Radiata
#18
Gemfibrozil reduces Lp(a) by about 18%, but had a wide error band of +/- 15% and wasn’t considered statistically significant. They took pretty high doses, of 2400 mg, which is a bit concerning from a gallstone risk.
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Well the not working well with grapefruit is a non starter. I could solve this whole lipid issue if I just stopped taking Rapa. But that seems counterproductive.
Any interaction between ezetimibe and grapefruit or anything else???
Hey RapAdmin, interested to hear what you think of this stuff. You can take it with Ezetimibe, I took fenofibrate w it for a cpl yrs… it actually DECREASES the risk of gallstones by adding Zetia/Ez….
what I found, though is that it really increased my fatigue and muscle pain. I experimented with adding a Statin and even rosuvastatin 5 mg twice a week was too much w the combo… I dropped the fenofibrate and Statin was still too much. Took a one or two month break from all of it, and then tried pravastatin by itself and still too much muscle pain…
I then went back to Fenofibrate after having been off it for a few months and it was just too much fatigue/muscle pain also. I rechallenged a couple times and still too much. I might try it again, when I first started taking it I had the same thing slightly but it went away, the last couple times it did not.
I actually really wanted to take bezafibrate over the years, that one doesn’t just hit PPAR Alpha, but Delta and Gamma as well, and it causes greater increase in Apo-A1, greater metabolic effects, etc… but it always caused me way too much fatigue and I’ve tried it for the last 20 years off and on a couple times… I think for me hitting the PPAR pathway lowers blood sugar/pressure or something… interested to see how you feel on it, people seem to do fine for the most part
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You have the same issue I and others here have. Statins and fibrates can cause severe muscle pain and fatigue. If you are not careful it can cause permanent muscle damage.
Also statins and fibrates can be toxic with grapefruit juice.
I have just gotten a prescription for 10 mg ezetimibe daily. It is the Acarbose version for cholesterol. It disables the enzymes that allow your body to absorb cholesterol.
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I have taken Ezetimibe for a long time… pretty weak on its own, but does really well in combination with a fibrate and esp a Statin, I am currently on Repatha and Ezetimibe, ApoB is 42-46…. Theoretically the fibrates should and do seem to cause fat loss and more so inhibit fat gain, due to increasing CPT , hitting ppar-a etc…
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Ulf
#23
On the video posted by RapAdmin, Brian Kennedy says one reason for choosing gemfibrozil is that it is safer than other fibrates. The studies bear him out. Muscle pain exists, but in less than one percent in the first link below and not mentioned in the other two.
The Helsinki Heart Study: an 8.5‐year safety and mortality follow‐up - Huttunen - 1994 - Journal of Internal Medicine - Wiley Online Library
10.1056/NEJM199908053410604 click on “Gemfibrozil for the Secondary Prevention of Heart Disease……”
Gemfibrozil is taken for downing triglycerides and increasing HDL; Impact on LDL and lp(a) is uncertain, most studies show no impact (see the last link above) others some reduction. However, there may be a beneficial change within LDL “We conclude that GEM significantly altered the composition and distribution of LDL subspecies with a shift from small dense LDL particles to large, less dense particles in HTG patients.
But our target is longevity. The Helsinki Heart study didn´t show any reduction in non-cardio related mortality for gemfibrozil, but perhaps this should not be any disappointment since it was not designed for longevity. We will know more when results are in from the trial I believe is taking place at Kennedy´s lab.
But I find what Brian Kennedy says in the video worrying: that when you take more than one supplement, you don´t know what happens. Positive effects can be cancelled and this is more common than additive effects. I heard more from him on this at a conference and find it so disconcerting that on the fly I decide to make a separate post on this.
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shc
#25
Have you incorporated Gemfibrozil in your regimen, @RapAdmin Would you have anything to report?
I have not yet ordered it. I plan to soon and will report if I start using it.
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Just a reminder that Grapefruit juice and Gemfibrozil have a negative interaction.
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Brian Kennedy stated that Gemfibrozil was the “safest”, but it does have the most drug interactions, something to think about for everyone interested in it. It does have the most positive data in reducing heart disease, though, both the Helsinki heart study and the VA- HIT study showed that it reduced events substantially. I have restarted Bezafibrate and this time I am somehow tolerating it ha ha. It keeps my blood sugar down about 10 points, in addition to whatever it’s doing on lipids that I haven’t measured yet. Beza has a lot of data too, it’s been around since 1980 and it has a lot of effects outside of lipids. The only big studies on that have been done after statins were re-introduced, so there’s a lot of statin contamination in those, but it does show, small benefits, and large benefits in people with metabolic syndrome. As I said earlier, I really think the fibrates can be used to enhance fat loss.
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Jonas
#29
The Q is if you have normal LDL and are already on a statin, would adding Gemfibrozil do more harm or good? In Kennedy’s study, is his population on Statin or not? what is the additive effect if any? Here is a study states Statin is better overall
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J0hn
#30
It’s interesting that Kennedy now says that it’s only gemfibrozil, of the Fibrate family, that has life extending properties, and that it has nothing to do with it’s PPAR-alpha properties.
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Ulf
#31
The study I saw showed less than 1% getting muscle problems from gemfibrozil. A significant minority gets this from statins.
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Statin hands down wins for CVD… gemfibrozil is just good for other pleiotropic stuff
AnUser
#33
McDonald’s diet is increasing my triglycerides levels, would gemfibrozil be good to lower these levels? I wonder with a combination of EPA or EPA + DHA. Statins seems to not be able to be used with it.
How about switching from McDonald’s to a pesco-mediterranean diet? That might be the best place to start for a smart guy like you.
Or at least switch to Subway. 
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RapMet
#35
Anything to report on this one, or you decided against it?
Ludovic
#36
Daily fenofibrate nanoparticle 145mg reduced my triglycerides from 90 to 63mg/dL. I started taking it for reducing LP(a).
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No - I’ve not pursued it. Not for any specific reason - just been busy and its low priority for me.
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Davin8r
#38
Have you seen any effect on your Lp(a)?
