#2682

Yes, it’s prescribed to me but I wasn’t taking it consistently. Now I will alternate it with rosuvastatin.

#2683

Oddly, seemingly similar statins have different results for different people.
When I first started taking statins I got muscle pains and didn’t even know at the time that that was a side effect of statins. Long story short: Having tried a few statins I landed on atorvastatin, (Lipitor) even though it is one of the oldest statins. And, it is probably the most studied statin by far.
So, I wouldn’t give up on statins. There are many to try.

4 Likes
#2684

Hi, do you have any particular favourite studies on this population? This area is where I feel there’s a good chance of finding long term safety data for extremely low apoB.

#2685

Using ubiquinol and/or vitamin k2 works for some people but not consistedly.

#2686

@LaraPo My apoB is 48 down from 73 1.5 years ago.

My apob stack

  • rosu 5mg x 2 every other day (to avoid weight lifting days). I’ve started reducing to 5mg every other day since my apoB is so low.
  • ezetimibe 10mg daily. I skip rapa day.
  • niacin 500mg alternating days with nicotinamide 500 mg. I skip rapa day.
  • vitamin b5 500mg daily. I skip rapa day.
  • fish oil daily
  • high fiber diet

I also aggressively manage blood sugar (HbA1c now at 5.5 down from 5.8 6 mos ago). I don’t know if that affects apoB but I believe it affects ASCVD.

5 Likes
#2687

Yes. Atorvastatin bothered me much more than rosuvastatin. I switched a year ago.

#2688

That’s pretty impressive from rosuvastatin eod. Is the drop from 73 to 48 primarily ftom the rosuva + ezetimibe? I.e. were you already high fibre, omega 3 and high exercise etc?

Out of curiosity what’s your blood pressure?

1 Like
#2689

Changes included

  • rosu & eze
  • vit b5
  • higher fiber; stopped dairy (was only nonfat)
  • less cardio exercise (due to knee pain which has now subsided; don’t know what caused it or stopped it)
  • stopped alcohol (1-3 drinks / year)
  • rapamycin
  • metformin
  • started / stopped LDN

BP has always been good: today was 100/61.
RHR was 41 this AM in a sitting position.

3 Likes
#2690

BP of 100/61 + 48 ApoB = eternal life?

That’s very impressive. How do you feel since starting the new regimen?

1 Like
#2691

Cancer and the heat death of the universe can still get him.

1 Like
#2692

I feel great when recovered from rapa and/or workouts. The combination of stress from: work, exercise (5-7 hours cardio + 3 hours weights per week), and rapa is a bit too much when all 3 are together. I am moving to a 2 week rapa cycle. Once I get my sleep working consistently I can get more aggressive (again) with rapa.

My latest effort is in HRV biofeedback. It’s going very well with an amazingly fast rate of improvement. I’m optimistic.

I’m interviewing Marco Altini of hrv4training soon to take a deep dive into HRV as a tool for stress mgmt vs training mgmt. I’m now using eliteHRV and hrv4biofeedback apps on my phone.

6 Likes
#2693

Mostly heard about it from Peter Attia’s podcast guests and then asked my cardiologist about and felt that he shared the view. Basically you see the low PSCK9 people doing well in general and the high PSCK9 people do poorly

Here is some of the history:

The discovery of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition is interesting. Nabil Seidah, a researcher in Montreal, Canada, identified PCSK9 encoded by a gene on chromosome 1.[1] Collaborating with a French group, they found out that a gain-of-function mutation in that gene was responsible for familial hypercholesterolemia in a French family. This was followed by similar findings from other researchers.[2]

In contrast, findings from the Dallas Heart Study showed that loss-of-function mutations in PCSK9 gene were associated with very low cholesterol levels and markedly reduced incidence of CVD.[3]

  1. Elguindy A, Yacoub MH. The discovery of PCSK9 inhibitors: A tale of creativity and multifaceted translational research. Glob Cardiol Sci Pract. 2013;2013:343–7. [PMC free article] [考研] [Google Scholar]

  2. Leren TP. Mutations in the PCSK9 gene in Norwegian subjects with autosomal dominant hypercholesterolemia. Clin Genet. 2004;65:419–22. [考研] [Google Scholar]

  3. Cohen J, Pertsemlidis A, Kotowski IK, Graham R, Garcia CK, Hobbs HH. Low LDL cholesterol in individuals of African descent resulting from frequent nonsense mutations in PCSK9. Nat Genet. 2005;37:161–5. [考研] [Google Scholar]

You can probably find more info about people with genetically lower PCSK9 through doing a lit search.

1 Like
#2694

if one were to start using one of those which would you suggest?

1 Like
#2695

Elite HRV is free but harder to figure out what to do. Hrv4biofeedback is $10 onetime fee on apple but is super easy to start using. It even helps you figure out your personal resonance breathing rate which I couldn’t do on my own. It’s a pick ‘em.

1 Like
#2696

Do you know if you are more an overproducer or absorber? That helps guy part of my decision making.

Abnormalities in cholesterol metabolism have been associated with patient response to statin and ezetimibe therapy for LDL cholesterol (LDL-C) lowering.

https://bostonheartdiagnostics.com/test/boston-heart-cholesterol-balance-test/

Can now be done from home in a cheaper way, here:

2 Likes
Sterols and Stanols for cholesterol reduction
#2697

I get angry at people saying false things that will get people killed. It’s ok to do so about flat earth, but not about this. Cardiovascular disease people have to be careful what they say IMO as it’s the only disease that can be prevented and treated well, and not think out loud. That is why this thread is my nemesis.

4 Likes
#2698

I think the original dispute was not about lowering apoB per se (disregarding the usual suspects of course) but about PCSK9i and their effect on all-cause mortality.

3 Likes
#2699

If CAC = 0 then LDL levels aren’t predictive of cardio event. See below.
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061010

2 Likes
#2700

Depend on the time period you are predicting over.

If you care about many decades or probably just about several decades it almost certainly does - and in a major way.

1 Like
#2701

Haven’t read the paper, but from a skim your conclusion seems like it may way off if this is the actual time period the paper looked at?

During a median follow-up of 4.3 years