New warnings are being added to the labels of cholesterol lowering drugs, such as Lipitor and Crestor, to indicate that they may raise levels of blood sugar and now could cause memory loss. This is getting to be a sticky situation and patients are confused. Hell, so am I. Statins have been shown to significantly reduce the risk of heart attack and heart disease and patients are still recommended to take the drugs. The “experts” just want to us to warn patients. Oh….how? The statin thing is one of the big constants in my business. It is like gravity. Now, all of a sudden, there are questions. In fact, there is a whole body of “experts” who question the use of statins and even cholesterol as a measure to be monitored or treated. This is especially true without a prior history of heart disease. The human body need cholesterol for many things. HDL is important. Fluffy, large LDL particles are not harmful like the small and dense ones. Heck, our most common test doesn’t even measure LDL but estimates it with the Friedewald equation. It makes you wonder whether we are doing the right thing? A person with a high LDL but low trigs and moderate HDL may be pushed to go on a statin (everyone wants their quality indicator scores to look good, you know) and it may be that their LDL is not harmful. Should we be doing a different but more expensive VAP test every time? Should we ignore that and just put everyone on a statin with all these new risks? This is the beauty of our business and what makes medicine an art. That is why doctors are still needed and not more and more number crunchers.
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