Statins [often used to reduce rapamycin-increased LDL] inhibit coenzyme Q10 AND GGP/MK4 AND dolichol AND N-linked glycosylation (+ other negative effects)

[AnUser]

Because it is weaker it is not enough in my opinion. I take 10 mg atorva and 5 mg ezetimibe.

[AlexKChen]

How about squalene synthase inhibitors or inhibitors of one of the other numerous enzyme intermediate

[AnUser]

Did you know that the largest clinical trial ever in the United States for age >=75 is currently studying atorvastatin, for aging?

[JKPrime]

Pcsk9 inhibitors like repatha, which come as injectables. The best approach is to combine it with low dose statins. In this way you are avoiding negative side effects of larger statin doses.

[AlexKChen]

Details?

It’s still possible it decreases aging rate, but the coenzyme q10 issues are really true, and the more supplements you already take, the easier to lapse on some of them

[AnUser]

Rosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial (2023)

Another massive study testing atorvastatin in older adults for healthspan! The recruiting PREVENTABLE study, where 20,000 older adults above age of 75 is randomized to 40 mg atorvastatin or placebo. Atorvastatin, and all statin medications, do more than just lower cholesterol. These drugs also reduce inflammation and they may help prevent memory loss, improve physical function, and even prevent cancer. Lipid levels are most useful to help understand an individual’s long-term health risk to prevent heart disease, but you have already lived past age 75 without heart disease. Congratulations! From the FAQ (2022) [image] So two massive trials are expected to be done for atorvastatin at 40 mg in older adults: STAREE and PREVENTABLE. Whether initiation of statins could increase survival free of dementia and disability in adults aged ≥75 years is unknown. PREVENTABLE, a double-blind, placebo-controlled randomized pragmatic clinical trial, will compare high-intensity statin thera…

[AlexKChen]

Zoledronate (Zol) is a nitrogen-containing bisphosphonate, which inhibits the farnesyl pyrophosphate synthase enzyme, central to the mevalonate pathwa

[essexaid]

I had been taking Ezetimibe 10mg daily along with Atorvastatin 80mg. However, I recently dropped the Ezetimibe due to it appearing to block absorption of Omega 3.

https://pubmed.ncbi.nlm.nih.gov/28531469/

I originally started taking Omega 3 to help reduce triglycerides but I recently tested for Lp(a) and it came back at 187 so I have increased the dose of Omega 3 to 4g per day. I have also started Niacin at 500mg and will slowly titrate up to 3g per day once I get the flushing under control. Thankfully my ApoB came back at 83. Any other ideas for things to try?

[AlexKChen]

Why don’t most statin users feel more tired from coenzyme q10 depletion

[AnUser]

I would read a bit more about Praluent (which probably reduce all-cause mortality), and Lp(a), then probably try and persuade my doctor based on the latter to get a prescription to lower apoB even futher, and Lp(a). Or possibly get it from elsewhere. Your apoB is pretty high in my opinion especially which such a high Lp(a) but doctors don’t understand it so much.

@AlexKChen

Why don’t most statin users feel more tired from coenzyme q10 depletion

Is the implicit premise that COQ10 depletion make you tired, even correct?

[AlexKChen]

The MISSING Piece of the Anti-Aging Puzzle?? A Molecule Essential For Muscle, Hormone And More!!

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.111.028571

[Virilius]

Evidence for CoQ10’s use in humans or even in mice is low.

[essexaid]

Thank you @AnUser. I had naively assumed that my ApoB was good since it was within the reference range so I really appreciate you pointing that out - I should have known better by now!

My GP has agreed to refer me to a cardiologist based on my Lp(a) level which will hopefully be the next step towards being prescribed a PSK9 inhibitor or at least being on the list for specific Lp(a) targeting drugs when they eventually get approved. I am grateful for your help.

[essexaid]

I don’t think I feel any more or less tired on statins. However when I supplement with CoQ10 I find that it reduces (but does not eliminate) statin induced muscle pain for me. It’s a subtle enough effect that I have taken it on and off over the four years of taking statins but on balance I would say it helps (for me anyway, even if it is a placebo).

[AlexKChen]

Peter Attia Dives Deep on STATINS (side effects & the best alternatives)

Plant sterols more atherogenic than cholesterol??

Just nexlizet it solves everything

[LukeMV]

It seems like the evidence is way better when you combine it with selenium.

[LiveLonger]

This is my experience too. More muscle tightness, especially in the legs. It resolved when I started taking CoQ10. I agree it is a subtle difference.

[DeStrider]

Use Bempedoic Acid. It doesn’t affect CoQ10.

The statins, as you know, do affect coenzyme Q10 . Bempedoic acid doesn’t.

According to the manufacturer’s labeling, there are no known contraindications to bempedoic acid. Serum uric acid levels have been observed to increase in patients taking bempedoic acid.

Bempedoic Acid to Reduce LDL-C

[jwpenuel]

I was on simvastatin for over 10 years and developed peripheral neuropathy which is a rare side effect:

Statins and Neuropathic Pain: A Narrative Review - Pain and Therapy

Apparently, CoQ10 deficiency due to inhibition of ubiquinone synthesis is the mechanism behind this process. I stopped simvastatin and have been taking CoQ10 and Vitamin E for the past 3-4 years with gradual improvement. I am on Repatha which had successfully lowered my LDL. Repatha does not have the same anti-inflammatory effects as statins and outcomes data shows only a small reduction in cardiovascular events compared to statins or combined statin plus Repatha:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094613/pdf/CD011748.pdf

I have researched bempedoic acid and am still a bit leery of potential side effects given my prior history.

[AlexKChen]

Can you just take several times a week to achieve meaningful benefits?

Peter Attia on the INSANE Longevity Benefits of Low ApoB (how to lower ApoB with diet)

Carbs carbs STAY AWAY FROM BREAD (even acarbose can’t blunt all the apoB/TG synthesis that then turns into LDL after)

I experimented with eating lots of mr tortilla and Ezekiel bread with acarbose but now am cutting it out for beans