Too Much Medical Testing 

September 4, 2017

Maybe it’s the books I’ve been reading lately, but I’m getting even more skeptical about the expansion of medical testing that doctors want to adopt to help keep us healthy!

Here’s my most recent recommendations. I’ve read 1-4 and I’m working towards 5 and 6.

  1. Overdiagnosed: Making People Sick in Pursuit of Health – Gilbert Welch
  2. Less Medicine More Health – Gilbert Welch
  3. Worried Sick: A Prescription for Health in an Overtreated America – Nortin Hadler
  4. Selling Sickness: How the World’s Biggest Pharmaceutical Companies are Turning Us All Into Patients – Ray Moynihan
  5. How We Do Harm: A Doctor Breaks Ranks about Being Sick in America – Otis Webb Brawley
  6. Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care – Martin Makary

Here’s the current dilemma. Doctors do coronary artery CT scans to check for calcium blockage. The scan gets high marks for being non invasive (but they use radiation). However, in 2011, a JAMA study showed that this test is associated with a higher rate of subsequent invasive heart procedures and higher costs. Specifically, patients were twice as likely to have more invasive cardiac procedures compared to patients who only had the normal stress test. The risks also include cumulative radiation exposure.

Basically radiologists do this new Coronary Artery Scan and then they don’t know how to interpret the results so they have to do further testing. Their latest question is whether an asymptomatic patient that has a non-obstructive amount of coronary calcium should be treated with surgery and drugs to prevent more plaque from forming.

I’ve written about this procedure in blogs and in the latest edition of The Magnesium Miracle. I say “The Coronary Calcium Scan has not ‘caught on’ as a screening tool probably because there are no drugs to ‘dissolve’ the calcium in coronary arteries. Allopathic medicine continues to use stents, calcium channel blockers and statin drugs – ineffectively. In my world, excess calcium depositing in arteries means a relative lack of magnesium and magnesium is a treatment for calcium build up in the body.”

In an Aug. 15, 2017 Medscape article the questions are piling up. The most important one is “Should clinicians take action when an asymptomatic patient has a coronary CT scan that shows nonobstructive plaque, or should these patients not have these scans in the first place?” There are two diametrically opposing views. The interventionist view is that nonobstructive coronary plaque requires action because it’s only going to get worse; they are of ‘the plaque or no plaque’ mentality. The other view says there is absolutely no data that says a patient can improve cardiovascular . . . morbidity or mortality by identifying nonobstructive plaque in healthy people, and there are downsides, including exposing patients to radiation, creating anxiety, and giving people unnecessary procedures or drugs with potential for harm…we’re just making patients miserable.”

Doctors who want to intervene are convinced that there is no cure for heart disease, which makes them want to start drug treatment on patients earlier and earlier not knowing that it’s magnesium deficiency and heart medications that are driving the disease in the first place!

The doctors that don’t support coronary scans on asymptomatic people say that preventive therapies should be engaged. However, doctors aren’t paid to talk about prevention to their patients and they don’t have time in their 7-minute appointment to do more than write a few prescriptions! This is where magnesium comes into play.

Medscape had the anti-scan doctor describe the experiences of two recent patients. “The first, a 64-year old woman, had a few episodes of atypical chest pain and was sent for CAC scoring. Her CAC was 75, so she was sent for a coronary angiogram, diagnosed with a 30% ostial LAD lesion, and given “a bag of medicine”—aspirin, statins, calcium-channel blockers, and beta-blockers—that she did not take. She had no cardiac risk factors; her total cholesterol was under 200 mg/dL; her LDL was around 100 mg/dL, and she was very upset and concerned about why she had gotten all these medications I told her that she really was low risk and reinforced diet, regular exercise, and not smoking, which she was already doing. A second very similar patient took the statin drug and experienced memory problems that ceased when she stopped taking the statin.”

Medscape also mentioned a dramatic case published in the Archives of Internal Medicine.A 52- year-old woman with atypical chest pain but normal ECG, troponins, CRP, and other markers underwent coronary CTA ‘just for reassurance.’ Both noncalcified and calcified plaque were identified, so she had a coronary angiogram that was complicated by a left main coronary dissection that required emergency CABG. Postoperatively the graft failed, stents thrombosed, and she ended up with refractory heart failure requiring a heart transplant.”

My advice is to beware of tests and treatments that are done “just for reassurance” or “just in case” or to obviously cover a doctor’s backside. And my continued advice is to take dietary supplements that are effective building blocks to help you continue to be healthy. You can google my name and dietary supplements to see my recommendations 

Carolyn Dean MD ND

The Doctor of the Future®

SUMMITS:
Beyond Pain Summit with Dr. Audrey Schnell launches Sept 5-Sept 16, 2017.

RESOURCES: Along the borders and in the links of my web site you can find my books, writings, and my call-in radio show. Email your questions to: questions@drcarolyndeanlive.com.

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