Right or Wrong?

When two physicians give you two different answers to the same question, one of them is right and one of them is wrong.

In these situations, what do you do? Blindly accept the advise of one or the other?

No. You become a gumshoe. You read. You investigate. You become Columbo.

I have truckloads of sympathy for those who are hoodwinked and corralled into taking medications that not only do them no good, but do them harm. My dear mother in law is one of them.

Her doctor put her on statins after she had a heart attack last year. She's fine now and doing well but if the doctor bothered to read a smattering of the scientific literature on cholesterol and women, she would know that statins are useless and cause everyone who takes them liver and neuromuscular harm.

What did Hypocrites say again? Do no what?

It's a shame really. And I feel sympathetic towards the doctors too. But when there is conflicting evidence in a particular area of medicine, don't you think that the doctors have a responsibility to know both sides? So very often they don't. They are entirely clueless to the opposing evidence.

To me this is malpractice. It's certainly wildly irresponsible and disgustingly lazy. This medical malaise is hurting and killing people everyday. Our president wants to know how to fix healthcare. How about insisting that doctors educate themselves on issues that have conflicting evidence?

Sometimes when something breaks, you need to throw the item away. There's just no repairing it. Time for a new one.

Comments

[fred hahn]

I do have a FB site Jeanie - here it is: http://www.facebook.com/profile.php?id=633467863&ref=name

Glad to hear you're well and that Bill is almost done with his book. I still have to get my act together and write 'Slow Burn Mobile.'

Thanks for the invite - we might get out that way next year in fact to see family in CA. Be nice to visit.

I think that Dakota guy WAS Colpo!! ;)

[Jeanie]

We're doing fabulous, Fred. Living the good life in Fort Collins, Colorado. Come visit some time and bring the family!! Do you have a Facebook presence, a la Jimmy Moore? You could reach lots and lots of people that way. I got some interesting responses when I posted your article on my FB site. Take care, my friend. Bill's book is nearly done. You'll be hearing from him soon.
Jeanie
Slow Burn rocks!
ps Wonder of that Dakota guy knows Colpo? ha!

[fred hahn]

Hi Jesnie! Thanks for liking the blog. How's life going for the Cambell's?

[Jeanie]

Hi Fred,
I just saw your HuffPost article about How Do We Become Fat and posted it immediately to my Facebook page. Thank you a million times for this wonderful, masterfully written piece. To give credit, I saw the link on Dr. Mike's twitter feed. Together, those of us who think alike can make a difference!
Cheers,
Jeanie Campbell

[steve]

There is no doubt that statins are over prescribed, and doctors put patients on it without advance lipoprotein testing such as VAP Berkely Heart, or what some consider the best test NMR. If after these tests which may show elevated small LDL despite the best lifestyle changes- low carb,etc. then statins make sense since they work in getting bad particles down when diet,etc does not. Broad generalizations such as yours that they do not work, are not only misinformed, but may cause those who would truly benefit from them to stop or preclude their taking them

[kadill]

Me thinks JohnDakoata is a very inexperienced troll.

80 Million is not 3.8% of the US population.

The correlation between LDL - as commonly reported on lab work - and CHD is rather weak, and after all correlation <> causation. Your argument also *assumes* that reducing total LDL is preferable to reducing the oxidation of existing LDL - which is achievable without pharmaceutical intervention. Even those studies which show positive outcomes for statin use, show very small changes in absolute risk, and the number to treat is something on the order of 250 to 1. Which means that for every 250 people who take a statin, 1 less person has a cardiac event . Even then all cause mortality remains unchanged

Cheers

[fred hahn]

Thanks for the reversal of tone John.

RE Atkins, you said:

"To see why Atkins is the worst diet review;

A randomized trial of a low-carbohydrate diet for obesity
The NewEngland Journal of Medicine
Foster, et al.
May 22, 2003. Vol. 348, Iss. 21; pg. 2082, 9 pgs

The only benefit atkins appears to provide is in short term weight loss. But (much like your position on statins) this piece of research determines that the cost/benefit of Atkins is uncertain. Particularly when you consider that Atkins, at it's core, takes advantage of a person's metabolic response to perceived starvation forcing preferential use of lipids and proteins as energy sources, and the negative hormonal consequences of the starvation response, it's a brutal process to put any body through."

I did give the study a read. Did you read the paper closely John or are referring to some other study which I can't imagine which it would be because there has NEVER been a study that showed a VLCD a la Atkins to be inferior to a HCD or LFD ITO health markers with the exception of LDL sometimes. And this isn't even an issue if one knows the nature of LDL.

Here is the conclusion of the study you cited above:

"Conclusions
The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor
and attrition was high in both groups."

And the conventional diet group had a higher drop out rate than the Atkins group.

An Atkins diet always produces superior outcomes ITO internal health markers and always produces greater weight loss specifically fat loss than LFD. Sometimes weight loss is similar but this can be attributed to lean mass losses in low fat, lower calorie diets. Lean mass is usually preserved in VLCD due to the higher fat and protein levels in some studies.

This statement from the study is a tad suspect:

Urinary Ketones
During the first three months, the percentage of patients who tested positive for urinary ketones was significantly greater in the group on the low-carbohydrate diet than in the group on the conventional diet (Fig. 2), but there were no significant differences
between the groups after three months. There was no significant relation between weight loss and ketosis at any time during the study."

The low fat group should not have ANY urinary ketones but this is insignificant. More than this, if you look at table 2 you see quite clearly that the Atkins group all of a sudden had a drop and far lower ketone bodies in their urine suggesting that they started eating more carbohydrate (which is suggested at the outset of the study on page 1) at about the 5 month mark.

If you look at the graph of weight loss, you see that as soon as this happened, they began to gain weight and this is the reason why at month 6 while the Atkins group still did better than the LF group, they lost the ground they gained. 'The proof is in the pudding' as the saying goes. In this case, it's in the ketones.

In fact, as ketone bodies lowered, fat loss halted or increased. In short, at month 5 the Atkins people started cheating (as did the LF group as their weight rose too.

What's worse is the discussion on saturated fats and LDL cholesterol. They do not discuss the difference nor did they test for LDL/VLDL and make the assumption that sat fat is bad for you since it raises LDL which in this study it did not.

In reading the author's discussion you can feel the bias. It's as thick as maple syrup.

The author's make this statement umpteenth times to justify the greater benefits seen in the Atkins group:

"Although part of this benefit may be due to the greater weight loss with the low-carbohydrate diet..."

YET, the authors conclude that by the end of the study there was no significant difference in weight loss. They are grasping at straws.

They are absolutely CLUELESS as to the mechanisms by which a VLCD improves internal health markers. People like this shouldn't be getting funding because they are incapable of thinking deeply enough. That's where people like Dr. Eades comes in. He can.

The researchers tried so hard to find excuses to belittle the superior results of the Atkins diet that it is almost sad and embarrassing.

So John, you'll have to come up with a better example than this study if you're going to call an Atkins diet "dangerous."

You said:

"Particularly when you consider that Atkins, at it's core, takes advantage of a person's metabolic response to perceived starvation forcing preferential use of lipids and proteins as energy sources, and the negative hormonal consequences of the starvation response, it's a brutal process to put any body through."

The study had the subjects eating ad libitum. So there was no starvation going on - just like the robust and long lived Inuit and Masai. And since when is getting the body to use lipids for fuel dangerous? It's the entire point! As for proteins, if you are ingesting enough dietary protein than muscle catabolism does not take place. On the contrary, several studies have shown increases in lean mass via DEXA when people, specifically seniors, are put on a VLCD ad libitum diet.

I'd like to see any data you have that supports your statement about 'negative hormonal response' on an Atkins, ad libitum diet. Surely you must have read something that supports that comment.

You also said:

"Regarding Dr. Mikes diets, if they do some people good who desperately want to lose weight quickly, then fine. They're dangerous , and require proper medical supervision. Atkins, and Dr. Bernstein clinics provided that because they understood the dangers."

If this were true, the many millions of people who have adopted and stick to a VLCD (as I do) would be making breaking news for the tens of thousands of us who would have been hospitalized by the diet. There is nary a case. Certainly none that have been proven.

Dr. Berstein happens to be my friend and he would not agree with you in the least. They have (had) clinics because they are physicians and there are many people who DO need their care. But the typical healthy person can indeed adopt an Atkins or a Protein Power diet with not only no negative consequences, but conversely will find themselves enjoying the very best health they have ever had in a few short months.

[fred hahn]

Yes the A to Z Weight Loss study. Atkins was faring far better ITO weight lost. The problem was that at month 6, the Atkins group was told to eat more carbs. They more they ate, the more weight they gained.

Still virtually ALL VLCD improve health markers to a far greater degree than low fat diets.

[JohnDakota]

Anyway Fred I'll stop taking up your space here. While I'm sure you don't agree, it's been good discussing statins with you. I know I come across as being a complete dick (trust me it's just the media.. hah.. not the person). I know a little more today than I did 2 days ago because I had to go re-read articles I haven't looked at since undergrad, and I have read some newer ones (and yes.. including the ones you have suggested.. just not the books.. I dont have time to read 400 page books right now).

Regarding the Dr. Mike stuff, if you truely think anything is libel, or close to libel then just delete it. This is your blog after all and you have control over it. I can't even edit any of my posts which I can clearly see have spelling errors and grammatical errors.

Anything I have posted is my personal opinion, and since I am hardly an authority on the topic of dieting (particularly highprotein diets... I simply eat well.. exercise etc..) my opinion should be taken with a grain of salt.

cheers

[JohnDakota]

And please don't misunderstand; I have some respect for Dr. Mike Eades because he can actually critique articles, even if I don't agree with him on statins.

You, however, just parrot his talking points. You can't come up with anything original or insightful of your own. You don't read, or criticize anything people cite to you. Instead you keep repeating completely out of context quotes (without citation....still) as if they establish anything significant.

I assure you, you can find a study in the scientific literature that will say basically anything you want to see. The point of reading the literature on a whole is to properly balance what everyone has said. Unfortunately, on the topic of statins, you/Dr. Mike appear to be off the mark. And instead of modifying your theory of reality, you explain any positive effects of statins as some function of an 'adherer' effect which is totally unsubstantiated or testable. It makes for a perfect excuse.

Regarding Dr. Mikes diets, if they do some people good who desperately want to lose weight quickly, then fine. They're dangerous , and require proper medical supervision. Atkins, and Dr. Bernstein clinics provided that because they understood the dangers. If you can explain to me why his particular variant of Atkins isn't dangerous then I'll be all ears. As far as I've read it's basically Atkins.

[JohnDakota]

Also, in terms of judgements in libel cases they go to determine the worth of an individual's reputation. Just googling Dr. Mike Eades name will yield a number of negative reports on his work, his publications, his interpretations of scientific literature and of course his diets. The 3rd hit (1st non-proteinpower.com hit) is a 100% negative critique of Dr. Mike.

Libel judgements also determine what damage was done to the person's reputation as to assign value. I hardly think my statements, in the comment section of your site (even if determined to be libel.. I contend they are not since I believe them to be true and could defend them as they're personal opinion) would hardly expose Dr. Mike to any actual harm to his reputation. Before I showed up here 2 days ago nobody had commented on this thread for almost a week. And since I came here it's been mainly you and me with occasionally Mr. Shultz.

So flatly, if you think what I've done is libel.. then so has;

http://www.anthonycolpo.com/Eades_Admits_Anthony_Colpo_Was_Right_On_Calories.html

[JohnDakota]

To see why Atkins is the worst diet review;

A randomized trial of a low-carbohydrate diet for obesity
The NewEngland Journal of Medicine
Foster, et al.
May 22, 2003. Vol. 348, Iss. 21; pg. 2082, 9 pgs

The only benefit atkins appears to provide is in short term weight loss. But (much like your position on statins) this piece of research determines that the cost/benefit of Atkins is uncertain. Particularly when you consider that Atkins, at it's core, takes advantage of a person's metabolic response to perceived starvation forcing preferential use of lipids and proteins as energy sources, and the negative hormonal consequences of the starvation response, it's a brutal process to put any body through.

Long term weight loss is about lifestyle changes. As Atkins, or Dr. Mike's version of Atkins, is not possible to maintain on the long term (both for 'adherence' and health reasons) it's an unsuitable diet.

The negative consequences of Atkins style diets on obese people is particularly worrisome. Atkins style diets potentiate the generation of reactive oxygen species (ROS) through the metabolism of lipids and amino acids in ketosis. Obese people are already at an increased chance of arteriosclerosis and other forms of CHD. Putting them on a diet that will dramatically increase ROS only worsens this.

And proper defenses to libel are fair comment, truth, and belief of truth. Dr. Mike's particular diet is spectacularly similar to the popular Atkins diet. While he may have 'tweaked' it in his own way, the core principles are all the same and it would shock me if Dr. Mike had never heard of Atkins, or was never exposed to his principles. Hence why I questioned your description of Dr. Mike as 'brilliant.' Anyone can modify technologies other people develop and make popular. That modification, unless revolutionary (which I hardly think Dr. Mike has accomplished), is hardly 'brilliant.'

[Brandon Schultz, D.C.]

Wasn't there a study within the last year showing long term comparison of low-carb(Atkins-like), Mediterranean and low fat diets and found the low-carb showing positive health indicators (overall lipoprotein profile, weight loss and others), and even being superior to the other two types of diets?
Why is Atkins the "worst fad diet"? The act of telling people to eliminate useless calories in the form of simple sugars and overly starch-dense foods is seen as bad does not make sense to me.
As Fred mentioned earlier, isn't there studies showing a lower carb intake improve blood lipid profiles in the same manner that statin drug intake purports to help decrease overall death and further CVD incidents?

In health
Brandon Schultz, D.C.

[fred hahn]

Like I said John, you're an angry fellow with a chip on your shoulder. Rather than see how misled you've been on the issue of statins, you berate, accuse and belittle others who know more than you do. You're behavior here on this blog is a classic example of a bruised ego and a childish demeanor.

Needing me to cite a study for you that was smack dab in front of your face from the get go is not called plagiarism - it's called blindness.

It is painfully obvious that all I was trying to do was relay information that I felt would help you to learn something out of the academic box you've shoved yourself into. So you've got 2 peer-reviewed papers, a masters thesis and are working on a PhD - good for you. PhD's are a dime a dozen.

What papers did you contribute to? Love to see them to see how well they were executed. Thousands of papers pass peer review and are not worth the paper they are printed on. Please give us the citations.

"FYI.. Books aren't necessarily peer reviewed, or reflect any sort of honest/objective representation of whatever field they aim to address."

And many are. So your point is...

You said:

"For example the Atkins diet solutions. You moan about statins being bad for people. Atkins is by far the worst fad diet. Oddly enough your buddy Dr. Mike ripped it off, gave it a new name and you call him 'brilliant'. Hell he couldn't even come up with a cool new catch term. He even stole 'metabolic advantage' as a coin phrase."

Like Newton said: "If I have seen farther than others it is because I have stood upon the shoulder of giants."

The fact that you call Atkins a fad (how old are you - 30?)shows how horrible ignorant you are in the subject. If anyone 'stole' anything on the low carb front it was Atkins who 'stole' the works of Banting from his booklet Letter on Corpulence written in 1864 and Dr. Blake Donaldson's 'Strong Medicine' written in 1962 not to mention the writing if the arctic explorer Vilhjalmur Stefansson diet experiences living with the Eskimo in 1906 or so. You probably know nothing of any of this work. A low carb diet is how our paleolithic ancestors evolved. I'm sure you are also unaware of the works of Dr. Loren Cordain, Dr. Jeff Volek, Dr. Richard Feinman, Dr. Mary Vernon, Dr. Mary Enig, and dozens of other I could name.

It would behoove you to visit the Nutrition and Metabolism Society where peer reviewed and published research on nutrition is widely discussed. www.nmsociety.org

The real fad diet is the current food pyramid which suggests we ingest 5 cups of sugar per day. Do the math. Do you know what the normal amount of sugar is in the blood stream? A teaspoon.

BTW, your accusations about Mike are damn close to libel. Be careful.

And I am certainly not the only one who calls him brilliant. Try stepping outside your door one day and get involved in the real world.

[JohnDakota]

FYI.. Books aren't necessarily peer reviewed, or reflect any sort of honest/objective representation of whatever field they aim to address.

For example the Atkins diet solutions. You moan about statins being bad for people. Atkins is by far the worst fad diet. Oddly enough your buddy Dr. Mike ripped it off, gave it a new name and you call him 'brilliant'. Hell he couldn't even come up with a cool new catch term. He even stole 'metabolic advantage' as a coin phrase.

[JohnDakota]

"Do you know what the word plagiarize means?"

Yes I do. Just because because Dr. Mike cites it doesn't abolish your responsibility to also cite it also. You are making the claims here, not Dr. Mike. Hence you need to properly cite the literature. I read Dr. Mike. He makes horrible comparisons between things that are not equal. Bitches and moans about biased media, and is utterly confused about his position on statins. Since I figured I was having a discussion with you, and not a discussion with Dr. Mike via proxy I figured you could put the simple citation down.

"To plagiarize is to pass of someone elses work as your own."

It's also to not adequately reference work. All you have ever done here is put the quote in quotation marks. Again, just because your friend talked about it doesn't mean you can get away without attributing where the work originates. Dr. Mike doesn't do research. He does opinion. He's a glorified journalist. THe very same type of people he complains about in the biased media.

"I clearly indicated that the info I pasted was from Dr. Eades blog."

Dr. Mike didn't perform the research. You always cite the original document. Again anyone with an undergrad knows this. Just because Dr. Mike has an impression of some piece of research doesn't mean his impression right. Frankly since his whole dieting fad is a complete rip off of Atkins i'd question the validity of any academic conclusions he arrives at.

And since we're playing pissing contest, I have two peer reviewed articles. A third in press. A Masters Thesis and am working on my Phd.

[fred hahn]

I didn't delete your last post John. Why would I? I've answered you each and every time. Maybe you didn't type in the security code before hitting enter? I have no idea.

You said:

"Secondly I'm glad you couldn't even be bothered to cite where you obtained this quote you keep throwing at me. That alone makes it abundantly clear that you make it a habit to plagiarize people's work, pervert it for your own purpose, and completely ignore it's context."

Do you know what the word plagiarize means? I think not since you didn't know what the word adherer meant either. To plagiarize is to pass of someone elses work as your own. I clearly indicated that the info I pasted was from Dr. Eades blog and you clearly knew that using his name many time in your posts.

Given that you don't know the meaning of basic words in the English language, I diubt you are who you say you are and simply cut and paste the information on statins in your post from Wiki or some other site. That's plagiarism.

Yes, you've asked for the citation many times. To not embarrass you I stayed silent. The paper it was cited from was at the top of the blogpost from Dr. Eades in full-blown view. In the first paragraph there is a link to the abstract

http://archinte.ama-assn.org/cgi/content/abstract/169/3/260

You never read the post did you? Here it is again. You'll see the study right in front of your face:

http://www.proteinpower.com/drmike/statins/more-statin-madness/

And this snippet from the post is what supports my position. It's not Dr. Eades opinion - it is what's so about the study and statins. If you could read critically rather than accept the conclusions of the researchers you'd understand that:

"First, the study authors admit that there is no gold standard, randomized controlled study data showing that statins are of benefit in preventing death except for one group of people (and they even get that wrong).

The beneficial effects on cardiovascular mortality of treatment with statins to decrease levels of low-density lipoprotein cholesterol (LDL-C) have been established in several long-term, placebo-controlled trials.

The value of primary prevention with statin therapy in the reduction of overall mortality has recently been questioned.

A pooled analysis of 8 randomized trials in primary prevention populations showed that statins did not reduce overall mortality, indicating that lipid-lowering therapy with statins should not be prescribed for true primary prevention in women of any age or in men older than 69 years.

What they’re saying here is that statins have been shown to reduce mortality from heart disease in those who have elevated LDL, which is true. But this decrease in deaths from heart disease is compensated for by an increase in deaths from cancer and other causes, so there really isn’t a gain. You’re still dead. Just maybe not from heart disease, but what difference does it make. Are you going to spend $200 per month for the rest of your life and stay on medications that may make you feel lousy and lose your memory just so you can die of something other than heart disease?

In the last paragraph in the quote above, the authors confess that the data from actual randomized control trials show that statins confer no all-cause mortality benefits to women of any age and to men over 69. They are playing a little fast and loose with the truth here because as I have posted before, the gold standard trials have shown no benefit for women and no benefit to men over 65 or to men under 65 who have never had heart disease."

And this study is an observational study. Ob studies cannot and do not prove casue and effect. Association does not equal causation. From the blog:

"Don’t fall for the false promise of this or any other version of an observational study. These kinds of studies do not prove causality. Nor do they prove that a drug regimen works. The patients in this study who religiously took their statins had better all-cause mortality than those who didn’t. But, as we saw above, adherers always have better all-cause mortality than non-adherers. In this case, was it that the adherers lived longer or was it that statins conferred some sort of benefit. We can’t tell. But we do know that in the real studies, the randomized control trials, statins didn’t do squat, so my vote would be that what we’re seeing here is an adherer effect and not a statin effect.

My advice is to continue to regard statins with a jaundiced eye. So far, we haven’t seen any evidence that justifies the expense and the side effects of these drugs."

Mike Eades is considered to be one of the most brilliant doctors in his field. You bash him without knowing that and this proves you are completely out of touch with the field. Before you go around insulting people and bashing them perhaps you should know something about them, no?

And I've published 2 books. You?

[JohnDakota]

Fred,

Thanks for deleting my last post. It's pretty obvious how you play here.

Secondly I'm glad you couldn't even be bothered to cite where you obtained this quote you keep throwing at me. That alone makes it abundantly clear that you make it a habit to plagiarize people's work, pervert it for your own purpose, and completely ignore it's context.

I've spent lots of time explaining in reasonably simple terms how statins work, where they act, and their effect on people. I have provided a number of references (which include complete, proper citation) so you can see them for yourself.

You have yet to cite me even where your single quote originates. For someone who has apparently published a book that is beyond sad.

[fred hahn]

It is you who are confused, rude and angry. You are not worth my time. Enjoy living with your ignorance.

[JohnDakota]

For someone who bitched and moaned about me apparently only reading abstracts, you're only able to plagiarize confused doctors, and concluding statements for articles you have yet to provide citation for.

For all I know they pooled 8 randomized trials that chose perfectly healthy people of various ages. If you would have bothered to read ANYTHING I have said or cited you would have seen that I firstly advocated for modification of diet/exercise/supplementation , and failing that prescription of statins second. Next.. all your plagiarized quote (since you have yet to provide the citation for it) says is that statins are not good for PREVENTION of CHD. Your plagiarized quote says nothing of treating people with CHD or are deemed at risk.

You are a laugh. You cite me some abstract that concludes the obvious (research is hard, and people don't comply) on a drug that isn't even a statin. Now you cite me something that doesn't really prove anything other than in some randomized trial compilation, possibly completely healthy people had no positive effects from statins.

[JohnDakota]

Cite a peer reviewed research article and I'll read it.

I'm not side stepping anything. You're putting out a quote that could be completely out of context.

Here.. I'll give you some homework;

1. CITE exactly where these quotes are coming from.

2. READ the articles I have cited and criticize them or provide adequate rebuttal as to why they are not valid.

3. stop wasting my time with out of context quotes that don't deal with the issue at hand.. which is STATINS have been well established to have a biological function in lowering cholesterol, LDL, VLDL, triglicerides and have a protective effect against CHD.

[fred hahn]

I am not basing my opinion on what Dr. Eades says John. I am basing it on what research reveals. Statins only aid men who have had a CV event or are at high risk and no one else. You cannot prove otherwise.

Are you going to read the books I suggested?

And again you sidestep:

"A pooled analysis of 8 randomized trials in primary prevention populations showed that statins did not reduce overall mortality, indicating that lipid-lowering therapy with statins should not be prescribed for true primary prevention in women of any age or in men older than 69 years."

[JohnDakota]

Look.. I'll walk you through the whole process of how statins work;

They're a class of molecules that interact with the enzyme named HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase (HMGCoAR). Their action on this enzyme is to inhibit it's function. What HMGCoAR does is catalyze a single step in the biosynthesis of isoprene units. Isoprenes are then used to synthesize a whole wack of compounds like fatty acids, cholesterol, hormones etc.

The mechanism of statin inhibition of HMGCoAR is well documented. A fantastic article published in Science on this topic is;

Science 11 May 2001:
Vol. 292. no. 5519, pp. 1160 - 1164
Structural Mechanism for Statin Inhibition of HMG-CoA Reductase
Eva S. Istvan, Johann Deisenhofer

I assure you I have read this article. It's only 4 pages and it's absolutely fascinating.

Now that the 'where do statins act?' question is answered, the next question is 'do they act?' As in, do they decrease cholesterol, LDL and VLDL proteins. Do they improve cardiovascular health? This is where we are butting heads. You believe they don't act in vivo even though much of the scientific literature would beg to differ.

For example;

Jan 2006, n engl j med, 352;1
Statin Therapy, LDL Cholesterol,
C-Reactive Protein, and Coronary Artery Disease
Nissen, S., et al.

That whole article was dedicated to measuring the effects of statins on a number of blood serum components including cholesterol, LDL, triglicerides etc. It also discussed other effects related to arterial health. So clearly statins work in vivo.

Now the question is 'so what? what's the consequence on people's health?' I believe this question was answered with my first citation that had been referenced over 1400x. Statins prolonged peoples lives who were at risk of CHD. To suggest that statins do nothing, and it's rather a function of a person's 'adherence' predisposition is to pull the blinders down and plug your ears. If it were merely an innate predisposition that is protecting groups from CHD then it's an amazing coincidence that these predisposed people happen to fall in statin test groups over and over again.

If you want to argue that patient compliance with drug regiments will make the whole issue moot, then why bother advocating anything. Compliance is never 100%. The point is to improve people's health status. Statins do that for many people.

Look.. the bottom line is you are basing your opinion on what and Dr. Mike says, and he doesn't even know what to think about statins. In a single article he will claim that statin's do nothing;

Dr. Mike: "... those who stuck with them are adherers and have what ever quality it is that adherers have that makes them live longer. And, if this is the case in this study as in the others, the statins don’t really do anything at all."

While 3 sentences later admit they reduce LDL proteins, and mortality!;

Dr. Mike: "What they’re saying here is that statins have been shown to reduce mortality from heart disease in those who have elevated LDL, which is true."

Dr. Mike also admits 2 sentences later that Statins do in fact help prevent Heart Disease. Hey! But since you're going to die of cancer down the road it's a moot point (something I've strongly disagreed with. Extending someone's life is never moot).

Dr. Mike: "But this decrease in deaths from heart disease is compensated for by an increase in deaths from cancer and other causes, so there really isn’t a gain. You’re still dead. Just maybe not from heart disease, but what difference does it make. Are you going to spend $200 per month for the rest of your life and stay on medications that may make you feel lousy and lose your memory just so you can die of something other than heart disease?"

So you're the one who suggested being the 'gumshoe.' It's time to do some 'gumshoe'n' of your own and stop plaigarizing the opinions of a confused person who tries to pass himself off as a doctor.

[fred hahn]

I know and agree that the adherer effect pertains to ALL studies. Dr. Eades is reporting the facts of such research. Given this fact, it is then impossible to state that it is without a doubt the statin drugs cause the benefit. If the exact same benefit is seen in the placebo group - and it was - it is not an opinion it is a fact.

And in observational studies, association does not mean causation. Ever.

The point is John, research reveals that statins are beneficial for men who have had a CV event only. And it shows they might be for men who are at high risk. The data in women suggest no benefit in longevity and that was the main point of my blog post.

Statins harm everyone who takes them to a greater or lesser degree.

The oath is 'Do no harm.' This assumes, of course, unless it is absolutely necessary to save a life. With statins in the VAST majority of people, it is not.

[JohnDakota]

Again Fred.. YOU seem to miss the point that patient compliance with a drug regime is not anything new, and it is not limited to statins. Neither you, nor Dr. Mike have shown how some innate quality of what you term 'adherers' lets them live longer, and how this innate quality has nothing to do with the use of statins.

Again, you simply quote OPINION.