Lipitor - Oh Where Can You Be?

[cheeryble]

ps: I know I know....it's complicated, and possibly post-menopausal women, unprotected by ovarian hormones, may become as men statinwise. That might however be balanced by cancer risk reduction. It's complicated.

What I do know is that regular doctors are generally speaking not capable of evaluating evidence to give advice. With due respect they woukdn't know what Bayes Theorem was if it hit them in the head.

Example:

When the USPSTF changed to recommending no PSA for symptomless men the American Board of Urologists went apoplectic, that it couldn't be so, and complaining that there was no urologist on the panel.

What they omitted or didn't realise was that you don't need an expert urologist you need experts at assessing evidence.

A year or two later they have accepted the recommendations, though sadly their workload has been halved and they're trading in their Mercedes. Happily there will be a whole lot of men living a pretty normal life without Impotence and incontinence.

Edited June 2, 2013 by cheeryble

[moe666]

MOE666

"If you are over the age of 40 taking a statin just might increase your life span 3 to 6 months"

Where did you get this from?

The Cholesterol Myth a very good book about the studies of cholesterol that has led to the over prescription of statins

[cheeryble]

Moe 66

If you are over the age of 40 taking a statin just might increase your life span 3 to 6 months

Hi Moe

It could be an extremely broad average for everyone, but your quote without context would be so vague as to be almost meaningless, and I would doubt it.

It needs more definition, like male/female, high TC or not, more specific age group, pre-existing CHD or not.

What is the context?

Thanks.

(what I believe was pointed out in your book....following Malcolm Kendrick and so on....was the almost childishly erroneous (my terms) origins of the lipid hypothesis by Keys.)

Edited June 2, 2013 by cheeryble

[Sheryl]

Statins were badly over-hyped when they first came out and now we are seeing the predictable backlash.

Also, as is normal when new drugs hit the market,. more has been learned over time about possible adverse effects than were evident in the initial trails. Minor side effects aside, the main adverse effects if concern are: liver toxicity (for which reason baseline and periodic repeat LFT needed for people on statins), muscle pain/damage and memory loss/cognitive impairment. (reversible when the med is stopped). Not everyone gets these problems, in fact majority do not, but some do.

As with any drug risks and potential benefits need to be intelligently weighed and this equation will differ with each individual. Statins do have a valuable role to play for soem patients but that does not mean that everyone with elevated LDL cholesterol or triglycerides should take them.

Anyone taking statins should do so under the care of a physician who is up to date on the issue and able to converse intelligently on the topic, including an explanation of the pros and cons specific to your individual case. Avoid doctors who just reflexively prescribe these drugs to everyone withe elevated lipids without looking at cardiac risk factors and discussing the risks and options with you. (Yes, I realize that rules out the average Thai GP. But such docs can with patience be found).

[cheeryble]

As with any drug risks and potential benefits need to be intelligently weighed and this equation will differ with each individual.

That's it Sheryl....a reasonable approach.

But you're certainly right about

Anyone taking statins should do so under the care of a physician who is up to date on the issue and able to converse intelligently on the topic, including an explanation of the pros and cons specific to your individual case. Avoid doctors who just reflexively prescribe these drugs to everyone withe elevated lipids without looking at cardiac risk factors and discussing the risks and options with you.

When high C was (reflexively) suggested to me as a risk factor that I should do something about pharmaceutically and I asked whether the high C was a cause or a marker I was met with a blank stare

Edited June 2, 2013 by cheeryble

[Sheryl]

Yes well, obviously blank stare = bad sign and look elsewhere for a doctor.

I even find some docs here who still think total an elevated cholesterol is an indication for treatment. Ads a vegetarian I have a low LDL and high HDL (exactly what one wants). Several times I have gotten the "lower your cholesterol" shpiel from Thai doctors because the total came over 200 (not specialists, of course -- usually the ones working in health check up depts). Attempt to point out that the HDL and LDL are both in desirable range and the LDL:HDL ratio very favorable leads to completely blank looks.

These are the folks who skated through med school with average grades at best and haven't read much of anything other than perhaps drug company literature since. Plenty of them about, but there are also some really good doctors to be found. Pays to search them out.

[moe666]

A few years ago went in for a check up the Drs. Assistant talked to me asked all the questions, how is your cholesterol? I actually have low cholesterol it runs around 130, I replied. He says o lucky you. I asked him if he knew the dangers of low cholesterol, he say What dangers, I say yes: Low testosterone, mental disorders, loss of memory. He was shocked that what the drug salesman who visited on a regular basis hadn't explained the dangers of low cholesterol especially when induced by a drug.

[moe666]

Moe 66

If you are over the age of 40 taking a statin just might increase your life span 3 to 6 months

Hi Moe

It could be an extremely broad average for everyone, but your quote without context would be so vague as to be almost meaningless, and I would doubt it.

It needs more definition, like male/female, high TC or not, more specific age group, pre-existing CHD or not.

What is the context?

Thanks.

(what I believe was pointed out in your book....following Malcolm Kendrick and so on....was the almost childishly erroneous (my terms) origins of the lipid hypothesis by Keys.)

Sorry I cannot give you the reference of my information as it came from a healthcare professional who had been reading some articles on the latest research on statin use.

[Old Man River]

Bestatin is simvastatin, not atorvastatin. Different drugs although from the same family.

Sheryl, on atorvastatin (Lipitor), due the strengths equate? For example, does 20 mg of Lipitor = 20 mg of atorvastatin?

Thanks,

[Sheryl]

More or less, yes. Dosages for both generally range 10 - 80 mg with 20/day common. But as they are not exactly the same drug yo will not necessarily respond exactly the same to equivalent doses.

[Nowhereman60]

I pay nothing for it thanks to Uncle Sam. I get it mailed here from Express Scripts to my APO mail box,