Why Is It That Nothing Is Ever Easy?

Thanks go to Michael for asking an interesting question about why I stopped an antibiotic regimen. It points to difficult decisions we all make, some esoteric questions about using statistical analysis, and how heart disease can make your head spin.

I stopped the doxycyline because the effect (MMP suppression) is supposedly durable (its effect is permanent according to the initial studies but we have no long term data yet). I don't yet understand the durability aspect and am researching it (this all new stuff). The azithromycin was stopped because all the studies said it was worthless. So what remains is my anomaly. Here is the problem.

In a statistical sense we are all sample populations (the variable "n" in a statistical analysis) of one. As we all intuitively know, an "n" of one is not large enough to make an inference about a larger population in any analysis. However, that does not mean that "nothing" happened. It just means we cannot infer the same outcome will occur in another population (i.e. someone else). Also in statistical Design of Experiments (DOE) there is the problem of "confounding factors." In layman's terms, it means we all take so many damn medications, supplements, eat different, live different, etc. that it is often statistically impossible to determine with any confidence that a particularly factor (taking an antibiotic) was the primary or even contributing factor in any outcome (disease reversal).

So here I sit. After six scans, the ONLY time I either stopped progression or significantly limited it (below 10%) is in years when I took a course of antibiotics. Now every cardiologist I know who is up on the latest studies will tell me I'm nuts if I think the antibiotics had anything to do with limiting plaque growth. Remember, the doxycycline is to reduce MMP which inhibits plaque rupture, not plaque growth and large scale studies show azithromycin (one-time thought to be a magic bullet) to be worthless. Taking long-term antibiotics without hard proof of some beneficial effect is pretty stupid for obvious reasons. So what the hell do I do?

Now don't get me wrong. There is another possible explanation here and that is this newly postulated effect where niacin loses its effect against lipoprotein(a) which is my real problem. As I mentioned earlier, I am about to take a baseline blood test before withdrawing niacin and then restarting it later (yeah, yeah, HeartHawk, the human test lab). The bottom line here is that even I have doubts, suspicions, and anxieties even though I study this stuff almost everyday and can dice up the statistical data like a Japanese teppanyaki chef. Yup, heart disease can make you a real head-case. And I bet you thought you were the only one going crazy!

Hey, misery loves company.


HeartHawk