Statins and Cholesterol

I have now read right through the Stephanie Seneff (2011) essay to the end. Very anti-statin, and full of challenges. But I have also just heard (25th Feb, 2014) Professor Ian Young, (Director of the Centre for Public Health, Queen's University Belfast) give the Albert Latner lecture at Newcastle University on "My cholesterol -- why is it so high?"; very pro-statin and a most frustrating affair.  I shall comment first on Ian Young.

The man presented no chink of doubt. We must all take statins from infancy up. He kept saying that a 1mM (mmol total cholesterol per litre blood) drop in total cholesterol causes a 25% lowering of risk of vascular event; but, while his curves showed a steep line of correlation for 40 year olds, it was an almost flat line for 80 years. (So for me there is practically no benefit).

In no case was the vertical axis on any of his graphs 'General health'; he was only talking about 'Rate (or risk) of vascular event'. To a hammer everything looks like a nail and to a cardiologist the object is to lower risk of a 'vascular event'. What about the adverse side-effects; the muscle pains, and increased risk of diabetes (both of which Young conceded), Alzheimer's, ALS, and Parkinson's (which were mentioned by Stephanie Seneff)?

Cholesterol is essential. Ian Young correctly remarked that blocking the synthetic pathway at HMGCoA synthase (as statins do) will indeed cause a shortage of cholesterol and lead to scavenging pathways and the relocation of existing cholesterol. If the scavenged cholesterol is from coronary plaques, well-and-good; but what if it is in brain myelin or muscle cell membranes (as emphasised by Stephanie Seneff)? And what about ubiquinone and dolicol, which are also essential and also on the pathway blocked by statins  (as emphasised by Stephanie Seneff )? If there ARE INDEED adverse side effects of statins it is easy to see why!

So the clinical debate should be about the side effects versus benefits. I heard a paper in a Glasgow Heart meeting in the late 1990s  which concluded that for over 40 year olds (or over 50) the OVERALL benefits of statins do not outweigh the OVERALL damage. I was impressed (staggered, indeed) at the failure of the clinical cardiologists to see that this trumped the (undenied) fact that statins lower cardiovascular risk.

I am certainly not going to take statins. I do not feel I need them. And whether or not I should lower blood cholesterol there is something too utterly daft about poisoning myself at great expense in order to achieve that; and simply to switch from a healthy death from a coronary to a lingering death from mental, muscular and neurological decay. If I were under 40 and had familial hypercholesterolaemia, I think I would try diet, red-wine, and niacin (e.g. brewer's yeast) before I tried statins. (There are many types of familial hypercholesterolaemia; the most common by a factor of 2 is a defective LDL-receptor, which presumably hoicks LDL particles out of the circulation and into some (presumably) removal pathway.

Professor Ian Young talked away about nuts, expensive margarine, salt, exercise, the 'J'-curve for alcohol, etc. But he conceded that only 10% of our cholesterol comes from diet. So, surely the question is why do we MAKE too much? What regulates the synthetic pathway? [**]  Does alcohol in excess of 2 units per day, or smoking, etc, up-regulate the synthetic pathway, or affect the partitioning between pools of cholesterol, e;g; by enhancing oxidative damage. What is the rôle of lipid oxidation (briefly mentioned by Young)?   [** My colleague Loranne Agius suggests that excess carbohydrate feeds into fat production in the liver which requires cholesterol for its excretion]

Young pointed out that HDL-cholesterol is "good"; that low 'cardiovascular risk' correlates with higher HDL (in the 1 - 2 mM range, independently of LDL or total Ch.); in fact high HDL-Ch is 10-fold healthier than low HDL-Ch (while low LDL-Ch is only 3 times healthier than high); the best predictor of heart disease is therefore the ratio LDL/HDL, the next best is HDL, the least good is LDL or total blood cholesterol. So, what determines partitioning between the various 'pools' of cholesterol: HDL, LDL, its 'locus operandi' (where it is needed, in muscle and nerve membranes), and its 'locus morbidus' (i.e. coronary plaques where it is not wanted - we suppose)?  What is the rôle of lipid oxidation (briefly mentioned by Young) in affecting the partitioning?  Presumably the HDL particle is picking up and re-locating cholesterol and is wholly good. But it is HDL-cholesterol that is measured, so we do not know if the HDL is largely unloaded or nearly full; the latter giving the impression of plenty of HDL particle, but actually being nearly useless as a scavenger. There is a route for elimination of lipid, lipid-cholesterol-ester and cholesterol which involves liver, bile and gut. Guessing here, and maybe naively, but is it damaged (e.g. oxidized) fat/cholesterol that is eliminated, rather than merely surplus?   So many unanswered questions.

Perhaps the coronary plaques are, in a wider sense, beneficial. After all, they protect us against Alzheimer's disease, and a lingering death! What are the evolutionary benefits (to the genes) of surviving beyond age 70?  They must be very small and may be negative; a little 'grandparenting', and 'advice' (perhaps), but is that sufficient to pay for the food and space?

Coming to Stephanie Seneff (2011), I believe this contains errors, and her fundamental technique is strange and (I suspect) fallible; that of looking at a bunch of statin-based and non-statin-based reviews and counting in each the incidence of words like 'dementia'. If 'Statin' reviews mention dementia, that does not necessarily mean that Statins cause dementia. What if statins PROTECT against dementia, or the paper says STATIN DOES NOT CAUSE dementia, while on the other hand diuretic pharmacologists may focus on salt balance and blood volume, even it their drugs do actually cause hallucinations. I do not follow Seneff's argument about lactate and acidosis; splitting ATP to ADP and Pi generates H+, but there is 10 - 100 times as much lactic acid synthesized as ATP split (and ATP is resynthesised while lactate accumulates). I think she has the oxidation of cholesterol-sulphate to cholesterol-sulphide wrong, for that is surely a reduction, and I have never heard of there being any useful energy available from that. (Indeed, I had not heard about cholesterol-sulphate or cholesterol-sulphide.) But she is right about cholesterol being needed. And statins being toxic. Is she right about statins causing raised fructose, or dementia, or ALS, etc? That needs checking, not dismissing.

But I am no expert.
Ian West,  (12 Longhirst Village, MORPETH, NE61 3LT)

Re: Your Amazon.co.uk Enquiry

Dear Jason,

You have been very helpful. However, I shall still warn everyone I
know to beware of "Amazon Prime". I found a page on your website which
said "click this button to begin a 30 day free trial". It DID NOT say
that I would automatically upgrade to a paying member after 30 days.
And in any case I DID NOT PRESS that button. Furthermore, I looked at
all three emails from Amazon sent on 13th Jan and NONE of them say
anything about Amazon Prime, let alone automatic conversion to full
Fee Paying Membership after 30 days.

I may well have opted for "1 day delivery and free 30 day trial of
Amazon Prime", thinking that it was indeed 'Free'. (How naif can you
get!). But as you rightly observe I do not know what Amazon Prime is
and certainly did not wish to join that. The 30 day period was,
however, very educational; I know I want nothing to do with Amazon
Prime; and I did not know that before.

Unfortunately I have stopped that Credit Card. Not, I should say,
because of the erroneous £49.00 charge, for I had stopped the card for
another fraud before I noticed this entry. I think TSB should manage
to credit my account, but there may be some problem.

You have been very helpful. If you are this helpful to all customers I
think this 'Amazon Prime' idea must count as one of Amazon's few
failures.

Best wishes, Ian West
--
Ian West
12 Longhirst Village,
MORPETH, NE61 3LT, UK
Tel: 01670 791880
*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-*-
On 24 Feb 2014, at 17:25, Amazon.co.uk wrote:

Your Account
Amazon.co.uk
Message From Customer Service
Hello Ian,

This is Jason from Amazon Customer Services.

 
Further to our conversation I've checked your account and found that
the charge of GBP 49.00 relates to Amazon Prime. When you placed an
order on the 13 January 2014, you chose the following delivery option:
"One-Day Delivery with a free trial of Amazon Prime (1 business day)".

While you weren't charged at sign-up, your membership is upgraded to a
paid membership plan for your own convenience once the trial period
ends.

As you didn't cancel your membership once the trial period ended, our
system automatically charged you the annual subscription fee for
Amazon Prime, GBP 49.00.

However, our records indicate that you haven't used your Amazon Prime
membership, so it doesn't seem that the Amazon Prime service is
something you'd benefit from.

I've now cancelled your Amazon Prime membership and requested a refund
of GBP 49.00 for the membership fee.

Refunds usually go through in 2 to 3 business days so you should see
this credited to your account on your next statement. Please note,
this does not include your bank's processing time.

Cancelling your Prime membership means that you'll lose your Prime
benefits. Any new or pending orders may be subject to delivery costs.
Cancelling your membership will also cancel the membership benefits of
any invited household members. You will also lose access to Kindle
Owners Lending Library.

For more information about Amazon Prime, including the Terms &
Conditions, please visit our Help pages at:

http://www.amazon.co.uk/gp/help/customer/display.html?nodeId=200182130

I hope this helps. We look forward to seeing you again soon.

Warmest regards,
Jason S
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The Big Six Power Companies

Big Six Energy Companies

" It looks as though Capital Gains Tax is too low in Britain, and too high on the continent."

We read that the profits of the Big Six energy companies have (when averaged) increased five fold since the financial crisis of 2008/9; increasing from 0.22 B£ to 1.2 B£. That has been due to price hikes and hard winters. There was a major hike in 2012 which lifted all 6 into profitability. So why a hike in 2013? One suspects that the companies saw that they got away with it in 2012, and were tempted to try it again. 

Back in February this year I pointed out (Ref.1) that Centrica¨ (i.e. British Gas) announced increased profits of 11% over the previous year. I also showed that share prices rose by a similar 11%. , and concluded that the shareholders expected to see those profits. It was clear they had no intention of investing them in the business. Nor was that extra money destined to insulating the homes of chilly customers; nor to pay for more expensive raw materials, for those prices had fallen.

In the Table 1 below I look at all six of our biggest energy providers. One feature is immediately obvious; only two of the six are British owned — Centrica and SSE. Of the others, 2 are German, 1 French and 1 Spanish (Iberdrola). The next point that strikes the eye is that there seem to be two types of business strategy; while the 2 British-owned companies return a piffling divident (P/E over 1000), the continental companies return a handsome dividend of between 7% p.a. on the capital invested in EDF, to 9.6% for shares in Iberdrola¨. On the other hand shares in the continental companies have all slumped steadily over the 5 years from Jan 2009, while shares in the British companies have shown a steady and sustained rise over the same 5 years with a smoothed average of 8% p.a (for SSE) to a staggering 18% p.a. (for Centrica). Who needs a dividend if the share itself increases in value at a rate that is 9 times greater than inflation!

 

It looks as though Capital Gains Tax is too low in Britain, and too high on the continent; with the possibility of a compensating imbalance in corporation tax levels such that in Britain, companies find it prudent not to make a profit if that can be legally avoided.

Table 1

Data for Northumberland, including VAT (5%), 'standard' direct debit rate, unit cost (pence/kwh), standing charge (pence/day)

 

Company	Curr. Unit (p/kwh)	Standing Charge (p/day)	P/E ratio	Smoothed 5 yr. ann. share rise%
Npower (RWE AG)	14.879	10.0	10.5	-20%
British Gas (Centrica Plc)	12.320	26.000	1,561.97	+18%
SSE (SSE Plc)	14.35	16.45	1,617.76	+8%
E.On (EOAN.DE)	Not revealed	Not revealed	12.23	-12%
Scottish Power (Iberdrola )	9.689	28.70	10.36	-5%
EDF (ƒElectriciteŽ de France)	13.78	18.90	14.17

References:

[1] http://occidentis.blogspot.co.uk/2013/02/centricas-profit_27.html

Cawstein
cawstein@gmail.com

Autumn

"Season of mists"

I find autumn to be a deeply satisfactory season. Such used not to be the case, when I was young, but now that I have completed my 'three score years and ten' and am enjoying these supernumerary years, it seems different.

The leaves turn and fall, the trees drip gently, the fallen apples rot, the unpicked beans dry and rattle in their pods. Things are tidying themselves up for the long sleep. In my early twenties, the golden days of autumn were just as beautiful on the banks of the Cherwell as here on the Longhirst burn, but they chided me. My unassuaged longings chided me. The fleeing swallows mocked me.  Another wasted summer gone!

Do I kid myself that I also shall sleep to wake in a new springtime? Is it thus that the 'obviously false' hope of a new life-after-death enters our minds; hard wired; like our 'obviously false' belief in causation, simultaneity, gravity. To my conscious mind it is clear that it is not I that will be born again, to learn to walk, to talk, to read, to love. It may not be my children, or my grandchildren, any more than they will be my swallows, or my roses that will return. But there is a confidence that this will all come again.

And I can return to raking leaves, refreshed from my little pause for thought.

Cawstein
cawstein@gmail.com

Is a Dog the Ideal Companion?

Dear G.

I have spent some time mulling over the conundrum that your idea of
getting a pet dog has posed for me. Dogs are doubtless very rewarding.
For different people there will be different 'perfect' dogs, but they
each have much to offer, and with the great variety available it is
possible for many people to find a good fit. You can feed a dog and it
is grateful, you can take him for a walk and he will love it (and be
grateful), you can tell him off and he will be contrite, without
answering back. Dogs will watch you sit down and will come and lie at
your feet; they will look up at you with questioning but admiring
eyes, dimly understanding the barest outline of your thoughts or moods
-- but wholly trusting. An ideal companion you might think. How could
a human (man or woman) compete? A human would want to walk when you
want to sit, would doubt your facts and question your conclusions.
They might eat with gratitude the food you put in front of them, and
look at you with admiring incomprehension; but they would want to walk
north when you want to walk south, want to throw sticks for you to
chase (dammit!) instead of picking up your sticks, and worst of all
they might want to climb onto the furniture and into your bed.

Yet I cannot get out of my head the idea that a pet dog is a surrogate
companion, a stand-in for a human companion. Is the problem one of
choice; we can choose our dog but with a human companion they are at
least in part choosing us? Is it perhaps a question of communication,
for amidst all those words we often fail to make it clear what we do
want and what we do not want of our companion? That is not simply
because of the complexity that words allow, but from shyness; the
difficulty of talking to an equal.

Ah! perhaps a glimmer of the answer is filtering through to my dull
brain -- 'equality'. There is an asymmetry in the man/dog relationship
that is absent (or less marked) in the more equal relationship between
two humans. How refreshing it is to be always right, always boss. No
one is going to question the superiority of a human companion when it
comes to playing duets, or having a conversation. But it is often
tiring, and sometimes humiliating to deal with an equal; even more so
with a self-appointed superior.

Did you get that dog?

L. Cawstein
cawstein@gmail.com

Suicide: hindered and assisted

"In a world of limited resources, to keep one person alive is to condemn another to death."    

     There has been considerable discussion in the media during the last 5 years of the law regarding 'assisted suicide'. There has been no similar consideration of the law re 'hindered suicide', though I think the two issues are linked.

      Our reluctance to allow the legal killing of another human being is understandable. It does not take much imagination to conjure up situations where pressure is put on disabled people to consent to their removal, for reasons that concern the interests of the carers and not the patient. The present unofficial system in Great Britain seems to work, to some extent; assistance can be given, but is never legally condoned, so any protest, by any party, could lead to the prosecution and disgrace of the assister. It is pragmatic, if also ridiculous;  but it seems that a majority of British citizens believe it preferable to any alternative. Oregon State and Switzerland represent a tiny minority of polities that allow 'assisted suicide'.

    I am here suggesting that to prevent a person from dying may represent an intrusion into individual sovereignty as much as to prevent a person from living; a violation of their human right.  

    I am putting forward the notion that to contribute to a person's death by doing nothing is vastly different from contributing to their death by a positive action. There should be greater clarity on whether knowing of someone's intention to take a lethal dose constitutes 'complicity', or simply 'minding your own business'. 

    When an overwhelming majority of people believed in minute-by-minute supervision of everyone's life by an all-attentive, all-powerful (though otherwise very human) God, one could shrug and say "It is God's will". We (mostly) do not now think of a real God of that type, though there is practically no serious debate as to what we do mean (or could) mean by 'God' [1]. However, it seems to me that the metaphor of "God's will" still has some meaning, even for an atheist. We all die, by a 'law of nature'; some sooner, some later. It is in a way unfortunate that many deaths can now be prevented very easily, for now the line between life and death is drawn, not by external natural forces, but by human ones. We have the terribly difficult task of deciding where to draw that line.

    In a world of limited resources, the decision becomes slightly easier, for to keep one person alive is to condemn another to death. 

    

(Edited, 8th Jan 2025)

References:

[1] West, I.C. (2019) "God for Atheists", AuthorHouse, Bloomington IN. ISBN:978-1-7283-9399-5 (sc); ISBN:978-1-7283-9398-8 (e).

Productive Thinking

We spent some time trying to outline a systematic approach to thinking productively, stimulated by the mere title of Susan Stebbing's "Thinking to Some Purpose" (Pelican, London, 1939).

I suggested "Ten Obstacles to Clear and Productive Thought", as follows.

[1] Ignorance: in spite of the resources of the internet it is still a problem that most of us most of the time do not sufficiently know 'the facts'.

[2] Prejudice: we assume we know, and we often assume what we want to be true, which makes our error all the more difficult to rectify.

[3] Manipulation: we can be played upon by clever advertising, or 'hidden persuaders'.

[4] Potted thinking: we reduce an argument to a sentence, to make it easier to remember and express, even when the truth and the power slip away with the detail.  Emotive language can pack a lot of argument into a single work (e.g. 'freedom').

[5] Ambiguities of language: it is surprizingly hard to say exactly what we mean, and to know what someone else means from what they say.

[6] Logical slips: for example Post hoc ergo propter hoc, (or mistaking 'correlation' for 'causation'), and Petitio principii  (or circular argument, which used to be called "Begging the Question" until that term got high-jacked by the ignorant to mean simply "posing the question". 'Wise men give wise answers; this is a wise answer, because/therefore this is a wise man.').

[7] Attention span: we often drop a subject, or get side-tracked, before its goal has been reached.

[8] Conflict: is often avoided on emotional grounds when it should be welcomed on logical grounds.

[9] Circles: to find oneself repeatedly covering familiar ground suggest that the argument is being directed by a sub-conscious pilot.

[10] False syntheses: if repeated cases tend to illustrate the same general truth you have either discovered a valuable general principle, or a hobby-horse.

L. Cawstein
cawstein@gmail.com