Books written by Ray Sullivan

Friday, 16 May 2014

Statins - the Accountant's Drug?

I'm not a doctor, I have no qualifications in medicine at all, so the following is pure lay observation.

There is a debate raging in the UK right now over claims made in a recent edition of the British Medical Journal (BMJ) that the risks presented by Statins versus the benefits had been overstated.  The authors of the article have withdrawn some of their claims because they have come from an uncontrolled study and the BMJ is considering withdrawing the article in its entirety.

I keep a weather eye on this Statin issue; it's been raging for quite a while and I have personal knowledge of people who have been on Statins for a limited time and experienced severe symptoms.  I know from reports that the medical profession claims very few people report serious side effects - there is actually some evidence that people do, but the data may not be as joined up as it could be - but my personal experience is that often people just stop taking the drugs, don't go back for more prescriptions and choose not to engage in a debate they are medically unqualified to win, but who know in their hearts they are right.  So perhaps the levels of side effects are under-reported because doctors are generally quite zealous about prescribing the drugs and the end users just don't follow up and report their symptoms.

There is a lot of evidence that people who have suffered serious heart issues benefit from the drugs and although the risk of side effects is still possibly serious, the alternatives aren't great either.  In the UK people who are considered to be at risk of a heart attack are routinely prescribed these drugs, and I guess it depends on how you qualify 'at risk'.  One measure would appear to be down to cholesterol levels - there is a lot of debate going on about whether 'high' cholesterol levels actually increase an individual's risk of a heart attack by one iota, although it is accepted that following a heart attack elevated levels of cholesterol are a problem.  Statins are very effective at removing cholesterol, which is why they are prescribed, but the debate is whether most normal people ought to be worrying about these levels at all.

My take is that unless I'm proven to have an elevated risk of heart attack that can't be addressed by other means such as modifying lifestyle, the risks linked to Statins aren't worth it.  My GP will struggle to convince me to take Statins because my cholesterol has reached an arbitrary level or, for God's sake, I've reached a specific age as if that's important. But increasingly the government is pushing for a blanket application of the drugs.  Which should beg the question, why?

My view is that in the main it is probable that Statins would reduce the cost of treating heart disease nationally versus the costs of treating the side effects.  So from an accountants position prescribing everyone the drug makes sense.  However from an individual perspective, even as a maligned taxpayer who would love the NHS to save some money, if you are the person suffering those side effects which apparently can extend into early onset dementia as well as muscle wastage, then the personal cost is too much. If you want to explore a discussion on why the cholesterol argument may be a crock you might want to try 'The Statin Damage Crisis' by Duane Graveline MD. This guy is an experienced GP and one of a handful of medical doctors to qualify as an astronaut back in the day.

There isn't a definitive answer to the Statin question and there's a lot of drug company profits and lobbying involved too, so murky waters are likely, but I say that the drug and its side effects need to be better researched along with the arguments for prescribing them. For a slightly different slant, from a properly qualified doctor who is a fully paid up sceptic who does however believe in the case for Statins read Ben Goldacre's views here. Ben's webpage is a great port of call for anyone wanting to understand how science should work.

If you are prescribed Statins and don't experience any side effects, then it would appear that you should be fine, but perhaps check out Doctor Graveline's book just in case.  If you do experience side effects and you're not in serious risk of a heart attack, well my advice is to follow your head.  It's what accountants would recommend.
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