Thursday, September 23, 2010

"By following an effective diet, many of these abnormalities (genetically driven conditions of excessive cholesterol or triglicerides, aka "hyperlipidemias"-Editor's Note) can be dramatically corrected, sometimes completely. Familial hypertriglyceridemia, for instance, an inherited disorder of lipoprotein lipase in which triglyceride levels can exceed 1000 mg/dl, high enough to cause pancreatic damage, responds incredibly well to carbohydrate restriction and over-the-counter fish oil. I have a number of these people who enjoy triglyceride levels below 100 mg/dl--unheard of in conventionally treated people with this disorder." (Note: Many folks on a 'low fat' diet have a hard time getting their Tg levels below 100 even without genetic abnormality).
"Then why is it that, time after time, I see these people in consult, often as second or third opinions from lipidologists (presumed lipid specialists) or cardiologists, when the only solutions offered are 1) Lipitor or other statin drug, and 2) a low-fat diet? Occasionally, an aggressive lipidologist might offer niacin, a fibrate drug (Tricor or fenofibrate), or Lovaza (prescription fish oil).
"Sadly, the world of lipid disorders has been reduced to prescribing a statin drug and little else, 9 times out of 10.
"I continue to be shocked at the incredible influence the drug industry has over not just prescribing patterns, but thinking patterns. Perhaps I should say non-thinking patterns. The drugs make it too easy to feel like the doctor is doing something when, in truth, they are doing the minimum (at best) and missing an opportunity to provide true health-empowering advice that is far more likely to yield maximum control over these patterns with little to no medication.
"All in all, I am grateful that there is a growing discipline of "lipidology," a specialty devoted to diagnosing and treating hyperlipidemias. Unfortunately, much of the education of the lipidologist is too heavily influenced by the pharmaceutical industry. Not surprisingly, the drug people favor "education" that highlights their high-revenue products.
"Seeing a lipidologist is still better than seeing most primary care physicians or cardiologists. Just beware that you might be walking into the hands of someone who is simply the unwitting puppet of the pharmaceutical industry."

All in all, this makes sense.  If you abandon your health to the 'experts', you get 'expert' help and all the goods/bads that go with that.  The truth about doctors is that there are very good docs, very bad docs, and the majority that are somewhere in between.  It is very difficult to gauge in an objective way, and that's even for those few who get to choose.  We live in a long standing medical cartel, in which the power of the state has long been used to give AMA doctors legal protection from competition.  There are issues that result from that, most are not good for consumers. 
That said, warts and all, we still at this point in time have the most innovative health care, and the highest quality health care that one could get short of being wealthy enough to travel the globe.
Lastly, as Dr. Davis points out, low carb diets provide the best results for health for most if not all folks, even those with very challenging genetic starting points.  Folks who take the time to measure this prove the rule.

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