A blogger at the website HealthyCriticism.com shared this trenchant, if sad, thought on his blog. It is worth pondering:
“Between the billions in manufacture profits and the positive reviews of the data, not to mention the effects (placebo and otherwise) experienced by patients, you might wonder what the problem is. Isn’t everyone happy? Well, for starters, no, not everyone is happy: the side effects associated with statins (muscle pain and weakness, liver damage, neurological and digestive problems, and increased blood sugar) are not much fun. But I actually have a different concern: it seems to me that medical decision-makers have been so focused on the question ‘do statins work?’ that they’ve forgotten to ask the question ‘what do statins do?'”
“The basic effect of statins is to inhibit the activity of HMG-CoA reductase, an enzyme critical to the synthesis of cholesterol in the liver. According to the conventional wisdom, this leads to lower levels of LDL and total cholesterol in the blood, and reduces the chance of forming atherosclerotic plaques; the fewer the plaques, the lower the risk of death from acute cardiovascular disease. And you can certainly interpret the data as supporting this theory. A glowing review by the Cochrane Collaboration [author is probably referring to the 2013 review that we just dissected] found that statins (in general) produced significantly lower LDL and TC [total cholesterol], as well as a significant reduction in risks of major vascular events and all-cause mortality. Pretty great, right?”
This book’s analysis just pointed out the many flaws of the 2013 Cochrane report, but even assuming that research was totally untainted…
“There’s just one big problem with this tidy little story: there’s actually no evidence that higher cholesterol is associated with increased risk of mortality. This shouldn’t be all that surprising; cholesterol is a critical building block in all animal life, and the primary reason you have a central nervous system.”
Remember Dr. Peter Attia’s primer on the nature of cholesterol, and please consider reading it in-depth, so you can have a better understanding of this critical biochemical component. Once again, Dr. Attia’s series is available for free here.
“So it seems counterintuitive to view [cholesterol] as a bad thing. And the data don’t argue with your intuition; the Framingham Heart Study failed to find a positive association between cholesterol and mortality risk. That’s right: the mammoth study whose data are used to benchmark cardiovascular disease risks all over the civilized world didn’t find that lower cholesterol was protective against mortality.”
Science journalist Gary Taubes wrote about the flaws of the Framingham Heart Study (and its interpretation) in great length in Good Calories Bad Calories. Please read more about that related issue here.
The author continues: “This would seem to beg for a follow-up question: if there’s no evidence that lowering cholesterol protects against cardiovascular disease-related death, why do we see the effects we see in the statin trials?”
The author then offers a hypothesis that might explain the effects (read more here).
In conclusion, he writes “why doesn’t the conversation about statin use start with asking why cholesterol is elevated?… The solution could be as simple as a shift away from a carb-heavy diet. The question could also point to an inflammatory process being triggered by another illness. What it shouldn’t point to is a lazy, one-size-fits-all prescription for statins. Like many, many other decisions in healthcare, the choice to prescribe statins should be preceded by a sober discussion of the risks and benefits with the patient. Some patients will be inclined to trust the traditional care model and the trial data; some won’t. But what shouldn’t be done is plowing ahead until the mechanisms of statins are well and truly understood.”
At the end of the day that is what this discussion is really about: patients need excellent science and meticulous research that is not corrupted by industry funding and that fairly weighs the costs and benefits of drugs like GranuFlo and Lipitor.
In a free market society, companies should be allowed to profit from making technologies and medicines that help people. However, the patient needs to come first. Researchers, medical journal editors, regulators, and doctors all have a fiduciary responsibility to patients — to them and to their families.
The Lipitor story is confusing and evolving. But one thing is beyond certain: the messiness, sloppiness and industry corruption of research needs to end. We need much better processes, across the board, to ensure that patients, doctors and medical educators get information that is based on the best, most rigorous science available.
If you want clarity about your rights as a victim of Lipitor side effects, the lawyers at Davis & Crump can help. Get in touch now at 800-277-0300 for a free case consultation.