Sunday, May 24, 2020

Retrospective #463: “You eat healthy, take statins…”

The TV commercial begins, “You eat healthy, take statins…” and then goes on to describe a new class of drug designed, “to lower LDL-C when added to a high-dose statin” (my emphasis). That’s what gets me riled. Folks, if you’re “eating healthy,” unless you have a very rare condition called “familial hypercholesterolemia,” you shouldn’t need to take a statin, much less an added drug in addition to a high-dose statin. Geeez…
Of course, this claim all revolves around what you (or they, the drug maker) call “eating healthy.” The drug maker will claim, rightly, that their “eating healthy” is what you have been told to eat by the USDA/HHS, creators and promotors of the Dietary Guidelines for Americans from 1980 through 2015, including the upcoming 2020 update. A pictogram that describes it in a nutshell is at ChooseMyPlate.gov. It is endorsed by the AMA, the AHA, the ADA, etc., etc.
So, if you “eat healthy” in the way they prescribe, you very well may need to take a statin. And if it doesn’t lower your LDL-C sufficiently to satisfy the Total Cholesterol and LDL-C “Standards of Medical Practice” for a lipid profile, established by the tragically misguided practices of those government/medical entities, you’re going to be cajoled relentlessly to start taking a statin, and if a high-dose statin doesn’t “do the job,” to start taking this new drug.
In 2002, I had been a diagnosed a type 2 diabetic for 16 years and was still eating the Standard American Diet. I was on 3 classes of oral antidiabetic drugs (maxed out on 2), and my blood sugar was still “out of control.” To help me to lose weight, my doctor suggested I start eating Very Low Carb (VLC), i.e. just 20g of carbs a day. The first day I had a hypo, and 2 more that week. My doctor took me off 1 drug and cut the other 2 in half TWICE. In 9 months I lost 60 pounds.
Then in 2003, following the medical Standard of Care, my doctor started me on a high-dose statin and in no time got my LDL-C down to “target” (<70mg/dl). In 2006 I rededicated myself to VLC and lost over 100 pounds in a little over a year. By 2008 I had lost 170 pounds total and lowered my blood pressure to 110/70 on fewer BP meds.
Eating Very Low Carb also transformed my lipid panel. While my Total Cholesterol (TC) and LDL-C remained about the same, I doubled my HDL-C and lowered my triglycerides (TGs) by two-thirds. When my doctor saw these lipid panel outcomes, he used his clinical judgment and took me off statins completely. That was 2008, 12 years ago. I still eat VLC most of the time, and my latest lipids were TC 189; LDL-C* 83; HDL-C 92; non-HDL 97 and TG 56mg/dl.
* Calculated by Quest using Martin/Hopkins; previously Quest calculated LDL-C by the Friedewald method.
A chart below illustrates my TC and LDL-C while off, then on, then off again a statin, from 1980 to the present.









So, I think it’s reasonable to ask, “Is your ‘eating healthy,’ (the way the USDA/HHS and the AMA, AHA and ADA have been telling you to do all your life), the reason your doctor has you on a high-dose statin and is now twisting your arm unremittingly to take yet another drug to lower your LDL-C?” I think so. And my doctor apparently agreed. Do you think that if you changed the way you eat, you wouldn’t “need” to take a statin? Think about that!

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