--and the dust-up over Zetia and statins combined with Zetia of the last few days, points up the pitfalls not only of changing medical "standards", but how the standards get that way.

Mrs. D's description of how "normal" cholesterol levels have changed is a case in point--and quite often, these numerical standards change after assaults by pharmaceutical companies--not necessarily medical researchers with no ax to grind--that convince doctors and lab analysts of the "necessity" of some different range/level.

I too remember when a total cholesterol level below 200 was considered okay--it wasn't that long ago. Now, at most labs, the normal range for total cholesterol tops out around 160. And, for people who've already had adverse myocaridal events, many docs want to get it down to below 100. I have a heart surgeon friend (did two bypassses on my dad--I also tutored his son for SAT's, LOL) who believes this, and thinks everyone should be on a statin--he and I have some really interesting (though good-natured) arguments when I start claiming levels that low would interfere with vitamin d manufacture and absoption and would not provide a proper environment for the myelin sheathing of nerves to repair. (And I think vitamin D deficiency may well be a bigger problem than cholesterol levels at this point--I've yet to see convincing evidence that high cholesterol alone raises the risk of heart attack without concommitant high triglyceride levels and inflammation, represented by c-reactive protein levels--in fact, I believe, though I can't find the studies right now, that the latter has the highest correlation with myocardial events.)

For those who are worried about high cholesterol levels due to diet choice--not the ridiculous numbers some people have due to hereditary conditions (and this is not THAT common), I always suggest trying fish oil, fiber, and niacin first--all of those have long histories of reducing cholesterol levels. But the benefit won't be much if individuals can't reduce inflammatory levels and keep their triglycerides down (though the latter is helped greatly by proper essential fatty acid intake).

To me, this situation represents the whole rabbit hole modern pharmaceutical marketing takes us down--find, or redefine, a condition that is amenable to phramacological manipulation, whether it's a major health condition or not, tailor a new drug, or older existing one, to the condition, even if studies don't necessarily and unequivocally show the drug to benefit that condition, express surprise when taking said drug produces other conditons, tailor a drug to THAT condition . . .and so on etc., ad infinitum.

We become overmedicated, and deleterious interactive effects from these drugs . . .well, they can't be traced to/blamed on any one source, so the pharma companies, and physicians, are off the hook . . .

I'm not saying all drugs are bad--there are many, many that are life-saving, designed to fight obvious illnesses. But something's wrong when we start using such powerful substances without clear direct evidence not only that they are effective, but that there was a problem to begin with.