I’m of the same opinion, but there’s not a lot of data.
I know that statins are best taken in the evening:
Statins that stay in your system for a short time work best if you take them in the evening (before your body starts making cholesterol overnight).
Source: Statins: How They Work & Side Effects
So, I just take the bempedoic acid + ezetemibe at the same time for convenience sake, but have not dug deep into the pharmacokinetics or physiology.
Yep, same here: I’m on 10mg of atorvastatin, and take it at 10pm every evening exactly for the same reason. Couple more considerations: statins are at therir peak levels in blood about 60-90 minutes after consumption. And since cholesterol lipid transport particle production revs up after midnight, I’m hoping this hits it roughly at the right time.
However. I have been toying with the idea of switching the statin to 10 AM, if I’ll be taking bempedoic acid + ezetemibe 10 PM. Statin levels decline after roughly 12 hours, so if I cover the first 12 hours with the Bempo + zetia combo, and cover the second 12 hours with atorvastatin, then perhaps I’m providing a steady level of ApoB suppression over the entire 24 hours. This is of course all WAG speculation, and who knows what is optimal and if any of this makes any difference.
Source?
Effects of Ezetimibe on Serum Polyunsaturated Fatty Acids in Patients With Coronary Artery Disease 2013
Ezetimibe significantly decreased LDL cholesterol (138 ± 19 mg/dL to 97 ± 34 mg/dL, P < 0.01), but did not significantly affect high-density lipoprotein cholesterol, triglyceride, or any of the PUFAs measured during the follow-up period. Consequently, it did not affect the ratio of EPA to AA (0.40 ± 0.17 to 0.43 ± 0.18, P = ns) or the ratio of n-3 PUFA to n-6 PUFA (1.10 ± 0.39 to 1.09 ± 0.36, P = ns) during the follow-up period. Ezetimibe in combination with a low-dose statin, or as monotherapy in statin-intolerant patients, decreased LDL cholesterol, but did not significantly affect serum PUFA concentrations in patients with coronary artery disease.
Absence of evidence is not evidence of absence - and definitely not proof of absence
For now the conservative things seems to just test Omega Index and optimize Omegas intakes based on that if on Eze (and should measure and optimize then anyway).
Did you read the papers? We have evidence of absence here.
Ok, great. Typically studies are not powered to be able to pick that up.
You’re right that these studies are tiny, I didn’t pay attention to that.
After seeing this thread, I wanted to check my Omega Index after six months on Ezetimibe. It was about 14% before and about 14% after. No change.
It might block alpha-linoleic acid, not EPA and DHA. Did your blood test include that?
I did the basic this time, not the complete. I might do the complete again in a year or so. I can see if there is any impact on ALA relative to the last time I had a complete test (before starting Ezetimibe).
