‘Why Doctor Doesn’t Always Know Best’ …
Greg Lance – Watkins
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Why Doctor Doesn’t Always Know Best
By MARCUS STEAD
How often do you question the advice your GP gives you? Are you aware of the intense lobbying that takes place between pharmaceutical giants and local GPs? Do you know how many more prescriptions are issued in the UK compared to just a decade ago?
My story, about how a prescription I did not need left me with serious health issues, should act as a warning for everybody. Here is the story of what happened to me, and the alarming evidence I discovered about why GPs prescribe so many unnecessary and sometimes harmful drugs:
During the summer of 2017, the toenails on my right foot became discoloured and brittle. It wasn’t a pretty sight, but I was in no pain whatsoever and didn’t feel the need to bother my GP with it.
Around late October or early November, I visited my GP about an unrelated medical issue that has since been resolved, and I showed him my toenails in case the two problems were connected. He said that he thought it very likely I had a fungal nail infection and that I’d have to go on a ‘tough’ course of tablets if that turned out to be the case. But first, he wanted me to provide a toenail sample so they could attempt to grow fungus on them in the laboratory to determine whether they were infected.
A few days later I dropped off my toenail sample at the surgery in the small container provided, and was told I would receive a letter in the post in due course. A number of weeks passed and I heard nothing. At no point was I in any pain, and the fresh nail near the bed was showing signs of becoming healthier and more ‘normal’ looking. Whatever the problem was, my body appeared to be finding its own way of treating it.
Shortly before Christmas, I received a letter asking me to make an appointment with my GP to discuss the results, but the letter stated this was no cause for alarm and that it was routine procedure. The Christmas holiday period meant there was a delay in getting a non-urgent appointment, so I did not see the GP until early January.
On this occasion, I saw a different GP, one I had never met before. She told me that the results showed I had a fungal nail infection (as expected). She took a quick look at my feet, and said that she would be prescribing me Terbinafine (sometimes sold under the brand name Lamisil, though not in my case). I was to begin with a 28 day course, which was to be followed by another 28 day course on repeat prescription, with a view to me taking the tablets for around six months.
But first, I would need a blood test to check my liver function was normal. Upon hearing this, I was immediately suspicious as to whether these drugs were really necessary. After all, I was never in any pain, I wasn’t feeling any ill effects, and by this stage a substantial part of the nail bed was looking healthy, as more fresh nail gradually appeared.
However, I went ahead and had the blood test about a week later. A further week passed and I phoned the surgery for the test results. I was informed that my liver function was ‘normal’, and that my prescription would be ready for me to collect within a few days.
By the time I collected my prescription, it was around the third week of January. I was very wary about taking the tablets. It struck me as a huge overreaction to a problem with a mild infection that was gradually clearing up by itself. At the absolute most, I should have been prescribed Terbinafine in cream form. The instructions stated I was to take one per day. Against my better judgement, I took my first Terbinafine tablet the following morning.
Within an hour, I sensed something wasn’t right when I went to the toilet and my urine gave off a copper-like odour. By the following evening, I was beginning to experience serious side effects.
First of all, my sense of taste was much diminished. I managed to eat a meal that evening, but I didn’t enjoy it. By the following day, I was suffering from an upset stomach, mild diarrhoea, a fuzzy headache, and a dry mouth.
Within a few days, eating a full meal became difficult. I had no interest in snacking between meals or eating desserts, and my portion sizes were much reduced. All food tasted like cardboard and my stomach had a ‘full’ feeling, even if I had eaten virtually nothing.
By the end of my first week of taking Terbinafine, the side effects became more serious. I was unable to sleep for more than about four hours at a time, and I began to suffer from very low moods for no apparent reason. I have suffered from tinnitus my whole life, but the ringing in my ears became louder and more intense than before. I found it difficult to concentrate on anything for long periods, which is very unlike me.
The days dragged by and the situation did not improve. Eating was a chore, I was permanently tired, I found it hard to focus due to continual ‘brain fog’ (not easy when I make my living through writing and broadcasting), my mouth was dry, the mild diarrhoea continued, and it was badly affecting my quality of life. I drank very little alcohol during this period, partly because of my lack of appetite, and partly because I dreaded to think what this Terbinafine was doing to my liver.
After three weeks of taking one Terbinafine tablet per day, I had lost a stone in weight, a dangerous amount to lose in such a short space of time. I looked noticeably thinner and my general wellbeing was suffering considerably as the symptoms intensified. A friend, who is no stranger to tough and gruelling medicine as a long-term cancer survivor suggested that a chat with my pharmacist would be a good idea, so I did exactly that.
I am quite a big fan of pharmacists. I find them more open-minded and less ‘preachy’ than GPs on the whole, and I strongly recommend them as a first port of call when suffering from mild health problems.
I took my packet of Terbinafine and the accompanying leaflet with me to my local Boots store and the pharmacist showed me to the private consultation room. I explained the situation to her and she read the leaflet, which listed the possible side effects. I had experienced most, if not all of them by this stage.
When I told her about the drastic weight loss and deterioration in quality of life, she without hesitation advised me to stop taking them. What happened next struck me as extraordinary.
The pharmacist, a bright woman in her late 20s or early 30s, told me that she, too, suffered from a fungal nail infection some time ago, and had refused to take the tablets upon reading the side effects and discovering that a blood test would be needed prior to starting the course.
Instead, she did her own research (how many GPs do that?) and discovered a far less severe course of action. She bought a bottle of white vinegar from a supermarket and a packet of cotton wool sticks.
For the next six months, twice per day, she would wash her feet, dip a cotton wool stick in the white vinegar, and wipe it under and on the bed of the infected nails. It required a lot of discipline, her boyfriend said she smelt like a chip shop, but over time the infection cleared up.
She advised me to do the same thing, and to ‘do a bit of Googling’ to discover alternative ways of treating it. I bought a bottle of white vinegar on my way home from Boots, but I didn’t feel the urge to ‘treat’ my nails in any way as by this stage a substantial part of my lower nails were clear and healthy-looking. But I have a plan of action if the situation changes.
Needless to say, I stopped taking the Terbinafine immediately. I had a little rant on my Facebook wall about the experience that same evening, and a hospital doctor wrote a comment below my post saying that prescribing Terbinafine was a massive overreaction and there was no way she would take it.
My health began to improve somewhat within 48 hours. I was able to eat and digest a full meal, but was not enjoying it particularly, and I still had no interest in desserts or snacking. The ‘brain fog’ gradually began to clear within a week.
That said, more than a month later, I am still far from fully ‘back to normal’. I still have a number of symptoms including a dry mouth, a skin rash on my hands and difficulty sleeping for more than a few hours at a time. My sense of taste is still much-diminished, and I have lost a further half a stone in weight. I am eating food, but I’m not enjoying it.
In other words, I was given drugs I don’t need, for a problem I don’t have, and whose effects I am still suffering from more than a month after I stopped taking them.
So why did this happen? We have an overly-deferential relationship with GPs in this country and with the NHS in general. Yes, they do a lot of good, but there are fundamental flaws in the system and they are far from always right.
The term GP stands for ‘General Practitioner’. As the name suggests, they aren’t really ‘experts’ in anything, but have a basic understanding of most areas of medicine. That is not to say all GPs are bad, or that everything the GP tells us is wrong, but we DO need to question what we’re told far more often. Yes, GPs have gone through medical college and passed numerous exams. But what they are told becomes dated very quickly, as new drugs become available and medical understanding increases.
To keep their medical understanding up-to-date, GPs frequently attend seminars, tutorials and networking days put on by major pharmaceutical companies, complete with hospitality (nice lunches etc). The drug companies provide the food and a pleasant setting (a conference centre or hotel) and in return they get the opportunity to ‘talk up’ their latest products. This strikes me as dangerously close to bribery. At its kindest, it can be described as ‘lobbying’. What these representatives are NOT going to do is give totally unbiased, independent advice about their products to the GPs in attendance.
These companies are often huge multi-billion dollar organisations who have a vested financial interest in getting people to take these drugs. They do not put on these events for GPs and provide hospitality for fun. They have huge pockets and a deep focus, and they know that such events influence the way GPs prescribe drugs. Even on a day-to-day basis, the average GP surgery is full of stationary, equipment and gadgets containing the branding of these companies, subtly and subconsciously reinforcing the message that prescribing their drugs is automatically a good thing.
This very obvious conflict of interest is not given anywhere near enough publicity. The number of prescriptions issued in the UK has increased 50% in 14 years, and GP surgeries spend half of the NHS’s drugs budget. Prescriptions for painkillers have increased 50% in 10 years. In Blackpool, one in five adults takes so-called ‘antidepressants’. Between 2005 and 2012, the number of young people prescribed so-called ‘antidepressants’ increased by 54%. In Jersey, the number of people being prescribed ‘antidepressants’ increased by 48.5% in the six years between 2010 and 2016. The average person in the UK receives FIFTEEN prescriptions per year.
Re-read that last paragraph. Those statistics are extraordinary. And when we consider how heavily lobbied GPs are by the pharmaceutical industry, these figures begin to make sense. Over the last few years, the drugs industry has paid $13 BILLION in fines in the USA alone for a range of unethical activities, including bribing doctors to prescribe their drugs.
GPs are, for the most part, ‘repeaters’ rather than ‘thinkers’. How many GPs seriously question what they’re being told, firstly at medical school but especially in seminars put on by pharmaceutical giants, or give anywhere near enough thought to the fact it’s in the interest of these huge companies to get as many people as possible to take these drugs? And how many GPs are courageous enough to send substantial numbers of patients away from their surgeries WITHOUT the prescription drugs they were expecting?
We need to be much more aware of the dangers of overprescribing antibiotics and the increasing problem of antibiotic resistance. One of the major challenges GPs face is distinguishing between viral and bacterial infections. Viral infections do not require antibiotics, but if a person has a bacterial infection and is not prescribed antibiotics, patients can die and doctors can get sued. Therefore, to avoid taking a chance, GPs resort to prescribing antibiotics for all infections, even though this presents far bigger risks in the long run.
A solution to this problem would be for GP surgeries to buy the machinery that instantly tells us whether the patient has a viral or bacterial infection via a blood sample. The problem is that the machinery costs £700-£800 and each test costs £4.50. But he NHS would recoup these sums when we consider that viral infections would no longer be treated with a prescription of antibiotics, and that the cost of the tests would be when offset against the cost of ‘free’ prescriptions, available to all patients in Scotland, Wales and Northern Ireland, along with a substantial number of less well-off people in England.
We take the ability of antibiotics to fight off infections for granted, but their effectiveness is declining as viruses evolve to resist them. It is no exaggeration to say that without antibiotics, life on earth as we know it would end.
Without antibiotics, many medical procedures simply wouldn’t be possible. It’s not just the case that doctors would not be able to treat your infected finger. They wouldn’t be able to do any more bone surgery. They wouldn’t be able to treat cancer. They wouldn’t be able to run intensive care units in hospitals. These are harsh realities, but they are also facts.
Drug companies aim to prescribe as many pills as possible to maximise profits, but it is certainly not in the interests of the human race to see antibiotics lose their effectiveness . 97% of patients in the UK who ask their GP for antibiotics are prescribed them. Younger people reading this may live long enough to see this doomsday scenario unfold unless swift changes are made in our attitude towards antibiotics. It is estimated that superbugs resistant to antibiotics will kill more people than cancer and diabetes combined within 30 years.
The culture of GP surgeries does not lend itself to a thoughtful, flexible course of treatment, with appointments generally lasting ten minutes or less, so a dogmatic ‘prescription cure’ is seen as the easiest and quickest way of resolving any issue, often without addressing the root cause, or assessing the side effects and long-term impact of the drugs they prescribe.
Perhaps the most dangerous example of this is how GPs treat people with depression. There is a conventional wisdom among drug companies that ‘depression’ is caused by a chemical imbalance in the brain, known as ‘the Serotonin theory’. The scientific evidence backing this up is underwhelming to say the least. The drugs companies even kept the finding of their own research secret until compelled to release them by Freedom of Information requests.
There is likely to be a far more pragmatic explanation – people become ‘depressed’ because bad thing have happened to them, and the way our society operates is largely to blame. Why are so many people so unhappy in modern Britain? Families are not as close as they were 50 years ago, and are often spread out around the country or even across the world. There is no sense of ‘community’ in many areas. All too often, people do not have a ‘support network’ in their lives. They may have lots of superficial relationships with work colleagues and others, but in many cases they won’t feel ‘close’ to many people living locally.
A child who has grown up in an unstable household with an alcoholic parent, an absent father, or a single mother with a series of ‘boyfriends’ coming and going (who may well dislike the child), will very likely carry large emotional scars well into adulthood. The child who was bullied at school will not forget it as an adult.
A lot of people who claim to be ‘depressed’ are actually alcoholics. Alcohol is a depressant and those who use it to attempt to temporarily numb the pain of experiences they are having in their lives are doing themselves no favours whatsoever. They are using alcohol as an excuse not to address the problem at its core, and when the affects wear off, they feel more depressed than they did before, and so the vicious circle continues.
But how many GPs who see a patient who claims to be suffering from ‘depression’ will seek to address its root cause, or send them for appropriate therapy, when they can prescribe so-called ‘antidepressants’ and get them out of the room within the 10 minute appointment slot? Very often, GPs diagnose depression using the ‘PHQ-9 depression questionnaire’, which is loaded with negative questions and does its best to force you to think about how miserable your life is and how unhappy you are. It does not contain questions to balance it up such as ‘how often do you feel positive and optimistic about life?’
Unsurprisingly, the PHQ-9 questionnaire was devised by a drugs company that makes ‘antidepressant’ pills. This is not a coincidence.
Nic Barrow, a therapist, and a friend of some years, shares my deep suspicion of ‘antidepressants’, partly because of his own experiences when he was younger. He says that he gives people who come to him claiming to be depressed five pieces of advice: 1. Cut sugar out of your diet. 2. Work like mad. 3. Surround yourself with three to four positive people. 4. Exercise rigorously two to three times per week. 5. Develop a purpose for living that is greater than yourself.
Most of us spend far too much time staring into hypnotic gadgets, or sitting at desks, or slouching on the sofa, or taking our cars for journeys of less than a mile. A brisk, half-hour walk each day is a good remedy for a lot of psychological problems people think they have. It also reduces the risk of obesity and cancer. It’s a win-win deal. If a more drastic remedy is needed, cold water swimming helps anxiety and depression. Our bodies respond to cold water in a similar way to an anxiety attack. As the skin cools down rapidly, the body enters a state of shock, flooding the blood with stress hormones. Once the initial shock wears off, the chemical surge leaves swimmers feeling euphoric, as the ‘skin stimulation’ releases adrenaline.
Exercise, diet, friendships and a job that makes you feel fulfilled are usually the keys to resolving issues relating to ‘depression’. Even if the solutions described here don’t work for absolutely everybody, it is surely advisable for them to get to the root cause of the problem with the help of therapy rather than to rely on pills.
To paraphrase Dr Robert Lefever, I want my moods to change. I want to feel happy when I achieve something worthwhile, or when a sports team I support wins. I want to feel sad when somebody I know dies, or I see an injustice while watching the news. This is all part of the human experience. So-called ‘antidepressants’ prevent people from fully experiencing life’s highs as well as the lows. Furthermore, the evidence they actually work in helping people suffering from depression when compared to placebos is also shaky to say the least. But even if they do offer some relief, it’s a treatment of the symptoms rather than the root cause.
And it gets more serious, still. There is a growing body of evidence that so-called ‘antidepressants’ have dangerous and unpredictable side effects. I have personally witnessed how somebody I know underwent a deeply unpleasant personality change after taking them. More than 40 million prescriptions for SSRI antidepressants were handed out by doctors in the UK last year. In a small number of cases, evidence suggests the devastating side effects can lead to psychosis, violence, and possibly even murder.
In July 2017, the BBC broadcast a Panorama documentary about this very subject. They focussed on the case of 20-year-old James Holmes, who had no track record of violence or gun ownership, but at the 2012 midnight premiere of a Batman movie in Aurora, Colorado, he murdered 12 and injured 70 people. The programme showed there was substantial evidence that the drugs he was taking may well have played their part, and this was by no means an isolated example.
Further analysis of this can be found by reading ‘Cracked’ by James Davies. I can also recommend two clearly-written and straightforward articles on the subject by Dr Marcia Angell, a distinguished American doctor, and certainly no crank, which can be read here and here.
But the scandal surrounding prescription drugs goes way beyond so-called ‘antidepressants’. There is no evidence that opioid painkillers work beyond the first four to six weeks, and cause serious side-effects beyond that. In the long term, they may well make the pain worse, not better, and the withdrawal symptoms can be deeply unpleasant.
Raised blood pressure, raised levels of cholesterol and type two diabetes are not ‘diseases’. To a large extent, the risks they present can be remedied by exercise and moderating their diet. Giving patients supportive programmes for exercise would be more effective than medication, such as encouraging them to join walking groups.
Instead, there has been an intense campaign by the pharmaceutical giants to get more and more older people to take Statins (though the age at which people are encouraged to take them is getting younger and younger due to lobbying), and, as usual, GPs have followed this advice. Indeed, in recent weeks, a number of newspaper articles have appeared that have stated that ‘half or Britons’ will be offered ‘high blood pressure tablets’, while curiously the word ‘Statins’ failed to appear in any of them, which struck me as extremely odd. Most newspapers who covered the story did so sympathetically. It was as though they were relying on a press release from a pharmaceutical giant for their story, or maybe it was a press release from the NHS, who in turn had been lobbied by a pharmaceutical giant. If it carried the ‘NHS’ tag, it would make the press release appear more trustworthy.
Statins have a considerable number of common side effects, including a sore throat, nosebleeds, headaches, constipation, and muscle and joint pain. I have two stories from older people I know personally, who have had negative experiences with Statins.
One friend of mine, a man in his mid-70s, had been suffering from joint pain and mobility issues for some months. Upon reading an article in the Times about the side effects of Statins, he decided to stop taking them, and within days, he phoned me to tell me of an astonishing improvement in his mobility and overall health.
The other story comes from a man in his 60s who works as a writer, and he complained of a ‘brain fog’ soon after beginning to take Statins, though it cleared up fairly quickly soon after he stopped taking them. This is merely anecdotal, but it does appear to me as though a lot of people who take Statins become much more ‘doddery’ and unclear in their thinking, though it does appear the effects are reversed when they stop taking them.
Indeed, there is now growing evidence that Statins and even hayfever pills could be driving antibiotic resistance by changing the growth of bacteria in the human gut. Surely we should at the very least pause the mass prescription of Statins with this in mind?
The information in this article may appear shocking and outrageous, but we need to consider how medical advice has changed within the last 50 years. The Thalidomide scandal was a particularly prominent example of ‘bad medicine’. But those of you old enough to remember the 1970s (I am not!) will recall how after donating blood, you would sternly be told to take iron tablets. This is now considered completely unnecessary, possibly even harmful.
Furthermore, in the 1970s, burns were treated using greasy creams, which is now considered one of the worst things you can do. It was around the same time that X-ray machines disappeared from shoe shops, and today, we are told that X-rays should be kept to the absolute minimum.
Even in the last 15 years, the piles of old magazines have disappeared from my GP surgery waiting room, as they are considered a means of spreading viruses.
As times change, medical advice changes with it. The heavy lobbying by multi-billion dollar pharmaceutical giants is causing numerous drugs to be accepted and prescribed without sufficient scrutiny. 50 years from now, we will look back on this as a major scandal.
In the meantime, we ought to be far more questioning about what we are told by our GPs and be wary of the multi-billion dollar forces that influence them.
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