The Misguided War on Cholesterol
http://www.spacedoc.net/misguided_war_cholesterol.html

I was recently sent this as a glaring example of 40 years of anti-
cholesterol brainwashing.
An 85 year old woman was prescribed a high dose statin, had liver
problems, and they 1.) Say it was just latent hepatitis, and 2.)
Suggest rechallenge with Statins! *

It really saddens me to read reports of this kind. It violates every
bit of common sense I ever acquired in my 23 years of family practice
and runs antagonistic to everything I have learned in the past seven
years from my own research and experience with statin side effects.

My two episodes of statin associated transient global amnesia in the
year 2000 set my present course of researching the side effects of
this class of drugs. Their potential for harm exceeds even my wildest
expectations and to think how little of the truth has reached today's
doctors.

I understand the brainwashing of the past 40 years because I was part
of it, riding the anti-cholesterol bandwagon with all my peers,
singing the same song to my patients about the dangers of eggs, whole
milk and butter. Then I read Uffe Ravnskov's, The Cholesterol Myths,
and Kilmer McCully's The Homocysteine Revolution and was finally freed
of my oppressive mind-warp.

If we have learned anything these past few years it is that
cholesterol appears irrelevant to atherosclerosis and increased
cardiovascular risk. Only in the well-known familial
hypercholesterolemia of genetic etiology do blood lipids add to the
underlying problem. For the remaining 98%% of those with the usual
elevated cholesterol seen everyday, inflammation appears to be the
cause suggesting treatment should be directed at this cause.

I have learned that statin drugs benefit cardiovascular disease risk
and atherosclerosis by their powerful anti-inflammatory effect. Sure
they reduce LDL cholesterol and for years that was confusing. Statins
have a strong dual role and only their ability to reduce inflammation
is relevant to the benefit they produce. So why were these doctors
trying to reduce this 85 year old patient's cholesterol?

The next thing to emerge from the most recent decade of longitudinal
studies is that older women, and especially 85 year old women, receive
no benefit whatsoever from statin treatment unless heart disease
already is present. So here we have a medical team trying to lower
irrelevant cholesterol in a patient for whom there is no justification
in the first place?

Then once having induced liver inflammation, perhaps the most common
side effect of Statins, especially in older people, this medical team
found that because she had antibodies for Hepatitis C, that in itself
was sufficient cause for liver inflammation to reassure everyone and
justified their putting her back on the same statin, triggering yet
another attack of liver inflammation.

Did I get this right? Is there something here I did not understand?
Sadly, I shake my head for I understand too well how little about
statin side effect are reported back to the doctors. Unless FDA
corrects this oversight, it is likely that years will go by before
doctors are fully informed. Meanwhile problems of this nature and much
worse will continue.
*Acta Neurol Taiwan. 2007 Sep;16(3):163-7.

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor