#1910

When they replace that one, can they put the one in that makes vitamin C out of glucose?

I don’t know why we let that one go either.

#1911

Thanks, I’ll give it a try.

#1912

Yeah. Let’s work on that.

#1913

I like the Doublewood Citrus Bergamot over Jarrow. Twice the amount for the same price. So a 50% discount.

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#1914

This paper describes microvascular inflammation as a major contributor behind all aging related diseases:

The importance of microvascular inflammation in ageing and a… : Journal of Hypertension (lww.com)

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#1915

Along these same lines, I’m really starting to buy into the PCSK- 9 inhibitors. It’s no easy task to get to my goal of ApoB/ ApoA-1 less than 0.8. Even just ApoB under 80 can require high dose statins for many people. Everyone knows how I feel about that for primary prevention, especially in the low cardiac risk patient, since I happen to greatly value my cognitive functioning, lack of muscle pains, and low insulin resistance.

The price of these medications has dropped from 14,000 per year to about 5000. Hopefully this trend will continue. For the high risk patient it’s worth the money even now.

https://www.atherosclerosis-journal.com/article/S0021-9150(23)05074-8/fulltext?dgcid=raven_jbs_aip_email

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#1916

Vince is great. I did an interview (podcast) with him recently. I’ll post it when I publish in the next couple weeks.

#1918

It’s evident by the fact that for example Peter Attia takes PCSK9 inhibitors instead of statins, that they are better, or the newer siRNA therapies inhibiting PCSK9. Those that can afford them easily obviously chooses them over statins, because of the question marks you take up. Most people cannot, so let’s not exaggerate the side effects of statins, which are rare and in most cases reversible, and long-term questions about cognition… well there is lipophilic statins, and it is speculation.

I haven’t read this study…but interesting assosciations between statins lowering relative risk of liver cancer, and other liver disease:

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#1919

No reason not to take statins if you have no adverse side effects. I am not going to argue the point again, but statins are probably the most tested and reviewed drug on the market. The cohorts in statin studies are in the millions.
Little downside and substantial upside.
For example from the article you just cited
" regular use of statins was associated with a 15% lower hazard ratio of new-onset liver disease and a 28% lower hazard ratio for liver-related deaths compared with no statin use. Moreover, a decrease in hazard ratio of up to 74% was demonstrated for hepatocellular carcinoma in regular statin users compared with non–statin users."

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#1920

I agree, if you do not get side effects, statins are 100% worth it, most people do not get any. For the intelligentsia, and some rich people, they can make the case that PCSK9 inhibitors are better, but it’s grasping at straws… Benefit-to-cost ratio is very low IMO. It’s just an intellectual discussion.

#1922

@rivasp12 Just because you get muscle pains doesn’t mean statins are bad. It’s just you’re unlucky.
Saying statins decrease cognition is false, because the results are mixed, and we don’t really know… and by how much. And there are statins which don’t cross the BBB.

Someone who gets muscle pains from statins…can literally replace them with something else, and the muscle pains go away… How can you not follow reason?

Do you really think people are getting dementia from Rosuvastatin and other statins…with so many taking them… Really?

Both President Biden and President Trump take Rosuvastatin, so it’s good enough for me, with all the other evidence backing it. They have the best medical care possible. If I get side effects I will try something else (I have tried on-and-off rosuvastatin ~0.8 mg x 3 week with no side effects, my apoB has been low so I haven’t been more diligent).

Yes, even though relative reduction is all great, it is the absolute number (what your LDL ends up, and stays at), that is important imo.

I have also looked on reddit, and I’ve seen many report that citrus bergamot didn’t do anything for them.

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#1923

After being on rosuvastatin for 3 mo, I had to discontinue because of constant and strong muscle pain, especially on my legs. It feels as if I over exercised, which I did not. I guess I’m unlucky with statins. It’s my 5th time to try them. Switched to CBergamot, psyllium husk, and pantethine. Will see where it goes.

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#1924

I know Sam Harris couldn’t take them either because of that side effect, it’s rare, but it happens, at around 10% of people. (I hope I don’t get them…). You should take a look at other pharmaceuticals by the way consulting a doctor.

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#1925

The first statin drug I was prescribed was Simvastatin (Zocor®) because it was a new and popular statin at the time. I experienced the same thing, muscle pain, etc. My cardiologist suggested that I try another statin. This time he prescribed Atorvastatin (Lipitor®) which has a long history and few side effects. It worked for me an I have had no side effects from it. I have tried going off of it a few times when I was experiencing some unknown cause muscle ache. It was never the Lipitor. I could not tell subjectively how I felt when taking it or not taking it.
Rosuvastatin currently seems to be the choice of cardiologists. My daughter was prescribed it recently and she has had no adverse side effects so far.
I might suggest that you ask your doctor to prescribe another statin. You might try Lipitor.

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#1926

As I have posted earlier, citrus bergamot extract, which I am still taking at doses of over a gram twice a day, has had no noticeable effect on my lipids. The mind is a powerful thing when it comes to the placebo effect. If I started marketing Sasperilla as a lipid-lowering supplement 30 to 40% of my customers would swear by it. It possibly works for some people but I don’t consider it very effective compared to a statin.

Also, I cannot find a significant controlled study that finds statins increase your chance of getting Alzheimer’s disease. This kind of study would be difficult to do because of the enormous cost of the study. Therefore what we have are observational studies. But my personal belief is that because statins also reduce inflammation it reduces all-cause mortality not associated with lipid reduction.

"Statins have been reported to reduce the risk and be of benefit in the treatment of Alzheimer’s disease (AD)
“In the current ancillary ADAPT study we found that elective statin use was associated with significantly reduced risk of incident AD after adjustment for age, gender, education and Apolipoprotein E (ApoE) genotype.D.”

https://www.ingentaconnect.com/content/ben/car/2008/00000005/00000004/art00009

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#1927

Using Biden and Trump as your examples of people on statins might not be your strongest argument, at least when it comes to cognitive functioning. If anything, that might be an argument against statins.

I’ll repeat this. I’ve been practicing medicine in the real world in an actual clinical setting for decades. Ditto for my associates. We’re all board certified in various medical specialties.

People on statins are very very common encounters, especially the high risk patient on higher statin doses. Not uncommonly, they’ll start off with the drug and report mild side effects, but when they return in several months, it’s a totally different story.

They’re sick and tired of the daily leg pains, that yes initially seemed mild, but are now driving them nuts. The daily use of ibuprofen is giving GI issues, or the Tylenol is affecting their liver, and they’re wary of taking laxatives all the time for the constipation.

They’re worried about the mental fogginess or word retrieval issues. They don’t like the idea of diabetes risk. Alan Green also actually sees patients and is becoming alarmed at the insulin resistance in statin users.
In a study environment, these complaints would all be considered mild, but in the clinical setting , doctors can’t just brush off these concerns and throw some studies in their face. Any decent doctor will take their patients seriously and look for option B.

If a patient is at high risk for a heart attack or stroke, they may well be willing to pay the $400 a month for a PCSK 9. They’re paying $1500 a month for weight loss injections to the point that the drug companies can’t keep up with the demand.

In the low risk patient, where intervention isn’t as critical, it’s nice to know that things like psyllium, bergamot, and Amla are options.

I do understand that since I’m actually dealing with people that I see things from a different perspective. But patients rightly expect doctors to listen carefully to All of their concerns, and not just brush it off as inconsequential or Rare ( which isn’t the case).

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#1928

Would love to hear that. He’s a brilliant guy and a pioneer.

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#1929

They are alive, and not dead, like how many start to be, who do not take care of their lipids, at that age.
Biden has gaffe’s, but I’ve seen him to be in good shape cognitively in recent videos. If people can become president or be president, I don’t think they have dementia…
My point was they have the best medical team possible, and they’ve chosen rosuvastatin, despite ‘cognition’ speculations of statins. Don’t you think they know about it too?

Highly susceptible to nocebo effect.

#1930

Yeah, well, the risk of taking statins compared to not taking statins falls heavily in favor of taking statins. Your high-risk, high-dose patients are not relevant to this discussion.

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#1931

FWIW

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