Thursday, January 10, 2008

Prize for worst misuse of a statin

Cardiology rounds, Haydarpasa Numune Training and Research Hospital, Turkey.

Head of department, senior clinicians, residents and interns all stand around a gold plated replica of a Simvastatin package. Slowly each clinician raises their hands, palms uppermost, out to their sides, then arches them upwards to curl over and bring the tips of fingers to meet on mid line of their head, making a kind of a heart sign.

There is a deep sense of intense religious presence, a faint smell of incense and rapt attention to the reading of the simvastatin data sheet, excepting the adverse reactions page, which seems to have disappeared. All then intone:

We believe in the lipid hypothesis, the sole lipid hypothesis and nothing but the lipid hypothesis. We believe in the great saviour Simvastatin. We believe it is the answer to all ills, especially thyroid deficiency.

OK, I made all of that up.

Except the bit about thyroid deficiency.

Where did this rant come from? This paper.

Thyroid deficiency is a major driver of arteriosclerosis. Replacing the missing thyroid hormone reverses the arteriosclerosis. You would think that nothing could be simpler. Not so. You can also reverse the signs of arteriosclerosis with simvastatin WITHOUT replacing the thyroid hormone. It doesn't work quite as well as fixing the genuine problem but, hey, it's a glossy statin not a drab thyroid supplement. I don't suppose you feel much better on a statin with or without having your thyroid problem corrected.

Best quote from the abstract:

"No correlation was demonstrated between the changes in total or LDL-cholesterol concentration and IMT (degree of arteriosclerosis) in the simvastatin group."

Translation: The cholesterol hypothesis is garbage.

My thanks to Chris Masterjohn for dropping that one on me on New Year's Day. Luckily I didn't break any fillings while grinding my teeth!

You can read Chris' comments, including snippets from the full text, here at The Cholesterol Times.

You can read his whole web site here, it's good.



Chris said...

What a great blog. I've just found this and it is great.

Did you see this recent story that I have posted on my blog?

cholesterol is needed for muscle building

Morhangeois said...

In today's news, "Most people with diabetes should be considered for treatment with cholesterol-lowering statins."

That's the advice of the authors of a study in the Jan. 12 issue of The Lancet

What's next for statins?

Enjoy your blog immensely.


Peter said...

Thanks guys.

Chris, no I'd missed that. Interesting. It's a wonder anyone could manage exercise on a statin from what I've read... I have an observational study on egg intake and mammary recurrence post initial tx. Bearing in mind it's only observational, if there is causation then eggs knock spots off of herceptin.

Interesting blogs. I just hit the antioxidants section of Chris', wondering what would be there. Yes! Make your own and leave the plants with their toxins (chocolate excepted, of course)... Hee hee

And yes, whatever next for statins?