The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
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I am not saying they are nothing. But statins are the annoying kind of drug where the benefits are hard to perceive on an individual basis, but we have strong evidence does help at a population level. And the harms are even more rare, barring the more common transient stuff like muscle aches.
In more formal terms, the NNT is high, and so is the NNH. But the former is still significantly smaller than the latter, almost by an OOM. Both are diminished by his age and reasonably good health, at least on the basis of information provided, but I would be rather surprised if it came out to a complete wash or net harm (however small).
(I have neglected to specify that NNT and NNH require specific metrics or endpoints to assess, but I'm talking about the serious stuff, like number of cardiovascular events avoided in expectation or new onset T2DM/rhabdomyolysis)
As it stands, I think that @DirtyWaterHotDog is an intelligent sensible individual, and that their doctor has done due diligence before making the recommendation. I'd love to see an explicit QALY calculation, but let's be honest and admit that those are desirable but not strictly necessary, assuming a competent doctor exercising clinical judgement. I'm sure he's going to do his own research instead of deferring entirely to an argument I made while suffering from a serious migraine (even if I think that my advice is fine). I see no significant risk from initiating them, since they're easy to start and easy to stop if the most likely side-effects become annoying. The benefits are also probably small, but I think his actual doctor has a better picture than I do, and I see no real reason to disagree with them.
(If I was his actual doctor instead of a friendly stranger on the internet, I would be poring over the reports and calculating QRISK scores.)
Thanks for information btw.
As it stands, I have updated by priors. Reduced my apprehension towards them and calibrated the urgency to get on them.
I am setting a concrete deadline for end-of-year to get my cholesterol & weight in control. If it doesn't work, I'll take my doctors advice on statins.
I'm skipping GLP-drugs because I want to solve the root cause, not just the symptoms. Sleep, diet and work outs first. Rest will follow.
Note that I'm not strongly endorsing the statins. But your actual doctor probably knows your situation better than I do, and I trust them by default. More importantly, in a way, you can just quit if the side effects are more nuisance than the (small) benefits are worth.
Why not both? Seriously, even if you don't "need" them like someone with someone who is outright obese and diabetic, they'll help. There is no reason to think that you can't also make lifestyle modifications alongside them, and those are laudable goals anyway. You'll almost certainly lose weight, and it'll help the cardiovascular stuff. If your sleep is hampered by something like sleep apnea (which I do not know you have, but is not unlikely), then the weight loss will help with that too. It's easier to exercise and diet if you've already lost some weight and don't feel as hungry. The drugs should be easily affordable for you, you make a lot more money than I do.
If you had to choose between statins and semaglutide on my recommendation, then I would rather you pick the latter. Just talk about it with your doctor, as and when you see them again. If they advise against it, eh, that's fine by me.
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