Cholesterol is a waxy substance secreted by our livers and found in food that we eat. Medical studies correlate the amount of cholesterol in our blood with the amount of plaque build-up in our arteries, leading to heart attacks and strokes. It is believed that reducing cholesterol in the blood will reduce the risk of cardiovascular disease.
The common method for reducing cholesterol levels are drugs, both statins, which reduce the amount of cholesterol produced internally, and cholesterol absorption inhibitors, which reduce the amount received from food.
Without drugs, I have higher than recommended levels of cholesterol. By taking a statin, Lipitor (Pfizer), in low doses (10mg), my LDL-C (low density lipoprotein or "bad" cholesterol) is lowered to an acceptable level for most persons (2.6 mmol/l; 100 mg/dcl;). A few years ago, this was considered near "optimum".
Two things then happened. First, my brother had heart surgery under age 60. This increased my risk factors for cardiovascular disease to "high risk", because of family history. Secondly, the guidelines for optimum LDL-C levels for "high risk" patients were lowered from 2.5 mmol/l to 2.0 mmol/l.
My doctor then recommended increasing the Lipitor dosage to 20 mg and added a second drug, Ezetrol (Zetia in the U. S.) (Merck), a cholesterol absorption inhibitor. This successfully lowered my LDL-C to 1.8.mmol/l (70 mg/dcl).
Given the apparent success of these types of drugs and their resultant popularity, sales boomed. Lipitor became the #1 selling prescription drug in the U. S. (peaking at revenues of $12.7 billion annually in 2007); and Ezetrol brought in $ 5.0 billion for Merck.
Then a surprise. Under Congressional probing, it was discovered that Merck had failed to release clinical results which showed that while Ezetrol was effective in reducing cholesterol, it apparently had no effect on reducing the amount of plaque build-up in the arteries, and that eventual outcomes for patients were not improved. In fact, outcomes might actually be reduced. Merck pleaded that more studies were needed.
Of course, I asked my doctor about this. He didn't know. He was following the guidelines and the recommendations. He said he would ask his father-in-law, also a doctor, who knew more about these things than he did. I've yet to get an answer from him.
I stopped taking the Ezetrol for six months, but my LDL cholesterol returned to the old (previously acceptable) level. I've resumed taking the Ezetrol.
Now I have several concerns: (1) My drug treatment is not based on any symptoms that I have (other than higher than normal levels of cholesterol); (2) My doctor doesn't know whether a prescribed drug is effective; (3) Clinical reports cast suspicion on the drug; (4) Reasons for the guidelines to be made more stringent (availability of drugs or improved outcomes?); (5) The role of profits to the pharmaceutical industry.
The question of pharmaceutical profits arises particularly when I see their reps trying to get time with my doctor and wonder how successful they are in promoting their products. Lipitor is now available in generic form in Canada, but not in the U. S., due to "negotiations" between Pfizer and the generic manufacturer. It all makes you wonder.
It seems that cholesterol is naturally produced by my dad's body. He's a vegetarian. He also exercises regularly. Still, he has high cholesterol.
ReplyDeleteIt sounds like your doctor is burnt out. My suggestion to you is to find one that is on top of things. If he or she doesn't know and is competent, and more importantly, interested in their profession, they will eagerly seek out the truth, not tiredly wait for an answer from in-law.
Ahleena came down with a brain syndrome a year and a half ago. It affected her motor skills to the point that she couldn't walk properly. We took her to the Taiwan National University hospital. This was so cool. First of all, we weren't met with tired out doctors. Instead, a professor with his students came by at least once a day, and they vigorously discussed the symptoms. The students were already on top of things, as they were still studying. They eagerly tried to figure out what was going on. They went to their books and the Internet again and again. I they came to me and explained their ideas. Enough said. Go to the UBC hospital in future. Don't waste your time with doctors who are cynical and see what they are up to as business, as a means for paying for swimming pools, BMWs and European vacations. LOL.
is competant = stupid and lacks competence
ReplyDeleteDid they find what was wrong with Ahleena? I've seen her dancing on some of your videos and she looks normal.
ReplyDeleteMy doctor cancelled two appointments in November. I think he's reducing his practice at the clinic. I had to see his replacement in order to get prescriptions refilled and then had an argument about the quantity of pills. (It's an extra 3-hour round trip for me, if they cancel appointments and I need refills.) I'm now looking for a new doctor closer to home.
A fever affected her motor skills. Her regular functions came back later. I can't remember if they were ever figured out precisely. I do remember many young doctors coming up with ideas, which was much better than a normal medical experience here: meaning take this bag of meds and see you later. And thanks for padding my wallet.
ReplyDeleteStudent doctors kick ass. If I were truly sick, a university hospital would be my destination of preference.
To bad you cannot self-prescribe.