zazim
#182
scta, you continue to dig yourself deeper. He always emphasize his lifestyle before drugs. You are just like the people on Twitter darkly talking about people on rapamycin always looking old or having strokes or having cancer.
scta123
#183
Maybe you are right, it was just a thought. I am just very conflicted about lipid lowering therapies, especially statins which in theory should be much better than they are in reality and the fact that I am always wary of one sided argument. I believe that apoB are causal but on the other hand lipid lowering medicines don’t bring the desired reduction which points in direction that there is much more unknown about ASCVD than known. And lipids are just one (albeit important) factor in ASCVD, but not the only.
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Mostly because they are used in people who already have advanced ASVCD and only use them for a short amount of times in the studies. Statins don’t completely crush apoB by themselves either. Still, they are central to slowing down or even preventing ASVCD altogether. Additional medication and lifestyle changes will result in further protection but totally disregarding statins because they are not the ultimate solution is irrational.
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zazim
#185
Yes, I agree with everything you say. I think it is much more complicated. I think it is clear that metabolically unhealthy people, and especially diabetics, have more CVSD. A big part of the issue is the focus on LDL-C. A high percentage of the people with MIs have LDL-C less than 70. No one ever tested their ApoB in all likelihood.
In this chart, the steeper the curve, the worse the outcome. The commentary noted that the gold curve almost certainly had a large percentage of insulin resistant diabetic people with small triglyceride rich particles. Statins might help, but it wouldn’t address the underlying problem.
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Genja
#186
Rosuvastatin lowered my ApoB from 104 to 63 after 30 days at 10mg / day. Im overjoyed. I will prolly add Ezetimibe shortly to try to get below 50.
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jakexb
#187
Rosuvastatin taker here. I literally get side effects from everything but I have had zero issues from rosuvastatin. Just instantly lowered LDL. It’s been great for me.
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I have recently added Ezetimibe to my mix. So, far it has had zero noticeable side effects.
My next blood test will tell me how effective it is. I am substituting Ezetimibe, Pantethine and some other supplements that are supposed to drop lipid levels. We will see if the result is as good as the statin (Lipitor) that I was taking.
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For anyone worried about muscle pain, you can always stop the statin. And you can try every other day dosing. I use 10mg of rosuvastatin every other day. I get the same apoB / LDL-C as I did with 5mg everyday. But I have zero muscle issues now by not dosing on my lifting days. I also take ezetimibe everyday. I’m aiming for sub 60 apoB. I need another 5 points.
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I believe novos recommends simvastatin which is why I started it. I want to get my hands on fluvastatin, but its not always in stock from the Indian pharmacies, unfortunately. I’ve read some statins can down regulate sirt 6, but fluvastatin enhances it?
My ldl wasn’t good (134), so I started taking high dose 40 mg simvastatin, now im on 20 simvastatin and 10 ezetimibe. Unfortunately my glucose has taken a hit, I was at 93 fasting glucose, now I’m at 97 while taking 25 jardiance and acarbose (though I’m taking other things which might affect glucose). I don’t know if this is just an unfortunate coincidence, but my hunger has went up coinciding with the ezetimibe switch
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Wow - good information, thanks for posting. Thats really interesting - I’m going to dig into that a little more. From my initial impression of the research right now, the SIRT6 sirtuin seems much more likely to have a longevity effect than any of the others.
We find that fluvastatin inhibits Sirt1–3 at higher concentrations but has a unique, activating effect on Sirt6.
Structural Basis for Activation of Human Sirtuin 6 by Fluvastatin
https://pubs.acs.org/doi/abs/10.1021/acsmedchemlett.0c00407
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Price of Fluvastatin (from India sources) is cheap as dirt.
Anyone here have experience with Fluvastatin? Are downsides more than other statins in your experience?
It looks pretty good from a side effect profile, and no interaction with grapefruit juice for those doing that protocol…
Adverse effects
Adverse effects are comparable to other statins. Common are nausea, indigestion, insomnia and headache. Myalgia (muscle pain), and rarely rhabdomyolysis, characteristic side effects for statins, can also occur.[6]
Interactions
Contrary to lovastatin, simvastatin and atorvastatin, fluvastatin has no relevant interactions with drugs that inhibit the liver enzyme CYP3A4, and a generally lower potential for interactions than most other statins. Fluconazole, a potent inhibitor of CYP2C9, does increase fluvastatin levels.[6]
(82 rupees to the $US)
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AnUser
#193
According to Thomas Dayspring there is no difference between the statins and crossing the BBB, so it’s a wash for side effects on potential increase in Alzheimer’s disease risk. From oversupression of synthesis in the brain.
And I thought I was so clever in taking Rosuvastatin over other statins…
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But Dayspring is coming from the lipid perspective only, not the overall health perspective (I suspect). While I haven’t had time to dig into it, a statin that boosts SIRT6 might seem to have additional health benefits above and beyond the lipid lowering benefits…
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AnUser
#195
My point is that there’s nothing stopping at least me from trying other statins now that’s out the way. I have to confirm again he said that and I didn’t dream about it…
I don’t know anything about boosting SIRT6, but isn’t there other things that can be used for that? If so why aren’t we doing it (supplement, etc)? Some googling suggest there could be SIRT6 boosting supplements.
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For those with drastic glucose increases on other statins, I think I read fluvastatin relative to certain statins doesn’t raise it as much (like the one I’ve been taking - simvastatin) Effect of statins on fasting glucose in non-diabetic individuals: nationwide population-based health examination in Korea | Cardiovascular Diabetology | Full Text
Kachhela and another popular Indian supplier were out of fluvastatin when I asked about a month ago, hopefully one of these suppliers has it
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scta123
#197
I believe David Sinclair works on sirtuins as a health and lifespan regulators… they are linked to metabolic control, apoptosis, cell survival, development, inflammation, and healthy aging…
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scta123
#198
Maybe check the video I shared a while ago. It is very informative on the subject…
AnUser
#199
It mostly important for us with APOE4 alleles, they are quite rare. I’ll continue to probably take statins until PCSK9 inhibitors are off patent unless I can’t get optimal apoB levels.
If I didn’t have APOE4 alleles I’d not care at all about “alzheimer’s - statins link”, I would have such much lower risk in the first place.
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scta123
#200
I don’t think they are that rare. The general frequency of the APOE4 allele ranges from 9% to 23% in diverse ethnic populations (23% in European descent population). It increases risk for Alzheimer’s disease and is also associated with an earlier Alzheimer’s onset. APOE 4 more than doubles chances of developing late-onset Alzheimer’s. Another 2% to 3% of people have two copies, which renders them 8 to 10 times more likely to get the disease. In addition to raising the chances of Alzheimer’s, the APOE4 variant increases a person’s risk of heart disease and stroke.
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AnUser
#201
JUPITER trial counterpoint, and interesting perspective from a doctor how they think.
I will probably try atorvastatin 10 mg later on, when my supply of rosuvastatin is out. I don’t really prefer either drug that much. Atorvastatin for reduce diabetes risk, possibly decrease in parkinson, possibly better mood. Or Rosuvastatin that is more hepatoselective and might decrease brain desmosterol less.
For those with myalgia (muscle pain from statin), from Harvard:
I would add trying a different statin.
Check for gout, elevated uric acid before starting bempedoic acid.
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