#1393

So anything goes then and we can believe anything we want.
Not adjusting decisions based on quality of evidence is a grave mistake, not something a commander would do in a war and neither should we do with our health.

3 Likes
#1394

I can achieve the same results with Metamucil and citrus bergamot. Not a whiff of evidence that it’s going to impair my mental status, now or in the future.

I’m not so much of a scientific purist that I’m going to insist on a great study when I can just switch.

Sometimes it’s just common sense.

1 Like
#1395

Of course, except that most people won’t achieve the same results with two supplements. If you can keep apoB low and one intervention has less possible risk than the other, sure. However, statins have benefits in stabilizing plaques etc, so lifestyle and supplements cannot completely replace it.

It found that a daily dose of about 10 grams of psyllium husk lowered harmful LDL cholesterol 13 mg/dL when taken for at least three weeks.

That won’t cut it. I tried the same with oat beta glucans, but it has such a small effect it isn’t worth it. And berberine which I took is a dirty drug with unknown side effects.

Citrus bergamot seems like it requires a lot of research, and I would want to know how it lowers ldl cholesterol if it does.

That might be because very few use it, there is a very little data and trials. Absence of evidence is not evidence of absence. I believe you when it comes to psylium husk though.

1 Like
#1396

Actually lots of studies on citrus bergamot and very impressive.

No myopathy, joint pains, liver damage or cognitive impairment.

Everyone has their own risk tolerance.

#1397

It depends on the magnitude of the side effects.

In treating high blood pressure, hctz gave low potassium in some patients, so I just monitor the levels and supplement when necessary.
On the other hand, lisinopril was associated with lung cancer. Studies weren’t perfect but from then on I switched to the ARB’s.

I’m not risking dementia or cancer waiting for the perfect study. First do no harm.

Medicine is an art as well as a science.

1 Like
#1398

Risking dementia or cancer from all statins is ludicrous. But we differ in what evidence we deem is of acceptable quality. Anti-statins in this way is just populism and ideology, and not rooted in evidence. Accepting low quality studies means you aren’t basing decisions on evidence. The real world effect will be as expected.

1 Like
#1399

I think this study was funded by the pharmaceutical industry. For a different perspective read - Eat Rich, Live Long. Blockages are most likely the result of stressors (diet, stress, enviromental) that cause damage to the arteries. The body is programmed to fix those and it does so with a combination of Calcium, LDL and others. The biggest cause of damage is Insulin Resistance. If you are concerned about your heart health you need to get a heart CAC test. I do not have the study but I did read some research that Rapamycin shows promise in easing blockage and artery stiffness. Vitamin K2 is the thing that will keep calcium out of the arteries. Google or Youtube - Vitamin K2 and heart etc.

1 Like
#1400

My own symptom was two things that I knew I knew, but I had problems retrieving the memory. I have just tried to retrieve them again (having stopped RYR a while ago) and had no problem. Its not a spectactularly reliable anecdote, but its good enough for me.

1 Like
#1401

I believe that Metamucil has too much lead. You may want to switch to one of the three brands of psyllium husk with low lead levels.

1 Like
#1402

Salt substitutes shown to reduce CVD risks.

3 Likes
#1403

The potential for negative cognitive effect appears to be tied to HMGCRi in the brain, perhaps confounded by positive cerebrovascular effects - so we seem to observe a net near zero (but probably present) negative cognitive effect.

I’m not sure hydrophilic statins like rosuvastatin would be an issue since it basically doesn’t cross the BBB. Very much hepatoselective.

Ultimately, one can capture a bulk of the effect of rosuvastatin with low-dose intermittent once weekly - active for ~4 days with ED50 at ~2 mg. But ultimately I’d like to see someone at least close to borderline indicated before Rx statins personally.

#1404

Always about the benefit/risk assessment of course.

For secondary prevention, or in those at high CV risk, I do see the advantage of crestor . I like the low dose option as well.

For primary prevention, the absolute risk reduction of total mortality is so low with statins that the benefit/risk no longer works. I’ve seen both mild and severe cognitive issues . This study is also concerning:

Mendelian Randomization Study of PCSK9 and HMG-CoA Reductase Inhibition and Cognitive Function | Journal of the American College of Cardiology (jacc.org)

For the low risk rapa user, I think fiber and citrus bergamot are good choices if concerned over lipids.

2 Likes
#1405

Dr. Brad Stanfield is actually quite based.

1 Like
#1406

You think he’s based or biased?

1 Like
#1407

Yes, based.

20 characters

#1408

I take K2. But there is no evidence that it is a substitute for statins.
The Framingham study was also funded by the pharmaceutical industry as most drug studies are. However, the results of the Framingham study,
" The FHS cohorts now comprise three generations of participants (n ≈ 15,000) and two minority cohorts. The FHS cohorts are densely phenotyped, with recurring follow-up examinations and surveillance for cardiovascular and non-cardiovascular end points"
has been used by thousands of researchers. Many other studies have backed up the Framingham study

I don’t have any interest in whether you personally take a statin or not.
Survival was significantly increased among subjects treated with statins versus no statins at ages 78 to 85
The protective effect of statins observed among the very old appears to be independent of TC.
So, I am not arguing for or against the effect of statins in lowering cholesterol.

A small insight into the European view of statins:
"The most important reasons for statin discontinuation (and non-adherence) are statin-associated adverse effects (statin intolerance, SI) as well as anti-statin movements, fake news relating to statin therapy, and a lack of patient education resulting in a fear of adverse effects.

2 Likes
#1409

I have a friend (>60yo male) who was diagnosed 1.5 years ago with advanced Coronary Artery Disease (CAD). He had multiple stents put in, which really helped his symptoms. (Blood to the heart–not just a good idea, but a great idea. :smiley: ). He takes all the Rx his cardiologist team recommends. (A team with an excellent reputation.) He made all the lifestyle changes they wanted (no more nicotine, etc.) He has excellent ND support on supplements, and has made major diet changes, exercises regularly, etc.

I’d like to hear from others in similar situations, or anyone with deeper knowledge about CAD, as to whether they’d recommend rapamycin to him, and if so, under what conditions. Thanks! (If this should be a new topic, @RapAdmin feel free to move; I wasn’t sure.)

My focus here is rapamycin, not so much how he should deal with his CAD. Rapamycin. Please comment on that, if you have insights. Thank you.

#1411

Or maybe one should actually read before making biased, factually incorrect overarching claims with words such as “never” - clinical outcomes you describe are tied to payment.

See 30-day hospital readmission rate (risk-adjusted) and mortality rates are a factor for payment. You leaving AMA is actually just inadvertently helping the hospital get more payments.

They are not liable for natural deaths in the hospital - that’s a given of the court system - the hospital did not cause harm and making such a guarantee can lead to abuse similar to life insurance fraud. Hospitals aren’t insurance companies. But liability exists for malpractice - that would be due to harm caused and the tort system deals with that.

What one should be more concerned about is the private equity takeover of medicine. Good luck navigating that without deep knowledge of the system.

https://data.cms.gov/provider-data/topics/hospitals/linking-quality-to-payment#hospital-readmissions-reduction-program

I have doubts that you’d consider the opposing arguments but I’ll put it here for others. Feel free to block me. Steve Jobs relied on an “alternative” naturopathic diet and herbs instead of the “mainstream” early surgery.

Here’s a citation from 60 Minutes:

“Everyone else wanted Steve Jobs to move quickly against his tumor. His friends wanted him to get an operation. His wife wanted him to get an operation. But the Apple CEO, so used to swimming against the tide of popular opinion, insisted on trying alternative therapies for nine crucial months. Before he died, Jobs resolved to let the world know he deeply regretted the critical decision, biographer Walter Isaacson has told 60 Minutes”

Moral of the story: contrarianism is usually wrong, and most of the time those going against the tide are a form of fashionable nonconformist conformism without an informational advantage. Generally, that’s part of the appeal of “alternative medicine” - a popular belief that one has obtained unique knowledge when it is often illusory superiority, as opposed to pursuing experimental interventions where plenty of open-minded research scientists cross-country are ready to try anything that appears to have a decent probability of success, albeit a tiny base success rate.

Being contrarian for contrarian’s sake is not true contrarianism and a rigorous contrarian should consider the base rate of being factually incorrect, especially when it’s a field where the stakes are high, such as medicine. Recognizing where exactly one has deep information asymmetry and knowledge gaps is the first step to wisdom. The greatest enemy is illusory knowledge.

8 Likes
#1412

This has happened a lot in this thread:

49333300a506374332092fde1588ee6da1778bfb_2_593x499

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#1413

Thanks. What about supplemental rapamycin for my friend? (No, his stents didn’t have rapa on them; I checked.)