Waclive
GLP-1 Enthusiast
Be sure to tell her that 33% of FDA approved meds are pulled each year because of how harmful they are.
What do you tell your Doctor
- Thread starter Cdub100
- Start date
Calm Logic
GLP-1 Specialist
Waclive
GLP-1 Enthusiast
I think 33% is what they pull but the % should be way lower if they presented all the data besides what they wanted to present because they would never be approved in the first place.
"It took a median of 4.2 years after the drugs were approved for these safety concerns to come to light, the study found, and issues were more common among psychiatric drugs, biologic drugs, drugs that were granted "accelerated approval" and drugs that were approved near the regulatory deadline for approval."
Fucking yikes!
Not meant to start an argument, but that is not each year! This ⅓ number seems to refer to overall drugs that get an additional FDA level addition to the initial approval document. I actually see this as a positive rather than a negative, since as even a large study only involves a few thousand people, there is plenty of room to discover rare or long term problems. I’ve heard the approval and release to the public called the Phase IV trial because of this (and how medication injury can be reported to the FDA for their review.)
Your point that approved medication isn’t perfectly safe is still true, it’s just partly or largely due to our discovery of further information. Still, since the greys don’t even have the initial trials, it’s not unreasonable to say they are still unproven.
I had a conversation a couple days ago about how we need to be careful to not throw out the baby with the bathwater out of over trust or over irritation with distrust in the system, both for approved meds and greys. For sure many of the greys have stalled in their development towards being an approved wealth generating molecule because there is something that was shown to not work… and this often doesn’t rate publication when it’s funded by an entity with secondary gain issues.
It makes perfect sense if you think about it:
Drug trials are often only going to last weeks to months (so they won't typically catch long-term issues prior to approval). Also, since manufacturers are paying for them, they're going to be constructed in a way that's looking for the bare minimum they can get away with in terms of side effect monitoring and will tend to focus on results the manufacturer anticipates will paint the drug in a positive light.
The first 5 years after approval of a new drug are the actual safety trials.
That's why whenever you're prescribed something you should always ask the doctor if there's a generic alternative available. It's not about cost savings (although that helps too). Newer/stupider doctors are often prescribing whatever the newest drug are, since they're fresh on their mind after being gassed up on how great they are by pharma reps. More competent doctors who know the game usually try to start with older/proven drugs.
Waclive
GLP-1 Enthusiast
TL;DR: you're right, but the system is broken and doesn't play in our favor, however, I am aware there's a lot more that goes into that than what we're discussing here
I would say there is an inherent problem with the system when it comes to drug trials itself if a whopping 33% of drugs are recalled simply because the trials aren't long enough to catch the dangerous sides. It's clearly a for profit model over making the world a better place by helping people. Not that making money is a bad thing. But money made with the knowledge that some people will be hurt/die is not acceptable. And there's all kinds of evidence to show the latter is more true.
If you listen to what Brigham Buler has to say, they don't give all the information to the FDA and set trial guidelines to, like mentioned, paint the study in the most positive light for the company researching the drugs, not for the end consumer.
I'm definitely not here to cry about it or argue, there's nothing in life that doesn't come with some sort of risk. It's just shitty those risks are passed on to us without the full knowledge because trials and approvals are just things to give an illusion of safety when you peel back the drapes and the sunlight comes flooding in. I don't think there's a cabal of people rubbing their hands like Scrooge McDuck, but I do believe people at the top have their hands tied with fiduciary responsibility to the share holders of their companies.
There is also more to it than just this. There's a whole system at play here. And over time it's gotten to this point of essentially being a scam in my opinion. If you know about the inner workings of the machine, then it comes a lot more clear that medicine today isn't about healing, it's about money.
I would say there is an inherent problem with the system when it comes to drug trials itself if a whopping 33% of drugs are recalled simply because the trials aren't long enough to catch the dangerous sides. It's clearly a for profit model over making the world a better place by helping people. Not that making money is a bad thing. But money made with the knowledge that some people will be hurt/die is not acceptable. And there's all kinds of evidence to show the latter is more true.
If you listen to what Brigham Buler has to say, they don't give all the information to the FDA and set trial guidelines to, like mentioned, paint the study in the most positive light for the company researching the drugs, not for the end consumer.
I'm definitely not here to cry about it or argue, there's nothing in life that doesn't come with some sort of risk. It's just shitty those risks are passed on to us without the full knowledge because trials and approvals are just things to give an illusion of safety when you peel back the drapes and the sunlight comes flooding in. I don't think there's a cabal of people rubbing their hands like Scrooge McDuck, but I do believe people at the top have their hands tied with fiduciary responsibility to the share holders of their companies.
There is also more to it than just this. There's a whole system at play here. And over time it's gotten to this point of essentially being a scam in my opinion. If you know about the inner workings of the machine, then it comes a lot more clear that medicine today isn't about healing, it's about money.
I agree, except, I DO think there literally is a cabal of scrooge mcducks. History shows disporportionate influence of this billionaire class to benefit themselves…
If it helps, the 33% consists of drugs since the beginning. And a lot of it is clarifying what additional things to watch for. One thing I have often thought is that things sold as medications “without being allowed to say they are meant to treat any disease” that are considered “natural” can bypass the FDA and are not under scrutiny at all, but there’s no reason any molecule should be excused.
Really the grey community is such a rich resource we should gather data about sides. We somehow rarely think any truly bad things will happen to us… like cancer, organ injury, and mysterious biochemical alterations.
Waclive
GLP-1 Enthusiast
I have an inherent distrust for all of these industries, based on my own experiences and research, and I just don't want to lean into it too much or I'll become too cynical and not even go get blood work done 😅
100% agree with you this is why these communities exist. These places fill in the gaps with the anecdotes and personal experiences people share, especially if you have a doctor not willing to entertain such things about YOUR health. There's not much that will upset me more than a gas lighting doctor.
I have to remind myself that doctors and any other health professional are just as indoctrinated as anyone else, and perhaps more so since it’s easy to slip that stuff into the kind of training that requires rigorous and extensive learning. People really can’t hear until they are ready to hear, and big business corporations are so loud. But they have piggybacked on real science so don’t let them block you from that.
Waclive
GLP-1 Enthusiast
100%
If you don't have the time or resources to filter through the bullshit, it's hard to get to the right answer.
I've always been the type of person to take my health into my own hands. Then with the state world the last couple years, it's just amplified the signal for me.
rGrain
GLP-1 Novice
🚫No Source Discussion🚫
I told her I was on compounded Zepbound and she got me on actual Zepbound through the VA she was like "you guys shouldn't be on compounded it's not safe but your numbers are really good finally
The person who throws up their arms and proclaims "it's all a scam" is just as idiotic as the person who blindly trusts the process, IMO.
The key insight to be gained here is that just about everywhere you're going to find pockets of regulatory and government capture where monied interests have manipulated and engineered various systems to their own benefit. Don't be upset by that. Just understand that's the natural and expected outcome and accept it exists.
The answer isn't to bury your head in the sand, but rather to explore the ways in which the systems have been manipulated, to the extent that they connect with your life.
Like with pharma, it's not that "all doctors are out to get you." It's that they're educated by a system that has been captured in various ways and their beliefs and biases will reflect that. Most doctors and medical researchers are good people who genuinely want to help. Look for other clever people who have peeled back the layers in a given domain and benefit from their work to save yourself some time in getting up to speed, but check their work too.
Waclive
GLP-1 Enthusiast
I'm the type of person that thinks everything is figure-out-able. I will always figure out what works for me despite what any doctor tells me and I know isn't representative of my reality. That's not throwing hands up and saying fuck it why try since it's all a scam. That's noticing what a perverted system it is and finding an alternative solution to my medical concerns. No one should just give up on anything, especially on their health.
I said that nothing in life comes without risk, and that includes following a doctors advice, especially when you know the system they're brought up in. I find it less risky to take my health into my own hands and figuring out what works for me in my situation. Do I think you or anyone else should? No. Do I think you should educate yourself and listen to your heart of hearts? Absolutely I do. But make those decisions with all the information you can. And I say that because a lot people don't believe the doctor works the insurance company VS working for the patient because they don't have time to do research when life is lifing.
It just shouldn't be that way when it comes to health care is all I'm saying. Life isn't fair, we all know that. The system we have is bad and it shouldn't be that way. Navigating the health care system shouldn't bankrupt people in a country of so much excess is what I think.
I said that nothing in life comes without risk, and that includes following a doctors advice, especially when you know the system they're brought up in. I find it less risky to take my health into my own hands and figuring out what works for me in my situation. Do I think you or anyone else should? No. Do I think you should educate yourself and listen to your heart of hearts? Absolutely I do. But make those decisions with all the information you can. And I say that because a lot people don't believe the doctor works the insurance company VS working for the patient because they don't have time to do research when life is lifing.
It just shouldn't be that way when it comes to health care is all I'm saying. Life isn't fair, we all know that. The system we have is bad and it shouldn't be that way. Navigating the health care system shouldn't bankrupt people in a country of so much excess is what I think.
Same. But what’s horrifying for me, is that with each step I take, I discover that I had been completely ignorant of a whole bunch of important things before. And this does not seem to get better😬. Live and learn I suppose.
Waclive
GLP-1 Enthusiast
It's like having a food motivated house cat. If you're not paying attention, it'll snatch your food off your plate. Even when you're paying attention, it still trys to snatch your food but it's just more sneaky about it 😂😂
HereKittyKitty
GLP-1 Enthusiast
Absolutely disclose if facing surgery or a procedure of any kind. Doesn't mean you have to disclose grey. Just compounded.If you have any surgeries booked in the near future and on GLP then this news article may be a consideration
TLDR : digestive slow down could require significantly longer fasting before surgery. If the surgical team knows your on GLP they can better prepare. Reducing the risk of breathing complications and potential death for minor surgical procedures.
Doctors turn Ozempic patients away from surgery due to extra risks
Doctors say they are forced to delay some procedures due to the risk of serious consequences for patients on Ozempic-like drugs.www.abc.net.au
Probably worst cast , however I would not have considered this before reading.
lessthanhalf
GLP-1 Specialist
This is not correct. Coronary calcium scores are one of the most accurate tests for risk of heart attack, in some ways more accurate than angiography. Most heart attacks do not occur at sites of arterial narrowing but occur when a plaque ruptures and a clot forms. Coronary calcium scores give an idea of how much plaque there is in the coronary arteries overall, the more areas of plaque the higher the risk of one rupturing and causing a heart attack. Angiography will tell you if there are dangerous narrowings of arteries that would be better treated by stents or bypasses.
For example my coronary calcium score was 645 at 57 yo. This puts me at a risk of major cardiovascular event ( heart attack stroke or death ) of about 20% over 10 years , and a bit worse if you add in a few extra risk factors, and is in the highest risk category where aggressive treatment with high intensity lipid lowering therapy and aspirin is required as well as reducing any other risk factors like hypertension etc. My angiogram showed a 15% right coronary artery stenosis and a 50% stenosis of the left main descending branch. This does not need stenting or surgery, but despite not being terrible does not change the risk calculated from the coronary calcium score, because they measure different things.
These issues require a good understanding of the statistics and research used to work out these risks and of what treatments have been proven to reduce those risks, the only people who should be deciding what treatments are a good idea if there is known cardiovascular disease ( based on a high coronary calcium score ) is a cardiologist. Standard medical treatments used in these circumstances have been tested on a massive scale - hundreds of thousands of patients , over decades and are proven to reduce risks, and by a lot, roughly dropping the chances by half.
This research is on a much more massive scale than the evidence of GLP's reducing risk, by a factor of maybe 100 to a 1000 times as many patient years of testing.
Statin therapy reduces new plaque formation and stabilises the existing ones making rupture less likely, and low dose aspirin reduces the odds of clots forming if one does rupture. GLP medications especially semaglutide has also been proven to reduce risks of stroke, heart attack and death, but not as much as statins, and if there is any degree of known cardiovascular disease or a calculated high long term risk from traditional risk factors, then both are a good idea, not one or the other, and no one should be stopping statins used for high cardiovascular risk or known heart disease because GLP's also can lower lipid levels. They are not as effective and the risks of stopping statins could be very high maybe a 10% increased risk of serious cardiovascular disease over the next 10 years, or an extra unnecessary 1% chance of death, heart attack or stroke per year, whether you are taking GLP medications or not.
pulled from the market?
Attachments
Very good read my friend!
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I tell her everything, She is cool with it. On the other hand every time I visit she insists each time that I DO NOT HAVE A HERNIA! " Cough ,Cough ! "
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Ironically, you bolded and most confidently stated the one claim in your post that has never been studied clinically. I agree that someone in the situation you're describing (who has already narrowed their treatment lane to statins, progressed to that point, and been on them for years) would likely do poorly to abandon statins at that point from a purely cardiovascular point of view.
Still, "no one" is a pretty broad qualifier. Statins are not the one true drug that all must believe in and proclaim their deference to from the rooftops. They're just another class of drugs with their own mix of pros and cons, like every other class of drug.
As a simple exception to "no one," it's easy to posit someone who is experiencing dementia, finds that symptoms reduce when statins are discontinued, and has decided they would prefer to be able to think more clearly in their final years over letting their cognitive faculties slip away from them just to get an extra year of life in a memory care unit. As arrogant as your typical cardiologist can be, I suspect that even in that case you'd find agreement from them if the family pushed for such a trade off.
It is pretty close to impossible to find a decent PCP where I live, unless you have the money to be self pay and/or a concierge service. My PCP is meh at best and didn’t tell me that my Testosterone was really low because it was at a 6 when the bottom limit of acceptable for a woman is a 4. So I walked around with horrible brain fog, inability to gain muscle, and zero libido for an extra year until I started on TRT through a private clinic.
All this to say, I go for a yearly check up and blood work just to keep a general eye on things, but I don’t tell him anything because he’s lost his entitlement to a medical opinion as far as I’m concerned.
All this to say, I go for a yearly check up and blood work just to keep a general eye on things, but I don’t tell him anything because he’s lost his entitlement to a medical opinion as far as I’m concerned.
Sadly, I think concierge care will be the only path forward there and like you I'm also in an area where nobody is doing it so I too am stuck doing extended research. Part of that is that medical school doesn't really select for good critical thinking skills so only a minority of doctors are effective in that regard, so finding a capable doctor is already a challenge. Then add in that there are so many guardrails in place (standard of care, guidelines and policies set by the clinic they're working at, medical liability quirks, etc.) that even if you find a sharp doctor they'll be pretty limited in their ability to properly personalize your care. At this point you're basically engaging in the medical equivalent of going from McDonald's to McDonald's location trying to find one that sells real ice cream instead of soft serve.
Kinda where I am at. My actual Dr I see once a year, and for any other visit I get a random nurse practicioner. At my last weight loss appt I said I got my perscription online. They see the same commercials we all do.
I respect and agree with your take on doctors, but I cannot get behind your unflattering likening to McD’s soft serve. Those hot fudge sundaes, when made right, are pure heaven.
…Except I don’t want one right now because my Reta dose for the week appears to have kicked in.
PatchyFog
GLP-1 Novice
🚫No Source Discussion🚫
I've told my PCP a couple of times I'm taking "Chinese Research Chemicals I bought from strangers on the Internet." I'm a funny guy, so he always thinks I'm joking.
HereKittyKitty
GLP-1 Enthusiast
Priceless
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Hambocommando
GLP-1 Apprentice
I'm honest with my VA doc. She's a NP at a local clinic in a small town, so not VA proper. The VA makes you jump through flaming hoops to get prescribed a GLP1, and I know those hoops would make me punch someone in the face and quit. So I went with a compounding pharmacy out of pocket for Tirz. Tirz started out amazing, but then it went bad fast with side effects that wouldn't go away. I told them I was going to take dosing and medication into my own hands so I knew what was going on. They know I'm smart enough to educate myself on the science and if I have questions, I'll go to them! I'm not a medical professional, but I studied/tutored with half of them in college classes. I helped the head nurse get through bio-chem.
But after years of struggling with depression, statin, and thyroid meds because they make me feel weird, as well as constant debilitating pain, my doc is honestly happy I'm making life changes.
I don't keep a scale at home. I make myself go to the clinic to weigh in every few weeks and get a blood pressure check. The weight loss is a side effect to feeling better for me. I want them to watch the biological changes in real time along with me. I want them to see the ups and downs so they can use that knowledge when dealing with other patients. I want them to see what kinds of crazy changes this stuff can manage so that in the future, they'll help other people fight to get meds that might help them.
But after years of struggling with depression, statin, and thyroid meds because they make me feel weird, as well as constant debilitating pain, my doc is honestly happy I'm making life changes.
I don't keep a scale at home. I make myself go to the clinic to weigh in every few weeks and get a blood pressure check. The weight loss is a side effect to feeling better for me. I want them to watch the biological changes in real time along with me. I want them to see the ups and downs so they can use that knowledge when dealing with other patients. I want them to see what kinds of crazy changes this stuff can manage so that in the future, they'll help other people fight to get meds that might help them.
Hambocommando
GLP-1 Apprentice
Did you have to go through the MOVE program and did they limit your maximum dose? That's what my doc told me I would have to do.
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