Monthly Archives: August 2009

SOUTHERN AFRICAN APOCALYPSE NOW

The placatory hat-doffing Dose of Humility, like the Lancet authors,  is skewed as usual for  placatory political expediency.

The Four Horsemen, the  plagues  of the Southern African apocalypse –  Ill-Health (AIDS -TB- cholera, maternal and infantile mortality); Crime (violence, corruption);   Lifestyle including  the deadliest licensed drugs (alcohol and smoking); and Poverty (from ignorance, illiteracy, lack of education and thus skills and jobs, and thus  worsening despair) ;  – are all  the direct result of ANC policy,  Disaster Capitalism benefiting only the chosen,  gleefully reinforced by the new peoples’ government  since 1994:

continuing the same age-old pattern of socioeconomic deprivation, apartheid war on the people by an oppressive elite as in  previous aeons, and  from  reckless  sexual and financial promiscuity exemplified and boasted as a virtue  by the  current State President himself, since he has done everything possible  to  avoid vindicating  this reputation.

These plagues bode  ill for health in Southern Africa.

It became clear  from 1998  that any politician leader would be better than   Mbeki – but Mbeki’s fault was simply being a self-opinionated deluded emperor without any clothes;  whereas Zuma has by his violent utterances and condomless example even more than his criminality (since he has fought for years to avoid vindicating himself in a court) and lack of leadership inspired yet more corruption, AIDs, and violence against women,  children and other minorities.

Fifteen years ago the ANC alliance, through Madiba Nelson Mandela’s long martyrdom and refusal to bow to white terrorism,   was handed one of the richest economies and best-skilled business sector, agriculture, fisheries, and civil service- judiciary, health, all-level  education, roads and transport in the world.  All they had to do was oversee that these were expanded progressively under the in-place  highly trained teachers and service experts while training en mass previously disadvantaged people to integrate and expand services at all level.

Instead, and despite iconic voices of protest (  Mandela and the Archbishops)-  our brilliant leaders at that time  and mostly still in power- Mbeki, the Zumas, Asmal, Manuel, Kasrils, Omar, Maduna, Irwin,  Ramaphosa, Sexwale, Lekota, Motlanthe, the Msimangs, Tshabalalas, Hlopes, Selebes and Shaiks, – set about demolishing (far quicker than Mugabe did in Zim) what was working, giving away national assets like Iscor and  our oil and fishing and water reserves in private deals while placing incompetent cadres even more greedy and indifferent to the needs of the poor (than the apartheid regime) in charge of everything,

and handing over management of key departments like education, energy, health, justice, police, prisons, social welfare, natural resources, SAA, SABC & Eskom to the most corrupt and incompetent brothers and sisters so as to reduce to failed states what were the breadbaskets of the world – RSA, and the petty peacock  chiefs/kings -for- life of Zimbabwe, Swaziland and Kwazulu;

and deploying our huge army (mostly employment for AIDS sufferers and spreaders) to cushy jobs if not as generals and admirals, while the few able-bodied are deployed to foreign warzones- presumably sold at mercenary rates paid by UNO etc- to no purpose  except mostly to commit rape, corruption, mayhem – in other failed states like the Congo and Somalia;

while the competent policemen here are immobilized by lack of leadership and endemic violence caused, lauded by the ANC – the utterances and actions of the Zumas, Malemas and “ministers” (a hideously ironic word)  of Injustice and Disorder..

And opening our borders and coffers to other despots like the ex-president of Haiti (whom they fund at R5million a year), and Mugabe and his thugs- mass killers since 1982 – (whom they keep in power in gold and marble palaces with hundreds of millions of our taxes  a year) and millions of desperate refugees from neighbouring failed states which the ANC has gladly encouraged and paid to fail;

when we already have such desperate growing poverty and despair and joblessness here that the inevitable happens- murderous anger is taken out on the helpless hardest-working most productive – women (and children), farmers, the tiny minority of harworking business and professional people,  and equally industrious immigrants .

The ANC cannot or will not run even a bus,  a school or a village sensibly despite having total power since 1994, and Jacob Zuma being in supreme command as head of the ANC and thus RSA  for at least 2 years- never mind as chairman of the ANC since 1994, and deputy state president with enormous powers from ~1998 to ~2006.

So what chance does a sensible minister like Hogan or Motsoaledi have, when it is not their token titular appointment for appearances’ sake, but insider pull and extremist wishes in the party that matters, ?

when Zuma has shown by his corrupt and crazy actions and utterances for the past decade that (like Malema) he has no self-control or will of his own, he keeps on taking more child brides (like Mswati) and producing his own army of offspring, and making impossible  promises-  like creating half a million new jobs this year while traveling the world as a “statesman ” like Mbeki did, – and introducing the best and most expensive NHI in the world – “this year”- when only perhaps 10% of the workforce is actually working formally and earning meaningful incomes (not even 14% of the total population can afford decent medical aid) , and our total direct and indirect  tax burden for the productive is already among the highest in the world;

while Eskom declares yet again a R9billion deficit, and more threats of power paralysis if more money is not yet again futilely thrown at its rotten directors who (like SABC and SAA and the Cabinet) have never been called to account for their criminal theft and abuses the past years.

And still there is no national policy and budget to fast-track away from  deadly-polluting oil/coal -which reserves are not infinite, we should desperately  conserve for plastics, chemicals  etc, and away from  even deadlier nuclear power – by far the most expensive,  to environment-enriching and infinite natural power (and fresh water) from the sea, wind and sun.

Like the Armsgate and Oilgate sagas, will the truth about the covert deal with the French – over buying weapons (from Thint) we didnt need a decade ago, and now multiple thoroughly discredited nuclear PBRs pebble-bed reactors-  also be swept under the carpet for another decade if not forever? while a second dangerous nuclear reactor is insanely  installed within the residential area of Cape Town?

Talk about planning another Chernobyl, Three Mile Island, another apocalypse now,  when ANC policy has driven our world-class nuclear power scientist to run nuclear power stations in Britain, when our top ANC  appointees  still can’t run Eskom and the police  efficiently, threatening again to paralyze industry while blaming domestic consumers…

When the ANC wont tolerate honest competent forceful  ministers of health like Madladla-Routledge and Hogan, what chance does Dr Motsoaledi have to speedily  reverse the world’s worst maternal and child and AIDs and TB and lifestyle- and drug- related  mortality rates of any  industrialized country?

when the root problem is frustration and despair (from destruction of the education system and apprenticeships,  closure of nursing colleges, refusal to allow the advanced private hospitals to train nursing sisters); let alone set up more medical schools, failure to apprehend and incarcerate dangerous criminals),  and thus rampant fear, disease and unemployability  poverty;

leading to selfdestruction of  communities and the world’s  highest homicide rates (with alcohol, smoking, drugs, knives, broken bottles, bicycle spokes, sticks and stones, methanol, fire, dangerous driving, fists, feet and  guns),  both on the defenceless masses and the tiny productive skilled minority- the very  people who  keep the system running and pay the taxes.

When cabinet minister’s response is, dont complain, dont ask for police protection against robbery and violence, dont complain about gigantic institutionalized  political – Member of Parliament-  and civil service fraud, when convicted massive fraudsters like Shaik are fraudulently released from jail at Government whim while hundreds  die in jail of progressive disease without parole-   if you dont like it, leave.

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METFORMIN OR INSULIN AND DIABETIC PREGNANCY OUTCOMES:

This new controlled study from a Surrey UK university of “Pregnancy outcomes in women with gestational diabetes treated with metformin or insulin” confirms that it is criminal negligence-  culpable homicide – not to put those battling with overweight – weight gain- on preventative metformin.

Comparing diabetic pregnancies treated with metformin up to 2500mg/d with diabetic pregnancies treated with insulin, “the Women treated with insulin had significantly greater mean weight gain from enrollment to term (2.72kg vs. 0.94kg P<.001). There was no difference between the metformin and insulin groups respectively  comparing hypertension , induction of labour, or rate of Caesarean section. No perinatal loss occurred in either group. BUT the metformin benefits for the baby (and thus lower costs) were enormous: “Neonatal morbidity was improved in the metformin group all p<0.01:  prematurity (0 vs. 10%), neonatal jaundice (8 vs. 30% ) and admission to neonatal unit (6 vs. 19%).

It is just a year since Glueck ea in Cincinnati showed that adding metformin to tolerance to sensible diet in women with PCOS  before conception greatly improved both conception rate, successful pregnancy and lowered gestational diabetes rate from 30% to 12%.

METFORMIN:    85 years of study of this plant extract, dozens of studies of up to 20 years show that:

in titrated dose to tolerance  in diabetics,  it  lowers deathrate  and all major chronic degenerative aging diseases by 1/3;

and 4 RCTs on 4 continents for a mean of ~3.5years  show it at least halves the incidence of new diabetes and thus grave risks

– without the metformin extract itself in sensible use producing a single significant adverse effect.

So, (unless as the greatest US economist of the 20th century Ken Galbraith argued, one factors  human greed-  social politics- vested interests- into the sociomedical paradigm),  it is medically incomprehensible that there is still resistance to prescribing metformin until patients develop metabolic complications- polycystic ovary syndrome, infertility, gestational and permanent diabetes.

If one delays metformin till presentation of growth- menstrual- infertility problems, or worse, diabetes, one exposes children and adults inexorably to problems with conception, pregnancy losses, personality development, severe overweight let alone obesity, metabolic syndrome, depression, hypertension, gallstones, stroke, ischemic heart disease, cancer, arthritis, blindness, kidney failure, autoimmune disease, dementia- or simply early sudden death.

Not to mention the astronomical cost and burden of treating all these avoidable complications -not least of which is non-curative surgery for preventable coronary, stroke, diabetic, gastric bypass, diabetic, transplant, gangrene amputation, cancer and biliary disease- and the vast cosmetic- bariatric surgery industry.

But that is just what politicians, Big Business, organized disease and drug industry fear, why metformin and other natural supplements are increasingly suppressed by the Regulators they fund, in USA, UK, EU and here, – to prevent up to 90% reduction in turnover from the prevalent  diseases of the overfed and aging.

Just imagine if  even half  of private and public sector hospital beds and clinics taken up by these diseases could be shut down, the lost surgeries, lost jobs and lost opportunities for fiddling budgets and tenders and bribes.

POSTULATE: BALANCED HORMONE MODULATION OF BOTH ESTROGEN & INSULIN BY TESTOSTERONE & METFORMIN REDUCES ALL-CAUSE & CANCER MORTALITY.

We last reviewed metformin reduction of breast cancer in April;

and  see update August 2009 postulate-appropriate-balanced-hormone-modulation-including-with-metformin-reduces-both-all-cause-and-all-cancer-mortality/ .

In our last review of metformin and prostate cancer 6 months ago,  there was only one definitive study on prostate cancer, showing that  human prostate cancer cells grown in mice are 50% reduced by oral metformin; this was not due to metformin’s inhibition of the AMPK pathway, but associated with metformin causing a  strong reduction of cyclin D1 protein level in tumors.

Now McGill  University confirms   that metformin activated AMPK and has  growth inhibitory actions on prostate and colon cancer cells via reducing adiponectin activation; suggesting that metformin may be of particular value in attenuating the adverse effects of obesity on neoplasia.

University Washington at Seattle
has now published a population case-controlled study :  “epidemiologic studies  suggest a decreased relative risk of cancer with metformin use, and preclinical studies of prostate cancer (PCa) show antitumor activity with metformin. In this study  in 1001 men aged 35-74 years diagnosed with PCa between 2002 and 2005 in King County,  in Caucasian men (but not Blacks), metformin use was more common in controls than in cases (4.7 vs. 2.8%, p = 0.04), resulting in a 44% risk reduction for PCa (adjusted OR = 0.56; 95% CI 0.32-1.00).

But in a Cardiff University UK general practice  study published  next month  in 62,809 diabetics treated  after 2000,  metformin use was associated with lower risk of cancer of the colon or pancreas, but did not affect the risk of breast or prostate cancer.

So the evidence for metformin effect against human prostate cancer seems  likely (p=0.04) at least in vitro and in Washington state whites if not blacks, or in Cardiff men..

But a  small  new study from Tehran Iran confirms that diabetes mellitus (DM) is  associated with decreased risk of prostate cancer (PC) in several reports. In 194 newly diagnosed prostate cancer patients, those with DM were significantly less likely to have PC (OR: 0.44, P = 0.003). Time since DM diagnosis was also inversely correlated with the risk of cancer (P trend < 0.0001). Control patients had significantly higher testosterone, estradiol, and testosterone/SHBG ratio (P < 0.05). As time since DM diagnosis increased by quartiles, testosterone significantly increased (P trend < 0.05). The risk of PC also significantly declined (P trend < 0.0001) following an initial remarkable increase early after DM diagnosis. After including the hormones in the logistic regression model, there was a weak, yet significant inverse association of testosterone/SHBG and DM duration with the risk of PC. CONCLUSIONS: Based on our results DM duration is inversely correlated with the risk of prostate cancer. Our results do not support the hypothesis that sex hormones, including testosterone, play a major role in the protective effect of DM against PC.

We recently reviewed that both appropriate HRT, and metformin, halve the risk of premature death from both breast cancer and all causes.

A small new international trial (APHRODITE) of lowdose transdermal testosterone for low sexual desire in 277 overweight postmenopausal women   around 54 years of age produced 4 cases of breast cancer in the next 2 years ie a rate of 0.72% a year. Testosterone patches increased the  free testosterone levels 4 fold after 6 months, and doubled free estradiol levels without change in SHBG or   estrone levels. Hence the testosterone: estradiol   ratio   was only about doubled by the low dose of testosterone used. There was  no significant increase in virilization on either the 150 or 300 mcg/day testosterone dose.

But transdermal testosterone is the most likely route for aromatization  to estrogen; and no data has yet been published on morbidity or  mortality in the APHRODITE women so treated.    No other studies have shown that testosterone replacement  increases breast cancer- quite the contrary.   Hence from Aphrodite one can postulate that the unmasking of a few dormant breast cancers in the first two years was due to the high-aromatization route ( ie transdermal)  chosen, with lowdose testosterone not increasing the testosterone: estradiol ratio protectively enough to compensate for the cancer-activating  increase in estradiol level. This differs greatly from the standard 20:1 ratio of testosterone:estradiol dose eg 1mg testosterone: 0.05mg estradiol used the past 60 years in standard subcutaneous  Mixogen-like combinations established as the gold standard for postmenopausal women  by Masters and Grody 1953 in the first, 13month RCT, and used for the next 50 years by eg Gelfand ea in Quebec, and our group in Cape Town.

This column has previously reviewed strong data showing that testosterone replacement – mostly by implant or depot injection, usually by combined testosterone and estradiol- in both rodent, monkey  and human females , reduces breast cancer mortality and  incidence.

A 2002 study in Toronto showed that  in early-stage female breast cancer, fasting insulin was associated with distant recurrence and death; the hazard ratios and 95% confidence intervals (CI) for those in the highest versus the lowest ( insulin quartile were 2.0 (95% CI, 1.2 to 3.3) and 3.1 (95% CI, 1.7 to 5.7), respectively. There was some evidence to suggest that the association of insulin with breast cancer outcomes may be nonlinear. Insulin was correlated with body mass index (Spearman r = 0.59, P <.001), which, in turn, was associated with distant recurrence and death (P <.001). In multivariate analyses that included fasting insulin and available tumor- and treatment-related variables, adjusted hazard ratios for the upper versus lower insulin quartile were 2.1 (95% CI, 1.2 to 3.6) and 3.3 (95% CI, 1.5 to 7.0) for distant recurrence and death, respectively. CONCLUSION: Fasting insulin level is associated with outcome in women with early breast cancer. High levels of fasting insulin identify women with poor outcomes in whom more effective treatment strategies should be explored.

Postulate: since

  • increased testosterone production is a physiological defence mechanism against increasing adiposity and insulin ;
  • metformin lowers free testosterone levels modestly;
  • low testosterone is associated with lower prostate and breast cancer incidence, but higher incidence of high-grade prostate/ breast cancer and thus prostate/breast  cancer mortality.;
  • both insulin resistance and type 2 diabetes and low testosterone levels increase all-cause morbidity and all-cause and cancer mortality..
  • The fatter the woman, the more estrone is produced from fat (while testosterone production from the ovary rises)- hence the virilizing polycystic ovary syndrome; which is reversed by metformin;  in those not treated with metformin, the increased estrone effect on breast  is balanced by the increased testosterone as shown by the neutral  effect on breast cancer incidence  in 8year and  31year followup of PCOS cases;
  • The Women’s Health Initiative  showed that in women under 60yrs treated appropriately with oral  sexhormone therapy, all-cause morbidity  and mortality and breast cancer incidence and mortality were all reduced by about a third;

hence it is plausible that while metformin may increase the incidence of prostate cancer in diabetics through lowering testosterone levels,  it remains to be seen whether there is any exception to the rule that appropriate hormone modulation with insulin sensitizers (appropriate balanced human sexhormone -testosterone-estrogen replacement  and metformin reversal of insulin resistance, overweight and diabetes)   lowers the all-cause and cancer mortality in both men and women.

This increases the rationale for early appropriate balanced hormone replacement in both men and women, and preventative metformin in increasing overweight before development of full-blown metabolic syndrome, obesity, diabetes and cancer. The cost of delay  of such appropriate permanent proven physiological  therapy is horrendous- high-risk bariatric surgery for obesity,  or  sudden death heartattack, stroke, blindness or kidney failure;  if not radio-chemotherapy and organ removal  for cancer.

ndb

URGENT UPDATE: AMERICAN/MEXICAN SWINE FLU IN SOUTHERN AFRICA

URGENT WARNING:

The first 2 pneumonia deaths associated with swine flu have now been reported from South Africa. Until details  of their  illness and  pathology tests and  autopsies and treatment   are revealed, as usual we will never know what other underlying risk factors there were.

What can we do to protect ourselves?

New Vitamin D data fits with what we know about fighting infection  – that in both the malnourished ( Dar-es Salaam) and nourished  eg (Canada) AIDS+TB patients, boosting vit D3 , let alone vitamin C,  b-carotene,  zinc,  aloe,  sutherlandia, and  deficient iron, drastically reduced mortality.  eg Grant 2009- Vitamin D also reduces the production of proinflammatory cytokines ie the cytokine storm for which antioxidants – free radical scavengers– are recommended .

Since we queried 3 months ago why only Mexicans were dying then, many deaths linked to the new H1N1 American-Mexican swine flu  have occurred outside Mexico (although at a far lower rate than in central- the poor- Americas), mostly in the frail but undoubtedly also in the healthy wellnourished very young- in whom the problem seems to include cytokinin storm overwhelming the lungs with  hyperimmune response to a new virus.

Us oldies have both less immune response, and also tolerance from previous exposure. Perhaps (just as us oldies may have inherited some resistance- tolerance from our parents/ grandparents who survived the 1918 & mid-19th Century Russian H1N1 epidemics), our adult children have also inherited tolerance thrrough  us.
Whereas  those who are malnourished AND have AIDs/TB  may have too weak immune systems to respond fatally to this ‘new’ virus.
Dr Barry Shoub head of the National Institute of Communicable Diseases NICD at his UCT  lecture July 2009  agrees – its a relief to hear confirmed that while this virus has spread like wildfire here, there is no increased mortality being reported from the townships where AIDs and  multiple resistant  MRTB are the most rampant and fatal in the world. .   On the other hand, unfortunately cortisone treatment has also not been reported to help those with the apparent hyperimmune response to this new flu.

We mustn’t depend on, wait for rescue with  Tamiflu, Relenza ( resistance spreads rapidly, and adverse effects are serious),  or on a hasty  untested American Swine Flu vaccine – especially if it is laced with squalene let alone mercury or aluminium?.

We urgently need to boost both the frail, and the very young, with what we have: oral antioxidants: vitamin D between 5000-10000 iu/day or 50 000 iu/week; b-carotene about 10 000 iu/day;  zinc 30-60mg/day;    vitamin C+bioflavinoid 50/50(Enhanced Vitamin C) 1/2gm  to 5gm (a heaped teaspoon)  twice a day- increasing gradually over a week to tolerance ie  the dose that doesnt cause diarrhoea; vits E, lipoic acid;  and extra calcium carb 1/2gm twice a day also to minimize vit C diarrhoea;  Probiotics; Aloe; fish oil (eg cod liver oil) a tsp or 4gm a day); sutherlandia; and colloidal silver ACS nasal spray and orally; with a good nonspecific multinutrient. . .

And since this flu virus seems to kill the lungs if it does serious  harm, we need to boost lung defense specifically  with For-Lungspan- N-acetyl cysteine (an antioxidant) and guaifenesin each  a few hundred mg/day.

These all- natural nutritional supplements are  available over the counter – and the more malnourished the person, the less will already make a big difference to nutrition and resistance.

And obviously in the malnourished, or  frail, it is crucial to check hemoglobin and iron levels and reverse iron deficiency if present- deficiency can be assumed  in poor girls/women who are still menstruating, in those with chronic heartburn  let alone previous bowel bleeding or absorption problems, the pregnant, and in poor township kids who are likely riddled with parasites – if their hemoglobin is below ~12g, add iron for sure. .

And obviously general nutrition is crucial: with mass unemployment, and rampant endemic price fixing abuse of basic foodstuffs which business and politicians choose to ignore if not conspire in,  the poor may not be able to afford nourishing balanced diet. But many  do spend money on buying essential supplements – for which they need guidance as above..

And for solace the poor spend more on smoking and alcoholism –  the greatest killers of both users and those they encounter: it is incomprehensible that businesses  employ staff who destroy themselves and others by smoking or  alcohol  abuse, since these are choices. This despite the fact that in most countries suicide – especially assisted suicide- is illegal.

So is the use of sugar, which is one of the deadliest addictions (for promoting  decay, infection, glycation) – especially when it is so easily substituted by a safe alternative sweetener  like stevia or  saccharine-cyclamate, and when the food chain is now stuffed with high-calorie cornstarch.

All commercial sweetened  “cooldrinks” should be banned if they contain the adverse additive  problems of  caffeine  sugar   aspartamate  benzene and/or phosphoric acid.  Like its fermentation product  alcohol C2H5OH,  sugar C6H12O6  is a deadly intoxicant and corrosive oxidant, and should like alcohol be red-labeled  in cooldrinks for sale  solely to consenting adults, since these destabilize the brain (le alone immunity) just like alcohol does, by sending the blood sugar and then insulin soaring and plummeting wildly.  Compare the chemical effects of  about 12-24gm alcohol – 72-150kcalories (an average sugary  a”glass” or two  of beer  or  wine, a generous “tot” of spirits)  with  that of one or two Red Bulls or even Cokes or Fantas.

And undiluted or adulterated commercial “fruit juice” is bad by the glass since it is high in sugar (fructose), it should be used if at all in small volumes diluted in water- and one has to drink perhaps 6 litres a day (or 6kg of fruit)  to obtain 3 gm vitamin C .

If tap water (the best) is not enough, there are  rooibos or  other  teas, chicory, modest coffee, skim milk, and soda water to satisfy all desires- and  for those with a sweet tooth, a relatively safe concentrate to dilute well like Eleven to One in a wide range of fruit flavours. Fresh fruit in moderation, and coloured veggies are always the best, for their roughage, polyphenols, vitamins, antioxidants etc- but they do not provide enough of these for our polluted stressed depressing  and contagious world, especially for the longerlived. .

And with rampant overweight-obesity-(pre)diabetes, fatfree cooking must be enforced, to minimize intake of both carcinogens and worse, glycates , AGES— sugar fused with fat or protein.

PER ASTRA AD ARDUA: ASTROLOGY, STATINS AND SCAMS: AN ASTEROID AND AN AURORA FOR JUPITER.

ASTEROID-   a new study from Harvard and the Cleveland Clinics – boasts the safety and efficacy of achieving very-low low-density lipoprotein cholesterol LDLC with highdose  rosuvastatin Crestor.

But it notes carefully: “on-treatment atheroma volume, change in atheroma volume, and the high % of patients with atheroma regression did not differ by the achieved LDLC level. ”

Since the trial lasted only 2 years in only 471 average obese (BMI ~28.5kg) patients aged around 58yrs, it was far too small and short to determine whether there was any non-cardiovascular benefit or risk from the drug in this high-risk metabolic syndrome population, 95% of whom were hypertensive, 13% diabetic, and who have a high risk of future cancer, dementia, arthritis.

So the only purpose it served is to show that there is no shortterm benefit in highdose versus lowdose statin, in more than moderate lowering of LDLC and raising of HDLC.

In the  AURORA* trial in dialysis patients, “although the mean LDL cholesterol was reduced by 43% in the rosuvastatin arm of the study at three months, no difference in the primary end point (death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke) was demonstrated at an average follow-up of 3.8 years. [1]

The stark reality- which ( fungus extract) statin, and more modern  antidiabetic drug   proponents hate- is that metformin (a plant derivative)  is the only panacea, patented drug ever that reduces not just heart attack by half in type 2 diabetes but also reduces all-cause mortality by at least one-third; and when used preventitively and to optimal titrated tolerance  in the overweight, reduces the incidence of new diabetes by up to 90%. That just about puts it ahead of vitamin D and fish oil and appropriate HRT  as miracle agents.

And statin proponents  studiously remain silent that while titrated metformin has zero persisting adverse effects in controlled trials of up to 20years, statins produce insidious adverse effects (depression; myo-hepatorenal, memory loss,  non-natural deaths, lowering of sex hormones and erectile function) in up to a quarter of longterm users – with  significant increase in cancer (especially of the breast) when the LDLC is  severely depressed; and fail to influence insulin resistance and diabetes long term.

So, like most statin trials ,  JUPITER and ASTEROID reports  are twisted to promote statins, whereas they do nothing to recommend statins,   show that they are anywhere near as good and safe for longterm mortality reduction as   natural non-patent agents-  metformin, appropriate HRT and eg fish oil and vitamin-mineral-biological-plant supplements – which lack the insidious adverse effects of the statins. .  After some 40 years of use, the only indication for statins remain (if any) those rare patients with severe resistant hypercholesterolemia above perhaps 8 or 10 mmol/L.

And rosuvastatin is apparently the strongest as well as the youngest (preteen) of the current statins; so it should be used in low dose if at all. Have we learnt nothing from stilboestrol, thalidomide, practolol, cerivastatin,  troglitazone, Vioxx?

It is obvious why statin promoters- the manufacturers and their hirelings- continue to spend $millions promoting the $billion statin trade. But it is doctors and especially Authorities- academics and regulators-  who must explain why they are jeapordizing patients’ lives, why  a high percentage of older patients- especially the overweight- are on  the hugely advertized statins when they should be on the safe and highly beneficial metformin, fish oil and the other proven  multibeneficial supplements eg vits-minerals, biologicals including appropriate HRT, and plant extracts.

PER ASTRA AD ARDUA ET LUCRUM:

The promoters of rosuvastatin – Crestor-  make studious use of astrology- ASTEROID, JUPITER, AURORA–  astronomical eponyms – to deviously promote the mystique of statins through their trial titles. But at least astute astrological physicians like Shakespeare’s contemporary  Dr Simon Forman had some justification- there was seldom better treatment at the time, often far worse, and it was harmless (with romantic overtones)  apart from perhaps distracting from more onerous changes in lifestyle and diet; and  had  grains of truth in the as-yet not scientifically recognized planetary and solar-lunar changes in weather etc which influence health..

And rosuvastatin studies only appear on Medline from 2001- barely a decade ago -so there cannot be any longterm experience let alone trial (as there is for metformin)  on this wannabe chronic prevention drug for at least another decade. And  the history of rosuvastatin, it’s discoverer and place of origin, is mysteriously not apparent  on the AstraZeneca or any other website. This at 20 times the cost of simvastatin in UK .

Clearly  Big Pharma and their lobbyists – with the glad connivance of Regulators and Medical Schemes-  – still depend on age-old psychology to bluff doctors let alone patients.

*Aurora has two meanings, both of which are apposite for their use in statin ie Astra-Zeneca marketing :

  • while Astra refers to the wandering stars!

Clearly the manufacturers of Crestor (Astra-Zeneca)  wish  these glowing images and more as their $reward for boosting their protege drug. And Zeneca is also under fire that “Women concerned about breast cancer are being bombarded with a massive advertising campaign for the drug tamoxifen” – which like all other modern drugs has no evidence base for longterm preventitive use.

BREAST CANCER OVERDIAGNOSIS BY COMMERCIALIZED SCREENING MAMMOGRAPHY: IS THE DOWNSIDE WORTH IT?

It is a no-brainer that mammography is invaluable diagnostically for

– a new breast lump, pain/discomfort  or bleeding.

– for followup of any pathology already present or likely eg the woman with obvious genetic risk of breast cancer;

– And for monitoring at baseline  and periodically on permanent appropriate physiological  HRT.

Rare women do present with distant spread of breast cancer before such cancer presents in the breast. But the hot chestnut* is:  how many well women  with clinically normal breasts at average risk of breast cancer  benefit or suffer by having screening – their apparently healthy ‘chestnuts’   squashed and irradiated regularly for decades looking for  preclinical cancer?

when the downsides also include time, pain, cost,  possible  increased risk from  cancer by both irradiation, pressure and needling, six unnecessary biopsies for each cancer found, and no clear evidence  that the resultant anxiety and  cancer therapy extends wellness and life?

A *chestnut includes an “old or stale joke (British)”, or ” music of sentimental value”!. The joke may indeed be on average-risk older women who are conned into having repeated- and risky-  screening mammography on their often most cherished ornaments.

The Breast Cancermongers – the screening mammography SMG  activists- now proclaim that 1 in 8 women ie 12.5%  will get breast cancer in her lifetime; but between 40 and 59yrs that number reduces to 1:15 ie about 7%. Without screening mammography of “normal” breasts, does breast cancer  actually present as a disease  in even   5% of sensible average-risk  women in the average at-risk middle decades?  and will prompt removal of such early  cancer before it presents itself to her/ the doctor with lump/pain/bleeding avoid  shortened lifespan  in any asymptomatic woman screened? Especially if appropriate balanced postmenopausal systemic human HRT is  continued lifelong to  reduce by 1/3 the  the far more common other major causes of  disease and deaths as well as deaths from breast cancer?

Note the disturbing figures  from Wiki:  “Of every U.S. woman screened, about 7% will be called back for a diagnostic session (although some studies estimate the number closer to 10%-15%). About 1% of those screened  will be referred for a biopsy; the remaining 6% are found to be of benign cause. Of the 1% referred for biopsy, about 0.35% will have a cancer and 0.65%will not. Of the  0.35% who do have cancer, about 0.2% have a low stage ie noninvasive cancer that will be essentially cured after treatment.” But who is to say that these 0.2% would ever have presented with cancer in their lifetime- ie are these the 2 out of 3 per 1000 overdiagnosed by SMG?

The incidence of BRCA in USA women in the 50-65yr agegroup is claimed to have risen  almost 50%  from 0.23 to 0.33% between 1975 and 2000, and has since fallen back about 25%. That almost 50% increase can only have been from the introduction of almost compulsory SMG. Despite advances in treatment, breast cancer mortality took almost 15years to start falling ie after plateau at about 0.07% for decades  till 1988, it has fallen steadily to 0.045% in 2006. A report in about 2002 says that ‘ Breast cancer incidence increased more or less steadily between 1940 and 1987 and has since stabilized at 0.1%.’

So we have a major credibility gap in reports from the USA: some authority says an overall incidence between 50 and 69yrs of 1%, another  say 0.25%.

More important, in 1999 Mettlin noted that “ some of the decline  in BRCA incidence and mortality is attributable to the lower mortality rates for women born between 1924 and 1938, who have reached the age where their breast cancer mortality experience most affects the overall rate; the  hypothesis being  that  increased fertility rates  following World War II reduced their risk of developing breast cancer and, therefore, of dying of breast cancer.”

The reality, not disease-mongering to promote SMG, was  simply put in 1995: “Between 1940 and 1982, breast cancer incidence rates in the United States increased by approximately 1% per year, largely in women over 40 years old. From 1982 through 1987, the rate of increase accelerated to around 4% per year and then leveled off – the rising rate  mainly attributable to early detection, due to the increase in breast cancer screening. The increase in breast cancer cases (with no change in incidence rates) among women 20 to 39 years old during 1970 to 1990 was due to a shift in the age distribution of the population. However, breast cancer mortality rates have remained fairly stable, with almost no change from 1950 to 1990 [42], increasing only about 0.2% per year [3]”

The issue remains a hot chestnut: like screening  colonic imaging and prostatic screening,  is this massive  universal individual screening of the apparent low-risk good, indifferent or bad for women, their men, families  and whoever has to pay the financial cost?

What the Wiki review does not say is that there are almost 20 000 articles already listed on Medline the past 50 years; and some 400 articles on screening mammography in asymptomatic women since 1966. Yet 60 year after mammography was invented,  the cost-benefit for women of the $billion SMG  industry is being increasingly questioned:

(paraphrased) Editorial “Overdiagnosis and mammography screening” 9 July 2009,    BMJ 2009;339:b1

The UK NHS recently scrapped its leaflet inviting well women to undergo mammography since it failed to mention the major harm of screening—overdiagnosis. The question is no longer whether, but how often, this occurs.

In a  new BMJ special on breast cancer,  Jorgensen  ea, Gotzche ea and Zahl ea,   again discuss evidence that screening has led to overdiagnosis of breast cancer not only in the UK, but also in Canada, Australia, Sweden, and Norway.

Overdiagnosis refers to detection of abnormalities that will never cause symptoms or death during a patient’s lifetime- when the cancer grows so slowly that the patient dies of other causes before it produces symptoms or when the cancer remains dormant (or shrinks).   

Because doctors don’t know which patients are overdiagnosed, we tend to treat them all.

Overdiagnosis therefore results in unnecessary treatment – perhaps in one in two (or even 2 in 3) women.

With   widespread efforts to diagnose cancer earlier, over-diagnosis has become an increasingly vexing problem.

H Gilbert Welch, professor of medicine, USA.