Check this thread for TUDCA: UDCA (ursodiol) / TUDCA for healthspan and lifespan?
I don’t take it but for high AST and other liver markers it seems to work well and to be safe.
1 Like
No, not an idiot, but I don’t think you’ll get good cycle advice here and this forum isn’t friendly towards PED use, so advice will be skewed and tends to be over cautious and uninformed on this subject. I’d suggest joining Chase Iron’s discord or at least hanging out on meso-rx, professional muscle, t-nation, steroid source talk, enhance genetics etc.
That said, 52.3% with that RBC sounds like a hydration issue (what is the hemoglobin level?), and most manage it also with daily cardio that includes at least some HIIT. That’s considered mandatory if you’re going to use gear. But nobody doing cycles is worried about 52.3%. There’s a lot of discussion on this topic on excel male dot com and by YouTube doctors. None are worried about erythrocytosis causing clotting, but some worry about arterial shear stress over time. But 52.3 isn’t enough to worry about regardless.
Your liver enzymes aren’t bad for what you’re doing. Add NAC. Take som astragalus for your kidneys, but your eGFR probably dropped because of muscle turnover and mass. Get a cystatin C and use the national kidney foundation calculator.
Estradiol is fine for your T levels, but does put you in gynecomastia territory. Same comment on the prolactin. I’d knock the estradiol down below 60, maybe to 40.
It seems like your biggest issue is that you’re wasting time doing this and stressing yourself body for no good reason if you’re not eating enough. You can’t be afraid to gain some fat. I’d discontinue if you can’t maintain a surplus and train very hard because otherwise you’re just spinning your wheels.
4 Likes
@jnorm ezetimibe will bump your liver enzymes. An AST of 42 isn’t too bad but if you are concerned you can take 1/2 or even a 1/3 of that 10 mg dose and get pretty much the same effect on your lipids. That will likely allow your AST to return to normal. I’d do that before I added TUDCA.
3 Likes
What dosage are you taking to get total T of ~2400, if you don’t mind me asking?
400/week of the cypionate ester. IM’ing EoD.
That was my trough iirc.
I’ve always wondered how it scales. Does T go up linearly with dose, or is there a curve? Probably individual.
One more piece of evidence: Cardiovascular Health - #1725 by RapAdmin
Pooled analysis revealed that combination LLT significantly more effectively reduced the LDL-C level from baseline (mean difference, −12.96 mg/dL; 95% CI, −17.27 to −8.65; P<.001) and significantly reduced all-cause mortality (OR, 0.81; 95% CI, 0.67 to 0.97; P=.02), major adverse cardiovascular events (OR, 0.82; 95% CI, 0.69 to 0.97; P=.02), and stroke incidence (OR, 0.83; 95% CI, 0.75 to 0.91; P<.001), with an insignificant effect on cardiovascular mortality (OR, 0.86; 95% CI, 0.65 to 1.12; P=.26) when compared with statin monotherapy. The risk of adverse events and the therapy discontinuation rate were comparable between groups.
5 Likes
After propensity score matching, baseline characteristics including hypertension (85.4% vs 85.3%), diabetes (46.3% vs 46.3%), and prior myocardial infarction (29.8% vs 29.6%) were well-balanced between groups. The statin plus ezetimibe group showed significantly lower risk across multiple outcomes compared to statin monotherapy: all-cause mortality (HR 1.445, 95% CI 1.412-1.480), dementia (HR 1.498, 95% CI 1.447-1.550), cardiac arrest (HR 1.332, 95% CI 1.263-1.404), and stroke (HR 1.253, 95% CI 1.202-1.306). More modest risk reductions were observed for atrial fibrillation (HR 1.132, 95% CI 1.110-1.154) and heart failure (HR 1.075, 95% CI 1.059-1.091), while ventricular tachycardia showed no significant difference between groups (HR 1.035, 95% CI 0.999-1.072).
4 Likes
Apologies if I missed this. Does anyone have any empirical data on the merit of the generalization that low or normal triglycerides (well below 100) with elevated LDL suggests being a hyper adsorber whereas an elevated lipid profile with high trigs is more suggestive of being a hyperproducer? If one is a hyperproducer is 10 mg/day ezetimibe the ceiling or can it safely be taken at higher doses and to what effect?
Ezetimibe primarily blocks the (NPC1L1) cholesterol transporter in the intestine. The 10mg dose is enough to nearly saturate that effect (blocking 50-60% of cholesterol ingestion) that’s why it’s not dose dependent.
4 Likes
I think you would certainly need to follow Liver function tests if taking more than 10 of ezetimibe. Even at 10 I see my LFT’s bump (with statin on board as well). As @cl-user says you don’t get a lot of benefit above 5 so you are already pretty much maxed out at 10 mg. I try hard not to put pressure on my liver even if the enzyme bumps are clinically minor, they indicate stress on the liver.
1 Like
There isn’t any need to take more than 10 mg of Ezetimibe. It isn’t worth the risk to your liver for any minuscule additive gain.
3 Likes
Might as well share my numbers, since I meet those criteria. These are averages from at lest 3 readings, taken over at least 3 month intervals (i.e. each results is a Jan, April, Sept or similar):
Untreated:
LDL-C: 180 mg/dl
HDL-C: 53 mg/dl
Trigs: 70.4 mg/dl
HBA1C: 5.0%
ALT: 42
I have familial hypercholesterolemia, and likely the “hyper absorption” type. As you can see, my trigs were low, HDL-C was good, metabolic health great, but I had some fatty liver and sky high LDL-C.
After treatment with Rosuvastatin 10mg:
LDL-C: 177 mg/dl
HDL-C: 60 mg/dl
Trigs: 67 mg/dl
HBA1C: 5.2%
ALT: 25.0
So for me, the statin alone did very little for LDL-C, but did seem to help with the liver.
Rosuvastatin 5mg, and Ezetimide 5 mg: (half doses of each. Only 1 time for this result):
LDL-C: 93 mg/dl
HDL-C 58 mg/dl
Trigs 59 mg/dl
HBA1C: 5.0%
ALT: didn’t measure
Rosuvastatin 10 mg, and Ezetimibe 10 mg: (using the proper doses)
LDL-C: 71 mg/dl
HDL-C: 45 mg/dl
Trigs: 56 mg/dl
HBA1C: 5.2%
ALT: 31.4
So addition of Ezetimibe was incredibly effective at LDL-C lowering. The 5mg is definitely very effective, but 10 mg is still better. The statin at 10 mg does seem to add 0.2% onto my HBA1C. You can see when I reduced the statin to 5 mg, my A1C went back down again. None of the medications has any measurable negative effects on the liver either. In fact, all the results are better than pre-treatment, and ultrasound showed that a small amount of fatty liver totally resolved once I started treatment.
And for reference, I now use 10 mg Rosu, 10 mg Ezet, and Repatha (injectable PCSK9i):
LDL-C: 43 mg/dl
HDL-C: 58 mg/dl
Trigs: 62 mg/dl
HBA1C: 5.2%
ALT: 28.3
Pretty happy with this. And I totally agree with the others that 5 mg Ezetimibe is very powerful in combination with a statin, and 10 mg gets you some incremental additional benefit. I can’t see any value in going higher. If you want to lower LDL-C more, just add a different drug.
6 Likes