#1188

I think if you are above the normal levels of LDL, you may want to consider lowering it back into the normal range.

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#1189

Using statins affects cytosolic metabolism in making acetyl coa more available for other things. It is not just a question of reducing cholesterol.

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#1190

Here is different chronic disease states that can lower cholesterol, paraphrased from Gil Carvalho MD PhD:

Cancer, we even know the mechanism

Infections

Liver diseases

General frailty and lack of appetite

Absorption issues

“A lot of people who are sick and in the last 5 to 10 years of their life have an underlying disease process that can lower their cholesterol. And that disease process might be the cause of death. So you can’t assume that it is the cholesterol that is causing the death because you have multiple variables.”

https://twitter.com/fproofmastery/status/1603027464992821249

#1191

The studies control for cancer and it’s hard to believe that in very large population studies things like liver disease and infections aren’t fairly obvious. Furthermore, the effects of infections would be short lived.
I doubt that frailty lowers LDL to any significant degree.

#1192

Are you familiar with this

https://onlinelibrary.wiley.com/doi/10.1111/acel.13751

#1193

They didn’t control for liver disease, absorption issues, lack of appetite/frailty. And the infections can be parasitic infections, which they also didn’t control for.

#1194

Yeah, I guess the study investigators missed the fact that those with very low LDL’s were chronically ill with liver diseases and parasites. And this has been the case in multiple large population studies.

#1195

So you’re saying they did control for it? And that other studies have done so as well?
Nowhere did I see that they did so.

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#1196

This is an excellent explanation of serum lipid levels.

Basically, I take away from this that the ApoB levels are a better indication of CVR than LDL, HDL, or triglycerides.

Other members of this forum have said that ApoB is a better indicator of CVR than libid levels.

I have been concerned about rapamycin raising my LDL and triglyceride levels.

Unfortunately, I don’t have any data on my ApoB levels taken before I started rapamycin.

But, my recent test that was taken on 11/07/22 shows that my ApoB levels are good even after taking rapamycin for a year.

Do any members have a history of their ApoB levels before and after taking rapamycin for more than a few months?

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#1197
#1198

It would be nice to see a discussion of these findings to know what the ramifications are.

#1201

That study isn’t really as applicable to say taking rosuvastatin which has a limited ability to cross the BBB though. Here is a study on pravastatin showing insignificant amounts past the BBB, which is also hydrophilic but still less hepatoselective than rosuvastatin btw.

If one is seeking to minimize potential side effects as a potential low-cost preventative over say ezetimibe + PCSK9i + ASOs - assuming one already got a solid CLIA-certified WGS with a full understanding of what types of pharmacogenetics are favorable - my hunch would be 2.5 mg of rosuvastatin qwk (maybe berberine addition - which is a PCSK9i to some extent - is worth a shot to induce the expression of OATP1B1 mRNA in certain peeps) and cycling could drastically reduce potential NNH on a lot of fronts for “healthy” individuals for long-term use, on top of making sure Vitamin D3 is at around 40 ng/dL. The half-life of rosuvastatin would put it at 4 days or so out of the week.

Here’s a list for clear cut pharmacogenetic applications in rosuvastatin: ABCG2, SLCO1B11, SLCO1B15, SLCO1B19, SLCO1B114, SLCO1B115, SLCO1B137, rs4149056, rs2231142

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#1202

I like the idea of very low dose weekly paired with berberine. Would almost certainly eliminate the side effect issue.

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#1203

Lovastatin has a very long history too - fermented rice with significant amounts of naturally occuring statins was used for a longggg time in China for at least 1,000 years with known properties to treat “blood circulation stasis”.

#1204

Hard to say for sure…we know PCSK9 loss-of-function peeps appear to be doing fine at the very low ends of LDL-C (and LDL-P/apoB)

If you’re interested, this study could be helpful in figuring out a more precise range.

image
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Luckily, I already have LDL-P <1000 unmedicated (unless you count omega-3 intake and ultra-low dose dietary statin from food, etc) with low apoB and Lp(a). The main issue I have is figuring out what to make of low HDL-P (despite high HDL-C) since HDL therapies seem to be mostly awash.

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#1205

There have now been several studies showing the same U shaped LDL curve. I’m no longer buying into the reverse causation explanation.

Your numbers are really good. Wouldn’t worry about HDL- P.

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#1206

We ignore what the Chinese have done for centuries at our own detriment.

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#1207

Statins also affect a lot of things in the body with a lot of pleiotropic effects.

We have increased PCSK9 and increased Lp(a) with statins as what appears to be dose-dependent.

It’s hard to tell for sure, but rosuvastatin 2.5 mg (or even 1-2 mg) once weekly on top of 5 mg ezetimibe daily could be worth exploring with more data when it comes to a “poor man’s polypill”. LDL 70-90 (assuming not discordant with LDL-P with “Pattern B”) might be a good range to be in and is doable with this combination for “healthy” people under physician supervision assuming they actually have lipidology training/knowledge - especially drug drug interactions and all the complexities involved with statins.

I would personally be more interested in data regarding a combination of ezetimibe/PCSK9i/ASO, but I understand most people are generally sensitive to costs.

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#1208

Thanks! It’s still hard to tell - I recall some forms of HDL may be atherogenic while HDL is an even murkier topic

#1209

You are right, we especially don’t want to ignore the dangers of traditional Chinese medicine.

1 Mammals
1.1 Human parts and excreta
1.2 Donkey-hide gelatin
1.3 Deer penis
1.4 Flying squirrel feces
1.5 Pangolin scales
1.6 Rhinoceros horn
1.7 Tiger penis
2 Reptiles and amphibians
2.1 Snake oil
2.2 Toad secretions
2.3 Toad-headed gecko
2.4 Turtle shell
3 Marine life
3.1 Seahorse
3.2 Shark fin soup
4 Insects
4.1 Blister beetle
4.2 Centipede
4.3 Hornets nest
4.4 Leech
4.5 Scorpion
5 Fungi
5.1 Supernatural mushroom
5.2 Tremella fuciformis
6 Plants
6.1 Monkshood root
6.2 Birthworts
6.3 Camellia sinensis
6.4 Cayenne pepper
6.5 Chinese cucumber
6.6 Chrysanthemum flowers
6.7 Cocklebur fruit
6.8 Crow dipper
6.9 Croton seed
6.10 Dioscorea root
6.11 Ginger
6.12 Ginkgo
6.13 Ginseng
6.14 Goji berry
6.15 Horny goat weed
6.16 Lily bulb
6.17 Pear
6.18 Chinese Rhubarb
6.19 Round cardamon fruit
6.20 Thunder god vine
6.21 Trichosanthis root
6.22 Strychnine
6.23 Sweet wormwood
6.24 Willow bark
7 Inorganic chemicals and minerals
7.1 Arsenic
7.2 Lead
7.3 Mercury
8 See also
9 Reference

Of course, there are a couple of useful medicines hidden amongst the poisons.
Not meant to offend the Chinese and their great many inventions and contributions to medicine.

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