Thursday, February 2, 2012

Women, Statins,9171,1973295,00.html

Interesting article, complex topic.

First, there's very little info that supports the efficacy of statin use for females, so I hope those who are getting that recommendation will take the time to research the matter carefully.  My opinion based on experience is that doctors have as difficult a time keeping up with medical developments as any other profession does - there's absolutely not a guarantee that the doctor knows more than you do or could - especially since it's not the doctor's life that's at stake.

You needn't take my word for that - have a listen to this episode of Jimmy Moore's excellent podcast, for a decryption of how cardiologist Lowell Gerber found his way out of the low fat woods using carb restriction, and along the found out "that my patients had not been lying to me".  IOW, the patients kept saying "Doc, I am doing what you say" but their conditions were worsening; it was only when the doc took his own advice that he realized he'd had them barking up the medically correct but wrong tree.

When looking at statin results, the confusing language is hard to get around.  They talk about reduction of mortality from cardiac events.  They talk about "reduction of risk."  They talk about better cardiac results for this group or that group.  But often, what is found in statin trials is the cardiac disease is interrupted, apparently, but other disease risks increase.  Many statin trials show a wash for all cause mortality; thus the Cochrane Collection's ambivalent report on their efficacy in a 2011 meta analysis.

Further, statin trials are short, meaning there is probably time to evaluate the benefit but not to evaluate the side effects.  With many medications, the benefits make themselves know before the costs - for example, alcohol and cocaine (and stimulants in general).

One thing I think HAS been proved about statins, and that is that they work, if they do, due to a reduction in inflammation.  They are supposed to work by lowering levels of lipoproteins (the vessels that transport cholesterol), but that causality has never been proved.  I would say it was convincingly disproved by vytorin, a med which combined statins with another cholesterol lowering drug, and was effective at lowering cholesterol - but increased mortality of those taking the drug (as I've reported on before).

Notice in the two year old article linked above, however, the entire intro is build around the "cholesterol gunks up your arteries like grease in a pipe" model.  How quaint!

If you want to dig deep into the science of lipoproteins, cholesterol and disease - I recommend this podcast/transcript from Chris Kresser with Chris Masterjohn, and this link from Cholesterol

Here's the BLUF:  think of heart disease as the result of broken glass floating around in your blood vessels, and the atherosclerotic plaques are your body's response to the cuts.  What do I mean by "broken glass"?  Masterjohn equates easily oxidized particles in the blood to glass - useful when whole, but dangerous when broken.  The particles in your blood that oxidize most easily are LDL particles with a high content of polyunsaturated fatty acids (PUFAs), and the small, dense LDL particles left over after your body responds to high carb intake via conversion of glucose to triglycerides.  Under the "what to do" category, think of inflammation reduction via carb restriction and low intake of PUFAs, ingesting enough of the essential vitamins and minerals, maintaining a healthy gut, and cultivating a good set of gut bacteria.  Easier said than done, sure, but the first step is - carb restriction.  No sugar/no wheat is part two.  These two are probably 80% of the formula.

Eat meat, vegetables, nuts and seeds, little fruit or starch, no sugar/wheat.

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