conflicts of interest

  1. New rules double use of cholesterol meds

    They say there are two things you never want to see being made: laws, and sausages.

    Let's add a third one to that list: medical guidelines. Especially for widely used drugs like cholesterol meds.

    The rules, regulations and procedures your doctor is expected to follow -- the guidelines he's supposed to use when making critical decisions about your health -- are the product of a badly flawed system heavily stacked in favor of the drug industry.

    And if you want more proof of that, take a closer look at the new statin guidelines.

    These are the new rules that are supposed to double the use of cholesterol meds, putting millions of people with normal cholesterol levels onto the drugs.

    But these new rules weren't created by unbiased and impartial scientists. No, these industry-friendly guidelines were created by... well... friends of the industry.

    And the conflicts start at the top.

    The chair of the 15-member panel had financial ties to six different makers of cholesterol meds. He says he cut those ties when he was named chair, as if Big Pharma conflicts are a switch you can flick on and off at will.

    It doesn't work like that -- and he's not the only one with major conflicts.

    Two of the panel's key co-chairs also had financial conflicts. And if that's not enough, the entire panel was stacked in favor of the drug industry, with 8 of the 15 members reporting financial ties to Big Pharma, according to BMJ.

    Yes -- the exact number needed to form a majority. Coincidence? I'll let you decide, but I think the proof is in the pudding: The guidelines are expected to double the number of statin users to 72 million Americans, or 60 percent of the entire population over 45.

    If these massive conflicts were the only problem with the new guidelines, it would be enough to ignore them completely. Unfortunately, it's not the only problem.

    The new guidelines are based on calculating a patient's 10-year risk of a heart attack. If that risk hits 7.5 percent or higher, doctors are supposed to put the patient on statins.

    They've even been given a tool to figure it all out, an online "risk calculator."

    That makes it sound like a scientific instrument, right? The word "calculator" suggests nothing but cold, hard, objective numbers. But in this case, the numbers don't add up -- because Harvard University researchers have found that the calculator wildly overestimates heart risk.

    On average, the calculator will overshoot your heart risk by between 75 percent and 150 percent. That means millions of people who shouldn't get the cholesterol meds even based on the expansive new guidelines could be put on them anyway.

    There's already talk of adjusting the calculator, but don't waste your time waiting for those tweaks. There are better, safer and more reliable ways to protect your heart whether your risk is low, high or somewhere in between -- and you don't have to go near a statin to get this protection.

    Start with the heart-friendly nutrients I recommend to my own patients: L-Carnitine, omega-3 fatty acids and magnesium. Then work with your own naturopathic doctor to tailor an approach that's right for you.

  2. Why you should never trust 'doctor's orders'

    Sometimes, it might seem like your doctor is relying on years of education and experience.

    Other times, you might be convinced he's making it up as he goes.

    In reality, most doctors follow the guidelines issued by the major medical associations -- and that means some of the biggest decisions he makes about you and your health are based on badly biased information.

    Treatment guidelines are routinely written by "experts" with a direct financial stake in the outcome -- and now, a new study finds a massive chain of conflicts in the guidelines written for diabetes treatments and cholesterol control.

    Since these just so happen to be two of the most medicated (not to mention over-medicated) conditions in the country, is anyone really surprised?

    There have been 288 "experts" on the 14 cholesterol and diabetes panels that have met in the United States and Canada over the past decade, and researchers say 52 percent of them had conflicts of interest such as financial ties to the drug industry.

    Even worse, they found those conflicts among 11 percent of the panelists who claimed they were free and clear.

    Whoops. Busted!

    And of course, you can't really stack a deck without putting some of your best cards on top -- so half of all chairs of the guideline-writing committees had conflicts.

    The panels were convened by organizations including private ones like the American Diabetes Association and American Heart Association as well as government groups such as the U.S. Preventive Services Task Force.

    But when you break it down, only 16 percent of the members of government-sponsored panels had conflicts, versus 69 percent of those convened by nongovernmental groups.

    What's more, five of the groups in the study didn't even require conflict disclosures -- and the U.S. Preventive Services Task Force won't reveal its own without a Freedom of Information Act request.

    That's one of those things that make it look like you're hiding something... even if you're not.

    This isn't limited to cholesterol and diabetes panels -- not by a longshot.

    Earlier this year, researchers examined 17 critical guidelines from the American Heart Association and American College of Cardiology that were issued between 2003 and 2008, and found that 56 percent of the 498 people who helped write them had conflicts of interest... including 81 percent of those who led the groups.

    Put it all together, and it's pretty clear why you can't leave your doctor's office without yet another prescription: The deck was stacked against you long before you even walked through the door.

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