Ector
New Member
Vitamin K2 for plaque. 600 mg daily. 200 mg three times a day. For at least 5-6 months.This is what a specialist said.
MESO-Rx
Anabolic Steroids
Blood Pressure and Plaque In The Arteries
- Thread starter malfeasance
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Eddie.
Member
Mentioned it before too but OP is biased and thinks chase is only promoting the Koncentrated K supplement lol
I had a battery of other tests done after this calcium score and they were all normal. Stress test, ECG, carotid ultrasound (zero plaque), holter. I've gotten my blood pressure down to sub 120/80 consistently and inject Repatha every 2 weeks. My guess is that I am in a better spot going forward now knowing this than a typical average Joe running borderline BP and cholesterol at my age. If I could do it all over again it would have been a statin from day 1 abusing AAS, fixing BP issues and no cigarettes (I smoked 1/2 pack a day for 10 years). The cardiac testing facility did tell me that they are seeing lots of younger patients due to vaping addictions as young as 20s (which really doesn't make sense to me how vaping causes ASCVD but that's what they told me.)
Ghoul
Member
I hear you. I was just saying every kid should get a "human body owner's manual" for long term maintenance that gets updated and reviewed every year, lol.
It didn't really hit me until I listened to a panel of preventive cardiologists (why don't we have more of those?) literally pounding the table at a medical conference, clearly angry over the lack of priority given to blood pressure, not just by patients but front line medical providers as well.
For most people, it's relatively easy to bring to optimal levels( below 120/70), with lifestyle changes but also safe, largely side effect free meds as needed.
In fact, the leading edge experts, the ones who are ahead of "official guidelines" advocate getting it down with meds immediately if over 130/80, and then consider reducing or eliminating drugs if lifestyle manages to improve it.
The long term payoff is huge, and the earlier it starts the bigger the benefit since "BP pressure x time of exposure=damage".
However, it's never too late, and you're certainly better off getting a handle on it now, while there's health worth preserving, than after a heart attack or stroke (or dementia, kidney failure, etc) which is unfortunately the case for too many folks.
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I am glad to hear that you are doing the right thing! We only got one health and while we all love AAS we gotta mitigate and take better care of ourselves and stay proactive.
I keep my blood pressure on about 110-15/60-65 on average.
Recently introduced Rosuvastin after being on just Ezemtib and additionally added Bempoic Acid.
Also started taking more actions for blood sugar management and want to majorly improve my bloodmarkers before upping AAS or throwing in more stuff. I am too old to fuck around, i just stick with things that work well, make me feel good and provide quality of life while improving health overall.
Looking back at it i wish i had started educating myself earlier taken action much earlier and now it kinda bites me in the ass but hey, you just gotta have more work to do and challenges to overcome!
The annoying part for me is that here (in Germany) getting these kind of pro-active panels and checkups take ages. First of all you get put on a waiting list which is usually at least 8-10 months (i personally never gotten one earlier than a year despite paying for it myself) and then most of them just laugh at you.
"Why would you take IGF1? Why do you bother with ApoB and LipoA?"
"Why do you want a ultra sound of your organs, youre fine!"
Its frowned upon on and makes me so upset, i just wish it was easier to get these checks and covered by insurance fully.
Instead its just the classic school medicine approach, got pain? "Well, here is some Ibuprofen!" Instead of looking for the cause of it.
Ghoul
Member
I have what is considered "Cadillac insurance" in the US, the best medical insurance one could have, around $40,000 / year for two people, and they won't cover APO testing because they say it hasn't been proven effective!
And even when costs aren't an issue, doctors are still indoctrinated into "cost/benefit" mentality with everything from diagnostics to medicine,
If an expensive test only reduces deaths from a certain cancer by 2%, that's not considered cost effective so they won't do it! It may not be "worth it" to the "system" but it certainly is to me!
You have to be your own advocate if
you want the best outcomes. That means educating yourself, pressing your doctor for attention, and in my case, I'll often ask "If money weren't an issue, is this medicine/procedure/test the best thing available for treating my condition?". Because I want to know what the "best" option is, then we can figure out how to get it.
I didn't know any better 15-20 years ago. None of us really did as much as we do today. What I do find rather funny is guys talking about running all this gear with "no side effects" then they show their torched lipids. Torching your lipids is a side effect and probably one of the worst. Just bc you aren't getting gyno, going bald, or getting acne doesn't mean primo, anavar and masteron are safe drugs nuking your HDL. I for the life of me have no clue how guys are running all this masteron all the time without literally running towards ASCVD. I had a call with a well known coach and he tried to tell me that taking a statin would kill me via "tubular necrosis" and I could fix things with diet. Umm ok.
Yeah i had the same with my Doctor but with Ezemtib and Bempoic Acid.
"Oh youre not that old, you dont need Ezemtibe! 300 Cholesterol is normal!"
Made me want to flip the table there. Talked to another Doc, he only wanted to give me 40mg Simvastin.
After going through 5 other doctors i managed to find a guy who was on top of the things and properly listend to me, i explained him the situation, cited a few studies and therapeutic approaches from other doctors and he gave me a prescription for 10mg Ezemtib and 180mg Bempoic Acid.
Despite paying for the doctors appointments myself and paying for the medication on my own doctors were so hesitant and most of them didnt even knew about Ezemtib or Bempoic Acid at all. Just crazy.
As @Ghoul said, you gotta be your own doctor, do your own research and be as proactive as possible.
I'm convinced that it's not just the absolute numbers (age, cholesterol, BP). There is something about using steroids that makes it all worse and doctors don't have experience treating steroid patients so if you are 35-40 with some semi-bad cholesterol numbers you probably don't have ASCVD and that's how they operate. Now if you are 35-40 with semi-bad cholesterol numbers and you've been using steroids for 10 years you very well may have ASCVD.
Everyone in my Family has shit Lipids unfortunately, no one ever in my family had a cholesterol lower than 250. Everyone's LipoA is below 7, highest i've seen was 10 and ApoB was also perfect and doctors use that as an excuse "If its in the family, not worth running medicine"
Luckily i only run Test and Primo and that doesnt really change my lipids. Ofc only running 200-250mg of Primo total so thats not really much anyways but as you said. Most, if not even all doctors have 0 clue about AAS users, TRT or actual new therapies like Ezemtibe, Bempoic Acid, Repatha and so on.
K2 as MK-7 matters most it seems. As far as plaque build up
Calcified plaque, perhaps, but there's plenty of evidence of plaque reduction, especially the high risk kind that is linearly correlated with LDL-C reduction:
Atherosclerotic coronary plaque regression from lipid-lowering therapies: A meta-analysis and meta-regression - PMC
Studies reporting collective and comprehensive data on plaque regression of different lipid-lowering therapies (LLTs) are limited. We evaluated plaque regression of LLTs based on multiple markers and performed subgroup analyses based on LLT type and ...pmc.ncbi.nlm.nih.gov
Out of the entire dataset of n=8742, only 1204 (13.77%) were on PSCK9 (Australia/Japan) and 116 (1.33%) on PSCK9+Statin (Japan). I do believe that there is some sampling bias as not all these studies are focused on arterial plaque and that most people also do not have access to PSCK9 due to cost and drug availability.
Do you see any value in Ezetimibe and Bempedoic acid if LDL/ApoB/Lp(a) is already sufficiently low through the use of PSCK9 + statins? It almost feels like their sole purpose is just to drop LDL, or to act as a replacement for statin intolerants.
egruberman
Member
Personally, I do see a value, which is distinct from suggesting that should be true for everyone. The data are beginning to show that there is no point at which the benefit of LDL and ApoB reduction diminish. The lower the better it seems in terms of plaque regression and outcomes. There may be a point at which LDL becomes harmfully low, but presently that point is speculative.
If the data were more conclusive and the ACC endorsed a poly-pharmacy approach, I would certainly suggest that Ezetimibe and bempedoic acid has value for everyone. Today however, I have to offer these caveats.
That said, all four compounds have complementary mechanisms of action. Of the four, I’d rank them in order of Statins, Repatha, Bempedoic Acid, and Ezetimibe in terms of adverse side effects. The worst of them in terms of adverse side effects are statins and those are dose and compound dependents. There are also, not any contraindications between the four compounds.
So, my personal approach is to achieve as much lipid lowering as possible using reasonably low doses to avoid adverse side effects. That’s been pretty successful for me.
There are different genetic influences for elevated lipids. Some may be hyper-responders to PCSK9 inhibitors. Statins run the gamut in terms of response and side effects. For BA and ezetimibe, I’ve seen no anecdotal reports of problems and the literature suggests they’re both benign. Both have been showed to have improved outcomes when used along with other lipid lowering therapies. All in all, that makes a strong case for considering them.
Are there cases of people using 20mg of Ezemtib or more? I came across some studies and anything above 10mg just seems to be a waste of money, most articles suggest that with 20mg you get about 7-12% additional improvement but thats it.
Now that i got BA and Ezetimb covered by insurance, they technically allow me to double my dose but dont think its worth it or?
As for the Bloodpressure topic, i've been a keen fan of Telmisartarn and due to the Pioglitazone i noticed a watery layer forming under my skin, esp. in the legs and wanted look into changing my Telmisartan to a 40/12.5 combination including Hydrochlorothiazide. Do you guys its worth a try?
Assuming a poly-pharma approach and given the limited evidence we have today on extremely low values of LDL/ApoB, at what point would you consider backing off on the Bemp and Eze? A single digit LDL or ApoB<50? Do triglycerides even matter at this point? It would probably be nuked and so far gone.
I don't like HCTZ, you can however get this from india. Telm (40mg) + Cilnidipine (10mg) + Chlorthalidone (6.25/12.5mg) which I think is a much better choice. However if you're stuck with insurance then it looks like you don't have much of an option.
egruberman
Member
My gut feeling is ~20mg/dL LDL-C, which is approximately where mine is at. I am on exogenous testosterone, however like most others. I haven't done a comprehensive vitamin panel to check for absorption issues. Specifically in cases of hypobetalipoproteinemia and LDL below 20mg/dL there is a concern around the absorption of fat soluble vitamins.
ApoB, I would think, would always be as low as I could get it. I'm not sure there's an issue otherwise and it is an atherogenic particle.
Ghoul
Member
So would you say in pharmaceutical self treatment of high LDL, ezetimibe & BA would be a reasonable initial strategy?
I did this to LDL 13 and ApoB 40 with Lipitor 10 and Repatha. This is my pure speculation but I seemingly had compensatory problems.
My HDL went from 62 to 40.
My triglycerides shot THRU THE ROOF after being regularly rock bottom and subsequently my VLDL tripled.
Now that I ditched the Lipitor, my triglycerides dropped but are still higher than baseline and my LDL is now 56 and ApoB is 51.
Something happens in my body at the triglycerides level as my LDL drops too low (either that or it's the Repatha mechanism). On Lipitor 10 my HDL remained high and my triglycerides were at baseline in the 50s while my LDL dropped from 160 to 100 and my ApoB from 130 to 83. I'm struggling to decide if I am going to be better off at Lipitor 20 only vs using Repatha. This was my cardiologist initial recommendation - to double Lipitor. She only prescribed Repatha based on my insistence and her consults with their lipidologist who said there is no lower limit and said that Lower is better absolutely.
My Triglycerides went down almost by half using Inj. Carnitine at 600mg morning/evening with a meal. HDL only improved by about 6 points and LDL went down by 10. Thats the main reason i use it as it also helps with Insulin Sensitivity and since then a major part of my daily regimen.
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