Which is better?

4. October 2007 William Davis (12)
If you have the common pattern of high LDL particle number (NMR) with small LDL--a pattern highly related to coronary plaque--which is better:




Lipitor or a combination of fish oil, vitamin D, and elimination of wheat?


Lipitor quite effectively reduces LDL particle number, usually on the order of 40% or so. Effect on LDL particle size: None. Side-effects: plenty, including muscle aches (inevitable in my experience, not the ridiculous 2% they claim) and occasionally mental effects such as impaired short-term memory.

Lipitor does seem to exert a modest effect on reduction of C-reactive protein, around 30%. It also reduces cardiovascular events by 30%.



A combination of fish oil, vitamin D, and elimination of wheat:

Reduces LDL particle number commonly by a similar 40% (though variable, depending on body weight). There is substantial improvement in LDL particle size, a large drop in C-reactive protein, often >50%, a 30% or more reduction in cardiovacular events.



On this combination, however, you also:

--Lose weight, often substantially.

--Improve bone health, esp. osteoporosis and arthritis.

--Reduce cancer risk from the vit D supplementation.

--Reduce risk of stroke.

--Reduce postprandial (after-eating) abnormalities like intermediate-density lipoprotein.

--Reduce winter blues.

--Experience more energy.

--Obtain increased clarity of thought (from elimination of wheat).

--Reduce blood pressure.


Oh, and there's no muscle aches.
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Comments (12) -

  • A new reader

    10/4/2007 3:43:00 PM |

    What's your beef with wheat?

  • Anonymous

    10/4/2007 3:51:00 PM |

    I married a depressive. Passion generated seritonin, so she was fine. She went off her pills.

    Then, she was prescribed a statin.

    The normal physiological process in "falling in love" moves from seritonin to frendship chemicals and then nothing at which point you have hopefully bound yourselves up in obligations, respect, and friendship.

    Well, statins decrease testosterone in women, which supports the seritonin production, so if that women is a depressive, the passion is terminated and you never get to friendship.

    No woman should ever be prescribed a statin. Sure they might have better cardiac health, but their quality of life will sink--if they survive the depression and suicides.

    Not fun.

    Never sign an ARM. Never take a statin.

  • Dr. Davis

    10/4/2007 3:55:00 PM |

    Please see my numerous prior posts on this question. Wheat products are among the most heart disease and diabetes causing foods I  know.

  • Anonymous

    10/4/2007 3:57:00 PM |

    Here's an even better idea, combine both tratments and lower your risk even further !!! In MOST people statins are very and VERY helpful.

  • Dr. Davis

    10/4/2007 4:22:00 PM |

    There are times when the Lipitor becomes superfluous.

  • WCCAguy

    10/4/2007 5:23:00 PM |

    Hi Dr. Davis,

    Because I know my risk is high due to previous cardiac events, I didn't stop taking Lipitor 80 and Zetia 10 before getting a Berkeley Heart Lab (BHL) blood draw earlier in the week.

    My thought was that I could assess my BHL numbers, begin ramping up on the TYP program recommendations this week and next, and then draw down my Lipitor dose sometime later over time (perhaps never to 0) as I feel more confident that I'm not putting myself at increased risk in doing so.

    Does that make sense as a general strategy for transitioning to TYP?  Any other general thoughts about this?

  • Anonymous

    10/4/2007 7:57:00 PM |

    I've come to think of wheat as a "sugar equivalent"  and it makes no difference if it's whole wheat or not.

  • Dr. Davis

    10/4/2007 9:06:00 PM |

    Yes, absolutely. A stepwise approach to converting to a program with the least amount of drugs but maximum benefit is usually best.

  • Anonymous

    10/6/2007 5:22:00 PM |

    Actually I would think the best combination would be Zocor and Slo niacin. According to the Hats Trial this combination reduced the risk of heart attack by 90% versus placebo. In this case the niacin would probably be the best thing for the small LDL particuls. Add your vitamin D and an aspirin a day and you have virtually no chance of heart disease if you eat well and excercise.

  • Michelle C

    10/26/2007 1:50:00 AM |

    Dr. Davis,

    Could the short term memory problems associated with a statin be mistaken for the beginnings of memory problems associated with aging.  My grandmother is 84, has taken a statin for years, but in the last few has been having problems with her short term memory.  

    I asked her internist about it, but his comment was that the research was controversial and had her keeping taking the lipitor.

    She also is slipping toward hypothyroidism which may have to be treated soon.

    Thanks!

  • Dr. Davis

    10/26/2007 1:59:00 AM |

    Hi, Michelle--

    To my knowledge, the only way to connect Lipitor with memory deficits is to stop the drug for about 4 weeks. It takes that long to see the effects recede if it is indeed due to the drug. However, you will need to discuss this with your grandmother's doctor first.

  • Anonymous

    8/10/2010 12:27:32 AM |

    "muscle aches (inevitable in my experience)"

    I took statins for about 20 years until a couple of weeks ago when I decided to stop.  I didn't experience muscle aches.

    --Lub Dub (my TYP membership name)

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Media mis-information

Media mis-information

21. April 2007 William Davis (2)
This is an excerpt from a popular health website, EverydayHealth.com:


A Cholesterol-Busting Vitamin?
Did you know that niacin, one of the B vitamins, is also a potent cholesterol fighter? Find out how niacin can help reduce cholesterol…

Niacin is safe — except in people with chronic liver disease or certain other conditions, including diabetes and peptic ulcer. It is also inexpensive. However, it has numerous side effects. It can cause rashes and aggravate gout, diabetes, or peptic ulcers. Early in therapy, it can cause facial flushing for several minutes soon after a dose, although this response often stops after about two weeks of therapy and can be reduced by taking aspirin or ibuprofen half an hour before taking the niacin. A sustained-release preparation of niacin (Niaspan) appears to have fewer side effects, but may cause more liver function abnormalities, especially when combined with a statin.

Many people begin treatment at low doses (250 mg twice a day, for example) and, over six weeks or so, gradually build up to an amount that lowers lipid levels, anywhere from 1,000 to 2,500 mg split between two doses during the day. This gradual approach may help build tolerance to side effects such as facial flushing. Although niacin is available over the counter, you should not use it in quantities sufficient to lower cholesterol without a physician’s supervision. It is important to test liver function and levels of blood sugar and uric acid before beginning niacin therapy and during the course of treatment.

(Bold emphasis mine.)

At http://www.everydayhealth.com/publicsite/index.aspx?puid=548e8630-32d6-41dd-91a7-48e1cbac65ad&p=4




After an enticing headline, the article goes on to scare the pants off you. It also sounds like accurate information, delivered in an unbiased way, cold and straight.

If we were to use niacin this way, it would indeed be intolerable for most. Do not follow the above nonsensical advice. But that may have been the intention from the start.


Very telling are the fact that, both above and below the article were colorful advertisements for Lipitor, complete with Dr. Robert Jarvik’s (inventor of an implantable mechanical heart) soothing, professorial image.

Did they want to bait us with promising information about cholesterol and niacin, only to throw water on our fire and steer us towards something else?

That would be typical drug company marketing.

All in all, I’m grateful for the attention the media provides for health issues. Perhaps many people wouldn’t even be aware of niacin and other healthy strategies if some website, newspaper, or magazine article hadn’t talked about it.

But I do worry about bias. Was this an unbiased report? Or was it more like much of the physician-directed mail I receive, cleverly concealed propaganda from the drug manufacturers? Who wrote it? No author is listed. Could it have been ghost written by someone in the drug company itself, or an arm of the drug company? That’s a very common practice for the literature physicians receive, glossy, high-class materials paid for by drug companies, written by drug company-owned companies, but no company logo or name listed.

My point: Be skeptical of what the media tells us. There’s usually a good deal of truth in the reporting, but there’s also often just enough mis-information or slanting of content to make you behave or believe a certain way. “If niacin is this dangerous, maybe I really should take the Lipitor.”
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Comments (2) -

  • Bearcub

    7/1/2007 2:34:00 PM |

    My cardiologisdt has recommended that I take Niaspan instead of using Lipitor.. can you tell me more about that ??

  • Dr. Davis

    7/1/2007 5:13:00 PM |

    Big issue. Please refer to the website that this Blog supplements, www.trackyourplaque.com.

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