Another thread of e2 crushed lab work from primo

[NotHuman]

Well there’s people like myself who didn’t have a lowering effect on bloodwork. But it definitely had an impact on how I felt. Until I went to a 3:1 test/primo ratio I felt like shit w/ typical low e2 sides. But bloodwork on ultra sensitive test showed it out of range high

I certainly believe you, but are you sure it was real?

 

[NotHuman]

NK can't hurt, but all the literature points to shows a reduction in intima media thickness, which is promising, but isn't quite the same as tracking outcomes, nor does it suggest a reduction in calcified plaque. By contrast, there was a study published on bempedoic acid in the past year that shows a clear reduction in MACE (major adverse cardiac events).

To be clear, I'm not suggesting there's anything wrong with NK or that it's inferior to bempedoic acid, just that it hasn't yet met the gold standard of improving outcomes. Niacin, for example improved biomarkers, but has been shown not to be of any benefit and is potentially harmful.

Unmedicated, my total cholesterol was just north of 200mg/dL. Lifestyle changes were able to bring that down some, but when I compared my lipids to a friend of mine who is sedentary and has metabolic syndrome, but is on rosuvastatin, that caused me to reconsider my stance on statins. When I got my CAC, I decided to try all the things and see how I respond.

With a total of 400mg/dL, I'd definitely suggest an aggressive approach. It's worthwhile getting an NMR lipid panel and measuring both ApoB and Lp(a). The lipidologist Tom Dayspring recommends managing ApoB to something less than 80mg/dL for most or 60mg/dL for high risk folks.

I never expected to hear Dayspring’s name on this forum, but am pleased to see I’m not the only one familiar with his work. Respect

 

[Ouch]

If you have FH, I'm curious what your CAC score shows. Might as well get started with Repatha. Probably hard to get insurance to cover, but the copay card is easy to get.

IMHO, PCSK9 inhibitors are the best thing since statins.

I’ll definitely report my results back. I’ll be 3 weeks post cycle when I get my test. I tried getting Repatha from previous Dr and insurance denied it. But I have a new doc (who ordered the cac for me) and I am going to ask him about it when I go over my test results.

Off cycle 20mg weekly of Rosuvastatin cuts my total in half and has my numbers in check. It’s not w/o sides though esp brain fog. But I have found pregnenalone helps to offset that.

 

[Ouch]

I certainly believe you, but are you sure it was real?

Great question. Im wondering myself if it might be Mast. I bought based off of lab reports but did not personally test it myself. I asked Jano about sending in a vial but at this point I only have 1 left and am probably just going to run it for the next 5 weeks and then toss it. I’ve never done Mast but everything I’ve read about it does seem to correlate to my experience.

 

[VakarianSK]

If you have FH, I'm curious what your CAC score shows. Might as well get started with Repatha. Probably hard to get insurance to cover, but the copay card is easy to get.

IMHO, PCSK9 inhibitors are the best thing since statins.

Do you have experience with the copay card? I'm very interested in Repatha and I've heard it's hard to get a cardiologist to prescribe it due to insurance.

But then the same people say if you tell your cardiologist you will pay out of pocket then they usually have no problem prescribing it.

I applied and got a copay card already (even though I don't have a prescription yet because I am making my cardiologist appointment this week). Can I just tell my cardiologist I will pay out of pocket to get the prescription and then just use the copay card?

 

[buzzingonaas]

I’ll definitely report my results back. I’ll be 3 weeks post cycle when I get my test. I tried getting Repatha from previous Dr and insurance denied it. But I have a new doc (who ordered the cac for me) and I am going to ask him about it when I go over my test results.

Off cycle 20mg weekly of Rosuvastatin cuts my total in half and has my numbers in check. It’s not w/o sides though esp brain fog. But I have found pregnenalone helps to offset that.

Did your cardiologist just order the cac when you asked or did he/your insurance require labs? My lipids are alright right now but were a little nasty in the past and want to check but not sure insurance requirements. (My cardiologist knows I take gear and probably wouldn’t have an issue ordering one just based on that alone)

 

[Ouch]

Did your cardiologist just order the cac when you asked or did he/your insurance require labs? My lipids are alright right now but were a little nasty in the past and want to check but not sure insurance requirements. (My cardiologist knows I take gear and probably wouldn’t have an issue ordering one just based on that alone)

It wasn’t from a cardiologist, but from my new GP (actually I think he is a nurse practitioner). But he did work at a cardiologist office prior. He ordered it on my first visit actually after reviewing my past bloodwork history. I didn’t even ask he just suggested it.

Im a bit of a medical mystery/experiment when it comes to cholesterol stuff. I have family hyperlipidemia - so left untreated my numbers are through the roof…however, I was seeing a lipid specialist for years who had me undergo all types of tests.

One such test was where they measure the different sizes of cholesterol - both hdl and ldl actually come in 2 different sizes. So technically there’s 4 types of cholesterol - small (bad) and large/fluffy (good). So someone can have solid numbers on a regular test, but if the majority of the TYPE of cholesterol is the small kind then that can be troublesome.

For me, even though my numbers are ridiculous, the test showed I had mostly large/fluffy type. So I think this guy wants to see what’s inside…and Im happy about that.

I do think for insurance purposes there would need to be some type of history for them to cover it. Ymmv but that’s my experience with these assholes.

 

[egruberman]

I applied and got a copay card already (even though I don't have a prescription yet because I am making my cardiologist appointment this week). Can I just tell my cardiologist I will pay out of pocket to get the prescription and then just use the copay card?

This is precisely what I was going to do when I discovered that my insurance actually covers it. I can't confirm, but my understanding is that you get the Rx, and the copay covers what your insurance doesn't. I think it'll cover the whole thing. Another person on Meso has done this successfully.

One such test was where they measure the different sizes of cholesterol

Particle size matters. It is possible to have high LDL but not be at risk if the particles are the right size. However, a more precise measure of risk is to get ApoB which correlates linearly.

All of these biomarkers are available with an NMR lipid panel. I've had a hard time getting a doc to order one, so I just pay out of pocket. I get the Quest "CardioIQ" panel. I buy Quest labs through several online vendors and track my numbers through the Quest portal. The cheapest place I've found for that panel is walkinlabs.com where it's $135. I get one a year.

Did your cardiologist just order the cac when you asked or did he/your insurance require labs? My lipids are alright right now but were a little nasty in the past and want to check but not sure insurance requirements. (My cardiologist knows I take gear and probably wouldn’t have an issue ordering one just based on that alone)

A CAC is pretty cheap. I think it's a few hundred self-pay and most insurance will cover it with no complaints. The results are pretty easy to decipher. If one gets a non-zero result that's beyond the margin of error at anything below the age of 50, then aggressive lipid management is the intervention.