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I would add more ... when it comes to chronic diseases, modern medicine is about treatment after the fact, after the damage has occurred and not about preventio

I would add more ... when it comes to chronic diseases, modern medicine is about treatment after the fact, after the damage has occurred and not about prevention. And while it’s incredibly efficient at treating acute conditions, it fails miserably at chronic ones because it’s treating symptoms instead of underlying causes. And sometimes those symptoms might actually be part of the body’s defenses against inflammation, which doctors suppress with pills. The perfect example is elevated LDL cholesterol. This is a marker for heart disease, however it can be high due to hypothyroidism or due to inflammation. LDL cells are actually part of the body’s immune system and by suppressing their synthesis or by accelerating their clearance, the body could be less effective at fighting infections or at repairing arterial walls that have been damaged. Plus pills are a blunt tool with many unintended side effects. It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia. Also the DASH diet, the one that is supposed to prevent CVD, is effectively poison as it’s encouraging people to eat ultra-processed food and oils high in omega-6, due to encouraging a big chunk of energy to come from “whole grains” (i.e. products which are often a lesson in chemistry and that might not even contain whole grains due to weak regulation), plus the phobia for saturated fat.

PhantomGremlin 7y ago
it fails miserably at chronic ones because it’s treating symptoms instead of underlying causes I'm not sure if "fails miserably" is the proper characterization. It's just simple capitalism. Just look at statins. They're something that they want to sell you for the rest of your life. Because statins treat symptoms, they're not a cure. But antibiotics? Just 10 days and you're done. Hmmm. Which is more profitable? It it any wonder that the US government is looking into how to fund development of new antibiotics? Same with vaccines. The government has had to step in to fund them.
- refurb 7y ago
  Yet one of the most profitable drug launches ever was a cure for hepatitis C.
  - PhantomGremlin 7y ago
    Flash in the pan revenues. No company wants to have this press: Gilead Sciences Inc. will continue to feel the financial sting this year of declining revenues from its hepatitis C business, forecasting combined 2018 sales of the drugs reaching only a fifth of what the biotech recorded at the height of its commercial success three years ago. https://www.biopharmadive.com/news/gilead-hepatitis-c-revenues-slide-fourth-quarter-earnings/516494/ https://www.biopharmadive.com/news/gilead-hepatitis-c-revenu... Contrast a statin for Pfizer: $125 billion in sales over 14 years. Lipitor alone "provided up to a quarter of Pfizer Inc.'s annual revenue for years." https://en.wikipedia.org/wiki/Atorvastatin#History https://en.wikipedia.org/wiki/Atorvastatin#History
    - refurb 7y ago
      Yeah, a company would certainly turn down a $10B a year drug because revenues declined after a few years! Sure it’s not as successful as Lipitor (pretty much the most successful drug ever), but it’s total sales DWARF 95% of the drugs out there.
  - verucanacl 7y ago
    For good reason. Curing Hep C was a breakthrough medical innovation, which ultimately will save the healthcare system tens of billions of dollars (preventing end stage liver disease, liver transplants, etc)
JamesBarney 7y ago
> It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia. Healthy people without any CVD taking statins experience no reduction in all cause mortality. People with a history of CVD definitely experience a reduction in all cause mortality. > It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia. So far statin's are associated with a reduced risk of dementia.(I have no idea about cancer, but can't imagine it increases the odds) Also where are you getting that the DASH diet is effectively poison or ultra processed?
- bad_user 7y ago
  >> People with a history of CVD definitely experience a reduction in all cause mortality. Actually it's people with a history of heart attacks and the reduction in all cause mortality is measured on average to be only a couple of months. --- >> So far statin's are associated with a reduced risk of dementia* The common side effects of statins are headaches, sleep problems, muscle aches or weakness, drowsiness, dizziness, nausea, abdominal pain, bloating, diarrhea, constipation, rash. There have also been reports of memory loss, forgetfulness and confusion. These are not emphasized, probably not so common, but the reports I've seen are freaking scary. Also if there is no reduction in all cause mortality, but there is a reduction in heart attacks, this means there's an increased likelihood that some other chronic disease will kill you. It's simple math really, if you don't die of heart attacks, you're more likely to die of cancer or dementia, as these are the most common causes of death. --- >> "Also where are you getting that the DASH diet is effectively poison or ultra processed?" By advising people to eat less saturated fat, you're effectively advising people to eat seed oils (the "heart healthy" oils), which actually increase the likelihood of cardiovascular disease, due to the very high omega-6 content, which is inflammatory, along with toxins from the extraction process. Here are some studies on this subject: https://gist.github.com/alexandru/5e21b75363904004f837c23f03afe017 https://gist.github.com/alexandru/5e21b75363904004f837c23f03... Also go into any supermarket and carefully read the label on any food labeled with "whole grains", especially those made of wheat. Most of them meet the definition of "ultra-processed" food and many of them are not even made of actual whole grains, because fiber has poor shelf life, so what they do is to use white flour and then add some bran back, which doesn't have the same effect. In my city I couldn't find any local bakeries that made bread out of whole grains. Corn is the same story, unless you're eating your home made polenta. And brown rice is toxic, so you're you're actually better off eating the white variety. The problem with DASH in this regard is not the advice to consume whole grains, but the advice to make whole grains a staple food in the diet.
verucanacl 7y ago
Several of your claims are inaccurate, which I'll attempt to correct. tl;dr - its way more complicated LDL particles are not (at least directly) a part of the immune system. They are lipoproteins, generated primarily in the liver, that are implicated in the pathogenesis of atherosclerosis (buildup of plaques in the blood vessels). The immune system, however, plays an important role in atherosclerosis, as it is thought that inflammation in the vasculature contributes to atherosclerosis. Statins (contrary to your assertion) have in fact been conclusively shown to improve mortality from cardiovascular events. You can find many studies in the last 20 years that have demonstrated this with high statistical significance (do a pubmed search or look for articles in the New England Journal of Medicine). Perhaps most interestingly, the latest research suggests that statins may improve cardiovascular outcomes not solely from LDL reduction (which has been the classically accepted hypothesis, as statins target the enzyme in the liver that regulates LDL reuptake), but also through anti-inflammatory mechanisms. This idea has been further strengthened by research suggesting that LDL reduction alone (as with a newer agent of drugs called anti PCSK9) may not provide as strong of a mortality benefit, weakening what is known as the "LDL hypothesis". In addition, another recent trial (called CANTOS) found that an anti-inflammatory agent targeting IL-1, an inflammatory cytokine, improved cardiovascular outcomes (such as heart attacks), further strengthening the notion that the immune system plays a key role in cardiovascular disease.
verucanacl 7y ago
I do, however, agree with you that much of modern medicine is focused on treatment as opposed to prevention. Type 2 diabetes is probably the best example, which is largely preventable with a good diet and exercise. Unfortunately, it's much easier for patients to take a pill after they start feeling symptoms than it is to adhere to a healthy lifestyle when they are asymptomatic..

PhantomGremlin 7y ago

it fails miserably at chronic ones because it’s treating symptoms instead of underlying causes I'm not sure if "fails miserably" is the proper characterization. It's just simple capitalism. Just look at statins. They're something that they want to sell you for the rest of your life. Because statins treat symptoms, they're not a cure. But antibiotics? Just 10 days and you're done. Hmmm. Which is more profitable? It it any wonder that the US government is looking into how to fund development of new antibiotics? Same with vaccines. The government has had to step in to fund them.

refurb 7y ago
Yet one of the most profitable drug launches ever was a cure for hepatitis C.
- PhantomGremlin 7y ago
  Flash in the pan revenues. No company wants to have this press: Gilead Sciences Inc. will continue to feel the financial sting this year of declining revenues from its hepatitis C business, forecasting combined 2018 sales of the drugs reaching only a fifth of what the biotech recorded at the height of its commercial success three years ago. https://www.biopharmadive.com/news/gilead-hepatitis-c-revenues-slide-fourth-quarter-earnings/516494/ https://www.biopharmadive.com/news/gilead-hepatitis-c-revenu... Contrast a statin for Pfizer: $125 billion in sales over 14 years. Lipitor alone "provided up to a quarter of Pfizer Inc.'s annual revenue for years." https://en.wikipedia.org/wiki/Atorvastatin#History https://en.wikipedia.org/wiki/Atorvastatin#History
  - refurb 7y ago
    Yeah, a company would certainly turn down a $10B a year drug because revenues declined after a few years! Sure it’s not as successful as Lipitor (pretty much the most successful drug ever), but it’s total sales DWARF 95% of the drugs out there.
- verucanacl 7y ago
  For good reason. Curing Hep C was a breakthrough medical innovation, which ultimately will save the healthcare system tens of billions of dollars (preventing end stage liver disease, liver transplants, etc)

JamesBarney 7y ago

> It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia. Healthy people without any CVD taking statins experience no reduction in all cause mortality. People with a history of CVD definitely experience a reduction in all cause mortality. > It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia. So far statin's are associated with a reduced risk of dementia.(I have no idea about cancer, but can't imagine it increases the odds) Also where are you getting that the DASH diet is effectively poison or ultra processed?

bad_user 7y ago
>> People with a history of CVD definitely experience a reduction in all cause mortality. Actually it's people with a history of heart attacks and the reduction in all cause mortality is measured on average to be only a couple of months. --- >> So far statin's are associated with a reduced risk of dementia* The common side effects of statins are headaches, sleep problems, muscle aches or weakness, drowsiness, dizziness, nausea, abdominal pain, bloating, diarrhea, constipation, rash. There have also been reports of memory loss, forgetfulness and confusion. These are not emphasized, probably not so common, but the reports I've seen are freaking scary. Also if there is no reduction in all cause mortality, but there is a reduction in heart attacks, this means there's an increased likelihood that some other chronic disease will kill you. It's simple math really, if you don't die of heart attacks, you're more likely to die of cancer or dementia, as these are the most common causes of death. --- >> "Also where are you getting that the DASH diet is effectively poison or ultra processed?" By advising people to eat less saturated fat, you're effectively advising people to eat seed oils (the "heart healthy" oils), which actually increase the likelihood of cardiovascular disease, due to the very high omega-6 content, which is inflammatory, along with toxins from the extraction process. Here are some studies on this subject: https://gist.github.com/alexandru/5e21b75363904004f837c23f03afe017 https://gist.github.com/alexandru/5e21b75363904004f837c23f03... Also go into any supermarket and carefully read the label on any food labeled with "whole grains", especially those made of wheat. Most of them meet the definition of "ultra-processed" food and many of them are not even made of actual whole grains, because fiber has poor shelf life, so what they do is to use white flour and then add some bran back, which doesn't have the same effect. In my city I couldn't find any local bakeries that made bread out of whole grains. Corn is the same story, unless you're eating your home made polenta. And brown rice is toxic, so you're you're actually better off eating the white variety. The problem with DASH in this regard is not the advice to consume whole grains, but the advice to make whole grains a staple food in the diet.

verucanacl 7y ago

Several of your claims are inaccurate, which I'll attempt to correct. tl;dr - its way more complicated LDL particles are not (at least directly) a part of the immune system. They are lipoproteins, generated primarily in the liver, that are implicated in the pathogenesis of atherosclerosis (buildup of plaques in the blood vessels). The immune system, however, plays an important role in atherosclerosis, as it is thought that inflammation in the vasculature contributes to atherosclerosis. Statins (contrary to your assertion) have in fact been conclusively shown to improve mortality from cardiovascular events. You can find many studies in the last 20 years that have demonstrated this with high statistical significance (do a pubmed search or look for articles in the New England Journal of Medicine). Perhaps most interestingly, the latest research suggests that statins may improve cardiovascular outcomes not solely from LDL reduction (which has been the classically accepted hypothesis, as statins target the enzyme in the liver that regulates LDL reuptake), but also through anti-inflammatory mechanisms. This idea has been further strengthened by research suggesting that LDL reduction alone (as with a newer agent of drugs called anti PCSK9) may not provide as strong of a mortality benefit, weakening what is known as the "LDL hypothesis". In addition, another recent trial (called CANTOS) found that an anti-inflammatory agent targeting IL-1, an inflammatory cytokine, improved cardiovascular outcomes (such as heart attacks), further strengthening the notion that the immune system plays a key role in cardiovascular disease.

verucanacl 7y ago

I do, however, agree with you that much of modern medicine is focused on treatment as opposed to prevention. Type 2 diabetes is probably the best example, which is largely preventable with a good diet and exercise. Unfortunately, it's much easier for patients to take a pill after they start feeling symptoms than it is to adhere to a healthy lifestyle when they are asymptomatic..