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Too Much Medicine

 

In an earlier alert I cited an article making the point that the goal of modern medicine is to treat people for “risk factors” rather than illnesses, combined with the ever-lowering cutoffs of what lab results constitute a “risk” has the effect of making everyone a customer of the pharmaceutical industry.  I have also noted David Healy’s comment that evidence-based medicine amounts to a risk-laundering system for pharma companies.  The “Too Much Medicine movement advocates less obsession about screening, prevention, lab levels, treating risk factors, and instead, says,  “don’t worry, don’t get too many labs or screenings, just live your life and deal with illnesses as they come up”.

  • The British Medical Journal has a search tag for articles on the theme of Too Much Medicine
  • A new network of medical students looks at Less is More: The dangers of too much medicine
  • Psychology Today covers a conference on overdiagnosisRecognise that all existing medical guidelines that define disease thresholds and make treatment recommendations are suspect. They have been developed by experts in each field who always have an intellectual conflict of interest (and often enough also have a financial conflict of interest) that biases them toward overdiagnosis and overtreatment in their pet area of research interest. New diagnostic standards are as dangerous as new drugs and need the same careful and independent vetting to tame unrealistic diagnostic enthusiasm.
  • BMJ devotes an entire issue to too much medicine.

Junk Science and Research Fraud

…the evidence based “quality mark” has been misappropriated and distorted by vested interests. In particular, the drug and medical devices industries increasingly set the research agenda. They define what counts as disease … and predisease “risk states” (such as low bone density, treatable with alendronate). They also decide which tests and treatments will be compared in empirical studies and choose (often surrogate) outcome measures for establishing “efficacy.”

Furthermore, by overpowering trials to ensure that small differences will be statistically significant, setting inclusion criteria to select those most likely to respond to treatment, manipulating the dose of both intervention and control drugs, using surrogate endpoints, and selectively publishing positive studies, industry may manage to publish its outputs as “unbiased” studies in leading peer reviewed journals.

Evidence based medicine’s quality checklists and risk of bias tools may be unable to detect the increasingly subtle biases in industry sponsored studies. Some so called evidence based policies … seem to be based largely on political conviction.

Food

  • San Francisco Weekly covers the farm-to-table movement, heavily influenced by ex-google and other ex-tech chefs.
  • Has the Sustainable Food Movement Failed? asks Gracy Olmsted. She notes that many “brainds”, like “free range” have been turned into funnels back into the mass production system.  Some interesting comments in the discussion section below the article.
  • EricMargolies explains how traditional French food and cooking has been destroyed (but Italian has not). “When you go to one of Paris’ charming little bistros or brasseries, the meal you order usually comes out of a tiny kitchen in the basement run by an immigrant from West Africa.   All those famed dishes on the menu –  lamb and veal stew,  kidneys, chicken in mushroom sauce, beef bourguignon,  steak tatar, tarte tatin, crème brule – are usually frozen in giant factories outside Paris and shipped to restaurants.  They come in large boxes from freezer trucks or “sous vide,”  that is, sealed in a  vacuum in  plastic bags, and then steamed for six hours before being sent to the restaurant customer. Such dishes are microwaved with the addition of reconstituted powdered sauces and flavorings. Most restaurants in France make use of other pre-prepared or frozen ingredients like diced vegetables, frozen seafood and deserts.    Few eateries, it seems have the time, space or money to employ traditional kitchen staffs to prepare food.”

Fake Food

Nutrition

Pharma

Cholesterol and Heart Disease

  • Dr Rakesh “Rocky” Patel MD asks, Does LDL-P matter?  He describes his own lab results consisting of high LDL-P numbers on the NMR particle panel, along with decreasing insulin resistance and imaging results showing arterial blockages dissolving.
  • Grip strength has predictive correlation with heart attack, stroke.  It may be a good aggregate measure for a number of factors, not only including trained strength, but muscle and circulatory health in general.
  • Dr. Donald Miller MD on Fallacies in Modern Medicine: Statins and the Cholesterol-Heart Hypothesis – cites many published research studies showing the lack of any real evidence that the use of statins to lower cholesterol has any benefits.
  • I watched the movie $tatin Nation 2 (it is $5 on Vimeo).  Highly recommended.  The movie is a great survey of the total lack of any scientific basis for the diet-heart-cholesterol hypothesis and the use of statins to lower cholesterol levels.  There were many, many fine points made in this movie – in particular the focus on total mortality rather than cholesterol lowering.   Statins do not reduce total mortality.  They discuss the results of a meta-analysis from Japan showing the higher the level of total cholesterol the lower the all-cause rate of mortality.  Another small point was the drive by the pharma industry to redefine normal biomarkers as a disease state and to get people taking drugs for preventive reasons – for example a blood pressure of 120/80 is now defined as “pre-hypertensive”.
  • From Justin Smith, a talk by Dr. Jerome P. Kassirrer, MD on Former Editor of Major Journal Exposes Statin Conflict of Interest.  The majority of the doctors who came up with the statin guidelines had conflicts of interest.  After Kassirrer published his book On the Take: How Medicine’s Complicity with Big Business Can Endanger Your Health, he lost his position as a medical journal editor.
  • Dr Hoffman talks to cardiologist and researcher Dr. Peter Langsjoen: “he argues that statistical deception has created the illusion that statins are safe and effective in preventing cardiovascular disease; He details the numerous side effects of statins, and suggests that even when symptoms are not obvious, cholesterol-lowering drugs may do the body irrevocable harm; Dr. Langsjoen shares new studies which suggest that statins may neutralize the artery-protecting benefits of vitamin K2“.  On the latter point, Langsjoen says that imaging studies show that statins increase the calcification of the arteries, generating the disease they are supposed to prevent.

Neurology

The Agriculture Police State

  • Small eastern Oregon ranchers Ross and Ava Denton were hit with an overload of spurious violations by a regulatory agency backed by an animal rights organization that opposes all ranching.  At the time of writing a piece, Ranchers are not Criminals … For Now on the Farm-to-Consumer Legal Defense Fund’s blog, they were at risk of having their entire herd of grass-fed cattle, sheep and hogs confiscated without having committed any actual violation.

Gut Biome

Ergonomics

  • I have been using the Apple Magic Trackpad at work where I have a Mac.  I have a history of hand and wrist problems especially on the right side where I have my mouse.  I believe that the repeated stress from mouse clicking is part of the problem.  The Apple Trackpad is the most ergonomic mouse that I have found so far.  All of the mouse movements including those that require clicking buttons on a standard mouse, are done by swiping the hand across the surface of the trackpad.  The trackpad requires very little pressure unlike a mouse button.

Gluten

Coffee

 

Full Disclosure regarding any Conflict of Interest:

I have no connection with, affiliate relationship, or any quid pro quo or other reciprocal benefit from any products that I recommend.  The seller probably does not even know that I exist.  This applies to books, documentary films, nutritional supplements, computer products, or any other thing I mention that sold, or given away for free.  These are things that I personally like.  If I know the person behind it or am friends, I disclose that.

 

Robert Blumen