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May 5, 2014

The Art of the Curb-Side Consult

By Jeffrey Dach

An innocent curbside consult with a victim of statin-induced neuropathy exposes the deceptive-fear tactics of the drug industry.

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Two African Witch Doctors Wearing Masks
Two African Witch Doctors Wearing Masks
(Image by (From Wikimedia) Photo Credit: Content Providers(s): CDC, Author: Photo Credit: Content Providers(s): CDC)
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The Art of the Curb-Side Consult by Jeffrey Dach MD

link to the original article

Last week, I had a curb-side consult with my neighbor, Bill Jones. I said "How ya doing, Bill?" Bill said "not too good", and then proceeded to show me the Ace Wrap on his arm and the two bottles of pills his doctor prescribed for his peripheral neuropathy. Bill was having burning pain, tingling, and numbness in the arm and hand constantly, all day and night, preventing him from sleeping. The pills were generic gabapentin, a drug marketed for treatment of peripheral neuropathy, and Tramadol, a synthetic opiate pain pill.

Knowing that a cocktail of B vitamins and alpha-lipoic acid will frequently clear up and heal a peripheral neuropathy, I asked Bill if he was taking any vitamins. Bill's face lit up. He became excited and invited me into his house. We sat in the kitchen and Bill brought out a sheet of paper listing his medications and vitamins.

At the top of the list was Pravastatin, a drug to reduce cholesterol. When I saw this, I immediately knew what was causing Bill's excruciating burning pain in the arm and hand. This is an obvious case of statin-induced neuropathy (1). My job had been simplified.

I told Bill the statin drug was causing his peripheral neuropathy, so he should stop the drug immediately. I also gave him a list of vitamins to take: Benfotiamine 150 mg three times a day, B12 methylcobalamin 5000 mcg sublingual tabs twice a day, P-5-P form of B6 50 mg. daily, Alpha-Lipoic Acid 50 mg three times a day, and Ubiquinone form of CoQ-10 100 mg twice a day.

Adverse Side Effects of Statin Drugs

The drug companies have cleverly planted deceptive articles in the media, proclaiming statin drugs have no side effects. In reality statin drugs have horrendous adverse side effects which have been documented in the medical literature for over thirty years. These include peripheral neuropathy, muscle pain, muscle damage, myopathy, cognitive dysfunction and dementia, autoimmune disease, drug-induced lupus, disturbance of immune function, etc (5).

No Good Reason to Take a Statin Drug

Bill had no evidence of heart disease, his cholesterol levels were perfectly normal, and he should never taken a statin drug in the first place. Amazingly, his doctors failed to recognize he had a statin-induced neuropathy, and instead gave Bill a worthless ineffective drug, gabapentin, as treatment for peripheral neuropathy, no more effective than placebo (13). They also gave him an opiate pain pill Tramadol, which is effective for pain relief; however, the price is narcotics addiction. Prescribing an opiate pain pill for a statin-induced neuropathy is misdiagnosis and mistreatment, a medical error of monumental proportions.

Who Benefits From a Statin Drug?

Medical science is clear that statin drugs reduce cholesterol quite well in men and women of all ages. However, there no health benefit obtained from lowering cholesterol in women, the elderly, or men with no underlying history of heart disease (8). According to Rita Redberg MD, in an article in the Archives of Internal Medicine, healthy men should not take a statin drug. On the other hand, thirty years of statin medical studies have shown a benefit greater than placebo for middle-aged men with known underlying heart disease (9). Although this benefit is not impressive, this is enough to justify prescribing a statin drug to men with known heart disease.

Temptation to Profit

Statin drugs are the most lucrative drugs ever, making more than 100 billion dollars for Pfizer (2). How did Pfizer make so much money? They put on the African Witch Doctor mask and created fear. Fear that if you don't take my drug, you die.

Creating Fear -- Medical Marketing of Statin Drugs

As a kid we used to visit the museum where they exhibited scary witch-doctor masks designed to induce fear in villagers. (See above image Lassa Witch doctors courtesy of CDC).

I often laughed at the scary masks and marveled at how primitive these people were. A modern doctor would never stoop so low as to don a scary mask to induce fear in the patient. How can that be part of any effective medical treatment? Our modern medical system is above that. We are not savages living in mud huts. We are civilized, we have nuclear weapons and the New York Times.

Fear-Tactic Advertising (10-12)

A Pfizer ad appeared in Chatelaine magazine in October 2001 showing a tagged toe of a corpse to promote cholesterol testing. The advertisement reads, "Which would you rather have, a cholesterol test or a toe tag?" This is fear-tactic advertising to convince healthy people to take a drug they don't need (10-12). This is our modern day equivalent of the witch-doctor scary mask; fear-tactic advertising to sell drugs to healthy people who don't need them. I guess we are not so lofty as we thought.

My Job As a Physician -- Un-Masking the Witch Doctors

How does one expose the fear-mongering and propaganda of the drug industry, which turns rational humans into lemmings?

Fifty years ago, when I laughed at the witch-doctor mask at the museum, I never could have imagined my job today would be to rip off the witch-doctor mask and expose their ruse. My job is to convince healthy people not to run like lemmings off the edge of the cliff, clamoring for bad drugs they don't need. Of course, this task would be immensely easier if Congress banned DTC consumer drug advertising, as most other countries have already done.

Above image: Lemmings running off cliff courtesy of Just Outside the Box. Link to header image: wooden african mask: courtesy of Ali Express.

Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663

Articles with related interest:

Healthy Men Shiould Not Take Statins

Cholesterol and Statin Drugs, a Choir Boy Turns Disbeliever

Cholesterol-Lowering Statin Drugs for Women Just Say No by Jeffrey Dach MD

Getting Off Statin Drug Stories by Jeffrey Dach

Does High Cholesterol Cause Heart Disease?

Reverse Heart Disease with Coronary Calcium Score

Heart Disease Part Two

Preventing and Reversing Heart Disease, Part Three

Links and references

1) http://www.neurology.org/content/58/9/1333.abstract
Statins and risk of polyneuropathy, A case-control study, D. Gaist, MD PhD, U. Jeppesen, MD PhD, M. Andersen, MD PhD, L. A. Garca Rodrguez, MD MSc, J. Hallas, MD PhD and S. H. Sindrup, MD PhD From the Department of Neurology (Drs. Gaist, Jeppesen, and Sindrup), Odense University Hospital; Epidemiology (Dr. Gaist) and Clinical Pharmacology (Drs. Andersen, Hallas, and Sindrup), Institute of Public Health, University of Southern Denmark; and Centro Español de Investigación Farmacoepidemiológica (Dr. Garca Rodrguez), Madrid, Spain.

Several case reports and a single epidemiologic study indicate that use of statins occasionally may have a deleterious effect on the peripheral nervous system. The authors therefore performed a population-based study to estimate the relative risk of idiopathic polyneuropathy in users of statins.

Method: The authors used a population-based patient registry to identify first-time-ever cases of idiopathic polyneuropathy registered in the 5-year period 1994 to 1998. For each case, validated according to predefined criteria, 25 control subjects were randomly selected among subjects from the background population matched for age, sex, and calendar time. The authors used a prescription register to assess exposure to drugs and estimated the odds ratio of use of statins (ever and current use) in cases of idiopathic polyneuropathy compared with control subjects.
Results: The authors verified a diagnosis of idiopathic polyneuropathy in 166 cases. The cases were classified as definite (35), probable (54), or possible (77). The odds ratio linking idiopathic polyneuropathy with statin use was 3.7 (95% CI 1.8 to 7.6) for all cases and 14.2 (5.3 to 38.0) for definite cases. The corresponding odds ratios in current users were 4.6 (2.1 to 10.0) for all cases and 16.1 (5.7 to 45.4) for definite cases. For patients treated with statins for 2 or more years the odds ratio of definite idiopathic polyneuropathy was 26.4 (7.8 to 45.4).
Conclusions: Long-term exposure to statins may substantially increase the risk of polyneuropathy.

2) http://articles.latimes.com/2011/nov/30/news/la-heb-lipitor-generic-20111130
Lipitor generated more than $100 billion in revenue for Pfizer since it was approved in 1997.

3) http://primaldocs.com/opinion/have-you-experienced-side-effects-of-statin-drugs/
Have YOU Experienced Side Effects of Statin Drugs?

Studies have confirmed that peripheral neuropathy (tingling and numbness or burning pain) may occur with statins.

4) http://www.sciencedirect.com/science/article/pii/S0140673604157395
Selenoprotein synthesis and side-effects of statins
Bernd Moosmann, PhDa, Christian Behl, PhDa,

Statins are possibly the most effective drugs for the prevention and treatment of hypercholesterolaemia and coronary heart disease. They are generally well tolerated, however, they do cause some unusual side-effects with potentially severe consequences, most prominently myopathy or rhabdomyolysis and polyneuropathy. We noted that the pattern of side-effects associated with statins resembles the pathology of selenium deficiency, and postulated that the mechanism lay in a well established, but often overlooked, biochemical pathway--the isopentenylation of selenocysteine-tRNA[Ser]Sec. A negative effect of statins on selenoprotein synthesis does seem to explain many of the enigmatic effects and side-effects of statins, in particular, statin-induced myopathy. Christian Behl, Department of Pathobiochemistry, Johannes Gutenberg University, Medical School, 55099 Mainz, Germany

5) http://scholar.google.com/scholar?q=related:edv9UVeSlC0J:scholar.google.com/&hl=en&as_sdt=0,10
Statin"Associated Peripheral Neuropathy: Review of the Literature

6) http://phil.cdc.gov/phil/details.asp?pid=1322
Witch Doctors Two Lassa Witch Doctors.

7) http://commons.wikimedia.org/wiki/File:Fremont_Solstice_Parade_-_witch_doctor_prepares.jpg
Man dressed as witch doctor preparing for Fremont Solstice Parade, Fremont, Seattle, Washington circa 2000.

8) http://jeffreydachmd.com/getting-off-statin-drug-stories-by-jeffrey-dach-md/ Getting Off Statin Drug Stories by Jeffrey Dach MD

9) http://jeffreydachmd.com/statin-drugs-revisited/
Statin Drugs Revisited by Jeffrey Dach MD

The 4S trial was done on 4444 patients who had known heart disease, randomized to simvastatin or placebo, and followed for 5.5 years. At the end of the follow up, they reported 182 deaths in the statin drug group (8.2 %) and 256 deaths in the placebo group (11.5% ). This provided an absolute mortality benefit of 3.3% over 5.5 years, or 0.6% per year. (12,13) The 6-year probabilities of survival for placebo was 88.5 % and for simvastatin was 91.8%, a difference of 3.3%.

Fear-Tactic Advertising

10) http://www.commonground.ca/OLD/iss/0611184/cg184_Cassels.shtml
Cholesterol TV ads clog reality by Alan Cassels

11) http://www.bcmj.org/letters/fear-tactic-advertising-0
Fear tactic advertising Issue: BCMJ, Vol. 44, No. 2, March 2002, page(s) 69 Letters Frederick Spohn, MD
"[I]t is most distressing to see an international drug manufacturer taking out half-page ads in the National Post (page SP8, 15 December 2001) to shill Pfizer's cholesterol-lowering drug with the spiel "Which would you rather have, a cholesterol test or a final exam?" [autopsy?] with a picture of a toe-tagged stiff on a gurney"
I believe that cholesterol tests a few years ago were costing the BC Medical Plan some $4 million annually with very little health benefit to our population. Fear tactic advertising to sell drugs is in very poor taste and is socially irresponsible at a time when we are attempting to keep health costs down and still provide an excellent health care system.
--Frederick Spohn, MD

12) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122842/?report=classic
BMJ. Apr 13, 2002; 324(7342): 908--911.
Direct to consumer advertising is medicalising normal human experience by Barbara Mintzes, graduate researcher
Centre for Health Services and Policy Research, University of British Columbia, 429-2194 Health Services Mall, Vancouver, BC, Canada V6T 1Z3
Lipid lowering drugs, for example, reduce mortality in men with heart disease yet there is under-prescribing in this population group. However, it is more lucrative to promote primary prevention as many more people are affected, despite the lack of significant reduction in mortality.2-10 In Chatelaine magazine in October 2001, Pfizer used the tagged toe of a corpse to promote cholesterol testing among women in their 50s without heart disease.2-11

13) http://www.aafp.org/afp/2011/0901/p480.html
Diabetic Peripheral Neuropathic Pain: Is Gabapentin Effective?

Am Fam Physician. 2011 Sep 1;84(5):480-482.
to the editor: Contrary to the authors' statements, gabapentin (Neurontin) in dosages up to 3,600 mg per day is not more effective than placebo for the treatment of diabetic peripheral-neuropathic pain. During discovery in a lawsuit filed in federal court, it was learned that the manufacturers of Neurontin systematically biased scientific evidence through data manipulation and suppression of negative studies to promote the drug for off-label uses.1,2

link to the original article

Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Fl 33314
954-792-4663

Authors Website: http://jeffreydachmd.com

Authors Bio:

Jeffrey Dach MD is a physician and author of three books, Natural Medicine 101, and Bioidentical Hormones 101, and Heart Book all available on Amazon, or as a free e-book on his web sites.

Dr. Dach is founder and chief medical officer of TrueMedMD, a clinic in Davie, Florida specializing in Bioidentical Hormones, natural thyroid, functional medicine and low level laser therapy.

Dr. Dach was originally trained and board certified as an Interventional and Diagnostic Radiologist, and worked in the hospital setting for 30 years in Broward County at the Memorial Hospital System. Because of declining visual acuity, Dr Dach retired from radiology and returned to clinical medicine about 8 years ago when he founded the TruMedMD Clinic offering bioidentical hormones and natural thyroid to the South Florida region. For more information about Dr Dach, you can find his entire CV posted on-line on his web site.


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