are all statins the same?

[peter s]

I don't mean this facetiously. I note that in an interview on the THINCS website, Dr. Graveline himself states that "The statin drugs available during the last decade of my practice were not today's more powerful top-seller statins like Lipitor and Zocor. I used these earlier drugs liberally and encountered no major problems." I am not sure which ones he is referring to though?

In any event, if he is referring to ones no longer on the market, of today's alternatives do they pretty much all cause the same effects in the same proportion or -- if one concludes that at least short term one does need to take one -- are any generally a better choice?

[Allen1]

Peter,

what was available in the past was very weak in comparison to the statins that are now so freely prescribed. Apart from being much more powerful these statins are also being prescribed at an ever increasing dosage size.

From my experience, I had problems when I was on a low dose of Zocor but I did not know at that time what was the cause of them. These problems went ballistic when my dosage was increased to 40mg for no other reason except it was changed to a generic Simvastatin that was much cheaper.

Some folk don't seem to have much in the way of problems for a very long time, while others are effected almost straight away. Don't be fooled into thinking that any good will come out of using this crap, while taking statins you are playing Russian Roulette with 3 chambers loaded, not many people are that lucky as to not be the one who will survive to walk away unscathed.

Although people on the higher dosages seem to be effected more frequently but there are still a lot of folk who took lower doses with drastic consequences. Different people react in different ways to this stuff but there are so many similar symptoms that all or most of the folk have shared, many of those symptoms do not always go away.

[Brian C.]

Drugs are patented molecules. Each statin is a molecule that differs from its competitors sufficiently to earn patent protection. The essential action, that of reducing the body's ability to form melavonic acid from HMG-CoA, is the same for each molecule but the virulence (I choose an emotionally loaded word deliberately) of this action varies approximately across a divide separating water-soluble from lipid-soluble forms. The latter (e.g.Lipitor) are able to cross the blood-brain barrier and hence interfere with cell function within the brain.

Homer Simpson would probably twig to the danger of this before the average doctor.

Doh!

Brian.

[peter s]

Are these older statins now off the market entirely?

[Brian C.]

Once the patents run out the molecules can be manufactured by any pharmaceutical company and sold under its generic name, e.g. Zocor now competes directly with a number of simvastatins.

Pfizer's patent runs out in 2010 and from then on their Lipitor brand will be competing with variously sourced atorvastatins.

Here's the Wikipedia page on "Statin" :

*http://en.wikipedia.org/wiki/Statin

It was reading this page and then closely examining the HMG-CoA reductase pathway diagram that I experienced cognitive dissonance between the claims for safety and tolerance and the reality of the biochemical action of this poison.

Each substance in green is essential for cell function everywhere in our bodies and NOBODY has described any counterbalancing mechanisms by which our cells could compensate for shortfalls in any one of them.

Brian.

Brian.

[flacorps]

So Dr. Endo finds a nifty plant poison and wonders how it might be used to make people healthier? And it takes 20 years for anyone to notice that it might react synergistically with other plant poisons, such as the furanocoumarins and the flavonoids (both of which are found in grapefruit together, but can be found separately in lemons and limes in the case of the former, and oranges in the case of the latter)? Products derived from the peels and oils of citrus fruit are ingredients in many, many foods; and in some cases the content of the plant poisons has been magnified and other mitigating substances (such as citric acid) have been removed. And as far as I know there is no good survey with respect to how much of each is present in baked goods, sparkling waters, soft drinks and what-have-you.

All of this adds up to malpractice and product liability of the most reckless kind, at least with respect to the last 10 years.

[cjbrooksjc]

The 'References' section at the end of the Wikipedia entry has a wealth of additional information relative to Statin use and effect; in particular, one by Uffe Ravnskov and other professionals on the effects and misuse of Statins in therapy: **http://www.bmj.com/cgi/content/full/332/7553/1330. Remove the ** before linking.

Brooks

[Allen1]

That was very interesting and I noticed a quick response by a certain Raymond G Holder :D

There are also some good links to other statin reports, I especially liked the TV interview one, I have read too much today though and my thinking ability is starting to go downhill again so I will leave this as is :(

Good post though :)

[Ray Holder]

Allen

When I first saw your posting, I thought you were referring to last month, about 5th to 8th Sept when Uffe Ravnscroft wrote another letter, and I responded to back up his work, but then I got the link up, and that one was 2 years ago.

I have tried to get access to this later correspondence, without success. I have a print off of my response, but as the BMJ have put his letter in the print version , it gives no access to responses made.

He continues to put his arguments forward, more strength to his arm!!!

Ray

[cjbrooksjc]

Following is one of Dr. Ravnskov's papers I particularly liked. Google Dr. Uffe Ravnskov for a wealth of articles.

**http://www.westonaprice.org/moderndiseases/benefits_cholest.html

More strength indeed!

Brooks

[Allen1]

Hi there Ray,

although the information is 2 years old, everything that was said then, is still valid to this day. Unfortunately that still goes for some of the highly intellectual professionals that cannot see past the end of their noses and others who's wallets have never been so full, still insist that statins can do no harm.

If those very same people stopped patting themselves on their backs and quit believing in the spiel that they preach actually listened and learned from what Uffe Ravnskov and others have tried to tell them, think of how many of us would have been saved from these side effects!

Apart from all the serious harm that has been caused by the stupidity of the "I know best" brigade I think when Uffe Ravnskov and all the others warnings have finally been acknowledged as what is happening in reality, those very same suppressors and doubters of the facts will once again get away with the trail of harm that they have created on such a massive scale.

I wish Uffe Ravnskov and everyone else involved with ending this nightmare all the very best but wouldn't it be nice if all of those who benefited from poisoning so many for so long got what they deserve, well maybe some day!

[Biologist]

peter s,

Good question. But note that Dr. Graveline did not mention how effective the older drugs were, only that he did not run into problems with them. I am not sure which he is speaking of either. There were some older drugs that also caused problems. It is likely a function of dosage. I do not think the older medications is an avenue worth pursuing though. I do not remember your particular situation, but -- any way you look at it -- forcing cholesterol numbers down is not the way to go for anyone except for some people with FH.

Good find, Brooks. I will real all that hyperlink and spend more time with other work by Dr. Uffe Ravnskov with a Google search. I read his most popular book (assuming he has more than one). It was one of my first. I am please to see he is still at it.

I read Ray's response that Allen1 pointed out. It appears Ray has commented on the reason (if not the actual mechanism) for a permanent reduction of carnitine after statins. His answer implies (to me) that we will need more exogenous carnitine to replace faulty endogenous synthesis of carnitine after statin damage -- as opposed to a new requirement for higher amounts of carnitine. I has wondered about this issue in another recent thread. Ray's text is here:

"The lowering of Q10 also seems to affect its ability to replenish itself, as a vulnerable 17 stage process is involved, so a long self- destruct process is put into effect. The remark "it can't be due to the statin, because it would have stopped when you stopped taking it" is not valid, and the same applies to the reduction consequently of Carnitine, necessary for energy production from fat in skeletal and heart muscle, and permanent Secondary Carnitine Deficiency results, the cause of the muscle pain side effect."

The full text can be found at this hyperlink:

*http://www.bmj.com/cgi/eletters/332/7553/1330#140547

Biologist

[Biologist]

There have been questions (for years) about the actual number of people who experience adverse side effects from statins. We commonly hear that statins "are well tolerated." It appears not. Regardless, it would be more accurate to say "statins appear to be well tolerated by those who appear to tolerate them" -- but I suspect even that's wrong for reasons I discussed here regarding the Perversion of the Placebo Effect. It got me for years:

http://spacedoc.net/board/viewtopic.php?p=7742#7742

The following two pieces of text are instructive regarding my previous assertions that the numbers of people adversely effected are much much much higher than reported. I rest my case:

"In the recent incremental decrease in end points through aggressive lipid lowering (IDEAL) trial,6 which compared usual dose simvastatin with 80 mg atorvastatin, no significant difference was seen on the major end points. However, the number of adverse effects were far higher than in any previous statin trial. Almost 90% of participants in both groups had side effects, and in almost half of them they were recorded as serious. The authors of the IDEAL trial did not comment on this alarming finding except by mentioning that "there was no difference between the groups in the frequency of adverse events that were rated as serious"; neither did they inform readers about the nature of these events.

Complete text here: *http://www.bmj.com/cgi/content/full/332/7553/1330

[Biologist's note: It said "almost 90% of participants IN BOTH GROUPS had side effects." That means 90% of participants who were taking commonly prescribed dosages of Zocor. This also shows that higher dosages are particularly counterproductive -- I consider 40 mg of simvastin to be very high, but is commonly prescribed.]
_____________

Here's the other text:

"I have not done anything like a formal study, but I have an opportunity to see many many patients on statins and ask them nosy questions.

I am in private practice with two internists, one of whom is a statin fanatic, even prescribing statins to elderly women with HDLs of 80 and LDLs of 130 or 140. She goes on vacation 3 months of the year and I see her patients in that time, some for routine refills, some for medical problems. When I'm in the mood, I scrounge around asking them for potential statin side effects.

Almost without exception they have minor complains that could certainly be attributed to statins. By minor I mean subtle forgetfullness, vague muscle fatigue at the end of the day, mild disequilibrium; the type of stuff they probably wouldn't have told me about had I not specifically asked. A small minority of these have severe muscle aches and are miserable and dying to stop the drug if only it were "safe."

Many of these patients become my patients because they don't want to have to go back onto the statin again.

Of the hundred or so of my statin-loving coworker's statin-using patients whom I have seen over the past two and one half years since she joined our clinic, I would guess about three or four definitively denied having any symptoms, but I didn't question all one hundred well enough to be sure it was only those few--it could have been lots more. But my general, vague and possibly biased, impression is that it's the exception not the rule for people to deny potential statin caused symptoms began after starting their statins.

Most doctors would be crazy to ask elderly women about dizziness, fatigue, and forgetfulness because of course they're going to be dizzy, tired, and forgetful sometimes, and just by asking, now you've got them worried. Unless you also happen to have a potential solution for their mild complaints (ie "you should stop your Lipitor, Mrs. Pumpernickle) you just don't want to open that can of worms. But it seems to me we have a nation of dizzy, achey, tired older middle aged and elderly men and women who feel better after stopping the drug."

Complete text here: *http://www.bmj.com/cgi/eletters/332/7553/1330#135392

Biologist

[Biologist]

Note that one of the reasons that side effects were higher in this particular study was that there appears to have been no "pre-screening." Most such studies automatically eliminate people who show immediate signs of bad effects from ever participating in the studies -- but this fact may not be taken into consideration when final results are reported for side effects observed in the studies. In practice, this class of "eliminated patients" often are treated with statins -- long term. They are told such complaints are just in their heads, or if not just in their heads, to take the statins anyway.

Biologist

[Brian C.]

I view "statin therapy" as akin to "American peacekeeping".
I'll leave it to others to chew that over and spit out the similarities.

Brian.

[Biologist]

I'm going to mention the obvious here since we will continue to have new readers to this forum who may not have completely thought through the doctor / patient dynamics yet where statins are concerned. Let's look at this section of the text I quoted above:

"Almost without exception they have minor complains that could
certainly be attributed to statins. By minor I mean subtle
forgetfullness, vague muscle fatigue at the end of the day, mild
disequilibrium; the type of stuff they probably wouldn't have told
me about had I not specifically asked. A small minority of these
have severe muscle aches and are miserable and dying to stop
the drug if only it were "safe.

Many of these patients become my patients because they don't
want to have to go back onto the statin again."

Keep in mind, this doctor is temporarily seeing/treating WHAT REMAINS of the "statin fanatic" doctor's patients. The key to understanding what is happening is the last sentence. Dr. Statin Fanatic has already lost many or most of her former statin patients to other doctors or to no doctors (i.e., they quit seeing doctors). They are no longer active participants in her practice. They do not show up for prescription refills or routine lipid level and liver testing. The "stand in doctor" does not see all her serious mistakes, because they are simply not around anymore.

Others just don't fill their prescriptions. From having purchased all doctors' DEA (Drug Enforcement Agency) licensing numbers around the country from the AMA for quick cash (hey, times are tough for those good folks too, don't be so judgmental), Pharma knows fewer people are filling prescriptions, but the doctor would have no idea, and certainly not who is not filling them. If Pharma knows, it also knows to keep shut about it -- they might prefer the doctors not know that they know all they do about the doctor's prescribing habits. For the non-compliant patient, getting lipid tested once a year, particularly if insurance is paying for it, would not be considered a bad idea for the patient, they would still have an interest in how their numbers look. However, that does not mean they are taking their statins, and these people also would not be expected to complain about large or small statin-related side effects.

Biologist

PS. Easy there, Brian! Our NeoCon Party is always hot to help fix inferior economic systems. Some of those systems are currupt and ineffecient, you know. Word has it that you guys have a socialized (i.e., communist-like) medical system and stuff. That won't do. I hear our NeoCons already quit negociating with Spain without preconditions (and all other Latin countries adjacent to it to our south). You and your country-folk clearly need liberating. Canada better straighten up too. We (our NeoCons) can help.

[Brian C.]

Ah, but aren't we all getting socialized banking now?
Looking at the numbers that seems about the only Welfare we'll be able to afford in the near future on both sides of the Big Pond

Strange but true....


Brian.

[Biologist]

Brian, on this side of the pond we have been half socialist for years. It's just a bit more obvious these days.

Here's the formula:

Privatize the Profits, Socialize the Costs & Risks.

(Statins are a perfect example.)

Lots of folks (i.e., those who watch Fox News and listen devotedly to Rush Limbaugh) didn't object as they always figured they were part of the left side of the equation, or would be soon. They recently learned otherwise...

Biologist

[Brian C.]

Sad but true.


Brian.