Luckily, my last stress echo test showed “minimal if any heart damage” so even if rapamycin doesn’t help with vasospasms, I’m still interested in the many other areas of the body that rapamycin may benefit. Just trying to stay informed and educated regarding the safety of it with my existing condition.

1 Like

Thought I answered you here but maybe not…mainly to help prevent further heart attacks!! I was put on 5mg crestor in 2020 not because I had bad cholesterol but because it is considered a safety net…kind of like the baby aspirin. I learned of reservastol and its ability to lower cholesterol and asked my cardiologist if I could swap.
My most recent labs however showed a higher cholesterol reading than I’ve had in all my past labs so now I’m taking red yeast rice supplements too! We shall see what my cholesterol levels are in a few months.

1 Like

So what did they say?

Not medical advice, but:

Effect seems to be a 5 mg/dl decrease, compare it to 5 mg rosuvastatin ~50 mg/dl at your level, a 10x difference…

I have a hard time believing a cardiologist would think this replacement is a good idea for secondary prevention. Statins also have other benefits that lifestyle or supplements can’t replace (plaque stabilization, reducing inflammation, etc). Most importantly they are proven to reduce risk of events.

You should also look at the thread on BP, where optimal is lower as long as no symptoms (risk of falls), to reduce risk of events:

Also make sure to optimize everything else (HbA1C, untreated diabetes, lose weight with GLP-1 agonist like Ozempic if you’re overweight or obese – Ozempic reduce risk of events: which are things like stroke, MI’s, etc).

You can really manage your risk profile if you do everything right and if you are uncertain get a top cardiologist if you can.

6 Likes

You can also try DrFraser’s practice here, which also is a member here and understands risk management with many factors, sorted by evidence and efficacy:

5 Likes

Striving to be healthy both mentally and physically have been goals of mines since my mid 20s! I eat well, exercise and listen to lots of Mel Robbin’s haha. I have a few cardiologists and it’s so interesting how they all have such different opinions on diagnoses, etc. I am about 102lbs and 5’5” and work out regularly. The heart stuff came out of left park ballfield!! Anyways, one cardiologist I admire wasn’t thrilled with approval of the swap but said I could test it out. I’m going on 6 months now.
He wasn’t as open to inquiry about rapamycin, lol.

1 Like

I would suggest you look at bempadoic acid and ezetimibe (Zetia) if you don’t like the statins you are taking. Most of us here have had good luck with them.

See these discussion threads:

1 Like

I did a CIMT a month post MI, in Sept 2023, that showed presence of plaque in my carotid arteries. My Apo B went from 81 to 38 on 10 mg Crestor. I’m also on intermittent use of rapa. I’ve done some major lifestyle changes post MI. I did a follow up CIMT in late January 2025, and that result shows no plaque. No sure what to make of these findings! You’ll see two images - one shows plaque and the follow up with none.


3 Likes

@JeffW Wow Jeff, that is an excellent ApoB! Good for you! I haven’t been able to break lower than 40, but have recently added bempedoic acid to the brew, so we shall see.

@Dr.Bart Great to see that study! My vet sent me a study that showed Rapamycin also showed effectiveness in cat hearts. Incase you are curious, here you go…
javma-javma.23.04.0187 (1) Rapamycin HCM.pdf (885.8 KB)

3 Likes

No way - RAPACAT ! :rofl:

3 Likes

I’m not sure I’d believe them. I’ve not read much on CIMT yet, but it seems its not as good as other options. See here what Peter Attia’s group uses:

What diagnostics can capture the level of damage currently present in the arteries?

  • The pathology slides discussed earlier show different levels of damage
  • Biomarkers won’t differentiate this

The 2 most important things we can look at are:

  • 1 – Coronary artery calcium (CAC) score
  • 2 – A CT angiogram (CTA)

Calcium score (CAC)

  • This is done by doing a very quick CT scan of the heart without any intravenous contrast
  • It looks at the amount of calcification in the coronary arteries
    • This is very late in the disease process
  • Once you have calcium formation around coronary arteries you’re at the 2nd to last stage of atherosclerosis
    • It’s a late stage of healing
    • Calcium formation is a very advanced finding of disease but it doesn’t tell you much about what’s happening at the point of calcification
  • Just yesterday, Peter got a patient’s calcium score back and it was not a very high number, but it wasn’t 0
    • That’s already a big red flag
    • It was at one part of their heart, but that doesn’t really tell much
    • The fact that they have a score of, say 15 at one part of their left anterior descending really means nothing about what’s happening there
    • But that becomes a real global alarm given that person’s age (early 40s)
    • Further, if they have a calcified point right there, they undoubtedly have atherosclerosis elsewhere

The CT angiogram (CTA) is a much better test

  • But it comes at a higher cost and it comes with more radiation
    • At really good places, it should be in the ballpark of 2 millisieverts of radiation
      • That’s a very small dose of radiation, about 4% of your annual allotted radiation, according to the NRC
  • A CT scan of the heart (this one is with contrast) captures the calcification
    • They typically run a dry scan first to look for calcium
    • But then once the contrast is in, you can see with great illumination the arteries
    • This gives a better sense of the luminal narrowing and the presence of soft plaque

Really, the CAC and the CTA are a very important thing that we use also in risk prediction, especially if the patient is themselves on the fence about preventative measures

Source: Heart Disease: Labs & Diagnostic Tests - Peter Attia

3 Likes

I love this so much! And just like that… a new nickname for them was born!

All three have been on it for a month and their very old selves do seem to be perkier! I can’t really be sure because they are old cats who have good weeks and meh weeks.

I think my husband felt left out, so he is now on week 2!

3 Likes

I’ll speak from a prevention perspective below.

On cimt vs CAC, I think it was Dr Snyder in Attia pods art that said that by the time you are calcium on your CAC scan, you’ve developped ascvd. So for me, it’s a lagging indicator, if you’re looking at prevention. Note that you can have a CAC score of 0 and high ldl.

Cimt shows both soft and calcified plaque, which in theory should show you the progession of the disease if you take one every year.

3 Likes

It’s clear to me you’re trying to optimize your health, so I’ll make two comments.
I’m unaware of any good evidence that resveretrol lowers cholesterol.
I don’t think anyone should take red yeast rice. It’s far better to take a statin.

6 Likes

Absolutely, the ER Doctors are aligned on these 2 statements!
Furthermore, I don’t think resveretrol taken orally does anything. I think Dr. Stanfield has a decent review as does Matt Kaeberlein.
It’s not on my list for anything.

7 Likes

Aiui Resveratrol is an HDAC and cox-1 inhibitor. I don’t like inhibiting cox-1.

1 Like

I am a work in progress, lol. I never want to take Medicine but natural stuff? Gimme gimme gimme! I was doing some more reading about rosuvaststin and may just go back on it. Only stopped it about 3 months ago and I was only taking 5mg for precautionary reasons. My ldl cholesterol pre my heart attacks in 2020 and then even last year has always been in the 40s so I’m not sure my switching to reservastol is a factor in the big jump to 123 LDL last week. Sigh. I appreciate all the knowledge and carefully worded advice around here in this group. :slight_smile:

2 Likes

It’s interesting how people have different perspectives. For example mine happens to be the exact opposite - “I never want to take any ‘natural’ supplement, but medicine, gimme, gimme, gimme”.

“Natural” is a strange concept. Arsenic is “natural”, so is snake venom and any number of plant poisons. And many of the “natural” supplements are extracts of substances in plants or massively concentrated select ingredients that would never occur in nature at those doses - highly “unnatural”.

Apart from marketing, “natural” really means very little - and the little that it does mean, is all very, very, very bad. When I see “natural”, I immediately distrust it - here is why…

“Natural” supplements, means these are some poorly characterized, poorly studied molecules that occur in random amounts in a plant, that you really don’t know what they are doing. A plant extract is often just a collection of thousands of different chemicals which have never been studied. You are taking it on faith that somehow this random collection is going to have a good health effect. Often that is not the case, as thousands of cases of all kinds of negative outcomes and even deaths, liver failure, organ failure, poisonings and overdoses all come from “natural” supplements, which - alert - are not cleared or regulated by the FDA. You are playing russian roulette with your health. “Natural” supplements to me are mystery pills in a bottle.

Here is a fact - the vast majority of these have never been properly studied. At best, there are some small trials, often by the seller or interested parties, often poorly designed studies that form the basis of various health claims - which must then, to keep it legal, have a disclaimer that they are not designed to treat any condition… which somehow gets ignored by the consumer, SMH.

Now contrast that with medications. A medication, before it gets approved by the FDA or any health regulatory agency in the developed world, must undergo extensive trials with multiple stages - phases designed to prove that the medication is SAFE for humans - which a “natural” supplement doesn’t do, or is required to do. Pharma companies spend billions developing a drug. A “natural” supplement can be some guy stuffing god knows what into pill boxes in his garage. Next, it must be determined that there is a positive health outcome - so not an equivalent of a sugar pill or “natural” supplement where you have to take it on faith that it works. Then there are clinical trials with large numbers of subjects which tell us the real world effects of the medication. The medications are all under scrutiny from medical researchers, from doctors in practice and from patients - there are databases where side effects are reported and followed for years. None of this is true for “natural” supplements - all you hear are “testimonials” often paid for, anecdotal tales and then they can make the news when someone tragically dies or is severely injured… just no controls at all. And medications must list in great detail all the possible side effects, even the very rare ones. Not true of “natural” supplements. And when the medication is manufactured, it is manufactured to exacting specifications and under the scrutiny of the appropriate regulatory agency, the FDA. When you get the medication, you are assured that you are getting exactly what is says on the packaging, at the dose specified. Meanwhile, none of this is true for “natural” supplements, and in fact repeated investigations have shown that often the vast majority of what is sold in supplements has either none of the claimed ingredient, a harmful ingredient or an ingredient at some random dose. It’s absolute Wild West, completely unregulated - the regulatory agencies only get involved when people start dying.

Does this mean that all medication is safe? Nope. There’s always a risk. But at least we have a mechanism for control. You have no idea what it is that’s in your “natural” supplement. I like medications because I have a certain amount of assureance that I know what I am getting. And I can carefully read extensive studies of these medications and then make my decision. I have none of these tools with “natural” supplements.

To me, the analogy is between buying alcohol from a well-known and regulated and subject to the law manufacturer in a legal store. That’s medication. It might be good or bad for me, but I know what I am getting. Meanwhile, someone tells me, “nah, I avoid those stores and manufacturers, I prefer that one guy in a dark alley who can hook me up with a homebrew moonshine made somewhere that no regulatory agency has access to, but it’s good, trust me bro”. I have no faith that the hooch from the dodgy guy won’t leave me blind. I know what I’m getting from Seagram or Johnny Walker bought at the supermarket. Both want to make money, but only one is held accountable, and consequently has to maintain standards and safety. Do you see why when I hear “natural” - I flee as fast as legs can carry me, and meanwhile, I will carefuly consider medication from an established provider?

My point is not to say that my approach is better than your approach. It is to simply present a case of why having the opposite approach has its own logic. I’m not trying to convince you of anything, just provide another way of looking at things, the final choice is always up to the individual. YMMV.

5 Likes

Ah well nevermind. xx

Have you made any changes in your diet or drug regimen in the past month?
Are you taking rapamycin right now? Higher dosing, or more frequent dosing, can raise blood lipid levels.

1 Like

Hi! The only change I had made was swapping the 5mg statin for 120mg reservastol.
I have been taking a hair vitamin called Nutrafol for a few months, too.

I took one 1mg sirolumis pill last Friday and have been monitoring my bp daily.

Tonight I started back on the 5mg statin…

1 Like