A month or so ago I went in for a general physical checkup, the first I’d had in years. Overall things are okay — no unexpected lumps, lesions or blood test results — but the physician noticed that my cholesterol (both TC and LDL) was a little high.*
I knew that, but it wasn’t as high as it had been six months ago (I had neglected to tell him I’d had bloodwork done prior to signing up at the gym), so I was pleased. My counts were down by about 5% with relatively small changes in diet and with somewhat larger changes in exercise.
(I’ve never been much of a fan of worrying about diet, cholesterol, weight or exercise, at least not since I hit my early 20s. Cholesterol’s easy; just back off on the fats and eat more fiber. This, miraculously, automatically keeps weight under control. The physical side of it is so easy to get that indolence of any kind is, to my mind, inexcusable. Strange attitudes, you’d think, from a former high school fat kid — but then, by applying the foregoing to my own life, I stopped being a fat kid, so maybe those attitudes aren’t so strange after all.)
Anyway, owing to my lack of detail regarding my own habits — the examination took all of five minutes, so maybe that was part of the problem — the physician didn’t know about my more recent history, and said he wanted me to go on Lipitor™.
Which I outright rejected doing, because I know what statins do to people. I’m far too attached to my muscles and liver to want to go shitting them out wantonly in the name of dropping my TC by a few digits.
Beyond the ghastly adverse reactions to statins, though, there’s the dual-edged fact that (1) statins have not been shown to reduce heart disease rates at all; and (2) one pill doth not a lifestyle change make.
Point 1 is important because drugs such as Lipitor™ are marketed on the argument that high cholesterol leads to heart disease; thus, lowering your TC will reduce your risk of heart disease. Problem is that, while people on statins do in fact have lower TC, they do not have lower heart disease rates. In other words, there’s no positive correlation between lowering cholesterol and lower incidence of heart disease.
Essentially the forty million or so people on statins now are acting as a giant lab experiment, testing the claims of manufactuer efficacy — and more than a few putting their health at grave risk — without any sort of compensation and damned little notice that what they’re doing might not actually be doing anything good for them. (Pfizer has lately added a tiny little text disclaimer to their ads admitting that there’s no link between Lipitor™ usage and reduced rates of heart disease, but if you thought the breast-implant stink was bad in the ’90s, wait until the shit hits the fan on this one.)
Point 2 should already be tickling the brains of alert readers. If there’s no correlation between cholesterol and heart disease, presumably there must be other factors that determine incidence of problems. Or that would be the sensible conclusion, at any rate.
For example, if I had followed my physician’s advice, I would have started on Lipitor™ — but I would not have been advised to increase my physical activity, change my diet or — presumably — give up smoking (which I did some time ago). I have the saddening impression that I simply would have left with a prescription and no other advice regarding ways to make a difference.
I could even argue that the physician’s first impulse — reach for the pad and prescribe a drug — was not the ideal one, not for someone with a TC far too low to be regarded as severe. Sure, it’s a little high … but it’s not alarmingly high, and it’s well in the range that can respond quickly to diet and exercise. Which (as I mentioned before) was already happening.
Nevertheless, rather than run the risk of annoying me by telling me to modify my diet and add some physical activity to my life, the physician decided the correct course would be to fill me full of a drug with a legion of mild to possibly fatal side-effects.
Now there’s an OTC version of Xenical, a drug that changes the chemical structure of some fats so they can’t be absorbed, giving Americans another excuse to ignore healthful diet guidelines. Rather than reduce fat in the diet, you can theoretically just snork it up and take the OTC pill (proposed name Alli) to avoid any responsibility whatsoever for your actions.
Between statins, Alli and fiber pills, you really don’t need to pay attention to what you eat at all, actually. Pack in ten pounds of red meat a day, take Alli to keep the fat from building up, Lipitor™ to pull out the cholesterol, Metamucil™ to unblock your colon and Pepcid™ to handle the heartburn. Oh, and a green tea capsule to reduce colon cancer risk. Presumably you could pop Viagra™ to make up for the effects of lousy circulation as well.
Now if there were only a pill that let you work out without having to actually put forth any effort. Wouldn’t that be great? We’d all look like supermodels, eat like pigs and have absolutelyy no self-discipline or self-restraint whatsoever.
But the lesson of statins might be telling us something more. It might be telling us, for instance, that an exclusive focus on one sub-element of food — or keying in too much on one allegedly useful diagnostic criterion — doesn’t really tell us much about overall health. We might have a lesson before us that TC is one factor in a continuüm of indicators which may or may not suggest something useful about a person’s overall diet and risk of heart disease.
Maybe what needed to happen was for my physician to tell me, look, your TC is a little high; I’d like you to get off your ass and start exercising, stop sucking down the pizza and, if you’re smoking, quit it … or you’re not going to be living a very comfortable life in another twenty years or so. Sure, that might have offended me; but it surely would have got the point across.
Maybe we could spend a little less time being polite to one another where health concerns are rife; and maybe our medicine maufacturers could stop trying to produce and market drugs to a segment of society that simply doesn’t need them.
Maybe Americans need to be insulted into behaving more healthfully, rather than funnel-fed pills to answer all our concerns.
* By “a little high” I mean in the 230s for TC. That’s worse than the Federally-mandated 200, but it’s nowhere near a bad as the human-WMD level of 300 or more.
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