above).
Cholesterol in and of itself is not bad. High LDL, depending on your particle size (dictated by genetics and diet), can be very bad and in people with metabolic syndrome usually is.
Very much false, essentially the only people we see who get MIs in their teens/early 20s have familial hyperlipidemia with LDL >300. Untreated familial HLD guarantees an MI by 30. And these people generally have mostly small, dense LDL.
So yes, very high LDL is a strong independent risk factor for CVD.
This is just nonsense. Most of the 2000-3000 year old mummies examined from Egypt had some degree of CVD, many severe. It's what killed Ramsis II. Our closest common ancestors among the apes get CAD, albeit at lower rates.
Heart disease has likely been the #1 non-infectious, non-traumatic cause of death for all of human history.
No, the problem IS that it's unaffordable for most.
And again, coronary calcium scoring just tells you that you have CAD without getting cathed. It doesn't predict or reduce the incidence of sudden cardiac death.
Getting LDL profiles would be helpful and hopefully will be possible in the future.
Not one thing I've posted is nonsense however. You have some correct information but have read too many biased sources and lack the full picture. It's not nearly as simplistic as you've made it out to be.
The reality is that the "healthiest" diet is a near vegetarian diet that limits any meat intake to seafood and skinless chicken on occasion. Both simple carbohydrates and trans/saturated fats are very pro-inflammatory, increase insulin resistance/obesity, lower HDL, etc.
quote:
--you have "high cholesterol": I'd be interested in seeing what they even mean by this. It's likely that high cholesterol is actually good for you and not bad. But either way, the headline LDL number they give you (which I'm guessing is the impetus for Lipitor) is basically entirely irrelevant.
LDL alone is not particularly meaningful, though it is very rare for someone with a high proportion of large LDL particles to have LDL levels >190. In people with extremely high LDL, it is safe to assume it is largely the unhealthy small, dense LSL that likes to deposit in your vessel walls.
Ideally everyone would get a LDL-profile but again, most patients can't afford it and virtually nobody covers it. I'd order it on all patients as part of their lipid profile if I could.
quote:
Absolute, complete horseshite. Essentially all actual clinical studies attempting to show the effect of cholesterol on all-cause mortality show it having a POSITIVE effect.
High HDL improves all cause mortality. High LDL does not increase all cause mortality but does increase CV mortality though not proportional to the level until the levels get VERY high (for the reasons discussed above).
Cholesterol in and of itself is not bad. High LDL, depending on your particle size (dictated by genetics and diet), can be very bad and in people with metabolic syndrome usually is.
quote:
You basically can't have too much.
Very much false, essentially the only people we see who get MIs in their teens/early 20s have familial hyperlipidemia with LDL >300. Untreated familial HLD guarantees an MI by 30. And these people generally have mostly small, dense LDL.
So yes, very high LDL is a strong independent risk factor for CVD.
quote:
Prior, to, say, 1910, CVD essentially didn't show up in the entire medical history of humanity.
This is just nonsense. Most of the 2000-3000 year old mummies examined from Egypt had some degree of CVD, many severe. It's what killed Ramsis II. Our closest common ancestors among the apes get CAD, albeit at lower rates.
Heart disease has likely been the #1 non-infectious, non-traumatic cause of death for all of human history.
quote:
So the problem in actually adopting the correct science is Medicare won't pay for it? I don't deny practical limits, but that doesn't mean you should still keep spouting nonsense.
No, the problem IS that it's unaffordable for most.
And again, coronary calcium scoring just tells you that you have CAD without getting cathed. It doesn't predict or reduce the incidence of sudden cardiac death.
Getting LDL profiles would be helpful and hopefully will be possible in the future.
Not one thing I've posted is nonsense however. You have some correct information but have read too many biased sources and lack the full picture. It's not nearly as simplistic as you've made it out to be.
Posted on 8/8/18 at 5:54 pm to Rust Cohle
quote:
There are still doctors out there prescribing statins for elevated total cholesterol, and anyone who is up-to-date in medicine knows that is antiquated practice. A target healthy HDL often show total cholesterol numbers that are “high”
This is correct, but most physicians have moved away from this practice. I never start statins for total cholesterol and rarely for LDL elevation alone unless >190-200 (discussed above). Statins have the most benefit in diabetics, whose constant pro-inflammatory state results in rapid deposition of LDL, VLDL and free triglycerides in the arterial intima. Anyone >35-40 with diabetes should be on a statin regardless of cholesterol numbers because these people essentially ALL have small, dense LDL and there is no such thing as too low of an LDL for diabetics because of this.
High HDL is actually a good predictor of overall health as it represents a reasonably good diet and unusually some form of aerobic exercise.
Posted on 8/8/18 at 5:55 pm to Rust Cohle
quote:
A lot of the patients we see have lots of calcium lining the arteries, and make balloons and stents very difficult to pass, but nobody is suggesting we stop ingesting calcium.
Calcium deposits on existing plaque.
Posted on 8/8/18 at 6:01 pm to Mo Jeaux
What is it about that documentary that makes you say that? I have been all about low-carb high-fat diet for a decade, but recently have been trying to be more open minded, and I’m really surprised at the cases that people can make for plant-based diet‘s.
It’s hard to deny the size of the study that was done in forks over knives. And I think it’s apparent that vegans have the lowest case of heart disease and stroke. It’s very possible that the data is manipulated like Ansell keys did in the 50s. There are so many factors that could decide which diet aperson should be on for longevity. Maybe it’s best to eat ancesterialy, And that’s what the data really shows is the foods that are not native to you cause the most damage. It’s possible that Your diet should be something different than mine. Or that when someone is diagnosed with a disease their diet should be totally different after the diagnosis. Maybe a plant diet is best if we cut out certain types of grain, or a meat diet is best if we cut out certain types of dairy. With today’s wide variety of genetics, and diets there’s just too many factors to come up with a definitive answer.
I think we all obtain these ideals, and they become part of our identity and it’s hard for us to switch to another school of thought. Doctors are the same way, and it’s in that scenario that it can become dangerous. Doctors really have to look inwards and constantly question their beliefs. If they refuse to do so, when we look at the highest cause of mortality, it will be doctors.
It’s hard to deny the size of the study that was done in forks over knives. And I think it’s apparent that vegans have the lowest case of heart disease and stroke. It’s very possible that the data is manipulated like Ansell keys did in the 50s. There are so many factors that could decide which diet aperson should be on for longevity. Maybe it’s best to eat ancesterialy, And that’s what the data really shows is the foods that are not native to you cause the most damage. It’s possible that Your diet should be something different than mine. Or that when someone is diagnosed with a disease their diet should be totally different after the diagnosis. Maybe a plant diet is best if we cut out certain types of grain, or a meat diet is best if we cut out certain types of dairy. With today’s wide variety of genetics, and diets there’s just too many factors to come up with a definitive answer.
I think we all obtain these ideals, and they become part of our identity and it’s hard for us to switch to another school of thought. Doctors are the same way, and it’s in that scenario that it can become dangerous. Doctors really have to look inwards and constantly question their beliefs. If they refuse to do so, when we look at the highest cause of mortality, it will be doctors.
Posted on 8/8/18 at 6:24 pm to Rust Cohle
The highest cause of morality will always be personal decision making. Eating McDonalds and KFC is bad for you and every conceptually understands this without having it explained to them.
With the exception of those with strong genetic predispositions, the prevention or delaying of CAD is largely in your own hands.
With the exception of those with strong genetic predispositions, the prevention or delaying of CAD is largely in your own hands.
Posted on 8/8/18 at 6:43 pm to Roger Klarvin
Once we eliminate processed foods, and eat more of a Whole Foods diet, the argument whether plant-based or fat based diet might just be splitting hairs as far as mortality goes.
You said a low fat high carb diet is bad, but that’s essentially what a vegan diet is. You also said a high fat diet with low carbs is bad, but if you want your patients to hit all your recommended targets it’s definitive that this is the way to do it. Doctors will talk about staying away from fat, then the next breath tell them to supplement with fish oil.
You mentioned the young adult having a high cholesterol, leading to heart disease, and a diabetic that is pro inflammatory leading to heart disease, I think it’s most important to stop vilifying cholesterol, and distinguish to your patients that it’s not the cholesterol causing the inflammation, and manipulating this repairing mechanism might have bad effects on other areas of your body.
You said a low fat high carb diet is bad, but that’s essentially what a vegan diet is. You also said a high fat diet with low carbs is bad, but if you want your patients to hit all your recommended targets it’s definitive that this is the way to do it. Doctors will talk about staying away from fat, then the next breath tell them to supplement with fish oil.
You mentioned the young adult having a high cholesterol, leading to heart disease, and a diabetic that is pro inflammatory leading to heart disease, I think it’s most important to stop vilifying cholesterol, and distinguish to your patients that it’s not the cholesterol causing the inflammation, and manipulating this repairing mechanism might have bad effects on other areas of your body.
This post was edited on 8/8/18 at 6:52 pm
Posted on 8/8/18 at 6:53 pm to Roger Klarvin
OP here
Yeah my total cholesterol is 292. Triglycerides 242. LDL 204
I weigh196 lbs and strict diet has not lowered my levels whatsoever
Yeah my total cholesterol is 292. Triglycerides 242. LDL 204
I weigh196 lbs and strict diet has not lowered my levels whatsoever
Posted on 8/8/18 at 6:54 pm to Rust Cohle
quote:
You said a low fat high carb diet is bad, but that’s essentially what a vegan diet is
Technically true, but that's not generally what is meant by "low fat, high carb". This is the diet that substitutes in processed carbs and "low-fat" foods that have been loaded with simple carbohydrate to mask the lack of flavor when fat is removed.
quote:
You also said a high fat diet with low carbs is bad
I said it CAN be. Many high fat diet proponents do not discriminate the types of fats they are eating. Trans-fats and saturated fats are bad and very-proinflammatory. The most inflammatory thing humans eat is red meat.
A high fat diet that consists of polyunsaturated fats and limits the meat intake to chicken and seafood is a very different matter, though a vegan diet is still likely superior in terms of preventing CAD based on what we know.
quote:
and distinguish to your patients that it’s not the cholesterol causing the inflammation
And we do (and if they aren't they should be). Cholesterol is the bullet, not the gun. Inflammation creates an environment that leads to lipid deposition and vascular disease. Once you have that inflammatory nidus, the more LDL and the higher it's density the more likely you are to develop disease.
Would we love everyone to change their lifestyle? Of course, but experience tells us most people wont change. So we do the next best thing and try to control and limit risk factors.
Posted on 8/8/18 at 6:55 pm to LSUfan20005
Yes I had he LDL-P done too. It was 2895
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