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re: Dr Wants to Prescribe Statins..I Disagree

Posted on 9/5/18 at 6:37 pm to
Posted by Bullredbf
thibodaux
Member since Feb 2013
901 posts
Posted on 9/5/18 at 6:37 pm to
There are no kickbacks for rx meds. Thats all conspiracy bull. Your numbers arent bad but they arent great either. No the total
Means squat. Look at hdl, ldl and trig. Your hdl is good with a mediocre ldl. I would prescribe exercise and diet. However, recheck in 6 months, if the same i would also prescribe meds

It never ceases to amaze me at the short sightedness of patients. U worry about dementia but not stroke, coronary disease or pvd. The risk of one far outweighs thw other.
Posted by BeerMoney
Baton Rouge
Member since Jul 2012
8782 posts
Posted on 9/5/18 at 6:38 pm to
I had a nurse practitioner try to put me on statins with similar numbers. Found a recommended doctor with good reviews online. He told me naw due to the tchdl ratio and my other lifestyle factors. So continuing to work out and live decent.

Not going to take maintenance medication. My numbers haven’t changed over the years but they have revised the numbers they’ll use to prescribe meds. Screw thst
Posted by Hopeful Doc
Member since Sep 2010
15388 posts
Posted on 9/5/18 at 6:39 pm to
quote:

Cholesterol is one of the often overblown aspects of the checkup process as having too low of cholesterol can be a bad thing



This either simply isn't true, or isn't simply true, depending on how you would like to look at it.


There is absolutely zero evidence pointing toward there being such thing as "too low" of an LDL or non-HDL cholesterol. There is a group with a certain Gene that routinely have LDL 20 or less. They most certainly do not have an increase in cardiovascular risk or any other known long term side effects.

The improve it trial more or less shows that, regarding LDL, lower is better, though the "lower" group was on average around 53mg/dL. This group had fewer adverse cardiovascular events than the group with a higher LDL (around 70). This applies to patients after a heart attack. It is not directly applicable to your Joe Blow with no risk factors. What we do know fairly certainly is that there isn't an LDL so low that it's known to cause problems.


High HDL on the other hand ("good" cholesterol) is associated with fewer cardiac events. If this number is low, it is a risk for heart attack and stroke.


While Debakey is undoubtedly a brilliant man that pioneered medicine like few in the thousands of years before him, his opinion on how to manage patients is unfortunately lacking a significant amount of new data and new outcomes that he never was able to see and learn.
Posted by Hopeful Doc
Member since Sep 2010
15388 posts
Posted on 9/5/18 at 6:44 pm to
quote:

There are no kickbacks for rx meds.



People don't want to hear that, unfortunately. My iced water from Sonic today means that I'm going to write one insulin vs another to them.

quote:

It never ceases to amaze me at the short sightedness of patients. U worry about dementia but not stroke, coronary disease or pvd. The risk of one far outweighs thw other


They've never seen a walking, talking guy that "felt fine" reduced to a nonspeaking hemiplegic overnight. And if they have, they haven't been there telling them diet, exercise, and this or that medicine every few months for years before they watched it happen.


I'd like to see what the risk of vascular dementia in untreated moderate CAD-risk patients is vs dementia associated with statins. I'd imagine it's comparable.
Posted by Salamander_Wilson
Member since Jul 2015
8263 posts
Posted on 9/5/18 at 6:48 pm to
quote:

U worry about dementia but not stroke, coronary disease or pvd. The risk of one far outweighs thw other.


How about the fact that statin use decreases CVI risk only in men who have previously had CVIs and has been shown to decrease overall mortality across the board.

So yes, if you take a statin you are less likely to have a heart attack or stroke if you've already had one. Otherwise, taking a statin gives you a higher risk of death from all causes.

And that's if you believe statins work by decreasing cholesterol. There are competing theories out there that posit statins work by decreasing inflammation and the decrease in cholesterol is only an accessory outcome. Plenty of scientists don't believe cholesterol is the ultimate cause of heart disease.
This post was edited on 9/5/18 at 6:53 pm
Posted by Spock's Eyebrow
Member since May 2012
12300 posts
Posted on 9/5/18 at 6:49 pm to
quote:

you need a statin end of discussion.


Also gabapentin.
Posted by WaWaWeeWa
Member since Oct 2015
15714 posts
Posted on 9/5/18 at 7:00 pm to
Can you link me the scientific studies supporting your claims? I’m not trying to troll. I want to learn about this but I’m not going to blindly trust YouTube videos. I need scientific evidence.
Posted by Jake88
Member since Apr 2005
77861 posts
Posted on 9/5/18 at 7:03 pm to
I asked to be put on statins with a total cholesterol of 190. I know four internists who take them prophylactically. They also help lower hsCRP.
Posted by slackster
Houston
Member since Mar 2009
91300 posts
Posted on 9/5/18 at 7:12 pm to
I assumed if it was a thing, it wasn't on all scripts, just the $200/mth stuff like Vyvanse and shite.

Guess the lunches will have to do instead.
Posted by Tiguar
Montana
Member since Mar 2012
33131 posts
Posted on 9/5/18 at 7:22 pm to
Hyperlipidemia is in a bit of a state of controversy.

One organization focuses more on numbers, one focuses more on overall risk and concomitant disease states.

I tend to lend more credence to the ACC/AHA guidelines.



Do you have diabetes?

Do you have history of heart disease

Plug in your numbers on this tool

LINK

Is the result 7.5% or above and are you over 40 years old?

If you answered "no" to all those, then you probably won't receive much benefit from the statin.

If you answered "yes" to any of those, you may need to give your doctor more credit and see what they recommend.
Posted by bigwheel
Lake Charles
Member since Feb 2008
6491 posts
Posted on 9/5/18 at 7:23 pm to
What med school did you go to
Posted by ItalianTiger
BR
Member since Feb 2005
779 posts
Posted on 9/5/18 at 7:24 pm to
New ldl guideline is <100.
Posted by beachdude
FL
Member since Nov 2008
6290 posts
Posted on 9/5/18 at 7:26 pm to
Don’t go to a doctor unless you are sick or injured.
Posted by Tiguar
Montana
Member since Mar 2012
33131 posts
Posted on 9/5/18 at 7:26 pm to
Pharmacy school + residency
Posted by Mingo Was His NameO
Brooklyn
Member since Mar 2016
36388 posts
Posted on 9/5/18 at 7:32 pm to
quote:

It is just amazing how people actually believe doctors receive kickbacks.

Does every doctor receive them? Is it just a select few?

There are approximately 1 million doctors in the US. Do they all receive payment? How much do they get?

Scruffy must have missed out on the application for the kickbacks


Do you not see the free pens all over every doctors office baw? That cuts TENS maybe even HUNDREDES off overhead every year.
Posted by SirSaintly
Uptown, New Orleans
Member since Feb 2013
3187 posts
Posted on 9/5/18 at 7:33 pm to
Took the test and I have 0.5% Current 10 yr ASCVD risk.
Posted by AUCE05
Member since Dec 2009
44854 posts
Posted on 9/5/18 at 7:48 pm to
Diffently take the advice of people on the internet vs a guy who spent his life specializing on the human body.
Posted by RCA
Member since Aug 2018
419 posts
Posted on 9/5/18 at 9:17 pm to
quote:

Can you link me the scientific studies supporting your claims? I’m not trying to troll. I want to learn about this but I’m not going to blindly trust YouTube videos. I need scientific evidence.


Do your own research and convince yourself. I don't blindly trust youtube videos either. I know bs when I hear it. There are many videos on small dense LDL. Google it and papers will come up. Have fun reading that mess. Here's one: Small Dense Low-Density Lipoprotein as Biomarker for Atherosclerotic Diseases

A/Prof. Ken Sikaris - 'Making Sense of LDL' He provides sources in his videos.

As far as statins, here's one video.
Dr. Mercola Interviews Dr. Stephanie Seneff on Statins


Posted by HighAnkleSprain
Pierre Part
Member since Sep 2017
149 posts
Posted on 9/5/18 at 9:23 pm to
had yearly physical done. You’re illiterate.
Posted by tigersbh
Baton Rouge
Member since Oct 2005
12491 posts
Posted on 9/5/18 at 9:59 pm to
quote:

Take some red rice yeast then.


I take that and plant sterols and my cholesterol has come way down.
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