NICE Guidelines news item published Nov 2024. - Thyroid UK

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NICE Guidelines news item published Nov 2024.

arTistapple profile image
17 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
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17 Replies
RedApple profile image
RedApple

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.

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.

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

helvella profile image
helvellaAdministrator

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.

helvella profile image
helvellaAdministrator

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.

arTistapple profile image
arTistapple

That indeed is it Cake-Maker. Thank you.

arTistapple profile image
arTistapple

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

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
arTistapple profile image
arTistapple in reply tohumanbean

Thanks humanbean. Brings the issue up to date somewhat.

FancyPants54 profile image
FancyPants54

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

FancyPants54 profile image
FancyPants54

That's the way to be.

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). :(

arTistapple profile image
arTistapple

Yes triglycerides are the ‘new’ focus. However it all needs brain power (which I don’t presently have) to assess it. Same with the an and b type cholesterol. Too tired!

I stopped the Ubiquinol (CoQ10) because I had no idea if it was doing anything and hugely expensive. Might go back to it though. For all I know it could be in some way importantly contributing to view of arteries. I honestly think the cholesterol is there doing its utmost to protect the arteries (some doctors even believe that). So removing it, is actually to our peril!

arTistapple profile image
arTistapple

Certainly it would seem doctors. They are supposed to be providing the knowledgable service. Mine have done a pretty poor job of it and I am trying to fill in the gaps in their knowledge. Turns out there are more gaps than knowledge. It in itself is exhausting!

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