Statins and diabetes

In the Jan 9, 2012 issue of Archives of Internal Medicine in the Online First section an article appeared showing that women studied as part of the Women’s Health Initiative who were on statin drugs during the study developed diabetes at greater rates than those who were not on these drugs.  According to the statistical analysis of the authors, being on a statin increased the relative risk of developing diabetes by 48 percent!

These were observational studies and, as such, can’t be used to determine causality.  But they are interesting nonetheless because according to one of the authors there have been other clinical trials showing the same thing.  One of the authors of the study, Dr. JoAnn Manson, Professor of Medicine and Harvard Medical School commented on the findings of this study and what they mean to doctors who put patients on statins.  Dr. Manson’s commentary was provided by Medscape, a site for physicians to go to learn about the latest in medical wizardry.  The site requires registration, but if you are interested, you are allowed to register even if you aren’t a physician.

I decided that instead of commenting on Dr. Manson’s video after the fact, I would do it in real time right on the video.  This is my first effort at anything like this, so you can let me know what you think of it.  If you find it enjoyable and/or helpful, please drop a note in the comments, and I may be inspired to try it again.

You’ll notice my repeated assertions that statins don’t provide any benefits.  What I’m talking about is the fact that statins have never been shown to decrease all-cause mortality. (See the first sentence in the Lipitor product insert above.)   In other words, if you take a statin, you gain no increase in life expectancy.  If I, myself, am evaluating a drug that I might have to take, I would certainly want to make sure it didn’t simply replace one risk factor for another.

Note: The comments on this video made by me are my opinions based on my reading of the medical literature.  They are no substitute for consultation with your own physician, and should in no way be construed as medical advice.  The decision to start, continue or discontinue any drug regimen is a serious one and should be a decision made after careful discussion with your own physician.

As I mentioned in the video above, I just read a book by a cardiologist practicing the California who has dived deeply into the scientific evidence and feels the same way about the lipid hypothesis as I do.  And about statin drugs.  And this a real cardiologist.  Ernest N. Curtis, M.D. has written The Cholesterol Delusion, a book that takes a different approach to dismantling the lipid hypothesis than The Great Cholesterol Con, but is just as effective.  If you’re still in the camp that worries about cholesterol, you may take solace from the information in this terrific book.  If you need to persuade a friend or loved one, this is the book.

If you enjoy the way I sometimes dissect studies on this blog, you will love Dr. Curtis’s book because that’s what he does.  He dismembers the studies that the lipophobes rely on to maintain their fantasy that cholesterol really does cause heart disease.

Take for example the Lipid Research Clinics Coronary Primary Prevention Trial (LRCCPPT), the authors of which made the oft repeated claim that each 1 percent reduction in cholesterol gives a 2 percent reduction in cardiac risk.  Dr. Curtis eviscerates this study and describes how the authors dishonestly spun their experiment’s end result, which was essentially meaningless, in such a way that it has become one of the mainstays in the argument for cholesterol lowering.

During the study, 7 percent of the subjects on a cholesterol-lowering drug died while 8.6 percent of those on placebo died.  Dr. Curtis describes how this minuscule difference can be converted into a relative risk difference of 19 percent, which is what the authors were crowing about.  But that number isn’t nearly as important as the absolute risk, which is the difference between the 8.6 and 7, or 1.6 percent.  So those subjects on the drug (which is not without side effects and costs if the subjects had been paying for it themselves) ended up with a 1.6 percent lower absolute risk than those who didn’t take the drug.

But that’s not the end of the story.  Was the 1.6 percent difference even statistically significant?  Here’s where things get interesting.

How significant is the difference between 7.0% and 8.6%? Common sense tells us that this difference is of no practical significance.  But what about the more esoteric criterion of statistical significance?  According to the pretrial protocol, which called for a level of certainty with p<0.01, it didn’t even come close.  If one applies the more lenient criterion of p<0.05, it still fails the test when the typical two-tailed test is employed.

If one applies the p<0.05 criterion and uses the less rigorous one-tailed test, however, this difference barely qualifies as statistically significant.  This is, in fact, what the investigators did.  In one of the most flagrantly dishonest acts ever seen in a major medical study, the authors apparently changed the criteria for significance after reviewing the data.

The is absolutely shameful behavior way beyond the pale.  When researchers design a study, they set on the front end the statistical parameters by which the outcome of their experiment is to be measured.  They do this at the start so there can be no fudging at the end when the results are in.  Everyone agrees to the standards and off they go to do the study, and the outcome either reaches the level of statistical significance by the predetermined measure or not.  In this case, the standards were set, but when they weren’t reached, the standards were reduced once and then again before the results barely were able to claim statistical significance.  Shameful indeed.  And this is one of the major studies, quoted daily, showing that a reduction in cholesterol brings about a reduction in heart disease.  Jesus wept.

Why didn’t other scientists say anything about this.  One did and wrote  a withering critique in the Journal of the American Medical Association, but the journal kept it under wraps for a year before publishing.  By that time, the LRCCPPT had gotten so much coverage and the cholesterol-lowering-prevents-heart-disease mantra had swept the nation, so everyone pretty much ignored the grousing of a scientist who saw the emperor without any clothes. (You can’t tell much from the abstract I linked to, but Dr. Curtis reprints some of the juicier parts.)

This study isn’t the only one with warts all over it nor the only one routinely misinterpreted.   But it’s not surprising given the vast amount of money at stake in the business of reducing cholesterol by drug therapy whether that cholesterol reduction is important or not.

After you read Dr. Curtis’s book you will become as big a skeptic as I am of medical studies and regard them all with a jaundiced eye.












Please note: I reserve the right to delete comments that are offensive or off-topic.

Leave a Reply

Your email address will not be published. Required fields are marked *

287 thoughts on “Statins and diabetes

  1. I like the real-time video commentary. Your volume is quite a bit lower than hers though, which is a minor issue but something you may wish to consider in future posts.

    I look forward to checking out Dr. Curtis’s book. Thanks for the heads-up.

    Is the disconnect between the evidence and the mainstream opinion on statins all about money?

    • I think I got the volume issue fixed. At least I hope so. If you have a chance, listen to just a little and let me know if it’s better. Thanks. And thanks for the feedback.

      • The volume was good when I listened just now. I forwarded this post on to my Dad, and he is finally thinking of quitting the Lipitor that he has been on for a year since his stroke. My Mom, me, their close nurse friend and a bunch of others didn’t outrank his doctor, but your post and video seems to have made that connection for him. Thanks!

    • I can’t wait to show this to my class. They are so cute and so impressionable. They all want to be doctors to help people, and they are always so surprised when money makes the world go round.

  2. I think the video commentary was awesome. And I laughed out loud (again and again) at your reactions to her.

    The format is wonderful — it’s great to see your real-time feedback.

  3. Holy S**t seems like an appropriate response. This study should send alarm bells ringing, but it seems like the findings are falling on deaf ears.

    You mentioned statin use being somewhat beneficial for men under 65 who have had heart attacks, but what about those who are 65 or over? A loved one of mine suffered a heart attack a few years ago. He is now 65 and has been taking lipitor since the event.

    P.S. the video commentary was a nice touch!

    • The gold-standard evidence shows very modest benefit for males under 65 who have had heart attacks. For males over 65, it doesn’t matter whether they’ve had a heart attack or not. I suppose the data don’t really address the issue of a male under 65 and having a heart attack, taking statins and living to over 65. Wish I could give you more info.

  4. This format is great and the volume was fine. I’d love to have you do more like this.
    While I have had no problem saying ‘no’ to my doctor regarding statins, it’s a tough sell to convince others who haven’t read as widely. For some reason the Dr. in front of you has so much more credibility.

  5. Loved the “video dissection”. Great form of feedback, and hey, much less editing.. does that equal more posts in the new year? :)

    Either way, cheers. Keep fighting the good fight, I know we all are.

  6. Thank you! I stopped taking statins about a year ago after reading widely about the dangers and making what I consider to be the best decision for me. My doctor was very unhappy with my decision, but it is not his body.

  7. My two cents: It foxed me at first to see the “play” symbol in the middle of the screen when your video was playing in the corner. I thought, “oh no, his part is playing but hers isn’t” (thinking they should be simultaneous). So I pressed the play button, but that just took me off to youtube. Not a big deal. Most people probably would “get” it straight away.

    As I watched I found myself remembering scenes from TV and movies where someone facing a difficult decision has a “devil” on one shoulder and an “angel” on the other – the two sides of his conscience, each trying to persuade him.

    Which were you?

  8. Wish I could forward this to a female friend who is on statins, but I’m tired of being called a fearmonger.
    Liked the new format! Very helpful.
    NRSVP,( as I do not need my comments responded to.)

  9. Your video critique is a nice complement to your writing style output. I’d keep doing this, especially following your theme of debunking mainstream dogma wherever there are other videos making spurious claims, or subtracting from the sum total of intelligence on the planet.

    A few more of these under your belt and I see a syndicated radio show in your future, if not television. Good voice!

    Cheers and please keep up the great work!

  10. Excellent format…

    Keep up the new addition.
    I also “shared” your link to this to multiple diabetes support forums.

  11. Great format Dr. Eades!

    I have heard that vets are putting dogs on statins now.
    My wife has to keep signing affidavits from her GP that she has been warned that she will probably die because she refuses to take statins.

    Sometimes I think the whole world has gone(been) insane.

  12. I love the format. Like another poster, I laughed repeatedly at your responses.

    And I appreciate the irony that in substantiating your “controversial” position that Lipitor poses no benefits, you cite the Lipitor product insert! If it wasn’t so tragic, it would be funny.

  13. I think this format is great–and SO much easier to post on Facebook to widely share the info and hope at least a few friends might better learn about this dangerous drug. Sadly, many people are scared into taking unnecessary meds by their doctors, or– in the case of my mom-in-law nurse taking statins to reduce inflammation–simply because she really trusts the recommendations of the brilliant doctors with which she works. And what can I do to help her to get off this dangerous med? Nothing. I’m just a lay-person who reads a lot…NOT a ‘white coat’. Not that I think doctors are bad people, of course;)

  14. i’m with the others — i liked it and found it more useful than a commentary AFTER the video, because it allows one to get the message point by point.

    as for the original video … Dr. Deans must be so proud.

  15. Paula Dean comments on CNN right now on having been diagnosed with D2 a while ago. She told it was not her diet to blame because she eats “everything in moderation”. She plans to a release a low-calorie cooking book sponsored by her medications produces. The media sources mentioned that there were a lot of cheese and butter in her unhealthy cooking. I remember Paula telling some time ago that she could eat any food because her cholesterol was terrifically low. My guess is now – is it possible that tendency for genetically low cholesterol could be related to the tendency of a high blood sugar? Nutrients has to go somewhere in an overweight or obese individual.

    • Paula Deen is a Southern cook. Southern food is rife with grain (primarily wheat and corn, except in Louisiana where it’s rice) and refined sugar. And many of the grain foods Southerners eat now are refined industrial foodlike substances, on top of that. They don’t prepare grains in any traditional way, they just use them straight out of the box. So there’s no saving grace attribute to these foods that would reduce their hazards in the body (i.e., soaking whole grains to eliminate phytates). On top of that, they’ve adopted just enough of the government’s dietary recommendations to eat margarine instead of butter and vegetable shortening instead of lard, and cut back somewhat on their intake of animal foods, particularly organ meats.

      “Moderation” is a meaningless word. Deen was a sitting duck from day one and I really think she was diagnosed as late as she was *only* because she’s never quit using butter or full-fat cheeses. Her diabetes diagnosis comes twenty-four years later in her personal timeline than my mother’s diagnosis came in hers; Mom never has been able to afford butter or lots of meat, and has relied heavily on grains because of her poverty. I believe the animal foods, particularly the animal fats, have a protective effect when one also eats industrial junk. Those of us limited in our food choices by poverty or those of us who listen to the government’s recommendations are left with no protection at all, unless we’re lucky enough to encounter the idea that we should ditch industrial foods to begin with.

  16. Hi Dr Eades – I am a nurse practitioner student and I enjoy reading your blog. Just curious… with this recent commentary on statins and the research you have cited, is it your opinion that medical professionals should discontinue statins in favor of a different drug OR that we should not be lowering high LDL, and total cholesterol at all? As a student, we are taught that LDL cholesterol is a major player in inflammation and atherosclerosis… leading up to heart attack, etc etc… Would be great to hear your opinion on this.

    • My opinion is all over this blog. Just enter ‘cholesterol’ or ‘LDL’ or ‘lipids’ into the search function and you can find my thoughts. In a nutshell, I don’t think LDL is a major player. I think it’s more of a marker. Small, dense LDL particles have shown to confer some risk, but these can be easily transformed into the large, fluffy, type A kind simply by switching to a low-carbohydrate diet. If you grab a copy of Dr. Curtis’s book that I recommended in this post, you’ll find a dissection of the studies purporting to show a relationship between cholesterol and heart disease.

  17. I loved the video comments. I laughed out loud a number of times at your reaction! Would love to see more of this format.

  18. Could there have been a selection bias in the study? Women who had metabolic syndrome, were pre-diabetic, probably had worse lipid profiles and were put on statins. The statins didn’t “cause” diabetes, it was already on the way.
    I like the video commentary. We teach a college level health class from time to time and videos interest that demographic better than the printed word.

    • Metabolic syndrome is not a death sentence. You’re still at a point where you could reverse your symptoms and normalize. Type 2 diabetes is different–yes, you can eat to compensate for the diabetes, but you will always have to do so, since the damage has been done. Steve Cooksey (look him up on Google) has demonstrated this with his own disease. If he eats to compensate, his sugars are normal. If he tries to eat higher-carb than what maintains his sugars at normal, he starts seeing abnormal sugars.

  19. I am reeling from the effects of just watching this woman try to minimize a FORTY-EIGHT % increase in relative risk of developing diabetes. That is HUGE. I almost see the dark angel on one of her shoulders and the white angel on the other, as she switches from telling us to stay on statins to telling us that the increased risk is a concern.

    I’ve always trusted the results of clinical studies and the way they’ve been reported; but I’m beginning to see the dark angels on authors’ shoulders everywhere. Of course the drug companies want to sell drugs, and make money. And of course many drugs are life-savers, but what happened to medical ethics? What about “First, do no harm?”

    Yes, Dr. Eades, this video annotated format is very effective. A super way to provide real-time informaton; it’s very clear and telling…whooo…and makes complex medical data accessible to ordinary people.

    It kinda ticks me off when she says patients must be very watchful of possible indications of diabetes, blah blah….so if a statin-taking patient begins to have symptoms – at that point, how much =irreversible= damage has been done to the pancreas & liver??

    I think I need to go out in the snow and cool down a little.

    • The irony is that in Dr. Curtis’ book he says that anyone relying on a relative risk to promote their data is probably hiding something — unfortunately it was the Harvard doc trumpeting it so Dr. Eades used that number as well. Increasing the risk of something from 1% to 1.5% is a 50% increase in relative risk, but clearly an insignificant increase in absolute risk. Dr. Curtis it seems clear believes the majority of modern medical research is a colossal and reprehensible waste of time and money — and while I am not QUITE that much of a skeptic, in some ways I agree.

      As a doctor in the field I am left feeling quite out of sorts — watch out more for diabetes if someone is on a statin so you catch it earlier? What kind of advice is that? By the way it is standard of care to put folks with diabetes on a statin because they have higher risk of dying from CAD. It’s all nuts.

      There were some weaknesses in Curtis’ arguments (he notes that if cholesterol were a circulating “poison” it would likely cause atherosclerosis in even distribution, whereas atherosclerosis occurs at branching points in high pressure arteries – clearly points of mechanical stress and he believes it is all genetic and bad luck, and that diet has no contribution.) I think it makes sense that an inflammatory mechanism that could certainly partially be mediated by poor diet choices could explain atherosclerosis at stressed arterial walls.

      I liked that Curtis is skeptical of all death certificate data and that was an excellent point. Curtis may not be aware of the very interesting historical data about upticks in heart attacks in the 1920s from the city of London hospital autopsy data (Stephan Guyenet has a terrific blog series about it, and I think it is one of the most telling things pointing the finger at cigarettes and trans fats.)

      But yesterday was a perfect example of how misled we all are. I was at a playdate with my kids, and the very lovely and nice hostess was bemoaning how she tries to keep her kids from eating so much sugar. I told her that I make sure my kids get full fat milk and butter on their veggies and fill them up with all of that FIRST to decrease the overall sugar intake, and she looked at me like I had three heads. (I didn’t even get into the benefits of grassfed butter :-) Sigh. It’s a long road ahead.

      • Dr. Deans is absolutely correct about the relative risk issue. What is important is the absolute risk, which, as she points out, can be minimal yet still provide a large relative risk. I’ve addressed that in a couple of posts in the past using statistics of deaths from commercial airline crashes.

        American Airlines and United Airlines were involved in the 911 crashes and then American experienced another crash not long after in an airliner bound for Puerto Rico (I think). Delta hasn’t experienced a major crash since the Dallas crash in 1985 (in which, sadly, I lost one of my best friends). I don’t know what the current statistics are for the absolute chance of dying in a commercial airliner crash, but they are phenomenally low. Last statistics I saw (from 2004) were one fatality for every 6.4 million passengers, and this includes all commercial airline fatalities world wide including those from Russian planes such as the Tu-154 (and Tu-134) that drop like flies. US statistics are much, much lower than the worldwide statistics. If we take these statistics and pretend they are US statistics calculated since 1985 and assume just for grins that the average passenger flies 1000 miles per trip, we can come up with our own absolute risk per mile flown. It calculates out to be 0.0000000001563 deaths per mile flown. So you can see that the absolute risk for flying on a commercial airliner are virtually non-existent. If we put in the difference in fatalities on American and on Delta, you would get some sort of number like 0.0000000001600 for American and maybe something along the lines of 0.0000000000800 for Delta. (Realize that I’m making these numbers up for purposes of illustration, but they’re probably not that far off the mark.) If you want to see the relative risk since 1985 for flying American vs flying Delta, you would simply divide 0.0000000001600 by 0.0000000000800 which process would give you the number 2. Which, of course, means that based on statistics since 1985, you’re at double the risk of death from flying American. Can you imagine the furor if Delta mounted an ad campaign based on the theme that they are twice as safe to fly as American or United? This is essentially what the companies making statin drugs do when they tell you that your risk of stroke or heart attack is reduced by 36 percent if you take their drug. They are using relative risk, not absolute risk, which is minuscule.

        • Dr Eades:The other American Airlines Plane Flight 587 was not bound for Puerto Rico but for my hometown Santo Domingo,Dominican Republic.The debris fell all over Queens on November 12 2001,probably the most terrible year in New York History.

  20. In our water???? OMG that scares the you know what out of me. I had heard this before, but considered it conspiracy theory chatter. Please assure me that cannot happen? What happened to freedom of choice?
    Yeah, I know (fluoride), but I’ve not lived in a community for the last 20 years with fluoridated water. “The words of many (drug companies), no matter how foolish, can cause a man (or woman) to doubt their own wisdom”. And, as Mark Twain said “There are 3 kinds of lies – lies, damn lies and statistics”

      • Sigh, John Reckless wants it in the water supply? Well, it’s already a reality.

        How do I know? I’d discovered, after working in public clean drinking water projects for over a decade , a very shocking discovery–the most commonly used drugs, like statins, are already in our water supply. Yep. And this is simply because of the already widespread use and the way water is recycled in most urban public utilities. Don’t believe me, here’s the details from only the most recent reporting and probably all you need to spark your interest in drilling your own water well:

        “Members of the AP National Investigative Team reviewed hundreds of scientific reports, analyzed federal drinking water databases, visited environmental study sites and treatment plants and interviewed more than 230 officials, academics and scientists. They also surveyed the nation’s 50 largest cities and a dozen other major water providers, as well as smaller community water providers in all 50 states.

        Key findings. Here are some of the key test results obtained by the AP:

        Officials in Philadelphia said testing there discovered 56 pharmaceuticals or byproducts in treated drinking water, including medicines for pain, infection, high cholesterol, asthma, epilepsy, mental illness and heart problems. Sixty-three pharmaceuticals or byproducts were found in the city’s watersheds.
        Anti-epileptic and anti-anxiety medications were detected in a portion of the treated drinking water for 18.5 million people in Southern California.
        Researchers at the U.S. Geological Survey analyzed a Passaic Valley Water Commission drinking water treatment plant, which serves 850,000 people in Northern New Jersey, and found a metabolized angina medicine and the mood-stabilizing carbamazepine in drinking water.
        A sex hormone was detected in San Francisco’s drinking water.
        The drinking water for Washington, D.C., and surrounding areas tested positive for six pharmaceuticals.
        Three medications, including an antibiotic, were found in drinking water supplied to Tucson, Ariz.
        The situation is undoubtedly worse than suggested by the positive test results in the major population centers documented by the AP.”

        Complete story here:

        On the one hand Dr. Mike is right to focus us on fighting the good fight of balancing our own internal terroir, seeking a low carb and more pristine functioning metabolism, yet we must also be vigilant and recognize we live in a near fully corrupted macro environment. One in which our challenge of nutrition is not only on balancing the overabundance and imbalance of pure crap foods that spark excessive insulin response, but also the even more insidious corruption of our metabolic potentials because of the widespread prevalence of pharmaceutical pollutants due to the reckless overindulgence of others–both the medical professionals that prescribe them and the idiot masses that consume them.

        Whether or not you think you’re willfully playing the game, you’re already drafted and part of the team.

  21. Re jaundiced eyes. The clip you cite with the greater mortality with a statin used the maximum dose: 80 mg. How about a person taking only 10 mg?

    As I understand it, there’s no evidence that statins help women of any age. But no evidence doesn’t mean something isn’t true. There’s no real evidence the sun will come up tomorrow, but I tend to believe that it will.

    Too many unknowns to make a really intelligent decision, alas.

      • I don’t agree. I read the reviews of Curtis’s book and got a sense of what it’s about. I’ve read a lot of the literature. I think it’s a matter of balancing risks. Take two patients, both 60-year-old women.

        Patient A has a family history of heart disease. Every older relative has died of heart disease. A first-degree relative had a heart attack under 50. Patient A has a total cholesterol level of 400, and even on a LC diet, a Lipoprofile showed pattern B. No family history of cancer. Maybe because they all died young from heart disease.

        Patient B has a family history of cancer. Her younger sister died of breast cancer at 40. No family members have had heart attacks. Her total cholesterol is 250. A first-degree relative has diabetes. Both of them have HDL levels of 55.

        Statins don’t reduce total mortality. They do reduce rates of heart attacks, and once you’ve had a heart attack you know everyone will try to put you on a low-fat diet. Maybe statins cause more cancer.

        So I’d give patient A the lowest dose of a statin that brought cholesterol down somewhat, but not as low as the doctor wanted, and I’d tell patient B to avoid them like the plague.

        If cholesterol doesn’t matter, why do people with familial hypercholesterolemia and cholesterol levels of 800 or so have heart attacks in their teens?

        I think cholesterol matters, but much much less than people think, and dietary cholesterol not much at all.

        • Gretchen,

          “If cholesterol doesn’t matter, why do people with familial hypercholesterolemia and cholesterol levels of 800 or so have heart attacks in their teens?”

          It seems that you’re making the classic correlation-causation error. Since there is a substantial body of critiques that eviscerate the studies asserting a causal link between cholesterol and heart disease, it’s reasonable to ask what other factors common to people who have familial hypercholesterolemia could cause heart disease. I haven’t studied this subset of the medical literature, and I can’t understand medical literature without skilled interpretation, but it appears that you have these skills. Have researchers pursued alternative theories?

        • Gretchen, people with a family history of familial hypercholesterolemia didn’t always have heart problems. See this paper which describes how starting about 1915, the “excess mortality” started to show up. Before that time, there was no evidence that these families died any earlier than any other groups. They speculated that there were environmental factors that caused people to apparently develop heart disease from high cholesterol.

      • Hi Dr.Eades Just wanted to say. I was put on Lipitor when it first came out. I was on it for years. I had the side effects of joint pain and soreness…felt like I was beat with a hammer. I developed Type 2 diabetes. When my Dr. told me I had diabetes…I was floored. I said ” no one in my family has it” his answer “history has to start somewhere”.
        I can see now where the “history” started. I no longer take any statin to my current physicians displeasure!

    • Gretchen, since the makers of statins are making claims that their medications are of benefit to those taking them, the impetus is upon them to provide support for these claims. Actually the impetus is upon them to find support, THEN make these claims. Simply saying that “no evidence doesn’t mean something isn’t true” is a meaningless statement in the scientific world and would leave anyone open to selling “magic water” to cure all manner of illness because, after all, just because I can’t prove my “magic water” makes men stronger, immune to illness, bullet proof and better with the ladies, doesn’t mean my claims aren’t true, right?

      • Fritzy, Let’s say that the first studies of statins were all done on brunettes. You’re a blonde. So there’s no evidence that they will work for you. Do you want to wait 15 years for a study in blondes? By that time you might be dead. Or do you want to assume it’s likely that they will work about the same despite your hair color?

        Yes, drug companies should provide evidence that their drugs work in all kinds of subgroups. But it’s not likely to happen. So each patient has to decide which risks and benefits will apply to him/her.

        What if a drug company finds a compound that will kill otherwise antibiotic-resistant bacteria. You get that infection. Would you decline that drug because it had never been tested in your racial group or age group?

  22. Enjoyed this video with your commentary very much! Great idea and please continue. My husband and I are great fans of your low-carb. lifestyle plans. Keep it up! We must turn around the FDA’s food pyramid and start focusing on what is really the problem in this country.
    Thank you

  23. Of course I’ve read such information many times over the years from you, Gary Taubes, et al. and greatly appreciate your bringing this to our attention. But it was fun watching the video with your input. It was so obviously a big, fat lie she was spouting (reminded my husband of GWBush’s deliveries). Thanks, Dr. E!

  24. Mike,

    What you did with the embedded video of you explaining, expanding, elaborating on Dr. Manson’s video is one of the most effective ways of teaching. Lately, I’ve experimented with this technique a few times in class (or when I train faculty on how to use a digital tool that helps students study better), and it grabs my student’s attention more than just reading something I wrote or listening to a lecture. For me, it is not only effective, but also saves me time because I can focus on the most important part of the message while still keeping my students interested. Another important aspect is that if feels more ‘personal’ as the audience can actually ‘see you’ and that seems to go along way to grab people’s attention. Finally, at least for me, it adds a little bit more fun to do these kinds of things to add variety in the way I present messages to my students or the faculty I train.

    The last part of your video sounded like the ‘bottom line’ segment in Protein Power… I think that is a great idea as this is what the audience will hear last and summarizes the key points; the ‘take-home message’ if you will.

    I use Camtasia to embed my own video into another one will great results. Is that what you’re using? I know you are a Mac guy :) (maybe I’m wrong).

    Nicely done!

  25. First let me say I love the video format..
    Second, thank you for bringing this important issue to light.
    As a cardiology nurse I can tell you that every patient regardless of age, gender or cholesterol level that sets foot into our Coronary Care Unit is put on a statin and usually at the highest dosage…this has never sat right with me due to the side effects…Now I have more reasons to dislike them…Try convincing mainstream doctors though..they all sound like the one on the video…they’ve been brain washed by bad research and big pharma (like most of us too)…I couldn’t believe my ears when she mentioned putting it in the water supply..what is that about??? I’m in this something that was/is truly contemplated in the US?? OMG!!…keep up the great work..

  26. As always, you’re great on video.

    I think, for grins & giggles, you ought to offer to do a weekly spot on a local SB TV newscast.

    Maybe Oprah will see it. 😉

  27. Seems backward. Isn’t it more likely that women with high insulin/high glycemic diets are more likely to be on statins to lower their (sugar induced increase in) cholesterol? If high sugar and simple carb diets are raise cholesterol levels, then such women will be put on statin drugs by their doctors and the women go on their merry way developing insulin resistance with their poor diets. So the statins do not increase diabetic incidence, but insulin resistant women, on their way to becoming diabetic, are more likely to develop elevated cholesterol and be put on statins. Am I missing something here?

  28. Video with commentary window is great. I would hate to be on the receiving end of your commenting and head shaking. It is even better that you are blogging again. You were sorely missed.

  29. This all makes one wonder about the current “protocols” that all diabetic patients MUST be put on a statin. Statins increase the risk of diabetes and yet ALL diabetic patients are put on statins!
    When is this scandal going to break? Has the media been totally bought by Pharma?

    • The notion that all diabetics should be put on statins came from a retrospective observational study, and we all know, or should know, how worthless observational studies in terms of determining causality. It’s a real shame.

      • So glad you addressed that. I am newly diagnosed diabetic and only a morning diabetic on metformin. I have excellent cholesterol numbers and my Dr was trying to use EBS (evidence based studies) showing that statins decrease chance of heart attacks in diabetics, and of course, had an example of a patient who refused and then had a heart attack and was started on statins in the hospital. IMO, we all know what is right for our bodies and introducing a drug with such bad side effects is ridiculous when cholesterol is great, diabetes under control and losing weight. My diabetes could have become worse had I agreed to the statins.

  30. Dr. Eades, I am huge fan. I have used your program to lose lots of wait and even help reverse my father’s diabetes. By the way, I heard you and MD on Amy Alkon’s show Sunday night. It was great, you guys did a great job.

    It’s off subject but I’m sure you’ve heard by now, Paula Deen has diabetes. Surprise, surprise. But she only comes forward once she has a deal to promote Novo Nordisk. Shame on her.

    Off the subject still, I was hoping to ask you a question that pertains to a lot of people. Are you familiar with the work being done on BPH? Is it now safe to say that an enlarged prostate is a symptom of metabolic syndrome?

      • I’ve read studies that confirm (Sweden) and others that refute (Harvard) the hypothesis linking high insulin levels to BPH. I sure hope more conclusive evidence is forthcoming.

        On this particular video blog I can only say I love it. I especially like how you look down and to your right towards the speaker. SO GOOD! :)

        One more question, if I may. It’s very much related to this blog, particularly hypercholesterolemia. What are the people with a genetic predisposition to create lots of cholesterol to do? Is it mostly a matter of monitoring your blood work (what I’ve heard you refer to as your “labs”)? Is a low-carb diet advisable for such people? I imagine the answer is yes, if not, what’s the best course?

        Part of the reason I ask is because a well-known trainer in the world of mixed martial arts died last summer at the age of 37. He died in his sleep from a heart attack. Obviously, I don’t know all the specifics about his case. But it’s pretty scary considering he was a very fit guy. I think I recall hearing/reading that something like one-third of all people with heart disease learn about it when they drop dead from their first heart attack. Is that about right?

  31. Love, love, love this format. So much easier then trying to read a rebuttal to the video. I had no problem with the.volume.
    Have been reading your blog for a couple of years. I’m still fighting with my doctor but have finally made the decision to get off statins even if I have to switch docs.
    Is it ok to just stop or should a person gradually go off?
    Thanks for this blog and also for all the tweets. They have pointed me to some good information.
    Now on to fighting GMO’s (California initiative in Nov.)

  32. “statins have never been shown to decrease all-cause mortality”….
    How long would a study have to be to demonstrate a decrease in all-cause mortality?

  33. Thank you so much for this information. My husband, now 71, had a stroke at age 55 (dang genetics!). He has been on statins ever since. Scares me, of course, because I am the one who reads about statin drugs and their side effects. Since he has the family history, and has had the occlusion of one carotid artery, I am reluctant to even mention it. When you discuss cholesterol and the heart, are you including arterial health within that discussion?

  34. Format is a great idea. Keep it up.
    As to your question of whether docs will keep diabetics on statins, I believe they will.
    My husband’s endocrinologist looked at his lab work, saw that his cholesterol was high and he was not on a statin, and immediately prescribed Crestor. This was just after the JUPITER study was reported. I questioned the prescription because of the reporeted increased incidence of diabetes in the statin group, and her answer was, “he already has diabetes, so what difference could it make?”

    • I think that I should respond here. My father died last August from complications of diabetes. He was a retired doctor and neither he nor his doctors thought there was any reason to try a low carb diet. I believe he had statin-induced dementia. No one would listen to me that there might be a better way. You should be concerned about a statin Rx!!

      • Hi Judy,

        Thanks for your input. I guess I should have included a little more info.

        I’ve long believed that just because the doctor prescribes something, that doesn’t mean you have to take it (I’ve refused my share of statin prescriptions from my own docs through the years.) My husband, on the other hand, would have willingly gone along with the prescription. But since I took care of his prescription meds, I simply “forgot” to refill the Crestor once the samples were gone.

        We no longer see that endo, and my husband’s cardiologist agrees with me that the purported benefits of statins in a 73 yo man with multiple medical problems probably don’t justify the possible side effects.

        Thank goodness the cardiologist has some common sense…

      • Judy
        How terribly frustrating that must’ve been, that no one would listen to you.

        My dad died in 2009 of complications from heart disease. He’d been on Lipitor for years, and I’m beginning to suspect his dementia was statin-induced too.

        This subject can keep a person awake at night.

  35. A female is over 65 years old, has been diagnosed with Type II Diabetes, and has been taking Zocor for several years without any lowering of her cholesterol: what should she be telling her endocrinologist?

  36. The video format is highly effective. I loved watching it.

    This statin issue has really hit home for me. My mother had a small heart attack this past summer. I tried to tell the attending cardiologist who inserted her stent that she couldn’t take statins because she has fibromyalgia, arthritis and scleroderma, and couldn’t tolerate any more pain. He told us that taking a statin drug was the single most important thing she could do to improve her heart health, along with a low fat diet. Realizing my mother would now be needing a good cardiologist, I started researching, even though the attending nurse told me this guy was excellent and one of the best. But after he wanted to do another stent procedure without even taking the time to see her, we decided it was time for a second opinion.

    I found a highly-rated cardiologist from a “best doctor” list published in a magazine. He was compassionate, took a long time with us and we both were impressed, until I asked the statin question. Again… “The single most cause of heart attacks is high cholesterol. Statins lower cholesterol and are the most important thing you can do to lower your risk.” I asked him why then all controversy regarding statins, and his response, “There will always be some people that just like controversy and try to cause trouble.”

    Ok, that is a big enough concern, but I also have a concern that the actual results of these studies can’t even be relied on. When I questioned my doctor about tests showing that statins haven’t helped women, he claimed that the major statin tests were done back in the 50s and 60s, when women were typically not included. That is why you don’t see statistics that statin drugs help women. Do you know if that was the case here?

    I listen to a doctor channel on satellite radio occasionally. Most of the doctors on the show are in a city you would assume had state-of-the-art care. One day, an MD on the show was touting the benefits of statins so aggressively, he suggested we even give it to children to prevent heart disease. It was so bizarre, the other doctors on the show seemed uncomfortable.

    This is really getting out of control and it is shameful. Even with the minimal success rate of 1.6% – not sure if article translates into actual numbers – people will think, “But what if I were to be in that 1.6%?” They are willing to take the risk. Not many feel empowered, especially the sick.

    • You wrote “he claimed that the major statin tests were done back in the 50s and 60s, when women were typically not included.”

      A typical example of a doctor trying to baffle a patient with BS to get the patient to go along with the doctor’s recommendations.

      The first statin wasn’t even discovered until the mid 70s, and it caused huge side effects in animal studies. It took about 20 years before the drug was refined enough to be used on humans. The first significant human study ever done on statins was completed in 1994, and statins went on sale soon thereafter. (Incidentally, the study, the 4S study, was pretty much worthless. It showed that taking simvistatin lowered cholesterol 35% therefore lowered the risk for heart disease. Yet there is no reliable evidence that cholesterol causes heart disease.)

      • Unbelievable. I really appreciate the clarification and your input.

        It’s amazing what high regard people hold their doctor in. They might feel they are hard-pressed to find a good contractor or lawyer in their town, but for some reason they assume every doctor they go to is worthy of trusting their life to.

        My doctor at least admitted statins help very few people. After this experience with my mom, I now believe many of these guys must be on the take.

        In fact there was an article a few years back in the NY Times written by an MD who told the story of how he got in over his head with a pharmaceutical company that was paying him to promote statins, both by influencing other doctors through seminars and by writing prescriptions. He claimed he had prescription quotas to meet and the company was pretty aggressively pressuring him to deliver. The more talks he gave, the more money he made. The more money he made, the more pressure they put on him. I remember thinking it was sounding a little like a tv show no longer on the air. Speaking of tv shows, where is 60 Minutes when you need them? I don’t know about anyone else, but I am outraged by this!

  37. Dr. Eades you are one of the most likable and honest men I’ve even seen. You’ve been such an influence on me and my family, so thank you very much for taking the time to get this very important information out there! If it wasn’t for you and people like you, I’d still be on the road to diabetes and all kinds of illnesses just for following conventional wisdom. So thanks again!

  38. Love the real-time commentary. I think this kind of thing will really help people understand how to critically evaluate research. I wouldn’t have known if I hadn’t studied statistics in school. Thanks for your blog and for all you do!

  39. My vote is for more of your videos. My husband and I loved it!!! You are a revered household name in our home and have been for years!

  40. Dr Eades:
    There is no doubt that to many are prescribed statins based on a simple Friedewald calculation/estimate of cholesterol levels at the doctors office and possible elevated cholesterol and or LDL makes no sens and in today’s world represents superficial analysis. But, what would you say to an LDL level deemed normal, but an NMR profile totally discordant with the LDL; in other words, say an LDL of 125, but a particle count at 2000 LDL whether the patient is on a low carb or high carb diet? Assume normal weight, no thyroid, vit D above 40, A1c of 5.4 and a family history? Seems to me there may be an underlying metabolic issue with LDL receptors and maybe in this case a statin makes sense and all cause mortality less of a concern.
    Population studies are great, but in the end we are all an experiment of N=1.

  41. Hi Dr. Eades,
    Well, viewing that was lots of fun! And you obviously have had a good time doing it, too. Tell me, how do you suppose the pharmacological industry has managed to co-opt so many of the best and the brightest to fall in line with them? Surely not all of these people are greedy or evil. How can it be that these really smart people have gone so far in academia, only to let go of their natural intelligence and skepticism? Although many have been reached by dollars from big pharma, I believe people like Dr. Manson wouldn’t knowingly make a fool of herself publicly if she didn’t really believe in her own words. What an amazing mystery of human nature.

    I’d also like you to know that I’m one of the many people out there who have experienced wonderful changes in their lives due to your and MD’s writings, starting with “Protein Power”. Thank you.

  42. Great video. Loved it. But for me your volume is still too low.

    You saved me from becoming a diabetic over 10 years ago and I am so grateful for Protein Power.

    Unfortunately, a great doctor that I had in California was recently forced to resign his medical license because he did “unethical” things like telling patients they didn’t need to take statins.(My ex husband was someone he told this to, though the family doctor insisted he take them.) This family doctor, who is very happy about my FBG and good A1C, tells me that I must be constantly vigilant about my eating, but insists that I must eat more fruit.

    Thank you for your books and blog.

  43. The play-by-play video commentary was fabulous.

    My mom was put on statins a few years ago for her high cholesterol, and put on a low fat, high carbohydrate diet. I tried to dissuade her but “the doctor knows best”. Rather than losing weight she has gone from being overweight to obese and is now diabetic and has had a stroke. Might have happened anyway, and there is a very strong family history of diabetes, if one believes that is the sole cause, but then I would think that being higher risk for diabetes would preclude being put on statins. I can’t help but wonder how long it will be before anything changes.

  44. Excellent post!

    My wife and I have both been on statin and have decided to stop taking them. Another author you may want to consider is Dr. Duane Graveline, M.D. His book “LIPITOR, Thief of Memory” was also an eyeopener. You might find it interesting that the brain cholesterol that is needed for cognitive function, CO-Q10, and other vital “stuff” is blocked by statins and is related to cognitive dysfunction.

  45. What a marvelously effective approach. Your embedded video commentary was extremely well done and very enjoyable to view. Of course the fact that you’re right and the conventional wisdom is wrong just makes it more fun. Please keep doing this whenever you can.

  46. Dr. Mike, I’m very pleased that you are back in blogging mode again. My vote would be to continue with the video commentary from time to time in the future. This one was very effective.

    BTW, I can’t resist commenting on Dr. Manson because her presentation in the video came across as insincere at best and dishonest at worst. She didn’t even have the decency to acknowledge other, extensively-reported adverse side effects of statins (such as cognitive decline) by investigators like Dr. Beatrice Golomb at UC San Diego. For the benefit of your other blog readers, here’s a link to a January 2009 news release by the university that summarizes some details in a review that Dr. Golomb co-authored.

    • I was in one of Dr. Golomb’s studies, and she struck me as a very caring person. She even sent me a long e-mail outlining where we stand with studies, which my doctor actually read, although he didn’t take much of her advice.

      I later saw a UTube of one of her talks to doctors, and she came across as very angry. She also talks very fast. And I could see that most of the audience was tuning her out. Sad.

      • Oh yes. I sent her a small donation because she said she’s having trouble getting grant money because her ideas aren’t mainstream. Ever since then U Calif San Diego has been sending me fund-raising appeals.

  47. Loved the format. My husband had a mild stroke this summer and all his labs/tests were normal excepting his cholesteral. His neurologist ran both of us in the ground at the first appointment when we told him that my husband did not want to take a statin. We go again next week and I’m sure will get the same treatment on the statin. Our primary agrees with us on not taking it though. Which is why he’s our primary.

    I am just amazed at the damage I see done by statins. I do quality work in a hospital and am familiar with the govt. mandates to treat certain conditions with certain medications and/or procedures or you don’t get your full reimbursement. I follow these patients who have CHF, AMI and when I see the ages of some of them, I cringe.

    We’re more than happy to prescribe insulin and all the oral meds for diabetes and keep patients on a constant carb diet, but never once do we think to reduce the carbs and heal them. No, we just go along with our sliding scale and mop up after hypoglycemic events instead of actually *fixing* the problem. No wonder they don’t worry about statin usage causing diabetes, it’s a money maker all the way around (except for the poor patient who shells out a buck a test strip and dies early from complications.)

  48. Hi Dr. Eades-

    I’m a fan, but it strikes me as a bit odd that you are flabbergasted at the “48%!” higher *relative* risk of diabetes with statins, while in the same article, exposing the deceptive misuse of relative risk vs absolute risk in another study.

    Do we have the absolute risk data for diabetes & statins? 48% higher relative risk could be 5% absolute (if 10% of people get diabetes), or on the SAD, it could be as high as 25% (if 50% of people will eventually get diabetes.) I’m not a statistics nerd, so I could have this wrong, but I *would* be interested in knowing the change in absolute risk, and if you prefer that measure, I’d like to encourage you to use it consistently regardless of whether you are in agreement with the study.

    BTW – I do like the video commentary. The real time aspect of it makes it really clear what you’re responding to.

    • John H. – My same thought exactly! I kept reading and re-reading everything to make sure I hadn’t missed something! I’m on high doses of statins, but I don’t think I will let a minuscule effect like a 48% relative risk increase of diabetes affect my decision to remain on it. I’m glad you commented. I wish Dr. Eades would respond to it.

  49. Very helpful. In addition, it is a good way to teach how to listen and evaluate for ourselves what some ‘authority’ is telling us.

  50. Mike, absolutely outstanding! To see another credentialed, educated expert comment in real time about something another credentialed, educated expert is saying must have a significant impact on the audience. If nothing else, it graphically points out the fact that credentialed, educated experts can disagree and forces one to realize the idea that their health is in their hands – they can’t just simply trust what they hear to be the truth – and they’re going to have to dig a little deeper, study the arguments and use reason and logic to make a decision, to choose, who is more likely expressing truth! Well done! Please do some more! May I link to these on my website? Thanks!

  51. Well, I feel like this is Christmas all over again. First, it has been a gift that you have blogged four times so far in 2012. I get so exited when I see a notification in my inbox from your blog. Second, you must continue these informational videos. Those of us going against the grain and against conventional “wisdom” need a voice of reason to keep us from feeling defeated by the ignorant. Laugh out loud comedy and you at your best!

  52. Hey Doc,
    I love the new format! I’m glad your back blogging too, I missed your rants and the way you tear apart conventional wisdom. Getting to watch and listen now is definitely a plus!
    Thanks for all your hard work.

  53. Mike – great video format – a winner!

    Oh, and here’s your next story about Chef Paula Deen, who is diagnosed with Diabetes.

    The NY Times said: “Deen’s illness was probably caused by any of a number of forces, including excess weight, high blood pressure, lack of exercise and high blood levels of sugar, fat and cholesterol.

    “There’s no denying that Paula’s food has a lot of what we call the deadly triangle: fat, sugar and salt,”

  54. Great stuff Dr. Mike….

    It only makes sense that blockage of denovo cholesterol synthesis by statins would be associated with diabetogenesis. Endogenous cholesterol is critical for the normal function of pancreatic β cells…the cells that manufacture insulin. Disruption of these cells would obviously, in my opinion, lead to diabetes.
    Cholesterol regulates the voltage gated calcium channels, mobilization and function of insulin vesicles within the cell membrane. Drug induced cholesterol reduction, greatly affects pancreatic cell function….and thus diabetes can develop.

    However, the statin therapy effect upon diabetogenesis is dose-dependent:
    -WOSCOPS had a 30% decrease in diabetes (pravastatin…pleiotropic action of statin therapy?)
    -LIPID Trial, glucose intolerant subjects showed no decrease in diabetes (pravastatin again, but much lower LDL-c)
    -JUPITER Trial (with VERY potent rosuvastatin), and huge decrease of LDL-c, had 25% increase in diabetes

    So we see a dose/strength dependent effect of statins upon diabetes, that masks any “anti-inflammatory” pleiotropic effects of statin drugs….better to just take an aspirin???
    Dr. John

  55. Dr. Manson did a study on strength training and seniors in 1990 in JAMA. I liked her then. After listening to her blatant fraud in defending statins despite the diabetes risk, I have completely lost trust in her and her research. Fraud.

  56. Loved the video format! Loved your responses. Someone way up in comments said they laughed out loud several times at your responses and reactions…I’m in that boat. Too awesome!
    Regarding the topic, I find the entire thought process within the medical establishment regarding medications and our health to be frightening! Statins in the water supply?!
    I’m off to spread the good word now. Thank you so much for your time and knowledge!

  57. Dr. Eades:
    This is off subject, but I have dabbled in the low carb several times in my 63 years and realize just how good I feel on eating low carb so after reading Wheat Belly by Dr. Davis, checking out the Paleo/Primal plans, revisiting your Protein Power (love your cookbook) I am now going to make this my life-plan. But before I do–I have a health issue I need some clarification on–Osteoporosis.
    I have been diagnosed with osteopenia–2 bone density scans-1 in 2009, now a 2 year follow-up. This has no doubt been a result of being bulimic from the age of 19 to 31.
    I have been taking Evista for the past 2 years. The 2nd and latest scan in October shows no improvement, but also no loss in density.
    Do all these calcium supplements and a hormone drug really help? I exercise and have generally eaten well and kind of low-carb for the past few years. Blood pressure OK, blood tests within normal ranges.
    What is the impact of low-carb on osteoporosis? I haven’t found much on it but some references that low-carb may help–alkaline and acidic stuff.. I have just started my research, but do you have a post on this issue? Or perhaps a study?
    My husband is on statins and has done OK–BUT he had a stroke at 49 and a heart attack with triple bypass surgery at 56. Your video here was VERY interesting. I have begun to question so much of what the corporations and their accompanying politicians are telling us and what toxic path they have been and continue to lead us down. I AIN’T GOIN’. I want to get off the Evista. My Dr. is in the tank completely for these drugs.


  58. The video was awesome, my only comment, and this is a minor point, is that maybe you don’t need to be so shy, maybe you can take up a bit more screen real estate for your window? Maybe even a side-by-side kind of thing would be fun to watch?

  59. Your method of presentation was wonderful, I thought — the points being unambiguous when interspersed with her narrative.

    The topic made me weep, though. My husband was put on statins nearly two decades ago, and developed diabetes after five years of Lipitor. He is slim and athletic and has always been so. The first thing people say when they learn he’s diabetic is “How did a person who looks like you develop diabetes?”

    Maybe we have a hint now.

  60. Amazing…but not, sadly, unexpected. I actually found my own diabetes by monitoring my blood sugar to see what made what foods made it go up and by how much in an effort to lose weight. I brought my fasting numbers to my doctor’s attention and he agreed to test me. He was quite surprised by the result of the glucose test as my HbA1c was 5.2…a testament to my low carb diet, thank you Dr. Eades.

    After being slapped in the face with this diagnosis, I researched the ADA recommendations. Frankly, I was horrified. I truly believe that mainstream medicine and big pharma are in bed together so to speak. Why else would they advocate dietary measures that so clearly necessitate ever increasing medical and medication intervention? I, for one, won’t play that game. I have taken control of my own health and, thankfully, my doctor is right there with me.

    Thank you for continuing to bring us the information we need in order to make the best decisions for our health. Really like the video within video response. Keep ’em coming!

  61. The ‘withering critique’ by Dr. Kronmal drove a response by the investigators, which was published in JAMA.

    It begins:
    ‘With regard to the issue of significance, Dr Kronmal does not dispute that a reduction in the combined incidence of coronary heart disease (CHD) death and myocardial infarction at least as great as that observed in the LRC-CPPT would have arisen by chance alone in less than one experiment out of 20 (ie, P<.05). However, he criticizes our use of the conventional P equals .05 cutpoint in describing this result'

    Maybe Dr. Eades would like to discuss, since most of us don't have JAMA access to the rest of the rebuttal!

    • The conventional P=0.05 was not what was set as the standard at the start of the experiment. And a substandard form of arriving at the P=0.05 was used when the more conventional two-tailed test method failed to achieve significance. It would be like building a baseball stadium and announcing that the left field fence was 330 feet away from home plate, meaning a player would have to hit a baseball over 330 feet in left field to get a homer. Then discovering that none of the baseball players could hit a regular baseball the 330 feet initially established as home run distance. You really want a home run, so you then change from a regular baseball to a different kind of ball that goes farther, and you still can’t get it over the fence. You can only hit it 260 feet. So you then move the fence in from 330 ft to 250 ft and declare the hit a home run. That’s basically what they did in this study.

  62. Hi Doctor Eades,

    I’m not sure how to way up the evidence around statins. I’m an avid follower of your blog and have learned a lot about interpreting medical literature and its shortcomings from your blog and others like it. However, the cochrane collaboration review about statins last year states all cause mortality DOES come down with statins, risk of cancer DOES NOT increase, and few trials reported costs on quality of life (although i suppose that means they just werent recorded, not that they dont exist).

    I was hoping you could comment on the cochrane interpretation and the interpretation you put forward on your blog.



  63. Hi, Dr. Eades

    There’s lots of shenanigans in scientific research. (e.g. did you hear the latest on resveratrol ? )

    LRC-CPPT is one of the trials where they used relative risk to make the numbers sound impressive CAD mortality in controls vs treatment ( 38 vs 30) and total mortality in controls vs treatment ( 71 vs 68) is not supportive of cholesterol lowering out of 3,806 subjects.

    Most of the public never heard of LRC-CPPT, let alone know the absolute numbers.

    What bothers me about statin mania is that healthy CAD free men and women are being put on dangerous and POWERFUL drugs because their ( meaningless) total cholesterol , HDL and LDL does not fit the false guidelines by the fraudulent NCEP. Tests like HDL efflux function are not yet available and probably would be expensive and certainly labor intensive

    Kudos to Dr. Dariush Mozaffarian for coming out publicly and admitting plain LDL level is a poor biomarker for CAD risk , and that saturated fat and natural red meat are not risk factors for CAD.

    Only processed foods are, and trans fats.

    Perhaps HDL efflux / function and its ability to do its job, might lead us somewhere. Also perhaps the LDL particle size research will lead us somewhere. But , the current cholesterol number tests are next to useless.

    Some cultures like the Tarahumara have HDL levels of ONLY 25 and LDL a bit over 100 and are virtually CAD free

    But even so, there are so many other things involved in coronary artery disease than just lipoproteins

    Dr. Steven Nissen ADMITTED that even if we put EVERYBODY ( putting it in the water supply) on statin drugs CAD would STILL be the NUMBER ONE CAUSE of death in the United States/ Kudos to him for at least admitting this.

    You might want to watch the Dr. Steven Nissen lecture on IVUS and the Dr. Darisuh Mozaffarian podcast on my blog. :)

    Take care, Dr. Eades.

    Wishing You Well.


  64. Could you please explain why the 4S Study was pretty much worthless? As far as secondary prevention, the 4S had the biggest absolute risk reduction ( 3.3% ) for all-cause mortality. A pretty feeble reduction, to be sure. The HPS had half the benefit ( 1.7% ), which makes one wonder of the 4S results were maybe fixed.

  65. Hi Dr. Mike!

    I read through Dr. Manson’s paper:
    Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women’s Health Initiative

    Towards the end it says:
    “The Cholesterol Treatment Trialists’ Collaboration found that statins significantly benefit vascular mortality and morbidity and all-cause mortality in diabetic populations with rates comparable with those without DM. 45”

    45. Cholesterol Treatment Trialists’ Collaboration (CTT). Accessed September 30, 2011.

    Went to the CTT site and it says:
    “Benefits of statin therapy among patients with diabetes mellitus

    The CTT collaboration explored the effects of statin therapy in more detail among the 18,686 individuals with diabetes (1466 type 1 and 17,220 type 2) included within the 14 trials. During mean follow up of 4.3 years, 3247 of these diabetic individuals had major vascular events. Among them, there was a 9% proportional reduction in all-cause mortality per mmol/l reduction in LDL cholesterol, which was similar to the 13% reduction among those without diabetes (figure).”

    Figure 8

    Are they massaging the numbers weirdly, or is this correct?


    Be well,
    Ben Fury

  66. Dr. Eades,

    Great post! I see the results were adjusted for age, race, BMI, etc., but were they adjusted for lipid levels as well?

    Also, have high lipid levels been associated with diabetes or metabolic syndrome?

    Thank you.

  67. I guess I am the lone voice of dissent. I loathe videos and generally do not even bother watching them. I read quickly. It feels like a real waste of time to have to wait for the video to load (over slow dial-up) and then listen to something at the slow rate of speed at which a person speaks (vs. the fast rate of speed that I am able to read). All too often, it turns out not to be worth it. Sorry.

    • Often, I feel the same way about videos. But this one is unlike most of them.

      I’m curious as to if you actually watched _this_ one. I get the impression that you did not.

      If not, you may want to give it a try. (Though I’ll admit that watching any video over dial up must be an absolute nightmare.)

    • Donna, I didn’t want to be negative, but I’m with you. If I spent 15 to 30 minutes each watching all the videos people want me to watch, I’d do nothing else. Unfortunately, I think it’s where things are heading.

    • Donna,

      Although I don’t have to deal with dial-up speed (you have my sympathy), I do share your dislike of videos in general, always feeling cheated out of a story when I click a link and find a video. I simply refuse to watch it, leaving the site immediately. But Dr. Eades gives us a good blog post with the video, and I’m hoping this format will simply be a “rare treat”, not replace his usual “in depth reporting”.

    • I know what you mean, Donna. I, too, have dial-up, and I, too, skip over videos.

      Dr. Mike, would it be possible for you to also do a text version when you do these videos?

      I’m enjoying the sudden abundance of blogs. Thanks!

    • I agree Donna… I get very frustrated when I follow a link for a headline that sounds interesting, and it takes me to a video I must watch. I’d rather read! But this was the exception, I really enjoyed this, and felt it was more effective than reading, especially for the skeptics I will forward this to.

  68. This was great, Doc! Please do more of these whenever you like.

    My doctor is a nice guy, smart, too, open to discussion about things. But when all is said and done, EVERY TIME I visit he gets the “serious” face on at some point during the visit and tells me I should be taking my statins (I was on them for a year or so several years ago before finally waking up). So when I tell him “there’s been no benefit to taking them, and it’s been shown that they don’t decrease all cause mortality” he comes back with “You’ve been diagnosed with diabetes, so you aren’t normal anymore and you need the statin.”

    So while there’s a chance my odds of getting diabetes was upped by taking the statins, now I’m supposed to be on them because I have now developed diabetes.

    The drug companies are laughing all the way to the bank.

  69. Mike,

    What about the Ravnskov Hypothesis? (“Fat and Cholesterol Are Good For You”, by Uffe Ravnskov). Ravnskov says that artery disease is caused by micro-organisms, both viral and bacterial, at least 50 varieties, that LDL particles are part of the immune system, and that LDL particles enter the arterial wall from the outside, through vasa vasorum.

    It seems logical to me that large, fluffy LDL particles would be much more effective at capturing microbial toxins than would small, dense LDL particles, leading to a positive statistical correlation between small, dense particles and artery disease, not because small, dense particles are dangerous, but because small, dense particles are ineffective components of the immune system.

    It also seems logical to me that mobilization of the immune system would lead to a positive statistical correlation between LDL and artery disease, not because LDL is causing artery disease, but because artery disease is causing LDL.

    The Ravnskov Hypothesis is the only one I’ve found that explains why arteries get plaque formations and veins don’t. (In arteries, the LDL particles are moving through thicker walls and, more importantly, against a pressure gradient.)

    Norm Houtz

    • Like others, Ravnskov’s is an hypothesis. A hypothesis means it hasn’t been proven – that it is simply speculation, even scientific speculation. But still an hypothesis. In my view, vastly more likely to be true than the lipid hypothesis.

  70. Suppose for a moment that the mysterious and elusive benefits of statins are not related to the cholesterol-lowering (which seems to be what the backers are saying).
    Douglas Kell suggests that they may be due to the iron- binding properties of statin molecules.

    But if they are due to the inhibition of de-novo cholesterol synthesis (rather than the serum level per se) there is an easier way to inhibit de novo cholesterol synthesis;
    1) eat more cholesterol. Dietary cholesterol inhibits DNCS; this is tightly regulated. DNCS from acetate takes 26 different enzyme-controlled reactions, and the complete process takes about 6 seconds, so it would need tight regulation.
    2) eat less PUFA, that is, consume most fats as highly saturated animal fats and tropical fruit oils. PUFA increases both cellular uptake of LDL and DNCS; this is how it lowers cholesterol. There is less in the blood but more in total in the body, and the liver is making more to supply it.

    Perhaps by diverting acetate and HMG away from cholesterol some statins elevate ketone bodies in some people at some doses under some conditions, and this accounts for the benefits (such as they are).

  71. When LDL is lowered by a fad drug or a low-fat diet, the reason may sometimes be that it is now being tucked away in foamy cell artery plaques, so is disappearing from the blood….

    • George, Tucking LDL away in plaques sometimes reminds me of the way your computer’s virus protection software tucks viruses away in virus vaults. We still have the virus but it’s supposed to be in a safe place.

      I’ve wondered if maybe computer nerds could use their knowledge of sequestering viruses to suggest ways to understand how the body could make LDL safe. Not treatments, but ideas for experiments to learn mechanisms.

  72. I went to see a cardiologist in the L.A. area today because a routine EKG (without symptoms) showed some bundle branch blockage. He has an excellent education and training, but said after 3 min. with me that I probably needed to be taking statin drugs – this was without blood work. I am 69 years old, smoked for 30 years, and I have diabetes. He was very upset when I challenged him on lowering of numbers vs. morbidity rates. My lifestyle has changed drastically as I have recently lost 50 lbs., started aerobics, weightlifting and swimming. None of those factors seemed to faze him.

    • I actually feel a little sorry for (some) docs — this guy is giving you the ‘standard of care’ and if he doesn’t, HE could get in trouble with his local medical board. He neither knows you well enough nor cares about you enough to jeopardize his career and his family’s well-being in order to fight the establishment.

      And if he does do as Dr. Mike did, and begin — in fear and trembling — prescribing this “fad” diet/lifestyle to his patients… he would be sticking his neck out and even if ‘the diet’ works, getting it chopped off! (Most docs are not malicious or *intentional* tools of Big Pharma; they’re doing the best they can (which, granted, ain’t verrah good!) with the pressures they are under.)

    • Hi Pamela: just because no studies have been able to demonstrate lower mortality, doesn’t mean statins don’t lower mortality. It may be because no doctors will leave patients in studies long enough. This is a great blog, but carefully consider all the information you receive.

      • Let me address this issue with a quote from Dr. Curtis’s book that anyone prescribing statins should consider and certainly anyone considering taking them should consider at length. He has been giving a rundown of the numerous side effects of statin drugs and goes on to say:

        As severe as some of these short-term side effects can be, they pale into relative insignificance when compared to the potential long-term problems. The chief difficulty here is that no one knows what the long-term effects may be from altering the basic biochemistry of the human body over a period of time. Because cholesterol is the key element in the formation of cell membranes, which are the protective coat for the cells, it may be that blocking cholesterol’s production will weaken the protective barrier and allow the entry of toxins or carcinogens that were previously excluded. There are disturbing reports of increased cancer in some cholesterol-lowering studies, but, in fact, this process may take many years to play out. It’s enough at this point to acknowledge that the long-term effects are completely unknown. This is a risk that should receive serious attention before half the population is placed on these drugs, that, in effect, accomplish nothing more than low-dose aspirin or an extra glass or two of water each day.

        • Thanks for that, Dr. Eades.
          I am happy to report that all of my tests came back with good results. I met with the doctor today (who by the way has excellent credentials), and he did say I do have plaque, but not enough to be concerned with at this time. He mentioned statins again, but also acknowledged my reluctance to take them. He told me to exercise aerobically 5 x / wk. and to eat a “heart healthy” diet. I decided that we may indeed have a very different idea of what that might mean, so I left it at that. :-)

          • It’s impossible for your doctor to tell you you have plaque unless he/she does either an coronary angiogram or a coronary calcium scan. If he/she didn’t do either one of those tests, then you don’t know whether you have plaque or not.

          • Dr. Mike,

            My doctor had me undergo a carotid artery sonogram to check on possible plaque buildup because of my very high cholesterol. It came back 100% negative so he didn’t prescribe me statins (rather he reluctantly agreed with my refusal to take them and let that result buy me some time until the test showed positive, which he believes is my certain future at such elevated levels).

            Quick questions:

            Is a carotid artery sonogram a good enough test to rely on as an indicator of plaque presence or absence, or am I kidding myself in taking comfort from those results?

            Also, if coronary angiogram or coronary calcium scan are the only ways to definitively know, which one would you suggest is the more effective and least invasive of the two?

            And finally, are these two tests you recommend something every doctor can/should be able to know about and prescribe–they never seem to be mentioned these as options.


          • The coronary calcium score describes what’s going on in the coronary arteries. A carotid ultrasound (or sonogram) tells what’s happening in the carotid arteries. It is possible to get a scan of the neck when getting a calcium scan of the heart although it costs a little more. A carotid ultrasound that is clean is good, but it doesn’t uncategorically equate to clean coronary arteries.

        • I’m not sure I understand the last line about aspirin, or water. Is Dr. Curtis implying the cholesterol lowering effect is worthless? Isn’t this still unknown?

          There is evidence that low baseline cholesterol improves mortality. This study looks at the long term effects of starting with low total cholesterol (unfortunately they didn’t have LDL baseline data):

          If you’re willing to accept low-natural LDL is good, then it’s at least plausible that un-natural lowering via statins (or some other method) could be beneficial for some people…right?

          Any clarification would be much appreciated. I stopped taking my prescribed statin last year. I’m due for a check up, and would like to be up to date on the latest info.

  73. My hubby and I both liked your video analysis. Very entertaining! My personal opinion, though, is that I wouldn’t want the video as a replacement for the writing. It’s a wonderful addition, but PLEASE don’t stop the writing.

    Sincerely, Anti-statinator Karen

  74. Dr Eades, do you have any comments for APO E4 patients who seem to be able to greatly reduce their small dense LDL by taking statins. I am one of those patients and would like to find a way to stop taking statins (Crestor) while still keeping my sdLDL at minimum. Thank you so much for your blog and your comments!

      • Unfortunately, my attempt to reduce statins was made when my diet still had to be corrected (I didn’t know I was APO E4 at the time.) Now the diet is right, and I should do it again as you advise. Thank you!

      • People who take statins are worried about cholesterol
        and tend to avoid eating saturated fats . They substitute
        carbohydrates that lead to diabetes. Counfounding variable? Thank you.

  75. The widespread adoption of a healthy high fat low carb diet that would lead to a lean population in the US and Europe and go a long way to eliminating many of the health problems that currently afflict these populations would be a disaster for the economies of these nations. The fast food and general food industries, the wheat and corn farming industries and especially the health and pharmaceutical business would all be virtually decimated. To prevent an economic collapse of the gravest nature it is imperative that the current myth of fat being the root of all evil in our society be perpetuated.

  76. I just witnessed (or heard) quite a feat. After taking a walk, my friend came back to my place. I was hungry, so i made a quick meal of four over-easy eggs. I made the same for my friend. Only minutes after cleaning his plate, he said “oh ohh”. Of course, I asked, “what’s wrong?” He said that he knew a bad case of diarrhea was on the way; this is the same friend i mentioned in a previous post. Long story short, he made five trips to the bathroom in the space of an hour.

    I, too, experience a quick bout of the runs every so often after eating eggs, even if they are good quality and cooked well.

    I know that eggs are a major allergen for many. Thinking through the lens of evolution, this makes sense. I imagine our ancestors didn’t eat eggs all too often and at the very least they were eaten in very small quantities.

    Perhaps some of your patients can’t handle eggs.

    • Pete: some people can’t handle eggs, my husband being one of them. He’s 33 and healthy with no allergies and always loved eggs and had no issue with them until about 4 years ago. If he eats them now he doesn’t get sick but feels terrible cramping for hours. So he pretty much avoids them, except in tiny quantities in low-carb homemade baked goods. We consider it more of an intolerance than an allergy as he doesn’t swell up or get hives from eating eggs. Sounds like your friend might have developed an intolerance, which (in my book) is terribly sad. Eggs are an excellent food for those that tolerate them.

      • Allergy manifests itself in many different ways, not only swelling and hives, for example, my son is allergic on fish, if he does eat it (on couple occasions he eat by mistake breaded fish while thinking it was a chicken breast), he experiences bouts of diarrhea, cramps, belching.
        Unfortunately, eggs are a common allergen.

    • FWIW, I have had similar experiences eating undercooked eggs before. But when I cook eggs thoroughly, I never have this problem (and I have ~2-3 eggs every day for breakfast).

    • I have developed various food intolerances over the past decade, with increasing severity of symptoms. I was skin prick tested for allergies, and was told no allergy just considered an intolerance. Foods include egg whites (worse if raw), avocado, tomato, squash, and alcohol. If you google the term “histamine intolerance”, you can find some information about the source of these intolerances. Some foods contain high levels of histamine (esp aging fish and other aged products like cheese) and some cause mast cells to release histamine in large quantities. Either way, your body reacts to the histamine once it reaches your personal threshhold. I have the reaction to the histamine releasing foods of major gut cramping. Zantac can help (actually an antihistamine), but only treatment is avoidance. I wonder if the condition arose from my long untreated wheat intolerance? I’m now wheat free since October and feeling great, but still avoid those foods.

  77. LOVE this format for you. Please do more. Also going to send a link for this to every one I know, especially women! Thanks for your time and dedication to helping us.

  78. I fear for my older years. Even in my 40s as a woman I felt the pressure to take statins. I get stuff in the mail from my health insurance company about low fat diets. The pressure is enormous to plug me in to the system, the system that sucks money and good health out of me and funnels the money to the insurance and drug companies and finally to the researchers like the nice lady you so elegantly pilloried in your video. How is a person supposed to survive the gauntlet? All I can hope is that this way of eating will work after so many years of insulin resistance and that it will keep me healthy enough to keep me out of the doctor’s office and out of their web.

  79. Thanks Robinowitz, yeah i think an intolerance is a nice way to put it, because he didn’t always have post-egg reactions. Eggs though, like grain, were probably rarely eaten by early man. This, to me, explains help why many people are in fact allergic to them, despite being quality, low carb fare.

    Rita:no, not a fat issue, because he consumes a lot of other high fat foods without issue, though that can be a problem for others.

  80. This is a bit off topic, but don’t know where else to put it.
    Re the Ancestral Weight Loss Registry, mentioned in the Gary Taubes tweet, is there a place for those of us (perimenopausal) women who’ve had a significant improvement in blood work, (lipids and A1C) but have not succeeded in losing weight?

  81. It was chilling to hear her say that people on statins should be vigilant and look out for the symptoms of diabetes. It’s as if staying on the pills is the most important thing, and as long as you *realize* you’re becoming diabetic, that’s fine.

    I’m really quite creeped out by that.

  82. Thank you Good Dr Eades for your contributions to eventually ending this anti-cholesterol hysteria. It cannot happen soon enough and I’m with you Rachel, Dr Manson is really creepy in her recommendations. It’s amazing that people can tolerate statins at all.
    Proto-Cholesterol was ‘discovered’ by proto-animals 3/4 of a billion years ago. The difference between animals and plants is that we have it and they don’t. (We also have LOTS more of it than other ‘lower’ animals on the planet- I love animals, but I’m referring to the kinds that we share the planet with who did not invent computers, can’t use them and who don’t drive cars- need MUCHO cholesterol for all that and more). To have a nervous system and movement and to have a brain we have cholesterol. 25% of all the cholesterol in our bodies is in our brains. The most common organic molecule in the brain is cholesterol (inorganic most abundant- is water). Cholesterol is NEVER FUEL, it is only building material.

    Treating heart disease with statins is like the fire dept putting out a a house fire. The fire department comes and puts out the fire and then there is residual water lying around afterwards on the ground. That water is then blamed for having set the fire in the first place and just for good measure, let’s close the water pipes going into the house and let’s drain all the water at the fire departments disposal to boot.

    • Marilyn, I did indeed.

      Before my best friend and I began rigidly following a low carb diet, I would have agreed with the “other side”. Thing was, that “diet” wasn’t working for us, and it was just a matter of time before diabetes and heart disease settled in for the long haul. I thank God often for helping us find ‘Protein Power’. It as changed our lives.

      Sugar and fat ARE a bad combo, but nix the sugar (carbs), pump up the fat, keep the protein coming, and you’re golden! :)

  83. “This is my first effort at anything like this, so you can let me know what you think of it. If you find it enjoyable and/or helpful, please drop a note in the comments, and I may be inspired to try it again.”

    Loved it Dr. Eades, I think it’s one of the most effective formats of delivering your message you’ve done. I try to fight the battle against statins with my friends and loved ones here in my small corner of the world…. this video is definitely being added to my arsenal. Thanks!

    • While reading that I found my blood boiling, and got pretty steamed…and I don’t even have kids! It’s power and control all over again. Power is perceived, control is ENFORCED. Parents with kids in public schools are dooming them unless they pack them a lunch every day. How far into oblivion do people have to go before they look for a different way. Mark my words….In the next ten years they will have created a special drug aimed at these very kids. It will be a wonder drug that will “save” the obese, depressed, diabetic teens……and it just may kill them.

  84. Hi Mike,

    This is off the topic of the post, but I wanted to ask you about it please. My friend who I taught low carb too is reading an Indian weight loss book and it said this:

    “When too much protein is consumed at one time, it doesn’t get stacked away for future use instead it is converted to fat by a process called deamination. It will just load the liver where it will get broken down to glucose. So your expensive and difficult to digest protein (yeah, chicken, egg white, fish are tough on your system) is getting used for energy. Something that a banana could have easily done. (Cheap on your pocket and easy on your digestive system).”

    What exactly happens to excess protein? I thought in the Four Hour Body Tim Ferris mentioned a study that showed protein is utilized as well when eaten primarily all in one meal vs spread through the day. Their is a bodybuildilng myth that the body can only digest 30g of protein in one sitting. That seems to be what the author is talking about.

    I’d love to get your input on this please.

    Thanks again,


  85. I like the video format, particularly for any long or involved information. To have someone pause the video and explain or make any comments is so helpful, rather than write their comments after the fact.

    Besides, your facial expressions are commentary all by themselves!

  86. I have to come at this from another angle… I watched this with my husband and usually whenever we watch TV I use the remote to pause the picture to chat or ask something. Watching you pause the video all the time was just making me laugh because that is what I usually do!

    We loved this. Thank you for showing us how crazy this world is that we live in.

  87. Wonderful technique – these pompous medical specialists talking down to us and in an off-the-cuff manner dismiss a “48%” chance of developing diabetes as being enough to discontinue the medication. We’ll just keep an eye on it. But, there you are furnishing the truth at all of the correct places. The goal with all of these people I beleive is to treat, treat and treat some more. If you develop diabetes, we’ll treat it. Cancer? We’ll treat it. I was first prescribed statins 20 years ago because I have CHD. Well, I’ve had 3 angioplasties and must say they do the job. However, i still have CHD – its not like that this disease just goes away. However, IMO thanks to statin therapy, I now have severe nerve damage and myalgia. I stopped the statins almost two years ago and follow a very low carb diet – no grains at all. Now 50 pounds lighter and feeling great. The Dr. thinks I’m crazy. Perhaps – but that condition could be caused by statins also. Please when appropriate, do more of these!

  88. LOVED this picture-in-picture format. Made the material very easy to follow. Your expressions were the best commentary!

  89. @Michael, January 25, 2012 at 9:13 pm re: protein



    Protein is the major structural and functional component of all cells in your body. Proteins literally play a necessary role in many of the biological processes that allow you to live and function. Not to mention, about 25 percent of your muscle mass is made up of protein—and the rest is made up of water and glycogen (your body’s stored form of carbohydrates). So it’s no wonder why so many diets place a heavy emphasis on protein. But the reason you need to eat so much is simple: Unlike other nutrients, your body can not assemble protein by combining other nutrients, so enough must be consumed in your daily meals in order to achieve your desired health and appearance.


    Despite what you might have heard, your body can process a lot more protein than you think in each meal. Like a big steak dinner? Don’t worry, you can handle it. The most common claim is that your body can only handle 20 to 30 grams per meal and that the rest will go to waste. Nothing could be farther from the truth.

    The idea that your body can only handle limited amounts of protein was one of the initial reasons why people began eating meals every 2 to 3 hours. It was a tactic designed to prevent wasting food, while also raising your metabolism. However, science has proved that your body can take as much time as it needs to digest and absorb protein and utilizes all of the nutrients appropriately. With the exception of a massive protein binge—where you consume more protein in one meal than your body can handle in an entire day—you can feed yourself larger doses as part of a healthy approach to your diet.

  90. Dr. Mike,

    My cholesterol is 361. I have been on your program faithfully for about a year. I am a loyal follower and I adhere strictly to the diet. Very little cheating.

    My HDL is 45 and my triglycerides are 111. I’m 35 years old. Should I be concerned? What should I do? You wrote in The Power Protein Lifeplan that cholesterol over 250 is, “really high.” You suggest taking niacin and I wonder if that will be sufficient.

    I guess I’m in the minority of people who experience fat-induced lipemia. What should I do?

    • I may benefit from getting familiar with Dr Davis’s Track Your Plaque program ( It requires membership, but the blog is free and if you spend time exploring the related topics in his blog, you will get a lot of information, which includes everything about Niacin. Dr Davis’s program is largely in agreement with Dr Eades’s approach, in my opinion, but it is more focused on heart disease prevention. And yes, Dr Davis is against using statins except in specific cases of APOE4. (I am not a doctor and cannot go into further details.)

  91. Ah drug companies. The quote from the Lipitor insert reminds me of my own prescription for an NSAID that the doctor gave me for an injured foot.

    I looked up the FDA drug monograph read through pages of side effects and then saw this gem, “Doses of xxxxx display a therapeutic effect comparable to therapeutic doses of aspirin,…”

    I asked the pharmacist, “If I can take aspirin without problem and a bottle costs $1, why would I want this drug for $100 since the manufacturer only maintains that it is as good as aspirin?”

    The pharmacist replied, “If I were you, I wouldn’t get the prescription.”

  92. Hahaha! Loved the format. Did anyone else notice the good doctor is missing her outer eyebrows? Get her thyroid checked, stat!

  93. I enjoyed this video and the format worked well for this play-by-play, but it did take ~12 minutes to convey ~4 minutes of information, partly because of the delays between stopping her video & starting yours. So please don’t get the urge to switch entirely from writing to videoblogging – I can skim over written information 3-5X faster than watching a video, and since my time is finite I’d only be able to watch 20-33% of your videos.

    One way to shave off a couple of minutes would be to use closed captioning for some of your short or repeated comments – e.g. explain in detail that statins have no benefits for women etc. the first time and then pause the Statinator and type “Statins have no benefits” (perhaps in TV-Batman-like KAPOW mode) across her face the next time she repeats idiotic dogma.

    You seemed to be watching her video on a separate screen off to your right so we couldn’t see all of your facial expressions. If you were looking at the camera more, some of your reactions wouldn’t have needed to be verbalized, shaving off a bit more time.

    Are statins associated with thyroid or other conditions related to eyebrow hairloss? I couldn’t help but notice that this Statinator’s outer eyebrows were very thin.

  94. A couple years ago I was diagnosed with Hashimoto’s, and my total cholesterol at the time had gone up to 280 (though triglycerides were under 100 and HDL was 79). My PCP put me on Synthroid. All my reading seemed to indicate that I would do better on natural dessicated thyroid, but the doc disagreed and finally referred me to an ENDO to get me off her back. The endo took one look at my cholesterol numbers (which had inched up to 296 by this time) and immediately said she was writing me a prescription for a statin! I told her to go ahead and write it, but I’d never fill it and I’d never take them. We got into a terrible fight, and she insisted every single study showed HUGE benefits for women taking statins. I told her I wanted to try Armour thyroid as all my reading indicated that improper thyroid T4 to T3 conversion was the reason for my high cholesterol. She totally refused, saying she would NEVER prescribe a dangerous drug, and Armour thyroid was dangerous.

    But over the course of the year I saw her my cholesterol climbed up and up each time, we had terribly fights over statins every time I went, she would not consider Armour,

    Finally, through word of mouth, I found a nurse practitioner who was low carb friendly and believed in natual dessicated thyroid. She supported my diet totally, had no use for statins, and prescribed Armour for me, and in 6 weeks my total cholesterol dropped from the 300 range to 196 (with HDL, tris, etc still remaining good).

    My big worry is that I’ve moved to a new state in the last few months, and need to find a new doctor. I don’t want to get into fights about statins and diets all the time, let alone fights about my thryoid condition. But I have not clue how to find a local doctor who will be supportive, and hours of googling have not helped me either. So I just don’t go and pray I don’t need a doctor, but eventually my prescriptions will run out.

  95. Dr. Eades,
    I’ve been doing ProteinPower for over a year now. However, my migraines have become more frequent for some reason and my neuro doc wants me to try beta blockers to see if that helps with frequency. I’m concerned about what beta blockers might do to me long term (currently my BP, chol, tryg are all excellent as of my last physical two months ago).

    Are beta blockers worrisome in your view even if, to this point, I’ve been quite healthy with my numbers?

  96. Dr. Mike.

    I’m a nurse, Masters prepared. I get MedScape and the more I read the original article, the less sense it made. I wonder why this finding didn’t get more coverage in the press. Usually exposing the dangers of a common drug is front page news. .

    I hadn’t seen Dr. Manson’s video. I like your running commentary. Would love to see more. I also noticed her almost constant verbal tics “Um…um…ah..ah…um.” It’s almost as if she didn’t really believe what she was saying but had to say it anyway.

  97. Debbie C.
    Look for a doctor of functional medicine when you move. If you don’t find one, query the naturopaths in the area to find the most “out of the box” MD. I have had to do this as I also need Armour, and will always need a thyroid Rx.

  98. I spent 45 minutes on my dial-up yesterday and was able to view 3 minutes of the video.

    Afterwards, I went off and googled the WHI, and found a number of pages on all the side effects and “disappointing” results of hormone replacement therapy that showed up with the WHI. I had known, generally, about the rise and fall of HRT, but I don’t remember seeing the whole laundry list of bad things, including mental decline. I couldn’t help but compare HRT with statins — widely used, lots of glowing promises, probably on the market before they should have been . . . and then reality starts to rear its ugly head. HRT went down fast. Now people are beginning to discover side effects of statins. Perhaps the real value of the WHI will be bringing to light some of these drug problems that might not otherwise have gone unnoticed, except for the patients affected by them.

  99. Hi Dr Mike,

    First of all i would like to thank you for your blog and books. I first started reading your blog a few months back and motivated me to go back on the low carb way of life. I have read your books and Gary Taubes books and all are very good and in sync with my way of thinking.

    On the statin front I don’t believe such little data ( or cooked data ) has such an impact on medical professionals. Just boggles my noggin. I had a cholesterol test last week and my doc was going to give me a statin because my LDL was high and my triglycerides were low also my HDL was good. I tried to explain the Friedman formula and most likely that was used on my results and that it is probable that I have more type A LDL than type B LDL. My doc said i was talking nonsense. I wanted to get a polyacrylamide gradient gel electrophoresis test but he would not hear of it as is expensive and cant justify in his NHS cost. I am in the UK by the way. As I had good HDL and triglycerides there is no point in spending £300 on a test.

    Oh well!!

    Thanks a lot Doc

  100. Referred to this website by my crossfit gym. They should stick to exercise.

    These are the results of the 4S trial:
    Drug therapy for hypercholesterolaemia has remained controversial mainly because of insufficient clinical trial evidence for improved survival. The present trial was designed to evaluate the effect of cholesterol lowering with simvastatin on mortality and morbidity in patients with coronary heart disease (CHD). 4444 patients with angina pectoris or previous myocardial infarction and serum cholesterol 5.5-8.0 mmol/L on a lipid-lowering diet were randomised to double-blind treatment with simvastatin or placebo. Over the 5.4 years median follow-up period, simvastatin produced mean changes in total cholesterol, low-density-lipoprotein cholesterol, and high-density-lipoprotein cholesterol of -25%, -35%, and +8%, respectively, with few adverse effects. 256 patients (12%) in the placebo group died, compared with 182 (8%) in the simvastatin group. The relative risk of death in the simvastatin group was 0.70 (95% CI 0.58-0.85, p = 0.0003). The 6-year probabilities of survival in the placebo and simvastatin groups were 87.6% and 91.3%, respectively. There were 189 coronary deaths in the placebo group and 111 in the simvastatin group (relative risk 0.58, 95% CI 0.46-0.73), while noncardiovascular causes accounted for 49 and 46 deaths, respectively. 622 patients (28%) in the placebo group and 431 (19%) in the simvastatin group had one or more major coronary events. The relative risk was 0.66 (95% CI 0.59-0.75, p < 0.00001), and the respective probabilities of escaping such events were 70.5% and 79.6%. This risk was also significantly reduced in subgroups consisting of women and patients of both sexes aged 60 or more. Other benefits of treatment included a 37% reduction (p < 0.00001) in the risk of undergoing myocardial revascularisation procedures. This study shows that long-term treatment with simvastatin is safe and improves survival in CHD patients.

    Simvastatin saves lives for people with heart disease.
    Your statement above to the contrary is wrong.
    I am a cardiologist.
    Based on this data, I have to treat 27 people for 5 years to save 1 life. It doesn't sound like much, but I have a few thousand people in my practice. By treating 1000 patients for 5 years, I save 37 lives. Thats one person I save every 2 months by taking this simple pill. Like it or not, those are the facts. If you don't want to take it, don't take it. But don't believe the crap on this website. All these drugs are generic now. Doctors don't make money by prescribing them. Not everything is a conspiracy. If modern medicine doesn't help, then why is cardiac mortality down 60% in the past 60 years?

    • Well, now you’ve heard from me, and you’ve heard from a statinator in full bellow. Make your choice wisely. I would recommend reading The Cholesterol Delusion by a cardiologist before choosing to see what another cardiologist has to say.

      I particularly like Dr. Curtis’s (the cardiologist author of The Cholesterol Delusion) commentary on taking these drugs that have no proven benefit. He writes after discussing the numerous known side effects of statins:

      As severe as some of these short-term side effects can be, they pale into relative insignificance when compared to the potential long-term problems. The chief difficulty here is that no one knows what the long-term effects may be from altering the basic biochemistry of the human body over a period of time. Because cholesterol is the key element in the formation of cell membranes, which are the protective coat for the cells, it may be that blocking cholesterol’s production will weaken the protective barrier and allow the entry of toxins or carcinogens that were previously excluded. There are disturbing reports of increased cancer in some cholesterol-lowering studies, but, in fact, this process may take many years to play out. It’s enough at this point to acknowledge that the long-term effects are completely unknown. This is a risk that should receive serious attention before half the population is placed on these drugs, that, in effect, accomplish nothing more than low-dose aspirin or an extra glass or two of water each day.

      The doc commenting above (assuming he is a doc) is fiddling with a concept called numbers needed to treat (NNT). He needs a little schooling in his calculations of NNT. He can learn it here:

      What NNT means.

      When he learns about it, he can make the following calculations:

      Statin NNT figures

      Or if he doesn’t want to go through these intellectual exercises, perhaps he can go back to the top left of this post and read the Lipitor package insert to see what the promoters of this drug have to disclose. If he doesn’t believe that’s the actual package insert, he can go to the Lipitor website and pull it down. That’s where I got it.

  101. Have you done any research about Lipomas?
    I have followed a paleo diet pretty closely going on 2 years and it has not reduced any lipomas yet. There are no new ones but I have searched online for more info and can not really find answers.
    Can you help direct me? I would gladly read more but there is not much info out there regarding why they appear and how to dissolve them.
    Thanks for any help,

    • I haven’t read any recent research about lipomas, but I have surgically removed my fair share of them. They are small (usually, though I have taken out a couple of whoppers), benign fatty tumors that are well circumscribed and easy to remove. I wouldn’t think a diet – low-carb or other – would have much effect on them. Maybe a little reduction in size but no more reduction than in overall fat mass reduction. And that’s just a guess on my part because I did all my lipoma-ectomies before I really got into the treatment of obesity and related disorders.

  102. None so blind as those who refuse (choose not) to see. I was enlightened by Chris Masterjohn, the Weston A. Price foundation (The Healthy Heart special edition of Nourishing Traditions), Alan Watson (21 Days to a Healthy Heart) and Dr. Graveline (The Statin Damage Crisis and Lipitor: Thief of Memory). As Ray Peat stated: “Once we accept that knowledge is tentative, and that we are probably going to improve our knowledge in important ways when we learn more about the world, we are less likely to reject new information that conflicts with our present ideas.” Dr. Phil, I believe that the only benefit of a statin is to reduce inflammation, which can be done in other, safe ways. You can believe what you choose to believe, but in my opinion, if you really want to help people get and/or stay well, you should look into this a little deeper.

  103. Hi Dr. Eades, the Statin NNT link that you provided shows data for patients with out CHD, but the cardiologist is referencing NNT numbers for patients with CHD.

    • I know. But I also know that statins are worthless for women, and if this guy is any kind of statinator worth his salt, he’ll have women on the drugs as well as men. If so, his numbers, which he overstated anyway, will be much smaller. I’ve said all along that, as a group, men under 65 with diagnosed heart disease (not just risk factors – there is a difference) are the only group shown to have achieved a slight but statistically significant decrease in all-cause mortality. Were I in this group, which I’m not, I would still think twice about taking a statin because of Dr. Curtis’s caveat about the long-term effects of fiddling with a basic, and important, biological process.

  104. Dear Dr Eades,
    First, forgive me for putting this here, I wasn’t sure if I posted it in an appropriate, but several-years-old blog, if it would be seen.

    I don’t know if you are still looking for feedback/testimonials from readers who have tried Metabosol, but I wanted to share with you my first month’s experience with it. BTW, I just placed an order for 3 more canisters.

    I’am a 52 year old female. I was an overweight child, and I’ve been obese my entire adult life, except for the few times I’ve managed to starvation-diet my way down to a normal size… None of those times did I maintain it for very long, totally my own fault for thinking I could return to my old carb-addict eating habits.

    In 2001, I was diagnosed with type II diabetes. I tried low carb a couple times, knowing and believing that it was the best diet for lowering blood sugars, but I never lost more than a couple pounds on low carb in any of those failed attempts, (I so wanted to believe the “don’t count calories” thing, but Dr Atkins underestimated how much I can eat, when given permission to eat all I want) and would soon quit. Over the next 4 or 5 years, I kept my head in the sand as my weight increased and my health deteriorated.

    By 2006, I was a walking pharmacy, injecting Lantus, along with taking Lovastatin, Lisinopril, Glucophage, Actos and Glipizide by the handfuls. (I could have been in that ACCORD study!) My doctor and diabetes “educator” were both very anti-low carb, telling me that “Atkins diet had actually killed people” and I would “damage my liver and kidneys”, etc. etc. And then he would up my drug dosages or add a new one. It got to the point, where I was so weak and suffering so much muscle pain, that I seriously wondered how much longer I was going to live or if I even wanted to (primarily the results of the statins, I now know, but that’ another long story).

    I decided to give low carb another try in August of 2006, after a call from my doctor’s office telling me my A1c was 10.1. I knew I had to do it to save myself from the diabetes and improve my health, even if I didn’t lose much weight (I was 310 pounds at the time).

    This time, I did food tracking and calorie restriction, and “shocker” ;-), the pounds started to come off. I wasn’t hungry, I wasn’t struggling or employing Herculean amounts of “will power”. I hate exercise and didn’t force much of that on myself either… I was just eating a diet of healthy foods, at ratios of about 1600 calories, 65% fat, 25% protein, 10% carbohydrate (according to Over a period of 19 months, I went from 310 to 178, got off all the drugs, had normal blood pressure, trigs of 82, HDL of 99, and A1c of 5.1. It was like a miracle! I had a life again! I loved the way I was eating, didn’t want to change a thing, thought “this is it, I can do this for life”!

    Then menopause hit, and it all stopped working. Now I can tell you, I’m an active member of a large low carb forum, and I can remember while I was losing, reading posts from menopausal women complaining they couldn’t lose, and thinking “yeah, right. Go eat another Ding Dong…” Oh my, I was so righteous! I didn’t believe them at all. And then it happened to me. No matter what I did, I couldn’t stop the pounds from creeping back on. I was willing. I was able. I didn’t really have issues with hunger or cravings, I could stick to the plan (while I was losing, I went a solid year without a single cheat!)… it. just. didn’t. work! (I did see a homeopathic doctor who diagnosed me with low thyroid, but he didn’t accept insurance and I soon ran out of money. My mainstream, insurance accepting doctor said my thyroid test results were normal, and wouldn’t prescribe anything.) Over the last 3 years, I have watched the scales creep up and up until I was within 30 pounds of my 310 starting weight. Hourly hot flashes were ruining my life, so I began bio-identical hrt about 7 months ago. (I throw that in, because I don’t know how much getting my whack hormones balanced out has factored into what has changed)…

    After pretty much abandoning low carb eating all during the last holiday season, and with daily blood sugars running in the 300’s, I decided to resume a strict low carb way of eating, even if I didn’t lose a pound, once again just to save myself from the diabetes. I began January 6. Other than hrt, the only thing I did different this time, over all the failed attempts of the last few years, was added Metabosol. And here we are, 1 month later, I’ve lost 17 pounds! That’s more (by 3 times) than I’ve been able to lose in dozens of attempts over the past 3 years, no matter how hard I tried!

    I guess for a true test, I would need to stop the Metabosol for a month and see if my weight loss continues, but I’m not willing to do that, I’m sold!

    Dr Eades, the nerd in me was wondering what the actual action of Metabosol is, and the only thing I could find was this statement elsewhere in your blog:
    “may increase futile cycling in the hepatic cells and might, more or less, uncouple oxidation from phosphorylation, which would increase energy expenditure and bring about weight loss. ”
    Could you please put that in layman’s terms for me? I am particularly interested in whether this product would be of assistance to those following any kind of calorie restricting diet, or if there’s something special about the combination of ingredients that make it only effective when eating lots of fat. NOT that I plan to switch to a low-fat diet, heaven forbid!

    Thank you for your blog and all you do! You’re my go-to guy whenever I’m looking for the truth.

    • Thanks for your story. I can’t say for sure whether your good results are coming from the natural hormone replacement therapy or the Metabosol or both. I can understand your not wanting to stop either one to see which is the causative factor.

      There is no simple explanation as to how Metabosol works, but I’ll try. When you eat food, the energy in the food gets converted in a step-wise fashion into high-energy electrons. These high-energy electrons drive a complex system in the mitochondria that ends up creating ATP, the energy currency of the body. Metabosol makes this system less efficient so that more high energy electrons are required to produce a given amount of ATP, which means more energy in the form of food or body fat has to be provided to the mitochondrial system to produce the ATP. Metabosol contains one component that helps send a signal that you’re full to the brain, so you don’t eat as much and therefore this excess energy comes from body fat.

      As I said, there is no really simple explanation unless you really understand how the mitochondrial production of ATP works. Believe it or not, but I’m actually working on a post to demonstrate this. Once I have it written and posted, it will be easier to understand how Metabosol fits into the system and does its job.

      I don’t know if Metabosol works with simply a calorically restricted diet. We tested it with a low-carb diet, so that’s all I can really comment on.

      Keep up the good work.

      • Mike, your explanation seems to indicate that one of the ways Metabosol work is by uncoupling ATP production in the mitochondrion. I studied UCPs in the past, mainly in mice where there is abundant UCP1 in brown adipocytes (which existence in adult humans is still debated… a recent Swedish paper seemed to show that there may be more brown adipocytes in adult humans than we thought but I haven’t seen a lot of published work on this that refer to humans). White adipocytes have more UCP2 and UCP3, which some say may be involved in weight regulation. Many years ago, when Pentabosol was out (and I didn’t know too much about UCPs), I thought that one possible mechanism of action of one of the ingredients could be by inducing futile cycles (mainly at the level of the Krebs cycle… something like making the cycle short in either malate or oxaloacetate), so that more metabolites would be needed in order to produce the same amount of ATP. A little different than uncoupling but potentially effective.

        Of course, maybe the actual mechanism involves a little of uncoupling and futile cycles, which could be a synergistic effect of the components of Metabosol.

        I look forward to your upcoming post on this!

          • I thought you’d find this article interesting.

            The abstract concludes “basal mitochondrial substrate oxidation is increased in the muscle of endurance trained individuals yet energy production is unaltered, leading to an uncoupling of oxidative phosphorylation at rest. Increased mitochondrial uncoupling may represent another mechanism by which exercise training enhances muscle insulin sensitivity via increased fatty acid oxidation in the resting state.”

            Since there are strong parallels between the metabolic changes in endurance training and carb restriction, I wonder if carb restriction alone produces a similar change. As far as I know, no one has looked for that.

  105. I wonder if the cardiologist would care to comment on the following: HPS-same drug, more people, half the AR reduction (1.7%) Other secondary trials(LIPID, CARE) also showing much lower AR reduction. Or, how about all secondary trials since 2005 showing no benefit, a big bust!! Dr. Curtis has it right: low dose aspirin will accomplish the same thing. Also, 97 clinical trials showing omega-3s provide much greater AR reduction in CVD and all-cause mortality.

  106. @Scott: On that same NNT website, they have the NNT for people with CHD. NNT for a reduction in mortality:83. Absolute risk reduction for mortality 1.2% (again, fish oil, aspirin, etc.) AR reduction for a repeat heart attack: 2.6%. Very unimpressive numbers. You should also read what the authors have to say about the numbers.

  107. Your commentary is very useful, please do it more. The question I came away with is “could the statins I’m on inhibit reducing my Diabetes II?” The same day I was diagnosed with Type II and put on blood sugar control medication I was also put on blood pressure reducers and a statin, ‘though some have been changed by my latest primary care provider. Maybe I should cut the statin and not worry about cholesterol levels. The problem is how to get a member of the establishment to condone such an action.

  108. @Ned,
    Don’t take the statin. Take some fish oil instead — it’s more effective. And absolutely go on the protein power diet. Your cholesterol will go way down, and your Diabetes will improve immediately. If you’re taking drugs for the diabetes, you will need to work closely with a doctor to avoid overdose issues. I’m guessing if you asked Dr. Mike for a doc recommendation in your area, he could help with that. He won’t be able to give you medical advice on the internet, of course.

  109. Dr. Eades

    Greatly enjoying your articles, esp. the two-parter on restarting low carb.

    Somewhat off-topic question: My 72 year old diabetic dad wonders if a consistently rigorous low carb diet could so condition the pancreas to underproduce insulin that it could become “stuck” in an underproducing mode, even if the diet should change back to higher carb intake?

    I’ve never seen the possibility even addressed anywhere else so I direct this hypothetical to you. Thanks for any input I can share with him.

    • @Don,
      there always has to be enough glucose in the blood, even on low-carb, so there is always a requirement for insulin, so the pancreas cannot ever fall asleep, it can just be less overworked.
      Also, insulin is needed to disburse amino acids from protein as well as sugars. So you can never get into an underproduction state.

  110. ‘According to the statistical analysis of the authors, being on a statin increased the relative risk of developing diabetes by 48 percent!

    These were observational studies and, as such, can’t be used to determine causality.’

    Could have been the total sum of information about this drug.

  111. Hi Ronald,
    in my life I was doing many things on most of our continents and I worked with people in many cultures. and despite all the huge cultural differences people are not so different in any places. many yeas I spend in research until I simply gave up and now I am working in a industry were the daily BS is so overwhelming it is almost unbearable too. therefore I asked my self exact the same questions for many years. the answer was told me in a small-talk by a very unlikely person:

    “no one join the communistic party because he is evil and no one stay in a communistic party because he is good. the few how left the party are my friends”

    it is so simple. people do not change, we are what we are. with or without enlightenment our nature do not change: not over time and not under cultural pressure. take a look to the history books: Bruno got burned because he sad the sun is one of many stars. Galileo got almost killed too. you think this is so long ago? Radon was used for health beneficial treatments (also for making the hair thicker :-), heroin was given to children before bedtime and the same substance was used to treat addiction to morphine, people were blaming ice cream for being the root-cause for polio. you remember asbestos? many people still believe Rudy Giuliani cleaned the streets from crime…

    if you take time and remember how many things from your life in the in the past sound now ridiculous you will be not surprised about what is going on now in science.

    I simply lay back and wait until the next soup bubble burst… the most delicious part on this is then the many people who appears from everywhere with the words: “I told you so…” but were are they now? 😉


  112. Hi Dr Mike,

    First of all i would like to thank you for your blog and books. I first started reading your blog a few months back and motivated me to go back on the low carb way of life. I have read your books and Gary Taubes books and all are very good and in sync with my way of thinking.

    On the statin front I don’t believe such little data ( or cooked data ) has such an impact on medical professionals. Just boggles my noggin. I had a cholesterol test last week and my doc was going to give me a statin because my LDL was high and my triglycerides were low also my HDL was good. I tried to explain the Friedman formula and most likely that was used on my results and that it is probable that I have more type A LDL than type B LDL. My doc said i was talking nonsense. I wanted to get a polyacrylamide gradient gel electrophoresis test but he would not hear of it as is expensive and cant justify in his NHS cost. I am in the UK by the way. As I had good HDL and triglycerides there is no point in spending £300 on a test.

    Oh well!!

    Thanks a lot Doc


    • The indifference or lack of curiosity of physicians, not mentioning the hostile ones, is really appalling. What school should teach is to be curious, ask questions and know how to research and think for yourself. Analyzing and comparing information is fundamental for keeping an open mind. Here in Italy it is like physicians have blinders on.

      Thanks for keeping a curious and seeking group of individuals informed.

    • “On the statin front I don’t believe such little data ( or cooked data ) has such an impact on medical professionals. Just boggles my noggin.”

      And yet, a poorly-done study convinced almost all doctors that we need statins galore.

      The difference? The pharmaceutical industry had their thumb on the scale. Unfortunately for all of us, there isn’t a countervailing financial interest.

      Just my opinion…

  113. Here’s the BPA/insulin study. Sorry if someone else already posted the link, I didn’t read all the posts carefully. The study is fairly impressive, a doubling of the insulin response.

    Really liked the video format. The instruction has great immediacy, not to mention the down-to-earth quality of your vid vs. the stepford wife quality of the spin doctor. Loved the face palms most of all!

  114. This method of commentary….real time insert on the subject video…is EXTREMELY effective.
    Please continue it.
    My own case…LAD 75% blockage, double bypass CABG operation.
    Subsequent diabetes from 80mg Lipitor.
    Extensive research on my part followed.
    Initiated a low carb diet, took myself off statins, lost 14 lbs, ramped up road bike to 1000 kms/month.
    Cardiologist and GP went ballistic.
    Changed cardiologist and GP.
    Insisted on GTT 3 months later which returned 7.2 mmol/L
    (Normal is < 7.8)
    New medicos less strident but insisted on Crestor replacement.
    Foolishly I agreed to try …on understanding that any noticeable change in BG and I was off statins permanently.
    Blood glucose levels went through the roof.
    Took myself permanently off statins.
    THis time it took 9 months diet/exercise to get my BG back to normal.
    My only medication now is 100 mgs Aspirin daily.
    Current BP 120/60 BG < 100 mg/dl Resting HR 45.
    Near daily ride on bike my HR Average is 118 peaking at 153-155.
    I am 70 years young.

  115. Just started reading another book called ‘Ignore the Awkward’ by Uffe Ravnskov. He does a good job of taking apart all the statin trials as well…

  116. this is exactly the way to help the lay public understand and evaluate main stream medicine advice. I encourage you to continue this format… it is hugely helpful.

  117. Dr Eades,
    This topic is something I have been looking into for the last 7 years, since I developed angina at the age of 43. The cardiologist I consulted told me I had “indigestion”. I insisted on getting a heart scan, which revealed a single plaque in the LAD for a calcium score of 51. I initiated a no wheat diet and niacin, but refused statins. 18 months of so later, my score was 69, for an appox. 18 percent yearly increase. Better than the 30 percent that is normal, but not good enough. I then restricted carbs even more, and started on Cialis (it moves LDL in the larger particle direction, with none of the negative effects of the statins). My last scan revealed growth to 95, a 12 percent yearly increase. I do have very high Lp-PLA2 and high CRP levels, so I am going to try low dose crestor intermittently to lower the inflammatory markers (I take plenty of fish oil and Vit D, BTW). My theory is that if I tamp down inflammation periodically, it will stay down as I believe it is self reinforcing. I think one has to take control of their own medical destiny and not listen to any doctrine. Each group seems to get stuck in its own intellectual hole, whether it is allopathic or natural medicine. My goal is to find out what works. Serial CAC testing gives a heart disease patient critical information about disease progression for which there is no substitute.
    I believe many people are placed on statin therapy who have no heart disease whatsoever. An inexpensive heart scan could easily separate those who need therapy from those who don’t. I believe many people could attain zero growth without statins or with very minimal use. As always, seeking the truth is the best way to go.

  118. Dr. Eades,

    Loved your realtime commentary on Statins, hope you will continue.
    First time I’ve participated in an online site, but I wanted to add to other comments that doctors have insisted I stay on statins even though I’ve had liver damage in the past from Hep A, when my lab @s were in the thousands.

    Last doc insisted I go back on Lipitor because of high serum lipid numbers, especially TRIs, and it did bring
    my numbers down. However I’ve had pain in the area of the liver and recently took myself off Lipitor. I will be seeing a new Primary doc (Kaiser) next month, and I doubt he will be on board with my recent attempt to change to LCHF. I do have one question I’ve been afraid to ask,
    I’m a 78 y old female with diabetes,HBP, high lipids,
    etc. Am I too old and damaged from Ornish,and other vegetarian diets to receive benefit from this LCHF life style? I’ve been on it about 6 weeks,have lost some weight in all the wrong places, arms, legs, gaunt face, ribs showing, but still have my wheat belly, (height 5’4″
    wt 123) I now eat fish a couple of times a week,, but as yet can’t bring myself to eat other meat (I’m working on my attitude re: land animals as food source), and will read Keith’s book soon. Sorry for the length of this post, I just hope in your practice you have saved patients my age and condition. Thanks, and BTY a few libertarian comments would be just fine with me.

  119. Didn’t realize my full name would be on post – wasn’t paying attention I guess. Could you just post as JeanieL?


  120. Hi Dr Mike, I just found your blog and it’s very interesting. In January I started a primarily plant-based diet to lower my cholesterol. My numbers have dropped along with my weight but my doctor still thinks I need to be on pravachol due to family history of diabetes. I’m really balking and want to continue with my new diet. The doctor said I’m eating too many beans and I should eat some meat sometimes. I’m a 51 year old healthy female and she hasn’t convinced me that I need to be on a statin. Here are my recent numbers:

    tc 224 (down 18%)
    trig 226 (down 13%)
    hdl 38 (worse. was 41)
    ldl 141 (down 22%)

    A1C 5.9
    BG 83

    Also, I had a calcium cardio test in January and they found one tiny spot. I’m pretty clean inside and this is part of my rationalization for not taking the statin. It just doesn’t seem necessary.

    • Tell your doctor that statins have never been shown to decrease all-cause mortality in women of any age and with or without diagnosed heart disease. Ask him/her if elevated cholesterol is a disease or simply a lab finding.

  121. thanks for the work.

    at one point, she mentioned this should lead “early diagnose” (of diabetes).
    you forgot to mention, that more people will be on another drug (statin + whatever for diabetes).


  122. Good article. I’m of the strong opinion that no one should take statins ever. Just as an example of how aggressive most doctors are to push these dangerous drugs I once had a doctor try to prescribe statins to me with the excuse that I was diabetic and all diabetics should be put on statins to “protect them from heart disease” At that time I had an A1C of 4.3, Total cholesterol of 138, 75 LDL, 47 HDL and 80 triglycerides. This was the highest my cholesterol has ever been. After this it’s been as low as 106 and my A1C as low as 3.9 all due to a very low carb, high fat, moderat pretein diet. Let food be your medicine and don’t buy into the cholesterol hype. By the conventional wisdom I should be dead from the amount of eggs and butter I eat, but my labs are proof.

  123. I also enjoyed your commentary. It’s a shame that you wont hear anything like it in the mainstream media. I am just glad that we the net so if you look hard enough and weed through the B.S. you can find the facts.

  124. Very interesting article. I’m a 62 year old male with cholesterol at 170, HDL at 45, Triglycerides at 45 and LDL at last test at 119. I have rheumatoid arthritis and diabetes (hba1c of 6.7 at recent test – am not on diabetes drugs).

    My GP wanted to put me on statins when she saw my LDL at 119 (all previous tests had put in in the 103 range). My endocrinologist then chimed in and suggested it as well, indicating that my numbers didn’t matter, that it was the mere fact that I was 61, a male, and at risk for heart issues (RA and idabetes).

    I take 2-4 grams of Fish Oil daily (Barleans), CoQ10 (100mg).

    I don’t get it – seems like my numbers are decent and to me the real question is what kind of particles do I have ? the big fluffy ones or the small, dense ones? I also am on a Paleo diet now, which I expect will further lower my HBA1c.

    I was somewhat taken aback that for the endo doc, it was just simply a matter of my age, that I was male, and that I had diabetes. He suggested I go to the ADA site and read the supporting documentation.

    Your thoughts, Dr Eades?


  125. Pingback: Thursday’s WOD
  126. Mike!

    Wow — that was one of the most annoying videos I’ve ever tried to watch. Your interruptions didn’t help, but NEITHER of you made any sense.

    Remember the absurd news story that came out saying people who drank diet soft drinks were more likely to have metabolic syndrome and all sorts of other probelms?

    Well duh! People who drink diet soft drinks tend to be overweight, right? (Compared to those who don’t drink them. Otherwise, they wouldn’t drink them.) So OF COURSE they are more likely to have those problems.

    Isn’t it the same with people who are already on statins? They are a higher risk group for developing diabetes and CHD, or else they would not be on statins.

    Yours was a completely spurious argument. Her suggestion that those people might be at higher risk was too.

    Bottom line: This study says NOTHING about the relationship between statins and diabetes.

    Missed that one buddy.


    • You’ve obviously missed the point of the entire study. I would suggest you go back, reread it, indulge in a little critical thinking then come back to the discussion.

    • Richard Shaffner:Bottom line: This study says NOTHING about the relationship between statins and diabetes.
      Using your terminology “Hey Buddy” I say in the nicest possible way…
      Try doing a little research.
      Ask people who may have direct knowledge….like myself.
      I was placed on statins.
      Because it was the done thing following a heart operation ….which I had for a 75% LAD blockage.
      I was otherwise very fit at the time and the blockage was a one-off…..which resulted in chest pain.
      I never progressed to a heart attack.
      The statins elevated my normal level blood sugars in to the serious diabetic range.
      I knew they were historically normal because my profession required 6 monthly checks and I noted the results.
      After considerable research …including Michael Eades’ website… I elected to go off statins much to the highly vocal annoyance of my GP and Cardiologist.
      My blood sugars returned to normal.
      I changed GP and Cardiologist…..who pleaded with me to go back on a different statin….Crestor as opposed to a higher dose Lipitor.
      Conceding that highly professionally qualified people would know a lot more than I did, I agreed….for a trial period, because I was personally convinced that statins were a problem for me .
      As I consistently stated I could care less whether they were a miracle drug for others , they were a nightmare for me….and blood sugar was only ONE of the problems that drug caused.
      Guess what…my blood sugars skyrocketed to a serious diabetic range again.
      I quit statins altogether and now take NO medications apart from low dose aspirin.
      It took 9 months of diet and serious exercise to get my blood sugars back to normal the second time but now they are the level of a healthy 30 year old….I am 71….totally normal, not even faintly diabetic.None of the other problems re-occurred either.
      “Missed that one buddy”
      Yep, you sure did.
      There is a distinct relationship between statins and diabetes.
      The figures have always been there.
      They have been ignored , but they have always been there.
      $30 billion+ a year buys a lot of propaganda

      • John,

        First, I’d like to apologize to you and everyone who reads this blog for my the tone in my first post. I was in a sour mode and went off half-cocked. I’m not proud of that. Sorry.

        Second, I want to thank you for sharing your story. I’m sorry for your travails and congratulate you on your success. Seriously. That was quite an ordeal.

        I’ll have some other responses to the points Dr. Eades makes below, but I’m not about to try to tell you anything contrary to your experience. I think rule #1 is that each of us shoulf to tune-in to what works for us. Obviously, you have done that. Way to go.

        Actually, I found this blog because I’m wondering if I have statin-induced myopathy, so I was reading up on it. I’m trying what you tried — suspending the statins, working out, and losing weight on a no-carb diet. I hope I’m as successful as you have been!



        • Thank you for your last post.
          I suggest we file all previous posts under “enthusiastic response” …which requires no apology…and move on to matters that are of mutual benefit.
          I am quite strident on statin contra-indications…for me.
          This is quite important.
          I would never recommend others follow my experience without a comprehensive review of their particular circumstances with a GP that is open to ideas…unfortunately such GPs are thin on the ground.
          There is a huge amount of information on the internet from professionally qualified people that can be used to ask intelligent questions of your GP.
          If your GP feels affronted / threatened by this find another GP.
          But there is one area where we, as unqualified people, can go full throttle and that is diet and exercise.
          A low carb diet is essentially a lifestyle change and an exercise schedule can be as low as 30 minutes but must be a daily effort.
          The results can be extraordinary , but having lost 15 pounds you already know this.
          I never completely exempt certain items…too unrealistic…but jump on the bike (stationary or road bike) and work off the calorie infringement.

          • Thank you. I agree completely.

            I once had a GP that cursed the Internet and lamented having so many patients that “read-up on their own and thought they knew something about medicine.” My father was an MD and a professor at a med school. He felt completely differently — he wanted his patients to be as aware and informed as possible.

            Needless to say, I dropped that GP pretty fast.

            About carbs… I think it all depends on the individual. Clearly, many people handle carbs just fine. It also seems clear to me that many don’t (including me). I no longer believe that there is “one right diet” for everyone.


  127. (That is, her suggestion that those women on statins might be at higher risk for developing diabetes, because of the statin, is absurd. And irresponsible.)

  128. Mike,

    Thanks, I’ve read the abstract and I get their point well. Sounds like I should make my point better, though.

    They are saying there’s an association between those women taking statins and their later getting diabetes. My point is that is to be expected.

    (1) There is a well-known high positive correlation among those with “bad” cholesterol, those with metabiloc syndrome, those with pre-diabetes, and those who later get diabetes.

    (2) Those on statins must have “bad” cholesterol numbers, or else they wouldn’t be on the statins. (The statins may help with cholesterol, etc., but they do not slow the progression of metabolic syndrome to diabetes.)

    So of course people on statins, as a group, are more likely to develop diabetes, because many of them are likely to already have metabolic syndrome.

    So, my point is there is no risk from statins that Dr.Manson should people about, at least not from this study.

    Consider another example: I bet there is a high correlation between those who buy diet books, and those who later are diagnosed with weight-related health problems. Of course, that’s because both are correlated with being overweight. Should we then warn these people about the health risk of buying diet books? That conclusion would be just as absurd.

    Thanks for indulging my input on your blog. I won’t belabor the point further. (And I like your book about middle-aged dieting.)


    • Hi Richard–

      First, sorry about my tone in my first response. I must have been having a bad day.

      I do understand your point. But the researchers looked at this very issue using an analytic technique called propensity score analysis to ensure that the risk factors for diabetes were accounted for.

      Those with metabolic syndrome are at risk for developing obesity as well as diabetes. But in an interesting finding, it appears that women who weighed less were more prone to develop diabetes than those who weighed more, which doesn’t follow the typical pattern.

      Women with a BMI lower than 25.0 were at greater risk for new-onset DM than those with BMI of 30.0 or higher, who seem to be at lowest relative risk among BMI categories.

      The bottom line is that this is an observational study and can’t be used to prove causality. Which point I made in my video commentary. All the really valid trials on statins show that these drugs provide no benefit to women whatsoever, yet many thousands of the women who were accepted into this study were already on statins. Why? Because the statin makers have done a superb job in indoctrinating physicians so that any patient they see who has the least elevation of cholesterol and/or LDL leaves with a statin prescription despite evidence that such drugs will be effective.

      Now comes this study showing statin use perhaps does increase the risk for developing diabetes. Due to the observational nature of the study, we can’t say it does, but there is enough evidence showing a correlation so that it should be examined in a real randomized control trial to determine causality. And, in my view, it is unconscionable that doctors – who should know better – put female patients on statins, a drug known to cause memory issues, muscle pain, and risk of death, when those drugs have never been shown to produce benefit in that patient population and now may even cause diabetes.

      I was appalled that the physician in the video made the point that just because this study showed a correlation, physicians should not take their patients off statins.

      • Dr. Eades,

        Thank you. You are being very gracious, but I’m the one who owes you and your readers the apology.

        I was in a sour mood and went off half-cocked. I tried to make it sound light-hearted, but ended up sounding like a troll. I’m sorry.

        About your comments…I definitely agree with your point about this being an observational study, and that it can’t be used to prove causality. As you note, all it can be used for is to help identify connections that are worth further study.

        But, sadly, everyone goes further. Many people will bail on statins because of this, or just get frustrated and confused. This study is only good enough to suggest further studies, but many other things will come from it — good or bad.

        Don’t get me wrong about statins — I’m not a big fan and I’m suspending mine for a while to see if my muscles feel better than they do on them.

        But what I’m REALLY not a fan of is how some researchers, the press, the FDA, some doctors and many of us patients are so quick to jump to conclusions.

        The glaring example that I’m tuned-in to now is how everyone blamed dietary fat for so long. Now all the good research and the up-to-date doctors are saying a low-carb diet is better for improving hyperlipidemia and reducing one’s chances for metabolic syndrome and diabetes. How many millions of people have received the WRONG advice, for decades?

        You are right, of course, to point out that the researchers in this study used propensity scores to try to control those risk variables. But I question those propensity scores, how accurate they are, and how well they controlled for all the right variables.

        For example, during the time of the study, weren’t all doctors that prescribed statins also telling their patients to eat a low-fat, high-carb diet? And now doesn’t the latest research suggest the opposite, that such a diet actually works against hyperlipidemia and one’s chances for developing diabetes?

        So, it’s reasonable to assume that many statin patients were also adjusting their diets — in the wrong direction. What effect did that have? Would that alone explain the different observations in diabetes? I bet the researchers didn’t “control” for that. (Many still refuse to accept the recent research that implicates carbs and not fats.)

        Personally, I’ve decided not to “buy” the conclusions from any of these obvational studies. This study that implicates statins as a risk factor for diabetes is no better than the many studies back in the 1960’s, 70’s and 80’s that implicated dietary fat for hyperlipidemia and heart disease. At least, that’s how I see them.

        That was really my point. Sorry that I did such a poor job of making it.

        Thanks again,


  129. I’ve tried CoQ10 off and on, while on 20 mg simvastian and not. I have friends and family that say it helps them, but so far, I’ve not been able to tell any difference.

    I also tried the special water-soluble CoQ10 — still no difference over the first few weeks.

    Mainly I’m trying harder to improve my health so I won’t need a statin (even according to my doctor). Your “middle aged” diet has worked well for me (thank you).

    Now I’m following the approach that has worked so well for Peter Attia — more exercise and no carbs (other than those in nuts, veggies, etc.). I love eating protien, but I think I’ve often overdone it, interfering with my ketosis. Now when I’m hungry I just eat more high-fat food.

    I’ve lost 15 pounds and feel great!

    Thanks again!

  130. Excellent as always especially the video. You and your blog played a big role in my decision to take my elderly mom off of statins. Thank-you very much for speaking the truth. I just ordered The Cholesterol Delusion from Amazon.