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« Each Generation has its Ruination | Main | Accountability »

My Cholesterol 

I am late with my posting here this week; partly because on Monday I had to go to my doctor for my annual checkup.

Tuesday I made a visit to my eye-doctor for my annual eye examination. Both turned out good.

On Monday my doctor was concerned about my low resting heart rate, he had it a 40.

I explained it was always low, had been most of my life.

He said at my age he would like to check it out with an EKG, I agreed. The diagnosis, a strong, healthy heart beat.

Where the doc and I disagreed was on my cholesterol; he wanted to put me on a cholesterol lowering drug, and I refused. My cholesterol was at 286 last year and I refused then saying I would rather change my diet and increase my exercise.

I have done that and this year my level is down slightly but the doctor wants me to take Lipitor or something similar. I am refusing on the grounds that it will cost me $1,000 a year, it has some nasty side effects, and I am not convinced it is necessary.

I might be a little less skeptical if my doctor wasn’t getting a financial kick back from the drug company for convincing me to take this stuff. Plus he is already making money from the cholesterol screening.

I could ditch this doctor and find one that had my wellbeing at heart over and above his own financial interests, but frankly I can’t be bothered.

However, if I am not going to take his advice, I am considering next year to not even have my cholesterol checked, just have him check out my heart.

Cholesterol appears to be naturally high in my body no matter what, it is probably hereditary. I have been eating oatmeal almost every day of my life, so there is another bullshit theory out of the window.

I am not a medical doctor so I want to be clear that I am not offering advice, but I am simply suggesting that some might want to do as I have done and become informed and then make their own decision.

We live in an age of information and there is a lot of information out there both for and against. From what I read and hear these medications called statin are mainly beneficial to people who already have heart disease. I don’t have heart disease.

One of the best articles I have read on the subject is one from January 2008 in Business Week. It is a lengthy six page piece and it states that these cholesterol lowering drugs are a $27.8 billion a year industry.

That’s billion with a “B.” No wonder we a bombarded with nightly TV ads for the stuff, and the drug companies can afford to give kick-backs to doctors for prescribing it?

Read the fine print in Pfizer’s own Lipitor ad, it states in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor.

This means that for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks.

The difference credited to the drug? One fewer heart attack per 100 people.

So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit.

I draw a parallel here with riding a bike; if you took a cross-section of the population most would say it is much too dangerous to ride a bicycle on the road. Of course I disagree. Some would ask me if I have a death wish; actually I ride a bike because I have a “Life” wish.

A large portion of the population is sold on the idea that they need Lipitor; just as a large number are sold on the idea that cycling is dangerous. Informed people may or may not think otherwise.

High cholesterol can block arteries and cause heart attacks, but that will mostly happen to people who smoke and sit on their ass and don’t exercise. Exercising by riding a bike will help me live longer but there is also a slight possibility it can get me killed too.

However, I refuse to live my life in fear that I may die on the road, and allow that fear to stop me doing something I love, that is riding my bike.

I also refuse to give $1,000 a year of my hard earned money to doctors and drug companies to allay the extremely slight possibility that my high cholesterol might also kill me.

Against popular opinion, I for one will continue to live dangerously by riding my bike while not taking Lipitor. Maybe I do have a death wish.



Reader Comments (23)

Hey Dave. I read that same article a year or so ago, found others to back it up, and then went to my doc with it and told her I didn't see where the Lipitor benefits existed, especially when you compare the potential damage to the liver and all the cost of drugs and testing. I also had a heart scan done before going to see her, which revealed that there is nothing sticking to the inside of my arteries, meaning that the chol has nothing to grab and cause a clog.

She agreed but asked that I take high dose of fish oil. Prescription for such is $100/month, but can do similar OTC with fish oil pills if you research what to look for.

My Chol is near yours, mostly due to my blood lines. Dad has an issue with it too. I don't get tested any more. I'll get the heart scan done again 7-10 years and lump Chol test in with some other blood work sometime. I feel better now than ever before thanks to solid diet and riding the bike :) I'm down 30lbs in a year from riding as well.

Good solid research, and while I"m not a doc either, I'm on the same path.

July 13, 2011 | Unregistered CommenterRichard W

Resting heart rate of 40? Methinks you're doing just fine Dave!
Thankfully I've never had an issue with cholesterol. My ex-wife (hereditary as is yours apparently) did however. She managed to get hers down with fish oil and red yeast rice. We are over prescribed in this country and pounded by ads much like those for Lipitor on an hourly basis.

July 13, 2011 | Unregistered Commenterskylab

You are on the mark, Dave, I was on that stuff and it destroyed my muscular endurance, my muscles actually hurt when riding, Dr. Gabe Mirkin's site has great info on doing what you can via diet, but even the doctors says diet only affects your numbers by 10%.

July 13, 2011 | Unregistered CommenterMike Z

Live long and prosper, Dave. It'd be a little easier to swallow these kinds of drug recommendations if one weren't always suspicious that docs weren't incentivized by the drug makers to push them. Wired Magazine had a really interesting article awhile back entitled Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why (no subscription needed; it's available online). There's even a reference in the story to a strategy that was researched to elude the anti-doping efforts in sport (Ctrl+F on Fabrizio Benedetti to find the reference). There is so much money involved, and the nested interests of docs, Pharma, and health insurance companies ought to make us all skeptical.

July 13, 2011 | Unregistered Commenterbystander

Dave, lipitor will generic soon, so the price should drop to $120 a year or so.

July 13, 2011 | Unregistered CommenterTde

Had my right hip relpaced 15 March 2011, The op caused my prostate to enlarge had a catherter in for 3 weeks, could not pee! Dr put me on Avodart. The side effects have been horendous, Tired, No energy, have affected my bike riding 100% Dr re checked my prostate, The meds have worked, SOOOO! what to do, keep taking the meds and learn to live with the side effects? PLUS as you state the costs are very high. The Dr pointed out that in my Granfathers days. They just DIED!

July 13, 2011 | Unregistered Commenterjohn crump

I went through the same as you a year or so ago. Low resting heart rate, 45 & high LDL cholesterol but excellent HDL. Refused to take a stain. Told them if they could proved to me that my cholesterol was the small dense kind I would take it. Of course they don't check on the different kinds of LDL so they could tell me what kind of LDL cholesterol I had. Sent me for a CT scan of the heart which showed some blockage of two arteries but the main arterie the left aorta was clear. Was sent for a stress test and they finally gave up when they couldn't get my heart rate up on the test and the doctor while he believed in using stains and said it is an over the counter drug in England didn't think in my case the benefit justified the expense. All this at no direct cost to me. Who said state run health care is terrible.

July 13, 2011 | Unregistered CommenterJohn Le Marquand

Correct me if I'm wrong, Dave, but I think you just talked yourself into buying $1000 worth of cycling related gear. So will it be a new gruppo, maybe some wheels, or a tour of the wine country (also good for the heart)?

July 13, 2011 | Unregistered Commentertheguth

Why the wish to live longer?
How do you answer that anyway? Live longer than what?
Do the math. You can’t live longer than you end up living; death determines how long you live, so death is an essential part of living.
Maybe riding bikes, moderation, eating good foods, are also. So too drinking, drugs (medications) and partying if you wish. So who’s saying how long you could of if only you would (or would not) of?
A statement impossible to quantify by drug companies.
Is just believing you are living longer good enough?
There will always be purveyors of “longer life” (forever indefinable) and a “sucker born every minute”. You or I will not change that.


July 14, 2011 | Unregistered CommenterSteve

Dave, I agree with you on staying away from drugs. They can be very toxic, and they can mess up one's energy system.
A "good" source of natural healing answers is mercola.com. I'm not a huge fan of that website, but there are pieces of information difficult or even impossible to get elsewhere.

July 14, 2011 | Unregistered CommenterMicheal Blue

Another one size fits all diagnosis and perscription. We have to watch out for these and make smart decisions as you have. Lots of good comments already. My cholesterol is naturally low but even so I have observed a significant increase with a 10-15 pound weight increase to my 160 pound body (all fat some of which I have already eliminated). I would add to the above that if you have some body fat that you could eliminate without doing crazy stufff you would probably see some further improvement. Also keep watching the HDL-LDL relationship.

July 14, 2011 | Unregistered CommenterGary

Dave: I enjoy your blog and like you dislike enriching the pockets of medical businessmen (aka MDs) and large pharmaceutical companies. However, in some circumstances timely drug intervention is well advised. Full disclosure: I'm not a medical doctor but I do work in a human nutrition research center as a molecular biologist. A couple of points: total cholesterol comes from two sources, endogenous (made by your body) and dietary (contributed by what you eat). We all need some cholesterol since it is a fundamental building block for many of the steroid hormones like testosterone which the body needs. Like in most things, more is not necessarily good. If your high Cholesterol is due to genetics then the fact that you eat oatmeal every day won't improve your numbers. Basically the soluble fiber content of porridge binds dietary sources of cholesterol in your gut and makes some, but not all, of that source unavailable for absorption, e.g. the bound dietary cholesterol is passed through your system and not added to the endogenous cholesterol which your overly active genes are producing. So, oatmeal's contribution is intact!

People with high cholesterol generally fall into one of two groups: those who respond to diet and exercise and see their numbers improve and those who don't. The individuals who respond to diet and exercise changes typically are producing "normal" levels of cholesterol and the excess is coming largely through diet. The folks who don't see improvement after making the obvious lifestyle changes are the ones with elevated synthesis of endogenous cholesterol due to overactive gene expression events.

Far be it from me to give you advise on this matter, but I do hope that you'll make an educated decision. There are other drugs besides Lipitor which have demonstrated effectiveness in reducing cholesterol synthesis. As in all things not all of them work well with each individual. My Swedish mother-in-law had to try several different drug interventions before she found one that worked well without side effects. I don't want to sound too self serving but I do enjoy reading your blog and hope we're both around for a lot more of your interesting posts!

All the best,
George A.

July 14, 2011 | Unregistered CommenterGeorge A

One check might be have the heart scan to see if there are any problems internally. Then you can see if there is any issue that would need to be delt with. If not see if there are any other diet issues, lots of red meats, that might change things. I think you have the excersize thing covered:-)

July 14, 2011 | Unregistered CommenterRalph

I too have high cholesterol and have chosen to not take prescription medications to correct this. Additionally, I almost always agree with you and enjoy reading your informative weekly posts. However, physicians simply do not receive any financial kickback from prescription drug companies. To state otherwise is simply ignorant. I should know as I am one. To prescribe drugs based some financial gain would breach all kinds of patient/doctor ethical contracts.

July 14, 2011 | Unregistered CommenterChristian

Thank you for your comment and I'll accept that doctors are not taking direct payment, however, I did not make up that statement off the top of my head and I have placed a link in the peice to articles stating this.

July 15, 2011 | Registered CommenterDave Moulton

To add to the circus of big pharma:
Pfizer pulled it’s huge television ad campaign featuring “Doctor” Jarvik after watchdogs discovered Dr. Jarvik is not a cardiologist and is not licensed to practice medicine.
To add insult to injury, he didn’t even row the boat he’s shown in as he doesn’t row (they use a double) !
Welcome to the Monkey House, get your ticket at the door. Once you get in you can’t get out.


July 15, 2011 | Unregistered CommenterSteve

Actually, my cholesterol medication is biking! Before I started biking regularly, I had low good cholesterol, and high bad. After biking for several years, that turned around, and now my cholesterol is fine!

When my wife complains about my new bike parts arriving via UPS, I just remind her how "biking saved my life"!

July 15, 2011 | Unregistered CommenterAndy Katz

Hi Dave, My Cholesterol was also elevated and the Doc suggested drugs. I tried Benecol instead. It is a natural plant product and it dropped me from the 230s to 160s. Check it out at Amazon "Benecol Smart Chews".

July 16, 2011 | Unregistered CommenterTom

Stick to your guns, Dave! I'm 70 now. About 7 years ago, when I was still working, my doc told me my cholesterol was getting high and prescribed. I was shocked how expensive it was, even with my drug plan. After a week I found the side effects terrible. I had pains in all my joints and could hardly walk upright, so I discontinued it. Next time I went back to the doctor I told him and he suggested maybe I try another drug, but by that time I'd done some research and learned that they were all statins and worked the same way. I decided to go with diet and exercise, but that's easier said than done. So far my cholesterol hasn't really been coming down, but I refuse to on any of those drugs because my joint pains have not completely gone away. I'm sorry I ever succumbed to the drug. I also suffer from back pain (but I don't have it on the bike). My doctor prescribed Celebrex, but I really didn't notice much difference, maybe it was a low dose. Anyway, I discontinued that also because it cost too much.

Frankly, I'd never heard about cholesterol when I was growing up and don't recall my parents talking about it or taking medication for it. I agree on the "big pharma" profit motive angle.

July 17, 2011 | Unregistered CommenterJohn B

May I suggest the following doctor in Santa Rosa. He any a number of other doctors strongly advocate a plant based diet as the only way to significantly lower your cholesterol. May seem a bit radical until you compare it to having your chest cracked open.http://www.drmcdougall.com/about.html Enjoy.....David

July 17, 2011 | Unregistered CommenterDavid

I'm on the same page concerning the drug industry - the mainstream advertising and push to subscribe to many is a little a creepy - and good for their profit margin...

July 18, 2011 | Unregistered CommenterDan O

Ask your doctor what is the correlation between cholesterol and heart disease.

Then ask him what percentage of people with heart attacks have low cholesterol numbers.

July 21, 2011 | Unregistered Commenterbbattle

It's great to hear I'm not alone out there. about 3 - 4 years ago I discovered I had an overall reading of 7.8. Dr went balistic screaming STATIN. Fortunatly I was born into a family of sceptics that should have run a revolution, so I too did some research, and as an ex racer, now soul rider, discovered the lie that it Physer, and the harm Statins do to people without heart disease. Dr's never tell you this though. I started by cutting out sugar, you know how hard that is, then came full cream milk and most fried foods. Small changes, but they are working. My level yesterday is 6.6, yes still high and the Dr is still screaming STATIN, but I have never really tried a proper diet....so I think it's time. Back in the saddle and off to the grocery store.
I live at the coast, Cape Town South Africa, so the fish is fresh and the sushi amasing.
Viva le Bicyle.

October 6, 2011 | Unregistered CommenterLyle

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