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Do Drs get a bonus for prescribing certain drugs ?

Jillymo profile image
61 Replies

Does anybody know if Gps get a hand out for prescribing statins ? There has been a lot of controversy in regard to this topic.

Late yesterday afternoon I had a call from my surgery. It was a Dr I had never heard of or had I spoken to her before. She was suggesting I were put on statins! I asked for what reason she were suggesting this. Her reply was that I were at risk because I had suffered TIAs and a stroke and also have a heart condition, it was a precautionary measure!

I had the TIAs and stroke in 2019 yet it is now 2024 and they want to put me on statins ! I refused but then she ask why. I explained that I had just had injections into my joints to ease my pain and that I had heard statins can cause joint pain so why would I want to take such a medication ? I went on to explain my colesterol is fine and if my cadiologist thought I were in need of statins I am sure he would prescribe them.

I felt as if I were talking to a damned sales woman rather than a DR. I explained to her I would rather the surgery addressed my B12 issue by prescribing more frequent injections for my on going nero symptoms and would it be possible to contact my endocrinologist about my low TSH.......she made her excuses and said 'sorry for bothering you' and hung up. ! 🤔

Some of the symptoms of statins.....

Common side effects

Headache.

Dizziness.

I am waiting to be seen in ENT for vertigo and can do with out further dizziness.

Feeling sick.

Oh boy did I feel sick with the vertigo. Could I get through to a ruddy Dr ( NO ) 🤬

Feeling unusually tired or physically weak.

I suffer cronic lethargy so another I can do without.

Digestive system problems, such as constipation, diarrhoea, indigestion or farting.

Oh, farting and digestive issues when I have just been diagnosed with Crohns and awaiting a Capsule Swallow.

Joint and muscle pain.

Yet another I can happily live without especially as I have recently had injections into my joints !

Sleep problems.

I can sleep for England without any issues what so ever. 🛌 😴

Low blood platelet count.

I really need this one with my Antiphospholipid Syndrome and low B12 but she did comment I am not anemic because my iron levels are in range. They would be I am prescribed folic acid and I take an iron supplement !

Is it any wonder I have little or no faith in my surgery ?

Thats my rant of the day over with.

Just found this........

Do doctors get kickbacks for prescribing statins?

Of the 2,444 doctors in the Medicare prescribing database, almost 37 percent received industry payments. Researchers found that physicians who didn't receive industry money prescribed brand-name statins at a rate of almost 18 percent. Those who did take money prescribed brand-name drugs at a rate of almost 23 percent.16 Oct 2019

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Jillymo
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61 Replies
wedgewood profile image
wedgewood

I more and more believe that our surgeries are just another branch of big business……….

Jillymo profile image
Jillymo in reply towedgewood

Me too. It wont be long before they come knocking door to door selling their wares. 🚪💊

wedgewood profile image
wedgewood in reply toJillymo

It’s so upsetting , sad and maddening .

Jillymo profile image
Jillymo in reply towedgewood

And also very frightening as we age.

Considering we paid into it all our working lives and when we need to be seen cant even get through to the surgery let alone see a damned Dr.

No matter what time I ring my surgery I get a recorded message 'the que is now full ring back tomorrow' it is enough to drive the sanest around the bend. 🤪

grumpyold profile image
grumpyold

I'm pretty sure they do get a kick back, yes. I'm from the thyroid group. Statins are particularly bad for thyroid patients, especially women, yet every time I have a compulsory medication review, they try to foist statins on me. I wonder, do they ever remember the Hippocratic oath they took and the part where it says " do no harm"?!

I think anti depressants are also being pushed now as the new fave question seems to be " and how is your mood"?

Answer.....it'd be a lot better if you just gave me sufficient B12/thyroid hormone to get me well instead of pushing stuff that I don't need.

Jillymo profile image
Jillymo

I feel as you do.

If only they were to treat the problem in question instead of pushing meds we dont need I am sure many of us would feel a lot better.

Oh thats a beauty " how is your mood or have you had truma in your life "? It would be a god send if we hadn't had trauma at some time or another !

I dont feel any of the Drs at my surgery have heard of the oath let alone taken it. I dont think it is compulsary now.

Wheat profile image
Wheat

jillymo, so sorry to hear of your many health problems!

i have prochlorperazine maleate 5mg prescribed and take it for feeling sick/vomiting associated with vertigo and migraines. A weaker 3mg PM., as Buccastem M is sold in Boots. Needs researching but this might suit you.

I am very concerned re. uninformed, inadequate (or none) and inappropriate treatment by gps. Prefer to research and treat myself. Frankly the NHS scares me to death!

Jillymo profile image
Jillymo in reply toWheat

It would take wild horses to drag me around to the Drs surgery. 🐎

I dont need statins my cholesterol is fine plus I am under the care of a cardiologist and have annual angiograms. I have no intention of taking meds I dont need unless advised by my consultant to do so.

I tried to ring my surgery for blood results to find I were answered by an automated attendant - yes an automated attendant ! We will have ruddy robots next. 🤖

I were asked to key in the extension number if I knew the number of the person I were trying to reach or to use the automated name directory press two or press zero for an operator. I pressed every damned thing I could but all I got was 'this key is not valid'. It was at that point I wonted to let out a scream. 😩

Blearyeyed profile image
Blearyeyed in reply toJillymo

If you don't mind me asking , which health condition means that you see a cardiologist and get annual angiograms? Has your cardiologist never suggested statins ?

It could well be that your risk score for plaques could have increased , especially if you also have other illnesses that affect mobility too and this is why the GP thought it was time to take statins.

They are just for lowering cholesterol, if you have atherosclerosis or a higher risk of arterial plaques or blood clotting they are prescribed to help stabilise those plaques and reduce risks of them getting larger, even if you have normal blood cholesterol levels.

The number of people whom suffer joint pain or Neuropathy on statins in comparison that those taking them is very small , in comparison to how much it gets reported and discussed. There are also various statins to try or lower doses that help prevent that side effects if you get it with your first one.

And the idea that NHS GPs get personal kick backs of the style seen in some countries is also incorrect and unfair to say.

When it came to statins the GPs were encouraged some years ago through a Department of Health initiative to expand statin prescribing to various at risk groups as a Preventative, this encouragement of useful prescribed drugs including things like gaining the surgery credits which improve their classification and access to other health initiatives that they may not be able to fully fund as a practice.

In the case of Statins when it was found their value as a Preventative ,and not just as a cholesterol lowering medication, the government subsidised the cost of the initiative so that it reduced the toll on the Surgery's prescription budgets to encourage doctors to take notice of the research, and value of a statin to patients, and stopped them being reluctant to offer this chance to patients because of concerns about their surgery budgets.

Now doctors have also seen the results in their own patients this sort of encouragement to offer help isn't required now.

No money was changing hands and the benefit was to the patients access to medication to reduce their risks of heart issues as early as possible, that a patient win.

They don't just prescribe to anyone whom wouldn't benefit from preventative medications either, it's always a suggestion and the patient has the final say.

That's a really negative urban myth.

There are lots of things I agree that GPs and Practices don't do well , and things you can complain about but these sorts of allegations about over prescribing to get bonuses aren't one of them.

Jillymo profile image
Jillymo in reply toBlearyeyed

I am seen by a cardiologist because I have an aneurysm. In answer to your question my cardiologist hasn't recommended statins.

I have more than my fair share of health problems and have no intention of taking statins or any othe medication I feel is not needed. Just about everyone I know who has taken statins has suffered side effects. I already suffer with neuropathy, joint and muscle pain plus chronic lethargy.

The comment of Drs getting a kickback was not one that I made I simply googled it and pasted. I simply raised the question not a complaint.

With regard to the Dr who rang me I doubt very much if she even knew of my full history. Thankfully patients do have a choice and refused them. Maybe they should be educating patients with regard to nutrician and lifestyle changes rather than pushing the pills. As far as I am aware nobody has suggested they dish statins out to anybody.

Point me in the right direction of making a complaint. Pals is as currupt as the ombudsman who push complaints back and forth but resolve nothing.

Blearyeyed profile image
Blearyeyed in reply toJillymo

I totally agree with you in regards to GPs and Consultants getting more training and giving more advice about Self Care Prevention including Diet and Lifestyle.I have numerous health conditions myself and have always asked for advice on top of my healthy lifestyle before treatments , surgeries and during recovery or for specific use for my chronic health issues, they always show a total lack of knowledge on these matters and just roll out that usual stuff.

All of my Self Care and local services for physio I've had to research myself. Currently, I'm working with my NHS Physiotherapist, in sessions and in our own time , to work out a better comprehensive way to exercise for people with Chronic Dysautonomia and Chronic Pain issues. I also discovered that you can work with your GP surgery and find out if it's possible to be trained and act as a Patient volunteer offering Chronic Pain, Pacing and Chronic Fatigue sessions within the Surgery. I'm waiting to start training soon, my surgery didn't know this possibility existed.

Most doctors, at whatever level , seldom know what complimentary free exercise , diet and lifestyle options are available for patients in their local area or programmes , that can include patient input, exist to add to the options they can offer without stretching their budgets. Sadly, that means they get underused and when Trust budgets get reviewed the options are lost.

My local Trust in North Wales, for example, has lost their Hydrotherapy suite for this reason , it was a vital part of my pain and exercise treatment, but doctors didn't even realise it was available so hadn't been signing patients up.

I agree PALS is very ineffective in getting something done or changed.

If you want to make a complaint about Care in a NHS Hospital you should bypass them and write to the Chief Executive Office of that Trust, explaining all the details with evidence if you have it and requesting a response.

It's better to hand the letter in , in person to their Secretary, but if you can't the address and name will be on your Hospital Website.

The Exec do not like to hear complaints, they have to be included on peoples individual records and in official reports and they act swiftly to rectify the issue as soon as possible.

If you want to complain about a GP. Nurse , Dentists. Pharmacists etc. in Primary Care you should also bypass the In House Surgery complaints system if it is an important issue or related to bad or potentially neglectful care.

As these complaints will be listened to but may not get included in surgery reports or trigger retraining.

In that case , you need to complain with specific details and dates to your local Integrated Care Board ( ICB) they will review and question your surgery and report back to you about action taken. Those complaints also get written into the person or Practices official records.

I doubt, however, that they would find in your favour on a matter of a GP Surgery doing a prescribing review and ringing you if you were entitled to use a medication for prevention or for better treatment options. That's actually part of the work they are recommended to do by the Health Board to improve their services , so it would be considered as that surgery following the guidelines given by the Department of Health and fulfilling their obligation to their patients.

Even though it may be irritating to us as patients to get these calls , especially if we can't get other services we actually do need , in respect to medical reviews and prevention these calls are actually considered a proactive and positive thing for a surgery to do.

You could, however, try a polite in-house request in writing addressed to one of the Senior Practice Partners or the Practice Manager specifying your wish not to receive these offers and calls in the future and to have this written on your notes.

You may , however, then miss out on offers, opportunities or reviews you would actually find useful though if they follow your request to the letter so it needs careful consideration before you go down that route.

Take care , Bee

Wheat profile image
Wheat

Jillymo, It's surprising we are not all insane by now. Grrrh I hate automated phone calls, press this and that number ........ Another way to abuse us, I mean avoid contact with us. Best wishes x

Jillymo profile image
Jillymo in reply toWheat

I hope you have an enjoyable bank hol, go steady on the chocolate. 🍫

Insane, who me ? 🤪

Wheat profile image
Wheat

😀xx

Thrones12 profile image
Thrones12

hi Jillymo so sorry to read this it’s just awful. My husband went to gp this week his right foot is swelling again so as he has heart failure I said to him,nagged I mean lol, you really do need to get that looked at asap so I persuaded him to pop into surgery and see if he could see someone as it’s classed as a medical emergency and should be investigated by medics asap, she said no appointments available for at least a week so try another time as she had non available,he said to her what about an emergency appointment to see a gp then ? surely you keep some aside in case of emergencies? she said yes go to a and E that’s our emergency system now..You know that old saying “gods waiting room” that’s what it feels like now,we are slowly deteriorating and that can’t be arsed attitude that we keep getting from medics from reception right through to doctors is shocking the pants off us older persons these days . So sorry Jilly xx

Jillymo profile image
Jillymo in reply toThrones12

Your absolutly right - emergencys simply no longer exist. The crap they show on the telly of the chap having a stroke and to act ASAP is nothing other than bollards. Your told to ring 111, they ask god knows how many irrelevant questions. Your then told someone will ring you back which can take hours. If your lucky unfortunate enough to reach A&E after hours of waiting your then stuck on a trolley for 11 hrs or more in a corridoor ! 🤬

11 hrs I spent on a trolley in the corridoor with heart failure then the prunes put me in a gastro ward instead of cardiolgy ! Frightened of them you bet I am.

We remember the days whe Drs bloody well doctored they were dedicated and came out no matter what time it was. As for the press this button press that button it drives you mad.

Is your hubby on water tablets ? Since my being on them I dont get swollen legs. It is very worrying so keep nagging him. 😘

Thrones12 profile image
Thrones12 in reply toJillymo

Thank you Jilly I’ll talk to him again meantime looks like it’ll be a private gp booking again. Take care xx

deniseinmilden profile image
deniseinmilden

As far as I know, yes. And if not directly, as part of a government incentive (which I think they are - they were), it is highly possible that a supplier is adding "sweetners to sales" of their particular brand of statin.

A friend was a salesman for a while for a blood pressure pill company and if a GP practice bought enough units of their brand, he could give them free holidays and other "incentives". The lowest dose has little effect on most people so the Drs were encouraged to put all their patients on a low dose. Their patients felt cared for and often were impressed that the Dr was caring for them beyond their main complaint so thought they were a winner, rather than a pawn in malpractice.

It was an unbelievably corrupt racket.

At one time there was a link on here to a list of what things Dr's got points for prescribing. Different things got different levels of points. I remember antidepressants, blood pressure pills and smoking cessation advice were high on the list, while vitamins and minerals didn't feature.

If the practice ammassed enough points they could redeem them for funding for facilities.

About that time I requested my notes and was very cross to discover that they said I'd been given smoking cessation advice and insisted that it was removed. I was incensed because it looked like I made bad lifestyle choices, when I do everything I can to be as well as possible.

Another friend worked in the stroke unit of our local hospital and was appalled when they were using very expensive drugs inappropriately, just so they ticked boxes for funding.

I feel your pain and frustration! Good luck with your Crohn's and other issues.

Have you tried Stugeron 15 sea sicknesses pills for vertigo? They are very effective! Mine was/is caused by low folate but these pills help with the symptoms until I can get my levels back up if they drop.

Jillymo profile image
Jillymo in reply todeniseinmilden

Currupt is the correct word, a drug pusher would get sentenced but the NHS get away with it.

I no longer feel as if I belong in this world of today. The care has long gone, the NHS is just a money making scam and our health is determined by numbers and tick box's not symptoms ! My meds are often swapped for generics. I repeatedly have to complain.

I remember seeing that list but cant remember who posted it. Not sure if I saved it or not but will have a look.

The gastrologist is still investigating something shown on my scan they cant identify. I had a colonoscopy in January and still waiting for a capsuale swallow. Lets hope its not a cancer else I wouldn't stand a chance. There is no urgency to anything these days. Its taken a year and a half to get this far, it's enough to make you want to give up.

The vertigo became worse after I caught covid. It has been wretched and i'm now waiting to be seen in ENT. I had some out dated stugeron I took out of desperation to try and stop the spinning and sickness. Mine is down to an inner ear problem and a possible blockage in the glands. My Rheumy is supposed to be doing a doppler scan but still waiting.

Thanks for you kind wishes. 😘

Sailinglady profile image
Sailinglady in reply todeniseinmilden

There are clear rules around "kickbacks" from drug companies in the UK (and other countries). You can only accept gifts below a specific value (I think it is £15) whether that's from a drug rep or from a patient (I can't remember the precise value because I never see drug reps and rarely get gifts from patients). The days of going to exotic locations for conferences at the cost of pharmaceutical companies so that you would be given information about their drugs are long gone. When I first qualified, we would be taken out for very nice meals by the drug rep for Losec (branded version of omeprazole, we called him Larry Losec). It was very effective, we all prescribed/recommended his medicine. Then the rules came in, our recognition of what was happening grew, and the posh meals stopped.I still prescribe omeprazole now because it's cheap (less than £1 a month), can be taken on a full stomach (much easier than taking on an empty stomach) and can be very effective if someone has dyspepsia, or takes antiinflammatory medicines. But i spend just as much time reducing there amounts people's take too see if it's still needed because it does affect the absorption of so many nutrients (not just B12).

deniseinmilden profile image
deniseinmilden in reply toSailinglady

Wonderful to hear your reply giving the more up to date facts and adding useful balance to our thread - very much appreciated. Thank you!

Sailinglady profile image
Sailinglady

Are you based in the UK? In GB, primary care doctors are partly paid by something called the QOF (quality and outcomes framework). This sets the doctors targets based on guidance produced by bodies such as NICE (the national institute for health and clinical excellence). If they achieve these targets then they receive money.The targets for treating cholesterol basically require them to have a conversation with you about taking cholesterol lowering medication (statin or an alternative, given that you would be considered to be in the secondary prevention group e.g. someone who has had an event (stroke and TIAs) and is therefore at a much greater risk of another event so would benefit from trying a statin because it would reduce your risk of a further event by around 30% (it's very difficult to qualify what your actual risk without a statin would be). If you decline to take a statin, this is coded on your records and will still count towards their payment.

The QOF year runs from 1st April to 31st March each year. The period from January to March is usually spent trying to make sure the last few patients have been contacted and had whatever work done that was needed. In your case, this was a conversation to establish whether you wanted to take a medicine which has huge amounts of evidence showing that it will reduce your risk of having another stroke. You made your view clear, the person will have recorded it on the records. You are likely to have this conversation each year if your practice is being diligent.

The money from QOF is not a "kickback" from a drug company, it is centrally funded by the NHS (so we all pay for it with our taxes and national insurance) and the aim is to improve preventive medicine because this is a lot cheaper than treating someone who has had a stroke or heart attack.

These conversations can be very difficult because there is a lot of misinformation on social media from people who believe there is a more malign reason why these medicines are prescribed. The side effects impact around 1 in 10 people, and can occur with one statin, but not another. Since it's there to keep you healthier for longer, the aim is not to give you something that will make you feel more unwell. So if you get unpleasant side effects, then you would stop it, let them settle and then try a different statin.

The drug companies are not interested in promoting statins anymore, they cost in the order of £1 to £2 a month and are all prescribed generically now (e.g. no more expensive branded versions).

As you can probably guess from the above, I work in primary care in England (I'm not a doctor but I am a prescriber). I often have these conversations with people and often encounter people with the view that you hold. I don't get any payment for having these conversations (beyond my wages) and i spend time trying to find a statin at a dose which will work for an individual. If a statin won't work for them, the wee now need to try an alternative to a statin. These are more difficult, because the evidence is not as robust, they are much newer and therefore more expensive.

Jillymo profile image
Jillymo in reply toSailinglady

Thank you for your input it is appreciated.

I emphasise 'I am under the care of a cardiologist'. I am sure if I were in need of statins he would have prescribed them. I object to not being able to contact a Dr when i'm in need of one. This Dr phoned me out of the blue trying to push statins on me. I didn't have a clue who she was !

Perhaps if my dr's and consultants had listened to me and treated what I were attending for I wouldn't have suffered TIA's or a stroke. I dont want to go into too much detail but I think enough said.

Technoid profile image
Technoid in reply toJillymo

I would think the cardiologist should be able to best assess overall whether you might benefit from the statin Jillymo, and it seems odd that primary care should jump the gun on prescribing a statin if it hadn't yet been brought up by your cardiologist.

Jillymo profile image
Jillymo in reply toTechnoid

Hence why I refused statins......

But then my useless surgery only last year when I were chasing my cardiology appointment up told me I dont need to be seen by a cardiologist ! ! !

They had missed I have been under cardiology care since 2019 having annual angiograms in London and now at Bath !

As I have said before ' if my cardiologist thought I needed them they would have been prescribed long before now'.

Blearyeyed profile image
Blearyeyed in reply toSailinglady

Great reply. I hope many people take note of the facts you've included here, Bee

Tanglewooddream profile image
Tanglewooddream in reply toBlearyeyed

The facts are they are still being encouraged to push certain drugs. Preventative medicine? Tell it to the people who can’t get the B12 treatment, optimal thyroid treatment or diagnoses of PA and thyroid disease that they need and which would prevent a lot of future suffering and other treatments. Statins, anti-depressants, BP meds and PPIs seem to be the popular choices for the NHS. Yes, some people will need them in some cases, but often other issues are ignored.

Blearyeyed profile image
Blearyeyed in reply toTanglewooddream

I agree , as a person whom took nearly 50 years to have all of my conditions properly recognized and diagnosed, and who had B12 Deficiency causing growing problems in my other health conditions for 10 years before I noted the blood test results I'd had that were ignored.Not being able to get the treatment you need and having to fight for everything is something I've had to do for years , and nobody should have to do.

But the two topics are distinct.

The fact is that they are encouraged to persuade patients that could benefit from certain medications with their health issues , especially if they are more at risk of developing heart issues or having a stroke . In these cases prevention is better than the cure. But they don't push them.

It's always the patients choice and it's worth keeping an open mind about any medications , as even if you may not feel they would benefit you at first , they may be of great benefit as your health changes and certain symptoms begin to persist.

deniseinmilden profile image
deniseinmilden in reply toSailinglady

Equally excellent information, thank you!Your views are invaluable.

I've known for ages that there is a lot negative nonsense about statins, as there is vaccinations, and am very frustrated by this, knowing that yet many more people would benefit from them if there wasn't the nocebo stigma attached to them.

I hope that you can update our knowledge and attitudes, just as efforts are being made to improve the approach of the medics.

I have been on the receiving end of a lot of dire attitudes and bungling, but always remain optimistic and treat each new practioner as I find, in the hope that I can add them to my list of the few brilliant, open minded, ones that I have been lucky enough to have had care from.

purpleabc profile image
purpleabc

So sorry you have so many problems, you don't want to add to them by taking statins ! Well done for refusing. I thought they were to lower high cholesterol which you don't have. My husband took them for a few years and his cholesterol went down to just over one ...........but before I made him stop he had difficulty lifting his arms at all, I literally was helping to dress. Then I read about them causing muscle aches etc and made him stop. I read somewhere that you have to stop slowly or there is a chance of stroke !!! He was put on a different type called Ezetimibe which doesn't cause these problems . So many people are put on statins, like a new craze. Wish B12 was the next one. Take care Jillymo.

Jillymo profile image
Jillymo in reply topurpleabc

It makes me angry to think they can push statin's but we have to fight to get our B12. I couldn't help but smile at how quickly the Dr went off the phone when I mentioned an increase of my injections. 😂

Even Ezetimbe can cause stomach issues such as diarrhoea, which I can happily live without, lethagy I already suffer with.

Like many on here I now self inject B12. 😘

yorkshiregirl4 profile image
yorkshiregirl4

So sorry to hear of your ongoing struggle with ill-health and your battle to get a reasonable service from the NHS. I really do not understand how we arrived at this place where seeing a doctor is virtually impossible and extremely stressful to arrange.

I have managed to confirm three major diagnoses in the last 12 months but only after I suggested the reason for my own ill-health and persuaded my GP to write a referral letter during a phone call. I then paid to see the appropriate Consultant. I have not seen my GP for over a year.

We have a similar number of GP's and patients compared to pre-Covid in the UK so why is it going so wrong now? I have just been prescribed a crazy/inappropriate dose of an antibiotic for an infection and am awaiting to hear the excuse for this mistake. I was asked about statins recently by a nurse who then went on to record I had denied them. I don't even believe I have any risk to warrant this question.

I am so tired of the ongoing battle, as clearly you are, which is exhausting in itself and the only consolation, if there is any, is that it is happening to us all. I think we all feel like ranting every so often and best wishes Jillymo.

Jillymo profile image
Jillymo in reply toyorkshiregirl4

It really makes you want to throw the towel in. It seems you have to pay out of your own pocket to get a service today. I bet if I were to pay to see my gastrologist private he would pull his finger from his ass.

See a Dr ? You cant even get through on the phone ! As for the 111 service it's a joke. Better not start me off on that one. 🤬

Nobody is ever held responsible for errors it's classified as the norm these days ! It's hopefully on my records I have denied statins.

At least you have managed to get some of your issues diagnosed and can hopefully press forward but dont hold your breath on that one. Nobody seems to look at the whole picture and join the dots. It's as if the patient now days have to do the work for them.

My gastrologist canceled my appointments twice because he was on strike! Yet still the bugger is dragging his heels to identify what has been seen on my scan. If it were a cancer I wouldn't stand a chance after all this time.

Your right it is exhausting. 🤨

Cherylclaire profile image
CherylclaireForum Support

Hi, Jillymo.

I have had a similar problem.

Having been found accidentally to have calcification of the coronary arteries (CAC !) during a routine Lung Healthcheck scan, my cholesterol was tested and found to be high. A GP had already decided I needed statins (yes, one who'd never met me), another agreed - but neither would have a sensible "pros and cons" conversation.

Whether statins added to calcification, about why I was not at risk when my cholesterol had been higher, about whether there were better ways to decrease it, about whether D3 tablets prescribed for osteoporosis might be better given as oil-based capsules.... just told "why are you all so against statins ?" - like we are just one big fat nuisance !

I tried to get a GP, any one will do, to request the scan of my heart so that the CAC damage was on record. I still don't know if that has been done or not. It is the only way I can access it from the Healthcheck medical team.

Always useful to have a baseline - otherwise how do GPs know whether the statins are effective or not ?

I am taking the statins currently, as the local cardiologist that the GP contacted does not wish to see me. Really don't know what else to do - it is possible to find evidence for both taking them/ not taking them, both equally convincing outwardly, but I just don't know enough. Both my parents had heart problems. Without any monitoring, what else can I do ?

But yes, I do feel that I was pushed into this course without anyone willing (or able ?) to discuss this with me properly. Not even sure what statins are supposed to do and why: turn fatty bad cholesterol into calcium ? Because calcium more adhesive to blood vessel walls, so less likely to cause a stroke or heart attack by blocking vessels ? Now as you can tell, I'm just guessing ... but what other choice do I have ?

Jillymo profile image
Jillymo in reply toCherylclaire

The one that rang me was more like a sales person than a Dr. I had never heard of this GP let alone spoken to her ! I have been prescribed vit D3 for years for my hypoparathyroidism.

My endocrinologist prescribed me such a high dose of thyroxinew had my TSH was sky high. I am sure it was due to this I suffered heart failure.

I was quite adamant I wasn't going to take statins and told her if my cardiologist thought I need to take them he would have prescribed them to me. Knowing my luck next time I see the cardiologist he will prescribe them me.

There was no 'hows your breathing or how's your blood pressure' she didn't offer to check my cholesterol or ask if my legs swell ? She could have been the surgery cleaner for all I knew.

I was only sent to see a cardiologist beause I sufferd the heart failure ( mind you I had to wait months to be seen ). I was followed up with various tests and scans which showed I have an anersym and now i'm followed up regularly to see if it's got any bigger ! You have got to have something major or be at deaths door these days before they act.

My TIAs, stroke and heart failure took place in 2019. My question was why were statins not offered back then ? What really annoyed me was this Dr was getting on her high horse when I refused them. What a shame they dont phone up and offer us our B12 injections. 🤔

Cherylclaire profile image
CherylclaireForum Support in reply toJillymo

What a shame that they can't discuss/ explain their thinking. That way it is us making the right decisions for us together - not being told what's best for us or nagged into doing as we're told without question.

Doctors may well know best - so why the problem with clarification and transparency ?

Jillymo profile image
Jillymo in reply toCherylclaire

Do they know best ? 🤔

I find most not all to be quite belittling and many know little about my diagnosed conditions to the point they have put me at risk.

I felt like a naughty school girl being bullied for refusing to take them.

I think it was the lack of discusion that put my back up. They are nothing more than civil servants doing a job and should not be making decissions for us. It's my body and my decission. 😘

Technoid profile image
Technoid in reply toCherylclaire

Statins have a couple of different effects, all of which reduce cardiovascular disease risk

(1) They lower LDL cholesterol by causing the liver to produce less of it which also increases LDL receptor uptake from blood into cells that require it.

(2) They may lower triglycerides

(3) They may increase HDL cholesterol which helps to clear fat from your arteries

(4) They reduce inflammation and stabilize existing plaque, this is the effect you were describing above. This can increase a CAC score but has the effect of reducing risk since the calcified plaque is less likely to rupture.

Explained by a cardiologist:

m.youtube.com/watch?v=gb3xA...

Jillymo profile image
Jillymo in reply toTechnoid

They may ! They dont state the unwonted side effects constantly reported............

Side effects can vary between different statins, but common side effects include:

headache.

dizziness.

feeling sick.

feeling unusually tired or physically weak.

digestive system problems, such as constipation, diarrhoea, indigestion or farting.

muscle pain.

sleep problems.

low blood platelet count.

Technoid profile image
Technoid in reply toJillymo

In a double-blind placebo controlled trial some patients had fewer symptoms on statins than on the placebo and symptom intensity did not differ between months on placebo versus months on the statin.

Ref: jwatch.org/na54099/2021/09/...

There was some interesting research a few years ago on statin-induced muscle aches:

"According to the research, published in JACC: Basic to Translational Science, statins cause spontaneous and irregular leaks of calcium from storage compartments within muscle cells. Under normal conditions, coordinated releases of calcium from these stores make the muscles contract. Unregulated calcium leaks may cause damage to muscle cells, potentially leading to muscle pain and weakness.

The researchers suggest that in most people, muscle cells can tolerate this calcium leak. However, in people already susceptible due to their genes or lifestyle, the leak caused by statins may overwhelm the muscle cells, giving rise to muscle pain and weakness.

The findings explain why only some people experience muscle pain after taking statins and could help doctors to identify those most likely to experience symptoms so they can be offered alternative therapies.

The researchers also showed that moderate exercise may prevent the changes which lead to calcium leaks from occurring, and it may be an effective way for people taking statins to avoid muscle symptoms."

from bhf.org.uk/what-we-do/news-...

Recalling the symptoms lists often posted for injectable B12, the symptoms list for statins seems similarly likely to be significantly composed of correlated symptoms - the symptoms may indeed be seen in those that are prescribed statins, but they cannot be assumed to be the result of prescribing statins.

"Hydrophilic statins (pravastatin, rosuvastatin) may cause less muscular events than lipophilic statins (e.g. simvastatin, atorvastatin) due to lower passive diffusion into muscle cells" but "results do not suggest a systematically lower risk of muscular events for hydrophilic statins when compared to lipophilic statins"

(but the remaining effect may just be due to the nocebo effect mentioned previously).

ref : pubmed.ncbi.nlm.nih.gov/337...

There are other lipid lowering drugs aside from statins and Tom Dayspring goes into the various forms of available lipid-lowering medications quite thoroughly here:

m.youtube.com/watch?v=xryGH...

An emerging risk factor other than Apo-B/LDL-P, which is worth checking at least once, is Lp(a), which can elevate risk even if other blood lipid markers are in a normal range.

There are no current treatments for an elevated Lp(a) but an elevated finding might indicate more aggressive lipid-lowering treatment be considered to reduce overall risk.

Detailed here:

m.youtube.com/watch?v=r84d-...

wedgewood profile image
wedgewood in reply toTechnoid

I’ve just read the book by Dr. Malcolm Kendrick “ The Clot Thickens” . It really makes one think again about taking statins . Very well written and well researched. He is against statins .

Technoid profile image
Technoid in reply towedgewood

Hi Wedgewood,

Malcolm Kendrick is a very popular book author but his ideas do not have a scientific foundation. Happy to discuss specifics here as needed, but Gambit62 may may call it as off-topic if it runs long so can also do so over dm's if you would like.

For a quick overview : rationalwiki.org/wiki/Malco...

WIZARD6787 profile image
WIZARD6787 in reply towedgewood

I have read some of Kendrick's work. He is brilliant and can think. A threat to those who are not and don't.

In the USA there seems to be a movement away from statins and that whole line of thinking. It is expressed as we are not extending life. Which for the medicial community is the equivalent of admitting wrongdoing.

wedgewood profile image
wedgewood in reply toWIZARD6787

I feel that I shouldn’t have mentioned it because it might cause controversy . But I’m quite impressed with his reasoning .

Technoid profile image
Technoid in reply towedgewood

Yep, I'm happy to go into the specific validity of his various arguments if you would like but it would probably best be done in a dedicated thread and will obviously be off-topic for the forum. One place to start would be:

m.youtube.com/watch?v=ieRui...

pinkpaddleboarder profile image
pinkpaddleboarder

Doctors are pharmacy salesmen. Read the book statin Nation and so pleased to hear you refused them.

Jillymo profile image
Jillymo in reply topinkpaddleboarder

I have not read the book but I agree with the salesmen quotation.

I would rather die of a heart attack than spend the rest of my life suffering from neuropathy and my other debilitating ailments.

WIZARD6787 profile image
WIZARD6787 in reply topinkpaddleboarder

I see doctors as being trusted to be in charge and the vendors/pharmacy companies as paying off the ones licensed to be in charge.

Personally I find the ones who accepts bribes to be the ones that betray a trust and not only the problem but have the power to solve it. Which for me makes them more culpable.

Enough blame to go around including those that blindly trust.

Kennyatw profile image
Kennyatw

I know the doctors used to get kick backs for the antidepressants but that was a few years ago. They don't give out free samples anymore, at least where I live but I don't know about other places.

Kennyatw profile image
Kennyatw in reply toKennyatw

And you can email me at gigrape@hotmail.com if you want to anytime ❤️

Jillymo profile image
Jillymo in reply toKennyatw

Free samples ! I have never heard of that one before.

Caution with putting your email address on here better to private message it.

Kennyatw profile image
Kennyatw in reply toJillymo

How do I have people private message me

Jillymo profile image
Jillymo in reply toKennyatw

To private message someone click on their name and to the right you will see chat click on it.

Whan you receive a private message or a reply at the top right of the page is a paper aeroplane which will have a tick on it press on it to reply. I will send you a private message now.

Technoid profile image
Technoid

Hope this may help

m.youtube.com/watch?v=R6FGa...

Jillymo profile image
Jillymo in reply toTechnoid

Product Information

Heart disease is the leading cause of death worldwide, and for decades conventional health authorities have pushed that the culprits are fat and cholesterol clogging up coronary arteries. Consequently, lowering cholesterol has become a hugely lucrative business, and cholesterol-lowering Statin drugs are now the most prescribed medication in the world, with clinical data showing one billion people eligible for prescription. However, these cholesterol guidelines have been heavily criticized, and increasingly, doctors and researchers have been questioning the role cholesterol plays in heart disease. We now know that people with heart disease often do not, in fact, have high cholesterol, and even the strongest supporters of the cholesterol hypothesis now admit that no ideal level of cholesterol can be identified. Large-scale studies have proven that statins are not generating the benefits that were predicted, and new research shows that high cholesterol may actually prevent heart disease. Worse still, millions of people in the United States and worldwide are taking statins preventatively, at great cost to their health. A complete reevaluation of the real causes of heart disease is long overdue, not to mention an inquiry into why the pharmaceutical industry continues to overprescribe statins (and market them aggressively to consumers) despite this evidence. Statin Nation offers a new understanding of heart disease, and Justin Smith forges an innovative path away from the outdated cholesterol myth with a viable alternative model to address the real causes of heart disease. Statin Nation provides detailed examinations of nutritional alternatives that are up to six times more effective than statins, and other interventions that have been shown to be up to eleven times more effective than statins. But all of these methods are currently ignored by health authorities. Smith provides a heart disease prevention plan that anyone can use, providing hope for the future of heart-disease treatment with a purpose.

Various books on this topic to be found....
Technoid profile image
Technoid in reply toJillymo

Lifestyle and Nutrition should always be the first port of call but if a statin is being prescribed, that will generally be because there is significant elevated risk despite the available lifestyle and dietary interventions being applied. Genetic factors such as familial hypercholesterolemia cannot be ignored and severe FH will always require lipid lowering drugs to get someone into a safe range. Previous cardiovascular events are an important consideration.

If someone applies lifestyle and nutrition approaches sufficiently well to elimate most cardiovascular risk factors and also reduce ApoB/LDL-P to demonstrably safe levels where cardiovascular disease will not progress, then a clinician likely will not suggest or prescribe a statin at all.

FancyPants54 profile image
FancyPants54 in reply toTechnoid

Sorry, but I think that's a very naive statement. The clinicians recommend them to everyone "as a preventative measure" which is not proven and not necessary. They tried to tell my 89 year old mum to start them at her last medication review with the pharmacy because her kidney function was a little low! I soon told them where to put that idea. Ridiculous suggestion.

Cholesterol is so necessary to so many bodily functions that it's madness to force it low.

Technoid profile image
Technoid in reply toFancyPants54

"The clinicians recommend them to everyone "as a preventative measure"

I have no way to confirm that but I was pretty specific about the conditions which might justify suggesting or prescribing a statin. It's not up to me whether a clinician makes a good assessment of whether a statin is justified or not - many factors would have to be considered. No-one can force someone to take a statin - it should be a considered conversation between the patient and doctor. I'm fully aware that might not always (or often) be the case.

For your specific case, there is a relevant NICE guideline so there doesn't seem to have been any issue with suggesting a statin in that case. It certainly wasn't "ridiculous".

nice.org.uk/news/article/st...

A longer conversation would be required on your point regarding lowering cholesterol and I don't want to post a great deal and then have the thread removed which would waste my time which has previously happened. Instead, I advise to watch the videos I posted.

Technoid profile image
Technoid in reply toTechnoid

Some of the more popular dietary supplement approaches are covered in this article:

Can I Skip Statins and Just Take Supplements?

Some supplements have been shown to modestly lower cholesterol, but cardiologists say they’re no match for statins.

nytimes.com/2023/03/01/well...

wedgewood profile image
wedgewood in reply toJillymo

Yes , I’ve just read Dr Malcolm Kendrick’s book “ The Clot Thickens “ . Excellently written and researched . He is against statins , but gives other solutions to keep arteries clear . A very good read .

mauschen profile image
mauschen

In the UK, NO!

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