This is Dr. Saray Stancic. She’s another from the ranks of “doctors who got a serious illness and it completely changed how they view the treatment of serious illness”.

In her case, Stancic was diagnosed with multiple sclerosis, and wasn’t impressed with the results from the treatments offered, so (after 8 years of pain, suffering, and many medications, only for her condition to worsen) she set about doing better with an evidence-based lifestyle medicine approach.

After 7 years of her new approach, she would go on to successfully run a marathon and live symptom-free.

All this to say: her approach isn’t a magic quick fix, but it is a serious method for serious results, and after all, while it’d be nice to be magically in perfect health tomorrow, what’s important is being in good health for life, right?

If you’re interested in her impressive story, check out:

Doctor With Multiple Sclerosis On The Collapse Of US Healthcare

If you want to know what she did, then read on…

Six key lifestyle changes

Dr. Stancic credits her recovery to focus on the following evidence-based approaches:

The plant-centered plate

This is critical, and is the one she places most emphasis on. Most chronic diseases are exacerbated, if not outright caused, by chronic inflammation, and one cannot fix that without an anti-inflammatory diet.

An anti-inflammatory diet doesn’t have to be 100% plant-based, but broadly speaking, plants are almost always anti-inflammatory to a greater or lesser degree, while animal products are often pro-inflammatory—especially red meat and unfermented dairy.

For more details, see:

Anti-Inflammatory Diet 101 (What to Eat to Fight Inflammation)

Movement every day

While “exercise is good for you” is in principle not a shocker, remember that her starting point was being in terrible condition with badly flared-up MS.

Important to understand here is that excessive exercise can weaken the immune system and sometimes cause flare-ups of various chronic diseases.

Moving thoroughly and moving often, however, is best. So walking yes, absolutely, but also don’t neglect the rest of your body, do some gentle bodyweight squats (if you can; if you can’t, work up to them), stretch your arms as well as your legs, take all your joints through a full range of motion.

See also:

The Doctor Who Wants Us To Exercise Less, & Move More

Mindful stress management

Stress in life is unavoidable, but how we manage it is up to us. Bad things will continue to happen, great and small, but we can take a deep breath, remember that those things aren’t the boss of us, and deal with it calmly and conscientiously.

Mindfulness-Based Stress Reduction is of course the evidence-based “gold standard” for this, but whatever (not substance-based) method works for you, works for you!

About MBSR:

No-Frills, Evidence-Based Mindfulness

Good sleeping habits

Getting good sleep can be hard for anyone, let alone if you have chronic pain. However, Dr. Stancic advocates for doing whatever we can to get good sleep—which means not just duration (the famous “7–9 hours”), but also quality.

Learn more:

The 6 Dimensions Of Sleep (And Why They Matter)

Substance intake awareness

This one’s not so much of a “don’t do drugs, kids” as the heading makes it look. Dr. Stancic assumes we already know, for example, that smoking is bad for us in a long list of ways, and alcohol isn’t much better.

However, she also advises us that in our eagerness to do that plant-based diet, we would do better to go for whole foods plant-based, rather than the latest processed meat substitutes, for example.

And supplements? She bids us exercise caution, and to make sure to get good quality, as poor quality supplements can be worse than taking nothing (looking at you, cheap turmeric supplements that contain heavy metals).

And of course, that nutrients gained from diet will almost always be better than nutrients gained from supplements, as our body can usually use them better.

And see also, some commonly-made supplements mistakes:

Do You Know Which Supplements You Shouldn’t Take Together? (10 Pairs!)

Human connection

Lastly, we humans are a social species by evolution; as individuals, we may enjoy relatively more or less social contact, but having access to such is important not just for our mental health, but our physical health too—we will tend to deteriorate much more quickly when we have to deal with everything alone, all other things being equal.

It doesn’t mean you need a busy social life if that’s not in your nature, but it does mean it’s incredibly beneficial to have at least a small number of people that you trust and whose company you enjoy, at least relatively accessible to you (i.e., their life need not revolve around you, but they are the kind of people who will generally happily spend time with you and provide support when needed if they can).

As for how:

How To Beat Loneliness & Isolation

Want to know more from Dr. Stancic?

We recently reviewed this very good book of hers, which goes over each of these six things in much more detail than we have room for here:

What’s Missing from Medicine – by Dr. Saray Stancic

Enjoy!

The Hidden Complexities of Statins and Cardiovascular Disease (CVD)

This is Dr. Barbara Roberts. She’s a cardiologist and the Director of the Women’s Cardiac Center at one of the Brown University Medical School teaching hospitals. She’s an Associate Clinical Professor of Medicine and takes care of patients, teaches medical students, and does clinical research. She specializes in gender-specific aspects of heart disease, and in heart disease prevention.

We previously reviewed Dr. Barbara Roberts’ excellent book “The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs”. It prompted some requests to do a main feature about Statins, so we’re doing it today. It’s under the auspices of “Expert Insights” as we’ll be drawing almost entirely from Dr. Roberts’ work.

So, what are the risks of statins?

According to Dr. Roberts, one of the biggest risks is not just drug side-effects or anything like that, but rather, what they simply won’t treat. This is because statins will lower LDL (bad) cholesterol levels, without necessarily treating the underlying cause.

Imagine you got Covid, and it’s one of the earlier strains that’s more likely deadly than “merely” debilitating.

You’re coughing and your throat feels like you gargled glass.

Your doctor gives you a miracle cough medicine that stops your coughing and makes your throat feel much better.

(Then a few weeks later, you die, because this did absolutely nothing for the underlying problem)

You see the problem?

Are there problematic side-effects too, though?

There can be. But of course, all drugs can have side effects! So that’s not necessarily news, but what’s relevant here is the kind of track these side-effects can lead one down.

For example, Dr. Roberts cites a case in which a woman’s LDL levels were high and she was prescribed simvastatin (Zocor), 20mg/day. Here’s what happened, in sequence:

1. She started getting panic attacks. So, her doctor prescribed her sertraline (Zoloft) (a very common SSRI antidepressant) and when that didn’t fix it, paroxetine (Paxil). This didn’t work either… because the problem was not actually her mental health. The panic attacks got worse…
2. Then, while exercising, she started noticing progressive arm and leg weakness. Her doctor finally took her off the simvastatin, and temporarily switched to ezetimibe (Zetia), a less powerful nonstatin drug that blocks cholesterol absorption, which change eased her arm and leg problem.
3. As the Zetia was a stopgap measure, the doctor put her on atorvastatin (Lipitor). Now she got episodes of severe chest pressure, and a skyrocketing heart rate. She also got tremors and lost her body temperature regulation.
4. So the doctor stopped the atorvastatin and tried rosovastatin (Crestor), on which she now suffered exhaustion (we’re not surprised, by this point) and muscle pains in her arms and chest.
5. So the doctor stopped the rosovastatin and tried lovastatin (Mevacor), and now she had the same symptoms as before, plus light-headedness.
6. So the doctor stopped the lovastatin and tried fluvastatin (Lescol). Same thing happened.
7. So he stopped the fluvastatin and tried pravastatin (Pravachol), without improvement.
8. So finally he took her off all these statins because the high LDL was less deleterious to her life than all these things.
9. She did her own research, and went back to the doctor to ask for cholestyramine (Questran), which is a bile acid sequestrent and nothing to do with statins. She also asked for a long-acting niacin. In high doses, niacin (one of the B-vitamins) raises HDL (good) cholesterol, lowers LDL, and lowers tryglycerides.
10. Her own non-statin self-prescription (with her doctor’s signature) worked, and she went back to her life, her work, and took up running.

Quite a treatment journey! Want to know more about the option that actually worked?

Read: Bile Acid Resins or Sequestrants

What are the gender differences you/she mentioned?

A lot of this is still pending more research—basically it’s a similar problem in heart disease to one we’ve previously talked about with regard to diabetes. Diabetes disproportionately affects black people, while diabetes research disproportionately focuses on white people.

In this case, most heart disease research has focused on men, with women often not merely going unresearched, but also often undiagnosed and untreated until it’s too late. And the treatments, if prescribed? Assumed to be the same as for men.

Dr. Roberts tells of how medicine is taught:

❝When I was in medical school, my professors took the “bikini approach” to women’s health: women’s health meant breasts and reproductive organs. Otherwise the prototypical patient was presented as a man.❞

There has been some research done with statins and women, though! Just, still not a lot. But we do know for example that some statins can be especially useful for treating women’s atherosclerosis—with a 50% success rate, rather than 31% for men.

For lowering LDL, it can work but is generally not so hot in women.

Fun fact:

In men:

• High total cholesterol
• High non-HDL cholesterol
• High LDL cholesterol
• Low HDL cholesterol

…are all significantly associated with an increased risk of death from CVD.

In women:

…levels of LDL cholesterol even more than 190 were associated with only a small, statistically insignificant increased risk of dying from CVD.

So…

The fact that women derive less benefit from a medicine that mainly lowers LDL cholesterol, may be because elevated LDL cholesterol is less harmful to women than it is to men.

And also: Treatment and Response to Statins: Gender-related Differences

And for that matter: Women Versus Men: Is There Equal Benefit and Safety from Statins?*

Definitely a case where Betteridge’s Law of Headlines applies!

What should women do to avoid dying of CVD, then?

First, quick reminder of our general disclaimer: we can’t give medical advice and nothing here comprises such. However… One particularly relevant thing we found illuminating in Dr. Roberts’ work was this observation:

The metabolic syndrome is diagnosed if you have three (or more) out of five of the following:

1. Abdominal obesity (waist >35″ if a woman or >40″ if a man)
2. Fasting blood sugars of 100mg/dl or more
3. Fasting triglycerides of 150mg/dl or more
4. Blood pressure of 130/85 or higher
5. HDL <50 if a woman or <40 if a man

And yet… because these things can be addressed with exercise and a healthy diet, which neither pharmaceutical companies nor insurance companies have a particular stake in, there’s a lot of focus instead on LDL levels (since there are a flock of statins that can be sold be lower them)… Which, Dr. Roberts says, is not nearly as critical for women.

So women end up getting prescribed statins that cause panic attacks and all those things we mentioned earlier… To lower our LDL, which isn’t nearly as big a factor as the other things.

In summary:

Statins do have their place, especially for men. They can, however, mask underlying problems that need treatment—which becomes counterproductive.

When it comes to women, statins are—in broad terms—statistically not as good. They are a little more likely to be helpful specifically in cases of atherosclerosis, whereby they have a 50/50 chance of helping.

For women in particular, it may be worthwhile looking into alternative non-statin drugs, and, for everyone: diet and exercise.

Further reading: How Can I Safely Come Off Statins?