There are a few medications and supplements that specifically target inflammation. Statins, ezetimibe, pqq, colchicine, boswelia…
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Beth
#23
I was just going down the rabbit hole to figure out why one chooses bempedoic acid over ezetimbe or vice versa… or if i should be doing both. I just started ezetimbe this week, thanks to the good folks here! Is this study why you have chosen BA, I assume?
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Bempedoic Acid and Ezetemibe are usually combined in one pill. Bempedoic Acid is similar to a statin in effects but only affects the liver unlike stations which affect the whole body. Bempedoic Acid doesn’t have a risk of causing diabetes or muscle soreness.
I am intolerant to statins so I am thankful there is a statin alternative - Bempedoic Acid.
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More or less in declining order of impact in the absence of non-specific conditions, these are the dietary supplements for which there is decent evidence of reduced inflammation. I’m using inflammation as a generic term when, in fact, there are many different types with each type holding different health implications. My personal opinion is that we want to have low baseline inflammatory markers but a rapid inflammatory response. We would all be long dead were it not for inflammation and it could be beneficial to maintain a certain baseline of some kinds of inflammation. The benefit curve could be a skewed U-shape.
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Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fatty fish and fish oil supplements, have potent anti-inflammatory effects. They modulate the production of pro-inflammatory cytokines and eicosanoids, leading to reduced systemic inflammation. Consuming fatty fish like salmon, mackerel, or taking high-quality fish oil supplements is recommended.
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Curcumin, the active compound in turmeric, has demonstrated significant anti-inflammatory properties. It inhibits various inflammatory pathways, including the NF-kB pathway, and reduces the production of pro-inflammatory cytokines. Consuming turmeric as a spice in cooking or taking curcumin supplements can help reduce systemic inflammation.
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Polyphenols are abundant in fruits, vegetables, tea, coffee, and red wine. They possess antioxidant and anti-inflammatory properties, helping to reduce oxidative stress and inflammation in the body. Consuming a diet rich in colorful fruits and vegetables along with moderate consumption of tea or coffee can provide beneficial polyphenols.
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Vitamin D deficiency is associated with increased inflammation. Supplementing with vitamin D, especially in populations with low sun exposure or inadequate dietary intake, can help reduce systemic inflammation. Vitamin D modulates the immune system and has anti-inflammatory effects.
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Probiotics, especially certain strains like Lactobacillus and Bifidobacterium, can help modulate the gut microbiota and reduce inflammation. A healthy gut microbiome is associated with lower systemic inflammation. Consuming probiotic-rich foods like yogurt, kefir, or taking probiotic supplements can be beneficial.
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Vitamin C is a now somewhat overlooked but powerful antioxidant that can help reduce inflammation by scavenging free radicals and modulating immune responses. Consuming foods rich in vitamin C, such as citrus fruits, strawberries, and bell peppers, or taking vitamin C supplements, may help decrease systemic inflammation.
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Magnesium deficiency has been linked to chronic low-grade inflammation. Magnesium supplementation can help reduce inflammatory markers and improve immune function. Consuming magnesium-rich foods like nuts, seeds, whole grains, and leafy greens or taking magnesium supplements can be beneficial.
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Zinc is involved in immune function and has anti-inflammatory properties. Zinc deficiency is associated with increased inflammation. Consuming zinc-rich foods like meat, shellfish, legumes, nuts, and seeds or taking zinc supplements can help reduce systemic inflammation.
This is not an exhaustive list. Ginger, for example, might fit in there someplace as might astaxanthin.
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I started taking manganese 5mg per day about 8 months ago based on this.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529386/
But like many things too much can have serious side effects.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980854/
I also measure my PWV (pulse wave velocity) every morning, results here.
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Great list-thank you. Wanted to add: sauna or hot whirlpool, especially alternating with cold plunge. I don’t do the cold plunge but do alternate hot/cold --whirlpool-laps-whirlpool. There is some evidence this helps with inflammation --and it just feels like it does. Rhonda Patrick and Peter Attia both talk about it.
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Thank you for the Mn toxicity article. Do you have any metrics or have you observed any effects that you can attribute to Mn?
I posted a link to my results in the above post. I’d attribute a significant portion of the improvement to manganese supplementation.
But I “think” that with the other interventions, that the combination of things is also a significant factor.
There is no silver bullet and there is no one and done intervention as we age.
After all, there are currently 12 Hallmarks of Aging 
@Beth for me, CVD prevention has many layers. Lowering apoB is a layer that is a primary need for anyone who has confirmed plaques or related family history. Statins work great for some people (apparently) but not for me due to side effects. No problem. I’ll move to the next thing. BA is now in my home waiting for me to get home.
Layers (off the top of my head)
Metabolic health - exercise, sleep, good body comp, training the body to have metabolic flexibility (burn carbs and burn fat and switch between them easily). A diverse Whole Foods diet with mixed macros, Akkermansia, targeting 4.9 HbA1c
Artery health - nitric oxide, exercise, sleep. Low BP
Immune health - gut health and bone (marrow) health through diet and no antibiotics and select supplements. Low hsCRP and rarely get sick.
ApoB lowering - ezetimibe to reduce absorption, BA to reduce liver production, berberine (poor man’s pcsk9 inhibitor) to increase ldl receptor activation
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I was intrigued with your ability to measure PWV at home so I looked up the Withings scales and found that this feature is not available in the US. It could be just the App. I wonder if there is a way around this US limitation. Great information!
The feature is available but in a slightly different format. In Europe where this scale is an approved medical device you see the actual number on the display of the scale.
In the US and Canada you see a slider that indicates low, normal and high.
BUT you can download the raw data from the app and that is what I did to provide the 3 years of data in my post
Withings has some very cool home use devices.
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Thanks! (Drat! This software requires >19 characters to say thanks.)
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Thank you for the reference to Vyvyane Loh. I listened to her explain her model of arterial degradation. It seems to align well with the research in general in noting both the importance and the insufficiency of attending to inflammation, and the importance of focusing on Apo(b) particle count as the primary goal, perhaps with inflammation as part of that goal but that was not addressed.
The podcast ended with the question of how best to reduce the Apo(b) count by transitioning to promoting her services. She said the best way will depend on one’s unique circumstances.
I can appreciate the value of her services, especially for individuals having weight, diet, and illness challenges. However, I wonder if the best path to managing Apo(b) is not already well defined for fit older adults of normal weight and muscle development. If diet alone does not do the job for this population, isn’t the next step determining which pharmaceutical works best with the fewest side effects?
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This AI table (unverified but similar in three LLMs) provides a snapshot view of the pharmaceutical interventions to reduce Apo(b) and inflammation.
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@RobTuck as you say, her services are for people with obesity and metabolic issues. For the rest of us, I agree we have many levers to pull to see what works and what doesn’t. I’ve gotten off the statin bus, however. Side effects are a key part of the discovery process. I don’t know if mitochondrial health is more important than apoB particle count, but it is unquestionably important for more than CVD.
My doctor has finally agreed to try for insurance approval for a pcsk9 inhibitor. In any case I have Bempedoic acid to start once I get home. I’ve taken my last statin.
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Neo
#37
That’s great. Keep us posted.
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It seems that your table may be off for Bempedoic Acid? The literature I read is that Bempedoic Acid + Ezetemibe will reduce ApoB and Inflammation by about 45%. That’s exactly the results my father and I obtained as well. N=2
The chart below shows BA by itself lowers LDL by 32% and CRP by 42%. Add in Ezetemibe and you get about 45% and 45% which is exactly what I and my father experienced. The decrease in LDL was mirrored by our decrease in ApoB by percentage.
The benefits showed up in the bloodwork within the first 4 weeks. Our starting LDLs were 120 and 130. So we mirrored the participants in this study.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8915986/
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LaraPo
#39
Did you have any changes in renal panel biomarkers while on bempedoic acid?
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Yes, my renal indicators got slightly worse. However they were top notch before so I’m not sure if it was noise or an actual change.
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LaraPo
#41
I was just prescribed Bempedoic acid by my cardiologist, but my nephrologist warned me that it may affect kidney function.
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