Interesting - thank you. I will mention it to my GP next time I see him, although we are now past the point where there are any more different statins he can try to persuade me to try.
Colin Bignell
I'm pretty sure they get their 10 minute consult payment. Otherwise they wouldn't do it.
NT
Great video. Should be compulsory viewing for all medics, medical students - and everyone else to boot.
Jim Hawkins
I'm pretty sure you are wrong. GP practices are paid for the number of patients plus extra allowances for some services all subject to qof being satisfactory. How the cash is split up depends on the practice and is spent on staff, overheads, drugs and other treatments.
While Chris Hogg has given a link to a study that indicates that too low a level of cholesterol may be linked to stroke, statins would not have reduced your friend's levels to even the recommended maximum within just one week.
Statins work by interrupting the production of LDL-C in the liver. There would be no advantage to a gradual build up in dosage.
There are alternatives to statins, although statins are generally the most effective at reducing LDL-C (bad cholesterol).
Nicotinic acid (one of the forms of vitamin B3 or Niacin) reduces the body's ability to synthesise cholesterol. However, particularly if taken as a supplement rather than as part of the diet (chicken, eggs, carrots, beef and liver are sources of vitamin B3), it can also cause skin irritation, alter blood sugar levels, cause stomach problems and, in extreme cases, liver problems.
Ezetimibe works by reducing the absorption of cholesterol into the blood stream in the intestine. It is normally only prescribed when statins alone have failed to bring cholesterol levels down far enough or if the patient cannot take statins.
Fibrates are widely used in France, but are primarily of use for reducing plasma triglycerides. They have little or no effect on LDL-C.
Bile acid binders work by causing bile acids to be excreted, rather than being re-absorbed into the blood. These acids are needed to produce bile and, if they are not available, the body uses LDL cholesterol instead. They can however make constipation worse and are contra-indicated for some patients.
The best option for reducing cholesterol is diet and exercise.
Colin Bignell
You state the conventional view, precisely the view that the book "The Great Cholesterol Con".disputes.
Jim Hawkins
'Diet and exercise' is certainly a good regime to follow, regardless of whether you think cholesterol is important, although it leaves open the question as to what diet. Judging by the extremely deleterious effects the so-called 'western diet' has had on the health of the indigenous peoples who've been exposed to it since WWII (low fat, high refined carbohydrates, especially sugar, thank you Dr. Keys), not that!
Being in a book doesn't make it correct. The Atkins diet was in a popular book but it was also cr@p.
A lot of diabetics do very well on the Atkins diet, with well controlled blood sugar levels and normal cholesterol values!
Ithink there was a dsmall grain of truth in te Akins diet.
Over the years my eight used to vary. I discovered that the two things that caused weight gain were starch/sugar and alcohol. Fat made zero difference to it.
When I was poor I ate more starch. And put on weight., When I was with a drunk Glaswegian girlfriend, I drank, and put on weight.
When I got a little ,more comfortable, I ate more meat' less starch and lost weight.
I don't think our bodies do well on a high carbohydrate diet. We didnt evolve under that regime.
WE did evolve to consume fats though.
Snipped..
My dad died way back in the late 70s ,,,
Making his own bread and yoghurt,,
during NHS supported heyday of flora,,
if you suspect suppression of news re cholesterol an stuff... I suggest research the trans-fat scandal and would point out that sir Malkolm Rifkind recently swapped out wi Leon Brittain on the board of guveners of thon mega margarine company a canna remember the name of...
Leon is a Mystery man,, wi special knowledge o sumpthin,, pulled into Camerons guvment
................
Yer it was Unilever ,,
I had to search for the name..
and found this
.................
I had to google
The figures I have seen, are that the official choresterol levels are
5.0 for men and women. (UK measurements) However, the current published results ahow that below 5.4, men die and below 6.2, women die! These are average figures.The general ignorance level in many GPs is extremely high. They have a tendency to believe whatever load of rubbish is published in the journals, without applying a "common sense" filter. The most dangerous papers are those which rehash a collection of previous results without stating which results were discarded. Also, they will normally always prescribe the cheapest drug, not necessarily the one which is best for the patient. The doctor TV program was utter rubbish on migraine, the only drug which is effective is Sumatriptan and the Imigran (GSK) copies are not as effective as the original. The HRT bit was pretty poor also. I know women who have been on HRT for up to 40 years and only the ones who didn't take HRT have become infirm or developed cancer. The HRT benefits are obvious to me and why didn't the program talk to any women? It's their lives!
Purely as an side note, my 75yr old US friend reduced his blood pressure from 180 to 140 after a years course of 75mg of DHEA. I don't know if this just a coincidence. He said that lower levels he had taken in previous years, didn't have any effect.
Doctors are people .... they have opinions, and their views, and any current 'fad' of research will have statistics to support it. I have had 3 consultants and my GP's give totally different advice on taking daily dose of Aspirin ... if they can't agree on drug that has been synthesised since 1897; what chance on getting more esoteric things straight.
To pass an exam you need to memorise about 60% of the material you get ques tioned on. It needs to be partly understood. Most of it is then forgotten. The requirement for practical work helps in some areas, but only some.
To make things worse, many things are simply assumed to be known when they' re not. Then as you say there's the barely critical way further knowledge i s obtained. There's also the reality that a significant percentage of what was taught is simply profit driven bunk. Its a shame the NHS doesnt underst and the problem & choose to do better.
Most certainly it is a shame.
In my medical field of interest, one significant but extremely simple idea has made the leap from research to patient in about six or so years. (Not yet to all patients, but at least to a considerable number of those who are active online in pursuit of help and understanding.)
The idea? Take your one a day pill at bed-time rather than in the morning. Some people have found this a massive improvement - though some have changed back to the morning because it didn't work for them.
However, all patient information leaflets, most pharmacists, most doctors, still stick with advising to take in the morning. I suspect on the grounds that it has always been done that way. I know of absolutely zero research to back it up. There are quite a few papers now supporting taking at bed-time including case reports of almost unbelievable improvement and including the blood tests to "prove" it.
Apparently it usually takes about fourteen years for ideas to percolate through to patient care. By skipping the professionals this has better-than halved that.
that's better than philosophy where it takes about 700 years... most people today have te sort of world-view that characterised a 13th century monk...
True. Though I was being rather generous - fourteen years is towards the short end and does not allow the decades for existing dinosaur doctors to completely fail to keep up with anything.
I state ways to reduce cholesterol. I leave to the reader to decide whether that is a good thing or not.
Colin Bignell
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