Here are my latest cholesterol and inflammation scores after being back in rapamycin for the last 4-5 months. My Lipoprotein(a) result of 84.20 nmol/L seems to place me in a grey zone? When combined with Apolipoprotein B of 0.92 g/L just within “normal” range I think I need to take some action.
I hear some folks here have had good success with BrilloEZ combo of ezetimibe and bempedoic acid?
Cholesterol Status
Total Cholesterol X 5.01 mmol/L
LDL Cholesterol X 3.02 mmol/L
Non HDL Cholesterol 3.46 mmol/L
HDL Cholesterol 1.55 mmol/L
Total Cholesterol : HDL 3.23 Ratio
Triglycerides 0.97 mmol/L
Triglyceride : HDL 0.6 Ratio
Apolipoprotein A1 1.44 g/L
Apolipoprotein B 0.92 g/L
Lipoprotein(a) 84.20 nmol/L
A result of >75nmol/L is considered to reflect
increased risk (Framingham data).
(Range: < 75)
Our cholesterol and inflammation results look quite similar @Michele_Watson although I do have a much lower lp(a). Having reviewed the threads on here I have placed an order with Maulik for BrilloEZ which contains Bempedoic acid (180mg) + Ezetimibe (10mg). It can take 2-3 months to have full effect. I will report back here when I get my next blood test but could be a while.
I might try the BrilloEX (wonder if anyone on this thread is from Australia). I weigh 53 kgs and female (64 years old) I wonder if that might mean adjustments to dose? Low estrogen and low thyroid (no meds as yet) but these also contribute to my current cardio status.
Am very thin (0.82 WHP ratio) - so reassuring - tho will see what the stress echocardiogram test shows soon. My Lp(a) is 187. Today I started on a new bergamot formulation (Dr Mercola) and berberine. I am going to take a few natural PCSK9 inhibitors for now…for those that do not know how to calculate just measure waist then hip- then divide the waist by the hip measurement.
Started on flaxseed- bought a small Sunbeam electric grinder - works incredibly well. Now I can grind and keep in fridge a few days to incorporate in my diet. I mixed a tespoon amt with high phenol olive oil. Tastes ok but may just put on oats as is. Am also on a good Bergamot https://www.sciencedirect.com/science/article/pii/S1756464623003249 and abt to start on Berberine all natural PCSK9 inhibitors.
Calling them “natural PCSK9 inhibitors” is overstating it IMO. A PCSK9 inhibitor nukes LDL-C by half and improves outcomes like MACE in clinical trials.
What matters as far as I know is what your apoB is and other risk factors. Have you had a call with some expert in this area of Lp(a) or taken a look at what they say?
Lustgarten decreased his Lp(a) with his customized diet and approach as well.
Hi I am at the beginning of this journey tbh. However I am going to the Cardiovascular Lipid Clinic where I live soon and will be consulting a specialist to put my name forward when the new PCSK9 drugs arrive and also to get my children tested. At the moment my doctor is dismissing my concerns tells me I am moderate risk at Lp(a) of 187. I no longer trust medical opinions tbh after being vax injured. I do what I can based on my own deeper reading and at the moment berberine and bergamot feel good. Also considering low dose aspirin (first I need to check if I have the allele variants that will make me a responder). Levothyroxine even at 25mg felt very bad. I go with my body’s signals. My doctor does not feel a statin will be that useful in my circumstances.
A lot to unpack here to be honest, but I think what we should be vary of is basing medical decisions solely on feeling and body signals, this is subject to placebo and nocebo, and it’s easy to trick oneself into believing something is harmful when it’s actually not, or something is beneficial when it’s actually harmful. Of course if you have an obvious side effect of a drug or treatment or of great magnitude then that’s important to consider especially if it has been reported previously.
Usually I like to look at the actual clinical trial where one group has had the placebo and another the drug, that way it’s possible to see how people differ from the placebo effect in terms of side effects and beneficial effects. Supplements don’t have clinical trials in most cases or they are poorly done or too small to be useful because of cost considerations. And of course the most important risk factors as far as I know in your case isn’t something that can be felt, like apoB / LDL-C.
Lp(a) is new and a typical doctor isn’t going to know how to treat it and prevent complications from CVD, neither would they for radical CVD prevention. If you can’t find a specialist familiar with reducing risk with Lp(a) and overall ASCVD prevention, I recommend podcasts with Peter Attia on these two topics. I’m sure others in this thread have good sources. Best of luck.
Thanks I have Attia’s book and will soon be under a specialist’s management. My doctor did say he has had quite a few patients bring their cholesterol down with bergamot and said it is worth a try- retest in a few months. In Australia they are not keen to use statins unless its very high cholesterol. I have done heaps and heaps of reading, watched videos etc so am pretty informed now. Will see what the specialist advises.
Again, it goes back to that “well, something has to kill you, so I might as well let it be this thing you already have”, which isn’t a smart approach IMO.
Have we ever discussed these studies showing that testosterone reduces Lp(a), and reduces it quite significantly, up to 37% in one of the studies below:
makes sense to me - low estrogen affects thyroid function in women which adversely affects lipid regulation and surely impacts Lp(a) levels in post menopasue. I had no issues a few years ago my cholesterol and thyroid were good.
Interesting. I would however caution, that while something might lower Lp(a), it may net out to not be worth it. That’s true of many aspects of physiology. Focusing on just one aspect of a function, is how we can be led astray by mechanistic speculation. Parkinson’s Disease patients have frequently lower LDL, but we wouldn’t want to induce PD (by f.ex. destroying the substantia nigra), in order to get better LDL levels. Alzheimer’s patients have less cancer, but we wouldn’t want etc.
So OK, increasing testosterone might lower Lp(a), but what matters is not an isolated mechanistic effect, but outcomes. What is the net?
For example, I have sky high Lp(a), but also very good level of testosterone for my age. I have no intention of driving my testosterone sky high in hopes of some Lp(a) lowering. I don’t think it would net out well for me.
Now, perhaps for those who have suboptimally low T, supplementing might be a great idea, and lowering of Lp(a), a nice bonus. So I’m not opposed to HRT in the right context, but it’s worth looking at the big picture.
Ultimately it’s always about how it impacts outcomes, including all cause mortality. If adding T can be a positive, great!
I totally agree with you- dont want HRT as I already have an acoustic neuroma treated 6 years ago and who knows how HRT and especially progesterone might affect tumor regrowth. My Lp(a) is 187 but I feel good am very active. I cannot seem to tolerate even a small dose of levothyroxine so for now I am just focussing on being sensible re diet, sleep, stress levels and moderate exercise.
