#1169

Yeah, I’m doing the Cleerly this year… actually next year but soon. Dr. agreed to prescribe the CCTA and Medicare is supposed to cover Cleerly. I just signed up for medicare but haven’t gotten my card yet. I’ll let you know if this works. I’m just guessing but doesn’t it seem like if Medicare covers it then so should insurance? Not all insurance is equal.

3 grand for a stress test is robbery. I pay less than $2000/year and get 4 pretty complete labs/year and one stress test. He throws in a bunch of other crazy tests once a year that I haven’t figured out, and once you hit medicare you get Boston Heart evaluation. But I live in the sticks.

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#1170

The echocardiogram is really designed to detect heart abnormalities (enlargement, leaky valves, etc) so it is very useful for that. No one is getting it to detect plaque or anything.

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#1171

Ah, I see. Considering that the main reason for silent killer events (as it is called) seems to be the buildup of plaque then I’d assume the better option would be CCTA. Anecdotally, again (have an uncle with irregular heartbeats, don’t know the medical term for it though) but that is something which manifest itself in one way or the other. In other words, if you had a heart abnormality most likely than not you will know very early on. My uncle is in some kind of medication (sorry never asked him) since in his early 20’s and is now 87. So, in context of what @Beth was asking about, I still think she would be better served with CCTA (much cheaper and more appropriate if you have no known symptoms of any CVD) than what the doctor suggested to her (especially considering the steep cost).

2 Likes
#1172

Wow. Brad has really upped the quality with in-depth videos like these. Here about PCSK9(i).

Unfortunately prevention is niche, people don’t even know it’s possible for real either I presume, so it won’t be viewed by hundreds of thousands.

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#1173

I went directly to CCTA (skipping Stress test and CAC Score). My reasoning was those tests could easily miss underlying pathology and give me a falsely positive results. The CCTA found a blockage which those tests likely would’ve missed (I had zero calcium score, it was 100% soft plaque). Interestingly I submitted my CCTA files to Cleerly for verification and Cleerly didn’t find anything at all. The issue is that Cleerly ignores smaller vessels and my plaque was in my D2 (a fairly minor artery). The Cleerly report said I didn’t even have a D2 (in reality, their AI had just ignored that vessel presumably because it was below their minimum size to analyse). I think on average Cleerly is great, but in my particular case, the humans were better.

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#1174

This is really interesting feedback, so I’m glad you shared this.

Did you send your CCTA results to clearly yourself? Or your doc did? I’m just trying to figure out what the options are… the two step process vs going to a Cleerly approved center (few and far between).

This makes me wonder if one goes to a place that automatically uses Cleerly, is there a human who also looks at the results? If not, the two step process, as you did, seems more advantageous because you’d get what Cleerly has to offer, AND you would also get what Cleerly might miss, as happened in your case.

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#1175

I live in New Zealand, so had a normal CCTA done here (with humans). For the Cleerly analysis I had a Cleerly-aligned USA-based Doctor who arranged the Cleerly referral and billing. Once that was complete, my NZ radiology provider transferred my CCTA data files directly to Cleerly (this process was smooth for me and only entailed sending an email to authorise the transfer).

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#1176

To clarify, normally the people who do the CCTA have a guy that looks at it and gives his opinion. Then the images are sent to Cleerly (there are others with AI too, but this is the one we’re talking about) and they add their opinion.

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#1177

Have you done Cleerly already?

#1178

No, I’ve emailed them and gotten the particulars. I’m waiting for my medicare card, then I’ll talk to them about that and get it done. I’ll post here if it happens.

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#1179

I did it (CCTA w/Cleerly) recently. I was interested in seeing the status of OM2 (among others) which about 15 years ago was deemed 99% plugged!! This time it was clean as a whistle! There was plenty of plaque, distributed with the bulk being hard plaque, a spot or two around 70% blocked. Since my LDL at below 20 and APOB around 37 are at levels where presumably new plaque will not be deposited I am not perturbed. I am going to resume Nattokinase, Serrapeptase and Lumbrokinase after the New Years, have been on them for over a year. At 67 I have to expect issues. Testing gives me visibility on actions to take and effects of prior actions!

6 Likes
#1180

I finally got a blood test and wanted to share the results, which are looking quite good. Unfortunately I don’t have any values from before I started self administering drugs.

Stack prior to the test:
Pitavastatin: 2mg
Ezetimibe: 5mg
Bempedoic Acid: 90mg
Aspirin: 81mg
Metformin: 1g
Rapamycin: 5mg (once a week)

Triglycerides: 39 mg/dL
HDL: 58 mg/dL
LDL: 46 mg/dL

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#1181

Using a GLP1 you can likely drive those values down even further.

#1182

I wonder for how long have you been on this stack (before doing the blood work) and did you also check the fasted glucose? Your stack (which resembles mine, except Bempedoic acid) is great for lipids but not necessarily for glucose (hopefully metformin was enough to keep it in check). In my limited way of understanding health and longevity, lipids kept low is good to stay/keep one alive, glucose kept low is good for health and longevity.

If I were to oversimplify it even further, I’d say managing lipids gets you to 90, whereas also managing glucose gets you another 10-15 years on top of the 90 (total 100-105) and then exercise and 20% calorie restriction is good for another 5-10 and all of the sudden you are at 115-120. Add RAPA, acarbose, and SGLT2 for another 10-15 and now you’re cruising to 140 :slight_smile:

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#1184

It was adjusted over time (eg changing from Rosuvastatin to Pitavastatin and adding metformin) but I think it was pretty consistent for at least 2 months before the test.

My glucose levels did seem a bit high alright. Also I appear to be slightly anaemic. I’m wondering what the consensus is for longevity in regards to it.

Other stuff:
blood glucose 87mg/dl.
Hba1c 5.4%.
Red blood cell count: 4.63 million/mcl.
Haemoglobin 13.2 g/dl.
Blood pressure 99/55.
BMI 21.
Age 38.
Male.
AST 26 U/L
ALT 19 U/L
|gamma-GT 11 U/L

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#1185

Why are you taking aspirin 81 mg?

#1186

Colon cancer prevention.

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#1187

Thanks, I’m surprised more people don’t talk about it – or other drugs with gold standard RCT evidence for reducing risk of cancer.

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#1188

Time to start an SGLT2i and acarbose perhaps (if you’re not taking currently). Can’t help with the anemic part, but I’m sure there is others with more knowledge (that can chime in).

#1189

Few know about this, such an incredible absolute effect with a longer measurement period.

image

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