ApoE4.Info

Such great discussion, blade; very instructive for us all! I like the idea of doing a low radiation coronary calcium scan, but as Stavia points out, it will only show calcified plaque... not soft plaque which is likely present given your other risk factors. I'm still nervous about you starting a statin given your very frightening previous symptoms. The idea of cutting tablets and going with a really low dose is an decent option while paying very close attention to cognitive changes. I also like the idea of measuring desmosterol levels, but I can't find an affordable isolated test. It appears to always be bundled with many other markers.

I don't think that there are any studies that show that fibrates reduce the risk of coronary artery disease, despite improvement in lipid markers. And of course we are most interested in outcomes, not "surrogate" results of blood tests.

I could be wrong, but I thought Attia and Dayspring addressed this in their podcast. Didn't they indicate that there had been problems with the studies done to date? I thought they did recommend fibrates or Ezetimibe alone for folks who couldn't tolerate a statin. If true (listen to the section about statins and cognition), this may be an option for you until you can adequately address your insulin resistance. Best of luck, blade. Keep us posted on your progress.

SoCalGuy said

....I also recall hearing in the Attia podcast that some statins like atorvastatin and simvastatin can get into the brain which should be a big concern for anyone with an APOE 4 allele or two.

I asked my doc to measure desmosterol but she indicated she'd have no idea how to read the results which wasn't encouraging.

The hydrophilic statins pravastatin and rosuvastatin are said to be less likely to enter the brain and interfere with cholesterol manufacture there (the brain makes its own cholesterol, IIRC).

Desmosterol was standard in the old Health Diagnostic Laboratory panel. Daylight worked for them a bit (HDL crashed in scandal and failure). Desmosterol range on Health Diagnostic Lab panel: 0.50 < Optimal < 1.27 μg/mL . Mine in 2015 was 1.10.

Rather, 0.49 < Optimal < 1.28