I mentioned smoking in this thread. Smoking is great for statin sales. It's also a good trick:
My primary complaint with my doctor's doctoring over the course of my statin "therapy" was that I was never advised AT ALL, EVER about ANY side effects of statins including on the occasion we doubled my dosage and also including the times I presented with symptoms he should have recognized as potentially being attributable to statins. [See first footnote below] However, another complaint regards my smoking habit at the time.
My doctor, like most other doctors, was outsmarted. And so was I. Here's how:
There is no question that smoking is a significant Risk Factor for heart disease -- we've known that for many years. However, the scientific evidence, as well as common sense, indicates that a smoking habit is not likely a clinical indication for statin therapy! I believe this truth has been quietly shrouded for the sake of increased statin sales.
Smoking is a serious Risk Factor for cancer (which is recently reported to be the NEW number one killer of Americans -- not heart disease). And so are statins. Cigarettes cause cancer and statins cause cancer too. The combination implies even more cancer -- that's the common sense part of the equation. Smoking should be a contraindication for statin use due to the additional increased risk of cancer.
The statin link to cancer appears to be well confirmed by science. The early studies showed increased cancer rates with statins use -- even over the short duration of these studies where new skin cancers, for instance, were regularly observed. Skin cells replicate at accelerated rates which explains their assistance for exposing human carcinogens early on. Remember, most other cancers take decades to develop, such as lung cancer, from smoking. It is my understanding from my readings that this embarrassing cancer fact was finally fixed: the cancer link ceased to be reported on in study findings, and later by not even tracking the cancer rates at all.
But there's more. And it's not new. This paper, written in 2001, is based on studies going back in to the beginning of statin experimentation on humans. Forget the first sentence, it's very wrong based on any and all reasonable renditions of risk / benefit analysis and cost / benefit analysis. Substitute the word "insignificant" for the word "significant" in that sentence. Fish oil would have been significant, Vitamin D would have been a miracle.
*http://ang.sagepub.com/cgi/content/abstract/52/9/575
The best idea is to quit smoking if you are able, or to get nicotine (a non-carcinogen) some other way. I did both. Eighteen months before my crisis with statins (which I should add, involved an interaction with the antibiotic doxycycline which I had started taking a few days prior to my acute "statin attack.") [See second footnote below] I was certainly never advised that I should stop taking statins if and when I quit smoking, and come to think of it, as it was my ONLY risk factor aside from slightly "elevated" lipid levels (which smoking can cause, by the way), it is not at all clear to me, after some recent research, that I ever should have been on statins in the first place per the NCEP guidelines -- smoker or not! But I was an easy sell from the day I started and up until the morning of the day I quit. Sure I was. Statins were the miracle longevity elixir per the pharmomedical establishment as reported and reported and reported by the media and pharma's advertising -- and as continues to be reported and reported and reported still today.
However, my doctor was certainly aware of significant side effects from statins presumably including thoes that can develop years after starting statins as reported in the medical literature over this time period. Upon an emergency office visits the day after my damage, he acknowledged some of them. He should have known I was taking a significant risk for little or no potential return regardless of what eager pharma sales reps may have said/lied. In fact, at least today, it is becoming generally acknowledged by practicioners and researchers that if you take statins, you are going to die early, statistically speaking. The calculus is that by not taking them, when they may be legitimately indicated, you will die earlier still. Of course, not advising to supplement CoQ10 with statins basically assures early death. This should be a criminal offence. In the future it may well be. It's inexcusable.
I am not pleased that I was ever advised to take statins in the first place or advised to have my dosage increased (i.e., due to the "legitimacy issue" cited above and also due to the lack of advised consent both times). I am not pleased that I was not advised to take CoQ10 which is first year med school physiological common sense. I am not pleased that I was not advised that I should look forward to coming off statins if and when I quit smoking. But to be fair, I did not mentioned to my doctor that I had quit smoking, it just never came up. I was not anticipating ever coming off the wonder drug anyway -- I did not know any better. However, it seems to me, smoking should have been mentioned by any doctor each and every visit, when potential heart disease is the health concern.
For what is is worth, I was a very light smoker for sure when I smoked, but I certainly smoked more than "one per month" when I did. For many years prior to starting statins, I satiated my nicotine addiction with nicotine patches, nicotine gum and smokeless tobacco for health reasons (thereby presenting a small and largely treatable cancer risk, if your watching for it, but not any significant heart disease risk). I was atypically physically fit for my age -- maybe not first draft material (or second or third or fourth...) for a national football or baseball league, but in pretty decent shape never the less. (It is the carbon dioxide permanently binding to hemoglobin that lowers athletic performance -- that's why you never see it in sports.). I had tapered off and stopped smoking completely by 18 months prior to my crisis with statins. Had he asked, or if smoking had come up, I sure would have proudly informed him. However, whether he might have then suggested that I should stop taking statins, I will never know. I would like to think so. HOWEVER, for me the point is I never would have had any drug reaction with doxycycline if I were not already unnecessarily on the first dangerous drug when the second was started. I took it after my laser eye sight correction "surgery." It's the interaction which has caused the great majority of the serious harm for me. So aside from my own particular circumstances, that's what I have to say about smoking and statins. In summary, while a risk factor for heart disease, smoking is not an indication for statin therapy.
In a way, this is a pretty irresponsible post since I know that Pharma monitors this site. Pharma also sells outrageously over priced chemotherapy drugs. Until now, they may not have realized their new market expansion potential of having their sales managers (i.e., their drug reps) instruct their direct sales force (i.e., our doctors) to place cigarette smokers on chemo to head off cancer. Except for being a bit safer perhaps, it's no more asinine a concept than putting healthy people on metabolic poisons to ostensibly head off heart disease. In fact, they can do both with the same patient. Sorry if I've let the cat out of the bag.
On a related note, many doctors pretend to believe or actually believe (due to intensive brainwash therapy administered by Pharma) that if a patient tolerates statins for the first few months, they are set for a lifetime of statinization and office visits. However, while we may survive our first few years of therapeutic arsenic or cyanide dosing, that does not mean the it will not eventually do us in. If not, it is still an unreasonable risk for only similar health effects as realized by statins. It would also certainly lower the quality of life like statins do. On the upside these more classic and historic metabolic poisons do have the benefit of being much cheaper than statins -- and the best predictor of longevity is wealth, or conversely, the lack thereof.
Biologist
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FOOTNOTE #1
My original prescribing doctor, who I only ever saw once or twice, moved to another city right after my first prescription of 20 mg of Lipitor. It was at that time a new doctor took over where I was subsequently put on 40 mg of Zocor for six years. So, to be fair, my newer doctor would not have been aware that I was not briefed whatsoever on the downside of statins from the start -- while he should have done so himself at the time my dosage was doubled, or at any time over the next six years. A digression: I got 80 mg tablets prescribed and cut them in two as this was cheaper. Aren't I clever. Sneaky. Rest assured Merck was and is aware of this corruption in patient behavior, and pleased. Market retention. Here's an example: I regularly remove women from statins -- about four or five a year. It's too easy. Just suggest they check the Web to find that it does nothing but damage them per all the studies -- they all quit. I've checked back to see for some of them months later. However, sometimes its harder. I had one lady confide in me her dirty guilty little secret in a very hushed voice after looking around over her shoulder at work to make certain she was not overheard: she was not interested in quitting because she was getting the best of Merck! She was cheating! She was cutting her 80 mg pills in two for a (probably illegal?) discount! Another woman I spoke with knew I simply didn't understand. She must have told me in exasperation three times in five minutes: Her AND HER HUSBAND were both getting their's FOR FREE. Her insurance covered it -- All of it -- she could not possibly quit, getting it for free and all... Oh boy. She eventually saw the light. As they say, its hard to cheat an honest person... She's now an honest woman.
End of digression. Back to it.
Erectile dysfunction is an example of a missed opportunity to mention statin side effects to me. This should have been a clear signal to my doctor of a likely or potential side effect. There was no mention of statins at the time of my Viagra prescription or later for my Cialis prescriptions. Not a word. Any word a all would have gotten me doing some online research -- and I would have quit statins the same day. (In fact, cynical as it may sound, after reading up on "doctor motivations" provided by pharma, it's crossed my mind that may have been part of the reason no word was ever mentioned.) I also complained of sleep problems at office visits and got prescriptions for Ambien. Sleep issues can sure be a statin side effect by various mechanisms including the development of, or aggravation of, sleep apnea; but there are other mechanisms too including damage to parts of the brain including the hypothalamus which regulates sleep via hormone secretion. Again, the least suggestion would have been helpful; it would have made all the difference.
My sinus problems were considerably worse over the years I was statinized -- another known side effect. I was prescribed highly overpriced and highly ineffective nasal steroid sprays instead (which were often provided to me free of charge by my doctor from "samples" left by drug sales reps -- those guys are real nice about that -- always looking after the patient). In retrospect, there were many warning signs that I did not know to look out for -- I certainly would not have been much of an alcohol drinker if I had been warned of that particular "interaction" with statins (Actually, I would have quit the statins in a heartbeat.) I may write further on that issue another time. In short, I'll say this: Don't do it. At all. NO drinking while taking statins. Particularly for men.
Regarding the Patient Insert Sheet supposedly provided with the prescription itself (I think), I cannot swear II ever saw it or got it. I have recently found it online (the current version of it anyway). However, my pills were always counted out and placed in a different bottle by the pharmacist with no insert sheet, if that is where they are suppose to be. A short K-Mart printout was included with my prescription refills, but it provided little meaningful information to me, as I remember. Most potential side effects cited in these things always seems to be equaled or exceeded by placebo -- from others I've seen. It is a doctor's responsibly to alert the patient. It says so right in the doctor's Product Label for Zocor. Now you would need a microscope for the tiny print found on that official hardcopy for doctors; I know because I got one of them from the pharmacy recently. I gave up, but then found it online a few days ago and printed it out and read it -- all 31 pages. I wonder how many doctors have actually read it, or tried to. No need though. They have their sales managers, known as drug reps, who have read parts of it and can tell doctors all they need to know when they drop by with lunch.
FOOTNOTE #2
Doxycycline. I went looking for proof that it is an "interacter" with Zocor a few months ago. I may write on this matter in more detail another time, however, I will mention now that it turns out to be a known "interacter" with Zocor (and most other statins including Lipitor) which serves to greatly increase the plasma level of the statin drug -- often to toxic levels. (I can attest that it does indeed do that.) However, doxycycline IS NOT listed in the official Product Label text (even on its 10/2008 reprinting which I read). You'll sure find it listed here though. While it's one of the only places you will find it:
*http://www.umm.edu/altmed/drugs/simvastatin-114850.htm
Look at the "CYP3A4 inhibitors" paragraph under the "Drug Interactions" section. (Attention doctors, note that doxycycline is known to be both a competitive substrate for AND an inhibitor of Cyp3a4!) To have listed docycycline on the official Product Lable sheet, which is clearly "medicalese" and solely intended for prescribing doctors, might have (correctly) implicated the entire tetracycline class of antibiotics which might have severely limited the commercial use of statins. It might have crippled sales. I contend it was intentionally omitted. As we know, the best time to start an antibiotic, when indicated, is generally the day before yesterday -- that is, as soon as possible if not sooner. You want to stop the organism quickly at its earliest stage. There's often no time to stop statins first and give it several days to partly clear out of a patient's system before starting a course of antibiotics. Doctors would have realized this downside to prescribing statins and would have written fewer prescriptions -- particularly for people who never had any legitimate basis for being on such a metabolically disrupting drug as a statin. The damage caused by the interaction would be masked by the fact that the patient was sick (thus the reason for the antibiotic) and the patient would not consciously notice that he/she just never quite recovered to previous levels of health. Of if so, it would naturally be attributed to lingering effects of the infection. And later, "gotten use to" by the patient. Perfect.
In fact, I have a theory. It came to me this week: Having put in about 20 hours studying Lyme disease online about five or six years ago out of interest in this evolving epidemic, and also out of interest in this biologically curious organism, I know that doxycycline is often the drug of choice for long-term treatment. Lyme disease adversely effects cholesterol levels; therefore, many people with the disease are probably on statins -- perhaps many thousands of them. Under antibiotic treatment, while much of the infectious spirochete population is killed, these patients often fair very poorly in the process, and afterwards. It is said that toxins are released by the destroyed organisms. That is likely true; it is also likely not the whole picture. The drug combination is probably wreeking havoc. Patients must be removed from the statin drug -- and particularly during their extended courses of the doxycycline treatments !
In addition, I have previously posted on the particlar damage doxycylcine (as a member of the tetracycline class of antibiotics) does to the mitochondria, which is above and beyond the effect of dangerously increasing the dosage of statins to toxic levels. This class of antibiotic is used to disrupt mitochondrial function (i.e., mitochondrial protein systhesis) in mitochondrial research. Since much, if not the majority of statin damage is directed at disruption and mutations of the mitochondria, this may be another significant reason that the two drugs should never be administered together. This hyperlink
http://spacedoc.net/board/viewtopic.php?p=4846#4846 leads to that discussion months ago from a thread discussing similar drugs and potential statin interactions. Cut and paste the link *www.cytochemistry.net link found in my post to see how tetracycline is used in research on the mitochondria.
Biologist
). To make sure things stayed on the up and up regarding lab testing I took a drugstore home cholesterol test too. Hey, some of these national diagnoistic testing labs are tricky, you know, for example:
