CAC of 323. What can my 77 yo father do about this?

#63

I only wish I had started him on the cholesterol meds earlier so he would have had a lower CAC score. At least he started taking them before he had a heart attack or stroke!

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#64

@DeStrider, not starting earlier is my single biggest regret in life… I feel ya!

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#65

Honestly man, I know you’re sceptical, but it seems like you’re missing the forest for the trees here.

You have a positive CAC, which is growing yearly.

You’re talking about lead chelation and heavy metals, but you’re also sitting there with a LDL-C of 115 mg/dl or maybe 150 mg/dl and not treating it.

This makes absolutely no sense because the evidence of ApoB causing ASCVD for you is orders of magnitude stronger than the evidence for heavy metals. With ApoB of 90/LDL-C of 115 mg/dl you can easily build enough plaque to cause a heart attack and kill you - in fact, that’s pretty much the average trajectory that kills the average person in their 70’s or early 80s. A level of 150mg/dl accelerates process that even more and kills you earlier.

Your body actually isn’t that smart. Humans are the only species who have LDL-C this high. We get atherosclerosis from “normal” or “average” circulating LDL-C, and no other species does this. That appears to be more of an evolutionary glitch more than anything deliberate or advantageous. It looks like LDL-C might play some sort of role in the response to bacterial infection, and Lp(a) doesn’t have any obvious biological function but maybe can assist with wound healing. But, looking at the bigger picture, heart disease kills 1/4 of all people and bacterial infection and wound healing just isn’t that big of a deal in 2025.

There are people with genetic disorders of PCSK9 walking around with almost no circulating LDL-C/ApoB for their whole lifetime, and they have no heart disease, but also have no other deficits. There are also people who have reduced their LDL-C/ApoB to negligible levels with medications and they also don’t suffer from anything.

Also, there is value in the Cleery vs CAC. In your case, your CAC score is increasing every year, but is that because you’re continuing to lay down more plaque, or maybe this is a “good” thing because your soft plaque (i.e. vulnerable to rupture and kill you) is actually stabilising? Without the full CTCA, you don’t know. (IMO, if your LDL-C is 115-150mg/dl, you’re building plenty of plaque and some of it is calcifying.) CTCA can see the soft and calcified plaque. However, if you’re determined not to treat your high LDL-C then I agree it wouldn’t add value. But if you have an open mind, and you can actually see the soft and hard plaque, maybe it will push you over the edge into dealing with the LDL-C?

That all sounds absolutely awesome. I think you’re adding years to his life!!

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#66

I started pioglitazone next 3 months ago. Inveresting video on low dose pioglitazone which works on pancreas beta cells to reduce insulin resistance. https://www.youtube.com/watch?v=sYhXlPGiaOc

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#67

I did a month of bempedoic acid and just could not get up any speed. I don’t know why this isn’t mentioned anywhere. Maybe it’s because I’m low carb/keto and I need a little more ldl to ferry around the fats? In any case I quit so that I could get the spring work done and I’ve been better since. I may be able to tolerate it now that we’re done with the hard part.

My Lp(a) is very low and has been checked many times.

I agree that CAC is a blunt instrument and at this point I should do Cleerly. I’m going to ask the doc about it at my next appt. (July I think). If he agrees then that will probably happen. I hate to spend the money and it seems like the test is not risk free, also they pour a bunch of contrast in and I don’t like that either. But I can still manage things better at this point and the information might be worth it.

My sister just did it twice and found out she had 50% blockage. I won’t bore with the whole story. My sister is a character and married to a doctor.

I still have optimism about Cyclarity and think they will have a palatable solution relatively soon. It’s an injection, or a series of injections depending on your level of disrepair.

Thanks for the free advice! I might not take it but I take it seriously.

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#68

Nice video, thanks. I did post studies of 7.5mg dosing in the other thread, and that dose is available from Indian pharmacies. And yes, you can split pills - it’s very cheap, you could even split 30mg pills 4 ways for ultracheap doses. I am still researching pio, but am inclined to go with 7.5mg/day, at least to start with. How do you feel after 3 mo?

#69

Here is the video that convinced me to start pio. Not only helps with mitochondria disfunction, but also increases ATP for more energy. at 1:15.

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#70

Have you read anything that leads you to believe that there will be a “palatable solution” with regard to Cavidex relatively soon? I hope you’re right because as promising as it initially seemed to be based solely on the singular N=1 study the doctor who created did, I haven’t seen much more data beyond that. And that “success story” was based on an IV administration not the current suppository protocol.

#71

Sorry, I was thinking of Cyclarity. I’m bad with Nouns, especially names of things and people. I’m hoping in 5 years? There could be a product. It’s an injection or a series of injections that could remove oxidized cholesterol.

I edited my above post in case people are wondering what you’re talking about.

#72

Here’s a lecture Dr. Ralph DeFronzo gave at the Stanford Department of Medicine, covering some of the same ground, with additional color, plus graphs, and a Q&A at the end.

Reaven Lecture - Treatment of T2DM | DoM Grand Rounds | 20 March 2024

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