General Research - Ancillaries

[Sicsemptyran]

I thought I would create a thread where I just generally post anything I find interesting, and if others do, then great. Shoutout to @egruberman for sending me down the cholesterol rabbit hole recently.

Currently am running an experiment on myself with bempedoic acid, a relatively newer drug that is quite expensive if you get it through mainstream pharmacies as its branded form Nexletol or the combo pill with ezetimibe called Nexlizet. While the main effect of bempedoic acid is to lower LDL (and ApoB), the Phase III trials had some eyebrow raising effects to me.

For one, incidents of diabetes/hyperglycemia in the treatment group were lower than placebo, entirely the opposite of what we see from statins. In addition, hematocrit was 1.6% lower in the treatment group as compared to placebo, with erythrocytes being 1.8% lower.

To me, this sounds like it would be damn near a perfect drug for bodybuilders. Lowering of LDL, mitigating erythropoietic effects, not impacting insulin sensitivity (and possibly improving it), all without the negative muscle pain from statins. There are some small side effects, such as raising uric acid, as well as a warning regarding tendon rupture. That said, in reading the studies, the tendon ruptures are likely not drug related and frankly not a worry of mine based on the data.

Am 2 weeks into this experiment and will report back with my own results and bloodwork changes when I get them!

(Multiple edits for dumb little spelling mistakes, really should have read this before posting)

 

[egruberman]

That said, in reading the studies, the tendon ruptures are likely not drug related and frankly not a worry of mine based on the data.

I skimmed through the clinical trials and incidence of tendon rupture was in all cases also coincident with a high-dose statin.

hematocrit was 1.6% lower in the treatment group as compared to placebo, with erythrocytes being 1.8% lower.

This, I missed. It may have some explanation for my reasonable looking hematocrit on my unreasonable looking anabolic load.

 

[Sicsemptyran]

I skimmed through the clinical trials and incidence of tendon rupture was in all cases also coincident with a high-dose statin.

Absolutely. I understand the medical reasoning of testing so many of these new drugs on people who are already pursuing standard-of-care (max dose statins), but it really can cloud the data. One benefit to the bempedoic acid trials is they had the arm which was done in people who swore off statins, showing yet another study in which lowering LDL improves cardiovascular outcomes independent of mechanism.

This, I missed. It may have some explanation for my reasonable looking hematocrit on my unreasonable looking anabolic load.

I was very surprised by this, and there does not seem to be a great mechanistic explanation for it as statins do not have the same effect. Interestingly, among all the study participants, it was an incredibly reliable effect. If you take bempedoic acid, you can expect a drop in your hematocrit.

It's conveniently small enough to be clinically insignificant for most older individuals where I'd be worried about that, but large enough where it could put a ceiling on us who use AAS or drop us from a level where we have some slight unease to one where we do not bat an eye at it.

Terribly interesting and promising adjunct to our stockpile in my opinion. Especially so for those who refuse to touch statins either for legitimate side effects or dogma. Nexilizet (BA + Ezetimibe) could still lower risk substantially.

 

[egruberman]

I'm glad you made this topic. I'm of the opinion that bempedoic acid is under-utilized in the bodybuilding community.