I’m sorry if I’ve been a little less than diligent lately with getting new posts up and comments dealt with in a timely fashion. Tim Ferriss, author of the bestselling 4-Hour Workweek and popular blog of the same name, asked me to put up a post on his site. I put up an updated version of the “is a calorie just a calorie?” debate post, which was hit with numerous comments. Tim asked if I would deal with a few of the comments, which I did. It was fun, but it took some time. If you get into an argument with a hostile vegetarian you ought to take a look at comment # 73 and comment # 84 , my response. This will give you some hard info for your dispute.
I’ve sprinkled a couple of other comments in as well. All this – along with the book project – have kept me from my own blog. I wrote at the end of the last post that the next post would be a follow up on the Swedish study. I’m working on that post now (which will be the next post), but I wanted to get up some information that is a little more current. Information about one of my favorite subjects and least favorite drugs: statins.
Looks like Robert Jarvik has gotten into a little trouble. The fact that he passed himself off as a practicing physician (he had a medical degree but he has never taken the training or certification necessary to actually practice medicine) and an accomplished rower (he doesn’t row – a body double was used in the ads) has gotten the ire of a congressional committee. According to the New York Times
The House Energy and Commerce Committee has been looking into television ads featuring Dr. Jarvik. The committee disclosed that Pfizer had agreed to pay Dr. Jarvik at least $1.35 million under a two-year contract that expires next month. John D. Dingell, the Michigan Democrat who is chairman of that committee, raised questions about Dr. Jarvik’s credentials to recommend Lipitor.
And from an earlier NY Times piece
“It seems that Pfizer’s No. 1 priority is to sell lots of Lipitor, by whatever means necessary, including misleading the American people,” Mr. Dingell said.
Duh. You really think so?
Now, apparently Pfizer has changed its ad to ones identifying Jarvik as the man who invented the artificial heart. But that, too, is causing problems.
The committee has also contacted at least one former colleague of Dr. Jarvik’s who contended that he was not the actual inventor of the artificial heart, as stated in the ads.
In a letter to Pfizer in August 2006, three former colleagues of Dr. Jarvik’s at the University of Utah complained that the ads erroneously identified Dr. Jarvik as “inventor of the artificial heart.” That distinction, they said, should go to Dr. Jarvik’s mentor, Dr. Willem J. Kolff, and his associate, Dr. Tetsuzo Akutsu.
My bet is that Pfizer will ditch him altogether and start fresh with a new sales approach. I’m sure that Dr. Jarvik will be sad to see his $1.35 million contract evaporate. But his sadness will be more than compensated by my happiness at not having to see his face again.
On another note, it appears that while statins are taking heat on all fronts that everyone is jumping in and getting their kicks in. It’s hard for me to hide my glee.
Last week the Wall Street Journal weighed in with a piece (requires paid subscription) on the front page of their personal journal section describing the negative effects statins often have on the brains and cognition of those taking them.
Cognitive side effects like memory loss and fuzzy thinking aren’t listed on the patient information sheet for Lipitor, the popular cholesterol-lowering drug. But some doctors are voicing concerns that in a small portion of patients, statins like Lipitor may be helping hearts but hurting minds.
“This drug makes women stupid,” Orli Etingin, vice chairman of medicine at New York Presbyterian Hospital, declared at a recent luncheon discussion sponsored by Project A.L.S. to raise awareness of gender issues and the brain. Dr. Etingin, who is also founder and director of the Iris Cantor Women’s Health Center in New York, told of a typical patient in her 40s, unable to concentrate or recall words. Tests found nothing amiss, but when the woman stopped taking Lipitor, the symptoms vanished. When she resumed taking Lipitor, they returned.
“I’ve seen this in maybe two dozen patients,” Dr. Etingin said later, adding that they did better on other statins. “This is just observational, of course. We really need more studies, particularly on cognitive effects and women.”
It’s not only in women. Astronaut and physician Dr. Duane Graveline has severe memory and cognitive function problems when he started Lipitor. He wrote a book about it that
should be a cautionary tale to anyone contemplating going on statins unnecessarily (a group that encompasses almost all people because very, very few actually receive benefit from these drugs).
The WSJ piece tells the tale of a 69 year old lady who had a particularly bad experience.
A San Diego woman, Jane Brunzie, was so forgetful that her daughter was investigating Alzheimer’s care for her and refused to let her babysit for her 9-year-old granddaughter. Then the mother stopped taking a statin. “Literally, within eight days, I was back to normal — it was that dramatic,” says Mrs. Brunzie, 69 years old.
Doctors put her on different statins three more times. “They’d say, ‘Here, try these samples.’ Doctors don’t want to give up on it,” she says. “Within a few days of starting another one, I’d start losing my words again,” says Mrs. Brunzie, who has gone back to volunteering at the local elementary school she loves and is trying to bring her cholesterol down with dietary changes instead.
“I feel very blessed — I got about 99% of my memory back,” she adds. “But I worry about people like me who are starting to lose their words who may think they have just normal aging and it may not be.”
The article ends with a quote from Ms Brunzie that should be tattooed on anyone blindly taking any medicine given by a doctor.
You have to use your own brain, as well as your doctor’s brain, when it comes to your health.
You wrote:
“If you get into an argument with a hostile vegetarian you ought to take a look at comment # 73 and comment # 84, my response.”
Thanks so much for that, especially this tidbit:
“What needs to be remembered is that insulin isn’t the entire story. Insulin partners up with a counter-regulatory hormone called glucagon. Usually when insulin is up, glucagon is down and vice verse. During protein consumption, however, that isn’t the case. Both insulin AND glucagon are elevated. Why? Because protein intake stimulates an increase in insulin, not as much as does carbohydrate, but some. Why? Because insulin is required to get amino acids (the building locks of protein) into the cells just like it does sugar. But if protein intake runs up insulin, that same insulin will run blood sugar too low. If it weren’t for glucagon, eating protein would give us low blood sugar. The secretion of glucagon compensates. And, since glucagon is also a fat mobilizing hormone, we burn more fat if glucagon is higher, which is yet another reason the low-carb diet works so well for weight loss.”
This issue was an unresolved worry for me, ever since I had read the following from the book ‘Carbophobia’ by Dr Michael Gregar:
“Atkins’ featured foods like cheese and beef elevated insulin levels higher than “dreaded” high-carbohydrate foods like pasta. A single burger’s worth of beef, or three slices of cheddar, boosts insulin levels more than almost 2 cups of cooked pasta. In fact a study in the American Journal of Clinical Nutrition found that meat, compared to the amount of blood sugar it releases, seems to cause the most insulin secretion of any food tested.”
This was referencing the same study (1264) as the vegetarian in your instance. I did actually download it, but I couldn’t understand it.
It seemed kind of fishy to me, but I didn’t have the knowledge to assess its validity. I did get some interpretation/advice from our friend Hyperlipid here: http://high-fat-nutrition.blogspot.com/2008/02/lipoproteina-and-delta.html (see comments section) but I wasn’t entirely mollified.
I’ve become extremely jaded about journal/study references. Most lay readers won’t have the time and patience to wade through pages of biochemical jargon, nor any training in the scientific method in order to figure out whether the study settings were sufficiently rigorous. Dr Gregar cites 1,160 references in a very short book – It would take months to follow them up and determine their relevance and validity.
And it takes a lot of close reading to figure out if the “conclusion” of the experiment actually matches the data. “Peer reviewed” only carries weight if the author’s peers are not suffering from the same preconceptions, biases and conventional wisdom that he is.
Anyway, I really appreciate your taking the time to “demystify” studies from time to time.
Chainey
P.S. If you have a moment, please drop in to http://chainey.blogspot.com/ to see my attempt to pull together the current low-carb resources on the web. Any advice appreciated.
Hi Chainey–
Glucagon is an often overlooked part of the insulin equation. In Protein Power we wrote about the insulin to glucagon ratio and why this is really more important than what happens with insulin alone.
Took a look at the blog. Good job. It’s nice to have all those references together in one place.
Cheers–
MRE
Why don’t all doctors see this? My disabled sister (born hydocephalic), whom I’ve written about before, was prescribed Lescor. I wrote what I considered to be a reasoned, polite letter asking that she be taken off this drug. Someone born hydrocephalic does not need to be any more mentally impaired than she already is.
I got an abrupt phone call from her physician telling me that I should find another doctor since I obviously want my sister to be treated “holistically.” Huh? I never said that. All I said that I wanted her to be taken off a type of drug that has been shown to be harmful in most people. I also mentioned in my letter that a higher cholesterol has been shown to be beneficial in women over 50.
The physician (she) said she’s a woman over 50 and takes it, and wouldn’t prescribe something she felt was harmful. Of course she wouldn’t. But she doesn’t see that it’s harmful.
Unfortunately, I live 1000 miles away and it’s hard enough to find a “good” doctor in your home town, let alone that far away. Looks like she’ll be on statins for a good long while.
No need to reply. Just a rant.
Dr. James Dobson of the Focus on the Family radio show featured two broadcasts on heart disease this week. His guest for the show was Dr. Robert Eckel who is his cardiologist. Dobson suffered a heart attack and stroke 16 years ago and credits his use of Statin drugs in reducing his LDL to mid 40s as one of the main reasons he is healthy and alive today. He actually used the word miracle to describe the drug. Eckel mentioned 10% of users who experience muscle fatigue, this was the only drawback of the drug discussed. You can listen to the broadcasts here:
http://listen.family.org/daily/A000000924.cfm
Needless to say, this was disappointing to hear. But what can you say, he is apparently quite healthy.
But is he healthy because of statins or despite them? He is in the only group that has ever shown benefit from taking statin drugs: males under 65 who have had a heart attack.
Dr. Eades,
#73 has responded to you and I must say that I kind of agree with his position. I believe he’s wrong, but I think you were a little hard on him. I’m sure it’s frustrating for you to deal with such misinformation regularly, but most people want better health. If they believe something contrary to good health, it’s likely they’re misinformed, not because they’re willingly part of some grand conspiracy to suppress low-carb eating. Remember, there are considerably more experts out there that would say a low-fat lifestyle is the way to go. That doesn’t mean they’re right, but it does explain why so much of the public still believes that.
Hi Steve–
Actually, I’m more in agreement with comment #91: he got off light.
I don’t have a problem with people disagreeing with me – they do it all the time. What I have a problem with is the tone of their disagreement. The one thing I can’t abide is the insufferable holier-than-thou-ness of most low-fat, vegetarian diet advocates. And when holier-then-thou is combined with a misrepresentation of the medical literature, it really galls me. Go back and look at the tenor of Chris’s comment. This is not a person on a quest for the truth – this is a person who has found it. There is no equivocation here.
And while making statements like these he goes on to completely misquote the studies that he proffers for his rock-solid opinions.
His entire comment was like “a tale told by an idiot, full of sound and fury, signifying nothing.”
The only part of his entire comment that was even remotely valid he managed to invalidate with the very next phrase.
He starts out by saying:
So do I, Chris. But then he goes on to qualify ‘contrarians’
Say what?!?!?! Since when is the low-carb diet the mainstream approach? It takes a fair amount of self deception to believe that the low-carb approach is mainstream and the low-fat, high-carbohydrate diet the province of contrarians and mavericks.
Then to come back in his follow up comment with the old ‘There are many studies conducted on nutrition that disagree with your conclusions’ defense without specifying any of these studies is lame. Show me those many studies, Chris.
What he’s saying is that there are a lot of studies out there that proclaim the low-fat diet to be efficacious. And he’s right, there are such studies. The only problem is that these studies don’t compare low-fat diets to low-carb diets. If they do make the comparison, nines times out of ten the low-carb diet wins, the other time it’s a draw.
Nope, he got off easy.
Cheers–
MRE
Hey Mike,
Three things:
1- Nice to see you and Ferriss have something in common. I LOVE his book and have implemented a few of his moves (without dumping my job, yet, let’s wait on the economy a little). Cool to see you into lifestyle design as well.
2- Jarvik is done at Lipitor, completely. They’re pulling the ads and buying him out. He has a blog (who doesn’t) and he expresses regret and an explanation of the rowing controversy as an insurance thing rather than an inability thing. Rings mildly true, but he still looks like the crypt keeper.
3- Re: Dobson and Statins: It explains a lot. Particularly the mental degeneration effects of statins. It explains an awful lot. I wonder if the President is on statins…
The President? Isn’t that your boss your dissing in a public forum?
Cheers–
MRE
P.S. Tim Ferriss and I have more in common than you might imagine.
I understand that statins can lead to muscle weakness – as the heart is a muscle can statins lead to heart failure because of heart muscle weakness?
Probably not. The heart is made of a different kind of muscle than is skeletal muscle.
I thought statins depleted CoQ10 which is a necessary part of energy production in cells, and that the heart , containing a great deal of Co Q10, can develop failure because of the effects of statins ????? According to Peter Langsjoen in USA.
And also that CoQ10 is used to treat heart failure in Japan ??
Everything you say is true. I’ve just never heard of statins causing heart failure. Granted, I probably don’t know everything there is to know about statins, but I do more or less keep up with the statin literature, and I’ve never read about heart failure being a problem. It makes sense that it could be – I’ve just never read of it. And cardiac muscle is different than skeletal muscle, so physiology and pharmacology that apply to skeletal muscle don’t necessarily apply to cardiac muscle and vice verse.
A New York Times editorial on Wednesday pointed out that Jarvis started taking Lipitor a month after he began working as Pfizer’s spokesman for the product — it’s amazing what some people will do for $1.35 million!
Hmmm. I might take it myself for $1.35 mil. However, no one from Pfizer has called me yet.
Cheers–
MRE
I’m one of those “few” women who lost the ability to think clearly and to remember words while on Lipitor….I’m sure there are more than a few of us.
Life is much more clear and in focus now that I’m off of it.
Ressy
Glad to hear it.
I haven’t had time yet to read all the comments on the other blog but I can say that in my misguided youth I went lowfat vegetarian and what was the result? Asthma! After about 5 years of a standard diet it subsided to only exercise induced and now it is finally gone since I’ve been mostly eating low carb the past 9 years.
I think I have mentioned before that I have a sort of “hypo” metabolism — low blood pressure (100/64), fasting glucose at 50, low cholesterol 155 with perfect ratios on a standard diet & 175 on low carb/high fat (if I recall correctly)with HDL of 75, triglycerides below 30 LDL unknown since its based on a calculation (or have I got those two crossed? Its been awhile.) So my good cholesterol readings got even better eating eggs, bacon, steaks, cheese, and grande breves along with lots of colorful vegetables.
Regarding Lipitor, I have at least 3 family members who have been on it and 2 of them can’t go into their hot tubs without experiencing severe rashes and the third had muscle wasting so was switched to another statin and is experiencing memory loss.
Unrelated to this article, I just heard this podcast about some new research that is fascinating and I thought you would be interested too.
Evidently the research shows that high concentrations of glucose signal both adipose and muscle stem cells to differentiate into adipocytes at a higher percentage than the same stem cells grown in a low glucose environment. Also, both adipose and muscle stem cells differentiated into the same proportion of adipocytes. In addition, the researchers found that oxidative stress lead to the same result in the low glucose concentration cultures.
http://stke.sciencemag.org/cgi/content/full/sigtrans;1/5/ec41/DC1
Hey Terry–
Looks like a fascinating paper. I’ll have to pull the full text and read it. Just gives us all another reason to keep our glucose levels where they’re supposed to be.
Cheers–
MRE
re Statins and heart failure, this is one of the references to Dr Langsjoens work, hope the link works, I found it (and several others on ww.thincs.org
For those readers who havent heard of it, thincs stands for the international network of cholesterol skeptics
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16873939&query_hl=1&itool=pubmed_docsum
Nice reference. Thanks.
Tendon problems may be statin side effect
http://www.newsdaily.com/Science/UPI-1-20080229-19353800-bc-france-statinstendons.xml
The truth is that NO woman should ever be given Lipitor or any other statin drug for elevated cholesterol.
There are no statin trials with even the slightest hint of a mortality benefit in women and women should be told so.
In other words, statin drugs don’t work for women.
To read more: Just Say No to Statins
Jeffrey Dach MD
my web site
The truth is that NO woman should ever be given Lipitor or any other statin drug for elevated cholesterol.
There are no statin trials with even the slightest hint of a mortality benefit in women and women should be told so.
In other words, statin drugs don’t work for women.
To read more: Just Say No to Statins
Jeffrey Dach MD
my web site
I’m posting this here for lack of a more current topic to go with it. Please feel free to put it where ever you think best.
I just read this AP story of some investigative reporting they have done (I didn’t think that reporters did investigations anymore!)
http://news.yahoo.com/s/ap/20080309/ap_on_re_us/pharmawater_i
This has been a concern of mine for the past few years. I’m glad to see it finally addressed. After hearing rumors that prozac can be found in Seattle’s drinking water, when my grandmother, who had congestive heart failure, passed away a few years ago I was appaulled to learn that all of her perfectly good bubble wrapped medications were to be flushed down the toilet!. The amount of medications in pill form alone was two inches deep in a plastic box about the size of shoe box for light hikers. Aside from the waste of medications, and I do understand the reasons for the law requiring them to be disposed of, just the thought of all those pills going into the ground water made me think about how many times a day that must occur across the country. There must be a better system of drug disposal.
I am convinced that these trace amounts found in water are having an affect on the population. Obesity (which started to rise 15 years after birth control pills became commonly proscribed), feminization of boys in some areas and some cases of male baldness are three things I can think of off the top of my hear.
After reading the article I think everyone getting off as many drugs as possible will be the best long term solution for everyone.
I agree that getting off as many drugs as possible is the optimal solution. It’s not just drugs that are thrown down the toilet that make their way into the water supply. Many drugs are gotten rid of through the kidneys, so every time a person who is taking one of these drugs urinates, it adds drugs to the water. This is where most come from, and it’s starting to be a major problem.