Latest news with #Simvastatin
National Geographic
a day ago
- Health
- National Geographic
Statin drugs are an Internet villain. Do they deserve it?
Cholesterol-lowering medicines are some of the most commonly prescribed, effective drugs. Influencers on TikTok have other ideas. The cholesterol-lowering drug Simvastatin. Like other statins, this drug reduces the levels of low-density lipoprotein (LDL) cholesterol in the body. Over 40 million Americans currently take statins. Photograph by James King-Holmes, Science Photo Library Inside the average doctor's office, statins aren't controversial; they're a crucial lifesaving tool used to lower dangerously high cholesterol levels, reducing risk of heart attack. But on social media, the drug is often villainized, painted as a poison pill, or a symptom of a diseased medical system. Recently, influencers have claimed that statins cause more harm than good and have endless side effects. Others take even bigger swings, claiming that the fundamental science behind cholesterol is a myth, one that's used simply to sell more statins . 'If you only went online,' Spencer Nadolsky says, 'you would never want to have a statin.' Nadolsky, a physician who specializes in obesity and lipids, is familiar with the social media critiques. 'It's one of the most fear-mongered yet amazing drugs of our time,' he says. How did boring generic pharmaceutical—a drug prescribed to 200 million people worldwide—become controversial? Part of the answer is influencers who proselytize ketogenic and carnivore diets, promising weight loss and other health benefits through the consumption of high fat consumption and limited carbohydrates. When adhering to one of these diets, the body uses fat as its main fuel source instead of carbohydrates, which can lead to loss of body fat while maintaining muscle mass. The success of these diets is often bolstered by fit social media influencers eating red meat off a cutting board, touting the benefits of their preferred version of a low-carbohydrate, high-fat diet. One influencer even claimed that her transition from a vegan diet to a carnivore diet cured her of everything from brain fog to flatulence. But keto and carnivore have been associated with dramatic increases in low density lipoprotein (LDL) cholesterol—the cholesterol most strongly associated with heart disease, often called the 'bad' cholesterol. Rejecting the lipid hypothesis, many influencers cast doubt on the widely accepted concept that cholesterol contributes to atherosclerosis, which is the buildup of fats and cholesterol in and on the artery walls. The head of a 60 year old patient with high blood pressure and high blood cholesterol. The blood vessels are the result of atherosclerosis which is the buildup of fats and cholesterol in and on the artery walls. Image by Zephyr/Science Photo Library Clinical lipidologist Tom Dayspring describes claims like these as 'ketogenic nonsense.' He says that patients might not experience any symptoms of atherosclerosis until it's too late. What some people don't understand, Dayspring explains, is that heart disease only presents symptoms like chest pain and arrhythmia in very late stages of progression. Symptoms, Dayspring notes, can't be used to diagnosis the disease. 'Most people are dropping dead before they get any symptoms of heart disease,' he says. A scent, a touch, or a sip can be just what you need to lock an important moment into your mind forever. Dayspring says that LDL levels in the United States follow a bell curve. In general, doctors want to get their patients to the 20th percentile or lower, or around 100 mg of LDL cholesterol per deciliter of blood. Once you go above the 20th percentile, the exponential risk becomes a 'straight line to heaven,' Dayspring says. The only way to reduce serious medical issues like heart attacks, heart failure, and strokes brought on by plaque accumulation in the arteries is to achieve very low levels of LDL cholesterol. Dayspring describes it as 'an illegal dump job of cholesterol in your artery wall.' A lipid can only travel through plasma when it's wrapped in a protein known as a lipoprotein. 'Some lipoproteins, for whatever reason, leave plasma, crash the artery wall, and dump their cholesterol.' That's where statins can help. Low-density lipoproteins, or LDLs, are molecules that are a combination of fat and protein and are the form in which lipids are transported in the blood. LDLs transport cholesterol from the liver to the tissues of the body, including the arteries, which has lead LDL being known as "bad" cholesterol. Micrograph by Science Photo Library A colored transmission electron micrograph of high density lipoprotein (HDL), or 'good' cholesterol. HDL cholesterol plays a role in fat metabolism and contributes to cardiovascular health Micrograph by Lennart Nilsson, TT/Science Photo Library Approved in the United States in 1987, statins work by blocking an enzyme in the liver—where most of the body's cholesterol is produced—which prevents LDL production. Statins reduce the risk of heart attack, stroke, and heart disease, which is still the leading cause of death in the United States. Over 40 million Americans currently take statins. Until the early 2000s, statins were the only game in town for managing cholesterol, Dayspring says. Now, there are newer drugs that can also help. One class of drugs, PCSK9 inhibitors, lowers LDL cholesterol by blocking the protein that binds to LDL receptors, keeping these receptors available to clear LDL cholesterol from the blood stream. Unlike statins, these drugs haven't been vilified by. While LDL is often referred to as the 'bad' cholesterol because it can contribute to plaques, and HDL is called the 'good' cholesterol for clearing excess cholesterol from the arteries, it's not black and white. The body requires LDL to function since it assists in cellular construction and repair and serves as a building block for many essential hormones. 'I tell patients up front, [LDL] is the delivery cholesterol, because every tissue in your body needs tens of thousands of doses of cholesterol every day,' says Stephen Kopecky, a preventative cardiologist and the director of the Mayo Clinic's Statin Intolerance Clinic in Minnesota. 'If you didn't have it, you'd be dead,' Kopecky explains. 'So it can't be that bad. There's a sweet spot.' But LDL is just one measure of cholesterol. Dayspring thinks the most measurement to pay attention to is apolipoprotein B, or ApoB, the protein component found in several lipids, including LDL, but not HDL. ApoB, involved in cholesterol transport, is considered superior to LDL cholesterol to assess the risk of heart disease. Unlike LDL cholesterol, ApoB captures a more complete picture of all potentially plaque-causing particles in the blood. For example, a person with normal LDL cholesterol but high ApoB would still be at risk for heart disease. Looking at ApoB is relatively new in the United States, which has historically used LDL. But the rest of the world uses this measurement, says Kopecky. Statin side effects and intolerance Like all medication, statins have side effects. On social media, these side effects are often front-and-center, used by influencers to show that the drug is inefficient or steer followers from considering the medication altogether. The most common are muscle aches, headaches, digestive issues. More seriously, for people with insulin resistance, there's an increased risk to develop Type 2 diabetes (though the American Diabetes Association advises that people with diabetes go on a statin if they're older than 40). To Nadolsky, the benefits outweigh the risks. He compares taking statin to taking daily multivitamin. In his practice, he's able to convince skeptical patients who've bought into the influencer-driven narrative around statins with some basic facts. If the patient claims that LDL cholesterol is not the cause of development of plaque in the arteries, he'll point out that the association is 'one of the most grounded scientific things we know.' Nadolsky's claims are backed up by a trove of evidence, including a 2017 a meta-analysis in the European Heart Journal. That paper found that the totality of evidence 'unequivocally establishes' that LDL causes atherosclerotic cardiovascular disease (ACSVD.) In 2020, the panel restated its conclusion, and also identified emerging evidence for ApoB's role in ASCVD. Some patients, however, are statin intolerant. A 2022 meta-analysis drawing on 4.1 million patients found statin intolerance within 9.1 percent of this population. By Kopecky's estimation, there are three types of statin intolerant patients: those who experience body aches on the medication, and who cycle their use on and off to manage their cholesterol. Kopecky is part of this group. He experiences muscle aches after several months on a statin. Doctors will sometimes temporarily discontinue a patient's statins and then add statins back to their regimen with either modified doses or a different statin to curb side effects. A second group experiences 'these weird symptoms that aren't really related to when they take the medicine.' Researchers have observed a nocebo effect, or negative placebo effect associated with statins, and one 2020 study found this effect might be increasing. The third group, which Kopecky finds most concerning, are those worried about potential statin intolerance, who won't ever visit Kopecky's office. Many patients, he says, will come in and say, 'I don't want to take this drug. I've been on the Internet. I know that's bad for me, doctor.' A statin's effects on the brain are another concern around the medication. Statins are the only drug that can cross the blood-brain barrier and inhibit cholesterol synthesis in the brain, which is the body's most cholesterol-rich organ, Dayspring explains. Cholesterol is required for the brain to operate, but excess cholesterol in the brain can cause neurodegenerative diseases, including Alzheimer's. Dayspring points to the evidence which, he says, shows that 'statins do not hurt the brain in any way, but they actually improve dementia a little bit.' For the exceedingly rare group of people who experience brain fog while on statins, he theorizes that they've over-suppressed the brain's synthesis of cholesterol. But since the brain makes its own cholesterol, drugs that lower cholesterol levels in the liver do not affect the brain's cholesterol levels. Self-guided research on cholesterol and statins can lead to conflicting advice. A quick scan of the best-selling heart health books on Amazon shows titles like The Great Cholesterol Myth and The Cholesterol Hoax, and other offerings that advise readers to load up on red meat, Kopecky says. These books capitalize on a well-established formula. Diet books, Malcolm Gladwell wrote in the New Yorker more than two decades ago, are 'selling something that people want to buy: the idea that they can eat whatever they want.' Beyond misinformation, part of the mistrust around statins is that drug companies didn't initially provide all the information about the drug's side effects, leading doctors, including Kopecky, to pass on incomplete information to patients. It took 20 years before doctors realized that statins can cause a minor increase in blood glucose, which can lead to type 2 diabetes. The lagging response, Kopecky says, has led to some patients to distrust their doctors on this specific treatment. Cholesterol deposits causing the narrowing of a blood vessel which raises blood pressure and puts strain on the heart. Atherosclerosis is the main cause of heart attacks. Photograph by Lennart Nilsson, Boehringer Ingelheim/TT/Science Photo Library Colored coronary angiogram of a 53 year old patient with severe narrowing of the circumflex coronary artery. Photograph by Zephy/Science Photo Library Regardless of claims on the internet, the only lifestyle change that can help control LDL cholesterol is significantly reducing the consumption of saturated fats, Dayspring says. For people with cardiovascular risk that can't be controlled by lifestyle factors, pharmacological intervention is the only option. And the first drug doctors reach for is statins. Lifestyle, Kopecky says, is incredibly important. While a large portion a person's cholesterol is genetic, any positive change is welcome, according to the data. 'Nothing you do to improve your health is ever too little, and nothing you do to improve your health is ever too late in your life,' he says. But he's bearish on keto. 'You just can't eat a keto diet forever,' Kopecky says. There is a healthy version of the diet, he notes—one that relies on extra virgin olive oil, nuts, and avocado oils as the primary fat sources, with just one ounce of red meat per day—but that's a far cry from the steak-loaded cutting boards influencers tout on social media. The carnivore diet often conjures mental images of predators in the wild, consuming double-digit pounds of meat per day. There is even one strict regimen of red meat, salt, and water, is known as the 'Lion Diet.' But despite the image of a diet bridging the gap to our animalistic nature, only humans have high cholesterol, Dayspring notes. 'Things that eat meat all day long, have LDL cholesterols of 15 to 20.' One criticism of statins is that they're overprescribed. And a recent study published in JAMA Internal Medicine found that's likely the case, but it didn't question the benefits of statins or their necessity. According to the study, '50 million US adults aged 40 years and older meet criteria for elevated ASCVD risk,' for a statin prescription, even by the study's revised numbers. To convince wary patients, Nadolsky shares a personal datapoint: he's on a statin. 'I practice what I preach,' he says. Statins are one of the best medicines in use, according to Nadolsky. 'It's just a shame that people aren't utilizing them, due to the fear mongering that is done online.' A 2019 study published in JAMA Cardiology showed less adherence to taking statin medication was associated with more incidences of death for patients with ASCVD. Kopecky, too, is concerned with patients who explicitly say they don't want to take statins after reading about them on the internet. In response, his clinic polled 1,200 of these patients to see what would tip the scales to change their minds about statins. The patients wanted to know three things: cholesterol is involved in heart disease, doctors have a way to lower risk of heart disease, and the treatment is safe. As a result, Kopecky and the Mayo Clinic released a series of videos to address each of these three points. Still, medical misinformation still runs rampant on social media and even crops up next to reputable professionals on social media. When viewing a YouTube video of Kopecky discussing statin misinformation on Mayo Clinic Radio, two of the recommended videos in the sidebar were a video purporting to reveal the 'big pharma' conspiracy behind statins and a second one claiming that LDL cholesterol is a myth. 'LDL is not a myth, and you have to look at the totality of evidence,' Kopecky says. He thinks anyone with high cholesterol should seek treatment for it but understands they might not want to: 'You can't make everybody drink the Kool-Aid.'
Daily Record
04-06-2025
- Health
- Daily Record
‘AI-scientist' discovers that common medication could kill cancer cells
Commonly used non-cancer drugs could help in the treatment of the disease, an 'AI-scientist' has discovered. It seems that technology is reaching new heights, as an AI-powered 'scientist' has made a significant discovery. Working alongside human researchers, the AI model GPT-4 (not to be confused with ChatGPT) has suggested that combinations of cheap and safe drugs could also be effective at treating cancer. The research team, led by the University of Cambridge, used the GPT-4 large language model (LLM) to sift through extensive heaps of scientific literature in order to identify potential new cancer drugs. It was found that drugs for conditions such as high cholesterol and alcohol dependence could potentially kill cancer cells, in research results published in the Journal of the Royal Society Interface. The researchers asked GPT-4 to identify potential new drug combinations that could have an impact on a type of breast cancer cell which is commonly used in medical research. They instructed the 'AI scientist' to avoid standard cancer drugs and identify medications that would attack cancer cells without harming healthy cells. They also prompted the AI model to prioritise drugs that were affordable and approved by regulators. When GPT-4 had made its suggestions, the chosen drugs were then tested by human scientists to measure their effectiveness against breast cancer cells. It was found that three of the 12 drug combinations suggested by GPT-4 worked better than current breast cancer drugs. The AI model then learned from these tests and suggested a further four combinations, three of which also showed promising results. Simvastatin (commonly used to lower cholesterol) and disulfiram (used in alcohol dependence) stood out against breast cancer cells. And while these drugs are not traditionally associated with cancer care, they could be used as potential cancer treatments- although they would first have to go through extensive clinical trials. The researchers have emphasised that AI is not a replacement for scientists, but that supervised AI researchers have the potential to accelerate discovery in areas like cancer research. Models like GPT-4 have been known to return results that aren't true. But in scientific research, these incorrect suggestions, which are known as hallucinations, can still lead to new ideas that are worth testing. 'Supervised LLMs offer a scalable, imaginative layer of scientific exploration, and can help us as human scientists explore new paths that we hadn't thought of before,' said Professor Ross King from Cambridge's Department of Chemical Engineering and Biotechnology, who led the research. 'This is not automation replacing scientists, but a new kind of collaboration,' added co-author Dr Hector Zenil from King's College London. 'Guided by expert prompts and experimental feedback, the AI functioned like a tireless research partner—rapidly navigating an immense hypothesis space and proposing ideas that would take humans alone far longer to reach. 'This study demonstrates how AI can be woven directly into the iterative loop of scientific discovery, enabling adaptive, data-informed hypothesis generation and validation in real time." Join the Daily Record WhatsApp community!
The Herald Scotland
21-04-2025
- The Herald Scotland
Travelling in your 60s - how not to be a geriatric backpacker
We're semi-retired, with time to spare for once, and we've always wanted to explore Peru. You're only young (and old) once. Back in the day we'd thumbed and bummed our way around Europe. Lived in Spain, France, Portugal. I'm talking pre-WhatsApp, smartphones, before Pre-flying – we travelled by train for days. Letters took weeks to arrive. Nobody spoke English. Peru in the 21st century would be a doddle. A Machu Picchu sunrise (Image: Picasa) Still, it pays to be realistic. We considered camping. Briefly. There's a touch of asthma and a couple of dodgy knees to reckon with. We looked at hostels in various bits of the Andes. Sharing dorms with youngsters? They'd want to share your Simvastatin for recreational purposes. And we'd have to listen to them talking the same old drivel we used to talk. We looked out rucksacks from the back of cupboards. Jeez but they're hard on a frozen shoulder. So hotels, one rucksack and one case. Ditch the Swiss army knife to make space for the meds. It's still backpacking, isn't it? Of a sort. So, having planned everything meticulously, which admittedly isn't very rolling stone, off we went. First stop, Lima. LIMA Lima's mental. Over twelve million people living in an area that's officially a desert. Temperatures up to 30c in February when we were there. We've seen traffic in Cairo, braved buses in Mexico City, survived crossing Hanoi streets, but Lima had us quaking in our orthotic boots. We were advised to stay in middle-class Miraflores or Barranco. Even young proper backpackers stay there. Barranco is by the sea where you can watch the surfers doing crazy things and enjoy vibrant street art. Miraflores overlooks it, with a lovely malecón hectic with runners and Tai-Chi groups, dog-walkers and even crazier paragliders jumping off clifftops. Kennedy Park is a haven between busy roads where there are poetry readings, buskers, dancing, rock concerts and genuinely good art and crafts for sale at almost any time of night or day. It's also cat paradise. Scores of them, enjoying specially-built cat hotels, everybody feeding them and playing with them. We sent pictures back to our cat-loving daughter who knew all about them. 'I couldn't live there. I'd never get anything done.' Downtown there are beautiful old squares, elegant colonial buildings, but hemmed in by crumbling or unfinished tower blocks. Irrational planning decisions (we recognise them – we're from Glasgow) have spoiled a lot of it. Still, there's an exhilarating buzz and urgency about the place. Read more We checked what else funky carefree backpackers like us might do from a Lima base. There's Huacachina, an oasis in the desert, five hours south of the city. There's snorkelling in Paracas. You can fly over the famous Nazca Lines. I'm sure they're all great but when there's a perfectly nice café round the corner, a quiet bench with a cat to pat, why slaver yourself with sun cream and look like an old eejit? And there are great museums – Huaca Pucllana is a pre-Inca pyramid of the original Lima people. Built nearly two millennia ago it still stands, whereas modern Lima has been destroyed three times by earthquakes (and looks it). Another warning: do not fly directly to Cuzco. Sea-level to 4,000 metres will result in altitude sickness. So we planned our route via Arequipa, halfway up the Andes, then bus to Lake Titicaca and train to Cuzco for Machu Picchu. True kings of the road. But coming down into Arequipa airport the pilot veered abruptly upwards like Tom Cruise in Top Gun. Rain too heavy to land in. Flights for the next few days were cancelled. We're not going to complain about changing holiday plans – people died and homes were washed away. CUZCO A Cuzco street scene (Image: Picasa) Plan ahead was what everyone, but everyone advised. Don't. We lost out on two hotels, the bus and rail trips. If you're going in the more popular period of May to October it might be wise. Even then there's lots of accommodation and buses. Maybe pre-book the Titicaca train and Machu Picchu. A few days in advance, not months like us. We ended up doing Lima to Cuzco after all. And, yep, we got altitude sickness. Breathlessness and fatigue for a couple of days. We also got, at various points in the expedition, what is politely called travellers' tummy. I'm unashamedly delighted to report that so too did most of the super-fit young digital nomads we met. Coca leaves, available in every market, genuinely help. Chew them long enough and you feel like a shaman. We'd thought we'd missed Lake Titicaca. But a guide called Freddy Quispe, founder of Inca Soul, saved the day. Freddy drove us through the altiplano, past flocks of alpacas, llamas and vicuñas. Then we sailed out to the floating villages of the Uros Islands – a poor community but extraordinary and welcoming. What looks like a great plain surrounds Titicaca, alarmingly however it's where the lake has dried up over the last twenty years. We got to know Cuzco – Qusqu in Aymarian – with Freddy's advice, and by staying at the Antigua Casona hotel, in the middle of the pretty San Blas barrio. Cuzco, in contrast to Lima, is elegant, intact and manageable. We considered walking part of the Inca Sacred Valley, but why get soaked in the constant rain when you can find out all about it in warm and wonderfully collated museums and galleries. (Even in the rain, I discovered to my cost, you can get burnt – you're that much nearer the sun!) There were free concerts of tunas (students playing songs dating back hundreds of years), Amazonian dance, contemporary folk groups. (Though if I hear El Condor Pasa one more time…) The Inca empire only lasted a hundred years, when the Spaniards came and destroyed as much of it as they could, building churches over temples, digging up graveyards… as the Incas themselves had done to the peoples they had colonised. It's thought-provoking seeing full congregations of largely indigenous people – their ancestors having been tortured and burned alive by the Inquisition. (In its turn, Catholicism is fast being replaced by evangelism – we were assailed a couple of times by Bible-bashers. The latest form of soft power, American now instead of Inca or Spanish.) The old languages are being lost. We met people whose parents spoke Runa-Simi or Aymara but they themselves couldn't. We know that story here. Before we'd met my wife and I had both bought Victor Jara's album, Canto Libre. Jara, a Chilean killed by Pinochet's regime, has been a constant throughout our lives – his music, lyrics, his bravery and vision. The cover of Canto Libre shows him playing guitar above the Inca citadel below Machu Picchu. Nearly half a century later we would finally get there ourselves. We'd been warned that, due to the rains, we might not see much. But, at last, as Freddy took us through the Sacred Valley, Inti, the Inca sun god, smiled on us. The experience would need an article, a book, of its own. Bathed in myth and mystery, even the name of the citadel has been lost (Machu Picchu is the 'old peak' that rises over it). To be there is to be at the heart of something, ancient and powerful. 'Rise up with me brother, and be born' Pablo Neruda wrote of it. A llama drama (Image: Picasa) The train journey back is astonishing too. And for once we felt hardier than our youthful fellow-travellers. They all fell asleep or stared at their phones while we rolled through breath-taking Amazonian mountains and forests, past Inca and pre-Inca ruins, following the raging Urubamba river to Ollantaytambo. Back in Lima, we had the best ceviche – an example of the famous Japanese/Peruvian fusion food – with Michael Sharkey. Michael's from Glasgow but has been a priest in Carabayllo, one of the city's poorest barrios. He wouldn't let us visit him there – to dangerous, he said. But he gave us an insight into a Peru few visitors see. In all, a profound journey for us both. Deepest and darkest Peru? It's anything but dark. Dazzling flora, blue rugged sea, red desert sands, the multi-coloured threads of indigenous dress, rain forest greens, birds of every imaginable hue in simple town squares, avocado and yellow pepper fusion food, chicha juice made from purple corn… And Peruvians themselves, generous, vibrant, talkative, survivors of everything history's thrown at them. And we survived too. Sexagenarian quasi-backpackers with a host of memories to take into our third age. A cup of hot chocolate (Peruvian being the best in the world) and a hot water bottle and we'll be ready to tell the weans all about it. Prices in February 2025 TRAVEL. Prices for two people (inc. luggage, seats) Edinburgh – Madrid EasyJet: £339.88 (return) Madrid – Lima Air Europa £2,355.20 (return) Lima to Arequipa - Latam airlines £247.00 (one way) Lima to Cuzco - Latam Airlines £247 (one way) Cuzco to Lima Latam Airlines £163.40 (one way) BUSES (prices for two people, one way) Arequipa to Puno - Cruz del Mer Buses £29 Puno to- Cuzco - Turismo Mer Buses £78 HOTELS (prices for double room per night) Hotel Antigua Miraflores, Lima £80 Katari Hotel Plaza de Armas, Arequipa £78 Kuntur Inn, Puno (Breakfast inc.) £58 Antigua Cason San Blas, Cuzco (Breakfast inc.) £140 TOURS (for two people) Machu Picchu Sunrise Experience (Inca Soul) (inc Aguas Calientes hotel) £820 Lake Titicaca tour (Inca Soul) £488 Surfing, Lima Llamas in transit, Juliaca. Inca citadel, Machu Picchu behind. At Machu Picchu Machu Picchu Inca sunrise Lima beach from Miraflores Cuzco from San Blas Cuzco from San Cristóbal, San Blas Sexagenarian backpackers Lake Titicaca floating village Uros Islanders It rains a lot in Cuzco – but there are consolations! Cuzco street scene
