Dr. Brad Stanfield has familial idiopathic hypertension. He tried to control it with low-medium doses of candesartan, wasn’t enough, added off label use empagliflozin - doing what many of us here did/do - split the 25mg dose in two, which brought him to target of 120 SBP. But the empa apparently raised his LDL. He was already on a 5mg rosuvastatin dose, so he added ezetemibe, which brought him to target LDL of well below 70mg/dL toward the optimal range of 50-60 (based on the PESA study of no plaque added with that range). But then he got worried about rosuvastatin possibly deranging his glucose control, so he switched to 20mg of pravastatin - he has not yet re-tested for the effect of that substitution. Dr. Stanfield is a highly amusing individual and I greatly enjoyed his presentation, I think he has a decent chance at a medically oriented standup routine. His earnestness is disarming. Highly recommended to brighten your day.
Don’t Make The Same Mistake I Did (Dr. Brad Stanfield)
Dapagliflozin almost doubled my LDL. I was surprised because I couldn’t find data on that. Some papers report a tiny LDL increase that is not clinically significant. I guess everyone is different…
I wish I had such test results. I switched from atorvastatin 10mg/day to pitavastatin 4mg/day starting November 1, 2024, but also started empagliflozin 12.5/mg day on December 1, 2024, and tested for biomarkers April 7, 2025. So I don’t know if empagliflozin affected my lipids apart from switching statins. And when I added BA, I also boosted the empagliflozin from 12.5 to 25mg/day, and again don’t know if the bigger dose of empagliflozin affected my lipids apart from adding BA. This is why it’s important to test one intervention at a time. I try as much as possible, but it’s not always practical. And yes, the literature seems to say that empagliflozin, for example raises LDL only slightly, which is why Brad’s result surprised me.
I like Dr. Stanfield. He is right on the edge of being conservative with taking pharmaceuticals for longevity. Has the data on his rapamycin study come out yet?
Wow. I’m only just hearing about these side effects for this class of drugs.
