Cholesterol numbers on no med, then on statin then on statin + Repatha

[jtmarlin]

I said in another statin thread that I'd update my numbers as I added meds so here they are.

10mg of Lipitor + Repatha

Total 83
HDL 40
Trig 189 - not sure why this is high now it's usually 50 for me... I wonder if this is some sort of compensation given my LDL is so low now
LDL 13
ApoB 40


10mg of Lipitor only
Total 178
HDL 62
Trig 57
LDL 102
ApoB 83


No meds
Total 250
HDL 59
Trig 102
LDL 169
ApoB 120

I don't know why my triglycerides are so high now that I'm on Repatha. I did eat a burrito bowl right before my bloodwork which may have something to do with it. I never took fasting all that seriously w/cholesterol tests but maybe I should. Any thoughts?

 

[buck]

I have never found fasting to change my cholesterol numbers to any noticeable extent. Low single digit difference at most.

When lookig at your first set of numbers the levles are very low. And very low numbers tend to lead to shorter life spans from a few studies i have seen.
What may be best for the heart is not necessarily get for long term over all health.

 

[BamaCrazy]

I’m curious why your HDL dropped from 62 to 40. Apart from Test what else are you taking?

 

[jtmarlin]

I’m curious why your HDL dropped from 62 to 40. Apart from Test what else are you taking?

Nothing. It has to be a function of the repatha in some way. That's on 20mg of test per day cyp.

 

[jtmarlin]

I have never found fasting to change my cholesterol numbers to any noticeable extent. Low single digit difference at most.

When lookig at your first set of numbers the levles are very low. And very low numbers tend to lead to shorter life spans from a few studies i have seen.
What may be best for the heart is not necessarily get for long term over all health.

I'm not sure that what you are saying is true with regards to low LDL and lifespan especially if someone has ASCVD which I do but I didn't expect the numbers to be so low myself. My cardiologist initially wanted me to go from 10 to 20 mg of Lipitor and I asked for Repatha specifically and she got it approved. I see her in April for bloods. I pulled these bloods myself as a curiousity.

 

[BamaCrazy]

Nothing. It has to be a function of the repatha in some way.

That’s concerning. Repatha works as well or better than AAS at dropping HDL.

 

[egruberman]

I don't know why my triglycerides are so high now that I'm on Repatha.

I can’t say for certain, but it could be compensatory production of VLDL as a result of your LDL being so low. I’ll poke at the literature and see if I can come up with something more plausible.

LDL being that low is in the realm of concern. There’s not a lot of data on the topic but <25mg/dL seems to be the point at which concern begins in the literature. That doesn’t mean it’s inherently harmful, but there’s some uncertainty.

With the disclaimer that I’m just a lay person, maybe back off the statin and check again after a few months?

 

[jtmarlin]

I can’t say for certain, but it could be compensatory production of VLDL as a result of your LDL being so low. I’ll poke at the literature and see if I can come up with something more plausible.

LDL being that low is in the realm of concern. There’s not a lot of data on the topic but <25mg/dL seems to be the point at which concern begins in the literature. That doesn’t mean it’s inherently harmful, but there’s some uncertainty.

With the disclaimer that I’m just a lay person, maybe back off the statin and check again after a few months?

Yes my VLDL went from 10 to 30 as my triglycerides went up. This is a calculated number tho. So you think it's better to ditch the statin instead of go 20 statin and ditch Repatha?

 

[buck]

I'm not sure that what you are saying is true with regards to low LDL and lifespan especially if someone has ASCVD which I do but I didn't expect the numbers to be so low myself. My cardiologist initially wanted me to go from 10 to 20 mg of Lipitor and I asked for Repatha specifically and she got it approved. I see her in April for bloods. I pulled these bloods myself as a curiousity.

My reply was to the population at large. If you are not part of that group then you need to do what you think is best for you.

I saw Lipitor's own studies years ago hen they were pushing Dr's to start prescribing their 80mg tabs instead of their 20mg to lower heart attack risk, which their studies show it did. But life expectancy dropped more for the lower LDL group as they got cancer more often. And maybe they would have anyway. But the numbers show what they show.

I just think people should have all the data so they can make the best decision for them selves. If you haven't asked your cardiologist how much longer people tend to live with stain therapy as opposed to those that don't do it. You may want to ask that question as many may be surpresed at the respponce.

 

[jtmarlin]

My reply was to the population at large. If you are not part of that group then you need to do what you think is best for you.

I saw Lipitor's own studies years ago hen they were pushing Dr's to start prescribing their 80mg tabs instead of their 20mg to lower heart attack risk, which their studies show it did. But life expectancy dropped more for the lower LDL group as they got cancer more often. And maybe they would have anyway. But the numbers show what they show.

I just think people should have all the data so they can make the best decision for them selves. If you haven't asked your cardiologist how much longer people tend to live with stain therapy as opposed to those that don't do it. You may want to ask that question as many may be surpresed at the respponce.

What is convincing to the argument that there is a level of LDL that is too low is that there is a compensation of triglycerides in my bloods to create more VLDL bc the body senses LDL is too low. Whether this matters or not I don't know but it wasn't happening when my LDL was 100 on 10mg of Lipitor. After reading what egruberman had to say as well I'm backing off nuclear. I also did not expect to have levels this low. I thought it would put me in the 50s LDL but it appears Repatha is indeed a nuclear weapon to LDL.

 

[egruberman]

Yes my VLDL went from 10 to 30 as my triglycerides went up. This is a calculated number tho. So you think it's better to ditch the statin instead of go 20 statin and ditch Repatha?

This is an area where I can’t confidently give guidance. My *feeling* is that I’d rather be on Repatha than a statin. Given that you seem to be able to tolerate both and have the prescription for Repatha, you could back off the statin and see where you stand, optimally keeping ApoB under 60mg/dL and normalizing your LDL and trigs.

With ApoB being as low as it is, and presuming you don’t have any other glaring inflammatory markers, I suspect that your present conditions are not harmful, but they are somewhat unorthodox.

Again, I’ll review the literature and see if I can come up with a more informed opinion. Regardless, you’re not facing any acute risk and likely are in a better place with regard to the progression of ASCVD.

 

[jtmarlin]

This is an area where I can’t confidently give guidance. My *feeling* is that I’d rather be on Repatha than a statin. Given that you seem to be able to tolerate both and have the prescription for Repatha, you could back off the statin and see where you stand, optimally keeping ApoB under 60mg/dL and normalizing your LDL and trigs.

With ApoB being as low as it is, and presuming you don’t have any other glaring inflammatory markers, I suspect that your present conditions are not harmful, but they are somewhat unorthodox.

Again, I’ll review the literature and see if I can come up with a more informed opinion. Regardless, you’re not facing any acute risk and likely are in a better place with regard to the progression of ASCVD.

I had an appointment with the cardiologist office and they a lipidologist who said that lower is better with regards to LDL. Even zero. They were completely happy to let me stay with basically negligible LDL but I pushed back a bit and said I was concerned about being too low on LDL. We ultimately decided to settle only just using Repatha without additional statins and retest in April. They cited chronically elevated CK and liver values (which are due to exercise) as the easy choice for ditching the statins. I didn't argue but mentioned that to them and they "got it".

 

[buck]

I had an appointment with the cardiologist office and they a lipidologist who said that lower is better with regards to LDL. Even zero. They were completely happy to let me stay with basically negligible LDL but I pushed back a bit and said I was concerned about being too low on LDL. We ultimately decided to settle only just using Repatha without additional statins and retest in April. They cited chronically elevated CK and liver values (which are due to exercise) as the easy choice for ditching the statins. I didn't argue but mentioned that to them and they "got it".

Did you ask them how much those low levels increase lifespan over those that don't have those low numbers.

 

[jtmarlin]

Did you ask them how much those low levels increase lifespan over those that don't have those low numbers.

I did not but I did say that based on what I think to be true, I'd prefer and LDL above 25. This is why we ditched the statins.

 

[egruberman]

I had an appointment with the cardiologist office and they a lipidologist who said that lower is better with regards to LDL. Even zero. They were completely happy to let me stay with basically negligible LDL but I pushed back a bit and said I was concerned about being too low on LDL. We ultimately decided to settle only just using Repatha without additional statins and retest in April. They cited chronically elevated CK and liver values (which are due to exercise) as the easy choice for ditching the statins. I didn't argue but mentioned that to them and they "got it".

Interesting that they're comfortable with zero LDL. Even still, I'm curious to see where you land with Repatha mono-therapy.

 

[jtmarlin]

Interesting that they're comfortable with zero LDL. Even still, I'm curious to see where you land with Repatha mono-therapy.

I am as well. As a reminder I went from 168 to 102 on 10mg of Lipitor then 102 to 13 on the Lipitor + Repatha. I may even get bloods done on my own as a curiosity before April as these statins seem to go in and out really quick.

 

[jtmarlin]

I am as well. As a reminder I went from 168 to 102 on 10mg of Lipitor then 102 to 13 on the Lipitor + Repatha. I may even get bloods done on my own as a curiosity before April as these statins seem to go in and out really quick.

These are updated numbers on Repatha only. There are no dosing options it only comes in one autopen done every 2 weeks. It's clear to me after 2 blood tests that Repatha lowers HDL by 15 points. Lipitor did not do this to me. This is quite strange.

Total 118
Trig 79
HDL 46
VLDL 16
LDL 56
ApoB 51

This is while using 30mg of test e per day running a 62 E2 and 1500+ test - my guess is that I'm landing between 1500-2000 total test on this dose and run it indefinitely.

 

[Nidus]

I am as well. As a reminder I went from 168 to 102 on 10mg of Lipitor then 102 to 13 on the Lipitor + Repatha. I may even get bloods done on my own as a curiosity before April as these statins seem to go in and out really quick.

Repatha looks very powerful, would love to give this a try too. Have you had any DHT running at the same time?

 

[jtmarlin]

Repatha looks very powerful, would love to give this a try too. Have you had any DHT running at the same time?

Only testosterone e 30 mg per day no AI.

Repatha is not an easy drug to get. You will need a script.