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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Statin Rage

November 12th, 2008 · 12 Comments

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People seldom make me angry any more. When another driver cut me off yesterday, I didn’t even flip him the finger or honk my horn. I just figured that he was in a bigger hurry than I was.

Recently doctors have determined that when we are younger and when we are older we are happier than when we are middle-aged. That can’t be generally true, because I still remember my miserable youth.

My life instead has been one of increasing happiness. I’m much more likely to shed tears of joy, as I did on the evening of November 4, than to weep with rage.

But our doctors still infuriate me. Especially those physicians in league with the pharmaceutical companies that keep pushing the statins at us.

As a patient I know the statins all too well. Years ago when my doctor prescribed them, I tried to tolerate four of them. But each of them caused terrible muscle pains in my right leg.

I can’t therefore imagine anything more reckless to our health than for everyone to have to take a statin. Yet that is precisely what an appropriately named doctor in the U.K. suggests.

“Maybe people should be able to have their statin, perhaps if not in their drinking water, with their drinking water,” Dr. John Reckless told BBC News four years ago. Apparently not an idiot, he is chairman of Heart UK and a consultant endocrinologist at Bath University.

That was four years ago. But they keep pushing these drugs at us. And now they are pushing them at more and more of us.

Just this week the prestigious New England Journal of Medicine published the results of the “JUPITER Trial.” Jupiter stands for “Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin.”

They named the trial a “justification”? That’s open minded? Not. This “translates to by God we’re going to prove that statins prevent something,” comments one of my favorite bloggers.

The JUPITER study group concluded that men over 50 and women over 60 with normal LDL-cholesterol levels (less than 130 mg per deciliter) and highly-sensitivity C-reactive protein levels of 2.0 mg per liter or higher who took one of the statin drugs minimally reduced their risk of developing heart disease or dying of any cause as compared to those who took placebo. That’s it.

But the drug pushers and their allies in the mass media all jumped up and down over the study. Even The New York Times on Sunday reported that, “A large new study suggests that millions more people could benefit from taking the cholesterol-lowering drugs known as statins, even if they have low cholesterol, because the drugs can significantly lower their risk of heart attacks, strokes and death.”

What’s the big deal? We have known for years that C-reactive protein “is a general marker for inflammation and infection, so it can be used as a very rough proxy for heart disease risk, as Wikipedia says. But, the encyclopedia continues, “Since many things can cause elevated CRP, this is not a very specific prognostic indicator.”

Four physicians from Northwestern University’s Feinberg School of Medicine in the Annals of Internal Medicine two years ago reviewed how well CRP predicted heart attacks. They found “no definitive evidence that, for most individuals, CRP adds substantial predictive value above that provided by risk estimation using traditional risk factors for CVD [cardiovascular disease].”

For people with diabetes the lesson of the JUPITER Trial isn’t to swallow statins. It is to know our CRP level so we can control inflammation.

Diabetes has a direct link to inflammation. The better we control inflammation the better we can control our diabetes.

That’s why it is especially important for those of us with diabetes to prevent gum disease, which is chronic inflammation of the tissues surrounding and supporting our teeth. Inflammation also plays a central role in another complication of diabetes, peripheral arterial disease.

The test known as highly-sensitive C-reactive protein may not be a good guide for us to take a statin drug. But it is a good guide to the general level of inflammation in our body.

Do you known your CRP level off-hand? I didn’t and had to look mine up. It’s 0.4 mg per liter. I will skip the statins.

The great poet Dylan Thomas would have us, “Rage, rage against the dying of the light.” Certainly. But we must also rage against what’s not right.

This is a mirror of one of my articles that was originally published on Health Central.

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Posted in: Diabetes Medication

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12 responses so far ↓

  • 1 Nurse Nancy // Jan 1, 2009 at 8:15 am

    I agree that a CRP of 0.4 does not call for a statin, especially if the CRP was of the highly sensitive type. The issue changes, however, if LDL is elevated, and many providers consider a level of 100 to be the maximum for LDL. Triglyceride level also needs to be factored into the equation, and, again, a number over 100 is a concern. And, oh yes, let us not forget the family history, patient’s symptoms and the physical examination.

    As a provider, I take seriously the statin controversy and am in favor of a non-phamaceutical approach whenever and wherever it is realistic. On the other hand, I feel we are sometimes too quick to demonize medication which might be valuable or even life -prolonging for some individuals.

  • 2 David // Jan 3, 2009 at 4:55 pm

    Cast my vote against statins. They put me on couch and I couldn’t get up because of the pains in my legs, etc. I had recently had a knee replacement and was blaming the problem on that; however, upon stopping the statin therapy following my own investigations, the pain went away and I could walk again. While good for some, they’re bad for many more than are accounted for by the pharmaceutical companies.
    Rather than “too quick” to demonize this medication, I think we’re taking too long to reevaluate it’s side effects.

  • 3 Type 2 Linda // Jan 6, 2009 at 9:40 pm

    I have tried four different statins. In addition to weakness in both quadriceps, I developed severe hives on my arms and back. My arms looked like a cobblestone street and itched fiercely. I also tried Niacin, which produced the quad weakness within about 6 days, very disappointing. The only thing I tolerate is Zetia. For the folks who can handle them, I suppose statins can be a boon, but so many of us can’t. I managed to get my levels down under 200 with a decent ratio, but because of the diabetes, the push is for ever lower numbers and frankly, I’m sick of it.

  • 4 David Mendosa // Jan 7, 2009 at 8:13 am

    Dear Linda,

    I know just how you feel. None of the drugs worked for me. But a very low-carb diet, which I have written extensively about in other articles here, really did work.

    But about Zetia. I took it too, a few years ago, and also could tolerate it. Not surprising, because it has a totally different way of “working.” I put that term in quotes because of the very negative studies of Zetia that came out last year. So I just did a Google search and one article that you might want to read is at http://blogs.consumerreports.org/health/2008/09/zetia-down-for.html

    Best regards,

    David

  • 5 Chas // Jan 26, 2009 at 4:59 am

    David, here in the UK the doctors and diabetic specialists are absolutely still pushing the statins down our throats, and I was told not to be so “reckless” as to give them up.

  • 6 David Mendosa // Jan 26, 2009 at 8:58 am

    Dear Chas,

    Likewise in the U.S. But to use an old cliche, this sounds to me like the pot calling the kettle black.

    Best regards,

    David

  • 7 Dave S type 2 // Nov 22, 2009 at 5:34 am

    I had been doing some research, found alot of scuttle about apple cider vinegar? for lowering cholesterol?

  • 8 David Mendosa // Nov 22, 2009 at 8:24 am

    Dear Dave,

    Could you share the citations for the research on apple cider vinegar for cholesterol that you’ve found? It hasn’t been discussed here previously, and I haven’t heard anything about it.

    Best regards,

    David

  • 9 Cardiologist // Nov 25, 2009 at 2:08 am

    Be careful, David. You’re writing is generally excellent, but raging against statins on the basis of your personal experience is irresponsible. Yeah, CRP is sort of dopey, and giving everyone statins is silly, but look at the rest of the data. Those of us who can remember the pre-statin days would never want to go back to them. Statins are *great* drugs. Indisputably, they save lives, in lots of patient sub-populations. Sure, some people can’t tolerate them, and it’s too bad for you that you’re in that group, but lots of people can’t tolerate penicillin and aspirin. We’re still trying to define the groups that benefit from statins, just like we studied penicillin at the beginning of its life. That’s what physicians do. But at this point, I think diabetics who can tolerate a statin should be on one, without a lot of handwringing.

  • 10 Dave S type 2 // Nov 26, 2009 at 6:26 am

    Cardiologist, Please correct me if I’m wrong, But don’t statin drugs deplete your body of coq10 which is all our muscles (especially heart) doesn’t taking a statin to lower one product defeat the the rewards if it also lowers another very important enzyme?

  • 11 Dave S type 2 // Nov 26, 2009 at 6:34 am

    I don’t know why the medical industry seems to bock at natural or alternative remedies, but WEB MD has an article that is some what interesting on applecider vinegar, they almost admit it works, http://www.webmd.com/diet/apple-cider-vinegar

  • 12 Cardiologist // Nov 26, 2009 at 9:06 pm

    I don’t give a whit about co-Q10 or any other aspect of the molecular biology. I am not a molecule doctor, I am a person doctor. The data show that statins saves lives and that they are generally well tolerated. If they worked by changing the color of blood from red to purple and were as safe as they are now, I wouldn’t care. That’s why we do clinical trials. We’re not smart enough to understand the billions of possible molecular interactions. Molecular analyses lead us astray more often than not. Remember, in the 1990s everyone was pushing vitamin E as a great anti-oxidant. Clinical trials later showed that it causes heart failure. Oops. There is an old saying about being “too clever by half.” Don’t let that happen to you. If well-designed clinical trials show vinegar is effective and safe, then great, but until then, you’d be foolish to pass up the proven benefits of statins for the pie-in-the-sky of vinegar. Remember the vitamin E experience. (The article you mentioned cited lots of potential hazards of vinegar… am not sure about those.)

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