#15

Hmmmm, don’t say that to @AnUser (hope he’s not listening)…I’ll see how I feel, I guess. I don’t look forward to being on statins (or anything) for the rest of my life.

1 Like
#16

If I get side effects from statins I am not going to take them; I will take something else.
Most people get no side effects.

I don’t understand why it’s a problem to take something for the rest of your life if it’s healthy for you (promoting health).

3 Likes
#17

@Virilius were you saying that this is not the case?

Do others know - @DeStrider think you discussed something like this at one point?

#18

Based on what I remember, it wasn’t the EPA that was being blocked it was the ALA. It seems it may only have an effect on a subset of fat-soluble substances. The only two I have seen data about are vitamin K and alpha lipoic acid (ALA).

Then again, how much does it affect absorption? 5%? 10%? 50%? I wouldn’t worry about the first two, but if it was the last, I would do something about it.

3 Likes
#19

It seemed to be causing sleeplessness and rashes.

#20

Here is a paper on ezetimibe and omegas I posted a while back. This is what made me worried but it turned out not to affect me (omega index is high).

3 Likes
#21

I too have bad genetics specifically, homozygous (C;C) for the risk allele on 9p21 (the “heart attack gene”). So what is the mechanism? seems it leads to greater inflammatory response in the artery wall coupled with deficiency in ability to repair damage. So I started thinking more about inflammation being the underlying bad operator. Then came across more studies suggesting that if inflammation is very low, the impact of having higher Lp(a) (which I also have) is reduced. I don’t know if the Lp(a) and the 9p21 gene are one and the same or separate agents working in tandem, but it is clear that inflammation is a major player. This has refocused my efforts and choices. Though still want to get APOB down, I am viewing most of my efforts through the lens of inflammation reduction.

1 Like
#22

There are a few medications and supplements that specifically target inflammation. Statins, ezetimibe, pqq, colchicine, boswelia…

1 Like
#23

I was just going down the rabbit hole to figure out why one chooses bempedoic acid over ezetimbe or vice versa… or if i should be doing both. I just started ezetimbe this week, thanks to the good folks here! Is this study why you have chosen BA, I assume?

1 Like
#24

Bempedoic Acid and Ezetemibe are usually combined in one pill. Bempedoic Acid is similar to a statin in effects but only affects the liver unlike stations which affect the whole body. Bempedoic Acid doesn’t have a risk of causing diabetes or muscle soreness.

I am intolerant to statins so I am thankful there is a statin alternative - Bempedoic Acid.

4 Likes
#25

More or less in declining order of impact in the absence of non-specific conditions, these are the dietary supplements for which there is decent evidence of reduced inflammation. I’m using inflammation as a generic term when, in fact, there are many different types with each type holding different health implications. My personal opinion is that we want to have low baseline inflammatory markers but a rapid inflammatory response. We would all be long dead were it not for inflammation and it could be beneficial to maintain a certain baseline of some kinds of inflammation. The benefit curve could be a skewed U-shape.

  • Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fatty fish and fish oil supplements, have potent anti-inflammatory effects. They modulate the production of pro-inflammatory cytokines and eicosanoids, leading to reduced systemic inflammation. Consuming fatty fish like salmon, mackerel, or taking high-quality fish oil supplements is recommended.

  • Curcumin, the active compound in turmeric, has demonstrated significant anti-inflammatory properties. It inhibits various inflammatory pathways, including the NF-kB pathway, and reduces the production of pro-inflammatory cytokines. Consuming turmeric as a spice in cooking or taking curcumin supplements can help reduce systemic inflammation.

  • Polyphenols are abundant in fruits, vegetables, tea, coffee, and red wine. They possess antioxidant and anti-inflammatory properties, helping to reduce oxidative stress and inflammation in the body. Consuming a diet rich in colorful fruits and vegetables along with moderate consumption of tea or coffee can provide beneficial polyphenols.

  • Vitamin D deficiency is associated with increased inflammation. Supplementing with vitamin D, especially in populations with low sun exposure or inadequate dietary intake, can help reduce systemic inflammation. Vitamin D modulates the immune system and has anti-inflammatory effects.

  • Probiotics, especially certain strains like Lactobacillus and Bifidobacterium, can help modulate the gut microbiota and reduce inflammation. A healthy gut microbiome is associated with lower systemic inflammation. Consuming probiotic-rich foods like yogurt, kefir, or taking probiotic supplements can be beneficial.

  • Vitamin C is a now somewhat overlooked but powerful antioxidant that can help reduce inflammation by scavenging free radicals and modulating immune responses. Consuming foods rich in vitamin C, such as citrus fruits, strawberries, and bell peppers, or taking vitamin C supplements, may help decrease systemic inflammation.

  • Magnesium deficiency has been linked to chronic low-grade inflammation. Magnesium supplementation can help reduce inflammatory markers and improve immune function. Consuming magnesium-rich foods like nuts, seeds, whole grains, and leafy greens or taking magnesium supplements can be beneficial.

  • Zinc is involved in immune function and has anti-inflammatory properties. Zinc deficiency is associated with increased inflammation. Consuming zinc-rich foods like meat, shellfish, legumes, nuts, and seeds or taking zinc supplements can help reduce systemic inflammation.

This is not an exhaustive list. Ginger, for example, might fit in there someplace as might astaxanthin.

6 Likes
#26

I started taking manganese 5mg per day about 8 months ago based on this.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529386/

But like many things too much can have serious side effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980854/

I also measure my PWV (pulse wave velocity) every morning, results here.

2 Likes
#27

Great list-thank you. Wanted to add: sauna or hot whirlpool, especially alternating with cold plunge. I don’t do the cold plunge but do alternate hot/cold --whirlpool-laps-whirlpool. There is some evidence this helps with inflammation --and it just feels like it does. Rhonda Patrick and Peter Attia both talk about it.

1 Like
#28

Thank you for the Mn toxicity article. Do you have any metrics or have you observed any effects that you can attribute to Mn?

#29

I posted a link to my results in the above post. I’d attribute a significant portion of the improvement to manganese supplementation.

But I “think” that with the other interventions, that the combination of things is also a significant factor.

There is no silver bullet and there is no one and done intervention as we age.

After all, there are currently 12 Hallmarks of Aging :slight_smile:

#30

@Beth for me, CVD prevention has many layers. Lowering apoB is a layer that is a primary need for anyone who has confirmed plaques or related family history. Statins work great for some people (apparently) but not for me due to side effects. No problem. I’ll move to the next thing. BA is now in my home waiting for me to get home.

Layers (off the top of my head)

Metabolic health - exercise, sleep, good body comp, training the body to have metabolic flexibility (burn carbs and burn fat and switch between them easily). A diverse Whole Foods diet with mixed macros, Akkermansia, targeting 4.9 HbA1c

Artery health - nitric oxide, exercise, sleep. Low BP

Immune health - gut health and bone (marrow) health through diet and no antibiotics and select supplements. Low hsCRP and rarely get sick.

ApoB lowering - ezetimibe to reduce absorption, BA to reduce liver production, berberine (poor man’s pcsk9 inhibitor) to increase ldl receptor activation

4 Likes
#31

I was intrigued with your ability to measure PWV at home so I looked up the Withings scales and found that this feature is not available in the US. It could be just the App. I wonder if there is a way around this US limitation. Great information!

#32

The feature is available but in a slightly different format. In Europe where this scale is an approved medical device you see the actual number on the display of the scale.

In the US and Canada you see a slider that indicates low, normal and high.

BUT you can download the raw data from the app and that is what I did to provide the 3 years of data in my post :slight_smile:

Withings has some very cool home use devices.

1 Like
#33

Thanks! (Drat! This software requires >19 characters to say thanks.)

1 Like
#34

Thank you for the reference to Vyvyane Loh. I listened to her explain her model of arterial degradation. It seems to align well with the research in general in noting both the importance and the insufficiency of attending to inflammation, and the importance of focusing on Apo(b) particle count as the primary goal, perhaps with inflammation as part of that goal but that was not addressed.

The podcast ended with the question of how best to reduce the Apo(b) count by transitioning to promoting her services. She said the best way will depend on one’s unique circumstances.

I can appreciate the value of her services, especially for individuals having weight, diet, and illness challenges. However, I wonder if the best path to managing Apo(b) is not already well defined for fit older adults of normal weight and muscle development. If diet alone does not do the job for this population, isn’t the next step determining which pharmaceutical works best with the fewest side effects?

3 Likes