I was self medicating and then secured prescriptions when I saw a new cardiologist and lied to him when I said my old cardiologist had prescribed them for me.
The Indian pharmacy stuff was legit. Just as good as from a CVS or Walgreens.
MESO-Rx
Anabolic Steroids
Update on statins
- Thread starter 120nmol
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The Indian pharmacy stuff was legit. Just as good as from a CVS or Walgreens.
egruberman
Well-known Member
Yeah... That still has you with a 1 in 20 or so chance of death in the next 10 years.
In answer to your earlier question, AAS use can increase plaque burden independent of lipids, or more specifically, it can cause some endothelial dysfunction, and pro-inflammatory conditions increasing the accumulation of plaque burden for whatever ApoB is present.
The good news is, if your ApoB is sufficiently low, that's less likely to occur.
If y'all are getting rosuvastatin and ezetimibe from Indian pharma, might as well throw some bempedoic acid in as well.
trajtemberg
New Member
Anyone tried Niacin?
Is there any way to test for accumulated endothelial dysfunction?
egruberman
Well-known Member
There are some simple blood panels one can get in addition to lipids that help detect inflammatory conditions. Primarily that would be hs-CRP. I suspect you're probably also getting CBC, HbA1c, and that your blood pressure is good. Homocysteine is another good panel.
In terms of direct measurement of endothelial health, one can get a PWV (pulse wave velocity) test, which is a direct measurement of arterial stiffness.
Here's a review of PWV use in diagnosing ASCVD.
I have no idea how difficult it is to find this test or get it ordered, but it seems worthwhile for someone with advanced ASCVD (i.e. >100 CAC).
egruberman
Well-known Member
Niacin has zero efficacy in the treatment of ASCVD. It improves biomarkers somewhat, but has no positive effects on outcomes and potentially negative effects.
Niacin Therapy, HDL Cholesterol, and Cardiovascular Disease: Is the HDL Hypothesis Defunct? - Current Atherosclerosis Reports
High-density lipoprotein cholesterol (HDL-C) has been shown in epidemiologic studies to be associated with cardiovascular (CV) risk and thus significant efforts have been focused on HDL-C modulation. Multiple pharmaceutical agents have been developed with the goal of increasing HDL-C. Niacin...
link.springer.com
My last CRP test was at the dead bottom end of reference range. My father never had any diagnosed ASCVD and died at 76 of kidney issues. I just had a call with my paternal uncle who had a triple bypass at 66. Had a CAC score of 320 and was able to complete his stress test to 148bpm without exertion issues. Said he had high cholesterol but could never take a statin due to horrific side effects. Said he felt as if he was run over by a vehicle. He tried multiple ones and since his bypass is now on Repatha. My brother who is a few years older had a CAC score and was told it was "all good" but he didn't have a number to tell me.
Like I said I'm getting a second opinion this Thursday (to see if more testing is warranted). But I don't really have any exertion symptoms or anything I can consider angina. I do get anxiety at times.
egruberman
Well-known Member
While you may have detectable plaque burden that doesn't imply a certainty that you will have further issues. The likelihood of MACE increases and so it's something to be managed, but I've heard anecdotes of people with very high CAC scores with no issues. It's a game of probability.
No, because damage to the endothelium drives CVD, and you can do plenty of damage with AAS even if your cholesterol is bottomed out.
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