I was watching something on YouTube yesterday - I can’t remember on what topic - when this video popped into my feed:
Now that is a rather click-baity looking video, of the type I’d normally ignore.
But, having had an interest in (and serious reservations about) both statins and GLP-1 agonists (eg Ozempic) the headline, caught my eye. So I watched.
I note that the creator has a substack account and has written this up. Part of this is subscriber-only, but his description of the paper and how it’s being ignored is definitely worth reading:
The study cited in the video and article - published in Cell Metabolism in Feb 2024 - is downloadable from here, and below is a PDF:
In that study, researchers in China compared 2 groups:
a group of 30 people starting atorvastatin1 at a dose of 20 mg / day
a group of 10 people who didn’t, as controls
They then performed several measurements in serum and faeces collected from all subjects over 16 weeks and compared the 2 groups.
The key finding - as Dr Norwitz says - was that:
The statin quite dramatically reduced (approximately halved) GLP-1 levels, and these were still falling at the time of the last measurement.
This was associated with an increase in HbA1C - a marker of impaired glucose metabolism.
The article discusses several other important associated findings, hypothesising that the concurrent administration of a bile acid called ursodeoxycholic acid (“UDCA”) might ameliorate the effects on glucose metoabolism while preserving the effects on lipids. I am not discussing those here, largely because I don’t anyway subscribe to the foundational hypotheses upon which the mass administration of statins rely.
In recent years, there has been a huge focus on research into GLP-1 and the associated metabolic pathways. The pharma industry has been making hay with its GLP-1 agonist products, which are now being injected daily by millions of people worldwide. The market is worth tens of $billions annually.
So, you would have thought that if evidence emerged that another blockbuster product class was adversely interfering with this pathway, it would be huge news.
But it’s not.
This was actually the only study I could find directly on this topic. Nobody else appears to be pursuing this line of enquiry, and this paper itself has received very little attention in the 19 months since publication:
It is worth pointing out that this lack of engagement comes despite Cell Metabolism having an impact factor (30.9) placing it in the top few percent in the league table of influence.
The message of every single one of the 5 news articles citing the study was about how exciting it was that a supplement might be able to blunt the adverse side effects on glucose metabolism.
The paper has also been cited just 30 times in other journal articles (see here for the list), but, as with the news pieces, none of the articles citing this study ask the important question:
“What could this mean for the safety of these drugs when used long-term?”
In the UK the usual starting dose used to be 10 mg, but NICE now recommends 20 mg. It can be titrated up to 80 mg. So this is a low-ish dose. Significant numbers of people - perhaps the majority - are on higher doses.
It is like a bad medical TV drama. The patient is treated for something that doesn't need treating ,then needs treatment to counter the unwanted effects. The treatment required to remedy side effects causes more problems. Meanwhile those of us who refuse to participate keep getting messages to join in. This whole pantomime has made me question the validity of "Gold Standard" treatment for everyone, cardiology one of the worst offenders. It sounded good when first expounded by a GP I worked with but observing and reading wider no longer my view.
File this under the same heading as all those times when a pharma ad says, "do not stop taking [place other pharma drug here] when you start [our drug]" or words to that effect. The one thing pharma ads NEVER do is suggest that one pharma offering negates the need for another. It must be in the bylaws or something. Heaven forbids! Hell, I'm actually surprised it got cited 30 times. Willing to bet Pfizer has an entire department dedicated to making sure no paper suggests that their crap interacts badly with another pharma company's crap. Sales, dammit!