Pitavastatin

[Ghoul]

Yes. LDL was 100 last time on TRT. A could months ago. HDL 29.

Have the test done before you lower it.

Your lipids aren't going to be crazy, you'll be lucky if they're high enough to get a prescription since so many docs are behind on current guidelines.

Anything close to that, even quite a bit higher won't impact insurance. Even if it was 200, provided it was controlled with meds, with a 0 CAC you're still in very low risk category.

Insurers are interested in what your lipids are at the time you apply, and if you're on meds, they'll want to see a year or two of lipids to ensure you're compliant.

You also need to make sure your BP is controlled.

 

[newguy2]

Have the test done before you lower it.

Your lipids aren't going to be crazy, you'll be lucky if they're high enough to get a prescription since so many docs are behind on current guidelines.

Anything close to that, even quite a bit higher won't impact insurance. Even if it was 200, provided it was controlled with meds, with a 0 CAC you're still in very low risk category.

Insurers are interested in what your lipids are at the time you apply, and if you're on meds, they'll want to see a year or two of lipids to ensure you're compliant.

You also need to make sure your BP is controlled.

Thanks man. Yeah out of the blue on this blast my BP jumped up. It had been good for like 10 weeks and then it wasn't. I was actually able to my PCP to prescribe Telmisartan. Might have taken your advice and told him I used it in the past.

He's a new doc and seems like he'll listen so far. Although he tripped a bit on my creatinine level but he understands it may be from training/diet etc.

 

[Ghoul]

Thanks man. Yeah out of the blue on this blast my BP jumped up. It had been good for like 10 weeks and then it wasn't. I was actually able to my PCP to prescribe Telmisartan. Might have taken your advice and told him I used it in the past.

He's a new doc and seems like he'll listen so far. Although he tripped a bit on my creatinine level but he understands it may be from training/diet etc.

If you have halfway decent insurance, and play your cards right, you can leverage even mildly elevated LDL into a prescription for Repatha ($7,000 / year). Then you'll be able add Pitavastatin and/or Ezetimibe after if you want, Once you get Repatha, you'll won't ever have to "prove" you need a PCSK9 inhibitor again. I think it's a good idea but up to you.

 

[newguy2]

If you have halfway decent insurance, and play your cards right, you can leverage even mildly elevated LDL into a prescription for Repatha ($7,000 / year). Then you'll be able add Pitavastatin and/or Ezetimibe after if you want, Once you get Repatha, you'll won't ever have to "prove" you need a PCSK9 inhibitor again. I think it's a good idea but up to you.

That's one I haven't heard much about but I think have seen you mention.

 

[Deadpool99]

Apparently I got a 0 co-pay prescription for Metformin, Eplerenone, Jardiance, even an IGF-1 test (which is super weird). But my insurance doesn’t want to give me Pitavastatin.

They seem like they don’t mind prescribing any other statin and seem open to prescribing me weed. But no Pitavastatin.

I do have Zydus Pitavastatin, I guess I’ll roll with it till December when I can get them OTC in my home country.

Ik many rely on indian pharma but for someone used to getting everything branded from a pharmacy I grow very skeptical. I guess labwork will tell.

I usually trust people’s anecdotes/labs to assess if it worth investing in smth.

@Ghoul do you know how early I can re-test my lipids on pitavastatin 4mg, I’m mainly looking for the HDL increase, I’m so close to reference.

 

[Ghoul]

Apparently I got a 0 co-pay prescription for Metformin, Eplerenone, Jardiance, even an IGF-1 test (which is super weird). But my insurance doesn’t want to give me Pitavastatin.

They seem like they don’t mind prescribing any other statin and seem open to prescribing me weed. But no Pitavastatin.

I do have Zydus Pitavastatin, I guess I’ll roll with it till December when I can get them OTC in my home country.

Ik many rely on indian pharma but for someone used to getting everything branded from a pharmacy I grow very skeptical. I guess labwork will tell.

I usually trust people’s anecdotes/labs to assess if it worth investing in smth.

@Ghoul do you know how early I can re-test my lipids on pitavastatin 4mg, I’m mainly looking for the HDL increase, I’m so close to reference.

Sorry to hear the insurance trouble.

FYI pitavastatin was initially a brand name called Livalo. Before the patent expired a slightly different version was released called Zypitamag. Same drug, made with a magnesium base instead of calcium like the original, so it's not a generic, it's a "bioequivalent" of the original drug, and basically another branded version (was initially just slightly less expensive than Livalo). A true cheap generic of Livalo came out in 2024 when the Livalo patent expired.

Zypitamag is made in India by Zydus. So they are a premium manufacturer of the drug. I've used the India pharma version from Zydus (Pivasta) and I know many others who have with great success.

Here's what you can expect regarding HDL based on the studies done so far. HDL increases seem to keep accumulating with use over years. The highest increase recorded in a study was 26% from baseline.

Without getting into the technical details. you can expect the increase in HDL to be based on your baseline, before AAS. So if it goes up 20%, and your baseline is 60, that 12 points would be seen on your AAS lowered HDL. IE, if on gear your HDL drops to 25, you can expect to see the same 12 point, or very likely even more, added to that gear suppressed HDL number. Pita interferes with the pathway AAS crushes HDL by, so you get less of a drop, AND the additional production of HDL added.

 

[Deadpool99]

Sorry to hear the insurance trouble.

FYI pitavastatin was initially a brand name called Livalo. Before the patent expired a slightly different version was released called Zypitamag. Same drug, made with a magnesium base instead of calcium like the original, so it's not a generic, it's a "bioequivalent" of the original drug, and basically another branded version (was initially just slightly less expensive than Livalo). A true cheap generic of Livalo came out in 2024 when the Livalo patent expired.

Zypitamag is made in India by Zydus. So they are a premium manufacturer of the drug. I've used the India pharma version from Zydus (Pivasta) and I know many others who have with great success.

Here's what you can expect regarding HDL based on the studies done so far. HDL increases seem to keep accumulating with use over years. The highest increase recorded in a study was 26% from baseline.

Without getting into the technical details. you can expect the increase in HDL to be based on your baseline, before AAS. So if it goes up 20%, and your baseline is 60, that 12 points would be seen on your AAS lowered HDL. IE, if on gear your HDL drops to 25, you can expect to see the same 12 point, or very likely even more, added to that gear suppressed HDL number. Pita interferes with the pathway AAS crushes HDL by, so you get less of a drop, AND the additional production of HDL added.

Great to hear, thanks for the reassurance.

 

[Ghoul]

Great to hear, thanks for the reassurance.

Sorry here's the answer to your question re HDL timing lol

 

[bubba618]

I do have Zydus Pitavastatin, I guess I’ll roll with it till December when I can get them OTC in my home country.

Can I ask your home country?

 

[Deadpool99]

Can I ask your home country?

Kuwait, Middle east. Insulin/meds are all OTC. You can literally order them alongside your uber eats order (our equivalent to uber eats ofc).

However indian is ofc still cheaper cuz at the end of the day you’re getting branded meds. But I’ve grown used it to.

I also travel alot within europe, mainly italy and also alot of it is OTC.

 

[BamaCrazy]

I also travel alot within europe, mainly italy and also alot of it is OTC.

Except Benadryl I learned today. What a crazy thing to make a prescription.

 

[Civdiv]

Without getting into the technical details. you can expect the increase in HDL to be based on your baseline, before AAS. So if it goes up 20%, and your baseline is 60, that 12 points would be seen on your AAS lowered HDL. IE, if on gear your HDL drops to 25, you can expect to see the same 12 point, or very likely even more, added to that gear suppressed HDL number. Pita interferes with the pathway AAS crushes HDL by, so you get less of a drop, AND the additional production of HDL added.

That's pretty good to hear. My baseline hdl was 64 before gear crushed it. I ordered India pharma Pitavastatin a week ago and have been waiting on it. I wish I would have waited. I messaged my Doc out of curiosity about prescribing it. They said they never heard of it but looked it up and said it sounds great. I just told her that since cutting all the fats out of my weight loss diet my hdl has dropped. I sent her a screenshot of my private labs and she called in the prescription no problem. Turns out the asshole insurance company that denies me on everything approved this so no charge. Too bad I already have 200 bucks worth of India Pitavastatin on the way.

 

[keengkong]

I optimize thyroid hormones, keeping T3 at the higher end of normal, which stimulates high SHBG synthesis in the liver.

Also my high e2 (83) increases SHBG.

and

Insulin suppresses SHBG. Tirz keeps my
sensitivity high so insulin levels are low, even on rHGH.

What is SHBG?

 

[keengkong]

Another reason, it is often non-formulary for alot of insurances, they prefer rosuvastatin/atorvastatin/pravastatin. How do I know this? Just was placed on pita and insurance immediately balked for prior auth, would have been non preferred pricing, went with costplusdrugs for 25 bucks no insurance.

That type of stupid insurance stuff makes me angry. I could only get a limited number of Cialis (tadalafil) pills through my insurance. But I get generic and pay myself GoodRx, I can get tadalafil for not that expensive. I just started buying it for even less from PCT 24X7. I did see another post that says that since pitavastatin is generic, insurance may be more willing to cover it now. I don't see my cardiologist for about two months.

 

[Deadpool99]

That type of stupid insurance stuff makes me angry. I could only get a limited number of Cialis (tadalafil) pills through my insurance. But I get generic and pay myself GoodRx, I can get tadalafil for not that expensive. I just started buying it for even less from PCT 24X7. I did see another post that says that since pitavastatin is generic, insurance may be more willing to cover it now. I don't see my cardiologist for about two months.

Yep, for example my insurance, I have never seen an insurance pay for an expensive IGF-1 test that was uncalled for. But oh no, this guys wants Pita we can't let him get away with it.

 

[Deadpool99]

Yep, for example my insurance, I have never seen an insurance pay for an expensive IGF-1 test that was uncalled for. But oh no, this guys wants Pita we can't let him get away with it.

Tbf they did tell me to write an email with lab work and a doctor's note stating that pita would be my best and only option but way too much of a hassle.

 

[Rbvasques]

If anyone needs inspiration, my lipids from September 2024:

View attachment 352358

To September 2025:

View attachment 352359

This is with Pitavastatin 4, Ezetimebe, and Repatha. The Repatha is only adding 10-12% more improvement to the other two though.

After these, and stress echo + CPET results were sent, my preventative cardiologist added a note:

"You have undergone a complete cardiometabolic risk inversion. From a 10-year ASCVD risk near 18%, you now present with optimal blood pressure, an LDL profile in the lowest 0.1% of the population, and endurance-level aerobic fitness. Your current risk is ~2%, likely closer to 1% or less in reality. It's one of the most dramatic reversals of cardiovascular risk I've ever seen."

Not noted here is my A1C 4.8%, and my HS-CRP (systemic / arterial) inflammation dropping from 3.0 (normal for a 65+ year old, not 50) down to 0.4, expected in an early 20's athlete.

I'm well into maximum plaque regression and stabilization territory, as lipids move out of my arteries, and the remaining material turns into a tough fibrous cap not susceptible to rupturing and causing a blockage.

For context, this is on 200mg / wk Test-C, 4iu rHGH, and a diet high in saturated fat (mostly from meat, whole eggs, but also full fat dairy, coconut milk, etc).

View attachment 352370

Other meds are: 15mg Tirz, 40mg Telmisartan , 20mg Cilnidipine, 10mg Cialis, 100mcg T4, 5mg Selegiline. Supplements are multivitamin, K2+D3, Magnesium Threonate, Taurine, Creatine.

I have a similar “other meds” stack, i wonder what you benefit from the T4?
I ran it with hgh when i saw my free t4 very low, but other than that, i never use it.

 

[AlexDavis43]

What is SHBG?

FYI this is some pretty basic info that's the first entry on a google search

 

[Ghoul]

I have a similar “other meds” stack, i wonder what you benefit from the T4?
I ran it with hgh when i saw my free t4 very low, but other than that, i never use it.

More energy. Better cold tolerance. Faster weight loss. Less brain fog. Improves lipids (but lowers HDL).

Low thyroid worsens lipids (increases HDL but lowers function), and the opposite of all the above.

Essentially, T3 (T4 converts to T3) is the metabolic "throttle".

Increases mitochondrial biogenesis (more “engines” in cells).

Raises baseline cellular energy use.

Boosts oxygen consumption and heat production.

Enhances lipolysis, gluconeogenesis, and protein turnover.

 

[just some dude]

it’s something that works when you combine it with other things not just hammering it by itself