Please help, Statin advice, Lipids are off

[Cohiba]

@Scruf Are you on a keto diet? In your first post you said you were in ketosis every day.

If so, what do your macros look like?

The reason I ask is because keto diets are usually very high in fats, and the most fucked up my lipids have ever been was when I tried a keto diet for a short time.

Just something else to consider.

 

[readalot]

Brother, respectfully...

The 25 arimidex comment makes no sense. No way your were taking 25 mg of anastozole at a time. I can only assume you meant to write 0.25 mg

Your trig / hdl-c ratio is horrific.

Drop your total androgen dosing back to something reasonable 100 to 150 mg/week of Test only and retest your lipids in 12 weeks.

Why wreck yourself with such large kcal deficit? Horrible stress on your body....one foot on accelerator and other on brake.

Your total androgen load is too high. Reassess your lipids at a reasonable baseline. Do you have any prior data 200 mg/week or less of just Test ester?

Where is your CMP result?

8 IU of GH per day?

Fasting insulin?

Your cRP is not great.

What was your androgen dosing and injection frequency at the time of your blood work shown above? The blood was taken at trough?


Your FT (kudos on the lcms and eq dialysis tests) is insane. You are 48 and your body is trying to have a chat.

Please read. This effect is well understood.

Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk - PubMed

Testosterone administration to men is known to decrease high-density lipoprotein cholesterol (HDL-C) and the subclasses HDL(2) and HDL(3). It also might increase the number of small, dense, low-density lipoprotein cholesterol (LDL-C) particles in hypogonadal men. The decrease in HDL-C and in...

pubmed.ncbi.nlm.nih.gov

 

[readalot]

25 mg arimidex

How? You are taking 25 - 1 mg pills at a go? Made your own solution?

 

[Scruf]

@Scruf Are you on a keto diet? In your first post you said you were in ketosis every day.

If so, what do your macros look like?

The reason I ask is because keto diets are usually very high in fats, and the most fucked up my lipids have ever been was when I tried a keto diet for a short time.

Just something else to consider.

@Cohiba, I really appreciate your input. You are probably right. I am eating approximately 80% protien, 10% carbs and 10% fats. Most of my carbs are from vegetables. I am definitely going to re-asses my diet once I get below 200 lbs.

I have 13 pounds to go before I pull out of the Keto diet. Will be down a full 75lbs. I will transition to a more traditional bb/athlete diet, 45 protien, 45 carbs 10 fats. But definitely open to suggestions.

 

[Scruf]

How? You are taking 25 - 1 mg pills at a go? Made your own

My bad. I was taking .5mg anastrozol twice a week. I don’t know why I put 25

 

[Scruf]

Brother, respectfully...

@readalot, Thank you for your input and thoughtful post. Based on your handle “Readalot” I decided to, well, write a lot..Ha!. Sorry for the long reply, but here goes. I read your introduction, welcome to Meso!. I was one of the first members of meso back in the 90s. Here is my Re-intro, you might get a kick out of it.

Not a new member.

Been on this site for over 25 years, ever since it was called Mesomorphosis and DUDE2003 was the Source of choice. My old handle was TITAN and got lost in the great Meso crash of 2012. I am old as dirt and literally grew up in bodybuilding, my father was a bodybuilder and IFBB judge. Competed...

thinksteroids.com

The 25 arimidex comment makes no sense. No way your were taking 25 mg of anastozole at a time. I can only assume you meant to write 0.25 mg

Your trig / hdl-c ratio is horrific.

Drop your total androgen dosing back to something reasonable 100 to 150 mg/week of Test only and retest your lipids in 12 weeks.

Why wreck yourself with such large kcal deficit? Horrible stress on your body....one foot on accelerator and other on brake.

I had a lot of weight to lose, I was very fat and had a lot of fat stores to pull from. I am like the fat guy on the show “Alone” he doesn’t really hunt or gather, he is just living off of his fat stores. In all seriousness, the Alone diet is a thing. Check out this article very interesting. The Alone Diet - Guaranteed To Work | RAW with Marty Gallagher I have been using the Test/Primo to keep as much muscle as I can while dropping my weight below 200lbs. The Primo seems to help a lot with my bicycle workouts and keeps water retention down which is helpful while doing bicycle workouts. Currently, I am down 62 lbs (in three months). It is definitely a trade-off as I am losing muscle but I don’t think it is as unhealthy as carrying the extra 62 lbs of fat. For example, my doctor, years ago prescribed me the Ideal Protein diet which is a 900-calorie-a-day diet. My current diet is not too far off of the Ideal Protein diet.

Your total androgen load is too high. Reassess your lipids at a reasonable baseline. Do you have any prior data 200 mg/week or less of just Test ester?

Yes see image of test done on 7-3-2023 and 1-6-2019, Total Cholesterol 212, HDL 23 LDL 160. As well see image of test done on 1/6/2019: Total Cholesterol 180, HDL 29, LDL 125. Both tests were done with 200mg of Test and between 2 and 4 iu of HGH. Note there is a significant body weight difference.

Where is your CMP result?

I had tests done on 10/4 and 10/10, the reason they are so close is because I was trying a new service and the test was missing E2. So I retested on the 10th with E2 but no CMP. this CMP is from the 4th.

8 IU of GH per day?

I take 4iu a day

Fasting insulin?

I do not take insulin

Your cRP is not great.

CRP is getting better, as I lose weight it is coming down. Went from 3.61 to 1.43.

What was your androgen dosing and injection frequency at the time of your blood work shown above? The blood was taken at trough?

I take 100mg Test C twice a week. I also take 100mg of Primo twice a week, both doses are on the same day. I also take 80mg of Deca each week for my joints also on Saturday.

Blood work was done on Tuesdays, last dose of Test/Primo was three days before on Saturday.

Your FT (kudos on the lcms and eq dialysis tests) is insane. You are 48 and your body is trying to have a chat.

I am not sure what you are trying to say here. I am on an aggressive cut and trying to keep as much muscle as possible while increasing my ftp. Both of which i am accomplishing.

Please read. This effect is well understood.

Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk - PubMed

Testosterone administration to men is known to decrease high-density lipoprotein cholesterol (HDL-C) and the subclasses HDL(2) and HDL(3). It also might increase the number of small, dense, low-density lipoprotein cholesterol (LDL-C) particles in hypogonadal men. The decrease in HDL-C and in...

pubmed.ncbi.nlm.nih.gov

Great article, thanks for posting. The correlation between HDL/LDL is well established.

In my case we seem to have a problem with the ratio regardless of AAS usage. AAS usage makes it worse, however, even without the aas usage I am a candidate for a Statin. In looking back at my blood test from 2014 when I was actively racing bicycles, eating a very clean diet and doing 12 hour mountain bike events I still had a bad LDL/HDL ratio.



After receiving your comments, I went ahead and created a table of the last 9 blood tests that I have had taken since 2014, including a listing of the AAS that I was taking at the time of the blood test as well as my weight.

See results of the past 9 blood tests. Thank you for your comments. Cheers

 

[Cohiba]

@Cohiba, I really appreciate your input. You are probably right. I am eating approximately 80% protien, 10% carbs and 10% fats. Most of my carbs are from vegetables. I am definitely going to re-asses my diet once I get below 200 lbs.

I have 13 pounds to go before I pull out of the Keto diet. Will be down a full 75lbs. I will transition to a more traditional bb/athlete diet, 45 protien, 45 carbs 10 fats. But definitely open to suggestions.

Have you ever tried running a high protein, low carb and low fat diet for a while? (Without going full-blown keto)

I have had a lot of success cutting fat and staying lean with this macro split. So maybe rather than going equal protein and carbs, it would be something like this:

250p/150c/50f

 

[readalot]

@readalot, Thank you for your input and thoughtful post. Based on your handle “Readalot” I decided to, well, write a lot..Ha!. Sorry for the long reply, but here goes. I read your introduction, welcome to Meso!. I was one of the first members of meso back in the 90s. Here is my Re-intro, you might get a kick out of it.

Not a new member.

Been on this site for over 25 years, ever since it was called Mesomorphosis and DUDE2003 was the Source of choice. My old handle was TITAN and got lost in the great Meso crash of 2012. I am old as dirt and literally grew up in bodybuilding, my father was a bodybuilder and IFBB judge. Competed...

thinksteroids.com

I had a lot of weight to lose, I was very fat and had a lot of fat stores to pull from. I am like the fat guy on the show “Alone” he doesn’t really hunt or gather, he is just living off of his fat stores. In all seriousness, the Alone diet is a thing. Check out this article very interesting. The Alone Diet - Guaranteed To Work | RAW with Marty Gallagher I have been using the Test/Primo to keep as much muscle as I can while dropping my weight below 200lbs. The Primo seems to help a lot with my bicycle workouts and keeps water retention down which is helpful while doing bicycle workouts. Currently, I am down 62 lbs (in three months). It is definitely a trade-off as I am losing muscle but I don’t think it is as unhealthy as carrying the extra 62 lbs of fat. For example, my doctor, years ago prescribed me the Ideal Protein diet which is a 900-calorie-a-day diet. My current diet is not too far off of the Ideal Protein diet.


Yes see image of test done on 7-3-2023 and 1-6-2019, Total Cholesterol 212, HDL 23 LDL 160. As well see image of test done on 1/6/2019: Total Cholesterol 180, HDL 29, LDL 125. Both tests were done with 200mg of Test and between 2 and 4 iu of HGH. Note there is a significant body weight difference.

View attachment 268291
View attachment 268292


I had tests done on 10/4 and 10/10, the reason they are so close is because I was trying a new service and the test was missing E2. So I retested on the 10th with E2 but no CMP. this CMP is from the 4th.

View attachment 268293

I take 4iu a day

I do not take insulin

CRP is getting better, as I lose weight it is coming down. Went from 3.61 to 1.43.

I take 100mg Test C twice a week. I also take 100mg of Primo twice a week, both doses are on the same day. I also take 80mg of Deca each week for my joints also on Saturday.

Blood work was done on Tuesdays, last dose of Test/Primo was three days before on Saturday.


I am not sure what you are trying to say here. I am on an aggressive cut and trying to keep as much muscle as possible while increasing my ftp. Both of which i am accomplishing.


Great article, thanks for posting. The correlation between HDL/LDL is well established.

In my case we seem to have a problem with the ratio regardless of AAS usage. AAS usage makes it worse, however, even without the aas usage I am a candidate for a Statin. In looking back at my blood test from 2014 when I was actively racing bicycles, eating a very clean diet and doing 12 hour mountain bike events I still had a bad LDL/HDL ratio.

View attachment 268296

After receiving your comments, I went ahead and created a table of the last 9 blood tests that I have had taken since 2014, including a listing of the AAS that I was taking at the time of the blood test as well as my weight.

See results of the past 9 blood tests. Thank you for your comments. Cheers

View attachment 268297

Beautiful post Brother and I somehow missed the notification with all the flames going on at the Undeground subforum yesterday. Let me digest all of this and get back to you.

Congratulations on all the progress! Great job and this is an epic post you made. Love your table!

 

[readalot]

Sorry for the long reply, but here goes.

And please never apologize to me for writing quality stuff like that. I don't need stick figure drawings like some on here apparently. I am hoping the Meso culture in this regard can change for the better.

 

[Scruf]

Have you ever tried running a high protein, low carb and low fat diet for a while? (Without going full-blown keto)

I have had a lot of success cutting fat and staying lean with this macro split. So maybe rather than going equal protein and carbs, it would be something like this:

250p/150c/50f

I like it! What kind of carbs do you eat? Greens or complex carbs?

 

[Cohiba]

I like it! What kind of carbs do you eat? Greens or complex carbs?

Mostly complex. But greens too sometimes, on off days especially to get that full feeling with very little calories.

But I noticed your fats were really low on keto, so maybe that didn't cause your lipid issues as much. When I did Keto it was with high fats.

 

[readalot]

Effects of dietary fats on blood lipids: a review of direct comparison trials | Open Heart

The Triglyceride/High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio as a Risk Marker for Metabolic Syndrome and Cardiovascular Disease

Atherosclerosis is an immunoinflammatory pathological procedure in which lipid plaques are formed in the vessel walls, partially or completely occluding the lumen, and is accountable for atherosclerotic cardiovascular disease (ASCVD). ACSVD consists of ...

www.ncbi.nlm.nih.gov

High Ratio of Triglycerides to HDL-Cholesterol Predicts Extensive Coronary Disease

An abnormal ratio of triglycerides to HDL-cholesterol (TG/HDL-c) indicates an atherogenic lipid profile and a risk for the development of coronary disease.To investigate the association between lipid levels, specifically TG/HDL-c, and the extent of coronary ...

www.ncbi.nlm.nih.gov

Triglyceride/High-Density Lipoprotein Cholesterol Ratio: A Clue to Metabolic Syndrome, Insulin Resistance, and Severe Atherosclerosis - PubMed

High serum levels of triglycerides (Tg) and low levels of high-density lipoprotein cholesterol (HDL-C) are characteristic of the Metabolic Syndrome (MetS). We assessed the ratio of Tg to HDL-C as a way to identify MetS and insulin resistance. We also evaluated its association with severity of...

pubmed.ncbi.nlm.nih.gov

https://www.labcorp.com/tests/related-documents/L15035

The straight dope on cholesterol – Part I - Peter Attia

Welcome to a topic near and dear.

peterattiamd.com

Some homework if you are interested before my next post. Using trig / hdl-c ratio is a cheap way to get at what the expensive nmr test would give you... your lipid particle counts by size. It is great you are staying away from the 17aa AAS.

While the statins may help lower your ldl-c, I would still work on and explore dietary interventions that give you the lowest possible ratio, preferably under 1.0.

For me this intervention consists of a very high fat / no carbs keto type plan loaded with sat fat. I would typically have trigs in the 40s and hdl-c in high 60s [US units]. You may have a very different maconutrient response than me.


Another concern is your current androgen load may mask any significant improvement through dietary intervention. Something to think about.

Your table is great. I would focus on getting the trig/hdl-c ratio lowered as best you can through diet more than lowering the ldl-c since it is the small dense ldl particles that get you into trouble with cvd.

You are doing awesome with the body recomp and exercise. Now consider dietary strategy and optimum androgen load for your objective function. Tradeoff exists between max muscle and healthspan.

 

[Cohiba]

My cholesterol levels were fucked for many years. I had a calcium score done and it came back not so great, so I decided to finally get on a statin (crestor 5mg/day) and clean up my diet. These numbers are from about 9 months later.

This was also after doing that macro split I mentioned earlier.

 

[Scruf]

Effects of dietary fats on blood lipids: a review of direct comparison trials | Open Heart

The Triglyceride/High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio as a Risk Marker for Metabolic Syndrome and Cardiovascular Disease

Atherosclerosis is an immunoinflammatory pathological procedure in which lipid plaques are formed in the vessel walls, partially or completely occluding the lumen, and is accountable for atherosclerotic cardiovascular disease (ASCVD). ACSVD consists of ...

www.ncbi.nlm.nih.gov

High Ratio of Triglycerides to HDL-Cholesterol Predicts Extensive Coronary Disease

An abnormal ratio of triglycerides to HDL-cholesterol (TG/HDL-c) indicates an atherogenic lipid profile and a risk for the development of coronary disease.To investigate the association between lipid levels, specifically TG/HDL-c, and the extent of coronary ...

www.ncbi.nlm.nih.gov

Triglyceride/High-Density Lipoprotein Cholesterol Ratio: A Clue to Metabolic Syndrome, Insulin Resistance, and Severe Atherosclerosis - PubMed

High serum levels of triglycerides (Tg) and low levels of high-density lipoprotein cholesterol (HDL-C) are characteristic of the Metabolic Syndrome (MetS). We assessed the ratio of Tg to HDL-C as a way to identify MetS and insulin resistance. We also evaluated its association with severity of...

pubmed.ncbi.nlm.nih.gov

https://www.labcorp.com/tests/related-documents/L15035

The straight dope on cholesterol – Part I - Peter Attia

Welcome to a topic near and dear.

peterattiamd.com

Some homework if you are interested before my next post. Using trig / hdl-c ratio is a cheap way to get at what the expensive nmr test would give you... your lipid particle counts by size. It is great you are staying away from the 17aa AAS.

While the statins may help lower your ldl-c, I would still work on and explore dietary interventions that give you the lowest possible ratio, preferably under 1.0.

For me this intervention consists of a very high fat / no carbs keto type plan loaded with sat fat. I would typically have trigs in the 40s and hdl-c in high 60s [US units]. You may have a very different maconutrient response than me.


Another concern is your current androgen load may mask any significant improvement through dietary intervention. Something to think about.

Your table is great. I would focus on getting the trig/hdl-c ratio lowered as best you can through diet more than lowering the ldl-c since it is the small dense ldl particles that get you into trouble with cvd.

You are doing awesome with the body recomp and exercise. Now consider dietary strategy and optimum androgen load for your objective function. Tradeoff exists between max muscle and healthspan.

This is awesome. I just got back from a trip and will follow up shortly. Thank you!

 

[Scruf]

I currently take 10mg of Rovustatin and my Cholesterol is down from 221 to 124 and my LDL is down from 164 to 90. HDL is constant at 19. Lipa Protein A is 11.

Moral of the story, take the statin. All this bullshit about other nonstatin solutions are not effective.

 

[Eddie.]

I currently take 10mg of Rovustatin and my Cholesterol is down from 221 to 124 and my LDL is down from 164 to 90. HDL is constant at 19. Lipa Protein A is 11.

Moral of the story, take the statin. All this bullshit about other nonstatin solutions are not effective.

10mg per day? Man that's a lot, i see some guys taking 2,5 per day or 5 every other day. How long you're on rosuvostatin? Noticed any side effects?

 

[readalot]

HDL is constant at 19

Trigs?

hdl-c/trig ratio still in the gutter I fear.

Did you ever do the NMR test?

Apo A1 / Apo B?

Dose reduction is not a bullshit solution. It's basic harm reduction.

 

[Scruf]

10mg per day? Man that's a lot, i see some guys taking 2,5 per day or 5 every other day. How long you're on rosuvostatin? Noticed any side effects?

I have had zero side effects. I am currently feeling great. I have a family history of CVD so they started me on 10mg. My body, based on my family history and historical test will not increase my HDL but only fractionally. My brother takes 20mg and they can prescribe up to 40mg. Start at 5mg and see where it goes.. I have been on 10mg for 4 months.

 

[Scruf]

Trigs?

hdl-c/trig ratio still in the gutter I fear.

Did you ever do the NMR test?

Apo A1 / Apo B?

Dose reduction is not a bullshit solution. It's basic harm reduction.

My LDLs are below 100, in fact, they are at 90. My TGs are 76. My TG/HDL ratio is irrelevant when my overall cholesterol is at 124 and my LDL is at 90.

Also, I had a Cardio MRI with contrast as well as an echocardogram, both were normal.

 

[readalot]

My LDLs are below 100, in fact, they are at 90. My TGs are 76. My TG/HDL ratio is irrelevant when my overall cholesterol is at 124 and my LDL is at 90.

False. Check with your provider or coach on that. Big difference between lipoprotein concentrations vs particle counts and size distribution.

Even though you were downright shitty to me, I certainly still do care about your health.

Since you didn't read the more technical material I shared with you here's the simplified version:

Cholesterol Particle Sizes: Why Do These Matter and How Do You Test?

Large amounts of small LDL cholesterol particles can be concerning because of these smaller particles' superior ability to penetrate arterial walls.

www.healthline.com

For those interested. Hope it helps someone. Using a statin is not a get out of jail free card for androgen abuse or discordance between ldl-c and ApoB.

Glad your MRI/echo went well.