Have always had high cholesterol average 215 total, 115 LDL but since HDL and triglycerides good, ratio was always good and that’s what my doc went by. After 8 months on rapa total 248 LDL162 so stopped Rapa and numbers back to total 212 LDL 115, but, by then I’d heard about ApoB and asked for it - 126. I posted here and got lots of advice, thank you. I decided to go with 5mg Crestor. A year or so later Total 174 LDL 88. (She forgot to do APOB that time.) I decided to see if 2.5mg kept it lowered and recently got results - total 173 LDL 75, so even that small amount lowered it slightly more! ApoB 69 from 126. She also did an LPa - 65. I’m 72 calcium score was 0 at 71. Am aware it doesn’t show soft plaque and 15% chance it’s wrong but still encouraging.
I have chronic fatigue/fibromyalgia so it’s hard for me to know if something is making it worse, but one reason I went to 2.5 is I thought I had more fatigue, but that was after being on Crestor for many months the previous months no extra fatigue which confused me but recently read about a man who had no fatigue for many months then quite bad. Lately now even on 2.5mg the fatigue has been so bad and leg muscles weak. I have decided to stop Crestor for 3 weeks to see if I can figure this out.
My questions -
If I determine Crestor is not the problem, do you think my current numbers are ok at 173 total, LDL 75 and ApoB 69.
If not would you add ezetimibe?
If so would you try the ezetimbe/bempedoic acid and how much?
What do you think of the LPa being 65? When I first saw the normal level was discouraged that this put me at higher risk even above borderline but then noticed the next group starts at 180 so maybe 65 isn’t so bad?
Would you suggest getting another CAC in case first a mistake? I can’t do the CLEERLY now as too fatigued to commit to an hour drive up etc.
I see my doctor Thursday she’s pretty good about my taking info to her and acting on it so just thought I’d see if anyone here has any further input. Thank you!
You might try different statins to see how they affect you. I was on atorvastatin and move over to pitavastatin (due to lower risk of glucose/insulin disregulation) and was also taking bempadoic acid and ezetimibe. My LDL was in the mid-40s with all three, but I’ve run out of bempadoic acid, and with my switch over to the less effective statin (pitavastatin) and just the ezetimibe - and its still in the same range plus or minus a few points. I’d definitely recommend ezetimibe - it seems like a side effect free, low cost option for most people to help get down to the level where you can be confident that you are halting plaque prevention.
Doing another CAC without clearly AI analysis doesn’t seem to add a lot of value in my thinking. The key issue is soft plaque and another CAC isn’t going to tell you much without the Cleerly analysis.
Did rapamycin help your CF at all? Did you go back on it, or still off?
On the issue of LP(a) levels - I’m not sure there is a ton that you can do on that right now - see this thread, and new medications may be available soon for LP(a): CVD and high Lp(a) levels
Thank you so much! I’m going to print out that article for her as think I may need to make a case for lowering it more. Interesting what the article said re the CAC score going up after a statin because it hardens the soft plaque. It might be worthwhile to have it done again in 3 years or so as a way to at least guess if one had it, if one can’t do CLEERLY? It’s going to take a couple months to figure out if Crestor is an issue but for the time I’m off it, could I take only ezetimibe or is that strictly an add on to make statins more potent? Per Peter Attia I’d also like to get the ApoB a little lower. Also, if Crestor isn’t the issue, do you think going back to 5mg would help or does one pretty much know what it will do after being on it 9 months or so, although my fasting glucose is 99 now and used to be 80’s so another reason to switch to what you’re taking. No, the Rapa did absolutely nothing for the CFS which was very disappointing. Cort Johnson from Health Rising recently talked to a couple young guys from England who both have it, one is a biomedical engineer one an aeronautical engineer - they’re embarking on a huge study to test certain things in the blood and bringing in top data specialists. Looks very promising - too late for me but I have hope for the younger folks coming up. Again, thanks for your input/article.
Are you saying the bempadoic acid had no effect when added to your other efforts to lower apoB? I’m amazed and excited to try it if true.
I was on 40mg atorvastatin, and Bemdec (180mg BA with 10mg Ezetimibe) and my LDL-C was 40.
I changed to 40mg Pravastatin and 10mg ezetimibe and now my LDL-C is at 47.
I’m not going to bother with Bempadoic Acid now. It seems to provide minimal benefit and and I’m not convinced there is much benefit to getting to LDL of 40 vs. 47.
If your question is to Candleflower thanks for the suggestion - I am just now considering other things since I was on Crestor for many months no problem it’s only recently I’ve thought maybe it’s causing even more fatigue so gathering new info/ trying to figure it out. The weak leg muscles could just be a result of being in bed so much.
Hi RapAmin, saw my doctor but when I mentioned going off and taking ezetimibe she said it didn’t work near as well as Crestor. She missed my point of taking it so I’d have at least something while experimenting going off Crestor, almost sure because her mind was set that 2.5mg is such a small amount it could not be causing the fatigue. She’s probably right so I’ll just continue but if the profound fatigue comes back will revisit with her. I would like to take just a few more points off my numbers but not sure she’ll agree to add the ezetimibe - will deal with that next blood draw but am very pleased at how well just 2.5mg decreased everything. My nephew is on 5mg and is going to try decreasing his too, but he’s got the genetic problem so hope he watches closely. He’s 45 and only recently went on it, but it’s working well for him too. Wish he’d started much sooner but better late than never. His grandfather, mom, brother and 4 or 5 aunts and uncles have all had heart attacks, his grandfather died of his in his 40’s, leaving 12 kids. Thanks again for your input and article.
