Tuesday, January 15, 2008

Not Another Health and Nutrition Blog

Yes, it's true. I don't know if we really need another health and nutrition blog, but for reasons I'll explain in a moment, I felt the need to speak (and I like hearing myself talk). Hopefully I can add something. The "manifesto" of this blog was placed in the inaugural post. It's a little high-falutin' (reading Ivan Illich will do that to you), but I think it makes the point: individuals need to make decisions which maximize their health (or wealth, or any other goal). In order to make those decisions, people need information. If you trust others to hold the knowledge and make the decisions for you, you're doomed. It sounds pessimistic, I know, but as we'll see in the course of my blogging, the evidence strongly supports this viewpoint.

Let me start by briefly telling you how I arrived here. About three years ago, my wife and I tried the South Beach diet. We lost weight easily with the low-carb approach (which we quickly expanded from the original South Beach prescription), without starving, and eating food that didn't taste like cardboard (tonight's dinner will be a large steak, smothered in Bordelaise Sauce). This piqued my curiosity, because the result flew in the face of everything that doctors and the media were telling me about weight loss. I began by investigating the relationship between diet and heart disease, because low-carb diets are inevitably "high-fat", at least by current standards. I was really bothered that while on the one hand, obesity was supposedly a "risk factor" for heart disease, on the other hand, the only way I had ever lost any significant fat was to eat more fat; and of course, dietary fat was also supposedly a risk factor for heart disease. It didn't add up.

So I developed the hobby of researching evidence underpinning current health and nutrition dogma, mainly related to diet. What I found, and continue to find, is that most of what we're told is complete crap, bad science and politics driving public health recommendations affecting the lives of hundreds of millions people. I probably shouldn't have been surprised. I spent several years as a professional scientist, and was quite familiar with how "the system" works. Yet I had not previously extrapolated that experience to the arena of public health, probably because I (like most people) felt that such obviously important issues would be treated with due concern for the actual health of the population, rather than petty politics, careerism, and general money-grubbing (the norm in science, I'm afraid). Sadly, it doesn't turn out to be the case.

But the thing which really started to motivate me to actively blog on these topics was my reading of Peter Duesberg's book "Inventing the AIDS Virus". Duesberg makes a fairly convincing argument that AIDS is not caused by HIV, and that the Centers for Disease Control, National Institute of Health, and other organizations are basically generating a lot of hysteria to justify their own existence. Now it's always dangerous to draw conclusions from a single person's viewpoint, and in particular, Duesberg clearly harbors some bitterness towards the establishment. Duesberg carries some impressive scientific credentials, but ran into considerable career difficulty once he became a vocal opponent of the AIDS/HIV hypothesis. I had seen that kind of thing happen during my own scientific career. I'd also seen individuals whose career went in the toilet because they were lousy scientists, but who then blamed "the establishment" for screwing them. The only way to distinguish is to dig into the actual science, survey the totality of the evidence, and decide if someone like Duesberg is telling the whole story, or cherry-picking evidence to support his position, embarrass his enemies, etc.

I haven't gotten to the root of all of this yet, but I must say at this point that at least some of the leading scientists supporting the AIDS/HIV do not appear to be acting in a manner conducive to good science. Consider this exchange between a group of AIDS "dissidents" known as the Perth Group and Professor John Moore. You don't have to read the whole thing if you don't want to - it's lengthy and technical. But here's the point: the Perth Group makes detailed scientific arguments on 16 points, supported by no less than 72 literature references, many to peer-reviewed publications in respected scientific journals. Here was Moore's response:

You have gone through 21 drafts and a considerable amount of effort to say absolutely nothing that is of any conceivable interest to me. I'm glad you wasted your time though, as communicating with me (or trying to) is harmless, compared to the damage you AIDS denialists do to innocent people you attempt to confuse and thereby cause top be harmed. So, continue to knock yourself out, so to speak. All you will receive from me is my continued contempt, and derision.
John Moore.

Rather nasty and personal, don't you think? And if the evidence for the AIDS/HIV hypothesis is so overwhelming, would it not be simple for Moore to quash to Perth Group with said evidence and logic? Indeed, this is what the Perth Group requested:

You wrote: “All you will receive from me is my continued contempt and derision.”

As an academic surely you must pursue scientific discussions and don’t your students learn by your example? Don’t you teach your students that science progresses through scientific debate?

To which Moore replies:

You are confusing me for someone who is interested in what you have to say, and you are confusing yourself for someone who merits a more detailed response. Kindly correct yourself of those delusional tendencies. I despise you and your fellow AIDS denialists, and I regard your level of “scientific analysis” as pitiful and laughable.
John Moore

And after a final plea from the Perth Group to provide any scientific evidence of any kind, Moore replies:

Plead away, but I'll simply ignore your pleas, as will any bona fide scientist.
John Moore

I'm not sure what "bona fide" scientist means. From the above, it either means you're a total prick, or that you hold uncritical belief in the prevailing dogma. Neither is good for science, especially when that science is regarding something as important as AIDS. Indeed, I have had zero luck finding any actual scientific evidence against the points made by the AIDS "denialists". Instead you get a lot of "the evidence is overwhelming" with nobody ever presenting said evidence (if you can find it, please post a link here). That doesn't mean the evidence doesn't exist, because rather unfortunately even when there is "overwhelming" evidence for a given hypothesis, scientists behave in an essentially dogmatic fashion, accepting the truth of the hypothesis while not actually knowing the evidence which supports it. For example, I doubt you could find many professional physicists who can recite the experimental evidence supporting quantum electrodynamics (QED); yet to date, QED remains the most accurate physical theory ever devised, a status it has maintained in the face of 50 years worth of experiments with ever increasing accuracy. But a good scientist will at least find the evidence when a hypothesis is questioned, rather than just bleating "but everyone knows".

So back to the point: do you really want somebody like John Moore making decisions that affect your health? His goal seems to have more to do with securing his position in the status quo, as opposed to increasing your state of health. Further, he shows no desire to propagate information that is critical to making good decisions. It's like playing blackjack where you don't get to see any of the cards. You're guaranteed to get screwed.

Before calling it a day, lets talk about another example, that of the "benefits" of legal, prescribed drugs. Here's an excerpt from the linked article:

While approximately 10,000 per year die from the effects of illegal drugs, an article in the Journal of the American Medical Association (JAMA) reported that an estimated 106,000 hospitalized patients die each year from drugs which, by medical standards, are properly prescribed and properly administered. More than two million suffer serious side effects. [3]

An article in Newsweek [4] put this into perspective. Adverse drug reactions, from "properly" prescribed drugs, are the fourth leading cause of death in the United States. According to this article, only heart disease, cancer, and stroke kill more Americans than drugs prescribed by medical doctors. Reactions to prescription drugs kill more than twice as many Americans as HIV/AIDS or suicide. Fewer die from accidents or diabetes than adverse drug reactions. It is important to point out the limitations of this study. It did not include outpatients, cases of malpractice, or instances where the drugs were not taken as directed.

According to another AMA publication, drug related "problems" kill as many as 198,815 people, put 8.8 million in hospitals, and account for up to 28% of hospital admissions. [5] If these figures are accurate, only cancer and heart disease kill more patients than drugs.

Jesus wept. The article goes on to suggest that a good deal of heart disease and cancer could be caused by legal drugs as well. I suspect you have to broaden the net, and that nutritional and other recommendations (like avoiding sun, leading to Vitamin D deficiency) play a major role. In all of these cases, however, we again see a large organization (government + drug industry + doctors) acting in a manner which has greater benefits to them than you. This organization has the information (side effects, toxicity, etc.) and makes the treatment decisions; the public just does what it's told.

I'm not proposing that this is any sort of organized conspiracy theory. It's just how human nature shakes out in the behavior of social organiations. Just like organisms, organizations adopt strategies which maximize their chances for survival and growth. Drug companies have to sell medicine to survive. Any strategy that doesn't sell more drugs tends to die off, while those strategies increasing revenue persist (this includes development of new drugs that really do save lives). Further, it is to the benefit of all involved parties to cooperate for their mutual benefit. For instance, it's better for doctors to prescribe medicine than to simply send you home to get better on your own, because then the patient feels like the doctor did something, has to return for more medicine, etc. So obviously it's good for both the people who make drugs and the those who dispense them to push as many of them as possible for as long as possible, regardless of the outcome. The role of government should be to balance this tendency with the goal of optimizing health of the population, and it currently fails miserably.

I know, I know, I sound like a raving paranoid. But again, I think we can find plenty of evidence to support this view. Let's first return to the whole AIDS debacle. This page contains an excerpt from a Harper's article by Celia Farber questioning the ethics of clinical trials testing the drug Nevirapine to treat AIDS in pregnant women. It also contains a response from Robert Gallo, the scientist who supposedly proved the existence of the HIV virus and that it causes AIDS, along with responses to Gallo.

I believe Gallo's response makes his priorities abundantly clear; saving lives is not high on the list, unless it is done with AIDS drugs (by the way, the best you can say about AIDS treatment is that it extends life a bit; patients still suffer early death in the end). Joyce Ann Hafford, the victim in this case, showed no signs of illness until she began taking Nevirapine, which ultimately resulted in her death and nearly that of her unborn child; but that death seems to be nothing but an annoyance to Gallo. Farber's response hits it on the head:

To date, no remorse has been expressed to Hafford's family from any of those responsible for her death, and no compensation has been offered. The only additional shock the family could possibly receive is to now learn that international AIDS "treatment activists" have declared Joyce Ann's death not "relevant to the science of HIV." That statement is sociopathic – bereft of all empathy. This is what I have long suspected AIDS treatment activists to be and this is what they say, in their own words, when given a chance to say something about this tragic death.

Gallo's evidence as to the benefits of the anti-retroviral medications used to treat AIDS patients was a single meta-analysis, and pretty thoroughly dismantled. Meta-analyses are a subject I'll discuss further in another post, but they're usually done as a way to take a bunch of studies which don't give the desired result, gang them together, and perform a little black magic so that they now give the "right" answer, albeit one that is usually marginal at best. In other words, take a bunch of little piles of crap, put them together into one big pile of crap, plant a daisy on top, and declare it no longer crappy. Meta-studies are almost always scientific and statistical nonsense, and even when done with the greatest care and honesty should be viewed with considerable skepticism.

One final example, oh gentle reader, and I shall release you. This one is great, both because it is timely (just came up today), and because it hits one of my favorite subjects: the prevention and treatment of heart disease. Michael Eades has a great writeup on the recent release of results from the Enhance trial, which tested the efficacy of a drug combining Zocor (a statin, which reduces cholesterol) and Zetia (blocks absorption of cholesterol in the intestines). The manufacturer of Vytorin withheld the results of this trial for two years, which ought to raise some red flags. Why? The New York Times gives us the answer:

In a press release, Merck and Schering said that not only did Zetia fail to slow the accumulation of fatty plaque in the arteries, it actually seemed to contribute to plaque formation — although by such a small amount that the finding could have been a result of chance.

Yikes. The best thing you could possibly say is that Vytorin is draining the wallets of those taking it (or, since most of them probably have insurance, it's draining MY wallet, which is infinitely worse). The worst case scenario is that it potentially worsened patients' condition, while putting them at risk of well-known side-effects.

Now it should be clear why a drug company would behave this way: it's the money. What may be less clear is why doctors are so heavily bought into statin treatment, considering that there is no evidence that statins prolong life: they may slightly reduce heart attack risk in high-risk patients, but that risk reduction seems to be invariable offset by increased mortality from other factors, like cancer. But I doubt that most MDs know this. Doctors are not scientists. They treat disease, but they don't spend much (if any) brain space on understanding the origin of disease, the consequences of the currently accepted treatment, etc. Most doctors get their information from drug companies, the FDA, and organizations like the American Medical Association, all which which gave statins a big thumbs up.

Further, the doctor gets to be something of a minor hero. He gives a patient a cholesterol test, finds evidence of a "serious disease" as indicated by elevated "bad cholesterol". Doctor prescribes Vytorin, the next blood test shows significant reduction in the cholesterol, patient loves doctor for providing a "cure". Sadly, the cure must be maintained for the rest of the patient's life, at a significant expense, with continued oversight of the doctor, who also gets paid. And all of this is done in the absence of any evidence that the medication has any actual benefit in terms of improving the patients health (again, if you know of some, post it in the comments). All it really does is put money in the pockets of the doctors, drug companies, and blood labs.

The only way to avoid these kinds of outcomes is to get the information yourself. It can be difficult to understand, because it is often complex. But at the very least, get your information from a source that does not stand to benefit by getting you to make a particular choice, like taking some medication, eating a special kind of food, etc.


AmyM said...

Excellent article. I have recently been a victim of blood pressure meds and hormone injections and am working to regain my health.

Anonymous said...

I want to share a statin experience. I apologize for the length of the comment, but I think that the detail is necessary to give the whole picture of what the real consequences can be from simply being prescribed a billion dollar "wonder" drug.

My life was turned inside out simply because of a routine checkup.

Baseline stats: I am (was) a 56 yr. old male, sedentary (design at computer all day), normal libido, from the south, laid back not given to excitability, 6', 212 lbs., long term smoker, genetic longevity, decent lung capacity, mean Blood Pressure 118/65 sitting and standing, pulse 64, no special diets (typical southern foods), no supplements, no problems other than occasional bouts with back spasms, no allergies, good EKG, good EEG, blood count normal, thyroid panel normal and liver function normal.

BUT, a test said that I had "high" triglycerides 287, total cholesterol 149, HDL 37, LDL 55, glucose 89.

I was put on Vytorin 20 mg =Tri. 175, TC shot to 214, HDL 40, LDL shot to 139.
Then Vytorin 40mg = Tri. 199, TC 144, HDL 40, LDL 64.
Then Crestor 10mg = Tri. 98, TC 141, HDL 45, LDL 76, glucose 103.

I complained of losing energy and libido. I was told to exercise, I did and maintain 2 1/2 mile brisk walk each AM for nine months now.

I complained of greater loss of energy and libido. I was put on Effexor XR 75mg (taking Crestor 10 mg)

I complained of jittery feeling and restless sleep, increased Effexor to 150 mg and added Benztropine 1mg, Lorazepam 2mg (taking Crestor 10 mg).

I reported no significant change, increased Effexor to 225mg, Benztropine 2mg, Lorazepam 4mg (taking Crestor 10 mg).

I started having muscle and joint pain, added Darvocet to the cocktail, which curbed the pain, but had less energy and no libido (taking Crestor 10 mg).

I was switched to Cymbalta 60 mg, Lorazepam 4mg and Darvocet (taking Crestor 10 mg).

I started having anxiety and panic attacks (something that I had never experienced in my life), I had to cancel a business trip, because I panicked about being on a plane (I have flown my whole adult life), the doctor added Seroquill 100mg, increased Cymbalta to 90mg, Lorazepam 4mg and Darvocet (taking Crestor 10 mg).

There was no significant change, so I was switched to Wellbutrin XL 150mg, Lorazepam 4mg and Darvocet (taking Crestor 10 mg).

I had constant anxiety, no panic attacks, sweats, temperature sensitivity, weakness in legs, no libido, intermediate insomnia and started losing appetite and thus weight. Joint and muscle pain if I skipped Darvocet, increased Wellbutrin to 300mg, added Aderall 30mg and switched to Ibuprofen 600mg (taking Crestor 10 mg).

Symptoms got worse, so I switched doctors. New doctor stopped Adderall, weaned me from Wellbutrin and started me on Prozac 20mg and Xanex .25mg. Anxiety became intermittent, but I continued to lose energy, lose weight, feeling weaker with joint and muscle pain. Prozac was increased to 40 mg. No change.

I was switched to Paxil 20 mg; I had less frequent anxiety, but all other symptoms getting worse. Paxil was increased to 40 mg. This almost eliminated anxiety, only occasionally having to use Xanex, mainly to get to sleep at night, but waking up exhausted and wet clothes from sweating in the night. My fatigue and weakness were becoming debilitating with the addition of I was having problems with my eyesight at the computer and my sense of comprehension was waning greatly making it impossible for me to do my work. (Taking Crestor 10 mg).

I was sent to a psychiatrist for counseling for depression. The Psyc. determined that I did not need counseling, symptoms were chemical and switched me back to Prozac 20 mg, replaced Xanex with Lunesta and put me on Provigil 200mg. I had a slight return of the anxiety, but was told to use Xanex in those cases. I began regaining sense of comprehension, but getting weaker, losing more weight, and the right tibialis anterior started getting numb along with my right foot. (Taking Crestor 10 mg).

My walking partner, a retired pharmaceutical sales person, commented that there was foot drop in my right foot as I walked. We began discussing my whole ordeal over the course of the next few days. I was asked if I was on a statin and I said that I was on Crestor 10 mg. I was then asked if I was advised to supplement with Co-Q10, B-complex and Vitamin C and I said no. It was suggested that I do so immediately and go back to the doctor and revisit my symptoms with him. I had a visit to the Psyc. coming up soon so I did as was suggested. The Psyc. agreed with the supplementation suggestion and agreed that I should have been so advised, but praised the value of Crestor, especially in preventing Alzheimer’s. He increased the Provigil to 300mg. (taking Crestor 10 mg).

Two days later during our walk, I collapsed due to weakness in my legs and knees especially and my right foot was paralyzed. After helping me back home my walking partner suggested that I wean off of the Crestor over 2 weeks, because a sudden stop could make me prone to a stroke, boost the CoQ10 and get to a doctor. I was scheduled to leave on a 4 week business trip immediately which I could not miss due to missing the last one, but I did as was suggested about the Crestor and CoQ10. During the first two weeks of the trip, the pain was almost unbearable (eating Darvocet, hydrocodone & ibuprofen like candy), I could hardly walk or get out of chairs.

My associates, who had known me before this incident, kept insisting that I looked like I had had a stroke or something due to my appearance, weight loss, diminished mental capacity and walking.

Symptoms started improving drastically over the next two weeks.
I did extensive internet research and interviewed people with experiences while on statins while on the road and since my return and found literally hundreds of statin horror stories and complete ignorance by the users of statins that the unpleasant onset of symptoms that they were having (depression, fatigue and pain) might be attributable to statins.

Upon my return and relaying what I had found to my walking partner, I was told that the drug companies knew that such side effects would occur and in fact played with combining CoQ10, B & C vitamins with their statins. They had started instructing doctors to suggest such supplementation upon prescribing statins. I was also told that it could take from 6 months to a year to recoup from some of the side effects based on reports that had been seen, but that extensive nutritional supplementation would help.

Over this course:
I lost from 212 lbs. down to 170 lbs., lost muscle mass everywhere even down to my hands, lost close to 50% of my body strength, lost the ability to walk, concentrate and apprehend.

I lived with absolute fatigue, no libido, no appetite, depressive thoughts, anxiety, insomnia and horrible pain

I have been diagnosed with and/or treated for GAD (general anxiety disorder), depression, insomnia, arthritis, ED, poked, prodded and told that "I was just getting old". I have been sent to a shrink.

I came close to losing my ability to make a living.

All of this because of a number on a scale that prompted a doctor to put me on a statin, which I have now found, through my exhaustive research, has no advantages in overall mortality rate.

I am now back 5 days from the trip (Crestor free for almost 3 weeks now).
I have begun a full regimen of nutritional supplements and healthful diet.

I am back to walking the 2 1/2 miles again though my muscles get sore like they did when I had just started training.
I have 75% use of my right foot back (getting better everyday), occasional pain running from my left hip to my knee.
I am feeling a little better and stronger each day both mentally and physically, but I am now absolutely paranoid about going back to the doctor to even have my cholesterol checked.
I am checking into chiropractors to deal with the pain in my left leg.

Dave said...

Wow. I'm glad you both are recovering your health. Again, these examples underline the importance of making sure you have the information about treatments your doctor is recommending. I don't advocate paranoia, but I do advocate being informed. If you know what side-effects are possible, then you can be on the lookout.

Doctors can and do provide useful information, but should not be a replacement for your own judgment. You are ultimately the best judge of your own state of health.

These examples also indicate an unfortunate tendency, at least in the US, for doctors to treat problems by "addition" rather than "subtraction". Statins causing problems in an otherwise healthy person? Treat those problems with other drugs, which have side-effects requiring more drugs, etc. How come Statin Victim's doctor didn't realize that the statin was making his health worse, rather than better?

Anonymous said...

What people should ask their statin pusher doctors is why the other half of the population who die of heart attacks have normal or low cholesterol.

Cholesterol is a police and the inflammation is a criminal. We should not fight crime by limiting police presence in the high crime areas.

Unknown said...

Healthy blog..
Health and Nutrition