BBC radio broadcast on statins.

[xrn]

A 28 minute BBC radio broadcast from yesterday, on statins...

Dr Mark Porter

*http://downloads.bbc.co.uk/podcasts/radio4/medmatters/rss.xml

The General Practitioner, Dr Sarah Jarvis, is typical of the general level of medical stupidity that abounds. Clearly, she has bought into the myth of good and bad cholesterol.

Familial Hypercholesterolaemia is thought to dramatically increase the risk of heart disease, via atherosclerosis. I never had statins in childhood and I have not yet had any cardiac event.

Professor Tom Sanders - Interference with Q10. Discounted this as the reason for muscle adverse effects. No benefit from taking Q10 if taking a statin. Grapefruit juice interacts with some statins because flavanoid detoxified in liver.

Safety monitoring: "Safety is great but a lot of people get side effects"

No routine blood testing required because "statin drugs are pretty safe" :shock:

LDL below 2 is the target. Ratio of good to bad cholesterol. "Good cholesterol picks up bad cholesterol and takes it to the liver"

Consultant Lipidologist. Dr Nair. "Doubling dose of statin only gives 6% extra reduction". Using new drugs to reduce cholesterol (Ezetimibe). "Some patients are intolerant of statins... they complain of muscle aches"

apparently "Weight loss reduces cholesterol" according to Dr Sarah Jarvis

:roll:

Remove the asterisk from the URL to listen to the broadcast.

Regards,
xrn

[xrn]

My response to Times Online article, which I had addressed to all of the clinicians
who subscribe to the ideals embodied by THINCS

regards to all,
xrn

"This kind of press release is a cynical attempt to market by stealth. It tramples on public
trust and serves to stifle real debate. It is impossible for the public (or patients) to make
informed choices, when the press is full of this pre-digested nonsense (carefully released
by pharmaceutical companies... to witness from a similarly worded article in the Daily
Telegraph on the same day) while they remain ever-unwilling to print contrary viewpoints.

It could not be prudent to assume that just because we can see 21 negative comments to a
single online article about the purported benefits of statinisation, that those publicly
expressed opinions will have any significant impact on the rather too cosy relationships
between the statin producing pharmaceuticals, NICE, medics, health services and global
policies which concern cardiac health. The cholesterol myth is far too firmly embedded for
it to be shifted by a few members of the public just bleating about how awful statins really
are and their own humdrum and limited existence.

It is my sincere hope that this intelligent community of THINCers will forgive my own
impertinence in suggesting the following proposals, for it is is not my wish to be offensive
to doctors who CAN think and DO put the care of their patients at the top of the very long
list of priorities that arises when providing healthcare to patients. I offer these proposals
merely as points to stimulate open discussions. I have been struggling with the notion that
a significant group of clinicians has not formulated a set of standards to which it aspires.

This is not a slight on any single individual, nor on the THINCS community members as a
whole. I do not wish to imply anything by this meandering post... merely to say, Hello
THINCers, isn't it an appropriate time for the THINCS community to state something to the
world at large, en masse?

My frustration and impatience is born out of the THINCS viewpoint being largely unheard
and then considering the numbers of patients who are still to be damaged by poor
decisions to treat them with statins. Because I am not a clinician, my personal judgement
is unfettered by all of the issues that would attend the daily life, future career and
professional imperatives that must be considered by practising medics.

herewith...

Medics prescribing statins to men for the purposes of primary prevention, should be
required to undergo a period of professional supervision... that is they should not be
permitted to practice independently until they can satisfy the basic and desirable tenet
that the patient must never be on the receiving end of iatrogenic harm. The supervisory
period would end after the medic had received further training in both basic biochemistry
and rigorous scientific method.

Medics prescribing statins to women, for any purpose, should be censured/disciplined (by
the profession) for prescribing a medication which has never been shown to have the
desired effect. In other words, this is nothing other than wildly irresponsible medical
practice and it would be thoroughly deserving of the opprobrium of the medical
profession. The retraining and supervision conditions listed above should also be applied.

Medics should not be prescribing medications that they have insufficient knowledge about.
A line or two read from MIMS, USP, other data sheet compendia, or similar tomes, does not
constitute the medical practitioner's knowledge of a subject. This lazy approach, to
assimilating medical knowledge, should be thoroughly deprecated by the profession and
deemed to be a wholly unacceptable aspect of clinical practice.

The medical profession should subscribe to the notion that ALL medical research is made
public and that it should be freely available to every member of the public, and patients,
from a central repository. Every medical journal should be required to submit copies of
every research paper that they have been responsible for publishing, to the central
repository. Additionally, all medical papers should be assessed for public or patient
accessibility and, ideally, a plain language transcription explaining the concepts around
the key arguments and the data, should accompany each request for a technical research
paper.

The aim of such a system would be to ensure that patients are facilitated in making an
informed consent to treatment. A subsidiary consideration would be that medics would
have no excuses for being ill-informed. There can be no reasonable case made for
persisting with the current medical model of providing healthcare, which relies on the
patient being beholden to the clinician, for providing them with a few desultory scraps of
information, that often prove to be much less than the complete story (whether by
accident or design) that the patient requires, if they are to make reasonable decisions
about their medical condition and the treatment it requires.

The medical profession should exclude parties with a vested interest from initiating,
funding or participating in clinical research. The pressure to produce 'expected results' is
too great and the notion of some extra money or a new facility, is a very powerful driving
force in many cases. The natural corollary to removing commercial interests from research
is to adopt a system of overseeing essential medical research based upon genuine clinical
need. The decision to initiate research should come from within the profession via the
clinicians undertaking the work... as opposed to being initiated by non-practising
academic clinicians.

The current ludicrous requirements, for medics to complete 'CV' research, is damaging to
the profession. There can be little point in undertaking badly conducted, poor quality
research merely for the purpose of enhancing one's CV. (poor quality research only makes
the case that an applicant for a job would make a poor appointee, thus negating the need
to pursue foolish research for the sole purpose of increasing one's personal paper
publication count)

Medics who chose to work for pharmaceutical companies should be made aware that they
will automatically (on appointment) forfeit the right to make public pronouncements, in
the medical press or the national media, about matters of national health. This would
ensure that a nation's health policies would be free from the taint of any particular
methodology that is promoted and supported by the commercial interest in question.
Lobbying of a health policy producing department, by a commercial company, should
automatically disbar the commercial interest from being considered during the tendering
process.

Clinicians should remain free to accept numerous consultancies to commercial companies.
The acceptance of a single consultancy position should automatically disbar the clinician
from expressing an opinion about matters of public health, either in the medical
publications or in the public media.

I know that the above may appear idealistic and little more than a pipe dream. The
medical profession is unlikely to be moved from its current (demonstrably unacceptable)
position by means of external forces, or legislative changes, for the expectations of
clinicians are already set. The only force that is likely to have an impact on medical
practice will have to come from within the medical profession itself. Talking about current
issues on THINCS forums is useful for clarifying the issues and our thoughts about them
but, ultimately, one is only talking to the converted. It is the unconverted that need to hear
the message from THINCS.

I don't want to appear to be suggesting that THINCS should be engaging in some sort of
evangelical proselytising. I would like to see THINCS develop some policy that could be
agreed in common. It would help to give the organisation some much need shape and a
public face that would be visible to the outside world. It would assist the medics who are
not sure of where they stand right now, in knowing what THINCS stands for and what it
ultimately aims to do... by whichever means it choses to employ.

The phenomenal output of papers and books, written by the THINCS membership, that
refutes the cholesterol hypothesis meme, is really heart-warming. The fact that my local 7
doctor, GP practice has not heard of THINCS and is apparently unaware of issues
surrounding cholesterol administration in a primary prevention setting, is evidence that
the slow drip-drip of erudite and learned scientific research publications from THINCS
members, is having little impact on everyday clinical practice in the family medical
practitioner setting.

Addressing the indiscriminate promotion of statins for every ailment known to man, is not
going to be brought about through any single source, nor will a sea-change in medical
behaviour, vis-à-vis statin prescribing, come about because a few patients complained
that they felt unwell. It appears clear to me that THINCS is going to have to adopt a clearly
enunciated position if it is to have more effect than just providing a safe haven for like-
minded people to gather so that they may consider the lamentable state of big pharma
mediated healthcare."

[Brian C.]

Hullo, what's going on here? My reponse to xrn's initial posting has gone!
Either my statin-damaged mental state is to blame and I imagined it or....

Whichever way, it's disturbing.

Brian.