Another negative lipid profile trend

[Creekside]

As an update I recently obtained lab results and have made considerable progress in my lipid profile:
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I have tried to avoid as much as possible refined carbs and animal fats, do time restricted eating within a 10 hour window, eat steel cut oats and an apple every day and do a Prolon fast quarterly. I also started on 5mg of rosuvastatin every other day since January. I have not experienced any statin side affects such as fatigue, fogginess or muscle weakness, as in the past (10 years ago) with atorvastatin. I also have continued to work out 2 to 3 times a week following a pretty intense resistance regimen and walk at least 5 miles a day. I am pretty satisfied with my results thus far and will continue to monitor them.

Can you tell me about the every-other-day usage of rosuvastatin? (Why every other day vs. 1/2 a pill, do you notice any difference on days when you take it, ...)

I just started on it last week, 5mg/day -- I had a coronary calcium score just a bit lower than yours and an autoimmune disease that, while quiet in terms of frank symptoms, is still associated with a much higher incidence of cardiovascular events. The cardiologist said that most of the benefits from the statin come with the lowest dosage; upping the dose gains you relatively little compared with potential side effects. I did add Ubiquinol to my mix of vitamins since I started the statin.

[Orangeblossom]

Hi, I use the Michael Mosely books for the diet mentioned above (well quite loosely but you can use the ideas etc as you like e.g. intermittent fasting etc.) he has a new book out called Fast 800. Mainly focused on weight loss and combating type 2 diabetes...but can adapt for yourself - I just don't do the calorie counting etc.

My lipids are good - I also have treats and don't follow it particularly closely either. I know that can also depend on other things too like genetics and exercise as well. but the blood sugars are also usually good, too.

[JimBG]

Creekside wrote:
Can you tell me about the every-other-day usage of rosuvastatin? (Why every other day vs. 1/2 a pill, do you notice any difference on days when you take it, ...)

Creekside the idea for taking it every other day came from reading information on The Skeptical Cardiologist site as well as learning that Peter Attia had been taking atorvastatin every other day (actually I believe Monday, Wednesday and Friday) in the past. I don't know if he still does.

https://theskepticalcardiologist.com/2017/06/04/unsure-about-taking-a-statin-for-high-cholesterol-consider-a-compromise-approach/

I have been very reluctant to start on a statin preferring to use lifestyle approaches, however found that I was only able to improve my lipid profile so far. You might find other helpful information on that site related to statins, calcium scores and many related topics. I also discussed this approach with my cardiologist who was just simply glad that I decided to start taking it, although he recommended taking it daily.

I do not notice any difference on days I don't take it. I believe that the lipid lowering and anti-inflammatory effects take at least 2 weeks anyway.

[JimBG]

Thought I could share an update and my latest lab results:

--------------------------4/5/18 (Lab)------------3/19/19 (Lab)-------------9/10/19 (Lab)
TC------------------------261-----------------------163-------------------------148
HDL-----------------------55------------------------ 63-------------------------65
Tri------------------------126------------------------82------------------------- 82
LDL-----------------------182------------------------87--------------------------67
TC/HDL-------------------4.7----------------------- 2.6-------------------------2.3
LDL P#-------------------1974-----------------------1177-------------------------816
A1C------------------------5.1------------------------5.3
CRP-----------------------0.49----------------------0.30

The main change since the last lab was the addition of 10mg of Ezetimibe daily in June. This has had a beneficial impact on my lipid profile which is now at a point I am happy with and hope to maintain. To recap, by dietary changes over 8 months I was able move the needle substantially, however only so far with LDL particles dropping by 25% from 1974 to 1482 and then plateauing out in December. I added low dose Rosuvastatin (5mg every other day) in January and dropped another 20% to 1177. Adding Ezetimibe dropped it another 30% to 816 which is under 1000, my goal. I am also pleased that my LDL cholesterol is under 70 which I believe some studies have shown may reverse plaque. I have not experienced any muscle aches or mental fogginess. I have had some fatigue later in the day, but its hard to tell if this is just a function of my intense workouts and age. I don't recover like a 20 year old anymore as I will turn 65 in December.

[MagicBean]

...

[JimBG]

Have you been screened to determine whether you're a hyperabsorber of sterols, including plant sterols?

No I haven't. However my understanding is that E4s tend to be hyperabsorbers and accordingly Ezetimibe has been recommended to offset it. The lipidologist Tom Dayspring MD is an example of one who has made that recommendation.