|
|
| Author |
Message |
Chris Malcolm
medicine forum beginner
Joined: 10 Jun 2005
Posts: 37
|
 Posted: Mon Oct 17, 2005 9:37 am Post subject:
Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
|
|
|
Susan <nevermind@nomail.com> wrote:
| Quote: | David Rind wrote:
I think it's very hard in any individual to know whether a side effect
that comes on slowly and resolves slowly is due to a particular
medication, so I would keep an open mind about whether in this
particular case the statin was responsible for the change in mental
ability. People are wonderful at seeing cause and effect where there
isn't any, which is why blinded trials are so helpful.
I certainly understand that this can be true, BUT... I'm one of those
folks who gets adverse reactions that later, upon use in the larger
marketplace, turn out to happen to, say, .5% of all drug takers. The
bad stuff that happens to me gets blown off by most docs (except those
who know me for a while)as non-existent. I have to decide for myself,
despite what studies say, what's causing what. I'm the one to live with
the consequences.
|
The other problem is the individual one. If a drug is known to cause a
certain side effect in, say, 1% of the population, and you take the
drug, and suffer from the side effect, then stop the drug, and the
side effect ceases, this only suggests that the drug might have caused
the problem. The individual patient, and his doctor, can never know
for certain.
Some people here go on about the certainty of scientific results
compared with the fallibility of an individual jumping to the
conclusion that the drug made them ill. That's true in the trivial
sense that one swallow doesn't make a summer, but ignores the
important point that no amount of large scale statistical trials which
produce probabilities and risk factors can ever do more than make
informed guesses as to the probabilities in an individual case. Where
risk factors are concerned there are no certainties, just
well-informed guesses which could be wrong. The only certainties large
scale statisitcal trials can produce are certainties about the degree
of uncertainty in the probabilities :-)
| Quote: | But not being able to be sure that the statin was the cause doesn't make
it unreasonable for someone who seems to have had such a side effect to
decide that statins aren't worth the risk. Someone else might choose to
see whether a hydrophilic statin was better tolerated, and this would be
reasonable as well.
Something Chris didn't mention here, in terms of assessing and
moderating risk (Chris will correct me if I'm wrong) is that he was an
undiagnosed diabetic, probably for a good long time.
|
Being diabetic is a question of passing a certain threshold in
diagnostic parameters, a threshold which doctors adjust every few
years. Whether I might have been an undiagnosed diabetic five years
ago depends on whether we use the diagnostic criteria of five years
ago, of today, or of next year. What there is no doubt about is that
for years before diagnosis I was suffering some of the typical
symptoms of high blood sugar and high insulin levels, and that at the
time of diagnosis I had already suffered some of the typical damage
caused by such levels, such as mild neuropathy in the
extremeties. However, it is known that people who have higher than
normal blood sugar and insulin levels can already be suffering
permament damage due to those levels even when those levels are below
the current diagnostic levels for diabetes.
In other words, I could easily have have suffered the damage I did as
a result of years of being not yet quite diabetic.
I find it very difficult to have any respect for the intellects of
those who argue in support of the current fatuous mess with respect to
the diagnostic criteria for diabetes, the attempted sticking plaster
of pre-diabetes or the "metabolic syndrome", etc..
| Quote: | Since learning of
his diabetes, he's taken steps to maintain much better glycemic control,
and to increase his already impressive activity level. His risks have
doubtless dropped a great deal at the same time he's stopped the statin,
making the choice to do without them much less of an issue. His insulin
resistance, for one, should be greatly reduced.
|
My doctor wanted to prescribe me a statin as well as blood sugar
testing strips, but agreed to humour me and let me try and see if
intending to take more exercise and controlling my diet would lower
the measurements which increase my risk factors. His worry was the
unimpressive record of people in general in changing good intentions
about diet and exercise into effective permanent practice.
Since I've already had at least one heart attack I'm definitely at
risk. At least one? Twelve years ago a cardiologist told me that
something very frighteningly like a heart attack definitely hadn't
been. His opinion seemed to be strongly influenced by the speed of my
recovery, e.g. two hours after nearly passing out I slowly and
carefully walked up two flights of stairs to see my doctor. Three
years ago another cardiologist told me that not only had I just had a
mild heart attack, but that the previous cardiologist (whose notes he
was reading) had been over-optimistic in suggesting that twelve years
ago I hadn't had one then.
I haven't been able to keep up impressive activity levels. I was
initially over-enthusiastic in exercising and strained a variety of
tendons and joints by developing and using too much muscle strength
too fast. It'll probably take a few more months before they recover to
the point where I can do more than low-level maintenance exercising. I
think my current exercise levels might be impressive in a car driver,
but are probably average for a non-car-owner who gets about using the
old-fahioned legs method and avoids the use of power tools in DIY
house and garden maintenance.
--
Chris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/] |
|
| Back to top |
|
 |
Chris Malcolm
medicine forum beginner
Joined: 10 Jun 2005
Posts: 37
|
| Posted: Mon Oct 17, 2005 9:46 am Post subject:
Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
|
|
|
Don Kirkman <donkirk@covad.net> wrote:
| Quote: | It seems to me I heard somewhere that Chris Malcolm wrote in article
3regf9Fi89ucU1@individual.net>:
Robert <RobertsSong@hotmail.com> wrote:
I understand your point and many of us actually pretty much react the same
way. If we start a new drug and something happens then we blame it on the
drug whether it's the drug or not.
That's not what I did. The coincidence of the cognitive problems
starting after I started taking a drug raised the possibility that the
drug might be to blame.
The only way to find out is through studies and some science.
As it happens I am a scientist, though not a medical one. However,
you're not right that the only way to find out things like that is
through studies or science. Science is a formalisation of methods of
investigation that human beings were using successfully long before we
invented science. If science were the only way to find out things law
courts would never be able to come to a decision.
The standard of proof in a court of law is hardly adequate for diagnosis
and treatment of medical conditions. Legal decisions are typically
based on probability filtered through human mediaries (judge, attorneys,
jury, witnesses) rather than on scientific evidence(including scientific
probability) and are intended tot identify liability or culpability, not
to make a decision at the rigorous level science calls for.
|
It's such a pity that the rigorous level science calls for is so
rarely achieved :-)
--
Chris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/] |
|
| Back to top |
|
|
David Rind
medicine forum Guru Wannabe
Joined: 02 May 2005
Posts: 205
|
| Posted: Mon Oct 17, 2005 11:11 am Post subject:
Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
|
|
|
Chris Malcolm wrote:
| Quote: | Some people here go on about the certainty of scientific results
compared with the fallibility of an individual jumping to the
conclusion that the drug made them ill. That's true in the trivial
sense that one swallow doesn't make a summer, but ignores the
important point that no amount of large scale statistical trials which
produce probabilities and risk factors can ever do more than make
informed guesses as to the probabilities in an individual case. Where
risk factors are concerned there are no certainties, just
well-informed guesses which could be wrong. The only certainties large
scale statisitcal trials can produce are certainties about the degree
of uncertainty in the probabilities 
|
I think you're attacking a straw man there. I would definitely agree
that clinical trials, large or small, never lead to certainties. Proof
is a human concept not defined by p-values, confidence intervals, and
hypothesis tests.
However, recognizing the problems with even well-designed blinded trials
doesn't make the problems with unblinded reports any smaller. My guess
is that you are correct that your neurologic symptoms were due to
simvastatin, but I'd be a lot more sure of that if we were able to see
them come and go while you were taking pills that were either
simvastatin or placebo and then show that the symptoms only occurred
while the pill was simvastatin.
This just has to do with seeing how often people are fooled by their own
suggestibility and desire to see causation. This occurs with patients,
doctors, scientists, and everyone else and it makes the issue much
murkier than it would otherwise be.
But most of medicine involves making decisions on limited information,
and I in no way think that it's not completely reasonable to stop a drug
that seems likely to have caused a serious side effect even while other
explanations are possible.
--
David Rind
drind@caregroup.harvard.edu |
|
| Back to top |
|
|
eml
medicine forum Guru Wannabe
Joined: 12 Jun 2005
Posts: 135
|
| Posted: Mon Oct 17, 2005 3:40 pm Post subject:
Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
|
|
|
Robert wrote:
| Quote: |
Subclinical cases or borderline cases are compensated and need supportive
anti-oxidants including CoQ. Although not proven yet the implication being
one can slow down the progression at a more opportune time. You want to
preserve the few remaining cells rather than waiting until it's too late.
|
robert--once the disease has been unmasked IT IS TOO LATE. You cannot
treat it with antioxidants, etc. there are only symptomatic treatments
available for these neurodegenerative diseases. and i do not
understand your reference to my attempting to manipulate or deceive the
poster--i am not interested in manipulating anyone. but what a novel
thought --triggering diseases one may never experience in one's life
time with a drug as a positive aspect of the drug???? |
|
| Back to top |
|
|
Jason
medicine forum Guru
Joined: 29 Apr 2005
Posts: 1120
|
| Posted: Mon Oct 17, 2005 5:03 pm Post subject:
Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
|
|
|
In article <1129523021.053289.120370@g49g2000cwa.googlegroups.com>, "Tony
Wesley" <tonywesley@gmail.com> wrote:
| Quote: | Jason wrote:
[approximately 240 of text from previous posts snipped]
Hello,
If anyone in this newsgroup would like to learn more info. related to this
subject, please purchase the following book:
WHAT YOU MUST KNOW ABOUT STATIN DRUGS AND THEIR NATURAL ALTERNATIVES
by Jay S. Cohen, M.D.
I going to suggest you read something else.
"A Quick Guide to Newsgroup Etiquette"
http://www.wjh.harvard.edu/wjh/newsgrp.shtml
The relevant part I'd like you to read says:
"When you are following up someone's article, please summarize the
parts of the article to which you are responding."
Or you could read "Netiquette Guidelines"
http://www.cybernothing.org/cno/docs/rfc1855.html
The relevant part in "3.1.3 NetNews Guidelines" states:
"Content of a follow-up post should exceed quoted content."
Or looking at it another way, over 50% of your post should be new
material and less than 50% should be included material.
Jason, if you take the few seconds needed to cut the original text,
your message will stand out better and probably get read by more
people.
|
Thanks for the advice. I'll try to remember to do it when the
posts are longer than normal. I have noticed that some people
delete everything related to the former post. That's just does
not make sense since many people delete all former posts before
shutting down their computers.
--
NEWSGROUP SUBSCRIBERS MOTTO
We respect those subscribers that ask for advice or provide advice.
We do NOT respect the subscribers that enjoy criticizing people. |
|
| Back to top |
|
|
Robert
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1700
|
| Posted: Mon Oct 17, 2005 7:02 pm Post subject:
Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
|
|
|
"eml" <mmlevy46@hotmail.com> wrote in message
news:1129563643.558615.306050@g14g2000cwa.googlegroups.com...
| Quote: |
Robert wrote:
Subclinical cases or borderline cases are compensated and need
supportive
anti-oxidants including CoQ. Although not proven yet the implication
being
one can slow down the progression at a more opportune time. You want to
preserve the few remaining cells rather than waiting until it's too
late.
robert--once the disease has been unmasked IT IS TOO LATE.
No no no no!!!!!!!! You are referring to indolent conditions that decline |
with time. CoQ is being used right now for symptomatic cases and why not use
them before in subclinical states where they can be more effective. The
damage is linear from a normal number of cells, to low normal number with
normal function, to a low number of cells without symptoms, to a masked
state without symptoms compensated ,to an overt stage of uncompensated
sympotmatic expression.
We are saying you should have anti-oxidant treatment from the low number
with normal function on down.
One can take animal models in which a normal animal can be given a toxic
drug that selectively destroys that part of the brain.
The obvious usefulness is to come up with a neuroprotective substance
guarding against such damage.
The key is in finding subclinical situations such as in glucose tolerance
testing where you give a provacative substance to check for the bodies
reserves. It is possible to pick up pre-diabetes before the diabetes sets
in.
You cannot
| Quote: | treat it with antioxidants, etc. there are only symptomatic treatments
|
I am really not in a position to look into all the research.
Lancet Neurol. 2005 Jun;4(6):362-5. Related Articles, Books, LinkOut
Intake of vitamin E, vitamin C, and carotenoids and the risk of Parkinson's
disease: a meta-analysis.
Etminan M, Gill SS, Samii A.
Division of Clinical Epidemiology, Royal Victoria Hospital and McGill
University, Montreal, Quebec, Canada. metminan@shaw.ca <metminan@shaw.ca>
We studied the effect of vitamin C, vitamin E, and beta carotene intake on
the risk of Parkinson's disease (PD). We did a systematic review and
meta-analysis of observational studies published between 1966 and March 2005
searching MEDLINE, EMBASE, and the Cochrane Library. Eight studies were
identified (six case-control, one cohort, and one cross-sectional). We found
that dietary intake of vitamin E protects against PD. This protective
influence was seen with both moderate intake (relative risk 0.81, 95% CI
0.67-0.9 and high intake (0.78, 0.57-1.06) of vitamin E, although the
possible benefit associated with high intake of vitamin E was not
significant. The studies did not suggest any protective effects associated
with vitamin C or beta carotene. We conclude that dietary vitamin E may have
a neuroprotective effect attenuating the risk of PD. These results require
confirmation in randomised controlled trials.
Publication Types:
Meta-Analysis
PMID: 15907740 [PubMed - indexed for MEDLINE]
| Quote: | available for these neurodegenerative diseases. and i do not
understand your reference to my attempting to manipulate or deceive the
poster--i am not interested in manipulating anyone.
I really don't know what you mean by manipulation. |
but what a novel
| Quote: | thought --triggering diseases one may never experience in one's life
time with a drug as a positive aspect of the drug????
|
Those are not my words and again I would worry about what L has stated.
There has been breakthroughs in neurological studies involving drug induced
conditions in studying pathophysiology.
You yourself has stated that such "statin induced" PD should be studied. It
has to be proven first that they do then it is another step forward.
I understand your concern to study only symptomatic relief. You want to
develop a better L-dopa in treating, great.
You want to have better treatments end stage renal failure for diabetes. You
want better treatments in late stage ALZ.
Ann Clin Lab Sci. 2001 Jan;31(1):25-67. Related Articles, Cited in PMC,
Books, LinkOut
Mitochondrial medicine--molecular pathology of defective oxidative
phosphorylation.
Fosslien E.
Department of Pathology, College of Medicine, University of Illinois at
Chicago, 60612, USA. efosslie@uic.edu
Different tissues display distinct sensitivities to defective mitochondrial
oxidative phosphorylation (OXPHOS). Tissues highly dependent on oxygen such
as the cardiac muscle, skeletal and smooth muscle, the central and
peripheral nervous system, the kidney, and the insulin-producing pancreatic
beta-cell are especially susceptible to defective OXPHOS. There is evidence
that defective OXPHOS plays an important role in atherogenesis, in the
pathogenesis of Alzheimer's disease, Parkinson's disease, diabetes, and
aging. Defective OXPHOS may be caused by abnormal mitochondrial biosynthesis
due to inherited or acquired mutations in the nuclear (n) or mitochondrial
(mt) deoxyribonucleic acid (DNA). For instance, the presence of a mutation
of the mtDNA in the pancreatic beta-cell impairs adenosine triphosphate
(ATP) generation and insulin synthesis. The nuclear genome controls
mitochondrial biosynthesis, but mtDNA has a much higher mutation rate than
nDNA because it lacks histones and is exposed to the radical oxygen species
(ROS) generated by the electron transport chain, and the mtDNA repair system
is limited. Defective OXPHOS may be caused by insufficient fuel supply, by
defective electron transport chain enzymes (Complexes I - IV), lack of the
electron carrier coenzyme Q10, lack of oxygen due to ischemia or anemia, or
excessive membrane leakage, resulting in insufficient mitochondrial inner
membrane potential for ATP synthesis by the F0F1-ATPase. Human tissues can
counteract OXPHOS defects by stimulating mitochondrial biosynthesis;
however, above a certain threshold the lack of ATP causes cell death. Many
agents affect OXPHOS. Several nonsteroidal anti-inflammatory drugs (NSAIDs)
inhibit or uncouple OXPHOS and induce the 'topical' phase of
gastrointestinal ulcer formation. Uncoupled mitochondria reduce cell
viability. The Helicobacter pylori induces uncoupling. The uncoupling that
opens the membrane pores can activate apoptosis. Cholic acid in experimental
atherogenic diets inhibits Complex IV, cocaine inhibits Complex I, the
poliovirus inhibits Complex II, ceramide inhibits Complex III, azide,
cyanide, chloroform, and methamphetamine inhibit Complex IV. Ethanol abuse
and antiviral nucleoside analogue therapy inhibit mtDNA replication. By
contrast, melatonin stimulates Complexes I and IV and Gingko biloba
stimulates Complexes I and III. Oral Q10 supplementation is effective in
treating cardiomyopathies and in restoring plasma levels reduced by the
statin type of cholesterol-lowering drugs.
Publication Types:
Review
PMID: 11314862 [PubMed - indexed for MEDLINE] |
|
| Back to top |
|
|
marueel@yahoo.co.in
medicine forum beginner
Joined: 18 Oct 2005
Posts: 1
|
| Posted: Tue Oct 18, 2005 8:31 am Post subject:
Re: Cholesterol Levels Are Falling, But Red Flags Are Rising
|
|
|
I HAVE REGULAR TAKING SAME MEDICINE IN INDIAN VERSION.NOW I AM
QAUTION,I WILL STOP SAME AS STOCK LAST. THANK |
|
| Back to top |
|
|
Google
|
|
| Back to top |
|
|
|
|
The time now is Thu Jan 08, 2009 1:19 am | All times are GMT
|
|
Loans | Credit Cards | Xecuter 3 Mod Chip | Free Advertising | Personal Loans
|
|
Copyright © 2004-2005 DeniX Solutions SRL
|
|
Other DeniX Solutions sites:
electronics forum,
Science forum
Unix/Linux blog
Unix/Linux documentation
Unix/Linux forums
|
Powered by phpBB © 2001, 2005 phpBB Group
|
|
FAQ
Search
Memberlist
Usergroups
Register
Profile
Log in to check your private messages
Log in
Forum index
»
Medicine forums
»
cardiology
