Are Statins Still The Cat’s Meow?

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.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  7 comments for “Are Statins Still The Cat’s Meow?

  1. panacea
    March 3, 2012 at 11:01 pm

    I have mixed feelings on this and wonder- Has anyone considered that the patients put on statins were probably going to become (or already were) diabetic and now actually live long enough to have memory loss as they didn’t die in their 50s of an AMI? How can we do a RCT when the controls are dead?

  2. big picture doc
    March 1, 2012 at 1:59 pm

    This is why I only do acupuncture. I will never go back to primary care unless I can control what I write on a script pad and until insurance companies are forced to stop sending clerical staff to snoop in my patients’ private medical information. It feels so good not to be forced to practice bad medicine. An ethical and well-trained naturopath or eastern practitioner is of much more benefit in primary care. Most western drugs are crap. The best use of western drugs are in acute care situations and for some infectious diseases.

  3. Daniel
    February 29, 2012 at 4:21 pm

    Makes me think a little of an epidemiological study I just ran into regarding sedative/hypnotics, although a lack of mechanism is pretty salient. http://bmjopen.bmj.com/content/2/1/e000850.full

    I’d like to know your comments on this, Doug.

  4. Pat
    February 29, 2012 at 12:13 pm

    The FDA could be renamed the “Lawyers Full Employment Agency.” How many ambulance chasers are even now opening up case file preps, and starting to screen ads to run under 1-800-BAD-DRUG? Just like diabetic meds being associated with an “increased risk of strokes and heart disease”…well of course they are! Remember all the wack-job fringe doctors and nutrition “experts” suggesting fat-free children’s diets, and introducing statins in teenagers? I’ve always wondered, if the majority of the population is found to have “abnormal” lipid levels, then are they really…abnormal? One of the reasons I left primary care is herein illustrated: we were constantly assaulted with ever-tightening lipid targets to which I was required to conform patients, many of whom I thought did not need to be subjected to a chronic medication that was certainly not risk-free (and recommend to them something that I would not do myself). Doug spoke rightly about the art of medicine. This topic is a splendid example of how herd confromity enforced with lawyers, bureacrats, and societal paranoia, turns art into mere processing.

  5. Richard
    February 29, 2012 at 9:28 am

    so, to be safe, should I continue my statins but decrease the dose?

    • Doug Farrago
      February 29, 2012 at 10:10 am

      no one knows

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