(NaturalNews) To hear Big Pharma tell it, statin drugs are "miracle" medicines that have prevented millions of heart attacks and strokes. But a recent study published in the British Medical Journal tells a completely different story: For every heart attack prevented by the drug, two or more people suffered liver damage, kidney failure, cataracts or extreme muscle weakness as a result of taking the drug.
Statin drugs, in other words, harm far more people than they help.
Julia Hippisley-Cox and Carol Coupland led the study which examined data from over two million patients, including over 225,000 patients who were new statin drug users.
They found that for every 10,000 women being treated with statins, there were only 271 fewer cases of heart disease.
And yet, at the same time, the statin drugs caused 74 cases of liver damage, 23 cases of acute kidney failure, 39 cases of extreme muscle weakness and 307 cases of cataracts.
Statin drugs, in other words, helped 271 people but harmed 443 people. This demonstrates how they are wreaking havoc with the health of those who take them, causing damage that far outweighs any benefit they might offer.
Big Pharma's highly deceptive advertising implies that statin drugs help everyone who takes them. So if 10,000 people took the drugs, we're promised, heart attacks would be prevented in all 10,000 people. That's the implied message in the drug ads, anyway.
But this is just a wild exaggeration and distortion of the facts. Most drugs don't work on most people, and statin drugs only "work" on about 2.7% of those who take them. Yet they cause serious damage in about 4.4% of those who take them.
So if you take statin drugs, your odds of benefiting from them is less than 3 out of 100. But your odds of being harmed by them are more than 4 out of 100. For 96 out of 100 people, statin drugs do nothing except make the drug companies rich and pollute the waterways every time you flush the toilet.
Statin drugs, then, are basically a crap shoot with your health.
Keep the pharma profits rolling
From the point of view of Big Pharma, they have the added benefit of causing other diseases that often result in yet more drugs or medical procedures being prescribed. Kidney dialysis makes big money for hospitals, by the way. It's a multi-billion-dollar business all by itself. Statin drugs are therefore a way for the sick-care industry to recruit new patients into kidney dialysis, knowing that some percentage of statin drug users are going to end up with full-blown kidney failure.
What's really interesting about all this is how easy it is to fool doctors into prescribing statin drugs. Doctors mistakenly think these are miracle drugs, but they're never read the research. They've been convinced by drug reps, misleading medical journal articles and Big Pharma advertising -- and they bought it!
Mainstream doctors, you see, are perhaps the most gullible people on the planet. They'll gladly prescribe a drug that harms more people than it helps -- by the millions -- because they can be almost effortlessly swayed into pushing poison pills through "science babble" language used by drug companies to promote their pills.
Doctors are literally walking around today thinking statin drugs are such miracle lifesavers that some doctors openly talked about dripping the drug into the public water supply! That's how convinced they are about the drug's benefits. They think everyone should be taking statins whether they need them or not!
It's downright loony. But that's characteristic of western medicine, isn't it? Proclaim your poison to be "miracle medicine" while utterly ignoring the truth that those drugs harm far more people than they help (and they simply don't work on more than 90% of people who take them).
The statin scam
Statin drugs are a scam, plain and simple, and the doctors who prescribe them are puppets used by Big Pharma to sell high-profit drugs to people who for the most part won't even benefit from them. That this research exposing the truth about statin drugs even appeared in the British Medical Journal is a minor miracle all by itself, by the way. But it does indicate that the wall of lies constructed about statins by Big Pharma is starting to crack.
If the truth about statins were openly known, the drugs wouldn't be prescribed to anyone, and drug companies would be sued for billions of dollars for their false advertising and marketing manipulations.
Until that happens, just remember this: Any doctor who recommends a statin drug is a con man drug pusher. If they don't have the honesty to research the truth about these drugs and stop prescribing them, they certainly cannot be trusted with your health. If they're pushing statin drugs on you, they're really just working for Big Pharma, not for you, and they're not interested in real science and the real impacts of drugs on patients.
It brings up another hugely important question in modern medicine: Why don't doctors have the capability to question the false beliefs of their own industry? As you might have guessed, that's the topic of another story altogether
Statin Drugs??? Is this article valid???
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Consider the source, George.
To start with... virtually ALL therapies have potential side effects. The list of side effects for statins is very long and extensively documented - mostly because so many people have been on them for so long.
What one needs to look at is the bottom line - the DISTAL outcomes. The bottom line is that - for the right population - the simple (early) statins have done more than lower cholesterol levels. They reduce BOTH morbidity AND mortality risks. That net effect would include all the possible side effects which have been studied and extensively documented.
OR...
People can choose to manage their weight and eat right. Then many - but not all - wouldn't need to be on a cholesterol-lowering drug.
By the way, these distal outcome have not (yet) been shown to be true for some of the newer statins that you see extensively advertised on television today. This is a case where the older, cheaper stuff is probably better.
What isn't yet known is how aggressively cholesterol levels should be managed with statins. This right dose for the right population problem is still being extensively studied.
My own dad was put on a simple statin (Zocor or symvastatin) after a TIA (kind of a mini-stroke). Since then, his cognitive function has dramatically improved - possibly due to better circulation to his brain. I suspect that what we're doing for both his cancer and his stroke/cardiovascular risk management will extend both the length and the quality of his life. Not bad for an 88-year-old.
If the therapy didn't benefit him or if he had a side effect, well... he could always stop the therapy and deal with the natural course of his disease. Sometimes a switch-over to another statin (or another therapy like high-dose, time-released niacin) will minimize or eliminate the side-effect problem. Meanwhile... there are no do-overs on death, or a stroke that turns a living person into a drooling shadow of the person they once were.
As they say - lies, damn lies, and statistics.
- Bill
To start with... virtually ALL therapies have potential side effects. The list of side effects for statins is very long and extensively documented - mostly because so many people have been on them for so long.
What one needs to look at is the bottom line - the DISTAL outcomes. The bottom line is that - for the right population - the simple (early) statins have done more than lower cholesterol levels. They reduce BOTH morbidity AND mortality risks. That net effect would include all the possible side effects which have been studied and extensively documented.
OR...
People can choose to manage their weight and eat right. Then many - but not all - wouldn't need to be on a cholesterol-lowering drug.
By the way, these distal outcome have not (yet) been shown to be true for some of the newer statins that you see extensively advertised on television today. This is a case where the older, cheaper stuff is probably better.
What isn't yet known is how aggressively cholesterol levels should be managed with statins. This right dose for the right population problem is still being extensively studied.
My own dad was put on a simple statin (Zocor or symvastatin) after a TIA (kind of a mini-stroke). Since then, his cognitive function has dramatically improved - possibly due to better circulation to his brain. I suspect that what we're doing for both his cancer and his stroke/cardiovascular risk management will extend both the length and the quality of his life. Not bad for an 88-year-old.
If the therapy didn't benefit him or if he had a side effect, well... he could always stop the therapy and deal with the natural course of his disease. Sometimes a switch-over to another statin (or another therapy like high-dose, time-released niacin) will minimize or eliminate the side-effect problem. Meanwhile... there are no do-overs on death, or a stroke that turns a living person into a drooling shadow of the person they once were.
As they say - lies, damn lies, and statistics.
- Bill
The authors of the first study are not objective. They draw some terrible conclusions from their biases. But it's always nice to consider the source. Here is a link to the reputable source, BMJ, which published the study in question:
http://www.bmj.com/cgi/content/full/340 ... type=HWCIT
Here is the meatiest stuff from the abstract (NNT means number needed to treat, NNH is to harm; if the NNT is ten, you have to treat ten people to prevent one event--interesting how little various wonder drugs do on a per person basis eh?):
Based on the 20% threshold for cardiovascular risk, for women the NNT with any statin to prevent one case of cardiovascular disease over five years was 37 (95% confidence interval 27 to 64) and for oesophageal cancer was 1266 (850 to 3460) and for men the respective values were 33 (24 to 57) and 1082 (711 to 2807). In women the NNH for an additional case of acute renal failure over five years was 434 (284 to 783), of moderate or severe myopathy was 259 (186 to 375), of moderate or severe liver dysfunction was 136 (109 to 175), and of cataract was 33 (28 to 38). Overall, the NNHs and NNTs for men were similar to those for women, except for myopathy where the NNH was 91 (74 to 112).
First, the authors mention looking for FIRST recorded cardiovascular event; I'll need to read the whole thing to see if that meant we are only dealing with primary prevention here. Treating people who have already had events means the chance of benefit is much higher because the risk is higher; the risk of adverse events is about the same.
Second, the drugs prevent cardiovascular disease in one in ~35 people. Your chance of avoiding a heart attack, vascular death, etc was thus 2.86%.
Third, they found that statins may prevent throat cancer. Who knew? They blow this off as unconfirmed (but let's take those adverse events seriously, right?). The benefit is a lot less.
The risks they found for adverse events are much less, except for cataract, about the same as a vascular event. 0.23% for kidney failure, 0.38% for myopathy, 0.73% for liver damage (this is generally reversible, so when they say "dysfunction" they just mean, there was inflammation that should be monitored then goes away--no long term consequence). The myopathy and liver risks are well known although I wasn't familiar with the cataract or kidney risks.
So which would you rather have? A disabling stroke? A heart attack? Or a cataract? If we take all of this at face value (and there are many, many studies on statins to consider, including clear data that they prevent blood clots somewhat, whereas this study did not find that), I would much rather have a repairable cataract than potentially permanent cardiac disability.
Anyhoo, skimming the rest, it is also worth noting they looked for all sorts of stuff, from rheumatoid arthritis to 8 kinds of cancer. The more you look for the more you find by chance; statisticians therefore suggest the Bonferroni correction, which changes the p value for positivity when multiple searches are conducted to reduce false positive results. Look at all the tests they ran in table 3! It's nuts.
Also, the patients here are not randomized. This means that people with cataracts could be sicker or older or whatever and more likely to get a statin by chance (I think the benefit is real because it's shown in randomized trials).
Anyway, that's the thinking that should start the analysis of this one article of dozens on the subject. People deserve to know what they're getting in to with therapy, but imagine how hard it is to address this much detail in a 15 minute appointment!
http://www.bmj.com/cgi/content/full/340 ... type=HWCIT
Here is the meatiest stuff from the abstract (NNT means number needed to treat, NNH is to harm; if the NNT is ten, you have to treat ten people to prevent one event--interesting how little various wonder drugs do on a per person basis eh?):
Based on the 20% threshold for cardiovascular risk, for women the NNT with any statin to prevent one case of cardiovascular disease over five years was 37 (95% confidence interval 27 to 64) and for oesophageal cancer was 1266 (850 to 3460) and for men the respective values were 33 (24 to 57) and 1082 (711 to 2807). In women the NNH for an additional case of acute renal failure over five years was 434 (284 to 783), of moderate or severe myopathy was 259 (186 to 375), of moderate or severe liver dysfunction was 136 (109 to 175), and of cataract was 33 (28 to 38). Overall, the NNHs and NNTs for men were similar to those for women, except for myopathy where the NNH was 91 (74 to 112).
First, the authors mention looking for FIRST recorded cardiovascular event; I'll need to read the whole thing to see if that meant we are only dealing with primary prevention here. Treating people who have already had events means the chance of benefit is much higher because the risk is higher; the risk of adverse events is about the same.
Second, the drugs prevent cardiovascular disease in one in ~35 people. Your chance of avoiding a heart attack, vascular death, etc was thus 2.86%.
Third, they found that statins may prevent throat cancer. Who knew? They blow this off as unconfirmed (but let's take those adverse events seriously, right?). The benefit is a lot less.
The risks they found for adverse events are much less, except for cataract, about the same as a vascular event. 0.23% for kidney failure, 0.38% for myopathy, 0.73% for liver damage (this is generally reversible, so when they say "dysfunction" they just mean, there was inflammation that should be monitored then goes away--no long term consequence). The myopathy and liver risks are well known although I wasn't familiar with the cataract or kidney risks.
So which would you rather have? A disabling stroke? A heart attack? Or a cataract? If we take all of this at face value (and there are many, many studies on statins to consider, including clear data that they prevent blood clots somewhat, whereas this study did not find that), I would much rather have a repairable cataract than potentially permanent cardiac disability.
Anyhoo, skimming the rest, it is also worth noting they looked for all sorts of stuff, from rheumatoid arthritis to 8 kinds of cancer. The more you look for the more you find by chance; statisticians therefore suggest the Bonferroni correction, which changes the p value for positivity when multiple searches are conducted to reduce false positive results. Look at all the tests they ran in table 3! It's nuts.
Also, the patients here are not randomized. This means that people with cataracts could be sicker or older or whatever and more likely to get a statin by chance (I think the benefit is real because it's shown in randomized trials).
Anyway, that's the thinking that should start the analysis of this one article of dozens on the subject. People deserve to know what they're getting in to with therapy, but imagine how hard it is to address this much detail in a 15 minute appointment!
--Ian
Consider work like this, too... heart attacks are on their way out despite the explosion of diabetes and obesity. Substantial improvements in rates and outcomes was noted (after some increase in rates caused by more sensitive assays for heart attack). This is occurring because of heavy use of statin medicines, in part.
Population Trends in the Incidence and Outcomes of Acute Myocardial Infarction
Robert W. Yeh, M.D., Stephen Sidney, M.D., M.P.H., Malini Chandra, M.B.A., Michael Sorel, M.P.H., Joseph V. Selby, M.D., M.P.H., and Alan S. Go, M.D.
New Engl J Med
Volume 362:2155-2165 June 10, 2010 Number 23
ABSTRACT
Background Few studies have characterized recent population trends in the incidence and outcomes of myocardial infarction.
Methods We identified patients 30 years of age or older in a large, diverse, community-based population who were hospitalized for incident myocardial infarction between 1999 and 2008. Age- and sex-adjusted incidence rates were calculated for myocardial infarction overall and separately for ST-segment elevation and non–ST-segment elevation myocardial infarction. Patient characteristics, outpatient medications, and cardiac biomarker levels during hospitalization were identified from health plan databases, and 30-day mortality was ascertained from administrative databases, state death data, and Social Security Administration files.
Results We identified 46,086 hospitalizations for myocardial infarctions during 18,691,131 person-years of follow-up from 1999 to 2008. The age- and sex-adjusted incidence of myocardial infarction increased from 274 cases per 100,000 person-years in 1999 to 287 cases per 100,000 person-years in 2000, and it decreased each year thereafter, to 208 cases per 100,000 person-years in 2008, representing a 24% relative decrease over the study period. The age- and sex-adjusted incidence of ST-segment elevation myocardial infarction decreased throughout the study period (from 133 cases per 100,000 person-years in 1999 to 50 cases per 100,000 person-years in 2008, P<0.001 for linear trend). Thirty-day mortality was significantly lower in 2008 than in 1999 (adjusted odds ratio, 0.76; 95% confidence interval, 0.65 to 0.89).
Conclusions Within a large community-based population, the incidence of myocardial infarction decreased significantly after 2000, and the incidence of ST-segment elevation myocardial infarction decreased markedly after 1999. Reductions in short-term case fatality rates for myocardial infarction appear to be driven, in part, by a decrease in the incidence of ST-segment elevation myocardial infarction and a lower rate of death after non–ST-segment elevation myocardial infarction.
Population Trends in the Incidence and Outcomes of Acute Myocardial Infarction
Robert W. Yeh, M.D., Stephen Sidney, M.D., M.P.H., Malini Chandra, M.B.A., Michael Sorel, M.P.H., Joseph V. Selby, M.D., M.P.H., and Alan S. Go, M.D.
New Engl J Med
Volume 362:2155-2165 June 10, 2010 Number 23
ABSTRACT
Background Few studies have characterized recent population trends in the incidence and outcomes of myocardial infarction.
Methods We identified patients 30 years of age or older in a large, diverse, community-based population who were hospitalized for incident myocardial infarction between 1999 and 2008. Age- and sex-adjusted incidence rates were calculated for myocardial infarction overall and separately for ST-segment elevation and non–ST-segment elevation myocardial infarction. Patient characteristics, outpatient medications, and cardiac biomarker levels during hospitalization were identified from health plan databases, and 30-day mortality was ascertained from administrative databases, state death data, and Social Security Administration files.
Results We identified 46,086 hospitalizations for myocardial infarctions during 18,691,131 person-years of follow-up from 1999 to 2008. The age- and sex-adjusted incidence of myocardial infarction increased from 274 cases per 100,000 person-years in 1999 to 287 cases per 100,000 person-years in 2000, and it decreased each year thereafter, to 208 cases per 100,000 person-years in 2008, representing a 24% relative decrease over the study period. The age- and sex-adjusted incidence of ST-segment elevation myocardial infarction decreased throughout the study period (from 133 cases per 100,000 person-years in 1999 to 50 cases per 100,000 person-years in 2008, P<0.001 for linear trend). Thirty-day mortality was significantly lower in 2008 than in 1999 (adjusted odds ratio, 0.76; 95% confidence interval, 0.65 to 0.89).
Conclusions Within a large community-based population, the incidence of myocardial infarction decreased significantly after 2000, and the incidence of ST-segment elevation myocardial infarction decreased markedly after 1999. Reductions in short-term case fatality rates for myocardial infarction appear to be driven, in part, by a decrease in the incidence of ST-segment elevation myocardial infarction and a lower rate of death after non–ST-segment elevation myocardial infarction.
--Ian
Mentioned this thread to my MD the other day when we were talking...
I liked the response: "Protecting the heart is where it's at. That's what we want to do. If the heart goes, it doesn't matter what else you've prevented or protected."
(I know that's somewhat simplified and there was a LOT more to the conversation than that, but that particular comment said it all.)
I liked the response: "Protecting the heart is where it's at. That's what we want to do. If the heart goes, it doesn't matter what else you've prevented or protected."
(I know that's somewhat simplified and there was a LOT more to the conversation than that, but that particular comment said it all.)
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
It's a pretty good summary, Panther. In the article George posted, there was an implicit assumption:
..........severity of event avoided = severity of side effect
And that's nonsense for all the reasons stated above - including your own.
For what it's worth... include the brain in that comment as well. My dad is on a statin strictly to prevent an occlusive stroke - possibly "the big one." (A TIA for the brain is like having chest pain from a badly ischemic heart. It's a sign that something really bad may happen.)
The one thing worse than death is being alive in body only. We're not quite into taking the sick old man behind the barn with shotgun in hand. But if that happened to me, any of you have permission to do me that favor.
- Bill
..........severity of event avoided = severity of side effect
And that's nonsense for all the reasons stated above - including your own.
For what it's worth... include the brain in that comment as well. My dad is on a statin strictly to prevent an occlusive stroke - possibly "the big one." (A TIA for the brain is like having chest pain from a badly ischemic heart. It's a sign that something really bad may happen.)
The one thing worse than death is being alive in body only. We're not quite into taking the sick old man behind the barn with shotgun in hand. But if that happened to me, any of you have permission to do me that favor.
- Bill
The other thing to keep in mind about this sort of nonsense is that it indicted doctors for doing something despite information about side effects THAT HAD NOT COME OUT YET. Even if the drugs were a nightmare and this was news as of the BMJ article's posting, the only rational response is to call on doctors to change practice immediately--not to call them puppets and con artist drug pushers because they didn't anticipate the results of research not yet done.
There would be a gripe to file then; when use of beta blockers for heart attack was retired as a quality measure because we were doing it about 98% of the time, the NEJM editorial accompanying the news noted it only took TEN YEARS from the time the data was certain until the physicians were reliable at doing it.
Imagine if a car company waited ten years to perform a recall after finding a fault! Ha!
There would be a gripe to file then; when use of beta blockers for heart attack was retired as a quality measure because we were doing it about 98% of the time, the NEJM editorial accompanying the news noted it only took TEN YEARS from the time the data was certain until the physicians were reliable at doing it.
Imagine if a car company waited ten years to perform a recall after finding a fault! Ha!
--Ian
Bill, Ditto on the good body, bad brain scenario! I'll even prepay for the ammo!
Ian, Agreed.
Perhaps I should clarify what I was "upset" about earlier along those lines. I was upset with a few MDs that were misprescribing things in various ways (for cause, amount and period of time... which were well documented, but I didn't know about... caveat emptor) and who I found out were pushing certain meds that they had a financial interest in pushing when either something cheaper was available and/or it wasn't really indicated at all.
I hope it has become clear that 1) I go to MDs, but now I'm careful... trust but verify maybe... 2) I try to take an active role in my situation/care, but also consider the "big picture"... and 3) like anything there are good and bad. (You may disagree with me, but my experience is there are sometimes when for me trying to get everything I need from food just didn't/isn't working... for a number of reasons that have happened over a long period of time.
Good medicine = = good...
Bad medicine = = bad...
figuring it out = = tough...
inundation with garbage = = "garbage in, garbage out"!!
Ian, Agreed.
Perhaps I should clarify what I was "upset" about earlier along those lines. I was upset with a few MDs that were misprescribing things in various ways (for cause, amount and period of time... which were well documented, but I didn't know about... caveat emptor) and who I found out were pushing certain meds that they had a financial interest in pushing when either something cheaper was available and/or it wasn't really indicated at all.
I hope it has become clear that 1) I go to MDs, but now I'm careful... trust but verify maybe... 2) I try to take an active role in my situation/care, but also consider the "big picture"... and 3) like anything there are good and bad. (You may disagree with me, but my experience is there are sometimes when for me trying to get everything I need from food just didn't/isn't working... for a number of reasons that have happened over a long period of time.
Good medicine = = good...
Bad medicine = = bad...
figuring it out = = tough...
inundation with garbage = = "garbage in, garbage out"!!
==================================
My God-given Rights are NOT "void where prohibited by law!"
My God-given Rights are NOT "void where prohibited by law!"
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
I don't disagree with you. My friend Dr. Ian is a bit more slow on the uptake on this stuff than I, and not at all in a bad way. I'm in research. I'll take chances based on first principles. That's what I get PAID to do. Ian gets paid to do what is evidence-based (which takes forever to establish) and can get his ass handed to him in court when/if he strays off of that well-worn path and someone happens to be on the tail of that statistical spectrum with a bad outcome. I don't blame him for being the way he is.Panther wrote:
You may disagree with me, but my experience is there are sometimes when for me trying to get everything I need from food just didn't/isn't working...
A good example where Ian and I agree is on Vitamin D. We know most people are in short supply because half of us never get out of the house and into the sun, and the other half is obsessed over what their dermatologists are telling them. No sun = no vitamin D production. So most of us have to supplement. Low vitamin D means greater risk of osteoporosis, higher cancer risk, etc., etc. (all the things we're still discovering).
It's somewhere in-between natural food store foo foo herbals and vitamin D that Ian and I tend to behave a little differently. But we're pretty much on the same page nonetheless.
What can't be discounted is the benefit of a low glycemic index, moderate "good fat", hyper low "bad fat", higher fiber, fruits and vegetables diet that's as close to from-the-farm as possible. Eat right and not too much, and half the problems you may see in middle age may never happen. At my advancing middle age, I have yet to need a daily pharmaceutical except for something to combat the effects of this %^&@ *@&I pollen. And from what I know by analyzing health care data every day, that's pretty unusual. And it isn't all good genes (or T-shirts either...
).I'm with you on finding the right doctors, Panther. People like Ian and I struggle as well. But like you, we do our homework. That's more than most MDs get when a patient walks in the front door. And trust me, that's a VERY good thing for both you and your doctor.
- Bill
Bill, sorta true about the malpractice stuff. I'm not worried about getting hauled off to court about a supplement side effect. They don't do much, and harms are generally low as a result, and would be hard to establish (when there are harms, they affect very few of the users). Further, people love em, and happy people don't sue, usually. But not harming people is wise for other reasons.
And the data doesn't follow the way it's expected all the time. This was true in the WHI when all that HRT didn't pan out as planned, with women getting more breast cancer and not as much heart protection. However, there was just a paper in AJC journal club suggesting a mortality benefit for some women on HRT; moral is, if you don't wait for evidence, you CAN harm some people. Or just waste billions of dollars across the USA. With some things, there's a reasonable middle ground. Think lycopene might help prostates? It might. No proof. Go eat some tomato soup, but I wouldn't shell out for supplements. Want to eat some protein supplement? That's fine, too, but egg or poultry protein is generally a lot cheaper for similar stuff, and CR just found relatively large doses of heavy metals in em. Use in moderation.
I worry about even the vitamin D. Take calcium. Calcium is cool, right? Healthy bones, fewer fractures, muscle contractions depend on it, yadda yadda. Well, in RCT's when they gave calcium supplements the NNT was higher than the NNH, and not for trivial stuff: strokes, heart attacks, etc. Turns out that calcium goes into your arteries and your bones not just your bones. Think you're an exception because of your healthier arteries? Well sure, you're allowed to chance it. Funny way to spend your money though.
What does Vitamin D do? In part, it increases calcium absorption. Will we find similar risks of atherosclerosis from vitamin D? We might. So go slow and use reasonable low doses and follow the evolving literature. Especially since high dose annual vitamin D just turned out to make things WORSE:
http://jama.ama-assn.org/cgi/content/ab ... 03/18/1815
Vol. 303 No. 18, May 12, 2010 TABLE OF CONTENTS
JAMA
Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women
A Randomized Controlled Trial
Kerrie M. Sanders, PhD; Amanda L. Stuart, BappSc; Elizabeth J. Williamson, MA, PhD; Julie A. Simpson, PhD; Mark A. Kotowicz, MBBS, FRACP; Doris Young, MD, MBBS, FRACGP; Geoffrey C. Nicholson, PhD, FRACP
JAMA. 2010;303(18):1815-1822.
Context Improving vitamin D status may be an important modifiable risk factor to reduce falls and fractures; however, adherence to daily supplementation is typically poor.
Objective To determine whether a single annual dose of 500 000 IU of cholecalciferol administered orally to older women in autumn or winter would improve adherence and reduce the risk of falls and fracture.
Design, Setting, and Participants A double-blind, placebo-controlled trial of 2256 community-dwelling women, aged 70 years or older, considered to be at high risk of fracture were recruited from June 2003 to June 2005 and were randomly assigned to receive cholecalciferol or placebo each autumn to winter for 3 to 5 years. The study concluded in 2008.
Intervention 500 000 IU of cholecalciferol or placebo.
Main Outcome Measures Falls and fractures were ascertained using monthly calendars; details were confirmed by telephone interview. Fractures were radiologically confirmed. In a substudy, 137 randomly selected participants underwent serial blood sampling for 25-hydroxycholecalciferol and parathyroid hormone levels.
Results Women in the cholecalciferol (vitamin D) group had 171 fractures vs 135 in the placebo group; 837 women in the vitamin D group fell 2892 times (rate, 83.4 per 100 person-years) while 769 women in the placebo group fell 2512 times (rate, 72.7 per 100 person-years; incidence rate ratio [RR], 1.15; 95% confidence interval [CI], 1.02-1.30; P = .03). The incidence RR for fracture in the vitamin D group was 1.26 (95% CI, 1.00-1.59; P = .047) vs the placebo group (rates per 100 person-years, 4.9 vitamin D vs 3.9 placebo). A temporal pattern was observed in a post hoc analysis of falls. The incidence RR of falling in the vitamin D group vs the placebo group was 1.31 in the first 3 months after dosing and 1.13 during the following 9 months (test for homogeneity; P = .02). In the substudy, the median baseline serum 25-hydroxycholecalciferol was 49 nmol/L. Less than 3% of the substudy participants had 25-hydroxycholecalciferol levels lower than 25 nmol/L. In the vitamin D group, 25-hydroxycholecalciferol levels increased at 1 month after dosing to approximately 120 nmol/L, were approximately 90 nmol/L at 3 months, and remained higher than the placebo group 12 months after dosing.
Conclusion Among older community-dwelling women, annual oral administration of high-dose cholecalciferol resulted in an increased risk of falls and fractures.
Again, real bummer to spend money on something and find out it was hurting you. I haven't gotten any details on what Panther's supposed supplement needs are but I don't really want them--privacy is never bad and I don't want to deprive anyone of something they think is working, but generally, whole foods are the way to go.
And the data doesn't follow the way it's expected all the time. This was true in the WHI when all that HRT didn't pan out as planned, with women getting more breast cancer and not as much heart protection. However, there was just a paper in AJC journal club suggesting a mortality benefit for some women on HRT; moral is, if you don't wait for evidence, you CAN harm some people. Or just waste billions of dollars across the USA. With some things, there's a reasonable middle ground. Think lycopene might help prostates? It might. No proof. Go eat some tomato soup, but I wouldn't shell out for supplements. Want to eat some protein supplement? That's fine, too, but egg or poultry protein is generally a lot cheaper for similar stuff, and CR just found relatively large doses of heavy metals in em. Use in moderation.
I worry about even the vitamin D. Take calcium. Calcium is cool, right? Healthy bones, fewer fractures, muscle contractions depend on it, yadda yadda. Well, in RCT's when they gave calcium supplements the NNT was higher than the NNH, and not for trivial stuff: strokes, heart attacks, etc. Turns out that calcium goes into your arteries and your bones not just your bones. Think you're an exception because of your healthier arteries? Well sure, you're allowed to chance it. Funny way to spend your money though.
What does Vitamin D do? In part, it increases calcium absorption. Will we find similar risks of atherosclerosis from vitamin D? We might. So go slow and use reasonable low doses and follow the evolving literature. Especially since high dose annual vitamin D just turned out to make things WORSE:
http://jama.ama-assn.org/cgi/content/ab ... 03/18/1815
Vol. 303 No. 18, May 12, 2010 TABLE OF CONTENTS
JAMA
Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women
A Randomized Controlled Trial
Kerrie M. Sanders, PhD; Amanda L. Stuart, BappSc; Elizabeth J. Williamson, MA, PhD; Julie A. Simpson, PhD; Mark A. Kotowicz, MBBS, FRACP; Doris Young, MD, MBBS, FRACGP; Geoffrey C. Nicholson, PhD, FRACP
JAMA. 2010;303(18):1815-1822.
Context Improving vitamin D status may be an important modifiable risk factor to reduce falls and fractures; however, adherence to daily supplementation is typically poor.
Objective To determine whether a single annual dose of 500 000 IU of cholecalciferol administered orally to older women in autumn or winter would improve adherence and reduce the risk of falls and fracture.
Design, Setting, and Participants A double-blind, placebo-controlled trial of 2256 community-dwelling women, aged 70 years or older, considered to be at high risk of fracture were recruited from June 2003 to June 2005 and were randomly assigned to receive cholecalciferol or placebo each autumn to winter for 3 to 5 years. The study concluded in 2008.
Intervention 500 000 IU of cholecalciferol or placebo.
Main Outcome Measures Falls and fractures were ascertained using monthly calendars; details were confirmed by telephone interview. Fractures were radiologically confirmed. In a substudy, 137 randomly selected participants underwent serial blood sampling for 25-hydroxycholecalciferol and parathyroid hormone levels.
Results Women in the cholecalciferol (vitamin D) group had 171 fractures vs 135 in the placebo group; 837 women in the vitamin D group fell 2892 times (rate, 83.4 per 100 person-years) while 769 women in the placebo group fell 2512 times (rate, 72.7 per 100 person-years; incidence rate ratio [RR], 1.15; 95% confidence interval [CI], 1.02-1.30; P = .03). The incidence RR for fracture in the vitamin D group was 1.26 (95% CI, 1.00-1.59; P = .047) vs the placebo group (rates per 100 person-years, 4.9 vitamin D vs 3.9 placebo). A temporal pattern was observed in a post hoc analysis of falls. The incidence RR of falling in the vitamin D group vs the placebo group was 1.31 in the first 3 months after dosing and 1.13 during the following 9 months (test for homogeneity; P = .02). In the substudy, the median baseline serum 25-hydroxycholecalciferol was 49 nmol/L. Less than 3% of the substudy participants had 25-hydroxycholecalciferol levels lower than 25 nmol/L. In the vitamin D group, 25-hydroxycholecalciferol levels increased at 1 month after dosing to approximately 120 nmol/L, were approximately 90 nmol/L at 3 months, and remained higher than the placebo group 12 months after dosing.
Conclusion Among older community-dwelling women, annual oral administration of high-dose cholecalciferol resulted in an increased risk of falls and fractures.
Again, real bummer to spend money on something and find out it was hurting you. I haven't gotten any details on what Panther's supposed supplement needs are but I don't really want them--privacy is never bad and I don't want to deprive anyone of something they think is working, but generally, whole foods are the way to go.
--Ian
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
IanIJ wrote:
Again, real bummer to spend money on something and find out it was hurting you. I haven't gotten any details on what Panther's supposed supplement needs are but I don't really want them--privacy is never bad and I don't want to deprive anyone of something they think is working, but generally, whole foods are the way to go.
This doesn't surprise me. Does it surprise you?
It's that first principles thing in me. I can't help myself; my training does that. I would have been SHOCKED if a single mega-massive dose of D that's supposed to be absorbed and stored for the rest of the year would have had any beneficial outcome. And I'm not at all surprised that it caused harm. It's a fat soluble vitamin after all. You can kill someone with too much vitamin A (reported cases of that from eating polar bear liver). And too much vitamin E similarly can cause harm.
I've had training in control theory. What they tried to do is counter-intuitive to me. I would have been delightfully surprised to see it work. But nope... It didn't.
The le chatelier principle holds only in a simple chemical reaction. Throw in some feedback loops - which the body is full of - and forgetaboutit. We biomedical engineers who specialize in mathematical modeling of physiologic systems understand how nonlinear systems are outside "normal" ranges.
- Bill
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Here's a recent article on the subject, Van. Bottom line - no evidence of a primary relationship.
- BillJ Bone Miner Res. 2010 Apr 7.
Inhibiting gastric acid production does not affect intestinal calcium absorption in young healthy individuals: a randomized, crossover controlled clinical trial.
Wright MJ, Sullivan RR, Gaffney-Stomberg E, Caseria DM, O'Brien KO, Proctor DD, Simpson CA, Kerstetter JE, Insogna KL.
Department of Allied Health Sciences, University of Connecticut Storrs, CT (MJW, JEK).
Abstract
INTRODUCTION:
Proton pump inhibitors (PPIs) are the most potent gastric acid suppressing drugs available and their use is widespread. An emerging concern about chronic PPI therapy is whether these drugs impair intestinal calcium absorption, resulting in a negative calcium balance and thereby potentially causing bone loss. The objective of the study was to evaluate the acute effect of a proton pump inhibitor (PPI) omeprazole, or placebo, on intestinal calcium absorption in healthy adults.
MATERIALS AND METHODS:
Twelve young adults participated in a placebo-controlled, double-blind, cross-over study. There were two 3-week interventions that included a 14-day adjustment period (designed to stabilize calcium homeostasis) followed by 6 days of a diet containing 800 mg of calcium and 2.1 g/kg protein (intervention). During the last three days of the adjustment period and throughout the intervention period, subjects consumed omeprazole or placebo. Half of the subjects underwent 24 h continuous gastric acid pH monitoring. Intestinal calcium absorption was measured using dual-stable calcium isotopes at the end of each intervention.
RESULTS:
Treatment with omeprazole significantly increased gastric pH (mean pH on PPI: 5.38 +/- 0.13; mean pH on placebo: 2.70 +/- 0.44, p = 0.005). Neither calcium absorption (PPI: 34.2 +/- 2.4%; placebo: 31.5 +/- 2.1%, p = 0.24) nor urinary calcium (PPI: 321 +/- 38 mg/34 hrs; placebo: 355 +/- 37 mg/34 hrs, p = 0.07) differed between the PPI and placebo treatment.
CONCLUSION:
Short-term gastric acid suppression by PPIs does not attenuate intestinal calcium absorption in healthy young adults.
Last edited by Bill Glasheen on Thu Jun 17, 2010 3:44 am, edited 2 times in total.
