Doctors Arguing

When doctors disagree in public, it drive patients crazy. Most people assume that their health professionals know what the best treatment is for any given ailment. But on some matters there is surprising conflict.

Doctors Fight Over Statins:

Many cardiologists believe that the best way to prevent or treat heart disease is with a statin prescription. Others, however, question whether statins make much difference for people who don’t have heart disease.

Some cardiologists point out that a Mediterranean diet is more effective than statins in preventing death from cardiovascular disease (World Journal of Cardiology, July 26, 2015).

Statins and Longevity?

Researchers have estimated that taking a statin conscientiously for several years results in a “surprisingly small average gain in overall survival” (BMJ Open, Sept. 24, 2015).  They estimate that death is postponed by a median of three to four days.

Cardiologists vs Cardiologists Equals Confusion:

Many cardiologists find such analyses heretical. They fear that studies like this might encourage people to stop taking statin medication.

Dr. Steve Nissen, Chair of Cardiovascular Medicine at the Cleveland Clinic, worries that “discontinuing statin treatment may be a life-threatening mistake” (Annals of Internal Medicine, July 25, 2017).  He argues that dietary approaches are not an acceptable alternative to statin treatment.

In contrast, other prominent cardiologists argue that:

“It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat. Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 min a day and eating real food” (British Journal of Sports Medicine, Aug. 2017).

Doctors Fight about HRT:

Statins and diet are not the only contentious topics in healthcare. Others have included hormone replacement therapy for menopausal women.

Years ago, many physicians believed such drugs could prevent cardiovascular disease with few, if any, side effects. Now most doctors accept that HRT is linked to an increased risk of breast cancer and blood clots. Heart attacks and strokes may also be elevated.

Doctors Fight about Blood Glucose:

Aggressive treatment of blood sugar was long considered beneficial for people with type 2 diabetes. A large trial called ACCORD was designed to test that belief. The results shocked the medical community.

Patients who received the most intensive blood glucose treatment died earlier and fared worse than those getting more moderate treatment (New England Journal of Medicine, June 12, 2008).  It turns out that low blood sugar may be almost as bad as high blood sugar. Aggressive treatment can sometimes lead to dangerous dips in blood glucose levels.

When Paradigms Shift, Confusion Reigns:

Not surprisingly, patients find themselves caught in a terrible double bind when physicians don’t agree on optimal treatment programs. This is especially true when there is a paradigm shift in thinking.

Some health professionals may find it difficult to abandon traditional or outdated therapies. That is why it is so important for doctors to tell patients plainly when there is no consensus on the best approach. Shared decision-making takes patient perspectives into account, especially when doctors don’t agree.

Patient Stories:

Gary in Oregon responds to Dr. Nissen:

“Sorry, Dr. Nissen, but Internet fear mongering had nothing to do with my stopping simvastatin. I did do some Internet research and the common thread on several medical sites was that statins can cause severe muscle pain.

“The pain in my legs and other muscles was so bad I had to stop taking it. I had a difficult time even falling asleep. Within a year after starting simvastatin, I was diagnosed with Type 2 diabetes. There is no history of diabetes in my family. Perhaps this is a coincidence, but I don’t think so.

“With more and more evidence through legitimate studies showing little benefit for many people, I question its value except to the drug companies. I am now taking red yeast rice and have slightly modified my diet. My cholesterol is not where they say it should be but it is much lower and just above the upper normal limit.

“The ‘test’ to see if you need a statin or not sounds way too swayed to age. One size doesn’t fit all. But like many things my experience is just that – my experience.”

Lorraine in Atlanta had success with diet:

“I am 64 and used the Cardiovascular Risk calculator and got a risk of 2.8% so age doesn’t automatically cause the calculator to say you need a statin.

“My blood pressure is 110/68. What really helped me was my cholesterol at 162 and my HDL at 79. My cholesterol used to be 220.

“How did I achieve 162? A whole foods plant-based diet. I am a vegan. My husband had high cholesterol and LDL and was on a statin for several years. He also became a vegan and has cholesterol levels like mine. He was able to go off the statin. Don’t want to be on statins? Change your diet to plant-based.”

Joseph in Houston, Texas, also changed his diet:

“I tried several statins; they ALL caused muscle aches, muscle weakness and irreversible (to date) muscle damage to my quadriceps.

“I’ve had medical professionals (note plural) tell me privately that although statins can reduce cholesterol, overall their recommended use is a dirty little secret within the medical community, and that anyone who exhibits negative side effects should run from statins.

“I cleaned up my diet and I exercised with dedication. My cholesterol numbers are just over the borderline range. That does NOT mean I’m going to have a heart attack.

“By going strictly vegan, my cardiologist told me that I passed my nuclear stress test with ‘normal’ results and that he discharged me from care…with the recommendation that I follow my exercise routine and a move from strictly vegan to more Mediterranean Diet. He did NOT see any further need for statins. Not that I’d have taken them anymore anyway. To each his/her own, but there is NO way I’m going to sacrifice my quality of life to Big Pharma.”

What Do You Do When Doctors Fight?

Have you ever been in a situation where you have received conflicting information from different doctors? How did you deal with the confusion? We would love to hear your story. Please share your experience in the comment section below.

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  1. Virginia
    Reply

    All this disagreement between doctors can be traced to the standard protocol/ care plans that are the norm today. They certainly have their place but doctors quit thinking outside the box AND remembering that each patient is an individual. Our litigious society & insurance providers are responsible for this situation- doctors can just fall back on “I followed the protocol” when things go wrong. Patients have to use their heads & decide what works for them- medications can kill you or make you wish they did. If it hurts don’t do it!

  2. Diane
    Washington State
    Reply

    My doctor wants me to take statins. My legs are so painful. They feel like they will break. I have not been able to take pills for a long time, except my sythroid. Someone on your web site said to take Turmeric for leg pain from Statins. I am taking a commercial brand of turmeric pills. For two days I took 1 pill each day. The 3rd day the pill was too much for me. I cut the capsule in half. The leg pain is going away from the Turmeric but my legs feel like they will crack. I will try the Fenofibrate.

  3. c
    Reply

    I will NEVER trust a medical organization that continues to push products on a trusting public.

    Just a short while ago the AHA stated that coconut oil was bad and to use more corn and soy oils. HUH!!
    Well NPR told the rest of the story. Turns out corn and soy growers are not doing too well……seems like people are getting wise to GMO products and excessive amounts of herbicides used and then consumed by the public.

  4. Mary Jane
    NYC
    Reply

    If doctors fight in public, my inclination is to say, “take it out behind the barn.” Each doctor should give best advice to patients, and we patients need to take responsibility for our choices, and make decisions about how we’d like to live our lives.

  5. Garry TM
    Reply

    After two days on simvastatin I experienced violent spasms in my leg muscles and considerable pain. The spasms stopped after a couple of months but the pain lasted the better part of a year. All that after just two days.

    Successfully got good “numbers” with the use of Bergamont, the Italian fruit concentrate.

  6. Cassandra
    Reply

    It was discouraging to see the staged photo of two doctors fighting. While it’s good to see female doctors represented, having two women aggressively facing off with teeth bared and finger in the face just screams, “cat fight.” At least one appeared to be a surgeon. Otherwise, a good introduction to competing and entrenched views of medical treatments.

    • Rebecca
      Reply

      Why do you picture both fighting doctors as female? One would have been fine, but it almost appears that you are depicting a proverbial ‘cat fight’.

  7. Carol M.
    GA
    Reply

    While on Statins for many years for high cholesterol levels, I had no significant improvement using them and I was having TERRIBLE leg cramps. After reading that statins can cause muscle aches and leg cramps, I dropped them like a hot potato – LEG CRAMPS have just about gone away completely now.

    My GP put me on Fenofibrate for cholesterol and for the first time in my life my HDL and LDL levels are in normal levels. While it’s only my opinion, I would never recommend to anyone to use statins and personally speaking I will never take them again.

  8. Beth
    NC
    Reply

    After a long search for the cause of a fever of unknown origin, and after exhaustive testing turned up nothing, a rheumatologist diagnosed mild lupus. But my primary care doctor was not convinced and recommended that I hold off starting the medication the rheumatologist recommended since it can have serious side effects including irreversible blindness. He recommended I wait until the lupus, if that was what I had, created problems that warranted a trial of the drug. I had no idea what to do, but since he fever went away and I am biased against drugs, I went with my PCP. I am trying to follow an anti-Inflammatory diet instead of using meds. So far so good.
    P.S. The rheumatologist charges $1,500 for a 5 minute visit. Good grief!

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