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They probably recommended a low fat low cholesterol diet and a minimal amount of exercise. That's why you still need drugs.
LOL, nope. At least moderate amount of exercise, at least 150 minutes per week, I aim for 250+/week as time and my old age bones tolerate it. The docs ask me for specifics about the exercise I do ( elliptical and recumbant bicycle, resistance work with weights as a baseline to make sure I get that exercise), and walking around 2 miles several times a week. The docs ( pcp and cardiologist) have expressed approval of my exercise regime and I can attest that it sure helps the blood pressure, apparently the lipid levels and my general overall health.
Low carb diet, fruits, veggies, watching the calories and all things in moderation works best for me.
So it's anecdotal. But my experience with my own healthcare providers belies your blanket claims about docs knowing nothing about life style activities, not recommending these activities and pushing medications in lieu of diet, exercise or other lifestyle activities.
It's never solely medications. I don't know of any doctor who just puts patients on medications and never mentions lifestyle.
I have been prediabetic for decades and control it with watching what I eat and exercising. The statin I take is the lowest concentration on the market and only one tablet every other day. All my medications are at the lowest concentration on the market.
The older one gets the worse it gets because of the biological changes that occur on the body.
Interesting anecdote (at least to this old retired lab tech here, LOL). I've had my labs checked during twice a year visits to my PCP for a number of years. These labs are done at the laboratory maintained by the physician practice management group to which my PCP also belongs. Most lab results were fine, with the exception of glucose levels consistently over 100 mg/dL ( usually in the 104-110 range.) So I got slapped with the prediabetes label, and my PCP recommended exercise and watching the diet, which I have, but those levels never changed. She stopped worrying about it, she said, as those levels never changed, never increased. I attributed the glucose levels to possible effects of some of the medication I take ( simvastatin, metoprolol, possibly diltiazem) as the literature claims these drugs can elevate glucose levels, and the PCP agreed this could be.
So then I got the colon cancer diagnosis in 2022, and while they got it all with a colon resection and I did not need chemotherapy ( thanks to a combination of the stage 2-A, negative lymph nodes and tumor genetics-MSI-H), but now see an oncologist for regular surveillance for recurrence of the cancer ( or make sure the varmint stays away, I'd prefer to think). This also involves labs several times a year. The regional cancer center I attend has its own lab. While the test results from this lab compared with the lab used by my PCP are pretty much the same ( well within acceptable statistical variation for each analyte), the glucose level from the cancer center lab have been significantly lower ( ie, in the 80-90 mg/dL range) than those of the PCP lab. I did the happy dance when I saw the first normal glucose level.
Of course I attribute this to differences in the glucose methodology used by each lab. I'm curious enough about it to see if it's possible to find out which methodology is used by each lab, and check out the potential for each for increased glucose results due the presence of other components ( like drugs) in blood samples. That's one resolution I've made for the New Year, not that it will be easy, I'm a patient at both places, not a lab tech or from their perspective, an individual entitled to check out, or communicate with their lab facilities, and why in the world would any patient be interested in these
details anyway? Along with that resolution, I'm also working on a way to get these folks to coordinate my lab draws and tests so there aren't double blood draws and testing when the PCP and oncologist visit times are in close proximity. My attempts so far to do this have gone in one ear and out the other of the personnel I've tried to get to do it. Still a work in progress.
It's never solely medications. I don't know of any doctor who just puts patients on medications and never mentions lifestyle.
I have been prediabetic for decades and control it with watching what I eat and exercising. The statin I take is the lowest concentration on the market and only one tablet every other day. All my medications are at the lowest concentration on the market.
The older one gets the worse it gets because of the biological changes that occur on the body.
I appreciate reading both sides of the statins argument and the time taken to do the responses. The reason I did the original posting was I had what they call a mini-stroke (or TIA) but the stroke did not show any brain damage on the Brain MRI and CT scan at the ER so it was a warning. My only stroke symptom when it happened was I lost my ability to talk for about 2 1/2 hours, at which time it resolved on its own. Doctors do not know the cause, only possibilities. One possibility is a Lacunar infarction and the treatment for that type of stroke is high intensity statins. At the time of the stroke, I was already on 20mg's of Rosuvastatin due to 40% blockage in my coronary widow maker artery, and as far as side effects from that dosing, I had none that I was aware of after being on for about 3 years. However due to the mini-stroke, my doctor wants me to increase to 30mgs. With that recommendation I went back and looked at the side effects again at higher dosing, and what I read spooked me. However compared to placebo the risk/reward benefit from increasing is still very favorable but even so it led me to pause the Rosuvastatin increase. Anyone who has had a stroke probably knows that the probability of having a 2nd one in the following year goes way up so best to do all things possible to lower that risk and high intensity statin use is one of them (as well as aggressive blood pressure control). However what I was really trying to sort out with my post was if more people will do postings (or drug ratings such as on drug's.com) if they have a negative experience with a drug rather than a positive one. If that is correct, then that might help explain why well done double blind studies show significantly lower side effects than one would read about on forums and drug rating platforms like drug.com. Again thanks to all for the responses.
Interesting anecdote (at least to this old retired lab tech here, LOL). I've had my labs checked during twice a year visits to my PCP for a number of years. These labs are done at the laboratory maintained by the physician practice management group to which my PCP also belongs. Most lab results were fine, with the exception of glucose levels consistently over 100 mg/dL ( usually in the 104-110 range.) So I got slapped with the prediabetes label, and my PCP recommended exercise and watching the diet, which I have, but those levels never changed. She stopped worrying about it, she said, as those levels never changed, never increased. I attributed the glucose levels to possible effects of some of the medication I take ( simvastatin, metoprolol, possibly diltiazem) as the literature claims these drugs can elevate glucose levels, and the PCP agreed this could be.
This is another reason why statins are SO BAD. Elevated glucose causes metabolic syndrome (prediabetes) which causes elevated triglycerides.
A vicious cycle! Statins actually lead to higher cholesterol, so they give you more statins!
Last edited by Good4Nothin; 01-01-2024 at 11:10 AM..
Interesting anecdote (at least to this old retired lab tech here, LOL). I've had my labs checked during twice a year visits to my PCP for a number of years. These labs are done at the laboratory maintained by the physician practice management group to which my PCP also belongs. Most lab results were fine, with the exception of glucose levels consistently over 100 mg/dL ( usually in the 104-110 range.) So I got slapped with the prediabetes label, and my PCP recommended exercise and watching the diet, which I have, but those levels never changed. She stopped worrying about it, she said, as those levels never changed, never increased. I attributed the glucose levels to possible effects of some of the medication I take ( simvastatin, metoprolol, possibly diltiazem) as the literature claims these drugs can elevate glucose levels, and the PCP agreed this could be.
So then I got the colon cancer diagnosis in 2022, and while they got it all with a colon resection and I did not need chemotherapy ( thanks to a combination of the stage 2-A, negative lymph nodes and tumor genetics-MSI-H), but now see an oncologist for regular surveillance for recurrence of the cancer ( or make sure the varmint stays away, I'd prefer to think). This also involves labs several times a year. The regional cancer center I attend has its own lab. While the test results from this lab compared with the lab used by my PCP are pretty much the same ( well within acceptable statistical variation for each analyte), the glucose level from the cancer center lab have been significantly lower ( ie, in the 80-90 mg/dL range) than those of the PCP lab. I did the happy dance when I saw the first normal glucose level.
Of course I attribute this to differences in the glucose methodology used by each lab. I'm curious enough about it to see if it's possible to find out which methodology is used by each lab, and check out the potential for each for increased glucose results due the presence of other components ( like drugs) in blood samples. That's one resolution I've made for the New Year, not that it will be easy, I'm a patient at both places, not a lab tech or from their perspective, an individual entitled to check out, or communicate with their lab facilities, and why in the world would any patient be interested in these
details anyway? Along with that resolution, I'm also working on a way to get these folks to coordinate my lab draws and tests so there aren't double blood draws and testing when the PCP and oncologist visit times are in close proximity. My attempts so far to do this have gone in one ear and out the other of the personnel I've tried to get to do it. Still a work in progress.
"An expert committee compiled evidence-based recommendations for laboratory analysis in screening, diagnosis, or monitoring of diabetes. The overall quality of the evidence and the strength of the recommendations were evaluated."
I noticed this update evaluation as there were updates with diabetic ketoacidosis clinical recommendations and this article stated the laboratory criteria aspects.
Laboratory measurements of random or fasting glucose concentrations should not be performed as the primary means of routine outpatient monitoring of people with diabetes. Laboratory plasma glucose testing can be used to supplement information from other testing or to assess the accuracy of self-monitoring (see below) (60).
Analytical considerations
Preanalytical
Recommendation: Blood for fasting plasma glucose analysis should be drawn in the morning after the subject has fasted overnight (at least 8 h). B (low)
Recommendation: To minimize glycolysis, a tube containing a rapidly effective glycolytic inhibitor such as granulated citrate buffer should be used for collecting the sample. If this cannot be achieved, the sample tube should immediately be placed in an ice-water slurry and subjected to centrifugation to remove the cells within 15 to 30 min. Tubes with only enolase inhibitors such as sodium fluoride should not be relied on to prevent glycolysis. B (moderate)
Decrease in glucose concentration in the sample due to glycolysis is a serious and underappreciated problem (62, 63). Glucose concentrations decrease ex vivo in whole blood due to glucose consumption predominantly by red and white blood cells. The rate of glycolysis—reported to average 5% to 7% (approximately 0.6 mmol/L; 10 mg/dL) per hour (64) —varies with the glucose concentration, temperature, white blood cell count, and other factors (62, 65). Such a decrease of glucose will lead to missed diagnoses of diabetes in the large proportion of the population who have glucose concentrations near the cutpoints for diagnosis of diabetes.
Analytical
Recommendation: Based on biological variation, glucose measurement should have analytical imprecision ≤2.4%, bias ≤2.1% and total error ≤6.1%. To avoid misclassification of individuals, the goal for glucose analysis should be to minimize total analytical error and methods should be without measurable bias. B (moderate)
The method of glucose measurement did not influence the result. Comparison of results from approximately 6000 clinical laboratories reveals that the mean glucose concentrations measured in serum samples by the hexokinase and glucose oxidase methods are essentially the same (86). However, compared to a reference measurement procedure, significant (P < 0.001) bias (up to 13%) was observed for 40.6% of the peer groups (86). If, as is likely, similar biases occur with plasma, individuals near the diagnostic threshold could be misclassified."
There are preanalytical problems and if you switch labs there can be analytical variance. When I first started all "glucose" testing was collected in a gray top sodium fluoride and put on ice until it was brought to the lab and analyzed as soon as possible. Today there is no special handling of such testing. All samples are collected in heparin gel tubes without ice. Samples should be centrifuged as soon as possible. That is something that happens at the draw station.
Personally I use fasting chemistry panel glucose values as a rough estimate. A1C has less preanalytical variable problems and involves whole blood with no need for centrifugation. I rely more on the A1C and the guidelines for diabetic monitoring also recommends the same.
I appreciate reading both sides of the statins argument and the time taken to do the responses. The reason I did the original posting was I had what they call a mini-stroke (or TIA) but the stroke did not show any brain damage on the Brain MRI and CT scan at the ER so it was a warning. My only stroke symptom when it happened was I lost my ability to talk for about 2 1/2 hours, at which time it resolved on its own. Doctors do not know the cause, only possibilities. One possibility is a Lacunar infarction and the treatment for that type of stroke is high intensity statins. At the time of the stroke, I was already on 20mg's of Rosuvastatin due to 40% blockage in my coronary widow maker artery, and as far as side effects from that dosing, I had none that I was aware of after being on for about 3 years. However due to the mini-stroke, my doctor wants me to increase to 30mgs. With that recommendation I went back and looked at the side effects again at higher dosing, and what I read spooked me. However compared to placebo the risk/reward benefit from increasing is still very favorable but even so it led me to pause the Rosuvastatin increase. Anyone who has had a stroke probably knows that the probability of having a 2nd one in the following year goes way up so best to do all things possible to lower that risk and high intensity statin use is one of them (as well as aggressive blood pressure control). However what I was really trying to sort out with my post was if more people will do postings (or drug ratings such as on drug's.com) if they have a negative experience with a drug rather than a positive one. If that is correct, then that might help explain why well done double blind studies show significantly lower side effects than one would read about on forums and drug rating platforms like drug.com. Again thanks to all for the responses.
Thanks for the clarification. The self reporting of complications and side effects is questionable. It is assumed that the higher the concentration of the drug the greater the chances of adverse events. That's a gross generalization. Each drug has a unique risk profile. The incidence and cause vs association is again hard to determine from self reporting websites.
You see one person all over the net saying they almost died from the drug at that concentration and you want to read good news from others who didn't have a problem. That's a bias that will always be there you understand that. It doesn't change the reality of the situation though.
The practice guidelines look for detrimental outcomes based on current medical practice. If there were substantial detrimental outcomes then the practice guidelines would change. In order to institute that practice there had to be a study or studies showing a good benefit risk ratio. It might also illuminate which candidates are better candidates for higher dose and which are not that might succumb to adverse events.
Thanks for the clarification. The self reporting of complications and side effects is questionable. It is assumed that the higher the concentration of the drug the greater the chances of adverse events. That's a gross generalization. Each drug has a unique risk profile. The incidence and cause vs association is again hard to determine from self reporting websites.
You see one person all over the net saying they almost died from the drug at that concentration and you want to read good news from others who didn't have a problem. That's a bias that will always be there you understand that. It doesn't change the reality of the situation though.
The practice guidelines look for detrimental outcomes based on current medical practice. If there were substantial detrimental outcomes then the practice guidelines would change. In order to institute that practice there had to be a study or studies showing a good benefit risk ratio. It might also illuminate which candidates are better candidates for higher dose and which are not that might succumb to adverse events.
There was that highly publicized study saying bad effects were just as likely in the placebo group. That put to rest all concerns about statin side effects. It probably was another example of how the drug industry misuses statistics to sell their drugs.
There was that highly publicized study saying bad effects were just as likely in the placebo group. That put to rest all concerns about statin side effects. It probably was another example of how the drug industry misuses statistics to sell their drugs.
If a person believes that then don't take the drug. Don't take any drug. The problem that we though is that there are people out there with mental illness who refuse to take drugs for a variety of reasons. They have side effects and people get paranoid and and suspicious about the drugs. Those people end up in prison or mental wards when they could be leading productive lives. That's where the real tragedy lies.
Statins has had many studies to the point where we are not speaking of one study. It is generally a collection of studies called a meta-analysis that provides greater strength in the evidence.
Evidence based medicine means everything conventional medicine does tries to have concrete clinical study evidence in favor of doing x, y, and z. Without such evidence then things are done based on experience and one does not know if they really work or not. Alternative medicine has zero clinical evidence that they work. They are based on what people think might work or should work. The basis of that thinking is also highly suspect since it comes from the garbage heap of conventional medicine that was discarded and discredited.
Interesting anecdote (at least to this old retired lab tech here, LOL). I've had my labs checked during twice a year visits to my PCP for a number of years. These labs are done at the laboratory maintained by the physician practice management group to which my PCP also belongs. Most lab results were fine, with the exception of glucose levels consistently over 100 mg/dL ( usually in the 104-110 range.) So I got slapped with the prediabetes label, and my PCP recommended exercise and watching the diet, which I have, but those levels never changed. She stopped worrying about it, she said, as those levels never changed, never increased. I attributed the glucose levels to possible effects of some of the medication I take ( simvastatin, metoprolol, possibly diltiazem) as the literature claims these drugs can elevate glucose levels, and the PCP agreed this could be.
So then I got the colon cancer diagnosis in 2022, and while they got it all with a colon resection and I did not need chemotherapy ( thanks to a combination of the stage 2-A, negative lymph nodes and tumor genetics-MSI-H), but now see an oncologist for regular surveillance for recurrence of the cancer ( or make sure the varmint stays away, I'd prefer to think). This also involves labs several times a year. The regional cancer center I attend has its own lab. While the test results from this lab compared with the lab used by my PCP are pretty much the same ( well within acceptable statistical variation for each analyte), the glucose level from the cancer center lab have been significantly lower ( ie, in the 80-90 mg/dL range) than those of the PCP lab. I did the happy dance when I saw the first normal glucose level.
Of course I attribute this to differences in the glucose methodology used by each lab. I'm curious enough about it to see if it's possible to find out which methodology is used by each lab, and check out the potential for each for increased glucose results due the presence of other components ( like drugs) in blood samples. That's one resolution I've made for the New Year, not that it will be easy, I'm a patient at both places, not a lab tech or from their perspective, an individual entitled to check out, or communicate with their lab facilities, and why in the world would any patient be interested in these
details anyway? Along with that resolution, I'm also working on a way to get these folks to coordinate my lab draws and tests so there aren't double blood draws and testing when the PCP and oncologist visit times are in close proximity. My attempts so far to do this have gone in one ear and out the other of the personnel I've tried to get to do it. Still a work in progress.
It's actually a widely known phenomenon (but not understood) that after gastric cancer surgery, many people experience improvements in their fasting blood sugar, and even remission of type 2 diabetes if they're diabetic.
If a person believes that then don't take the drug. Don't take any drug. The problem that we though is that there are people out there with mental illness who refuse to take drugs for a variety of reasons. They have side effects and people get paranoid and and suspicious about the drugs. Those people end up in prison or mental wards when they could be leading productive lives. That's where the real tragedy lies.
Statins has had many studies to the point where we are not speaking of one study. It is generally a collection of studies called a meta-analysis that provides greater strength in the evidence.
Evidence based medicine means everything conventional medicine does tries to have concrete clinical study evidence in favor of doing x, y, and z. Without such evidence then things are done based on experience and one does not know if they really work or not. Alternative medicine has zero clinical evidence that they work. They are based on what people think might work or should work. The basis of that thinking is also highly suspect since it comes from the garbage heap of conventional medicine that was discarded and discredited.
I have never advocated "alternative" medicine, and I have never said clinical research is worthless. However, I know some of the tricks the drug industry plays to make big sellers like statins seem much better than they are.
And now you brought up psychiatric drugs, which is totally unrelated to this conversation. But even they are not nearly as great as MDs tend to believe.
As for "alternative" medicine having zero evidence, that depends on what you mean by "alternative." The idea that you can prevent many diseases by improving lifestyle started out as alternative, but now there is plenty of confirming research.
The idea that gut bacteria are important for health was alternative. The idea that a high carbohydrate diet can cause metabolic syndrome, prediabetes and diabetes was alternative.
Ideas may start as alternative before the mainstream is convinced. They have zero evidence, until they do have evidence. And by the way "alternative" and "holistic" are not the same thing.
Your mind seems completely closed to the idea of approaching health with a systems perspective, instead of a reductionist perspective.
Yes, reductionist modern medicine has some benefits, mostly in surgical technology, and to an extent certain drugs. But it also fails in many many ways.
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