Dr. Dhand delivers a sharp critique of "algorithmic medicine" that prioritizes rigid protocols over the nuanced clinical judgment required for elderly patients. It is a necessary call for physicians to treat the individual rather than mindlessly following a standardized checklist.
Deep Dive
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Deep Dive
This STATIN Prescription Makes Me MADAdded:
I'm going to tell you in this video a classic case of inappropriate statin prescribing that could even potentially be harmful that I saw not so long ago.
And it hits so many points including the era we live in where doctors feel the need to mindlessly follow protocol and not even think about what they are doing. So let me tell you the story.
There was a gentleman approximately 90 years old. He was of Asian descent. He had lived in the United States for a few years, but he came into hospital with a suspected stroke. The symptoms were relatively mild and he actually improved quite quickly. But imaging of the head, an MRI scan, did show a small stroke. So as always happens during this type of admission, typically a patient will come in, they'll be under a medical team.
They will see a neurologist and in this particular circumstance, a cardiologist was involved as well.
And each of these doctors said that because there was a small stroke, protocol dictated, and this would happen anywhere in the United States and I believe it's also the case in the United Kingdom, that a high-dose statin medication should be prescribed. So in this situation, it was atorvastatin, I believe Lipitor, that was prescribed at 80 mg, 80 mg, high dose because there was a stroke. But here is the kicker.
This gentleman, not only had he mostly recovered and actually thankfully for him, he had a daughter who's very involved and she was more into traditional Chinese medicine. He wasn't on any medicines before he came in. 90 years old. So he was back to his baseline and a lipid panel was obtained, cholesterol blood test.
Listen to this.
His LDL, quote unquote, bad cholesterol was 55.
In UK numbers, that is 1.4.
That is extremely low. That is really good. In fact, if doctors are focused on numbers, even with statin therapy, people rarely get to that cholesterol number. But because it was protocol to prescribe a statin medication, that was what was being given to him.
And thankfully, I later learned that the daughter, who was very skeptical, was going to take him off it anyway. But the doctors, these are doctors, people with an MD degree, and I'm not singling out any doctor. This would happen anywhere in the United States or United Kingdom.
They were intent on prescribing him a statin at the age of 90, somebody who was doing really well, who was back at his baseline, because he had So, let's think about three things here, which get to the ridiculousness of the situation. Number three, if you actually look at studies of statins or indeed lots of medications, they're not usually even studied at the extremes of age.
So, the medical profession will be all in on prescribing this medication as if it's gospel in someone who wasn't even studied in the first place in any of the studies. But they do this because it's protocol. A healthy 90-year-old ends up on a statin because he had a small stroke. Was that group even studied? No, they weren't. So, how is that following the science? Number two, with his cholesterol level already being so low, why would you even want to prescribe a statin to him? What are you trying to achieve? In fact, there's evidence that if you're aggressive with statins, you can actually precipitate potentially some cognitive issues because the brain is 60% fat. And this gentleman at the age of 90 was going to be put on this really high dose of statin. What if he had muscle aches or weakness, some of the other symptoms which are so commonly attributed to statins? It really is a crazy situation, but that's what medicine, the world of medicine, people with medical degrees were recommending because he had a stroke. Total lack of thinking. What are you doing? You don't have to tick boxes mindlessly.
And number one, why are we in this situation? When did doctors go from being people of common sense? I mean, those good old days of the community doctor, the family physician who would come to your house. Many of us grew up in that era. Those were not days which were as protocol driven. The doctor would be full of common sense. In fact, in those days, it was very difficult to get a prescription from the doctor. They would come in, they would spend time with you, they would know you and your family, and they would scribble on a chart. There was none of this computer stuff, spending hours documenting. It was all much more common sense back in those days. Now, I'm not saying protocols are never needed, but we've swung so far in a direction where there's just no thinking involved. I mean, it blows my mind. And thankfully, the daughter who was skeptical ended up removing him from this medication. But what are we doing here? How are we so invested in certain things? Because even statins, if you actually look at the data, the number needed to treat is huge. You have to often treat hundreds of people, even best-case scenario, there's a one in 20 or one in 30 chance that the medication might work for you.
The odds are terrible. But the way that the medical profession acts, I mean, you have a cardiologist and a neurologist come and say, "Oh, we must get the LDL under this number. We must have a high-dose statin." All they're doing is following what they've been told. They haven't even thought things through. Do they even know what the statistics are on statins? It makes me really sad, and thankfully in this situation, he wasn't condemned to a medication that he probably didn't need because the daughter was more involved and skeptical.
But, how many millions or even thousands of people out there in his demographic are being prescribed medications inappropriately just because doctors are ticking a box. I leave you with that thought. It works me up a little bit. A 90-year-old who is doing everything right was unfortunate enough to have this small stroke which he recovered from in the United States, and then gets put on all these medications that he doesn't need. Really sad situation.
The older members of society who have lived their whole life, who have worked so hard, who have raised a family, deserve better than doctors who just won't think outside the box and apply critical thinking and reasoning skills to what they're doing. And I'm not saying doctors are bad people. That's not the objective of this video. I think the medical profession is so utterly lost and quite hopeless in many ways, and we need a revolution of common sense in medicine. Thank you, everybody, for watching. Do check in the links down below for my website and all the other work I do, including my natural insulin resistance reversal and holistic fat loss program, also our natural health and well-being store. All those links down below. Keep going on your health journey, everyone. And if you enjoyed this video, I have a strange feeling you will also enjoy this video. Take care.
We'll speak again very soon.
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