#21

I’m not sure what monocolin K is but do take K for bones. I’ve about decided to just try the statin route but thanks for the info.

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#22

Hi ng0rge,

You’re right, LDL 269. :wink: As for other risk factors my BP is fine, as far as insulin resistance this is another measurement I’m wanting to ask my doc for, a fasting insulin level - learning all this thru this site and Peter Attia. Weight is 140 at 5’4” so not good, but not too bad either. My glucose was up to 100 last draw but the rapo might be affecting that as it’s usually 80’s and 90’s - doubt I have any kind of metabolic problem. Since you’ve also suggested adding the Zitia maybe I will ask for that too. Kinda hate to get on a statin but you guys tend to think I should and you all keep up with things much more than most doctors. Thanks again.

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#23

Some science…on Red Yeast Rice (RYR)

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#24

Literally just a lovastatin.

A. It’s true that red yeast rice, which contains monacolin K, a chemical that’s identical to the active ingredient in the cholesterol-lowering drug lovastatin (Mevacor), may reduce your LDL (bad) cholesterol and lower your total cholesterol. However, an independent analysis of a dozen 600-milligram (mg) capsules of red yeast rice products conducted a few years ago found that the actual monacolin K content varied widely — from 0.1 mg to 10.9 mg. (The lowest dose of lovastatin is 20 mg.) In addition, one-third of the products were contaminated with a potentially toxic compound called citrinin, which can damage the kidneys. The Food and Drug Administration (FDA) has blocked the sale of red yeast rice supplements that contain enough of the active ingredient to make them as effective as lovastatin because they haven’t undergone the drug approval process. Unlike FDA-approved drugs, supplements can be sold without proof of effectiveness and purity.

Can I use red yeast rice instead of a statin to lower my cholesterol? - Harvard Health

The only reason why anyone would ever consider that is because they fell for the “supplements = natural = good” and “medication = Big Pharma = bad” meme. Peak npc tier.

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#25

Sheesh I’m glad my current bottle is from Thorne as they are trustworthy from what I’ve read.

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#26

Yeah, the problem with supplements is they are not regulated, so they don’t have to provide any standard dosing for the active ingredient. It’s a crapshoot. No efficacy or safety studies required.

At least with pharma you know you are getting yourself in to for most part so you can evaluate your risk vs benefit ratio.

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#27

But that’s TRUE, I read it in the NEW YORK POST!

Yes, but a highly respected brand like Thorne is telling you the truth about what’s in it and they test so they know. But I would also recommend a statin. (that’s what I take)

I did too, but I started atorvastatin (10mg) and ezetimibe (Zetia 5mg) when I discovered my Lp(a) was high. It’s better to take low dose of both rather than a higher dose of just a statin. See if you have any side effects and be ready to experiment if you do. I’ll probably switch to bempedoic acid next time I order from India but it’s OK for now. Also think about adding CoQ10 because statins can deplete that.

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#28

Hi Mike yes I already have my liquid CoQ ready to go before even taking the test. Given my 0 score, my thought is to go with just 5mg Crestor for now - Attia says that knocks out 85% of ApoB he doesn’t think higher doses necessary. Test in 3 months if not significantly lower add the Zetia. Just messaged doc so will see what she thinks. I’ve heard Attia talk a lot about this Lpa will have to check it out suppose it follows along with ApoB. The guy who did my scan never heard of Attia or ApoB and was interested going to research it.

I have another question - when one states something is “in the family” such as cardiovascular disease, is there an age qualification to that? eg my mom and most of her 9 aunts and uncles all died of strokes or heart related issues but heck they all lived to high 80’s or into 90’s. Mom was 92. Most of us die of something by that age. Would the family members need to be in 50’s or so in order to say that, like with Peter Attia’s relatives, or at least to put an importance on it as far as treatment?

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#29

5mg rosuvastatin is 85% as efficious as 20mg rosuvastatin. 5mg blocks 45% LDL-C and 20mg blocks 55% LDL-C.

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#30

I hadn’t heard of Lp(a) but learned about it here (RapaNews). I wasn’t aware of any family history of CVD and my mom lived to 88. My ApoB was in normal range (87) but unexpectedly my Lp(a) came back high (195 nmol/L), they don’t normally correlate. Since Lp(a) is genetic (I told my brothers and sisters to check) and there isn’t yet a treatment, the recommendation is to lower ApoB. I still need to do imaging (CAC and/or CIMT) because I have no past testing (before this year) to go on. Lipidologists are currently stressing 2 things - test ApoB, in addition to the normal lipid panel…and test Lp(a) at least once, because that makes any ApoB particles that you do have, even more atherogenic.

PS. I would add Zetia (ezetimibe) from the get/go. I split a 10mg tab for 5 a day and the cost is reasonable.

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#31

Good thing your ApoB is fairly low given the high Lp(a). Is it a blood test or could I see it on my DNA I had done with 23andMe? So if it’s low, not as much concern re ApoB being high. So ideally they should both be done together but I bet most docs don’t know about either of these. Hope you can get one or both of those tests done would be good to get that baseline.

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#32

Yes, blood test. Higher levels in about 20% of population. If, like most people, your Lp(a) levels are in the normal range, then you should follow the normal guidelines for ApoB. Lp(a) doesn’t normally change much, check it once, if it’s normal you can forget about it.

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#33

I’m not a doctor, and there are a few doctors on here, so maybe they’ll clear this all up. Meanwhile the CIMT is an ultrasound of the carotid which is in the neck. I suppose the idea is that if you have managed to plug it then you probably have a problem elsewhere. They’re a little unreliable I’ve heard, but cheap. My neighbor was saved by one, they sent him straight from the gymnasium at the public screening to the hospital by ambulance, he got a surgery right away and lived maybe another 10 years. Smoker.

So the cheap ones are CAC and CIMT. The MRI type thing with Cleerly sounds like the best, but it’s like $1500 and you have to drive 5 hours.

Please chip in with the other options here.

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#34

My understanding (I haven’t had one) is that it takes a skilled and experienced operator to get a good image (ultrasound) and that it’s wise to use the same person if you want to compare results over time.

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#35

Oh so the carotid test is the CIMT, the one that shows soft plaque - I thought it was just like the CAC but showed soft vs hard wherever the CAC examined. Interesting! I had one then but it was thru Lifeline which I’ve heard isn’t reliable. Thanks for the info!

#36

CIMT and a “cardio test” are two different test.

“CIMT (Carotid Intima-Media Thickness) Test”

“What is Carotid Intima-Media Thickness (CIMT) Testing?”

“CIMT testing is a specialized type of ultrasound that is done on the carotid arteries (in your neck) to assess the lining of these arteries. Regular carotid ultrasounds evaluate the blood flow in the neck (which would be affected by larger blockages), but a CIMT test can measure the actual degree of inflammation and plaque that exists in the lining of the artery. It can also differentiate between soft plaque (the dangerous kind that can rupture and lead to a sudden heart attack or stroke), and hard plaque (calcified plaque that is more stable but when large enough can obstruct blood flow and cause serious complications). CIMT measurements can be done every 6 – 12 months to follow the course of disease, helping to verify improvements from prescribed medical interventions, or document that the disease is worsening and the patient warrants more aggressive treatment.”

Above copy is from;

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#37

Also review;

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#38

@Candleflower Your situation reminds me of what I recently went through with my 75 yo mother. She was diabetic (HBA1C of 10.5%) yet very low LDL at 96. So we never thought she would have a heart attack. She did the Lifeline screening every year and the results were always 0. There was no problems according to them.

9 months after her last Lifeline screening, she had stomach pains and thought it was food poisoning. She procrastinated but finally went to the hospital. When they were checking her in, they told her she was having a heart attack right then and they gave her baby aspirin and wheeled her off to the Cath lab where they put in 3 stents. She was very lucky. While they were checking her out, she also had a stroke which they then took care of. They kept her in the hospital for a few days and noted she had developed Afib.

She went home with a monitor, and the hospital noted that her heart would stop for up to 10 seconds at a time so she went back in and had a pacemaker put in instead of ablation. She was very fatigued and confused all the time before the pacemaker.

Now she is on about 14 different meds for her diabetes - Metformin and Empagliflozin ( 6.4% HBA1C now), she is on Lipitor (LDL of 32 now). Telmisartan (SBP went from 160s to 100s) Amiodarone for Afib, and a host of others. She is finally back to her old self and is going to cardiotherapy.

I hope that some of this may be a good reference for you. Find a good cardiologist and listen to him or her. If your insurance won’t provide you with the proper medications, order from India. We had to buy the Empagliflozin (Jardiance) from India as it was too expensive otherwise.

I hope that you and my mother will return quickly to good health and live long and prosperous lives.

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#39

I would work to get that down as much as possible; that is what I’m doing. I take a statin, bempadoic acid, and ezetimibe (1/4 tablet).

Read up here:

and if you really want to get into the science:

and

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#40

Hi Chris I remember your mentioning this in my other thread when I found out I had high ApoB but before my scan, which you all suggested. Did your mom have a CAC done? I’m wondering which is more important. Isn’t it the hard plaque that can break off and cause a stoke? I don’t think I need a cardiologist what would they do other than put me on a statin which I intend to go on, but will ask my PCP. Thanks for the info and glad your mom is ok!

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