Had a Heart Attack today at age ~30. Be safe guys.

[DugPrime]

Dropped the Tren + Mast, now just on 300 Test.

Decided it wasn't worth the risk.

Seems like in terms of cardiac remodeling + LDL risk, Test/Nandrolone/Primo are the ways to go.

But I'm not made out of money, so Test + Nand it'll be for the foreseeable future.

Nandrolone is as much toxic as Tren, if not more. Test is the way to go.

 

[eery]

God fucking damn it, i didnt see this until now. Im so happy you are still alive bro, keep us updated, stay safe and take care of yourself <3

 

[egruberman]

- Start high intensity statin therapy for goal of less than 55

Goddammit. I'm going to piss off your cardiologist but fuck this shit. I've posted this before and will post again:



See how they all flatline right in the middle? That's where the adverse side effects really start to kick in without a concomitant increase in efficacy.

I haven't gotten through this whole thread, but @Ghoul mentioned on the first page and maybe others have as well, but you want to tank your LDL. Get it as low as possible with the goal of achieving plaque regression. The ACC is *just* starting to come around to this notion even though the data has been present for about 10 years suggesting it, but they've been excessively concerned about the needs of insurers rather than all the people dying from ASCVD.

My aunt is in secondary prevention, has been for 20 years. Experiencing some angina lately and her cardiologist hasn't done a great job. I prepared the attached document for her. It is written for a lay person and is well grounded in the current research.

 

[egruberman]

If OP takes a pcsk9 inhibitor and gets his LDL down to <= 30 or so, and his BP down to 120/80 morning bp (so 105 or so at night), can he get rid of most of his risk?

The risk isn't eliminated, but will not increase.

Plaque regression is uncertain in the literature presently, but there is some promising data. If plaque regression does occur from having very low LDL, then the risk may diminish, but there's no precedent for that yet in the literature.

 

[RockyP]

Goddammit. I'm going to piss off your cardiologist but fuck this shit. I've posted this before and will post again:

View attachment 350292

See how they all flatline right in the middle? That's where the adverse side effects really start to kick in without a concomitant increase in efficacy.

I haven't gotten through this whole thread, but @Ghoul mentioned on the first page and maybe others have as well, but you want to tank your LDL. Get it as low as possible with the goal of achieving plaque regression. The ACC is *just* starting to come around to this notion even though the data has been present for about 10 years suggesting it, but they've been excessively concerned about the needs of insurers rather than all the people dying from ASCVD.

My aunt is in secondary prevention, has been for 20 years. Experiencing some angina lately and her cardiologist hasn't done a great job. I prepared the attached document for her. It is written for a lay person and is well grounded in the current research.

I’ve had to coax my cardiologist into allowing me to increase my Pitavastatin from 2 to 4 mg at an LDL of 68. He’s already pushing back on Zetia which I will likely add soon (I’m not expecting a huge decrease from 68 on 4 vs 2 mg pita). And I haven’t even spoken to him about bemp acid yet. I can get those latter Rx from my pcp (he said he’s actually learning from me) but it’s kinda nuts to be honest.

One thing, a few doctors have told me that it’s “not healthy” to have an LDL under 40. Something about cell membrane integrity etc. Any validity to this?

 

[egruberman]

Lovaza and Vascepa (and statins) can help stabilize these plaques?

Statins, specifically will help stabilize plaques and possibly result in a higher CAC score, but lower probability of an event.

 

[Photon]

One thing, a few doctors have told me that it’s “not healthy” to have an LDL under 40. Something about cell membrane integrity etc. Any validity to this?

Mines <10.
Instead of testing regularly, i do what i can to get it all the way down.

 

[RockyP]

LDL cholesterol: How low can you (safely) go? - Harvard Health

Lowering LDL cholesterol has been shown to lower risk of cardiovascular disease. Recent studies have suggested that more aggressive goals for LDL levels in people who already have CVD can decrease ...

www.health.harvard.edu

Seems like the docs I talked to were shooting from the hip and referencing old data. Studies referenced here showed 20% reduced risk for every 39 point drop in LDL with no adverse events in LDL as low as 20

 

[Photon]

Goddammit. I'm going to piss off your cardiologist but fuck this shit. I've posted this before and will post again:

View attachment 350292

See how they all flatline right in the middle? That's where the adverse side effects really start to kick in without a concomitant increase in efficacy.

I haven't gotten through this whole thread, but @Ghoul mentioned on the first page and maybe others have as well, but you want to tank your LDL. Get it as low as possible with the goal of achieving plaque regression. The ACC is *just* starting to come around to this notion even though the data has been present for about 10 years suggesting it, but they've been excessively concerned about the needs of insurers rather than all the people dying from ASCVD.

My aunt is in secondary prevention, has been for 20 years. Experiencing some angina lately and her cardiologist hasn't done a great job. I prepared the attached document for her. It is written for a lay person and is well grounded in the current research.

What are your thoughts on plant stanols like Benecol?

 

[egruberman]

One thing, a few doctors have told me that it’s “not healthy” to have an LDL under 40. Something about cell membrane integrity etc. Any validity to this?

Yeah, that's bullshit. Check the document I posted, there are cites in there on this topic, but the tl;dr is that nobody has identified an LDL value below which there is no further benefit to cardiovascular risk. Further, there is no LDL value below which any other aspects of health are compromised.

The people that believe that LDL can be "too low" are looking at the data that correlates low LDL with outcomes, but they didn't examine the population of those studies. People with very low LDL in the general population are suffering from some condition that has other negative health impacts. There's no causal relationship.

Nobody has identified any particular health risks in otherwise healthy individuals that have reduced their LDL to very low levels. There is some theoretical concern about vitamin absorption and sex hormone production. Obviously the latter isn't a problem for those of us on exogenous hormones and the former shouldn't be a problem either if one is supplementing effectively and monitoring the results.

I'm due for testing soon, but here's my last:

 

[Photon]

LDL cholesterol: How low can you (safely) go? - Harvard Health

Lowering LDL cholesterol has been shown to lower risk of cardiovascular disease. Recent studies have suggested that more aggressive goals for LDL levels in people who already have CVD can decrease ...

www.health.harvard.edu

Seems like the docs I talked to were shooting from the hip and referencing old data.

He links this in his doc.
I'm gonna bookmark it the next time my doc wants to take me off anything LOL.

LDL Cholesterol Lowering: Is There a Risk for Dementia and Hemorrhagic Stroke? - American College of Cardiology

www.acc.org

 

[RockyP]

Goddammit. I'm going to piss off your cardiologist but fuck this shit. I've posted this before and will post again:

View attachment 350292

See how they all flatline right in the middle? That's where the adverse side effects really start to kick in without a concomitant increase in efficacy.

I haven't gotten through this whole thread, but @Ghoul mentioned on the first page and maybe others have as well, but you want to tank your LDL. Get it as low as possible with the goal of achieving plaque regression. The ACC is *just* starting to come around to this notion even though the data has been present for about 10 years suggesting it, but they've been excessively concerned about the needs of insurers rather than all the people dying from ASCVD.

My aunt is in secondary prevention, has been for 20 years. Experiencing some angina lately and her cardiologist hasn't done a great job. I prepared the attached document for her. It is written for a lay person and is well grounded in the current research.

That document is gold. Thank you sir.

 

[egruberman]

What are your thoughts on plant stanols like Benecol?

They're perfectly peachy and will have an additive effect to the polypharma method I documented. They even work in concert with psyllium husks. Plant stanols will block absorption, and psyllium will absorb some cholesterol, causing the liver to harvest more from the bloodstream yielding an overall lowering effect.

The effect is mild, however, but distinct.

 

[egruberman]

He links this in his doc.
I'm gonna bookmark it the next time my doc wants to take me off anything LOL.

LDL Cholesterol Lowering: Is There a Risk for Dementia and Hemorrhagic Stroke? - American College of Cardiology

www.acc.org

View attachment 350309

I wish I could like this post harder.

 

[egruberman]

Anyone following along at home. Ezetimibe and bempedoic acid are both available through Indian pharma suppliers. I haven't checked recently, but the combo "Nexlizet", which is what I take, is onerously expensive and many insurers won't cover it in primary prevention. It's widely used in India and cheap as beans. Get some.

OP is in secondary prevention so it's time to get on a PCSK9i with all the other things. Get you an Rx for Repatha or Inclisiran. Insurers my require that the patient first attempt a maximal statin dose and so, fuck them.

Amgen will supply a copay card for Repatha. There are no qualification criteria that I'm aware of. I signed up before I discovered that my employer negotiated a "preventative medicine" benefit on top of my pharmacy benefit that automatically covers both Repatha and Nexlizet without prior auth.

 

[Photon]

Anyone following along at home. Ezetimibe and bempedoic acid are both available through Indian pharma suppliers. I haven't checked recently, but the combo "Nexlizet", which is what I take, is onerously expensive and many insurers won't cover it in primary prevention. It's widely used in India and cheap as beans. Get some.

OP is in secondary prevention so it's time to get on a PCSK9i with all the other things. Get you an Rx for Repatha or Inclisiran. Insurers my require that the patient first attempt a maximal statin dose and so, fuck them.

Amgen will supply a copay card for Repatha. There are no qualification criteria that I'm aware of. I signed up before I discovered that my employer negotiated a "preventative medicine" benefit on top of my pharmacy benefit that automatically covers both Repatha and Nexlizet without prior auth.

Nexlizet has a co-pay card too.
Else it's ~5$ for 10tabs India.

 

[DLTBB]

Hi Chem. I was lurking on here by chance and found this thread and recognised the name and avatar. Long time no see. Sorry to hear about this mate, I hope you’re feeling better now. Must’ve been a scary experience.

 

[david38016]

i know we don't talk about sources here so this is more of a general question of availability is there anyone getting PCSK9 Inhibitors inj. outside of medical prescription?

 

[RockyP]

i know we don't talk about sources here so this is more of a general question of availability is there anyone getting PCSK9 Inhibitors inj. outside of medical prescription?

I dont think there's a grey market for injectable cholesterol drugs...yet

 

[eryximachus]

I dont think there's a grey market for injectable cholesterol drugs...yet

I have faith in the CCP to deliver us from evil.