Fibrates to increase HDL

[whacked]

This class of meds has proven to be pretty effective at increasing HDL (and it lowers Trigs too if you have issues with your Trigs).

As such, perhaps it makes for an interesting consideration to an oral cycle?

Fenofibrate is one example of several.

As a welcomed side, Fenofibrate lowers abdominal and skeletal adiposity and improves insulin sensitivity as well.

I don’t really run much of anything anymore and I’m too old and cranky to deal with the sides from orals so this thread is more so just for fun and perhaps it helps someone.

 

[whacked]

Since high Triglycerides and low HDL (along with their ratio which should be around 1.0 or 1.5 at worst) ….are much more predictive than LDL for CVD, why aren’t people using Fibrates instead (see below) as these address these 2 things head on.

Ps. I don’t want my LDL levels low. Not healthy. LDL has plenty of positives.

Cholesterol Medications: Statins vs. Fibrates

Two common types of medications used to treat high cholesterol are statins and fibrates. Please continue reading to learn more about the differences between the two.

www.buzzrx.com

 

[joetrisman]

Since high Triglycerides and low HDL (along with their ratio which should be around 1.0 or 1.5 at worst) ….are much more predictive than LDL for CVD, why aren’t people using Fibrates instead (see below) as these address these 2 things head on.

Ps. I don’t want my LDL levels low. Not healthy. LDL has plenty of positives.

Cholesterol Medications: Statins vs. Fibrates

Two common types of medications used to treat high cholesterol are statins and fibrates. Please continue reading to learn more about the differences between the two.

www.buzzrx.com

As i recall, guidelines changed about 10 years ago because though fibrates improve dyslipidemia, this didn't actually translate into clinical outcome change in contrast to statins

 

[whacked]

As i recall, guidelines changed about 10 years ago because though fibrates improve dyslipidemia, this didn't actually translate into clinical outcome change in contrast to statins

I don’t recall that but thanks for sharing.

The timing sure is questionable though as this magically gave rise to even more statin use.

Fibrates’ MOA is totally different and one could even argue that in small amounts, confer appealing health benefits via favorable PPAR-expression.

An old product called Sesamin was popularized a decade ago in an attempt to mimic some of these positive actions. Fish Oil and CLA do to a small degree.

God forbid Big Pharma actually endorse something that actually ameliorates an issue without crappy sides and deleterious effects/damages to the body (whereby more meds are needed). Rinse, repeat - until polypharmacy is your life.

 

[whacked]

More interesting info on this class of meds …

I. Addresses the supposedly problematic LDL subtype (small dense particles)

Small dense LDL, a fraction of LDL that produces the maximum peroxidation products, is reduced via the action of fibrates by activating lipoprotein lipase (LPL). Fibrates increase this LPL mediated lipolysis via activation of transcription factors for peroxisome proliferator-activated receptors (PPAR).

II. Increases HDL & Decreases Trigs

Fibrates target atherogenic dyslipidemia by increasing plasma HDL-C concentrations and decreasing small dense LDL (sdLDL) particles and TGs, thus contributing to dyslipidemia management, particularly in patients with diabetes (DM) or the metabolic syndrome (MetS).

III. Lowers VLDL

Fibric Acid Derivatives (Fibrates): Fibrates, namely gemfibrozil and fenofibrate, are the drugs of choice for hypertriglyceridemia. Fibrates activate PPARs, which lower TG levels by reducing TG synthesis in the liver through increased fatty-acid oxidation. This action decreases the TG content of VLDL

 

[bg65]

There is emerging evidence that reducing LDL particle count is beneficial but there is no study that shows raising HDL (as a sole endpoint) reduces cardiovascular risk. Classic example is niacin. It'll raise your HDL but doesn't alter outcomes

 

[micro2000]

There is emerging evidence that reducing LDL particle count is beneficial but there is no study that shows raising HDL (as a sole endpoint) reduces cardiovascular risk. Classic example is niacin. It'll raise your HDL but doesn't alter outcomes

New research shows that while niacin increases HDL it increases pro-atherogenic proteins in the HDL complex.

 

[Knight9]

New research shows that while niacin increases HDL it increases pro-atherogenic proteins in the HDL complex.

Micro, good to see you around. Are you familiar with the latest and best ways to decrease LDL-C, increase particle size and maximize HDL functionality?

 

[micro2000]

Micro, good to see you around. Are you familiar with the latest and best ways to decrease LDL-C, increase particle size and maximize HDL functionality?

Unfortunately I don't. I just happened to run across the paper about niacin not too long ago.

 

[slayer37]

Peter Attia just did an awesome podcast on HDL. Long story short; HDL is not as protective or beneficial as we once believed.
Focus on decreasing LDL and ApoB.

 

[BLang]

I don’t recall that but thanks for sharing.

The timing sure is questionable though as this magically gave rise to even more statin use.

Fibrates’ MOA is totally different and one could even argue that in small amounts, confer appealing health benefits via favorable PPAR-expression.

An old product called Sesamin was popularized a decade ago in an attempt to mimic some of these positive actions. Fish Oil and CLA do to a small degree.

God forbid Big Pharma actually endorse something that actually ameliorates an issue without crappy sides and deleterious effects/damages to the body (whereby more meds are needed). Rinse, repeat - until polypharmacy is your lif

You complete gloss over jtrisman's point, and rather than doing a few minutes of research to see if there's any validity to it (there is), you bury your head in the sand and ascribe it all to a big conspiracy.

If you're going to do the whole "everything is a Big Pharma conspiracy" thing, at least base it in reality.

The reality is that there are several patented Pharmaceutical Fibrates (most developed by Parke-Davis in the 60s and 70s, currently a subsidiary of Pfizer), the most well known ones being Gemfibrozil AKA Lopid, and Fenofibrate which are currently prescribed to millions in the U.S.

But, there are major complications and contraindications wrt to it's their use being more than in very small, targeted situations, and have been shown in literature to have either little or no effect on all-cause mortality thus far. In fact their effect on triglycerides and HDL are less than Niacin.

A few minutes of research into the full literature and not just the stuff that confirms your biases would have shown you that.

So called "Big Pharma" has spent millions on development and research of these drugs, and would love nothing more than for Fibrates to have panned out like they'd hoped.

 

[buck]

The other side is studies seem to show low cholesterol do not lead to a longer life span. May have some heart benefits. But the body needs cholesterol. For example the brain is mostly fat with cholesterol making up a far amount of it.

 

[whacked]

@ BLang

Wow. Your best buddy bang your wife or something? Do I know you? Did you mistake him for me?

Know what the best part about getting older is?

You learn to laugh at internet tough guys vs engaging them and pissing away your life in an argument with internet know-it-alls.

Too old and I’m here to help people not convince people that they need a pill for everything or to suck Big Pharma’s sausage.

Next time you want to have a healthy civil debate to actually move the ball forward, learn to be more respectful in your approach. I don’t know you nor do I owe you my time.

The irony here is that you just confirmed your own biases. lol

As truly intelligent people share, the more I learn, the less I know. Learn some humility and to talk to people with grace. You look like an angry buffoon

Please don’t beat me up through the screen Mr Internet tough guy.

WTH lol.

 

[whacked]

The other side is studies seem to show low cholesterol do not lead to a longer life span. May have some heart benefits. But the body needs cholesterol. For example the brain is mostly fat with cholesterol making up a far amount of it.

Bingo. This is all a fact - not “head in the sand bias”. Lol.