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Correcting a BAD cholesterol

Gunsmith

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A local LEO from my area came to me asking if I would help him straighten his diet out because his cholesterol is “a bit off”

The guy is 38 years old , been weight lifting for 14 years strictly for strength but not a power lifter per se. he has used steroids for the whole 14 years he has been lifting and on TRT for the last 6 years but taking 250mg a week as opposed to his 150mg/wk prescription , he has admitted that he likes TREN stacked with anavar , he runs 6 weeks on 4 weeks off.

With the levels where they are I’m thinking that the best bet is to get on Lipitor Togo a jump on getting it down along with a break from the drugs and a diet

I’d like to hear some other opinions
 

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IronLion2

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If his BP and RBC are in check and he doesn't have a family history of heart disease, id for sure skip the statin.
His trigs and LDL are so jacked up, fixing diet should be #1 and a statin should only be added after that... You cant blame TRT or even tren for trigs of over 400, that's a western diet issue
 
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IronLion2

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100% he wasn't fasted when getting the blood draw. So the trig value doesn't tell you anything.

I figured something was skewed, never heard of trigs over the mid 200s. So my advice may be off than but I'm still anti statin, especially for someone in their 30s.
 

MyNameIsJeff

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I'm still anti statin, especially for someone in their 30s.
I totally agree. I recently reviewed the literature and concluded that the evidence for statins reducing CHD risk is very weak. The downsides of statins on the other hand are very real.
 

suppdude

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Or just tell him to drop the tren and anavar. Nothing is going to help running those two together even if taking 6 weeks on and 4 off.


Sent from my iPhone using Tapatalk
 

nothuman

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I totally agree. I recently reviewed the literature and concluded that the evidence for statins reducing CHD risk is very weak. The downsides of statins on the other hand are very real.

I can feel the people on statins here getting triggered by this fact.

PSCK9 Inhibitors on the other hand, which not many doctors are prescribing and not a lot of insurance companies are improving, may however, be a wonder drug for cholesterol and CHD risk. They were only approved two years ago but are a total bitch to obtain.
 

pesty4077

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I can feel the people on statins here getting triggered by this fact.

PSCK9 Inhibitors on the other hand, which not many doctors are prescribing and not a lot of insurance companies are improving, may however, be a wonder drug for cholesterol and CHD risk. They were only approved two years ago but are a total bitch to obtain.

I would like to know more on this subject.
 

nothuman

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maldorf

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The first issue is they are shots, not tabs. Also they’re very expensive and tough for insurance approval. I follow this expert lipidologist on twitter who has spoken highly of them

https://www.webmd.com/cholesterol-management/pcsk9-inhibitors-treatment

And here’s an article from yesterday about them
https://www.nytimes.com/2018/10/02/health/pcsk9-cholesterol-prices.html

Well cost seems to be the problem, health insurance is terribly expensive as it is. That article said "Drug companies gave the PCSK9 inhibitors exorbitant price tags — the list figure was as high as $14,600 per year, although payers generally negotiate much lower prices. But insurers balked at the costs and questioned the effectiveness of the new drugs. "

You have to be pragmatic about this. The cost is still too high to justify its widespread use. If someone wants the drugs that bad then they could pay out of pocket for them. Maybe the price will come down some. The insurance companies have to do something to control health care costs.
 

MyNameIsJeff

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Well cost seems to be the problem, health insurance is terribly expensive as it is. That article said "Drug companies gave the PCSK9 inhibitors exorbitant price tags — the list figure was as high as $14,600 per year, although payers generally negotiate much lower prices. But insurers balked at the costs and questioned the effectiveness of the new drugs. "

You have to be pragmatic about this. The cost is still too high to justify its widespread use. If someone wants the drugs that bad then they could pay out of pocket for them. Maybe the price will come down some. The insurance companies have to do something to control health care costs.
These sort of initial hiccups in availability are normal when there is a pharmaceutical innovation. 1) prices tend to be high due to the need to recuperate R&D costs and a lack of competition, and 2) Medical research needs to be accumulated to show effectiveness and superiority of these new drugs, which takes time.

Slow progress is being made on both fronts. New research in support of the drug is coming out and so new players will develop their own PCSK9i's. At the same time, insurance companies will be pressured to reimburse the drug. The US health care system is not ideal, but it's certainly better than socialized medicine in Europe and elsewhere. It will take years until those people will get access, while at least US patients can get the stuff since thanks to competition, some insurance proviers will find ways to offer it right now.. If the EU socialized medicine system were also used in the US, drug development would slow down tremendously. Anyways...

I was really impressed by the following:

Harvard Pilgrim struck a different deal. Amgen is reducing its price to Harvard Pilgrim — and will refund the cost of its drug, Repatha, for any patient taking it who goes on to have a heart attack or stroke. In return, Harvard Pilgrim also simplified its pre-authorization forms.

That's insane. It shows tremendous confidence of the drug maker in their product. They put their money where their mouth is.
 

bigsonbitch

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for me ill use a statiin like lipitor for a month to bring down my ldl....i hate them as i get aches and pains within the first 2 weeks.

after they come down some (admittedley for me they come down fast) ill take citrus bergomot to keep it low

diet is clean year round.
 
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akimbo

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If i would have ran around with sich values for a long time i would make sure that i get a comprehensive cardiological checkup (calcium scan etc.) Chances are high that there is already damage done and you should be aware of it.

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So what is his current diet like?
 

Gunsmith

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I'm not a fan or advocate of statins but with his levels being what they are I figured that taking some for 3-4 months to get the numbers down much faster than just diet and exercise alone would be a good jump start.

His diet is typical American garbage with a couple extra Protein shakes a day. He said he drinks a couple Monster drinks per shift at work. Lots of bread and starches probably 100+g sugar a day via sweet tea and coffee.

He has an appointment with my cardiologist next week
I'm currently working on a diet and we're gonna start him on a different Training routine Friday (little more volume and tempo) as well as cardio which he does none of now

Of course he is going to be off all drugs except his actual TRT dose.
 

Elvia1023

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The changes in his diet and the cardio should enough for dramatic changes. All the usual supps that are mentioned on here all the time as well. To keep it simple (this guy doesn't sound like the type of guy to take 5 different supps) you could recommend blended products such as NOW Foods Cholesterol Pro and Sytrinol. However it doesn't really matter what he uses if he stays on that dosing protocol of tren and avar it's a losing battle. As you know he needs longer periods off cycles and just on true trt. I woudl also recommend using oral aas sparingly and definitely not every cycle.
 

superbigd

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I totally agree. I recently reviewed the literature and concluded that the evidence for statins reducing CHD risk is very weak. The downsides of statins on the other hand are very real.

Can you expand mnij? Are you saying that telmisartan is over recommended on this board ?
 

MyNameIsJeff

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Can you expand mnij? Are you saying that telmisartan is over recommended on this board ?
No, I'm not saying that. Telmisartan is not a statin, it is an Angiotensin Receptor Blocker.

[...]That being said, after going through more recent papers I'm still unsure what to believe. There is a lot of contradictory findings even from similar RCTs and meta-analyses of the same set of studies.

I'm very skeptical of the 'big pharma' conspiracy theories, but on this case the medical establishment really seems to be pushing LDL reduction and statin use despite the lack of conclusive evidence, selectively picking studies that support their points while ignoring negative findings.

This recent opinion piece neatly summarizes how we still know very little:
https://ebm.bmj.com/content/22/1/15
 

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