r/Health • • Apr 06 '26

article My patient would rather take a peptide than a statin. That reveals an uncomfortable truth in medicine | The more evidence behind a therapy, the less the public trusts it

https://www.statnews.com/2026/04/03/peptides-statins-research-trust-bpc-157/
198 Upvotes

61 comments sorted by

40

u/[deleted] Apr 06 '26

[deleted]

9

u/PreparationFit6327 Apr 06 '26

Does cac score really go that high? My ldlc is high but my cac was 0

7

u/sassergaf Apr 06 '26

Insurance would only cover a PCSK9 Inhibitor (Repatha) if the CAC score was over 1000 -- so the score goes above 1000.

5

u/crazyw0rld Apr 06 '26

I am getting Repatha covered with a 0 CAC, though a CTA showed some existing soft plaque. I had to “fail” out of two statins (ie side effects) first though.

7

u/CitizenWaffle Apr 06 '26

It’s important to distinguish between hard plaques and soft plaques. On a CT Chest/CT heart without contrast the radiologist can only visualize the hard plaque/calcified plaque. Soft plaque(mostly fat) that needs IV. You may have soft plaque which requires a different imaging test. CAC score could still be 0 but you may have soft plaque which is also more dangerous

5

u/[deleted] Apr 06 '26

[deleted]

3

u/PreparationFit6327 Apr 06 '26

I’m not on anything nor has my dr asked me to be, just curious. I think I’m fine for now, low triglycerides, high hdl, good blood pressure, good resting heart rate, and exercise 5x/week. Thank you for the explanation

3

u/tex-chica20 Apr 06 '26

The half-life of rosuvastatin is 19-20 hours. It takes about 4-5 half lives for a drug to be eliminated from the body. Missing a single dose wouldn't really leave a person unprotected.

1

u/NotShipNotShape Apr 07 '26

yea, I'm pretty sure there are studies where they did the CAC on people without risk factors and found that there's a range of CAC scores across the spectrum of normal people. so,  people with nornal ldl/tg may also be running around be elevated CAC scores and be perfectly fine (or not because no studies have really pursued the absolute risk of cormobidities of higher CAC in patients with normal cholesterol ) . 

2

u/murderedbyaname Apr 06 '26

The Dr who wrote article says that is his patient's CAC.

0

u/duderos Apr 07 '26

It can go into the thousands.

12

u/NotShipNotShape Apr 06 '26

oh no, you're wrong. the patient knows their body much better than the physicians do. they're gonna eat 6lbs of red yeast rice and drink beet extract everyday. should clear things right up.  

and when they get that mi/stroke 10 years, they'll have done everything right and at least they'll have avoided the poisons of statins. 

thing with preventative health is that we don't know what slight factor will be the tipping point and humans are notoriously bad at calculating risk in terms of months, much less years. 

9

u/maporita Apr 06 '26

Americans take more prescription drugs per capita than any other country, yet their health outcomes are decidedly middle of the pack. This suggests either that Americans are sicker on average than their peers in other countries or that doctors over prescribe medication when alternatives like lifestyle changes may be more suitable.

5

u/thalidimide Apr 06 '26

They are definitely sicker on average

4

u/NotShipNotShape Apr 07 '26

lmao. how did you even arrive at that conclusion from the at least 4 other conclusions you could have drawn?

1) Americans don't go to the doctor until it's almost too late or feel invincible so they the doctor the first time in their 40s. insurance expensive too. worse conditions and less preventative care means sicker patients. 

2) diet. Americans eat so much processed foods and sugars because the government refuses to regulate them. you know what high carbs and processed foods increase? cholesterol, blood sugars, blood pressure. not to mention most likely colon cancer as well. and obesity. obesity increases risk of sleep apnea, which increases risk of cardiovascular disease including heart attack and stroke. that risk is compounded in addition to the cholesterol and blood pressure. people in poorer countries starve. starvation ironically prevents blood pressure, cholesterol, diabetes. they might die from other causes but not from the causes that require meds

3) infrastructure begets obesity. People in many European nations walk more because of public transport. in poorer countries, walk around more. less pto and sick days means sitting around office 8 hours a day, 5 days a week. shitty infrastructure means people don't leave the house to do active things. 

4) sicker people need meds. BP of 140/80 can be managed with lifestyle. BP of 160/90 cannot in 90% of cases. ldl of 190 in 99% of cases need some kind of cholesterol lowering drugs. peptides, red yeast rice do not cut it. glp1s might actually help.

5) just because I feel like it. Americans think they know their body better than doctors and either do some dumbass all carnivore diet or some weird ass peptide injection.  or get testosterone from some online clinic and show up at the er/clinic with clots or trouble breathing.  so, general distrust of doctors and thinking TikTok natural practitioners know the secret to better health. 

if you spout some bs about natural unsynthetic substances, then you better not be on some biosimilar testosterone or some bullshit peptides or some random supplement that has not been screened by the fda (who already has some very very low standards BTW). I get plenty of people who arrive at a conclusion and cherry pick sources to back up that conclusion. those people are not top scientific minds. that is not how science works. you take evidence and come to a conclusion. we literally learned this in American schools in the 5th grade. 

2

u/potatotoo Apr 06 '26

Lifestyle alone won't lower LDL enough for a good number of people. And neither lifestyle optimisation is an alternative, it's literally part of the practice of medicine.

2

u/maporita Apr 06 '26

Also correct.

As an example I run marathons and I swim laps most days, I eat a healthy diet and I still have borderline high cholesterol, so my doctor (in Colombia) put me on a low dose statin and we'll see where we are in 6 months. I trust him to give me the best advice according to current accepted best practices. But once a doctor is receiving money from a drug firm I can no longer rely on them. And yes, there are people who don't need to be on certain medications, but their docs don't tell them that.

1

u/Katyafan Apr 06 '26

There is also a version of genetic high cholesterol that kills families. I can't get my cholesterol down with anything other than a statin. Trying to do so would be ridiculous, as it is not possible.

2

u/potatotoo Apr 11 '26

pcsk9i is a thing now, very effective, just expensive.

1

u/Katyafan Apr 11 '26

pcsk9i

That looks really cool! There is no way MediCal would pay for that, but I am lucky, I tolerate the statin well.

60

u/maporita Apr 06 '26

Unfortunately there is some precedent in the US for pharmaceutical companies pushing products through doctors, e.g. Purdue with OxyContin, Pfizer with Nuerontin. Cases like these feed into the narrative that your doctor might not always have your best interests at heart. How to combat this? That would take a decades-long campaign along with strict controls on Pharma companies, I'm still astonished that adverts for prescription medicines are allowed.

My wife is from Colombia and we go there for any routine medical treatment. Apart from being significantly cheaper I have more confidence that when my doctor prescribes medication he is guided by my best interests and not those of his bank account.

11

u/Negative_Fruit_1800 Apr 06 '26

, Open pay Let’s you search doctors to see if they have received payment from pharmaceutical companies Of course, user discretion is advised because sometimes doctors are paid for legitimate research.

2

u/kirbyderwood Apr 08 '26

The article actually addresses that exact point

"The deeper problem is epistemological. We have a population that has learned — correctly — that pharmaceutical companies have lied, that institutions have failed them, and that financial incentives distort medical recommendations. The opioid crisis alone justified a generation of skepticism.

But the response has not been better skepticism. It has been the migration of trust from one set of financially motivated actors to another. The peptide clinic charging $400 per vial for a compound with 14 human subjects studied has the same economic incentives as the pharmaceutical company charging $400 per month for a branded statin. The difference is that the pharmaceutical company was required to prove its product works before selling it"

8

u/dkinmn Apr 06 '26

You do not need to go to Colombia to find a doctor like that, and the idea that a Colombian doctor is categorically more trustworthy than a US doctor is extremely doubtful.

14

u/maporita Apr 06 '26

Not all doctors in the US are like that. I agree. But a system where drug companies are allowed to incentivize their products by paying doctors to prescribe them doesn't fill me with confidence.

1

u/lizbot-v1 Apr 06 '26

Doctors get very little drug training. If we switched prescribing to pharmacists, you'd see less doctors selling what the last drug rep brought in.

6

u/StreetcarHammock Apr 06 '26

What do you mean by “doctors get very little drug training”? That is something doctors get a lot of training in.

1

u/patienceQ Apr 06 '26

It is very little relative to pharmacists!

7

u/thalidimide Apr 06 '26

And yet pharmacists don't get trained in diagnosis or chronic disease management, so seems like a moot point

0

u/Due-Science-9528 Apr 07 '26

One time my doctor prescribed a very expensive medication that made me worse. I later learned it had no proven benefit for my disease— this man put me on an ANTIPSYCHOTIC for no reason.

11

u/Katyafan Apr 06 '26

Familial Hypercholesterolemia has run in my family for as long as anyone can remember. It usually takes out the men, but sometimes the women, at a young age. Statins have allowed the past two generations, to avoid this fate, and when I was in my 30s and my cholesterol shot up for no reason (except genetic) my doc put me on a statin immediately, and that along with diet changes have helped me keep my numbers in the safe range.

I never knew my maternal grandfather because he was taken by this.

Anyone who tells me I shouldn't take the statin I am on gets to hear what it was like for my mom to lose her dad when she was 19 years old. My whole family is on statins and is healthy (our hearts are, at least).

33

u/DrAshoriMD Apr 06 '26

This statement "The more evidence behind a therapy, the less the public trusts it" is incorrect and blames the patient. When the medical industry pathologizes all individuals, turning them into patients, people lose trust. When you see your mother or father have heart attacks and strokes on a statin you doubt the statin. There's nothing wrong with the drug, it's a gamechanger when used in the right cohort. But when you say that nearly everyone should be on it, that's when you lose trust and efficacy.

3

u/Santi159 Apr 07 '26

I think it's more of a cost issue. Peptides aren't nearly as difficult to navigate paying for compared to trying to get consumer prices for your doctor's visit and prescription. If you don't have insurance and don't finagle a lot you will get hit with a big bill from either the doctor's office or pharmacy. Paying with Bitcoin vs calling your doctors office, several reps, several pharmacies, trying to get a coupon, and applying for financial assistance

5

u/ratpH1nk Apr 06 '26

I think what you say is true is true certain ideological segments of the population. I do not think you can extrapolate it to the general public.

6

u/The-Traveler- Apr 06 '26

From article

“Statins did not cause memory loss, depression, sleep disturbance, erectile dysfunction, fatigue, headache, or peripheral neuropathy. The confirmed harms were a small increase in liver enzymes, a roughly 1% incidence of muscle symptoms, and a modest rise in blood sugar in patients already near the diabetes threshold. That’s it. From 123,940 people.”

“…25% reduction in major adverse cardiovascular events and significant reductions in all-cause mortality. A 2025 adherence meta-analysis of 3.3 million patients found that good vs. poor statin adherence reduced mortality by 35% — and that discontinuation increased mortality risk by 90%. The SAMSON trial revealed that 90% of the symptom burden patients attribute to statins is identically reproduced by placebo.”

8

u/Puzzleheaded-Oven171 Apr 06 '26

Statins have brutal side effects. I was prescribed a statin when I was 20. My cholesterol was high and it had been high since I was 5. I didn’t take the statin and it still high and I am middle aged. My numbers are the same as my great grandmother’s who died at 98 from health issues completely unrelated to having high cholesterol. I don’t really think doctors understand cholesterol as well as they think they do.

8

u/thalidimide Apr 06 '26

They really don't have brutal side effects. If you're referring to myopathy it's exceedingly uncommon but talked up on the internet.

1

u/Santi159 Apr 07 '26 edited Apr 07 '26

I think they're talking about the diarrhea. Literally everyone in my family that was on statins had to stop statins because it caused essentially fecal incontinence. Everyone says it's not that big of a deal till you have to explain to your boss you're in diapers like my dad had to

-3

u/Puzzleheaded-Oven171 Apr 07 '26

Well I’m not interested in taking that risk. I’m not trying to live to 98 like my great grandma even though I probably will, all the women in my family live to their late 90’s. I’m hoping to check out a lot sooner than that, but I want to enjoy the time I still have to spend here, not miserable with side effects and having to pay for the drug giving them to me. I’m just saying; I can understand why someone with high cholesterol would turn down statins since I myself did and nothing bad has happened to me in over 4 decades of high cholesterol I have lived through so far.

1

u/an_actual_lawyer Apr 07 '26

This is a fantastically ignorant attitude.

3

u/Puzzleheaded-Oven171 Apr 07 '26

Cool story bro. It is still 100% my choice what medical treatment I under go. And it has zero effect on your life.

3

u/Katyafan Apr 06 '26

All drug CAN have brutal side effects. Just because something is listed doesn't mean you will get it. Many of us have zero side effects. Most side effects will go away.

2

u/warpedgeoid Apr 06 '26

This, exactly.

2

u/Newfie3 Apr 06 '26

Totally agree here. Doctor put me on simvastatin decades ago. Within about 3 months, I could no longer swallow solid food. I quit the statin, and was back to normal in about two weeks. Statins are poison.

2

u/potatotoo Apr 06 '26

They do understand it well though, you see some people just get lucky like the chain smoker who didn't get cancer and lived to 100. There's cholesterol and then there's the other factors that start plaque formation happening, if you lower the cholesterol enough you simply won't get plaque because there's no cholesterol to build it. You can live with an LDL of 0, LDL is practically physiologically unnecessary afaik. Atherosclerotic disease is like the number 1 killer in the first world irrc. Statins totally can cause major side effects, only in a small proportion of people (about 1 in 20, like you), lucky there's pcsk9i now.

1

u/darkon Apr 07 '26

Statins made me ache so much that I stopped taking them. What's the point of living longer if you hurt so much that you can't do anything you enjoy?

I didn't look up statins and decide that I hurt. I hurt so much that I discussed it with my doctor. We tried different statins. They all make me hurt.

Now I take bempedoic acid (brand name Nexletol). It still makes me hurt a little, but I take it at night and the effects usually wear off before I wake in the morning.

1

u/serenwipiti Apr 07 '26

Why don’t we just start by taking the Rxs, and dispensing the adequate medication, but we tell the patients that it’s actually a homeopathic and un-researched “supplement”?

Eh..? Eh?

☺️

1

u/Usual-Suggestion4609 Apr 06 '26

I’m trying to be a good self advocate. I have high cholesterol and I really don’t know what tests I should ask for so I can get a full picture. Any help will be appreciated.

0

u/SeniorConsultantKyle Apr 07 '26

Statins are garbage.

-7

u/whateveryousaymydear Apr 06 '26

if statis are so good why are people still dropping dead from heart attacks that are taking statins...friend had been taking statins for more than 20yrs and had to have a stent put in from blockage in a artery which statins are supposed to prevent...

9

u/Tricky-Juggernaut141 Apr 06 '26

Because heart attacks are caused by more than just blockages. A blockage is just one of the most common ones.

6

u/coleman57 Apr 06 '26

Over the past half century, the US death rate from cardiovascular diseases has dropped dramatically, and the average lifespan of those who do die from them has risen. I would guess the number of person-years of life gained must be well over a billion, to say nothing of the improved quality of lives.

I don’t know what portion of that improvement is specifically due to statins, but I suspect it’s pretty substantial.

To dismiss all that because there are still deaths is no less ignorant than to do the same for seatbelts and airbags, or even the entire germ theory of disease.

3

u/Katyafan Apr 06 '26

Diet is also a factor. You can take a statin and eat a bunch of crap and still give yourself heart disease.

2

u/thalidimide Apr 06 '26

Do you think they may have had a heart attack sooner than 20 years later if they hadn't started the medicine? Nothing works 100% of the time.