Who here is on a statin?

[AllGoodThings]

Never knew. Thanks

My insurance company wouldn't cover my pitavastatin generic and required a prior authorization from my Dr, and I had to tell the Dr I had tried other statins and had muscle cramps just so they wouldn't make me go through the BS hoops of trying what they wanted to pay for first. I got the prior authorization approved within a couple of days. I'm over 40 fwiw

 

[BamaCrazy]

My insurance company wouldn't cover my pitavastatin generic and required a prior authorization from my Dr, and I had to tell the Dr I had tried other statins and had muscle cramps just so they wouldn't make me go through the BS hoops of trying what they wanted to pay for first. I got the prior authorization approved within a couple of days. I'm over 40 fwiw

Do you have TriCare?

 

[AllGoodThings]

Do you have TriCare?

I do not

 

[BamaCrazy]

I do not

What you described are the same hoops I will need to jump through to get my PA approved for Pitavastatin.

 

[OldGHGuy]

I do not

I thought Pita was the less expensive statin? So why do we need to jump theough hoops to get it? Another example of a very broken medical system I suppose...

 

[Ghoul]

I thought Pita was the less expensive statin? So why do we need to jump theough hoops to get it? Another example of a very broken medical system I suppose...

All statins are now generics. Pitavastatin is the most expensive of them, the generic is about $35/mo vs $5/mo for Rosuvastatin (Crestor).

Still, $35 meds don't typically require preauthorization. They must not have updated their policy on it from when it was $350/mo (brand name Livalo) a couple of years ago. Most insurance companies dropped PA for it once it became generic and the price dropped by 90%.

 

[Deadpool99]

Yeah I see that's the "default" for severe chronic kidney disease, although Rosuvastatin is considered safe up to 10mg with CKD, even in dialysis patients,

FYI Pitavastatin has lower risk of muscle related sides in chronic kidney disease than Atorvastatin. Unlike Pitavastatin, Atorvastatin is metabolized by CYP3A4, and so are AAS, potentially causing a buildup of levels leading to muscle pain and rhabdo with simultaneous use of steroids.

Also Atorvastatin raises the risk of new onset diabetes higher than Rosu, and much higher than Pita, which actually improves rather than worsens insulin sensitivity.

I wanted to ask you @Ghoul
Is it worth considering ubiquinol on Pitavastatin 4mg, I don't buying supplements unless they are clinically called for, in theory it would be a great addition but to my knowledge Pitavastatin doesn't tank CoQ10, would it yield any benefit adding it.

 

[ganciodestro]

Why does no one ever mention pravastatin? It’s always and only pitavastatin first (which makes sense, since it’s the best in terms of benefits), but then I always hear rosuvastatin being mentioned. Why is pravastatin so rarely taken into consideration, given that it’s the second safest choice after pitavastatin?

 

[Deadpool99]

Why does no one ever mention pravastatin? It’s always and only pitavastatin first (which makes sense, since it’s the best in terms of benefits), but then I always hear rosuvastatin being mentioned. Why is pravastatin so rarely taken into consideration, given that it’s the second safest choice after pitavastatin?

Probably cuz it’s more widely available and popular, I’m guessing also rosu lowers ldl more

 

[Bammdk]

Serious question. I have pretty god numbers on low dose Atorvastatin (20mg).
Is there any reason to change anything? No sides ether. No change when blasting or using orals really.

LDL: 60
HDL : 45
Trig: 13.4

 

[Deadpool99]

Serious question. I have pretty god numbers on low dose Atorvastatin (20mg).
Is there any reason to change anything? No sides ether. No change when blasting or using orals really.

LDL: 60
HDL : 45
Trig: 13.4

Well in terms of numbers these are pretty good. But I personally don’t prefer Atorvastatin due to this picture, thanks to man himself @Ghoul

 

[Manualtrt]

That chart comes from this paper

https://www.jacc.org/doi/10.1016/j.jacc.2018.06.046

This paper suggests that for every 1 mmol/L (c.40 mg/dL) reduction in LDL-C, there is about a 22% relative reduction in the risk of major adverse cardiovascular events.

It does also confirm that earlier reduction provides greater lifetime benefit as cumulative exposure is reduced, starting LDL lowering earlier (e.g. middle age, or even earlier) can prevent or slow plaque accumulation.

I’m 40 and just started pita and eze I’m targeting getting ldl to sub 70 asap currently at 104).

 

[Bammdk]

Well in terms of numbers these are pretty good. But I personally don’t prefer Atorvastatin due to this picture, thanks to man himself @Ghoul

Please help me. Muscle Safety? Drug Interactions? Feel great in it. Only 20mg.

Why don’t every doctor just describe the others if better? Price?

 

[Deadpool99]

Please help me. Muscle Safety? Drug Interactions? Feel great in it. Only 20mg.

Why don’t every doctor just describe the others if better? Price?

If you feels great, numbers look good, and no side effects, to me that’s a clinical win.

If ur ever getting the muscle issues, insulin resistance, or mitochondrial fatigue symptoms, then switching to Rosuvastatin or Pitavastatin would make sense. But it seems ur doing well

If ur concerned with the CoQ10 depletion u can just use supplementation and it can buffer depletion if he wants to stay proactive.

 

[Bammdk]

If you feels great, numbers look good, and no side effects, to me that’s a clinical win.

If ur ever getting the muscle issues, insulin resistance, or mitochondrial fatigue symptoms, then switching to Rosuvastatin or Pitavastatin would make sense. But it seems ur doing well

If ur concerned with the CoQ10 depletion u can just use supplementation and it can buffer depletion if he wants to stay proactive.

Thank you!
Rosu is the same price and I can get it from my doctor easy. Maybe give it a try. Test in 3 months and see? If same numbers it’s better still. At least on paper.

 

[Deadpool99]

Thank you!
Rosu is the same price and I can get it from my doctor easy. Maybe give it a try. Test in 3 months and see? If same numbers it’s better still. At least on paper.

If cost and access are equal, rosuvastatin is arguably the “cleaner” choice on paper (less CoQ10 depletion, fewer interactions, neutral metabolic profile). Also more potent per mg.

The switch is reasonable, but it’s not mandatory if ur thriving on atorva.

A 3-month trial with labs is the smart, evidence-based way to test.

 

[Nidus]

I wanted to ask you @Ghoul
Is it worth considering ubiquinol on Pitavastatin 4mg, I don't buying supplements unless they are clinically called for, in theory it would be a great addition but to my knowledge Pitavastatin doesn't tank CoQ10, would it yield any benefit adding it.

ubiquinol is always worth it, just alone for the heart health and the mitrchondial function, ideally throwing in some PQQ as well

 

[Deadpool99]

ubiquinol is always worth it, just alone for the heart health and the mitrchondial function, ideally throwing in some PQQ as well

I also forgot to think about it in a ASS/GH context:

AAS can thicken heart muscle and stress mitochondria and GH increases metabolic load and oxidative stress, specially when I’m using tren.

So theoretically Ubiquinol helps buffer these, even if lipids and bloodwork look fine.

 

[the_pope]

Does it help to take statins only while blasting? I'll be using an oral, probably dbol for 4 weeks. While my lipids numbers are normally good, dbol and other orals tend to mess with them (not heavily, but still). Would it be worth it to use an statin only while blasting?

 

[Deadpool99]

Does it help to take in statins only while blasting? I'll be using an oral, probably dbol for 4 weeks. While my lipids numbers are normally good, dbol and other orals tend to mess with them (not heavily, but still). Would it be worth it to use an statin only while blasting?

If you only ever run a short 4-week oral and your baseline lipids are excellent, technically you could skip a statin. Your lipids will normalize after you stop.

BUT:
Each time you spend weeks with HDL near zero and LDL/ApoB elevated, you are accelerating vascular damage.

I’ve seen orals push HDL to single digits in 2-4 weeks, though not ss aggressive with LDL but they do increase LDL but it still takes a hit.