NICE Guidelines news item published Nov 2024. - Thyroid UK

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NICE Guidelines news item published Nov 2024.

arTistapple profile image
22 Replies

As usual I have tried to highlight this for ease of use on the Forum. Can’t do it. Apologies in advance. However someone else may have already posted it.

It’s about statins. I think it’s a bit of a ‘blitz’ following Dr. Malcolm Kendrick’s recent court success. An attempt to counteract his ‘win’. Briefly it’s a glossy piece of blurb, all about how much statin prescriptions are increasing year on year and basically to communicate what a good thing this is. No doubt to attempt to give GPs and the public some confidence after the outcome of the said court case.

Maybe it’s just me but it’s really just a pure PR exercise and amounts to boasting about increasing success purely by the number of prescriptions. They give no real indication of the body’s processes involved in the why and wherefore of the body’s needs for cholesterol.

I can’t see any ‘proof’ it’s helping. How many heart attacks/events is it stopping? Interesting that this is from NICE though and not the pharmaceutical companies themselves. It appears to me that NICE is merely a puppet for Big Pharma here.

I could be ‘blinded’ in this because of where I am at, at the moment. Virtually being cornered into taking them. If someone else could read this and let me down gently, as to my understanding of it, I would be obliged.

Roll on Dr Malcolm Kendrick et al for their bravery in saying nothing defamatory about statins but highlighting public awareness that statins are ……… best thought about very carefully before prescribing/taking.

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arTistapple profile image
arTistapple
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22 Replies
RedApple profile image
RedAppleAdministrator

arTistapple, Can you give us a clue about where you read this? Newspaper? Social media?

arTistapple profile image
arTistapple in reply toRedApple

RedApple it’s a newsfeed from NICE itself. Cake-Maker has kindly found it and highlighted it.

Cake-Maker profile image
Cake-Maker

Thank you for this. Very timely. As I write OH is currently having a bit of a meltdown as GP surgery has just phoned to say that he has to increase his statin as his cholesterol is raised (Triglycerides).

Mine is slightly raised but no meds required yet.

A GP friend has told me that current targets in GP contracts are to increase number of patients on Statins.

Looking for answers and alternatives

Is this it       arTistapple ?

nice.org.uk/news/articles/m...

For further info - think this is the Dr Kendrick Court Case referred to by OP

drmalcolmkendrick.org/2024/...

drmalcolmkendrick.org/2024/...

zoeharcombe.com/2024/06/har...

Much more about this and Dr Kendrick / Statins on internet including:

drmalcolmkendrick.org/stati...

arTistapple profile image
arTistapple in reply toCake-Maker

That need is it Cake-Maker. Thank you.

helvella profile image
helvellaAdministrator

More prescriptions, more people taking statins - or ezetimibe- doesn't mean quite what they imply.

Even if we accept the first million benefit, let's assume they have statistics to back that up, the next million will likely have been at lower risk, Hence, you'd not see quite the same level benefits. By the time you are into the sixth million, it is likely that you are already treating most of those who are most likely to benefit! And could well be beyond diminishing returns into harms outweighing the benefits.

Also, 900,000 more taking statins needs to be considered in the light of those who are no longer taking statins - perhaps they have since died, or they've quit for some reason. So that would imply more than 900,000 people newly prescribed statins.

But the way they present that implies every extra person gains exactly the same benefits.

More people are benefitting from NICE-recommended statins to reduce heart attacks and strokes

Around 5.3 million people in England were given a NICE-recommended statin or ezetimibe by their GP to help reduce their cholesterol during 2023/24, the largest number on record and almost 900,000 more than in 2022/23.

nice.org.uk/news/articles/m...

And there is a massive gung-ho about prescribing statins. I very recently had my cholesterol tested. Bear in mind, I have been recommended statins several times, twice very strongly. And always refused.

Cholesterol (General: 0 - 5.0 Desirable: <5.2mmol/L.) 3.57 mmol/L

If I took anything to lower my cholesterol, I'd likely hit overt hypocholesterolaemia very quickly! But they don't think, quite possibly don't test, before offering statins.

Cake-Maker profile image
Cake-Maker in reply tohelvella

May I ask how you’ve tackled your cholesterol issues pls Helvella?

Oh no. OH has just come back from shopping with low fat spread (not butter); skimmed milk (not semi - skimmed) …. and no chocolate or cheese!

helvella profile image
helvellaAdministrator in reply toCake-Maker

Yes, you can ask :-) - but I haven't treated them at all. It is just how I am. (And my thyroid hormone/TSH levels are currently acceptable.) That really is the issue! The prescribers are not taking into account that some of us really do not need statins (or any other cholesterol modifying agents).

I consume plenty of fat - butter, cheese, meat, olive oil.

The only lipid issue is that I could, possibly, do with a small increase in HDL.

Cake-Maker profile image
Cake-Maker in reply tohelvella

Thank you 😉

OH has no thyroid problems but has a BMI which is a bit higher than it should be. BP is well controlled. The current dose of statins (20 mg Pravasatatin) causes muscle weakness and cramp so he doesn’t walk as much as he used to.

Now they want to increase it!

I don’t think so!!

Sending him back for the cheese, butter etc.

We’re in our seventies. We don’t want to be ill but we don’t want to live be 100.

helvella profile image
helvellaAdministrator in reply toCake-Maker

My BMI is too high! Forgot to include that.

BP is OK - never been an issue though I can feel it rising when a medic approaches me! And still not too bad. If I do it again properly, always OK.

arTistapple profile image
arTistapple in reply tohelvella

My BP similar. My stress levels now go through the roof. No wonder so many elderly (moi) feel safer out of the clutches of medics.

Cake-Maker profile image
Cake-Maker in reply tohelvella

Have investigated OH’s blood results on Patient Access and apparently cholesterol per se is OK but its ratio of good /bad that’s not acceptable.

Appointment with nurse to discuss how this can be handled and another appt with Clinical Pharmacist to discuss low eGFR Renal Function test which is 57 nmol. Apparently anything below 60 has to be investigated.

My ‘medical’ sister did tell us that the appt with the Clinical Pharmacist will be to discuss meds currently being taken. She made the point that statins ar the calcium channel blocker for BP) could affect renal function and they may switch him to an ace inhibitor.

I couldn’t believe that statins could cause kidney problems / low eGFR so I had to do a very quick search. This site isn’t the best but it’s mentioned on others.

kidney.org/kidney-topics/fi...

If you look at symptoms of low kidney function they bear a strange resemblance to side effects of Statins!

Beam me up! We’re all lab rats enduring poly pharmacy as a result

He looks anxious and deflated and I wonder just what has been gained by this annual review other than unnecessary anxiety.

I’m really wondering whether the data generated by these reviews is for the benefit of practice targets and income rather than patient outcomes.

FancyPants54 profile image
FancyPants54 in reply toCake-Maker

Send him back out to do it again, properly! That's a terrible diet.

Cake-Maker profile image
Cake-Maker in reply toFancyPants54

😤

arTistapple profile image
arTistapple in reply tohelvella

According to one source I was reading (Lustig) he says now it’s only triglycerides that matter. He has made a thing about proportions and if proportions are correct even triglycerides may not be a big deal. And he emphasises hypothyroidism must be addressed first, or any cholesterol test will be nonsense. I am sure he never said nonsense but it’s what I understood.

Your cholesterol reading makes an absolute farce of being prescribed (or pushed towards) statins. I wish my cholesterol looked like that. I literally have been frightened for my life by my cardiologist AND endocrinologist has recommended ezitemibe!

There seems to be a place in medicine where one specialism takes over from others. A pecking order but no sign of discussion/collaboration. Plenty of assumption though.

helvella profile image
helvellaAdministrator in reply toarTistapple

And some sources say actual LDL and HDL measurements are pretty hopeless. And recommend Apo A and B and ratio:

Apolipoprot B\X2F\Apolipoprot A <1 0.54 ratio Normal

Apolipoprotein A1 1.04 - 2.02 1.32 g/L Normal

Apolipoprotein B 0.66 - 1.33 0.71 g/L Normal

Cake-Maker profile image
Cake-Maker in reply toarTistapple

OH has high Triglycerides according to the blood tests. Apparently that’s a different issue from the the cholesterol level itself or the ratio.

My head is spinning. I rang my ‘medical’ sister for advice and she wasn’t much help. Just told him to follow the advice if he wanted to or forget it if he didn’t 🙄

I’m trying to remember whether CoQ10 is meant to address Statin side effects or replace statins in reducing cholesterol. I know that Plant Sterols are said to reduce cholesterol but it’s all a bit of a mystery to me.

arTistapple profile image
arTistapple

Yes saw that too. And fasting test only. My GP or any doctor has never required fasting.

Cake-Maker profile image
Cake-Maker in reply toarTistapple

Our GP doesn’t either - but he still uses the range for fasting bloods - the top of which is 1.7. Top of ref interval for non fasting is 2.8 so OH isn’t doing too badly at 2.5.

My sis has just phoned back to remind me that her mother in law, who’s been eating lashings of cream, buckets of butter and anything she likes really, is 97 next week and refused statins years ago. She’s been taking Levothyroxine for hypothyroidism since she was diagnosed many years ago. No thyroid issues, a zest for life and a self confessed ‘foodie’

FancyPants54 profile image
FancyPants54 in reply toCake-Maker

That's the way to be.

humanbean profile image
humanbean

I've posted this picture before but I think it is worth repeating. I have tried listening to some videos of Prof. Ken Sikaris talks and I don't think he is a great speaker, but obviously people can look him up and decide for themselves.

Info on cholesterol
Cake-Maker profile image
Cake-Maker in reply tohumanbean

Thank you for posting.

humanbean profile image
humanbean

Some links about thyroid hormones and the heart :

.

Title : Hypothyroidism and the Heart

pmc.ncbi.nlm.nih.gov/articl...

.

Just to warn you - this one has a very alarming title about "Low T3 Syndrome"

ahajournals.org/doi/10.1161...

.

Title : Thyroid and the Heart

pmc.ncbi.nlm.nih.gov/articl...

.

Title : Thyroid and Cardiovascular Disease: Research Agenda for Enhancing Knowledge, Prevention, and Treatment

ahajournals.org/doi/10.1161...

.

Title : Thyroid Dysfunction in Heart Failure and Cardiovascular Outcomes

ahajournals.org/doi/full/10...

.

From the articles I've found in the past it seems that having good levels of thyroid hormones is particularly important in heart failure. But I don't seem to have any good saved research links about thyroid hormones and myocardial infarction (heart attack). :(

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