Doctor-Overcautious?

[anavar_goblin]

These labs aren’t anything to get excited about. The LFTs are likely part training effect and part gear related. The ALT spike may be due to primo so I’d watch that if you run it again. If you run anavar again might be good to check in on your Cystatin C levels (can be harsh on kidneys in some) as well as ggt to see if it’s having any actual impact on liver. Also good to track your hsCRP. otherwise those labs aren’t too bad at all given the compounds you’re on. Of course I’d advocate for using a statin and ezetimibe at the very least while on a cycle with DHT’s but some might consider that overkill. Really no reason to just let the LDL run wild. 8-12 weeks of LDL over 100 and HDL under 30 is clinically relevant for plaque buildup.

I just had an echo done and there wasn't any sign of plaque buildup. That they saw and it all came back clean no LVH or anything of the sort. Cardiologist was happy. I'll make sure to check those labs! Thank you for all this it's super helpful.

 

[anavar_goblin]

I had elevated liver enzyme levels for 30 years (although not 2x the top) and no Dr cared. Training and eating a high protein diet and gear can do that. When i eat more then 1.25gr/lb+ pf protein these days my levels go over the top of the range. And i am not on any big doses of gear.The same enzyme that is a by product of protein digestion is the same enzyme that they test for in the blood for liver damage.

I've noticed its high. I let him know I'm on a high protein diet as well. I'm healthy as can be and his specialty is physical therapy outside of being a Doc and while we were taking he commented that I look way more jacked than 3 months prior and he was stoked for me because he can see defined muscle definition. It was a big confidence booster since body dysmorphia sucks.

 

[buck]

I've noticed its high. I let him know I'm on a high protein diet as well. I'm healthy as can be and his specialty is physical therapy outside of being a Doc and while we were taking he commented that I look way more jacked than 3 months prior and he was stoked for me because he can see defined muscle definition. It was a big confidence booster since body dysmorphia sucks.

I was the second fattest kid in my class 50-60 years ago when being fat was not normal like it is theses days. I have stepped on bodybuilding stages in shape and felt fat. In the end how i feel about myself is about far more then the amount of fat i carry. knowing i can accomplish goals or fail and still get up and move ahead gives me more pride and sense of worth then low % of body fat.

 

[Photon]

I just had an echo done and there wasn't any sign of plaque buildup. That they saw and it all came back clean no LVH or anything of the sort. Cardiologist was happy. I'll make sure to check those labs! Thank you for all this it's super helpful.

echo won't show plaque
you need a cac scan for hard plaque
or a cleerly scan for hard+soft plaque

your baseline ldl is fine tho, if you get it back to that level i'd not worry about it too much.

 

[Sicsemptyran]

Just for starters some i have bookmarked. Hope i didn't double post any from different souses. My favorite is the one with 12.8 million showing the longest lifes spans have cholesterol levels around 220. And a couple hours of searching will show you even more if you care to look.

As @BP_6 alluded to, most of these studies haven't been debunked per se, because they're not wrong, but have been explained to lead quite clearly to other conclusions than what the studies suggest.

When the body is sick or dying, for example in cancer/drug addiction/etc, it is extraordinarily common for LDL to absolutely collapse. Total cholesterol (to your 220 point) also often collapses, because as we know HDL also drops in the presence of sickness and insulin resistance.

If you look at hospital mortality as BP_6 notes, the highest mortality are in those individuals with low to low-normal blood pressure rather than high blood pressure, because it shows they are dying. It doesn't mean that high blood pressure is good for health!

Beyond the mountains of literature showing clearly that lipid lowering and health-span with seemingly no lower limit, the final nail in the coffin for the too-low-might-be-bad argument is studies relating to those with a nonfunctional PCSK9 gene, the same gene PCSK9 inhibitors like Repatha work on. These individuals have hilariously low cholesterol, with LDL's oftentimes well below 30, and yet have seemingly ZERO negative impacts from the lack of LDL. They just don't get heart disease!

 

[buck]

As @BP_6 alluded to, most of these studies haven't been debunked per se, because they're not wrong, but have been explained to lead quite clearly to other conclusions than what the studies suggest.

When the body is sick or dying, for example in cancer/drug addiction/etc, it is extraordinarily common for LDL to absolutely collapse. Total cholesterol (to your 220 point) also often collapses, because as we know HDL also drops in the presence of sickness and insulin resistance.

If you look at hospital mortality as BP_6 notes, the highest mortality are in those individuals with low to low-normal blood pressure rather than high blood pressure, because it shows they are dying. It doesn't mean that high blood pressure is good for health!

Beyond the mountains of literature showing clearly that lipid lowering and health-span with seemingly no lower limit, the final nail in the coffin for the too-low-might-be-bad argument is studies relating to those with a nonfunctional PCSK9 gene, the same gene PCSK9 inhibitors like Repatha work on. These individuals have hilariously low cholesterol, with LDL's oftentimes well below 30, and yet have seemingly ZERO negative impacts from the lack of LDL. They just don't get heart disease!

I have seen not long term studies that show having very very low cholesterol levels for ones whole life makes for better longevity. Most studies are geared towards those that have diseases states

With blood pressure those that are sick in a hospital may not be better off with a low BP. Yet the evidence tends to show the lower the BP the better as long as there are no negative symptoms for the population as a whole as less damage is accrued.

What is good for sick or abnormal people isn't always the best for the average or healthy person.

For decades studies that the medical community pushed such as plant fats from trans fats being healthier then butter. But there was a push back from small groups till enough evidence came out showing that the majority opinion was wrong and so were the studies that seemed so overwhelming supportive at one time with all plant fats being better animal fats.

In the 2005 TNT study, 10,001 people with stable heart disease received either maximum-dose 80-mg Lipitor® or a standard dose of 10-mg Lipitor® daily.1 Maximum-dose Lipitor® reduced levels of harmful low density lipoprotein (LDL) to an average of 77 mg/dL. This represented a substantial reduction in LDL. In comparison, standard-dose Lipitor® reduced LDL to an average level of 101 mg/dL, which was also a good result.1

​

Over the five years of the study, 434 people (8.7%) in the 80-mg group experienced another cardiovascular incident (such as a heart attack or stroke) versus 548 people (10.9%) in the 10-mg group. This was an improvement of 2.2%, which meant 104 fewer cardiovascular incidents with maximum-dose Lipitor® compared with standard-dose Lipitor®. Twenty-nine fewer deaths from cardiovascular causes (126 versus 155) occurred with maximum-dose Lipitor®. These were also good results. However, this improvement in deaths was completely offset when 31 more people taking maximum-dose Lipitor® died from other causes. Overall, maximum-dose Lipitor® did not reduce the number of deaths in comparison with low-dose Lipitor®. In fact, the total number of deaths slightly increased in those taking maximum-dose Lipitor®. This startling fact means that maximum-dose Lipitor® increased the risk of death due to non-cardiovascular causes! This included 10 more deaths from cancer in the maximum-dose Lipitor® group versus the 10-mg group.1
LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med. 2005 Apr 4;352(14):1425‑35.


I support people reading and learning themselves best they can and do what they think is best for themselves. I don't tell people what they should do with their life.

 

[Sicsemptyran]

I have seen not long term studies that show having very very low cholesterol levels for ones whole life makes for better longevity. Most studies are geared towards those that have diseases states

With blood pressure those that are sick in a hospital may not be better off with a low BP. Yet the evidence tends to show the lower the BP the better as long as there are no negative symptoms for the population as a whole as less damage is accrued.

Agreed on all the above, besides the fact that the very very low LDL side has been shown, which I pointed out with the studies of individuals who have genetically low LDL.

There’s been countless Mendelian randomization studies showing quite clearly that lower LDL = better outcomes when other factors are controlled for, with no lower limit to be found as of yet.

To your study on Lipitor, I don’t think many people that share my take would be terribly surprised by that. Max dose statins, especially something like atorvastatin, is a horribly crude and counterproductive way of lowering LDL. Can lead to insulin sensitivity issues/etc.

I’d agree that the usual way of reaching a very very low LDL is likely counterproductive, but there’s only evidence the drug causing the low LDL is to blame, not lower LDL itself. In today’s age of having much more elegant tools to lower LDL, I think much of that risk can be avoided.

By the way, while I disagree with you and think the evidence is much more clear, I do sincerely appreciate your thoughtful response.

 

[dinfaralt]

everything here screams waste money to me.

you dont need anything else than trt + hgh in a deficit. go get to 10% bodyfat and blast primo and 10103412304130 different supplements, you're wasting bunch of money and health for 0.01kg extra muscle

 

[buck]

Agreed on all the above, besides the fact that the very very low LDL side has been shown, which I pointed out with the studies of individuals who have genetically low LDL.

There’s been countless Mendelian randomization studies showing quite clearly that lower LDL = better outcomes when other factors are controlled for, with no lower limit to be found as of yet.

To your study on Lipitor, I don’t think many people that share my take would be terribly surprised by that. Max dose statins, especially something like atorvastatin, is a horribly crude and counterproductive way of lowering LDL. Can lead to insulin sensitivity issues/etc.

I’d agree that the usual way of reaching a very very low LDL is likely counterproductive, but there’s only evidence the drug causing the low LDL is to blame, not lower LDL itself. In today’s age of having much more elegant tools to lower LDL, I think much of that risk can be avoided.

By the way, while I disagree with you and think the evidence is much more clear, I do sincerely appreciate your thoughtful response.

I just look at the numbers myself as a smart person can always explain away anything for either side of any issue i find. Each person should decide for themselves.


As half the people that have heart attacks have had what is considered healthy cholesterol levels it leaves me feeling there is more to the situation then then just the amount of cholesterol.

From cardiologists i have spoken when asked how much longer people tend to live when they start taking statins for a preventative measure they tell me they hve seen no studies showing they live longer. And from the few small studies i have found the time frame points to months longer at best with some studies showing only days more life. So i am not sure that just lowering cholesterol is the best approach. I have never said the levels should not be lowered.

My biggest contention is that medicine portrays they have the answer even though they can't answer many of the questions i ask. There was a time when Dr gave out placebos to help people feel better. But there job is to make people feel better so they try to act knowledgeable even when they are lacking.

And yes we do agree and there is nothing wrong with that as opinions differ on topics all the time amount people. So we can disagree that having low levels of cholesterol for the general population may of may not lead to the longest longevity from the population as a whole.

 

[dinfaralt]

And yes we do agree and there is nothing wrong with that as opinions differ on topics all the time amount people. So we can disagree that having low levels of cholesterol for the general population may of may not lead to the longest longevity from the population as a whole.

i do agree with you its a unknown. but its a big mistake you're comparing to the general population when reading these studies. you have to compare with aas users that have many different factors that play into a CV risk which exacerbates the amount of life you can save from it. which creates another unknown and another void hole i dont wanna get into.

studies suck because 99% of them lack data that is obvious that we want... i get your point. for most people they likely wont get a serious CV risk from blasting their trt+.

competitor, usually gets around 5% bf, blasting grams? different story.

these studies mainly look at people 50+, are you blasting enough to have a worse heart than a 50+ year old? that is the real question. and many people just aren't in that zone but theres nothing to lose other than money, since knowing your heart has a problem comes too late my opinion its always better to have good cholesterol on aas vs saving few bucks

 

[buck]

i do agree with you its a unknown. but its a big mistake you're comparing to the general population when reading these studies. you have to compare with aas users that have many different factors that play into a CV risk which exacerbates the amount of life you can save from it. which creates another unknown and another void hole i dont wanna get into.

studies suck because 99% of them lack data that is obvious that we want... i get your point. for most people they likely wont get a serious CV risk from blasting their trt+.

competitor, usually gets around 5% bf, blasting grams? different story.

these studies mainly look at people 50+, are you blasting enough to have a worse heart than a 50+ year old? that is the real question. and many people just aren't in that zone but theres nothing to lose other than money, since knowing your heart has a problem comes too late my opinion its always better to have good cholesterol on aas vs saving few bucks

Most all my posts are about long term longevity not specifically heart disease and the general population not those with heart disease. And is not about those on cycles or shorter term poor life style choices. I did tell the OP early on his numbers are nothing i would worry about shorter term. Most posts after that did not address the OP's post directly but was more general in nature.

But there is little data on optimal cholesterol levels and longevity. Plus the topic keep being turned to those with heart disease which most studies are geared towards. And there is more of them to draw from even though they often don't really apply well to my conversation around longevity fro the average person.

 

[dinfaralt]

So i am not sure where you got that from.

your 2 last messages about cholesterol. i joined the forum back in start of 2024 so havent seen your other messages if you've been inactive for some time.

But there is little data on optimal cholesterol levels and longevity. Plus the topic keep being turned to those with heart disease which most studies are geared towards. And there is more of them to draw from even though they often don't really apply well to my conversation around longevity fro the average person.

ik, just shared my 2 cents on blasting more gear = likely higher need for it.

avg person can eat all donuts they want, my perspective is its not good to compare to avg people when we're blasting aas but hey man you're free to read studies however you like. theres many factors related to this topic tied to aas abuse that differentiate us from the average population and relates us more as future CV risk profiles.

 

[buck]

your 2 last messages about cholesterol. i joined the forum back in start of 2024 so havent seen your other messages if you've been inactive for some time.


ik, just shared my 2 cents on blasting more gear = likely higher need for it.

avg person can eat all donuts they want, my perspective is its not good to compare to avg people when we're blasting aas but hey man you're free to read studies however you like. theres many factors related to this topic tied to aas abuse that differentiate us from the average population and relates us more as future CV risk profiles.

And my point was replying to my post with something that did not really pertain to what i was writing about may be non sequitur

 

[deadbeef]

Instead of cherry-picking studies that meet the narrative, why don't we look at all of the studies, including ones that don't show a benefit:



The evidence is unequivocal.

 

[dinfaralt]

And my point was replying to my post with something that did not really pertain to what i was writing about may be non sequitur

no i'll give you the benefit of the doubt. i skimmed through first page of the thread did not bother reading it with the chatgpt stats. i do believe my reply was relevant to what you was writing

i just got ocd from comparing to general population when its best to assume otherwise, not in people with already heart disease but a CV risk factor which everyone blastin above trt is a potential for. but i'll leave it at that since we're going nowhere

 

[buck]

no i'll give you the benefit of the doubt. i skimmed through first page of the thread did not bother reading it with the chatgpt stats. i do believe my reply was relevant to what you was writing

i just got ocd from comparing to general population when its best to assume otherwise, not in people with already heart disease but a CV risk factor which everyone blastin above trt is a potential for. but i'll leave it at that since we're going nowhere

As i am in this for the long term, started Dr prescribed TRT over 25 years ago and have done TRT(or cruise if you prefer) and cycles since then. So what is likely to be best for the population in general long term is probably the healthiest thing in general for me i figure. So that is what i try to apply to me. If others choose to go a different direction with their long term health i support them following that path as they are the ones living it.

 

[Sicsemptyran]

So that is what i try to apply to me. If others choose to go a different direction with their long term health i support them following that path as they are the ones living it.

I think that’s where I’m a bit confused, as @deadbeef just showed, the evidence is unequivocal that with all else equal -> lower LDL is better with no lower limit.

You keep saying the evidence is unclear or not present or not shown that very very low LDL is better, but there is a mountain of evidence. Again, I’d point you specifically towards studies on those born with a dysfunctional PCSK9 gene who live heart disease free but with zero other adverse side effects, with basically non-existent LDL.

 

[anavar_goblin]

no i'll give you the benefit of the doubt. i skimmed through first page of the thread did not bother reading it with the chatgpt stats. i do believe my reply was relevant to what you was writing

i just got ocd from comparing to general population when its best to assume otherwise, not in people with already heart disease but a CV risk factor which everyone blastin above trt is a potential for. but i'll leave it at that since we're going nowhere

I only used chatgtp here to better organize the data for a more reader friendly format. I do IT for a living and it helps a lot with organizing data driven points with no extra fluff if you use it in that way.


Its been great for comparing historical data on my blood work. I have 15 years of solid blood work and historically my HDL has historically been comically low no matter the diet, protocol, supplements. From full vegan, juice fasting, no dairy, no gluten, mostly fish and veggies, carnivore, paleo etc. it's never raised much of any always been under 30.