#1

This is very interesting for anyone curious to learn more about lipidology without throwing out the baby with the bath water.

Full disclosure: I take a statin with ezetimibe to bring down my apoB. I have been successful in this but have experienced negative side effects (muscle soreness/ weakness). I have been lowering my statin dose and frequency, and been using GG to recover my muscle power.

This person: Vuvyane Loh MD was on the STEMtalk podcast. I then found her own podcast which is full of interesting information. I think both the “apoB is everything/the lower the better” and the “LDL doesn’t matter/statins are poison” people (and everyone in between) will find her credible and interesting and useful.

Enjoy

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I really need your advice - High APO-B
#2

Vuvyane Lou’s Podcast:

https://vyvyanelohmd.com

Joseph mentioned this podcast:

Dr. Vyvyane Loh returns to STEM-Talk for her second appearance to talk about atherosclerotic heart disease. Also known as ASCVD, the disease has been reported to affect 26 million people in the U.S., and annually leads two million hospitalizations and more than 400,000 deaths.

Vyvyane is a board-certified physician in obesity and internal medicine. In episode 142 of STEM-Talk, we talked to Vyvyane about her Boston-based preventative-care practice that specializes in weight management and the treatment of chronic metabolic diseases such as diabetes, hypertension and dyslipidemia.

In today’s podcast, Vyvyane and host Dr. Ken Ford talk about ASCVD as well as recent research that has shown substantial individual variability in the response to statin therapy as a way to lower cardiovascular risk. Vyvyane and Ken also discuss how the current knowledge base informing clinical practice in medicine today is far behind advances in the biological sciences, especially in the field of ASCVD.

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#3

I listened to it a couple times today, since the first time I was spraying a complicated field and the sprayer computer had some problems. She needs your full attention.

Even giving half attention twice I concluded that I don’t want her checking my BS. Very smart and I will be listening to more of her stuff. Thanks for the heads up Joseph!

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#4

Here is her amazing review of mTOR. It is more detailed than anything I have heard before. I cannot speak to how accurate this is but I will accept it until I learn more. Dr Loh is very impressive. I am interviewing her tomorrow.

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#5

Far too much detail for a midwit like me, but the ten minutes from here to the end are haha funny. (Or maybe it’s just me.) At least 1.5x speed recommended.

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#6

I think you can change your statin or reduce the dose to eliminate any muscle pain or weakness.

A little weekend blog on my view of statins, etc.

Interestingly, IMO: Even though different statins are chemically very similar, they do have some different side effects on different people. When I first started on statins, my first prescribed statin was Zocor (simvastatin.

I was on just 20mg/day and got very pronounced muscle pains in my legs in about one week.

I complained to my doctor and he switched me to Lipitor (atorvastatin. I have never had any muscle pain or other side effects from Lipitor.

“Yesterday the Food and Drug Administration told doctors to stop prescribing the top 80-milligram dose of simvastatin, also known by the brand name Zocor (simvastatin), to new patients because of a heightened risk of muscle pain.” (Jun 9, 2011)

Currently, I am taking a combination of atorvastatin, bempedoic acid, ezetimibe, and pantethine.

As with many drugs, using the lowest dose possible that achieves the desired results is best. I have recently reduced my dose of atorvastatin to 20 mg/day because I am trying to get each of my lipids into my self-imposed desirable range. I want everything to be in the low normal range except HDL. (I am a follower of Thomas Dayspring, Dr. Lipid)

My latest results are great except for HDL, which is now in the low normal range.

I do believe by adjusting my dosages I can get the desired results.

"Atorvastatin is more effective at lowering LDL-C while bempedoic acid is more specific for lowering LDL-C without affecting HDL-C.

"Pantethine has also been shown to increase HDL cholesterol levels in some studies. Increases in HDL of up to 17% have been reported with pantethine supplementation.

"Ezetimibe does not significantly affect HDL cholesterol levels.

When combined with statins, ezetimibe provides additional LDL cholesterol-lowering"

“A meta-analysis of 5 randomized controlled trials found that bempedoic acid significantly reduced LDL cholesterol without affecting HDL cholesterol.”

Lowering atorvastatin to 20 mg daily will not, IMO, have a significant effect because the difference in lowering lipids with atorvastatin is, 20 vs 40mg/daily is 42.2% vs 48.6% for LDL lowering. The dose-response curve is not linear.

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Bottom line: I think by titrating the doses of atorvastatin, bempedoic acid, ezetimibe, and pantethine I can reach my desired goal.

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#7

You’ve got a perfect rationale for going off the statin and starting bempedoic acid or a PCSK9 inhibitor (or both!). You don’t need to keep suffering on the statin.

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#8

In theory yes. My doc doesn’t agree. I’ll buy some from India.

#9

Update on PCSK9i

My doc finally agreed to prescribe something other than a statin after I told him I would never take another statin.

He said Bempedoic acid wouldn’t do anything (?) but said a pcsk9i would be good for me. The insurance company said my LDL was very good with a statin so I should stay with the statin.

I’m already taking Bempedoic acid that I imported so I don’t care about the health insurance bullshit

I credit this forum for freeing me from US Healthcare hell.

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#10

My insurance wouldn’t pay for it either. My doc got me a months worth of free samples and we tested and it didn’t do that much good so they said no.

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#11

What dose and what was the Apo B / LDL-c impact?

#12

I’ve just read the summary he writes yearly and he didn’t even put it in there. It was a few years ago and sorry I can’t find it. I took a shot in my abdomen every week or so? At the time I was on a statin and the combo still didn’t get it below about 140 if I remember right.

It wasn’t much trouble and no side effects as I recall.

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#13

Would you please tell me from whom you buy your Bempedoic Acid? Thanks so much for this post about going off on your own to get the meds you need –

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#14

@Deborah_Hall I got my bempadoic acid from

Maulik at Vallabh Enterprise/Shreeji Impex.

Email: maulik7@gmail.com
WhatsApp number: +91 99251 71777

He takes Visa, $15 fee

I have also used Jagdish but his prices are usually higher. All of these sources are listed on this forum…just search for these names to find many references to them and others.

You will be tempted to buy a lot to spread the high cost of shipping and transaction fees but that will increase your risk of US Customs stopping the shipment. I buy 300 tablets at a time. Some people here are more aggressive and get away with it.

Good luck

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#15

FWIW: I have had two shipments out of many opened by U.S. NY customs.
Other than delaying my shipment for about 30 days, nothing happened.

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#16

The Visa fee is 10% of the purchase total $, so it gets expensive on larger orders. I would recommend paying by a lower cost method if you can.

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#17

[quote=“RapAdmin, post:16, topic:13278”]
The Visa fee is 10% of the purchase total $, so it gets expensive on larger orders. I would recommend paying by a lower cost method if you can.

True, but so far his quoted prices are more than 10% lower than Jagdish’s using WISE.
My orders have been executed and shipped faster than my orders from Jagdish.
He uses a slightly different form of EMS which I haven’t fully sussed out yet, and takes a slightly different route. His orders have been very fast.

He says he is working on different payment methods but I haven’t heard anything yet.
In my experience, for the products I have ordered, orders are faster and cheaper than with Jagdish even with the Visa fee.

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#18

I don’t place large orders. 100% loss at customs is very expensive. I lost my only order over 300 tablets (ordered from jagdish).

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#19

I feel better on 80mg of atorvastatin than on 20mg. I think this is likely due to the anti-inflammatory effects of this statin which are at least as valuable as the ApoB lowering effects IMO.

1 Like