Statins inhibit coenzyme Q10 AND GGP/MK4 AND dolichol AND N-linked glycosylation (+ other negative effects)

Supplementing it can reverse the effects (though there really gets a pt where you’re taking too many and it may be better to do alternatives)

ALSO INSULIN RESISTANCE

Or you can take a high dose statin and low dose CoQ10.

But there’s also N -linked glycosylation which depends on functional dolichol

This is what forms the glycans on IgG important for lower glycanage

https://www.sciencedirect.com/science/article/abs/pii/S1387380617300453

https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.118.312782

What other drugs can you take to lower apoB?

Ezetimibe - Wikipedia though it’s weaker

Because it is weaker it is not enough in my opinion. I take 10 mg atorva and 5 mg ezetimibe.

How about squalene synthase inhibitors or inhibitors of one of the other numerous enzyme intermediate

Did you know that the largest clinical trial ever in the United States for age >=75 is currently studying atorvastatin, for aging?

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Pcsk9 inhibitors like repatha, which come as injectables. The best approach is to combine it with low dose statins. In this way you are avoiding negative side effects of larger statin doses.

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Details?

It’s still possible it decreases aging rate, but the coenzyme q10 issues are really true, and the more supplements you already take, the easier to lapse on some of them

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Zoledronate (Zol) is a nitrogen-containing bisphosphonate, which inhibits the farnesyl pyrophosphate synthase enzyme, central to the mevalonate pathwa

I had been taking Ezetimibe 10mg daily along with Atorvastatin 80mg. However, I recently dropped the Ezetimibe due to it appearing to block absorption of Omega 3.

https://pubmed.ncbi.nlm.nih.gov/28531469/

I originally started taking Omega 3 to help reduce triglycerides but I recently tested for Lp(a) and it came back at 187 so I have increased the dose of Omega 3 to 4g per day. I have also started Niacin at 500mg and will slowly titrate up to 3g per day once I get the flushing under control. Thankfully my ApoB came back at 83. Any other ideas for things to try?

Why don’t most statin users feel more tired from coenzyme q10 depletion

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I would read a bit more about Praluent (which probably reduce all-cause mortality), and Lp(a), then probably try and persuade my doctor based on the latter to get a prescription to lower apoB even futher, and Lp(a). Or possibly get it from elsewhere. Your apoB is pretty high in my opinion especially which such a high Lp(a) but doctors don’t understand it so much.

Is the implicit premise that COQ10 depletion make you tired, even correct?

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https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.111.028571

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Evidence for CoQ10’s use in humans or even in mice is low.

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Thank you @AnUser. I had naively assumed that my ApoB was good since it was within the reference range so I really appreciate you pointing that out - I should have known better by now!

My GP has agreed to refer me to a cardiologist based on my Lp(a) level which will hopefully be the next step towards being prescribed a PSK9 inhibitor or at least being on the list for specific Lp(a) targeting drugs when they eventually get approved. I am grateful for your help.

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I don’t think I feel any more or less tired on statins. However when I supplement with CoQ10 I find that it reduces (but does not eliminate) statin induced muscle pain for me. It’s a subtle enough effect that I have taken it on and off over the four years of taking statins but on balance I would say it helps (for me anyway, even if it is a placebo).

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Plant sterols more atherogenic than cholesterol??

Just nexlizet it solves everything