I and my father have had wonderful results with Bempedoic Acid and Ezetemibe. However my father and I want to lower our ApoB and LDL from 65 (originally 130 and 120) to 45 so we are trying Atorvastatin. Our ApoB and LDL appear to move in lockstep. He has no side effects from Atorvastatin so I’m going to give it a go too and hopefully I won’t be intolerant to it.
I’ll be happy with an LDL and ApoB at 50 or below.
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Paiva
#658
I hope you get a goal that you aims.
I took benpedoic acid + ezetimibe and rosuvastatin 10mg. For get rid of leg pain I change rosuvastatin for Repatha. My Apob dropped from 56 to 32.
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Beth
#659
On repatha alone, my Apob had crept up to aprox 65 in March.
After I started rapa in April and added amla and ezetimibe (thanks to all of you!) my Apob just dropped to aprox 51. It’s the lowest it’s ever been! Attia says if you are high risk, aim for 30.
I wonder if benpedoic acid would do much more?
Either way, I’m thrilled
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Yes, Bempedoic Acid should also help.
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Sorry, a late reply, but, just ordered some aminoguanidine from the US outlet of SuperSmart to play with, but am not expecting much. It prevents some variants of AGE molecules from forming at an early stage, but is not a crosslink breaker. I.e. it may help prevent crosslinking, but won’t reverse it. Alt-711 (Alagebrium) does seem to break crosslinks, but I guess still didn’t perform will enough to merit continued development. (Of course, whether a drug works is one thing, whether to continue with its development is often a money/marketing decision).
Pyridoxamine at least seems to interfere with AGE formation at a late (post-Amadori) stage, which aminoguanidine was shown not to, as well as apparently interfering with AGE formation earlier stage s as well. If I recall correctly, the post-Amadori rearrangement, which is s late stage in AGE formation, is a relatively slow process, which makes me hope regular intermittent use of pyridoxamine may be beneficial. It was “taken off the market” in the U.S. because a company had it designated as an investigational drug, much the way David Sinclair tried (or is still trying?) to do with NMN.
However, even though the development of pyridoxamine as a drug - to prevent diabetic kidney disease - has ceased (as the studies didn’t meet their clinical endpoint), it still isn’t available here. But if you know someone in the U.K., yes, SuperSmart will sell it there.
Great news! It appears that I am not statin intolerant to all statins. Atorvastatin (so far) does not cause muscle soreness for me the way Rosuvastatin did. Hopefully I can now take a low dose Atorvastatin and reduce my LDL and ApoB to around 40-50.
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Bicep
#663
Take the GG with it and there may be no down side at all. Except the expense.
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Ludovic
#664
For your wife’s high lipid values you could consider fenofibrate nano 145mg. I started taking it 4 months ago because of its Lp(a) lowering effect. I don’t have any side effects that I am aware of and because it’s been on the market for so long, it should be safe longterm I suppose.
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mccoy
#665
Thanks Ludovic for the suggestion, in the meanwhile her GP did not prescribe anything else, just said to stick to ezetimibe (the lipids according to him are not excessively high).
I don’t know what to think about this attitude, the GP seems to fear a rise in liver enzymes (which took place with the very efficacious crestor) more than the high level of lipids and ApoB…
I’ll evaluate all suggestions if I decide to lower my lipids to bottom levels, I’ll also have to check them soon, last time they were pretty modest, already in the lower percentiles and maybe not worth an intervention, but levels do tend fluctuate.
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Davin8r
#666
That’s great, and I hope your experience is better than mine (failed every statin). Usually it took a while for the soreness to really kick in for me (up to a week or two), so I’d often get a false sense of security/relief before being disappointed.
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I have this personal theory that atorvastatin is better for men and rosuvastatin better for women.
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Yes, I’ve only been taking it a couple days so far…
zazim
#669
I think if you go into it assuming you will have no negative side effects, then you will be fine. That was certainly the case with me. The vast majority of people on statins have no side effects and when they do studies comparing statins to a placebo, both groups have similar side effects. 10 MG of Rosuvastatin and Repatha had a dramatic effect on lowering my cholesterol. I haven’t experienced any negative side effects or injection site issues. The combination reduced my LDL-C to 39 and my ApoB to 59 (LDL-P was 342). I wish I had started sooner.
It looks like I will be admitted to the Eli Lilly trial for lp(a). I just need to test high again, which should not be a problem!
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No. I didn’t expect side effects from Rosuvastatin but still got them. It took me a bit to figure it out too. Atorvastatin is much better as I have no side effects. The side effects from Rosuvastatin are real for me.
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Have you stopped bempedoic acid, if I may ask?
adssx
#673
Nonsense. From the FDA for atorvastatin:
See also: Prevalence of statin intolerance: a meta-analysis 2022
The overall prevalence of SI was 9.1% (95% confidence interval 8.0–10%).
The prevalence of SI in RCTs was significantly lower compared with cohort studies [4.9% (4.0–6.0%) vs. 17% (14–19%)].
Age [odds ratio (OR) 1.33, P = 0.04], female gender (OR 1.47, P = 0.007), Asian and Black race (P < 0.05 for both), obesity (OR 1.30, P = 0.02), diabetes mellitus (OR 1.26, P = 0.02), hypothyroidism (OR 1.37, P = 0.01), chronic liver, and renal failure (P < 0.05 for both) were significantly associated with SI in the meta-regression model. Antiarrhythmic agents, calcium channel blockers, alcohol use, and increased statin dose were also associated with a higher risk of SI.
Still, what is true is that, according to the National Lipid Association:
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That’s still over 90% who don’t get any side effects, i.e. the overwhelming majority.
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Agree. That is the reason why I am currently a bit cautious about statins and am currently testing ezetimibe due to its potential effect on BPH and its low-risk profile, as well as the prodrug bempedoic acid (started at 90mg daily). The only concern with bempedoic acid is the potential lowering of Acetyl-CoA in the liver. Somehow, there seems to be no “free lunch” in cholesterol lowering, as always. I am completely disappointed with Dr. Attia, who claimed that “PCSK9 and BA” are completely side-effects free 
.
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AnUser
#676
Statins have a low-risk profile.
Worrying about lowering Acetyl-CoA seems like mechanistic speculation.
adssx
#677
Of course, the vast majority of statin users are perfectly fine, and statins have a low-risk profile. I only commented on the nonsensical claim that detrimental side effects are in people’s heads (“if you go into it assuming you will have no negative side effects, then you will be fine”) and not reported in RCTs (“when they do studies comparing statins to a placebo, both groups have similar side effects”).
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