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Hemodoc
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« Reply #75 on: October 09, 2013, 10:01:11 AM »

Dear NDXUFan,

I believe you are conflating the issues of proof and association. There is no doubt that exercise status and obesity are correlated with Type II diabetes. You are correct in stating that we do not yet "KNOW" the cause of diabetes. You are incorrect in your diatribe against the correlation between obesity and exercise status with adult onset diabetes. It is the insulin resistance state more specifically that we do not understand.

We also have very little understanding about obesity and the physiologic effects of obesity on the rest of the body. An interesting discovery in the last few years is some of the endocrine aberrations of obesity such as finding the protein Leptin, which regulates satiety and other factors. The physiology associated with obesity, lack of exercise are often studied under the terms of the "metabolic" syndrome which involves an insulin resistance state. Yes, these are complex factors. Yes, it is not readily understood at this time what is the precise cause of Type II diabetes, but we are not completely in the dark on the associations, how to treat it effectively and better yet, how to prevent it in many patients.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
obsidianom
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« Reply #76 on: October 10, 2013, 09:18:23 AM »

NDXUFan: 

You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)


Not to cut to the jugular, but you appear to be completely unaware that type II, "adult onset" diabetes is associated with an EXCESS insulin production with insulin resistance. Once again, what is your point my friend? Your facts are simply in error. You appear to be suggesting the type of finding with Type I diabetes which is actually an autoimmune disease wiping out insulin production in the pancreas. Type II diabetes is quite different than Type I and has NOTHING to do with reduced insulin levels until VERY late in the process. Sorry, you are simply wrong about your assertions.

http://en.wikipedia.org/wiki/Insulin_resistance

I am curious, if the cause of type II diabetes is so well known, why are the top academic Nephrologists telling me that they do not know what causes Type II diabetes? 

http://medicine.iu.edu/nephrology/faculty-and-staff-directory/michael-a-kraus-md/

Clinical Interests:

•Home Dialysis
•Peritoneal Dialysis
•Dialysis Access Problems
•Continuous Renal Replacement Therapy (CRRT)
•Acute Renal Failure
•Chronic Kidney Disease
•Hypertension
•Glomerulonephritis

http://intmed.uc.edu/contact/directory/profile.aspx?epersonID=gallajh
Professor Emeritus of Nephrology, John Galla-University of Cincinnati. Dr. Galla is extensively published. 

Cincinnati Children's Hospital which is ranked #3 in the United States, "The cause of Type II diabetes is unknown." 

Our diabetes and endocrinology program was rated No. 6 in the country in the 2013-14 list of Best Children’s Hospitals published by U.S. News & World Report

http://www.cincinnatichildrens.org/service/d/diabetes/default/

http://health.usnews.com/best-hospitals/pediatric-rankings/diabetes-and-endocrinology


Honestly, never had any health problems until listening to your profession and their obsessive low fat diets.  The old food standard was filled with bread and pasta, which is very, very bad for diabetics and blood sugar control. Never really was a big carb eater or sugary drinks, rather have peanuts than a candy bar.  I am curious, I have a friend who is the same height as I am and same weight, is the picture of health, how could this be???  My body fat was tested at the University of Cincinnati and was told that it was "excellent."  Care to explain?  Now, that I am off of that stupid night shift, getting enough sleep and going back to my old ways of eating, my last A1C was 5.4 and the blood sugar score after that was 83, care to explain that one? 

Professor Emeritus of Organic Chemistry Joel Kauffman, 14 drug patents, 100 peer reviewed publications: 

Richard K. Bernstein, was diagnosed with IDDM at the age of 12 in 1946.  Following the advice of the American Heart Association (AHA) and the American Diabetes Association (ADbA) to eat a high-carb (40%, then 60% carb) diet, his condition worsened and most of the complications of IDDM began to appear.  He found that he could not normalize his blood sugars with any insulin regimen, and that exercise in his condition did not help.  By doing a literature search himself in 1965, he realized the potential benefits of normal blood sugars.

By using himself as the test animal he found that  about 30 g/day of slow-acting carbohydrate (essentially fiber with no simple sugars or high GI starches at all) was necessary to normalize his blood glucose levels, the rest of his diet being fat and protein. He obtained an MD degree at about age 45 partly to have his observations published in medical journals, because the papers were rejected when he did not have the MD degree. 

He has continued the diet for 35 years so far, which includes on many days, 3 eggs for breakfast  and no fruit.  His total cholesterol dropped from 300 mg/dL to 179, of which LDL-C = 63 and HDL-C = 116 (that is not a misprint).  His triglycerides dropped from 250 to 45. His lipoprotein(a) level, a marker of inflammation, became undetectable. In 1983 he began his own medical practice for diabetics. At the time of writing he is age 72 and he still works 12-14 hour days in his medical practice on diabetics.
Using individual cases to "prove" anyhting in medicine is ridiculous. I can point to the 100 year old who smokes. Does that prove smoking is safe? I can point to the 40 year old athlete who works out daily, and then suffers a major heart attack. Does that prove exercise is dangerous?   On and on I can go with individuals who defy the odds and in your thinking , "prove " certain facts.
Medicine is an ART, not a pure science. There are so many variables that we still dont even know exist. Genetics alone has such an effect on each person and we are just cracking the surface on that . WE can only look at studies of MANY patients to get data to direct our treatment and recommendattions. Some studies will contradict others.
In the end we can only draw our conclusions on the best available data form MANY studies of MANY patients. Anecdotal stories of individual patients are meaningless.

We may not know the exact "cause " of diabetes but we do know which factors TEND to increase the likelihood of developing it. Again genetics plays a HUGE role. That is why we check family history so carefully in patients. The other factors COMBINED with genetics tend to lead toward developing it. Some of the factors that clearly pop up over and over are diet, weight, exercise, lifestyle etc. Each factor may not "cause" diabetes  itself , but added to genetics can push a patient into the disorder.

I can honestly say I almost NEVER have seen a thin adult onset type 2 diabetic in my 25 years of practice. It can happen , but is rare.
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My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
NDXUFan
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« Reply #77 on: October 10, 2013, 09:48:12 PM »

NDXUFan: 

You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)


Not to cut to the jugular, but you appear to be completely unaware that type II, "adult onset" diabetes is associated with an EXCESS insulin production with insulin resistance. Once again, what is your point my friend? Your facts are simply in error. You appear to be suggesting the type of finding with Type I diabetes which is actually an autoimmune disease wiping out insulin production in the pancreas. Type II diabetes is quite different than Type I and has NOTHING to do with reduced insulin levels until VERY late in the process. Sorry, you are simply wrong about your assertions.

http://en.wikipedia.org/wiki/Insulin_resistance

I am curious, if the cause of type II diabetes is so well known, why are the top academic Nephrologists telling me that they do not know what causes Type II diabetes? 

http://medicine.iu.edu/nephrology/faculty-and-staff-directory/michael-a-kraus-md/

Clinical Interests:

•Home Dialysis
•Peritoneal Dialysis
•Dialysis Access Problems
•Continuous Renal Replacement Therapy (CRRT)
•Acute Renal Failure
•Chronic Kidney Disease
•Hypertension
•Glomerulonephritis

http://intmed.uc.edu/contact/directory/profile.aspx?epersonID=gallajh
Professor Emeritus of Nephrology, John Galla-University of Cincinnati. Dr. Galla is extensively published. 

Cincinnati Children's Hospital which is ranked #3 in the United States, "The cause of Type II diabetes is unknown." 

Our diabetes and endocrinology program was rated No. 6 in the country in the 2013-14 list of Best Children’s Hospitals published by U.S. News & World Report

http://www.cincinnatichildrens.org/service/d/diabetes/default/

http://health.usnews.com/best-hospitals/pediatric-rankings/diabetes-and-endocrinology


Honestly, never had any health problems until listening to your profession and their obsessive low fat diets.  The old food standard was filled with bread and pasta, which is very, very bad for diabetics and blood sugar control. Never really was a big carb eater or sugary drinks, rather have peanuts than a candy bar.  I am curious, I have a friend who is the same height as I am and same weight, is the picture of health, how could this be???  My body fat was tested at the University of Cincinnati and was told that it was "excellent."  Care to explain?  Now, that I am off of that stupid night shift, getting enough sleep and going back to my old ways of eating, my last A1C was 5.4 and the blood sugar score after that was 83, care to explain that one? 

Professor Emeritus of Organic Chemistry Joel Kauffman, 14 drug patents, 100 peer reviewed publications: 

Richard K. Bernstein, was diagnosed with IDDM at the age of 12 in 1946.  Following the advice of the American Heart Association (AHA) and the American Diabetes Association (ADbA) to eat a high-carb (40%, then 60% carb) diet, his condition worsened and most of the complications of IDDM began to appear.  He found that he could not normalize his blood sugars with any insulin regimen, and that exercise in his condition did not help.  By doing a literature search himself in 1965, he realized the potential benefits of normal blood sugars.

By using himself as the test animal he found that  about 30 g/day of slow-acting carbohydrate (essentially fiber with no simple sugars or high GI starches at all) was necessary to normalize his blood glucose levels, the rest of his diet being fat and protein. He obtained an MD degree at about age 45 partly to have his observations published in medical journals, because the papers were rejected when he did not have the MD degree. 

He has continued the diet for 35 years so far, which includes on many days, 3 eggs for breakfast  and no fruit.  His total cholesterol dropped from 300 mg/dL to 179, of which LDL-C = 63 and HDL-C = 116 (that is not a misprint).  His triglycerides dropped from 250 to 45. His lipoprotein(a) level, a marker of inflammation, became undetectable. In 1983 he began his own medical practice for diabetics. At the time of writing he is age 72 and he still works 12-14 hour days in his medical practice on diabetics.
Using individual cases to "prove" anyhting in medicine is ridiculous. I can point to the 100 year old who smokes. Does that prove smoking is safe? I can point to the 40 year old athlete who works out daily, and then suffers a major heart attack. Does that prove exercise is dangerous?   On and on I can go with individuals who defy the odds and in your thinking , "prove " certain facts.
Medicine is an ART, not a pure science. There are so many variables that we still dont even know exist. Genetics alone has such an effect on each person and we are just cracking the surface on that . WE can only look at studies of MANY patients to get data to direct our treatment and recommendattions. Some studies will contradict others.
In the end we can only draw our conclusions on the best available data form MANY studies of MANY patients. Anecdotal stories of individual patients are meaningless.

We may not know the exact "cause " of diabetes but we do know which factors TEND to increase the likelihood of developing it. Again genetics plays a HUGE role. That is why we check family history so carefully in patients. The other factors COMBINED with genetics tend to lead toward developing it. Some of the factors that clearly pop up over and over are diet, weight, exercise, lifestyle etc. Each factor may not "cause" diabetes  itself , but added to genetics can push a patient into the disorder.

I can honestly say I almost NEVER have seen a thin adult onset type 2 diabetic in my 25 years of practice. It can happen , but is rare.
   

NDXUFan:
Yes, now we are getting to some agreement, many studies of many patients.  This is why when some in the medical profession try to use one person as a lecture to everyone else, I have to laugh.....  Some of my family have had diabetes and that caused some physicians to obsess to me. Yet, they did not bother to listen that these individuals were 85-90 years old when they became diabetics.   When I was given the label of diabetic, I was walking at a bare minimum of 3 miles per day and many days, 5 miles per day.  I worked out four days per week......  Honestly, I think the cause was that I was not getting enough sleep from working so much overtime, 750 hours in 5 months.  Before this and the night shift, I never had any health issues of any kind, just the fever a few times per year.......  I would agree, genetics plays a huge role, no disagreement.  How would you feel if the medical profession tried to blame you for having cancer?  Honestly, I think it is a genetic issue.  What we have to look at in the numbers is a term called absolute risk.  In speaking to many chemists and physics people, they would tell you that the term relative risk is mathematically misleading.   

Stats Department-George Mason University:
An important feature of relative risk is that it tells you nothing about the actual risk. This can be very important for evaluating how significant a relative increase might be. A small increase in risk in a large population can result in many deaths. For example, brain tumors are diagnosed in about 6 per 100,000 persons per year, whereas malignant breast cancer is diagnosed in about 134 per 100,000 people. A 10 percent increase (relative risk of 1.1) in brain tumors means .10 x 6 = .6 new cases per 100,000 people. On the other hand, a 10 percent increase in breast cancer affects 134 per 100,000 people. If the population of the United States is 300 million (which is 3,000 times 100,000), the small increase in brain tumors would result in .6 x 3,000 = 1,800 new cases. In contrast, the same increase of rate in breast cancer would result in 134 x 3,000 = 402,000 new cases, more than 200 times as many.

http://www.stats.org/in_depth/faq/absolute_v_relative.htm
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Relentless
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« Reply #78 on: October 10, 2013, 11:46:51 PM »

NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote.  I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.
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NDXUFan
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« Reply #79 on: October 12, 2013, 03:20:08 PM »

NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote.  I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.


I know more than a few very qualified experts who disagree, think as you please.  Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's.  Relative Risk as a stat is worthless, what we need to look at is Absolute risk.   These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues.  Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect.  Claims that 400,000 people are dying from obesity is just total nonsense and guess what?  When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus.  In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong.  Another example, is wages between professional men and professional women.  It has been claimed that men make more than women, this is false and incorrect.  To compare wages, you must have individuals in the same field, education level,  work experience, etc.  When we do this, we find that professional women make more than professional men(Stanford Department of Economics).  Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies.  Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people.  The first goal of a corporation is to make money or profits.  As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard.  Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care.  The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.
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Hemodoc
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« Reply #80 on: October 12, 2013, 03:33:59 PM »

NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote.  I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.


I know more than a few very qualified experts who disagree, think as you please.  Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's.  Relative Risk as a stat is worthless, what we need to look at is Absolute risk.   These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues.  Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect.  Claims that 400,000 people are dying from obesity is just total nonsense and guess what?  When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus.  In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong.  Another example, is wages between professional men and professional women.  It has been claimed that men make more than women, this is false and incorrect.  To compare wages, you must have individuals in the same field, education level,  work experience, etc.  When we do this, we find that professional women make more than professional men(Stanford Department of Economics).  Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies.  Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people.  The first goal of a corporation is to make money or profits.  As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard.  Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care.  The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.

???
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
NDXUFan
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« Reply #81 on: October 12, 2013, 10:38:45 PM »

NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote.  I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.


I know more than a few very qualified experts who disagree, think as you please.  Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's.  Relative Risk as a stat is worthless, what we need to look at is Absolute risk.   These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues.  Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect.  Claims that 400,000 people are dying from obesity is just total nonsense and guess what?  When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus.  In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong.  Another example, is wages between professional men and professional women.  It has been claimed that men make more than women, this is false and incorrect.  To compare wages, you must have individuals in the same field, education level,  work experience, etc.  When we do this, we find that professional women make more than professional men(Stanford Department of Economics).  Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies.  Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people.  The first goal of a corporation is to make money or profits.  As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard.  Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care.  The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.

???
 

My point is that many things and stats are not being read correctly.  Another example of the latest obsession, Uffe Ravnskov, M.D. Nephrology and Ph.D. Chemistry: 

According to conventional wisdom it is wise to lower your cholesterol if it is too high. The main reason for this advice is the observation that people with a high cholesterol more often get a heart attack than people with a normal or a low cholesterol. The observation is correct, but it does not mean that the high cholesterol is the cause of the heart attack (see section 1). If it were, lowering of the high cholesterol by any means should prevent it, but it doesn´t (except with the new group of cholesterol-lowering drugs, the statins; see below).
Before the introduction of the new cholesterol lowering drugs, the statins, more than 40 trials have been performed to test if cholesterol-lowering can prevent a heart attack. In some of the trials the number of fatal heart attacks were lowered a little, in other trials the number of fatal heart attacks increased. Overviews of the trials have shown that when all results were taken together, just as many died in the treatment groups (e.g. those whose cholesterol was lowered) as in the untreated control group (78,79). The following table gives the accumulated results. None of the differences were statistically significant. Nor were they by more sophisticated analyses.

http://www.ravnskov.nu/myth5.htm

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NDXUFan
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« Reply #82 on: October 12, 2013, 10:46:29 PM »

Stephanie Seneff, Ph.D. Engineering, MIT:   

There is actually only a weak correlation between high cholesterol and heart disease. Many people with high cholesterol never get heart disease, and, conversely, many people with heart disease have low cholesterol levels. And the ever-so-popular statin drugs lead to many disturbing side effects that should convince the informed reader that they can't possibly be good for you [5] (Statin Side Effects)
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obsidianom
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« Reply #83 on: October 13, 2013, 05:49:52 AM »

Stephanie Seneff, Ph.D. Engineering, MIT:   

There is actually only a weak correlation between high cholesterol and heart disease. Many people with high cholesterol never get heart disease, and, conversely, many people with heart disease have low cholesterol levels. And the ever-so-popular statin drugs lead to many disturbing side effects that should convince the informed reader that they can't possibly be good for you [5] (Statin Side Effects)
I will simply say that statins have in fact lowered the number of fatalities from heart disease over the past many years. Now I agree it is not simply the lowering of the total cholesterol that is the reason. There are many other reasons including the significant anti inflammatory effects they induce that reduces the damage to the vascular system. There is also the far more important effect on the balance between HDLs and LDLs and and other effects on the balance of the lipoproteins and lipids. Simply talking about lowering total cholesterol is a simplistic and inaccurate approach to the issue.
Statins have in fact been one of the great life savers in modern medicine . We still dont have the complete picture as to why but the effects are clear , they save lives.
The drug companies are my least favorite corporations . They are guilty of much damage and bilking the public out of much money. They are one of the biggest reasons health care is so expensive and insurance premiums rise so fast. BUT, dont mix up the bad behavior with the drugs themselves. While some drugs are clearly horrible, statins in general are a big advance in life saving and general health. Yes they can have side effects , but the good far outreaches the bad.
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My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
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« Reply #84 on: October 13, 2013, 07:37:39 AM »

So is what u are telling me is that over weight people should not worry about getting heart problem or diabetes NDXUFan?  I just want to make sure before I go to a buffet for lunch. No offense but my wife is also a pediatric doctor and thinks you are  way off in your assumption, but it is your opinions so I will respect them.

But just one more time I will ask you the question NDXUFan.....



Are you trying to say that over weight people should not worry about getting heart problems or diabetes NDXUFan?
« Last Edit: October 13, 2013, 02:03:04 PM by Relentless » Logged
obsidianom
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« Reply #85 on: October 13, 2013, 10:31:00 AM »

NDXUfan, I have noticed almost all the articles and people you quote are at least 7 to 10 years in the past. In medicine today, things change so rapidly that often in 2 to 3 years we look at things differently . Anything that predates 2010 now has to be looked at carefully and with great caution as to whether it is still true. That is not to say everything pre 2010 is wrong, but like an old car it needs to be inspected carefully to see if it is still viable.  Some of the stuff you have quoted is over 10 to 15 years old and that is really out there . 
The articles you quoted above ran from 1999 to 2006 .  Lancet was 2006 , and the others were all older.  If you are going to argue a point, try getting more up to date info . I generally look at research in the last 3 years for my  information to base my arguments and treatment paradigms. Older stuff that is still viable will still be written about recently as it is tested and retested so it gains credance.
By the way, I have 2 brothers who are MDs and they are both epidemiologists . One is at CDC and the other at the state level. So I have had plenty of practice arguing medical facts and looking at research.
« Last Edit: October 13, 2013, 10:40:30 AM by obsidianom » Logged

My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
Hemodoc
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« Reply #86 on: October 13, 2013, 08:32:23 PM »

NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote.  I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.


I know more than a few very qualified experts who disagree, think as you please.  Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's.  Relative Risk as a stat is worthless, what we need to look at is Absolute risk.   These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues.  Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect.  Claims that 400,000 people are dying from obesity is just total nonsense and guess what?  When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus.  In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong.  Another example, is wages between professional men and professional women.  It has been claimed that men make more than women, this is false and incorrect.  To compare wages, you must have individuals in the same field, education level,  work experience, etc.  When we do this, we find that professional women make more than professional men(Stanford Department of Economics).  Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies.  Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people.  The first goal of a corporation is to make money or profits.  As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard.  Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care.  The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.

???
 

My point is that many things and stats are not being read correctly.  Another example of the latest obsession, Uffe Ravnskov, M.D. Nephrology and Ph.D. Chemistry: 

According to conventional wisdom it is wise to lower your cholesterol if it is too high. The main reason for this advice is the observation that people with a high cholesterol more often get a heart attack than people with a normal or a low cholesterol. The observation is correct, but it does not mean that the high cholesterol is the cause of the heart attack (see section 1). If it were, lowering of the high cholesterol by any means should prevent it, but it doesn´t (except with the new group of cholesterol-lowering drugs, the statins; see below).
Before the introduction of the new cholesterol lowering drugs, the statins, more than 40 trials have been performed to test if cholesterol-lowering can prevent a heart attack. In some of the trials the number of fatal heart attacks were lowered a little, in other trials the number of fatal heart attacks increased. Overviews of the trials have shown that when all results were taken together, just as many died in the treatment groups (e.g. those whose cholesterol was lowered) as in the untreated control group (78,79). The following table gives the accumulated results. None of the differences were statistically significant. Nor were they by more sophisticated analyses.

http://www.ravnskov.nu/myth5.htm

I will forgo looking up your links, but what you are trying to talk about is the issue of primary prevention of heart attacks across a general population. Secondary prevention trials offer the greatest evidence of statin benefit in a population proven at risk.
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Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
NDXUFan
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« Reply #87 on: October 14, 2013, 08:01:41 PM »

So is what u are telling me is that over weight people should not worry about getting heart problem or diabetes NDXUFan?  I just want to make sure before I go to a buffet for lunch. No offense but my wife is also a pediatric doctor and thinks you are  way off in your assumption, but it is your opinions so I will respect them.

But just one more time I will ask you the question NDXUFan.....



Are you trying to say that over weight people should not worry about getting heart problems or diabetes NDXUFan?

NDXUFan: 
My point is that many in the hard science/medical community disagree with those viewpoints.  I really think it comes down to genetics, not lifestyle.  I have just read and have experienced evidence that is contradictory.  Most of my family is in the hard sciences and they think there is not enough evidence for those viewpoints. 
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NDXUFan
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« Reply #88 on: October 14, 2013, 08:18:55 PM »

NDXUfan, I have noticed almost all the articles and people you quote are at least 7 to 10 years in the past. In medicine today, things change so rapidly that often in 2 to 3 years we look at things differently . Anything that predates 2010 now has to be looked at carefully and with great caution as to whether it is still true. That is not to say everything pre 2010 is wrong, but like an old car it needs to be inspected carefully to see if it is still viable.  Some of the stuff you have quoted is over 10 to 15 years old and that is really out there . 
The articles you quoted above ran from 1999 to 2006 .  Lancet was 2006 , and the others were all older.  If you are going to argue a point, try getting more up to date info . I generally look at research in the last 3 years for my  information to base my arguments and treatment paradigms. Older stuff that is still viable will still be written about recently as it is tested and retested so it gains credance.
By the way, I have 2 brothers who are MDs and they are both epidemiologists . One is at CDC and the other at the state level. So I have had plenty of practice arguing medical facts and looking at research.

ND:

My brother is a Ph.D. in Physics and Materials Science(Northwestern), Dad is a retired chemist, Cousin is a Ph.D. in Chemistry(EPA), Dad's friend is a Ph.D. in Physical Chemistry, and his daughter is a Ph.D. in Biology.  Each one has stated to me that there is not enough evidence for the cholesterol theory or HemoDoc's cause of global warming.  My cousin who worked for the EPA stated to prove global warming, you would need evidence for at least 500 years or more....    I am not arguing that you or your experts are stupid, my point is that my experts are just as good.

Here is Joel Kauffman's background:

Joel M. Kauffman PhD

Professor Emeritus

Education
PhD (Massachusetts Institute of Technology)

Research Interests


One of my principal research areas of interest is in medicinal chemistry, where the focus is on the design and synthesis of potential new drugs with antiinflammatory and antimicrobial properties.

A second research area of interest is the synthesis of new molecules with defined fluorescent properties. Applications include laser dyes, scintillation fluors, waveshifters, and eye protection. These fluorescent molecules, in addition to having high quantum yields and good chemical stability, must be resistant to the exciting light, and in the case of scintillators used to detect radiation from nuclear process, must be resistant to free radical production.
Synopsis
Dr. Kauffman holds a PhD from the Massachusetts Institute of Technology. His research interests include the synthesis of new drugs, fluorescent laser dyes, fluorescent stains for microscopy, and exposing fraud in mainstream medicine.

ND:

We agree on many issues in dialysis, mainly that many in dialysis are extremely arrogant and hypocritical......  It still blows me away that a group who would assert their right to act like a business, would deny that same right to someone else, the same right that they assert for themselves, so hypocritical.  Who died and promoted them as guardians of kidney transplants?  The shortage of kidneys is due to the policies that they themselves promote.  I hope someday they experience the results of their policies, they will be getting what they richly deserve. 
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obsidianom
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« Reply #89 on: October 15, 2013, 09:28:29 AM »

New MAJOR study on statins for lipid control , tolerance , and health effects.
They definatly lower LDLs and decrease mortality.

C (61% vs 44%, p<0.05).

Statin therapy may have had a survival benefit, the authors say. All-cause mortality at eight years trended toward a decrease for patients on daily and intermittent statin dosing compared with those who discontinued their medication (p=0.08).

A strategy of intermittent statin dosing can be an effective therapeutic option in some patients and may result in reduction in LDL-C and achievement of LDL-C goals, the authors conclude.

"This study is the largest to date to review different treatment regimens for patients with documented statin intolerance. Beyond confirming the results of previous small studies, it gives details on many interesting clinical characteristics of the statin intolerance population," said co-author Dr. Warner Mampuya of Centre Hospitalier Universitaire de Sherbrooke in Quebec, Canada, in an email to Reuters Health.

"Statins have well-documented benefits, and their discontinuation has been associated with increased risk for cardiovascular events. This study promotes the use of statins, which are important tools in lessening the burden of cardiovascular disease," he said.
 :clap;
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My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
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« Reply #90 on: October 16, 2013, 06:39:32 AM »

New MAJOR study on statins for lipid control , tolerance , and health effects.
They definatly lower LDLs and decrease mortality.

C (61% vs 44%, p<0.05).

Statin therapy may have had a survival benefit, the authors say. All-cause mortality at eight years trended toward a decrease for patients on daily and intermittent statin dosing compared with those who discontinued their medication (p=0.08).

A strategy of intermittent statin dosing can be an effective therapeutic option in some patients and may result in reduction in LDL-C and achievement of LDL-C goals, the authors conclude.

"This study is the largest to date to review different treatment regimens for patients with documented statin intolerance. Beyond confirming the results of previous small studies, it gives details on many interesting clinical characteristics of the statin intolerance population," said co-author Dr. Warner Mampuya of Centre Hospitalier Universitaire de Sherbrooke in Quebec, Canada, in an email to Reuters Health.

"Statins have well-documented benefits, and their discontinuation has been associated with increased risk for cardiovascular events. This study promotes the use of statins, which are important tools in lessening the burden of cardiovascular disease," he said.
 :clap;

ND: 
I am curious, who sponsored the study, the drug company?  I know of many people including myself that had memory issues while taking statins, I am not trying to be obnoxious, just honest.  I looked up the physician on Google and I did not find anything.  If you would, if you can, send a copy of the study so that one of my hard math people can read it.  I will try to send it to Joel Kauffman.  What is the absolute risk in this study?
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obsidianom
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« Reply #91 on: October 16, 2013, 08:58:04 AM »

Here is the info.  This was not a drug company study.!!!!!!!

 

■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
 

They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE



Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE















 























« Last Edit: October 16, 2013, 09:02:06 AM by obsidianom » Logged

My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
NDXUFan
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« Reply #92 on: October 19, 2013, 01:17:41 PM »

Here is the info.  This was not a drug company study.!!!!!!!

 

■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
 

They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE



Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE
   



Just asking :) 
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NDXUFan
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« Reply #93 on: October 21, 2013, 06:43:15 AM »

Here is the info.  This was not a drug company study.!!!!!!!

 

■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
 

They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE



Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE

I am curious, would you be willing to take statins?
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obsidianom
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« Reply #94 on: October 21, 2013, 09:09:10 AM »

Here is the info.  This was not a drug company study.!!!!!!!

 

■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
 

They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE



Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE

I am curious, would you be willing to take statins?
YES!!!. I have my wife on atorvastatin. Her cholesterol was over 330 and is now 180. Her father died  of an MI at 49 . So it runs in her family. My own cholesterol is TOO LOW. That is not good either. It was 90 but I have gotten it up to 120. My wife is the most important person in my life and I trust atorvastatin (lipitor) for her. She has been on cholesterol lowering agents for 35 years . She has a strong heart at least when checked a few months ago .She has outlived her father by 17 years already. When he died in 1962 there were no statins. I thank statins for keeping her going.
« Last Edit: October 21, 2013, 12:31:28 PM by obsidianom » Logged

My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
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« Reply #95 on: October 21, 2013, 10:26:27 AM »

Here is the info.  This was not a drug company study.!!!!!!!

 

■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
 

They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE



Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE

I am curious, would you be willing to take statins?
YES!!!. I have my wife on atorvastatin. Her cholesterol was over 330 and is now 180. Her father died  of an MI at 49 . So it runs in her family. My own cholesterol is TOO LOW. That is not good either. It was 90 but I have gotten it up to 120. My wife is the most important person in my life and I trust atorvastatin (lipitor) for her. She has been on cholesterol lowering agents for 35 years . She has a strong heart at least when checked a few months ago .She has outlived her father by 26 years already. When he died in 1962 there were no statins. I thank statins for keeping her going.

Statins have a very strong history of safe use. Both my wife and I are on statins as well. No problems.

I am very suspicious of a lot of research going on today that has a significant financial incentive involved, both for using a product and for NOT using a product. The secondary prevention and regression trials are quite well done over many, many years. If you look at epidemiology studies, Japanese in Japan have a very LOW rate of heart disease, but that changes when they come to the US and modify their diet.

Yes, heart disease is multifactoral and I believe Cholesterol is one of those factors. No it isn't the entire story, however, in my own anecdotal experience, the majority of my patients who had heart attacks had issues with cholesterol and other aspects of the metabolic syndrome.  And yes, exercise and weight loss is an important aspect of prevention and treatment.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
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« Reply #96 on: October 21, 2013, 10:47:18 AM »

My Acupuncturist says the statin drugs come from a common root and the drug companies are becoming $$$ rich but add other things that can be dangerous.  He just takes the root and I didn't pay any attention to the name.
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« Reply #97 on: October 21, 2013, 12:54:53 PM »


 Statin development
 
In 1971, Akira Endo, a Japanese biochemist working for the pharmaceutical company Sankyo, began the search for a cholesterol-lowering drug. Research had already shown cholesterol is mostly manufactured by the body in the liver, using the enzyme HMG-CoA reductase.[7] Endo and his team reasoned that certain microorganisms may produce inhibitors of the enzyme to defend themselves against other organisms, as mevalonate is a precursor of many substances required by organisms for the maintenance of their cell walls (ergosterol) or cytoskeleton (isoprenoids).[59] The first agent they identified was mevastatin (ML-236B), a molecule produced by the fungus Penicillium citrinum.
 
A British group isolated the same compound from Penicillium brevicompactum, named it compactin, and published their report in 1976.[60] The British group mentions antifungal properties, with no mention of HMG-CoA reductase inhibition.

Some types of statins are naturally occurring, and can be found in such foods as oyster mushrooms and red yeast rice. Randomized controlled trials found them to be effective, but the quality of the trials was lo
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My wife is the most important person in my life. Dialysis is an honor to do for her.
NxStage since June 2012 .
When not doing dialysis I am a physician ,for over 25 years now(not a nephrologist)

Any posting here should be used for informational purposes only . Talk to your own doctor about treatment decisions.
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« Reply #98 on: October 21, 2013, 01:05:30 PM »

Back in 1992 when I was diagnosed with fsgs, no one spoke to me about the link between CKD and high blood lipids.

Fast forward to 2003 when I moved back to the US and had a check up for insurance purposes.  I was shocked to see that my cholesterol was 550 and triglycerides 2100!  My PCP said he'd never seen such numbers in a non-diabetic patient, and he immediately referred me to a nephrologist.  I was really upset because I'd always watched my diet and I enjoy exercise and do so regularly.  My PCP told me that I could "eat nothing but cardboard for the rest of my life" and still have high blood lipids simply because of my renal disease.

I was put on statins and Zetia, one of the statins being Crestor.  I learned I was allergic to it, so I was put on pravastatin, one of the older statins that was not supposed to be as effective but had fewer side effect.  Almost immediately my cholesterol was lowered to within normal range, and my triglycerides came down to about 250 which was still high but it was a lot better than 2100!

I don't have a lot of fancy shmancy studies to back me up, but I can't believe that NOT treating CKD-induced high lipid levels is a smart thing to do.  I've tolerated the drugs very well, and I am thankful that they are available.
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« Reply #99 on: October 21, 2013, 01:39:13 PM »

Rerun, I always wonder about people who do that. How would he know how much of the root to take? And does he actually eat root or get some kind of pill for it? I never know if those kind of pills actually have in them what they say. I really wonder about people who drink those weird teas to get their supplements. They look so disgusting.

So many drugs are from plants, roots, funguses. I'd rather skip the "natural" route and take the pharmaceutical.
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