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Form what I recall red yeast extract was the "natural" product from which statin research evolved. To this day when I have patients who hate the evil chemicals of pharmaceuticals and refuse statins I will suggest that they instead use red yeast extract.
So if you say :
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DS MUST not be supplemented to treat coronary artery disease, this would mandate the FDA to enforce the FDCA.
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I am questioning then why red yeast extract continues to be utilized as a substitute for statins for the treatment and prevention of CAD ?
If that is the case then why have they not prevented red yeast extract from being sold ?
AMRN totally screwed up the roll out of vascepa. Insurance coverage was very sparce - physician behavior is such that they might try a new med - but once they get four or five rejections they cease using it - that is exactly what happened with vascepa - repeated rejections because of lack of prep with insurers resulted in lack of utilization - not only that once a doc writes it off as being a hassle - much more work to get them back on board
Current AHA recommendations
good review
http://circ.ahajournals.org/content/135/15/e867
YEa NEJM is fake news after all
Food for thought ....
A map of world Omega three intake
https://omegaquant.com/global-view-omega-3-index-levels/
Note that it is highest in the arctic – so what is the level of heart diesase in eskimos?
Unfortunately it does not appear to correlate ;
https://www.huffingtonpost.com/neal-barnard-md/eskimo-myth_b_5268420.html
http://www.nejm.org/doi/full/10.1056/NEJMoa1205409#t=article
Belizes CAD risk is above the US -
http://www.worldlifeexpectancy.com/cause-of-death/coronary-heart-disease/by-country/
Belizes CAD risk is above the US -
http://www.worldlifeexpectancy.com/cause-of-death/coronary-heart-disease/by-country/
Sudan and Belizes figures?
That sounds like a reasonable course ... hope it works !!
UFO ... as with most dietary supplements the toxicity of EPA is low - ie you can probably take a lot before it causes any significant issues - unfortunately I dont know if anyone is in possession of the data you want - ie how much is too much - and that will vary person by person ..... I am not aware of anyone overdosing on fish ....
some meds are very toxic as dosage increases - for example the older tricyclic antidepressants went rapidly from useful to toxic upon doubling or tripling dosage.
UFO .. In general increasing dosages do not continually increase benefit in a linear progression
For example if you double your dosage of your BP pill you do not double its lowering capacity. Most benefit from medications occur within their initial dosages - increases after that have diminishing returns and eventually will turn into negative side effects
Interesting logic - so if I recall correctly places like SUDAN and Belize and Norway have some of the highest consumption of EPA per capita - what do their mortaltity rates show ?
This idea has been around for a very long time summarized by the saying ...anything is a poison .... in a high enough dose
We use to lose one or two people a year in this country in water drinking contests ...
North:
I am sorry to hear about your DM1. I dont know if you are familiar with viacyte. They have two systems in research studies to treat DM.1. PEC Direct and PecEncap. Both systems use pancreatic cells encapsulated in a an envelope.
The PEC Direct requires immunosupression to allow the stem cells to survive its already in a Phase 2 or 3 study.
The PEC Encap will be amazing if they can optimize the capsule. Basically the pancreatic cells will function like your own pancreas but remain 'hidden' from your immune system (no immunosuppression needed ) . This will be an absolute amazing quantum leap forward in the treamtent of DM1. If it works no meds no monitoring and perfect BS control for two to three year at a time- then simply go in and get your capsule replaced in a brief in office procedure
I think this company is a tremendous investment but unfortunately is privately held
I wish you Health and courage in your challenges
I already sold at $4 ( bought at $1) ... but I am going to hop back in .....
SO if I ff you correctly in trigs >500-
LOvaza has 45% reduction Vascepa 27%
Meaning Lovaza is on a rough guess about 66% more effective in lowering trigs than vascepa - yea thats not very significant
Of course not that's like patients who are treated for htn come back and say well my pressure is now under control so i dont need the med
A funny story ...
When we first discovered that ASA was useful I was working ER. I had a gentleman come in with massive ST elevations in the throws of an MI. I looked at the EKG turned to the nurse and said give him an 81 mg aspirin immediately and went out to write more orders.
The guys eyes widened and I could read his face - 'the ole take two aspirin and call me in the morning routine he thought " he was in shock and thought I was a quack . After getting orders written nitro drip going morphine etc etc I sat and talked with him about the rationale for the ASA and he felt more at ease after our discussion
Unfortunately I have been around long enough to remember the days before stenting . When UK went to nationalized health the standard of care was if you walked into an ER with a stable MI you were given an aspirin and sent home !!
This has been going on for years - more snake oil is being sold today than at any other time - if the FDA wants something to do they should crack down on all these claims being made by the OTC's OTC's should be required to perform double blinded studies to prove what they say. Right now they are making billions and need prove nothing.
There are people advertising magic crystals on ebay to "help" with cancer, magic copper strips, magic foot pads that suck the 'poisons' out of your body and detoxify you - and oh dont forget those horrible 'chemicals' (as if your body and everything around you is not a 'chemical'). I find these people to be vile taking advantage of peoples desperation to line their own pockets
You make an excellent point - on one side a simple med like ASA has proven very useful on the other side Niacin is useless - thus there are two possibilities for EPA - it is entertaining that so many people can only see one possible outcome - I happen to believe there are two possible outcomes - or as is true with most things the answer will lie somewhere in between
Thank you for making my point - yes I remember well the days when cardiologist were touting niacin as the new wonder drug why it reduced inflammation increased HDL and it was going to cure atherosclerosis .... and then what happened ..... I think the only difficulty is you are unable to see the reflection
I really like that approach but my pet peave is places like Canada - we basically built theri health care system - almost every piece of technology they use was invented by us - then they get it for pennies on the dollar The US consumer pays for all the research then they get the meds for pennies - its time the rest of the world started to chip in for this research from which they all benefit !
Trigs over 500 are treated to prevent pancreatitis
Yea I am aware of all the anti-inflammatory effects lowering of inflammatory markers etc etc - niacin lowers inflammation as well https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804877/ - yet has no effect on coronary artery disease outcomes
so you are convinced that we have elucidated the entire mechanism of atherosclerosis and it is via inflammatory pathways and EPA will solve it all ... that is indeed your right to believe this
but it is also my right to say ..... I'm just not that certain or convinced at this time
Good ole LInus yup he certainly held onto the Vitamin C theory - May he Rest in Peace
I am sorry that you were made so ill by the med Personally no I dont use welchol very often I dont find it effective and as you indicated its a pain to take
Its not the med - the med does what it does
I have changed my belief that trigs play a major role in CAD I am not as convinced as I was when I started using the med in 2013 or thereabouts. I am not willing to put all my eggs in one basket that says trigs are the endall after statins in the prevention of CAD
So you are going to give statins to statin intolerant patients really ?
Nope
So your upset that I am agreeing with you??? Ok - it made my eyes water but dried up my nose
Wow a board certified pulmonologist really ?! Yea understanding Vascepa is like three dimensional calculus its really hard
Patient with known CAD stented x2 absolutely statin intolerant ldl 190 think pcsk9 woudl be warranted ?
Hilarious the sheltered world you live in . I have people that have to choose food or their meds - they choose food usually - I try to keep them in samples jumping from one med to another as best I can dependent on what I have sometimes with none sometimes generics out of walmart (if they are close to what they need) sometimes I buy it for them - at some point you will see the real world of imperfection that most have to live in.
Its so entertaining listening to people talk about things they dont experience - so you really think an insurer is concerned about preventing your MI 20 years down the road vs profits today. Ahh the naivete
If thats the case then why would they ever deny me an rx for a pcsk9? I mean afterall They lower LDL and may save many lives - the $12,000 a year is a steal compared to the cost of one bypass --- yet I never got one pcsk9 approved - hmmm wonder why that noble insurance company isnt concerned about patient longevity 20 years down the line -- just cant figure it out I must be conflated
It doesnt do all of things ?? ..... many people here say it does - are you calling them all liars ?
I just wanted to sing with the choir .....
Really .... I didnt know that .... thanks
My eyes are nice and runny but my nose is not ! My arteries are wide open. My chest pain is gone. My prostate has shrunk. My diabetes is gone. My Rheumatism is gone and I can dance like a spider on a hot tin roof - Vascepa - it cures what ails ya !!
Doesnt matter what docs think - insurance companies dictate and if they want to use a different med - they will - PERIOD. I have seen it over and over. They will even use a totally different class of medication and most docs arent gong to take the time to fill out a four page prior auth - they will just go with what is offered.