When I read an article in last week’s Times entitled ‘Ten million in the U.K. take statins – I was reluctant to do so, until now’ by Dr. Mark Porter, I raised an eyebrow and decided to read on. The strapline to the headline read: “Why I have decided that the risks associated with the drugs are now worth taking to control my cholesterol” to which my immediate sceptical reaction was, “I wonder how much he is being paid to write this?”
There is much debate about statins and their benefits. The zealots in favour of statins claim that they save thousands of lives and thereby reduce a huge financial burden on the NHS from people suffering heart disease and stroke. In his Times article, Dr. Porter writes that “the National Institute for Health and Care Excellence (NICE) estimates the annual healthcare cost of cardiovascular diseases in England alone at well over £7 billion”. On the other side of the debate are people like Dr. Aseem Malhotra, who suggest that the risks outweigh the benefits; people should seek alternative approaches to reducing their risk of cardiovascular disease.
But I was intrigued to find out why Dr. Porter had changed his mind.
The fact is, Dr. Porter has either sat on the fence or more accurately jumped back and forth over that fence several times. Interestingly, he has a genetic pre-disposition to high cholesterol so he has more than a passing interest in anything that will lower his cholesterol. In a 2009 article, as a healthy 46 year old, he wrote that he had taken statins for a six month period with no ill effects and a dramatic reduction in his cholesterol. He had, in his own words “got off the fence and joined the majority of my colleagues in the pro-statin lobby”.
However, based on the current article, it would seem that something changed, as he clearly stopped taking the statins at some point between 2009 and now, even with his genetic predisposition to high cholesterol. Furthermore, it appears that he leapt back over the fence and gave a change in diet a go instead.
In 2016, he wrote an article in which he went on a low carbohydrate diet for six weeks. For those who are familiar with Low-Carb, High-Fat (LCHF) diets, this was nothing of the kind. He simply cut out a lot of the sugar in his diet by cutting out fruit juices, bread, cakes, biscuits and confectionary and reducing his intake of rice, pasta and potatoes. It was kind of low-carb but not in the way that any proponent of the LCHF diet would recognise. He even continued to have a sugar in his coffee! However, despite this, his cholesterol dropped by 20% and his triglycerides by 30%. His risk of heart attack or stroke, as calculated by the qrisk.org calculator, dropped by nearly 15%. As, he said, not quite as dramatic a decrease as you might get with a statin, but not far off.
Much of the debate about statins revolves around the fact that they are now being recommended to anybody with a 10% chance of stroke or heart disease. Generally speaking, if you are a man in your early 60s, even with a healthy BMI and no other risk factors, you fall into this bracket. For women, the risks are lower, but you start having a 10% risk factor in your late 60s with a healthy BMI and no other risk factors. So, basically, most people over the age of 65 are going to fall into this category of a 10% chance of having stroke or heart attack in the next 10 years, and would therefore be offered statins by their doctor.
In his 2009 article, Dr. Porter notes that, if statins are prescribed to people with a 20% risk threshold, “it is estimated that about 35 people will need to take a statin for five years to prevent one of them developing cardiovascular disease. Over the same period one in 40 taking the drugs will develop a statin-induced cataract, about one in 100 will have liver problems and one in 400 will develop kidney failure. Reducing the threshold to just 10% will mean more people will have to be treated to save a life, but the odds of a serious side-effect like kidney failure remain exactly the same, shifting the risk-benefit ratio towards risk”. Those don’t sound like great odds to me for the more serious side-effects, but it doesn’t even consider the multitude of more minor side-effects.
In a BMJ article in response to the media headlines suggesting that statins should be prescribed to all people over the age of 50, Margaret McCartney presented evidence that the risk of ‘minor’ side-effects is significant and shouldn’t be underestimated and such side-effects have a profound effect on patients’ wellbeing.
A consumer panel of over 10,000 current and former statin users found that muscular side-effects were reported in 60% of former and 25% of current statin users. A French study reported that 10% of patients taking statins had muscular symptoms, leading to 30% of those stopping treatment.
Since exercise is one of the best ways to reduce your risks of cardiovascular disease, it seems counterintuitive to take a drug that negatively impacts your ability to exercise.
I came across an interesting tweet by Charlie Spedding in which he quotes a 66 year old runner who, having experienced calf and Achilles injuries, finally stopped taking his statins and switched to a low carb diet instead. Seven months later he broke a Parkrun course record he’d set eight years previously! He would have hung up his trainers had it not been for reading Charlie’s excellent book and considered that the statins may have been the problem.
It is difficult to find a study in the scientific literature that really highlights these risks or properly balances them against the benefits. Most clinical trials are funded by the drug companies whose interests in promoting public health have to be weighed against their interests in promoting profits, so getting to the heart of the data is problematic. Independently written meta-analyses, which seem great, are riddled with similar bias from the original data. In addition, patients tend not to report side-effects; many presume that their musculoskeletal problems or their memory issues or brain fogginess are just further symptoms of old age. Even when these are presented to the doctor, any link between these new symptoms and the statins are often overlooked. The whole wellbeing of the patient is important and so patients should be fully informed of the risks of taking new medication and these risks need to be balanced against the potential benefits. This is difficult when the risks are not transparent. In addition, alternatives, such as changes in lifestyle should always be the first choice and should be supported by the doctor. As Dr. Porter found out, even a small change in lifestyle can dramatically decrease your risks.
I suggest that Dr. Porter keeps jumping over the fence to keep himself fit, and I suggest he also cuts out the sugar in his coffee!
Dr. Maggie Cooper is a pharmacist and research scientist.
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A very important article by Dr. Maggie Cooper, urging people to have a healthy scepticism about Big Pharma recommendations such as statins, which I personally wouldn’t touch with a barge pole.
Dr. Maggie is an exception to the female doctors castigated in Dr. Vernon Coleman’s latest article:
How Women Doctors Destroyed Healthcare in Britain – The Expose (expose-news.com)
I have found pointing out to the Medic the poor statistical analysis around Statins does lessen their enthusiasm for prescribing them.
I wish I could say the same. From my experience the buggers won’t give up.
The whole industry formed by co-operation between celebrity doctors and the pharmaceutical companies really needs to be examined. The suspicion is that some doctors are paid, directly or indirectly, to write books and articles, or appear on television and radio. This is not in itself a problem (although it used to run against professional standards up till the 1970s), but if the publication supports some specific medical product or service then a conflict of interest arises. Even worse, for the author, is that under some situations they could experience either guilt or severe cognitive dissonance, especially if, when new evidence comes to light, they re-assess their earlier decisions as leading to excess deaths and then have to choose to face either their conscience or their mortgage lender. “It is difficult to get a man to understand something, when his salary depends on his not understanding it”.
I’m getting to that age where I get prompted to be screened for stuff, optician thinks I should see my GP about cholesterol. I can sort of see why people want to trust the medical industry – because it’s hard work if you don’t, to find out for yourself the pros and cons of things. But I feel now that I cannot trust what I am told by default, especially when it will likely involved people suggesting treatments and interventions that someone is getting ££££s for – which is most of the time.
Hasn’t the link between cholesterol and risk of atherosclerosis in the general population been debunked?
There is a difference between statins for some individuals at high risk and prophylactic prescribing across the population ‘just in case’.
“… thereby reduce a huge financial burden on the NHS… “ this garbage again.
First, if you socialise medical care everything is a ‘burden’ on the system. Therefore denationalise medical care and leave it to the private market where the cost burden is then on individuals not society.
Second, prescribing statins and the complications they cause in some is a cost ‘burden’, but stroke and heart attack victims often die, therefore they are not a future ‘burden’ on the NHS.
There has been a determined trend to medicalise us as a society, so everything is a clinical problem to be treated creating a huge industry and the notion that death can be eliminated.
And I read that the way Statins work is actually to poison the body to reduce the cholesterol levels. Doesn’t sound too great! Additionally our immune system needs the cholesterol to do it stuff.
Exercise might not be the magic pill but sounds like it is more likely to help you.
Or that some people can be eliminated after retirement age, to save the state on pensions. A bit like Pathways democide as justification for Covid deaths.
Just abolish the NHS, then the burden on the NHS disappears, the tax burden disappears, adults take responsibility for their own and family health with a huge incentive for healthy lifestyles.
I heartily recommend two books by Dr Malcolm Kendrick. ‘A Statin Nation’ and ‘The Great Cholesterol Con’. Both debunking the received wisdom that cholesterol (LDL) is bad and since statins cut both LDL and HDL cholesterol, therefore that’s got to be good. Dr Kendrick sides with Dr Malhotra in well researched and very accessible terms. (as a 75 yr old prescribed statins and not takin’ ’em but electing to be choosy with my diet. Nothing processed, low carb, plenty of lean meat with salads and plenty of gin. The latter whilst high calorifically, has zero carbs). Chin chin!
I like that diet!
i read that book too, mentions relative risk and actual risk. the actual risk is what counts they lie about statins usefulness from what remember and ive read high Cholesterol is good especially for the brain .
for years i believed it all eggs yolks are bad butter is bad red meat is bad now am total carnivore. again – without the guilt and worry !
Yes Sam, actual versus relative risk is tool to fool the unwary, as evidenced by the CV-19 jab scam.
Exactly, I would say the vast majority (being generous), if not probably all government/ NHS figures are of the relative as this is the easiest way of promoting a low significance in a result, to promote your view or agenda. This, and the means and natures of the measurements taken to obtain those results, would in themselves be questionable and in favour of the preferred result.
It does help having muscle mass so you can take in more calories if needed. The more muscle you have, the more calories you need to maintain that mass. BMI is not recommended for those with muscle mass as the muscle/fat ratio can have your BMI as overweight but not overweight because of excess fat.
I have high cholesterol , but a ratio of 3 for LDL to Hdl , which I am led to believe is beneficial . I have always taken regular exercise and never eat takeaways and generally have a low incidence of infections in my life …never had Covid ! It is my belief that cholesterol has protective powers over infections , and should not be castigated by the NHS as always a threat to life .
For those of you not familiar with Charlie Spedding. He’s a previous winner of the London Marathon & won a bronze in the 1984 Olympics marathon. He’s famously down to earth, keen on a pint. An all round top bloke.
Could Maggie explain why the British Heart Foundation is wrong:
https://www.bhf.org.uk/for-professionals/healthcare-professionals/blog/statins-10-facts-you-might-not-know
I’ve been taking them for 18 years without symptoms (minimal dose). They are not a big earner for Pharma via the NHS – just over a quid per prescription!
I don’t have time to give a detailed response although you can see others’ comments for an idea of some of the issues. My key point is that I am not convinced that the benefits outweigh the risks in the low risk group (particularly those in the 10-20% risk group) but, more importantly, changes in lifestyle and diet should be considered first before prescribing medication (especially when we don’t really fully understand the risks). Exercise and diet are associated with much lower risk and have proven benefit.
I’m also not convinced that cholesterol is really the problem, I think other factors are coming into play and it is likely that statins are having some effect on those processes in the body (more research needed). Cholesterol is needed to produce steroid hormones in the body which control metabolism, inflammation, immune functions, salt and water balance plus sexual characteristics and functions. We don’t fully understand what reducing levels of cholesterol in the body is doing in these processes so messing about with it may not be ideal, especially when the risks are low.
Regarding the profits, because many of the drugs are now off-patent, the cost to the NHS is much reduced. The BHF say the cost is £96 million, I think that is an underestimate (8 million on statins, £1 per month, £96 million – also consider cost per prescription, typically 3 months supply, adds on another ~£20 million to NHS). Mark Porter estimated 10 million currently on statins (£120 million). However, with the threshold for prescribing at 10%, approximately 25 million people would be eligible for statins so the drug costs could rise substantially, which is still a nice profit if you are manufacturing them.
Ah, thanks, Maggie, very kind of you to reply.
My 7.4 cholesterol came as a shock since we have always been healthy with diet and lifestyle so there were no large margins for improvement there. As treatments don’t eliminate all cholesterol, only what is judged excessive, it is still available for necessary biochemical processes. I appreciate your concerns, but forgive me for asking if your doubts are intuitive beliefs or are they evidenced anywhere? Perhaps you might have time to write about the BHF and the majority medical assertions in a DS article sometime.
Thank you again.
The risk benefit ratios for those with low risk are a real concern for me and are evidenced in the literature (and anecdotally of course) and in publications that don’t appear in the scientific literature but still have some value.
My doubts about cholesterol being the real offender have some basis, but I feel that we need more research because I don’t think anybody really knows. We know that lots of things come into play with formation of atherosclerotic plaques, it isn’t simply cholesterol, and the role of cholesterol may be quite minor compared with other factors. For example, atherosclerotic plaques are made up largely of collagen I and III, not cholesterol, if we interfere with the formation of the collagen then we can prevent formation of plaques. Cholesterol has a role in lipid accumulation and inflammation, but it isn’t what is actually in the plaques.
There are other factors which we should also consider like matrix metalloproteinases, elastin, insulin resistance etc. It is possible that these are much more important than the actual cholesterol levels and, if we could work out which patients are more susceptible (maybe increased levels of things other than cholesterol in the blood) then we wouldn’t need to give people who aren’t actually at risk of heart disease, medicines which might cause them harm. But at the moment, we don’t know who those people are but we know that people who have high cholesterol are more likely to have heart disease so statins are prescribed – but is the increased risk of heart disease because of the cholesterol or other factors which are also raised in combination with the cholesterol or even cause the cholesterol to be raised? That we don’t really know. We also don’t know if the statins are also playing a role in reducing these other factors (although several reports in the literature suggest they do) as well as reducing the cholesterol level and perhaps it is these benefits which are reducing mortality for heart disease rather than the reduced cholesterol.
So, more research, even funded by BHF, is welcome in this area!
Thank you – appreciate your candour.
Could the BHF explain this….?
https://youtu.be/wICtdUuEYZY?si=ARHrHkBIp7MuM5vp
The BHF is a bought and paid for fake charidee which was 100% in favour of masks throughout the Scamdemic. I wrote to challenge this and received a complete boiler plate response.
Avoid the BHF.
Wasn’t this the case with many ‘reputable’ scientific and medical journals that twisted long established virological facts completely out of shape? I wonder how many of these ‘reputable’ journals now support the absurd notion that a woman can have a pe*is and therefore we need to butcher our kids to achieve it?
Exactly.
Hi,
Out of interest, if it is a bought and paid for fake charity, why does that not show up in it’s audited accounts?
Not showing in the accounts because alot of the payments are disguised or backdoor.
But I doubt PricewaterhouseCoopers would jeopardise their reputation and penalties for turning a blind eye to malfeasance!
On Monday I saw a ticker specialist – well in his opinion – at appointment five, the previous four having been cancelled and only face- to- face at my insistence. The last appointment had been eighteen months ago, by ‘phone obviously
I dropped statins because I was encountering a bad reaction. I have had chest trouble for a lot of years and blindly took the prescribed medications including statins. It was round about 2019 that I noticed mood changes following moderate cardio work outs at the gym. Specifically I would develop horrible aggressive feelings that would remain for hours following a workout. I was frightened not just for myself but those around me. It was nothing to do with blood sugar levels. I did some research and lo and behold I was not on my own, other statin / gym users were reporting similar issues. Recommendations to drop the statins for a few weeks seemed logical and they were because four weeks later the internal anger post workout had gone.
I reported this to the ticker man 18 months ago and suggested my reaction was worthy of a yellow card report. Of course he ignored me. He volunteered a statin replacement. Never took it.
At Monday’s meet I repeated the above and said I was not concerned about my cholesterol levels and that I had made further dietary changes including dropping seed oils and switching wholly to animal fats. I also made it clear that my own researches specifically via Dr Malcolm Kendrick suggested to me that cholesterol was not the be all and end all of heart disease. The sneer on ticker man’s face did not go unnoticed.
Ticker man offered me an “expensive” replacement to oral statins – twice yearly injections. I let him know that injections were an absolute no no and when he asked why I bluntly told him – “the covid scam.” At which point he terminated the interview.
Item 6 in the BMJ article mentions these injections but fails to mention they are still in the trial stages. Not much possibility of informed consent likely from ticker man then.
The BHF is a fake charidee and is not interested in guiding those of us with chest problems only in directing us to pharmacological “solutions.”
Avoid the BHF.
good for you for speaking up! what rat that sneering dr, hope more of his patients speak up and stop the statins too and especially speak up about the scamdemic like you did.
Thanks for giving more detail. Reading Maggie’s second reply shows the medical complications involved and individual differences in reactions. So, I have found no problem with statins and my regular gym workouts. I don’t normally get involved in discussion but I met an old friend suffering weakness due to blocked arteries and said I took statins and would they help? But he won’t take them so this article intrigued me. Like you, I am very suspicious of the Covid treatments overreach and do not approve of mandates.
As a side effects sufferer from statins and other cholesterol lowering drugs I have taken a keen interest in them for years. The bottom line is that their effect on reducing cardiac events is grossly overstated. Claims are made for a 50% reduction in risk. But from what? If the absolute risk is 4% then the absolute risk reduction is only 2% which is statistically not significant.
But the whole statin argument presupposes that cholesterol reduction matters. It doesn’t. It’s what we call an epiphenomenon. They almost certainly produce their minimal effect because they are weakly anti-inflammatory. This hypothesis is backed up by two observations. First, that there are different cholesterol lowering drugs that are far superior in lowering it than statins, but have almost zero impact on cardiac events. Second, that there is increasing evidence that coronary artery inflammation results in damage to the intima (lining) with the deposition of cholesterol as part of an incomplete healing process. The process is independent of the blood cholesterol level. That evidence is strongly supported by the rise in sudden deaths occasioned by COVID vaccines, as the spike protein induces – myocarditis and intimal inflammation. So, given that cholesterol in the blood anyway comes from the liver metabolism of carbohydrates, and not ingestion of fat, there are good reasons why lowering it by drugs is barking up the wrong tree.
Thanks. Excellent post
I was recommended statins by my doctor last year because my risk factor was now 11%. Interestingly, he said that we wouldn’t have been having this conversation 5 years ago because the risk threshold was higher and had been reduced. He also said that it was due to be further reduced sometime in the future. I don’t take them.
“I don’t take them.”
Good man.
Friend of our in s a terrible state for years. Thought she was dying. Had DNR put on her notes.
Came off Statins. Right as rain in a month.
They are filth, and hugely over-prescribed
Statins are filth. Another money-making pharma scam.
The reason Doctors push Statins is they make money for the practice. They are paid for every prescription that they dole out. They are paid a certain amount for each one. Cheap drugs like Statins, and blood pressure pills, make them money.