Putting Statins in the Water

statin-tablets

The thought leaders of this world now are recommending that basically everyone 40 and older should be considered for the drug therapy.  Wow. I guess they want it in the water?  Intuitively, though, does it makes sense that nature would have had men and women on a statin at age 40?  It is not like the earth has mushrooms with statins in them everywhere. Could it possibly be that statins are just all we have to help people because most people won’t eat right and exercise?   That is my guess.  And it’s not like statins are amazing drugs.  If you look at www.theNNT.com you will see the following:

Taking a statin for primary prevention (with prior heart disease) over five years

Benefits in NNT

  • None were helped (life saved)
  • 1 in 104 were helped (preventing heart attack)
  • 1 in 154 were helped (preventing stroke)

Harms in NNH

  • 1 in 100 were harmed (develop diabetes)
  • 1 in 10 were harmed (muscle damage)

Does this sound that great to anyone?  You also have to add to this that most patients’ diets get worse after taking statin (can’t find that study right now) as they figure they have some sort of protector on board.  Or how about that a Mediterranean Diet may work better than a statin?

I am not some conspiracy dude or weird granola doctor but they still don’t have me convinced.  What am I missing here?

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] 

  6 comments for “Putting Statins in the Water

  1. November 16, 2016 at 3:28 pm

    I have been preaching against statins for years using these exact statistics. You do have a little typo in there. Primary prevention means WITHOUT prior heart disease. Basically, there is very little reason to lower someone’s circulating cholesterol levels when the only risk factor they present is high circulating cholesterol levels.

  2. Kurt
    November 16, 2016 at 2:31 pm

    Er, ummmmmm. I hate to disagree with you guys but this shit works. Yeah, I agree it allows people to continue to eat crap and keep the lipids down and prevent disease but yes there can be side effects. I will argue the point about developing diabetes while on a statin. With the 1 in 100 number concerning diabetes, I’d bet it was an obese at risk person who was going to get it anyways. I disagree with throwing it around like those above maintain but in the light of one with established vascular disease, it’s a must. Now I do have a few diabetics with great glyco-hb, no bad habits, no evidence of any vascular disease and have a PERFECTLY normal lipid profile. I mean danged normal (and they don’t smoke) I absolutely refuse to force a statin on one of those folks in spite of what the ivory tower bastards contend.

  3. Pat
    November 15, 2016 at 11:07 pm

    This is one in a long (and growing) list of reasons why I no longer do primary care. I was required by training, core measures, guidelines, nervous patients, and the omnipresence of legal liability to prescribe something I would not myself take.

  4. Sir Hakum of Hugo
    November 15, 2016 at 1:28 pm

    Hey, didn’t Merck get the real red yeast rice kicked out of the US market back in the Mevacor days?

    Common guys, without statins that is 2 less visits a year, lots of labs, and the chance to plug and play numbers into ACC/AHA risk calculator (where the answer is always above 7.5%).

    Next you’ll tell me there is no benefit of getting that blood pressure under 70/30, let alone under 120/80. Oh wait, yeah, we’re back the 1970’s goal of 140/90 again.

    But wait, get all the A1C’s under 6….

    PHQ-2 everybody so everybody gets an SSRI.

    What we should be doing is a NMR scan of lipids. Particle counts and particle sizes for everybody, so we can all get a statin.

    Doug and Perry, you are both sooooo right.

    Now, where is my bottle of Pravastatin……

    • Perry
      November 15, 2016 at 3:30 pm

      Personally, I think we’d all be better off with cannabis in the water.

  5. Perry
    November 15, 2016 at 10:00 am

    You have to wonder if someone is being paid off by the drug companies. Why on earth, with those NNTs and NNHs would someone recommend this?

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