mask_african_witch_doctor2

The Art of the Curb Side Cholesterol Consult by Jeffrey Dach MD

mask_african_witch_doctor2The Art of the Curb Side Consult by Jeffrey Dach MD

In our neighborhood, we take the garbage cans out to the curb twice a week for the garbage pickup.  Although we grumble about the extra work, it’s a good opportunity to get outside the house and say hello to our neighbors.  On one such occasion last week, I had a curb-side consult with my neighbor, Bill Jones.

While wheeling the garbage can around, I said “How ya doing, Bill?”  Bill said “not too good”, and then proceeded to show me the Ace Wrap on his arm and the two bottles of pills his doctor prescribed for his peripheral neuropathy.  Bill was having burning pain, tingling and numbness in the arm and hand constant, all day and night, preventing him from sleeping.  The pills were generic Neurontin (gabapentin) a drug marketed for treatment of peripheral neuropathy, and Tramadol, a synthetic opiate pain pill.

protective-arm-SleeveKnowing that a cocktail of B vitamins and alpha lipoic acid will frequently clear up and heal a peripheral neuropathy, I asked Bill if he was taking any vitamins.  Bill’s face lit up.  He became excited and invited me into his house.  We sat in the kitchen and Bill brought out a sheet of paper listing his medications and vitamins.

At the top of the list was Pravastatin a drug to reduce cholesterol. When I saw this, I immediately knew what was causing Bill’s excruciating burning pain in the arm and hand.  This is an obvious case of statin induced neuropathy.(1)  My job had been simplified.

I told Bill the statin drug was causing his peripheral neuropathy,  so he should stop the drug immediately.  I also gave him a list of vitamins to take: Benfotiamine 150 mg three times a day. B12 methylcobalamin  5000 mcg sublingual tabs twice a day, P-5-P form of B6  50 mg. daily, Alpha Lipoic Acid 50 mg three times a day, Ubiquinone form of CoQ-10 100 mg twice a day.

Adverse Side Effects of Statin Drugs

statins-headline2

The drug companies have cleverly planted deceptive articles in the media, such as the headline above, proclaiming statin drugs have no side effects. In reality statin drugs have horrendous adverse side effects which have been documented in the medical literature for over thirty years.  This is the ugly side to statins, including adverse side effects such as peripheral neuropathy, muscle pain, muscle damage, myopathy, cognitive dysfunction and dementia, autoimmune disease, drug induced lupus, disturbance of immune function, etc.(5)

No Good Reason to Take a Statin Drug

Statin Drug 2Bill had no evidence of heart disease, his cholesterol levels were perfectly normal, and he should never taken a statin drug in the first place.  Amazingly, his doctors failed to recognize he had a statin induced neuropathy, and instead gave Bill a worthless ineffective drug, gabapentin, as treatment for peripheral neuropathy, no more effective than placebo.(13)  They also gave him an opiate pain pill Tramadol which is effective for pain relief, however, the price is narcotics addiction.  Prescribing an opiate pain pill for a statin induced neuropathy is misdiagnosis and mistreatment, a medical error of monumental proportions.

Who Benefits From a Statin Drug?

Medical science is clear that statin drugs reduce cholesterol quite well in men and women of all ages.  However, there no health benefit obtained from lowering cholesterol in women, the elderly or men with no underlying history of heart disease.(8)  According to Rita Redberg MD, in an article in the Archives of Internal Medicine, healthy men should not take a statin drug. On the other hand, thirty years of statin medical studies have shown a benefit greater than placebo for middle aged men with known underlying heart disease.(9)  Although this benefit is not impressive, this is enough to justify prescribing a statin drug to men with known heart disease.

Temptation to Profit

Witch_doctors_PHIL_1322_loresStatin drugs are the most lucrative drugs ever, making more than 100 billion dollars for Pfizer.(2)  How did Pfizer make so much money?  They put on the African Witch Doctor mask and created fear. The fear is:  if you don’t take my drug, you die.  Of course, this is nonsense, but people are willing to believe nonsense if they are frightened enough.

(left image Lassa Witch doctors courtesy of CDC). 

Creating Fear – Medical Marketing of Statin Drugs

Remember the scary witch doctor masks on display at the museum intended to induce fear in villagers and motivate them to follow the witch doctor’s advice ?  I often laughed and marveled at how primitive these people were.  A modern doctor would never stoop so low as to don a scary mask to induce fear in the patient.  How can that be part of any effective medical treatment?  Our modern medical system is above that.  We are not savages living in mud huts.  We are civilized, we have nuclear weapons, and the New York Times.

WouldYouRatherCholesterol_Test_Toe_TAg_Pfizer_Statin

Fear Tactic Advertising (10-12)

Above image: Courtesy of Chatelaine magazine in October 2001, Tagged toe of a corpse to promote cholesterol testing.

The above image is a Pfizer ad for Lipitor, which reads, “Which would you rather have, a cholesterol test or a toe tag?”  This is fear tactic advertising to convince healthy people to take a drug they don’t need.(10-12).  This is our modern day equivalent of the witch doctor scary mask, fear tactic advertising to sell drugs to healthy people who don’t need them.  I guess we are not so lofty as we thought.

My Job As a Physician – Un-Masking the Witch Doctors

How does one expose the fear mongering and propaganda of  the drug industry which turns rational humans into lemmings?

Fifty years ago when I laughed at the witch doctor mask at the museum, I never could have imagined my job would be to expose the ruse of the witch doctor mask, and try to convince healthy people not to become lemmings jumping off the cliff, clamoring for bad drugs they don’t need.  Of course, this task would be immensely easier if Congress banned DTC consumer drug advertising, as most other countries have already done. black-sheep-lemming-outside-the-box

 

Left image: Lemmings running off cliff courtesy of Just Outside the Box.  Link to header image: wooden african mask: courtesy of Ali Express

Update 2 Weeks Later on  Bill’s Neuropathy: two weeks after stopping the statin drug and starting a new vitamin program as listed above,  Bill reports his arm and hand pain are considerably improved, and he is very grateful to the good doctor.

Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663

Articles with related interest:

Healthy Men Shiould Not Take Statins

Cholesterol and Statin Drugs, a Choir Boy Turns Disbeliever

Cholesterol Lowering Statin Drugs for Women Just Say No by Jeffrey Dach MD

Getting Off Statin Drug Stories by Jeffrey Dach

Does High Cholesterol Cause Heart Disease?

Reverse Heart Disease with Coronary Calcium Score

Heart Disease Part Two

Preventing and Reversing Heart Disease, Part Three

Links and references

1)  http://www.neurology.org/content/58/9/1333.abstract
Statins and risk of polyneuropathy A case-control study     D. Gaist, MD PhD,     U. Jeppesen, MD PhD,     M. Andersen, MD PhD,     L. A. García Rodríguez, MD MSc,
J. Hallas, MD PhD and     S. H. Sindrup, MD PhD     From the Department of Neurology (Drs. Gaist, Jeppesen, and Sindrup), Odense University Hospital; Epidemiology (Dr. Gaist) and Clinical Pharmacology (Drs. Andersen, Hallas, and Sindrup), Institute of Public Health, University of Southern Denmark; and Centro Español de Investigación Farmacoepidemiológica (Dr. García Rodríguez), Madrid, Spain.

Several case reports and a single epidemiologic study indicate that use of statins occasionally may have a deleterious effect on the peripheral nervous system. The authors therefore performed a population-based study to estimate the relative risk of idiopathic polyneuropathy in users of statins.
Method: The authors used a population-based patient registry to identify first-time-ever cases of idiopathic polyneuropathy registered in the 5-year period 1994 to 1998. For each case, validated according to predefined criteria, 25 control subjects were randomly selected among subjects from the background population matched for age, sex, and calendar time. The authors used a prescription register to assess exposure to drugs and estimated the odds ratio of use of statins (ever and current use) in cases of idiopathic polyneuropathy compared with control subjects.
Results: The authors verified a diagnosis of idiopathic polyneuropathy in 166 cases. The cases were classified as definite (35), probable (54), or possible (77). The odds ratio linking idiopathic polyneuropathy with statin use was 3.7 (95% CI 1.8 to 7.6) for all cases and 14.2 (5.3 to 38.0) for definite cases. The corresponding odds ratios in current users were 4.6 (2.1 to 10.0) for all cases and 16.1 (5.7 to 45.4) for definite cases. For patients treated with statins for 2 or more years the odds ratio of definite idiopathic polyneuropathy was 26.4 (7.8 to 45.4).
Conclusions: Long-term exposure to statins may substantially increase the risk of polyneuropathy.

2) http://articles.latimes.com/2011/nov/30/news/la-heb-lipitor-generic-20111130
Lipitor generated more than $100 billion in revenue for Pfizer since it was approved in 1997.

3) http://primaldocs.com/opinion/have-you-experienced-side-effects-of-statin-drugs/
Have YOU Experienced Side Effects of Statin Drugs?

Studies have confirmed that peripheral neuropathy (tingling and numbness or burning pain) may occur with statins.

4) http://www.sciencedirect.com/science/article/pii/S0140673604157395
Selenoprotein synthesis and side-effects of statins
Bernd Moosmann, PhDa, Christian Behl, PhDa,

Statins are possibly the most effective drugs for the prevention and treatment of hypercholesterolaemia and coronary heart disease.   They are generally well tolerated, however, they do cause some unusual side-effects with potentially severe consequences, most prominently myopathy or rhabdomyolysis and polyneuropathy. We noted that the pattern of side-effects associated with statins resembles the pathology of selenium deficiency, and postulated that the mechanism lay in a well established, but often overlooked, biochemical pathway—the isopentenylation of selenocysteine-tRNA[Ser]Sec. A negative effect of statins on selenoprotein synthesis does seem to explain many of the enigmatic effects and side-effects of statins, in particular, statin-induced myopathy.  Christian Behl, Department of Pathobiochemistry, Johannes Gutenberg University, Medical School, 55099 Mainz, Germany

5) http://scholar.google.com/scholar?q=related:edv9UVeSlC0J:scholar.google.com/&hl=en&as_sdt=0,10
Statin‐Associated Peripheral Neuropathy: Review of the Literature

6) http://phil.cdc.gov/phil/details.asp?pid=1322
Witch Doctors  Two Lassa Witch Doctors.

7) http://commons.wikimedia.org/wiki/File:Fremont_Solstice_Parade_-_witch_doctor_prepares.jpg
Man dressed as witch doctor preparing for Fremont Solstice Parade, Fremont, Seattle, Washington circa 2000.

8) http://jeffreydachmd.webomg.net/getting-off-statin-drug-stories-by-jeffrey-dach-md/  Getting Off Statin Drug Stories by Jeffrey Dach MD

9) http://jeffreydachmd.webomg.net/statin-drugs-revisited/
Statin Drugs Revisited by Jeffrey Dach MD

The 4S trial was done on 4444 patients who had known heart disease, randomized to simvastatin or placebo, and followed for 5.5 years.  At the end of the follow up, they reported 182 deaths in the statin drug group (8.2 %) and 256 deaths in the placebo group (11.5% ).  This provided  an absolute mortality benefit of 3.3% over 5.5 years, or 0.6% per year. (12,13)  The 6-year probabilities of survival for placebo was 88.5 % and for simvastatin was 91.8%, a difference of 3.3%.

Fear-Tactic Advertising

10) http://www.commonground.ca/OLD/iss/0611184/cg184_Cassels.shtml
Cholesterol TV ads clog reality by Alan Cassels

11) http://www.bcmj.org/letters/fear-tactic-advertising-0
Fear tactic advertising Issue: BCMJ, Vol. 44, No. 2, March 2002, page(s) 69 Letters Frederick Spohn, MD
…[I]t is most distressing to see an international drug manufacturer taking out half-page ads in the National Post (page SP8, 15 December 2001) to shill Pfizer’s cholesterol-lowering drug with the spiel “Which would you rather have, a cholesterol test or a final exam?” [autopsy?] with a picture of a toe-tagged stiff on a gurney…
I believe that cholesterol tests a few years ago were costing the BC Medical Plan some $4 million annually with very little health benefit to our population.
Fear tactic advertising to sell drugs is in very poor taste and is socially irresponsible at a time when we are attempting to keep health costs down and still provide an excellent health care system.
—Frederick Spohn, MD

12) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122842/?report=classic
BMJ. Apr 13, 2002; 324(7342): 908–911.
Direct to consumer advertising is medicalising normal human experience by Barbara Mintzes, graduate researcher
Centre for Health Services and Policy Research, University of British Columbia, 429-2194 Health Services Mall, Vancouver, BC, Canada V6T 1Z3
Lipid lowering drugs, for example, reduce mortality in men with heart disease yet there is under-prescribing in this population group. However, it is more lucrative to promote primary prevention as many more people are affected, despite the lack of significant reduction in mortality.2-10 In Chatelaine magazine in October 2001, Pfizer used the tagged toe of a corpse to promote cholesterol testing among women in their 50s without heart disease.2-11

13) http://www.aafp.org/afp/2011/0901/p480.html
Diabetic Peripheral Neuropathic Pain: Is Gabapentin Effective?

Am Fam Physician. 2011 Sep 1;84(5):480-482.
to the editor: Contrary to the authors’ statements, gabapentin (Neurontin) in dosages up to 3,600 mg per day is not more effective than placebo for the treatment of diabetic peripheral neuropathic pain. During discovery in a lawsuit filed in federal court, it was learned that the manufacturers of Neurontin systematically biased scientific evidence through data manipulation and suppression of negative studies to promote the drug for off-label uses.1,2

14) http://www.spacedoc.com/peripheral-neuropathy-from-statin-use?utm_source=June+21%2C+2014&utm_campaign=March+30+2014+Newsletter&utm_medium=email

Duane Graveline MD Statins and Peripheral Neuropathy

statin induced peripheral neuropathy

15) http://www.neurology.org/content/58/9/1333.abstract
Statins and risk of polyneuropathy A case-control study     D. Gaist, MD PhD,     U. Jeppesen, MD PhD,     M. Andersen, MD PhD,     L. A. García Rodríguez, MD MSc,
J. Hallas, MD PhD and     S. H. Sindrup, MD PhD     From the Department of Neurology (Drs. Gaist, Jeppesen, and Sindrup), Odense University Hospital; Epidemiology (Dr. Gaist) and Clinical Pharmacology (Drs. Andersen, Hallas, and Sindrup), Institute of Public Health, University of Southern Denmark; and Centro Español de Investigación Farmacoepidemiológica (Dr. García Rodríguez), Madrid, Spain.
Background: Several case reports and a single epidemiologic study indicate that use of statins occasionally may have a deleterious effect on the peripheral nervous system. The authors therefore performed a population-based study to estimate the relative risk of idiopathic polyneuropathy in users of statins.
Method: The authors used a population-based patient registry to identify first-time-ever cases of idiopathic polyneuropathy registered in the 5-year period 1994 to 1998. For each case, validated according to predefined criteria, 25 control subjects were randomly selected among subjects from the background population matched for age, sex, and calendar time. The authors used a prescription register to assess exposure to drugs and estimated the odds ratio of use of statins (ever and current use) in cases of idiopathic polyneuropathy compared with control subjects.
Results: The authors verified a diagnosis of idiopathic polyneuropathy in 166 cases. The cases were classified as definite (35), probable (54), or possible (77). The odds ratio linking idiopathic polyneuropathy with statin use was 3.7 (95% CI 1.8 to 7.6) for all cases and 14.2 (5.3 to 38.0) for definite cases. The corresponding odds ratios in current users were 4.6 (2.1 to 10.0) for all cases and 16.1 (5.7 to 45.4) for definite cases. For patients treated with statins for 2 or more years the odds ratio of definite idiopathic polyneuropathy was 26.4 (7.8 to 45.4).
Conclusions: Long-term exposure to statins may substantially increase the risk of polyneuropathy.

16) http://articles.latimes.com/2011/nov/30/news/la-heb-lipitor-generic-20111130
Lipitor generated more than $100 billion in revenue for Pfizer since it was approved in 1997.

17) http://primaldocs.com/opinion/have-you-experienced-side-effects-of-statin-drugs/
Have YOU Experienced Side Effects of Statin Drugs?

Studies have confirmed that peripheral neuropathy (tingling and numbness or burning pain) may occur with statins.

18) http://www.sciencedirect.com/science/article/pii/S0140673604157395
Selenoprotein synthesis and side-effects of statins
Bernd Moosmann, PhDa, Christian Behl, PhDa,

Statins are possibly the most effective drugs for the prevention and treatment of hypercholesterolaemia and coronary heart disease.   They are generally well tolerated, however, they do cause some unusual side-effects with potentially severe consequences, most prominently myopathy or rhabdomyolysis and polyneuropathy. We noted that the pattern of side-effects associated with statins resembles the pathology of selenium deficiency, and postulated that the mechanism lay in a well established, but often overlooked, biochemical pathway—the isopentenylation of selenocysteine-tRNA[Ser]Sec. A negative effect of statins on selenoprotein synthesis does seem to explain many of the enigmatic effects and side-effects of statins, in particular, statin-induced myopathy.  Correspondence to: Christian Behl, Department of Pathobiochemistry, Johannes Gutenberg University, Medical School, 55099 Mainz, Germany

19) http://scholar.google.com/scholar?q=related:edv9UVeSlC0J:scholar.google.com/&hl=en&as_sdt=0,10
Statin-Associated Peripheral Neuropathy: Review of the Literature

Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663
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