Cholesterol numbers on no med, then on statin then on statin + Repatha

[Avies48]

You need Pitavastatin.

Most primary care docs are unfamiliar with it, because it was $500/mo until recently (vs $5 for generics of other statins), and was very difficult to get coverage for.

It's now a generic at -$50/mo, most insurance will cover it, or buy from India pharmacy for $40/100 x 4mg tabs. Only one brand of generic available in the US or India so far, Zydus.

It's been the preferred statin for professional athletes, for good reason.

I planned to do a write up on this little known statin, so this is a little sloppy, but TLDR it provides 90% of the LDL lowering of the most potent "conventional" statins, along with unique characteristics like boosting HDL numbers (and improving HDL function, ie HDL's 'reverse cholesterol transport', the capacity to suck lipids out of your arteries, making it a great candidate for plaque regression, not just stopping further accumulation).

Uniquely, it doesn't increase insulin resistance like other statins, and often improves it(!).

It doesn't harm muscle mitochondrial function, the common issue with every other statin. Muscle related sides are very rare as a result.

It has an enhancing effect on fat lipolysis, and inhibits fat deposition, allowing for increased fat burn and recomposition, unlike the negative impact other statins have on fat metabolism.

It has no interactions with Test or GH because it's not metabolized by CYP3A4 like other statins, preventing accumulation that often leads to sides.

This was a quick and dirty summary, but aside from slightly less LDL lowering ability, and cost, this is clearly the best statin by a mile for prevention (outside of a few edge cases requiring rapid calcification of plaque due to imminent risk).

With Repatha, Ezetimebe, Pitavastatin 4mg you're looking at a 85-90% drop in LDL 10-15%. boost in HDL, and minimal, or more likely no sides.

Even just Pita 4mg and Ezetimebe it's approx 60% drop in LDL, 50% APOb, 30% triglycerides, and 10-15% boost in HDL with an excellent shot at not experiencing any sides.

The statin for statin haters like me.

Well fuxk i may have to ask about this one and add it to ezetimebe…


And it has 3 names as brands

Livalo

Nikita

Zypitamag

 

[Ghoul]

View attachment 342693

Well fuxk i may have to ask about this one and add it to ezetimebe…

Everyone I knew who's using it loves it. Even 2mg crushes LDL and no one thus far has experienced any sides.

It has the most potent LDL lowering effect per mg, for the same reason it has the lowest rate of "off target" effects, ie, sides.

The synthetic Pitavaststin molecule is the smallest of all statins, and fits perfectly into the receptor. All other statins are "sloppy" large molecules that only partially fit the receptor, and because of their size, don't always penetrate the cell membrane to get in to reach it. So much larger doses of other statins are needed for the same result, leading to excess amounts of the drug floating around causing unwanted side effects.

It's like an LDL lowering sniper rifle vs a shotgun.

 

[Avies48]

I've recently started Icosapent Ethyl capsules, @Nidus and @Ghoul what are your thoughts on this stuff?

I read a couple studies on potential plaque stabilization/regression, anti-inflammatory properties and cell strengthening and a couple other pleiotropic effects and since I was already taking EPA only fish oil my cardio was more than happy to switch me to the tested stuff.

Where did u get the fish oil capsules? I use to get them
From a source but dont think they carry them anymore

 

[Avies48]

Everyone I knew who's using it loves it. Even 2mg crushes LDL and no one thus far has experienced any sides.

It has the most potent LDL lowering effect per mg, for the same reason it has the lowest rate of "off target" effects, ie, sides.

The synthetic Pitavaststin molecule is the smallest of all statins, and fits perfectly into the receptor. All other statins are "sloppy" large molecules that only partially fit the receptor, and because of their size, don't always penetrate the cell membrane to get in to reach it. So much larger doses of other statins are needed for the same result, leading to excess amounts of the drug floating around causing unwanted side effects.

It's like an LDL lowering sniper rifle vs a shotgun.

Do u know if 247 carries this? Ima see and grab up the fish oils as well… along with the bp acid and zetia and see what my doc recommends

 

[Avies48]

Insurance and treatment guidelines expect a statin to already be used, and Vascepa is an add on. It's proven to protect cardiovascular health to a very high degree, with no sides in almost every case. Vascepa + Rosu blow away Ezetimebe + Rosu if someone's a medicine minimalist and doesn't want all 3.

I know plenty of guys are using fish oil / omega 3 supplements already anyway, and this is just a cleaner, more effective type of that.

Hmmm i had a blood clot when trying crestor at 5 mlg per day for 1 week… thats why telehealth doc scripted me repatha, but i wanna try something else … i dont have high trigs… just over all cholesterol and ldl

 

[Ghoul]

Do u know if 247 carries this? Ima see and grab up the fish oils as well… along with the bp acid and zetia and see what my doc recommends

It's not on his list but I knew he takes requests. There are also combo tabs with Ezetimebe, another side effect free LDL lowering compound so they go very well together. 2mg + eze = 60-70% LDL reduction. If you can't find it DM me.

 

[Photon]

It's not on his list but I knew he takes requests. There are also combo tabs with Ezetimebe, another side effect free LDL lowering compound so they go very well together. 2mg + eze = 60-70% LDL reduction. If you can't find it DM me.

I dont think PCT can get any of the combo pills with Pita..pity.

 

[Avies48]

It's not on his list but I knew he takes requests. There are also combo tabs with Ezetimebe, another side effect free LDL lowering compound so they go very well together. 2mg + eze = 60-70% LDL reduction. If you can't find it DM me.

Thanks man im hoping i can grab some somewhere

 

[Avies48]

I dont think PCT can get any of the combo pills with Pita..pity.

Can 24x7???

 

[MarkusLA]

@Ghoul

The synthetic Pitavaststin molecule is the smallest of all statins, and fits perfectly into the receptor. All other statins are "sloppy" large molecules that only partially fit the receptor, and because of their size, don't always penetrate the cell membrane to get in to reach it. So much larger doses of other statins are needed for the same result, leading to excess amounts of the drug floating around causing unwanted side effects.

Ghoul, interesting info. Do you have a link with more info on the size and receptor binding?

Also any info if this one crosses the blood-brain barrier like other statins?

Thanks!

 

[MarkusLA]

Considering the concern over Tryg. here, anyone ever looked at Carnitin?

600mg Carnitin keeps my Tryg at 70
1200 around 50 and with 1800mg at the moment they barely touch 45

@Nidus - I am running a test on myself now doing 1200mg/day. I'm doing the 2.4ml injection into the glute with a 1" 25g needle. It's a PITA. Are you doing the same?

 

[Nidus]

@Nidus - I am running a test on myself now doing 1200mg/day. I'm doing the 2.4ml injection into the glute with a 1" 25g needle. It's a PITA. Are you doing the same?

I use a 26g needle and a 5ml syringe, takes a while to push it in but feels much better to my previous 23g attempt. I inject it all subq and make sure it's spread out, once done I also massage the spot so it's not one big lump

 

[frenske]

@Ghoul Is there a way to fake a high cholesterol reading? I have Familial Hypercholesterolemia but below the cut of ranges for Repatha when on statins + ezetimibe.

 

[BamaCrazy]

@Ghoul Is there a way to fake a high cholesterol reading? I have Familial Hypercholesterolemia but below the cut of ranges for Repatha when on statins + ezetimibe.

You get Repatha by telling your doc the statin has started causing you muscle pains.

A statin intolerance is the ticket.

 

[Wizbang]

You get Repatha by telling your doc the statin has started causing you muscle pains.

A statin intolerance is the ticket.

This.

 

[Ghoul]

@Ghoul Is there a way to fake a high cholesterol reading? I have Familial Hypercholesterolemia but below the cut of ranges for Repatha when on statins + ezetimibe.

Doctors use a 4 week "washout" period to check baseline lipids.

Realistically they'll rebound 90%+ 10 days after stopping the statin and ezetimibe.

10-14 days of elevated cholesterol isn't going to cause any damage. Arteriosclerosis is very, very slow to develop.

There's nothing you could consume that would impact LDL in a short period of time. Only triglycerides rise quickly from food.

 

[Wizbang]

Figured I would post this for comparison purposes, the last screen shot newlipids is:

Repatha + Pita 1mg + Icosapent Ethyl 4g (results from Today)

 

[Photon]

Figured I would post this for comparison purposes, the last screen shot newlipids is:

Repatha + Pita 1mg + Icosapent Ethyl 4g (results from Today)

View attachment 360460View attachment 360461

When did you start Repatha?
2022?

The main change between 2024->2025 seems to be a drop in HDL and trigs.

 

[Wizbang]

When did you start Repatha?
2022?

The main change between 2024->2025 seems to be a drop in HDL and trigs.

So timeline looks like this 2021 was Rosuvastatin+Eze, 2022 was the introduction of Praluent (the big dip in LDL), Repatha was switch to in January of this year (2025) as my insurance made it the preferred med and Praluent became nonpreferred/PA. My cardio says they work pretty much the same so my results should be interchangeable between praluent and repatha. I am unsure why the drop in HDL, he seemed to not be too concerned about that as my LDL had steadily declined, when I achieved 70s he was "happy" and I continued to push to drop it further (pitavastatin introduction). It appears the HDL bump could be the as described effect of Pitavastatin where HDLs are driven up by its use. Vascepa was introduced in August I believe, I was looking more for the pleiotropic effects of the icosapent described in a few papers and cardiologist was totally cool with it as my trigs are not "high".

 

[vril]

10mgs of Reta helped so much with my Cholesterol