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Statins - miracle or menace?

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Statins - miracle or menace?

Old 27th Nov 2012, 18:47
  #101 (permalink)  
 
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Interesting report today on the common Grapefruit which apparently can have massive effects on those taking not only Statins but other drugs too!
Either they do not work or you overdose combined with Grapefruit!

Grapefruit drug interactions - Wikipedia, the free encyclopedia


Warning over grapefruit juice and cholesterol pills | Mail Online

Grapefruits can trigger overdoses in dozens of medicines researchers warn - Yahoo! Lifestyle UK

Pace

Last edited by Pace; 27th Nov 2012 at 20:05.
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Old 27th Nov 2012, 20:39
  #102 (permalink)  
 
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As old as the hills I am afraid

The Daily [email protected]@@ is as authoritative as this thread.

Anyhow I thought everyone on statins died of renal failure before they could get down to the kitchen to get a grapefruit
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Old 27th Nov 2012, 21:00
  #103 (permalink)  
 
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Anyhow I thought everyone on statins died of renal failure before they could get down to the kitchen to get a grapefruit
Presuming they can remember where the kitchen is and their muscles actually get them there
The Daily Ma*l must be the scourge of the GPs Surgery?

Pace
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Old 27th Nov 2012, 22:39
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Not at all. It makes the worried well chase elusive treatments from weird sources leaving us more time to manage those needing our care
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Old 28th Nov 2012, 05:58
  #105 (permalink)  
 
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Statins, Yay or nay ?

I'm my case, retrospectively - Nay.

In 2001 as an active ATPL/H I had an inferior MI - which was a bit of a Buggah, .....as I eventually got medically retired and lost my ticket....at age 45. But... I am still here.

I was prescribed statins post event (Pravastatin) and in the following years started to develop symptoms as decribed well in other forums - but at the time I didn't understand or associate the two.

In 2007, I had another heart attack, which resulted in a CABG (double).

The first line of my medical notes which I asked to see some months post op said, "Reaction to Statins".........Oh Buggah.....again.

I am very grateful to the skills of the surgeons and staff who treated me on the NHS, they were superb.

I do feel some bitterness towards the pharmacutical companies who are making hundreds of millions a year alone, just on this one product, and GPs ("incentivised" by said companies) are tossing these things out like sweeties at a panto.

Think a little more deeply about the message behind all these campaigns to give statins to the population at large- on a massive scale, its not quite as ultruistic as they would have you believe.

I now take a non statin replacement, (my cholesterol was never particulalry high in the first place (circa +/- 5.0), and 5+ years on from my CABG I'm fine thanks (Still working in aviation) .........but i'd rather had been the other side of an Inferior MI.....without the subsequent statin induced event.

Hopefully, my statin experience won't be that of others.

BS
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Old 28th Nov 2012, 20:19
  #106 (permalink)  
 
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Sorry to disappoint you but your GP gets precisely nothing for giving a patient statins. In fact it costs him time and his own money but that is a separate issue.

The push to give statins come from those nice specialists you are so pleased with

It is a sad fact that many patients can't understand that everything we do as doctors has a risk. We only do something if the benefit is greater than the risk, so we give statins because they save many lives but a few patients have side effects - yes I know this thread will be full of responses that everyone gets side effects but it isn't true

Let me put it another way. If you had taken statins with no side effects and then been the unfortunate 1 % to die from your surgery, your family might well be having a go at the surgeon asking why he didn't let your superb GP carry on with the statins

Sadly what a patient thinks of a doctor is far more determined by outcome and the title on their name badge than their actual skills or hard work. But that is for another thread.
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Old 29th Nov 2012, 12:31
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Through the QOF, general practices are rewarded financially for aspects of the quality of care they provide. QMAS ensures consistency in the calculation of quality achievement and disease prevalence, and is linked to payment systems.

This means that payment rules underpinning the new GMS contract are implemented consistently across all systems and all practices in England.

For 2011/12 practices were paid, on average, 130.51 for each point they achieved.
Are we sure that GP's don't get points and therefore cash for prescribing statins?
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Old 29th Nov 2012, 14:08
  #108 (permalink)  
 
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Homonculus,

thankyou for sharing your thoughts. I do have genuine and great regard for all those in the medical profession, irrespective of their job title. This was not a swipe at GPs, but one persons view of how the pharmacutical industry appears to the layman. As a medical professional you will have met and treated many thousands of people, most of whom gave you no thanks, or you will not see again, and those indivudals in their lives may only ever see a few medical professionals. So it is with being a pilot, I have flown many many thousands of people, our journeys all had a safe outcome, and yet I never got to meet or know any of them really, and they in their lives will maybe only ever meet a few pilots. Their perception of me at the time, or pilots in general, will be widely different from how I perceived myself and my profession - which is vocational, just like yours. Your points are well made and I respect your views.

BS
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Old 29th Nov 2012, 14:35
  #109 (permalink)  
 
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I tend to agree with Burr! We are laymen or patients so you are getting our views which will be things we read in the Daily Ma+l!

There is no mistrust of Doctors intentions but when you get a Multi Billion $ Industry who make those $Billions selling drugs there has to naturally be suspicion.
Those same Drug companies have massive marketing budgets to bring the medical world into their line of thinking and I am sure it works.

A cure would never suit those drug companies while a life long customer would and sometimes I wonder how much the drug companies prevent the Goal of cure rather than encouraging prolonged treatment as Cures would not be of benefit to them.

Where huge amounts of money come into the argument it is only natural to question the motives?

In the same way drugs have side effects, some small some not so small?
When we as laypeople see Scientists wanting to mass medicate people over the age of 50 healthy or otherwise with drugs like statins you have to question the motives or the fact that those scientists are seeing what they want to see because their mandate is to expand markets for the drug companies.

We had the horrendous revelation of the effects of sleeping pills churned out like smarties by Doctors 15 -20 years ago.
Those same Doctors would have been on forums like this claiming the evidence and safety of those drugs.

Now look at the results? Increases by 50% in dementia cases in those who took the drugs 15 years ago.

Somehow I have a sneaking suspicion that we will get the same with Statins at some point in the future.

Pace

Last edited by Pace; 29th Nov 2012 at 15:11.
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Old 29th Nov 2012, 14:53
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Homonculus,

Just looking back at your posts in this thread.......

Anyhow I thought everyone on statins died of renal failure before they could get down to the kitchen to get a grapefruit

Are these the comments of a medical professional in a public forum ? ......Bit harsh old man...........bit harsh

BS
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Old 29th Nov 2012, 15:19
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Gingernut:I was prescribed statins by my 'former' GP. Had a blood test first and everything fine (except cholesterol of 6.1). Took them for 3 months - another blood test - all my liver enzymes off the scale - said GP was 'surprised' I wasn't bright yellow. I refused to take anymore but she insisted it was nothing to do with the statins but agreed I could stay off them for another 3 months. 3 months later, another blood test and guess what ? everything back to normal. QED. GP still refused to believe that statins were to blame so I changed GP - simples - couldn't cope with that sort of illogical thinking! Had a liver scan and now al Ok again and now on something different for cholesterol (Ezetimibe) and things are fine with cholesterol levels now about 4.
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Old 29th Nov 2012, 15:46
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Crucially, tomahawk, did you insist that this was reported as an adverse reaction?
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Old 29th Nov 2012, 18:44
  #113 (permalink)  
 
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Burr Styers and Pace

Thanks. I appreciate your very sensible posts. I am not getting at patients in any way, and I agree pharmaceuticals like a lot of other big companies may have dubious practices from the individuals perspective.

This forum has great potential if it allow us as doctors to provide some non specific information. I really like to be challenged. However the renal failure issue was raised many weeks ago by a poster claiming statins damaged kidneys.

The bottom line is if you are fit and well you gain more benefit taking statins an not but of course you need a good GP who will check for liver problems and muscle problems
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Old 29th Nov 2012, 23:04
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all my liver enzymes off the scale
Yes, the lattitude is wide. By "deranged," this means 3x the usual level of "normal."

The bottom line, is that statins save lives. Stopping smoking and picking better parents is probably slightly more effective.

It's great to hear the other person's point of view, and it's always refreshing to realise that so many people take an interest in medical politics. And yes, we have to be very, very careful about the influence of drugs companies, (and we are generally.) The whole statin argument could be turned on it's head in a few years, and that's okay too.We have to work with what we've got, and that's why we are now (better) trained in critical appraisal now, it helps us sort out the wheat from the chaff.

I'm a little surprised about the vitriol pointed towards the medics (and nurses) involved in the prescribing of statins. But that's okay, we've got broad shoulders, and we're not all perfect ourselves. (I don't take a statin yet, but as I'm approaching 50, I'm sure there will be some health facist somewhere trying to force me to take Simvastatin 40mg with my cornflakes.)

We are in the business of improving health, we could deconstruct the arguments around QOF etc, but hand on heart, I don't think we're that naive.

We are on the patients side, we're paid to give advice, it's up to the patient whether they take it or not. Certainly for me, patient choice is paramount. I'd like to think we give a balanced argument.
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Old 30th Nov 2012, 05:50
  #115 (permalink)  
 
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Homonculus,

As one is also now CKD 2 (due to guess what), then I re-iterate, that the comments from a medical professional in a public forum regarding renal failure due to statins, appears to me, a little bit flippant, even if it endorsed by someone else on the thread - bit of a weak answer really. It also implies that you dispense statins, but don't share with your patients the bit about potential renal failure (conflict of interest ?).

I really do believe you have the patients best interest at heart, but do be mindful of your audience when you dispense your wisdom on these forums.

BS
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Old 30th Nov 2012, 06:10
  #116 (permalink)  
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OK Burr Styers, you've made your point...twice. How about the thread gets back on topic, and leave the personalities out of it.
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Old 30th Nov 2012, 09:19
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CKD2 isn't renal failure.

And people with CKD2 are very unlikely to progress to having renal failure.

They are far more likely to die from.........yes you guessed it......heart disease.

Which is why we are keen on intervening, which includes using statins.
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Old 30th Nov 2012, 10:46
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TSH levels

I would like to canvass opinion from both medics and patients on this forum.

For the medics, is it SOP to test everyone for Thyroid Stimulating Hormone (TSH) before prescribing statins?

For those on statins, was the TSH measured before you started?

Thanks,

MB
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Old 30th Nov 2012, 11:27
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Blue,

TSH was tested by my 'new' doctor who put me off statins, not by the 'old' doctor who prescribed statins and who said my side-effects were just 'old age' (at 55?).

If you want more to read: http://www.thincs.org/

Last edited by dirkdj; 30th Nov 2012 at 11:27.
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Old 30th Nov 2012, 11:43
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Glad to hear about the CKD2 bit, and the other bit...... I kinda guessed that

No doubt statins is a topic that will run and run, and it certainly seems to polarise opinions with all stakeholders.

Still.....why fret about these things.....gotta life to live, things to do, places to go, people to see

I wish Homonculus and all those medical professionals and contributors in this thread well, you have to make life affecting decisions that I don't - not everyone can do that, Respect.

And remember, growing old is mandatory, but growing up......is optional.

Take care all

BS
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