LDL Up on Lower Dose?

[Ghoul]

can we talk about his hdl? its never worth it to sacrifice your hdl to get low ldl. unless your total cholesterol is sky high and you just need to bring it down as aggresively as you can.

at this point its like trying cut bodyfat and in doing so he has lost all muscle aswell, and after that is he is just deciding to stay in the cut forever with 0 dietary fats.

That's widely believed, including by primary care physicians, but outdated thinking regarding HDL.

Overwhelming evidence has proven CV risk reduction is all about LDL.

Put simply, the only purpose of other lipid markers, including HDL, is to determine how low the LDL target should be. If you get LDL low enough, the significance of other factors becomes trivial.

Instead of pointing to a bunch of difficult to digest research papers, here's what the Director of Preventative Cardiology at Harvard Medical School's main teaching hospital had to say in a refreshingly plain English interview last month:

The complex story of HDL cholesterol - Harvard Health

High-density lipoprotein (HDL) is often called “good” cholesterol, but this may be misleading as some HDL particles appear to adversely affect cardiovascular health. People shou...

www.health.harvard.edu

 

[dinfar1337]

That's widely believed, including by primary care physicians, but outdated thinking regarding HDL.

i do agree with you on the cardivasuclar risk we're pretty much on the same page.

but we still need a decent amount of hdl for athletic purposes and i dont like tanking it to the ground to achieve fast results with ldl when it can be brought down in other ways

we need hdl for hormones, athletic purposes and other health factors beyond cardiovascular even on trt. in thinking of a solution we can all adhere too as long as theres no major cardiovascular risk.

 

[adrenalytic]

Try running the same thing for a decent period of time as opposed to swinging the pendulum back and forth every few weeks with big changes.

I don't think I was actually "swinging the pendulum back and forth". More like titrating up for 8 weeks, then steady blasting for 8 more and now titrating down to tolerable cruise levels. But yeah, that's the plan, to find a healthy cruise dose and stay there for a bit.

You've posted a lot of supplements (useful, okay, but not essential).

Not everything is for lipid management. My hepatic function is better than most people not on gear. I credit my supp stack for that. Liver is in great shape aside from some mildly elevated AST which is likely due to the intensity of my training. My training and pumps are also better than most. Partial credit to stack (rest is shear willpower). BP is in check thanks to supps. On a good day I can do pushups with my dick thanks to supps.

In short, I don't take anything that is not essential to me.

I think we differ in our idea of "essential".

I challenge you to do 15-20 days with zero direct fat in your diet.

Might be worth a try. I'll give this some thought.

Ask:

"Isn't HDL/LDL ratio largely discredited as a therapeutic target and absolute LDL-C the primary indicator of cardiovascular risk?"

and see what it says.

Then follow with: "Regenerate previous analysis based on this revision regarding ratio"

Based on those levels, using the best current science rather than guidelines, would an AAS using bodybuilder lowering ldl using pitavastatin 4mg + ezetimibe see significant risk reduction over the long term?

That's widely believed, including by primary care physicians, but outdated thinking regarding HDL.

Overwhelming evidence has proven CV risk reduction is all about LDL.

Put simply, the only purpose of other lipid markers, including HDL, is to determine how low the LDL target should be. If you get LDL low enough, the significance of other factors becomes trivial.

Instead of pointing to a bunch of difficult to digest research papers, here's what the Director of Preventative Cardiology at Harvard Medical School's main teaching hospital had to say in a refreshingly plain English interview last month:

View attachment 350080
View attachment 350081

The complex story of HDL cholesterol - Harvard Health

High-density lipoprotein (HDL) is often called “good” cholesterol, but this may be misleading as some HDL particles appear to adversely affect cardiovascular health. People shou...

www.health.harvard.edu

This is gold. Definitely bringing this to the appointment with me. Thanks!!!

 

[dinfar1337]

Might be worth a try. I'll give this some thought.

bro drop that ai instantly wtf is it saying. it scrambled on everything but some points of ghouls spoon feeding

imo 50-70 ldl is a good number to aim for and hdl higher or around 50. the lower ldl you get the better with still having a decent/or excellent hdl.

i think you should take my advice on keeping the hdl good which you have and try to lower ldl with ezemtimbie or pitavastatin and not remove dietary fats from your diet at all, that is just stupid way that will sacrifice your hdl.

 

[adrenalytic]

bro drop that ai instantly wtf is it saying. it scrambled on everything but some points of ghouls spoon feeding

imo 50-70 ldl is a good number to aim for and hdl higher or around 50. the lower ldl you get the better with still having a decent/or excellent hdl.

i think you should take my advice on keeping the hdl good which you have and try to lower ldl with ezemtimbie or pitavastatin and not remove dietary fats from your diet at all, that is just stupid way that will sacrifice your hdl.

Ya, I take everything it says with a grain of salt. Always fact check.

Def gonna get on a statin. Just hope I can get it for free haha, I'll let ya know how my appointment goes on Thurs.

 

[dinfar1337]

Ya, I take everything it says with a grain of salt. Always fact check.

Def gonna get on a statin. Just hope I can get it for free haha, I'll let ya know how my appointment goes on Thurs.

if you wanna limit fats in a better way, say goodbye to satured and trans fats and try to focus on unsatured fats.

cronometer is gold standard for having a good overview over your daily fat intake and what type of fats you're getting in

 

[adrenalytic]

if you wanna limit fats in a better way, say goodbye to satured and trans fats and try to focus on unsatured fats.

cronometer is gold standard for having a good overview over your daily fat intake and what type of fats you're getting in

I already do this. Crono has been my guiding light for the better part of a year. Admittedly, my diet is not perfect but it's pretty tight 5-6 days a week. There are places I could cut fat saturated fats but man, why bother living if you can't indulge once in a while?

 

[Ghoul]

bro drop that ai instantly wtf is it saying. it scrambled on everything but some points of ghouls spoon feeding

imo 50-70 ldl is a good number to aim for and hdl higher or around 50. the lower ldl you get the better with still having a decent/or excellent hdl.

i think you should take my advice on keeping the hdl good which you have and try to lower ldl with ezemtimbie or pitavastatin and not remove dietary fats from your diet at all, that is just stupid way that will sacrifice your hdl.

So your opinion vs the director of PREVENTATIVE Cardiology at Harvard Medical School's teaching hospital in Boston, lol.

I never resort to AI as a primary source, and every statement in the answer he received is supported by the most recent research, including the lower LDL guidelines from the European Society of Cardiology which I posted here the day after their release.

If you think anything is wrong, you need to call it out specifically, and back up your position. Vague denials and broad generalizations because he used a shortcut to get the answer by asking AI the correct questions have no credibility.

I've read thousands of published studies and it's very rare the statement "Causal" is made. It's typically decades before that's established. "Very strongly correlated" or any of a dozen other assertions are made before getting to that point of what amounts to certainty, yet that's exactly what you see in lipid guidelines now.



The results of very low LDL made possible for the first time because of PCSK9 drugs are also accurate and put an end to speculation.

There is no lower LDL limit below which cardiovascular risk does't continue to drop, and not any sign whatsoever of negative effects going down to near 0 LDL.

When did anything you know about lipids change? When was the last time you did the work to update your knowledge? It's too bad we can't ask the same blunt questions of primary care doctors, because the answers from them would explain why cardiovascular disease is still the #1, yet completely avoidable, cause of death.

 

[dinfar1337]

So your opinion vs the director of PREVENTATIVE Cardiology at Harvard Medical School's teaching hospital in Boston, lol.

hello, i've both agreed with it here

i do agree with you on the cardivasuclar risk we're pretty much on the same page.

and here.

bro drop that ai instantly wtf is it saying. it scrambled on everything but some points of ghouls spoon feeding

if you think i attacked that paper you should read my messages a little better. i saw the top screenshot and everything it said about >100 best <70 bad < 50 go see a doctor ldl i was talking about but credited for getting right at your spoon feeding

 

[dinfar1337]

I've never denied ldl is the main driver for cardiovascular risk.

i even said to you we're on the same page about that.

i differ from ldl is the only thing that matters when you look beyond cardiovascular risk. For people who chase perfomance and are on trt/ or blasting tanking hdl is stupid.

But yeah i think you misunderstood me and know this so i wont go too deep into it and point to "sources" and back up my claims since i dont think we actually have any disagreement here.

also i've never accused you of using ai or anything. but you're sometimes answering like you're not reading what people message you xd

 

[adrenalytic]

i saw the top screenshot and everything it said about >100 best <70 bad < 50

Ya, that was the only thing I saw that was blatantly incorrect which is why I called it out specifically. Everything else seemed quite plausible and in line with what @Ghoul has been saying for a while now (in other threads). I have not personally dove into source material to verify (yet).

 

[dinfar1337]

Ya, that was the only thing I saw that was blatantly incorrect which is why I called it out specifically. Everything else seemed quite plausible and in line with what @Ghoul has been saying for a while now (in other threads). I have not personally dove into source material to verify (yet).

i also agree with as low as possible ldl is the best(stated for the 4th or 5th time now)

I've got 10-15 HDL and 35-40 LDL, triglycerides 40.

but i also believe getting this bad lipids from cutting dietary fats in a attempt to lower ldl is just very very wrong unless you have big cardiovascular risk factor. which was what i was arguing against if anyone is still confused.

i didnt even engage that much with ghoul lol unless im misunderstanding and he want 0 hdl for low ldl

 

[adrenalytic]

Follow up.

I had my new patient appointment today. New GP seems alright.

We addressed a few things:

1. CTS - EMG scheduled.

2. I tried to get a mirabegron prescription but she said tamsulosin would be better in the presence of BPH, which, after shoving her finger up my ass without a reach-around, she confirmed I have. I had no argument prepared for that so I guess tamsulosin it is (for now). Don't know much about this drug.

3. High LDL - I said my last test came back LDL 106 and she said "that's actually pretty good" . She's sending me for testing in 2 weeks so I have that much time to crush my lipids so I can get on a statin. She goes by the ASCVD risk scores but with family history I should be able to convince her...I hope.

4. TRT - going to test my T and E and refer from there.

So the plan is this. Stop taking everything. Stop support for lipids, stop T injections. I'm going to use 25 mg Anavar ED to further crush lipids and so I can still perform in the gym while esters clear.

Two weeks for enanthate should be long enough right? I could prob buy more time if needed but I don't want to be so long with crashed everything.

 

[dinfar1337]

So the plan is this. Stop taking everything. Stop support for lipids, stop T injections. I'm going to use 25 mg Anavar ED to further crush lipids and so I can still perform in the gym while esters clear.

maybe you can not do this and get fake lab blood work?

im more than happy to help you create fake screenshots with your name on it. if that goes unchecked with american healthcare

 

[adrenalytic]

maybe you can not do this and get fake lab blood work?

im more than happy to help you create fake screenshots with your name on it. if that goes unchecked with american healthcare

Very generous offer brother but that would be insurance fraud here, a felony. I have to legit trash my body to get help unfortunately. I guess I don't really have to do it but if I'm gonna be in this for the long haul I should probably get some sustainable support for it. Two weeks is a drop in the bucket. I'll be back to normal in no time. I was able to get a script for Lovaza, pharma fish oil. Pretty happy about that.

But ya, good lookin' out bro. I do appreciate the offer to help.

 

[dinfar1337]

But ya, good lookin' out bro. I do appreciate the offer to help.

i will always be where the harm reduction potential is.

have a fun 2 weeks of being natty bro. my solitude will be with you

 

[adrenalytic]

i will always be where the harm reduction potential is.

have a fun 2 weeks of being natty bro. my solitude will be with you

I'll be fake natty with the anavar XD

 

[bubba618]

Also, I have an appointment with my Dr. this week. What are the guidelines for getting a script for Ezetimibe or Pitavastatin? If I am below that threshold, is it stupid to artificially raise my numbers just to qualify?

Since you're in the USA, just tell your doctor that you're fine paying out of pocket for the medications and since what you're asking for is FDA-approved and matches current recommendations for aggressive lipid management to just write the Rx anyway.

This is exactly the topic on hand for my upcoming appointment with my PCP/GP and I've already got the paperwork ready for doctor to send the Rx to the Mark Cuban Cost Plus Drug Company. In my case, rosuvastatin 10mg daily and 10mg ezetimibe daily for an out-of-pocket total of US$16 and change for a 90-day supply of both.

Pitavastatin 4mg 90-day supply costs US$50 and change which would give you 90 days of both pitavastatin and ezetimibe around US$60.

I'll be honest, I've been surprised looking over some of the availability and pricing coming out of Cost Plus lately. When I previously looked, they were sadly lacking on a number of items which they now seem to have. Still a few that are missing, but I'll let my insurance pharmacy plan deal with those.

 

[adrenalytic]

Since you're in the USA, just tell your doctor that you're fine paying out of pocket for the medications and since what you're asking for is FDA-approved and matches current recommendations for aggressive lipid management to just write the Rx anyway.

This is exactly the topic on hand for my upcoming appointment with my PCP/GP and I've already got the paperwork ready for doctor to send the Rx to the Mark Cuban Cost Plus Drug Company. In my case, rosuvastatin 10mg daily and 10mg ezetimibe daily for an out-of-pocket total of US$16 and change for a 90-day supply of both.

Pitavastatin 4mg 90-day supply costs US$50 and change which would give you 90 days of both pitavastatin and ezetimibe around US$60.

I'll be honest, I've been surprised looking over some of the availability and pricing coming out of Cost Plus lately. When I previously looked, they were sadly lacking on a number of items which they now seem to have. Still a few that are missing, but I'll let my insurance pharmacy plan deal with those.

I'll keep this in mind if she fights me after I get results back.

 

[DugPrime]

UP the dose back