Any reason why you’d prefer B+E as opposed to statins? Or supposedly fewer side effects?
@DeStrider how is ezetimibe working for you? What dose are you taking?
I am starting with 10 mg a day now, taking no statin, might add it later if I don’t find any other medicine like bempedoic acid.
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I wouldn’t expect an LDL reduction of more than 30-35% with the B+E combo.
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Were you also taking a PCSK9i?
What do you think the optimal adjunct thereby for someone on PCSK9i who is still not low enough vs aggressive Apo B targets? (In my case I also have genetically elevated Lp(a). I was thinking of adding ezetimibe.
Yes supposedly less muscle pain side effects commonly reported with statins. Then again, there are many others
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No but I am thinking about adding a PCSK9 inhibitor.
I would say ezetimibe + bempedoic acid, also a fibrate could be interesting as well
Ok, thanks. Happy with the PCS9i as my base med, including for what looks like a very good safety profile (and I experience no side effects) and because it helps lower my Lp(a)by around a third, but may research the fibrates in the future.
Bempedoic 1.3% -prostatomegaly reported vs 0.1% placebo. That is no joke. Too scary for me. Would have considered if it was maybe double the placebo, but not 10 times higher. I’ll probably give Rosuvastatin at small doses a try and see how it goes.
Here are the changes I noted in my relevant blood markers after a few months of ezetimibe 10mg.
| goal | 7/5/23 | 10/16/23 | |
|---|---|---|---|
| APO B | <70 | 87 | 77 |
| LDL | <70 | 98 | 83 |
| HDL | >60 | 60 | 67 |
| Total Cholesterol | <160 | 169 | 162 |
| Triglycerides | <70 | 48 | 57 |
| Tg/HDL | <1 | .8 | .85 |
The results showed positive effects and no side effects, but I havent reached my goals yet. Will continue with 10mg
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I accidentally pinged you when I meant @DeStrider always mix you two together since it’s both a purple C 
But yeah you both had negative effects from statins, interesting to hear you’re using ezetimibe as well.
I no longer believe I’ve had negative side effects from statins.
I was confused by the muscle soreness and occasional strains I get from work outs. But it doesnt seem that my pains are what is described as a statin side effect, so I’ve increased my minimum dose rosuvastatin from alternate days to daily in hopes for further lipid improvement. Doctor agreed.
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October 25, 2023RESEARCH ARTICLE
Association Between Triglycerides and Risk of Dementia in Community-Dwelling Older Adults: A Prospective Cohort Study
(Association Between Triglycerides and Risk of Dementia in Community-Dwelling Older Adults: A Prospective Cohort Study | Neurology) Higher triglycerides were tied to lower dementia risk, prospective data from the ASPREE trial showed. (Neurology )
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This just screams reverse causality. Is there a rpc trial looking at lowering triglycerides and dementia rates?
That probably an aberrant splicing issue
Another Study Ties Statins to T2D: Should Practice Change?
Medscape, medical news
October 30, 2023
Again study showing increased risk of DM in patients on long-term statin therapy.
In the prostate?
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Studies have shown links between statin use and type 2 diabetes (T2D) for more than a decade. A US Food and Drug Administration label change for the drugs warned in 2012 about reports of increased risks of high blood glucose and glycosylated hemoglobin (A1c) levels. However, in the same warning, the FDA said it “continues to believe that the cardiovascular benefits of statins outweigh these small increased risks.”
For example, in a recent practice pointer on the risk of diabetes with statins published in the BMJ , Ishak Mansi, MD, of the Orlando VA Health Care System, Orlando, Florida and colleagues, write, “This potential adverse effect of diabetes with statin use should not be a barrier to starting statin treatment when indicated.”
Jill Crandall, MD, Albert Einstein College of Medicine, New York City, and colleagues conclude, “For individual patients, a potential modest increase in diabetes risk clearly needs to be balanced against the consistent and highly significant reductions in myocardial infarction, stroke and cardiovascular death associated with statin treatment.”
In the same vein, a recent review by Byron Hoogwerf, Emeritus, Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, is titled, “Statins may increase diabetes, but benefit still outweighs risk.”
The message seems pretty clear.
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The keywords here are " small increased risks". Everything seems to have some drawbacks.
Sadly there is no drug in existence that is perfectly tolerated by 100% of people taking it. We, as longevity pioneers, need to weigh risks against (potential) rewards.
For example, just check out rapamycin’s side effect profile. If it wasn’t for the potential 30% increase in lifespan, who in their right mind would risk the following side effects?
Sirolimus may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have any change in your mental state, decreased vision, weakness on one side of your body, or problems with speech or walking. These symptoms may start gradually and get worse quickly.
Sirolimus may cause serious side effects. Call your doctor at once if you have:
- redness, oozing, or slow healing of a skin wound;
- a new skin lesion, or a mole that has changed in size or color;
- unusual bleeding or bruising;
- sudden chest pain or discomfort, cough, feeling short of breath;
- tenderness around the transplanted kidney;
- signs of infection–fever, chills, painful mouth sores, skin sores, cold or flu symptoms, pain or burning when you urinate; or
- low red blood cells (anemia)–pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.
You should not use sirolimus if you have ever had a lung transplant or liver transplant.
Sirolimus may cause your body to overproduce white blood cells. This can lead to cancer, severe brain infection causing disability or death, or a viral infection causing kidney transplant failure.
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@AnUser I gave up Ezetimibe. My body can tolerate it fine, but it negates the cardio protective effects of Omega 3 fish oil which I take. ACM reduction was the same for taking Ezetimibe or Omega 3, so I kept with Omega. I will wait to see my next blood work and then decide what to do next. Probably Bempedoic Acid.
I’m really not having much luck with cholesterol lowering approaches!
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