DHEA levels naturally drop off with aging and high levels of stress - this makes sense as the adrenals become less active and or over active with stress. I like the literature pros, but have a hard time seeing clinical objective data in my patients. That being said, I do Rx it with estrogen, progesterone and occasionally testosterone as part of a hormone replacement. Pregnenolone can be another way to increase DHEA with some nootropic effect, but another one that does not have overwhelming data. Some younger women see improvement in libido since you get a small amount of free testosterone increase. Dr. Neal Rouzier is a big fan of DHEA.
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Here in Australia, doctors are not well informed. If you ask to go on HRT they say it ‘causes breast cancer’ (based on the flawed WHI study of 2002). Most of them have no clue as to what kind to prescribe, and even if they allow you to go on it you have to come off it after 5 years!
I take bioidentical E2 and micronized progesterone, have done since age 49. Without it I literally can’t sleep.
I finally found a doctor, and when I met him I said: ‘I want to stay on this for the rest of my life’. He said ‘you’ve come to the right place’.
Nothing is more important (to me) than sleep.
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Yes, sleep is probably a better health predictor than diet.
Providers in the U.S. are not any better than what you ran into in Australia. I stopped delivering babies about 14 years ago and stopped surgery about 2 years ago to see hormone patients all day.
WHO is based on CEE - conjugated equine estrogen and MPA - medroxyprogesterone acetate. The studies on the estradiol (E2) and micronized progesterone look much better, but small in numbers and power probably due to lack of pharmaceutical support. I am glad you have found a value and doctor to help.
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Me too @David !
The very fact that most doctors here are not that well informed has led me to this forum.
I’m so grateful for the friendliness and knowledge of the people on this forum.
It has been such a great help to me.
Thank you.
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I totally agree and also appreciate all of the knowledge on this forum. The members are extremely well informed and keep each other in check. Debates back and forth show movement in the status quo. I try to be very careful in what I say has data and logic behind it and not just some standard medical speak that has contrary studies. Statins are one of the those subjects that you help bring up.
Thank you for your contributions.
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Ezetimibe would be another drug to consider if you’re concerned about statins.
Different statins are absorbed in non-liver tissues differently. I think every other day 5mg Rosuvastatin is a nice compromise.
Comparative pharmacology of rosuvastatin - PubMed.
Based on my readings, I wish pcsk9 inhibitors weren’t price prohibitive, as they seem better targeted than statins.
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But even zetia has side effects you might not want.
Common:
Respiratory infections
Joint pain
Fatigue
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One of the courses and or pod casts, from my memory, noted a study of just licking a Rosuvastatin had a noted effect on cholesterol numbers - I believe it was tried for people not able to tolerate statins. I like Rosuvastatin over others due to it being water solualbe. Another point about statins from a course was that the anti-inflammatory effect of statins were more important than the true number manipulation and using lower doses than what is being recommend currently may have better tolerability and just as good as results. Sorry, I am sure there is an article to back up this, but not at my finger tips.
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Not sure what you mean, the APOB test or the drugs. I’ve never had an APOB test before. As far as the drugs go, my lipid levels are good and I don’t feel any side effects.
thank you @Rapasailor , yes I am considering that as well.
Peter Attia used to take 10mg of Zetia and 10mg Pravastatin 3 times a week for a while.
There seems to be a consensus that it’s not necessarily essential that a person takes the statin every day to achieve results.
Sorry, I should have clarified.
I thought you ordered a home testing APOB test metre, similar to a blood glucose metre.
I must have misunderstood.
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I was thinking a pravastatin might be better for me, since it appears to have less affect on blood sugar, which is an issue for me.
However, before I jump the gun with any of these interventions, I’m going to address my fat intake first and see if that helps.
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My cardiologist balked when I asked him to include an APOB in the usual panel he requests for me. I think he sees no real gain in information by adding this test to what he normally runs for me. So I’m just buying the test at a low price for my own self but I will bring in the result to him at my next appointment.
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Pravastatin is water soluble and the OG of statins. Water soluble seem to work better in women ( per Bale and Doneen Method). Agree with no treatment if you can correct with diet changes - Psyllium husk:) Checking end points CIMT / Calcium score helps sometimes if borderline.
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Most cardiologist are not fans of advanced lipid testing. Cardiologist are overwhelmed with urgent / emergent issues - heart attack and stroke. Showing them a test that may predict your risk in the next 10 years is not helpful to them. They are lifegaurds - focused on the people drowning and you need a swim coach:)
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Also, as I have been looking over my general blood work markers over many years, I find it rare to see any one marker (never) take a turn for the worse without many other markers following.
So, I don’t see ApoB getting out of whack without other lipid markers following suit.
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It will be interesting to see how my test comes out. I will post the result.
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Same with my Dr.'s they say not needed. So I gave up and payed Life Extension for the test I want and give him a copy. Dr. looks at it
and it shows APOB in range, he says “see I told you it was not needed”.
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I have to laugh. I can see my Dr. doing the same thing. We’ll see…
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My new physician, concierge, suggested an ApoB test and nearly fell out of my chair.
Direct primary care isn’t unreasonably priced, I pay about $60/Month the price of all my subscriptions combined.
Worth it to have someone whos knowledgeable.
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