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NFT: The anti-cholesterol drug Repatha

Ron from Ninerland : 12/1/2022 6:20 pm
Has anyone had any experience with this drug ? My cardiologist prescribed this to me after I refused to take Statins, however I'm reading anecdotal accounts of side effects that are as bad or worse than what one would expect from Statins. Also my LDL is down to 98 without taking anything. TriGlycerides are 150 something. Is this stuff even going to do me any good ?

I know a football board is not the best place to get medical information, but from the research I've done online I can't get a clear sense of how useful Repatha is. Any advice would be appreciated .
I've been pretty successful if fighting cholesterol  
US1 Giants : 12/1/2022 6:41 pm : link
by watching my weight. If let my weight spike then cholesterol becomes a problem for me again. Want to avoid cholesterol drugs as long as I can.
Maybe consult a lipid specialist  
JB_in_DC : 12/1/2022 6:44 pm : link
Insisting on a drug with your LDL seems strange to me.
How old are you?  
Bill in UT : 12/1/2022 7:36 pm : link
What's your family history? Have you tried any diets? Have you been scanned for any lipid buildups in your arteries? What's happening in your body, as far as lipid buildup and vessel constriction is more important than just numbers, imo. If fats are just floating thru you, and being picked up in your blood screenings, it's not as big a health risk.
Ron  
Samiam : 12/1/2022 8:02 pm : link
First, I think Bill’s questions are good ones. Second, my cardiologist wanted my LDL to be below 100 and as much below 100 as I could get. So, 98 is a good number but guessing your cardiologist wants it lower. Third, statins have been around for many years and there are many of them. If you experienced side effects with one, there are many more you can try and most don’t have side effects at least significant ones. I
I resisted  
Rick5 : 12/1/2022 8:16 pm : link
taking a statin for years because I was concerned about side effects. My ldl claimed to 160, and it was 159 after 6 months of eating animal protein only twice per week and nothing processed! I was basically a vegan. At that point I finally caved in and went on pravastatin 40 mg. I have had zero side effects and wished I did it earlier. My LDL dropped to 80 and my total cholesterol is 166.
Statins  
bmgints : 12/1/2022 8:17 pm : link
Statins are very safe medications relatively speaking (all medications have side effects and you should see how many issues are seen in ICUs due to Tylenol). Statins have much larger and longer evidence base of efficacy compared to repatha in terms of reducing cardiovascular events.
RE: How old are you?  
Ron from Ninerland : 12/1/2022 8:18 pm : link
In comment 15928396 Bill in UT said:
Quote:
What's your family history? Have you tried any diets? Have you been scanned for any lipid buildups in your arteries? What's happening in your body, as far as lipid buildup and vessel constriction is more important than just numbers, imo. If fats are just floating thru you, and being picked up in your blood screenings, it's not as big a health risk.
I did have an angioplasty and one stent in 2019. Since then I've been diagnosed with diabetes, but I'm controlling it pretty well with the help of Metformin and a reduced carb diet. I got my A1C down from 8.0 to 6.0. My echocardiograms have been clean. My father recently died of heart failure at age 88, but didn't start having heart problems until his mid 80's
RE: How old are you?  
Ron from Ninerland : 12/1/2022 8:20 pm : link
In comment 15928396 Bill in UT said:
Quote:
What's your family history? Have you tried any diets? Have you been scanned for any lipid buildups in your arteries? What's happening in your body, as far as lipid buildup and vessel constriction is more important than just numbers, imo. If fats are just floating thru you, and being picked up in your blood screenings, it's not as big a health risk.
Oh yeah, I'll be 66 in a couple of weeks.
Statins.  
Ron from Ninerland : 12/1/2022 8:24 pm : link
I tried a statin for a while and had horrible muscle pain. Beyond that I've had borderline high liver enzymes since I was in my 30's and now I'm taking up to 3 Tylenols a day and 500mg of Metformin. It seems like a big risk for me to be taking another drug that's going to affect the liver.
Is it true that statins can increase the risk of diabetes?  
US1 Giants : 12/1/2022 8:32 pm : link
Diabetes in later life runs in my family and scares me more than cholesterol.
Ron  
Samiam : 12/1/2022 8:33 pm : link
There is a non statin that reduces LDL. It called ezetimibe. I was on it for awhile and it did help although not as much as the statins. I did have issues with some statins but switched over a period of years until I found one that’s been working. Very low dose of Livalo. Since your LDL is pretty good to begin with, ask about the alternative like Ezetimibe if you’re not interested in Repatha.
RE: RE: How old are you?  
Bill in UT : 12/1/2022 8:34 pm : link
In comment 15928420 Ron from Ninerland said:
Quote:
In comment 15928396 Bill in UT said:


Quote:



Oh yeah, I'll be 66 in a couple of weeks.


ok, so you're just a kid :) Statins are good for keeping lipid levels down, but they are also an anti-inflammatory, which may be significant in heart disease so I continue to take them. I also still take a baby aspirin, the efficacy of which may be debatable these days. And I try to stay low carb, cause that's the only diet which has been good for my numbers. The problem is that the GPs and even the cardiologists really know nothing about the effects of serum lipid levels in any individual. So be sensible, don't turn your diet into food hell even if some doctor tells you to. If I had my choice on how to go, I'd gladly take heart failure in my mid-late 80's. I'd just hope for a heads up, so I could go out eating ice cream, cake, pizza, pasta and sandwiches my last couple of years :)
RE: RE: RE: How old are you?  
Ron from Ninerland : 12/1/2022 9:03 pm : link
In comment 15928432 Bill in UT said:
Quote:
In comment 15928420 Ron from Ninerland said:


Quote:


In comment 15928396 Bill in UT said:


Quote:



Oh yeah, I'll be 66 in a couple of weeks.



ok, so you're just a kid :) Statins are good for keeping lipid levels down, but they are also an anti-inflammatory, which may be significant in heart disease so I continue to take them. I also still take a baby aspirin, the efficacy of which may be debatable these days. And I try to stay low carb, cause that's the only diet which has been good for my numbers. The problem is that the GPs and even the cardiologists really know nothing about the effects of serum lipid levels in any individual. So be sensible, don't turn your diet into food hell even if some doctor tells you to. If I had my choice on how to go, I'd gladly take heart failure in my mid-late 80's. I'd just hope for a heads up, so I could go out eating ice cream, cake, pizza, pasta and sandwiches my last couple of years :)
Bill, thanks for your help. I haven't turned my life into a diet hell. I avoid high fructose corn syrup and junk like donuts, potato chips and cheddar goldfish ( the absolute worst ). I take it easy with mashed potatoes and white rice. I still eat pizza, most fruits and cane sugar sweetened desserts. Most importantly I test my glucose three to five times a day. One thing I've learned through testing is that the wrong meds or wrong combination of meds will send my glucose soaring.
RE: Ron  
Ron from Ninerland : 12/1/2022 9:06 pm : link
In comment 15928431 Samiam said:
Quote:
There is a non statin that reduces LDL. It called ezetimibe. I was on it for awhile and it did help although not as much as the statins. I did have issues with some statins but switched over a period of years until I found one that’s been working. Very low dose of Livalo. Since your LDL is pretty good to begin with, ask about the alternative like Ezetimibe if you’re not interested in Repatha.
Thanks Samian. I've looked up Ezetimibe and it too hits the liver, which I'm trying to avoid. Repatha does not affect the liver. My questions about it are if I really need it and if it has nasty side effects.
Repatha  
George from CT : 12/1/2022 11:52 pm : link
I’ve been on it for about a year now, no issues but it is self injections.
Do you know your HDL number? From what I’ve read and heard, my goal is to try and get my LDL below my HDL.
lipids  
Hilary : 12/2/2022 7:40 am : link
To determine whether treatment of lipids is needed doctors use the american college of cardiology risk calculator. They enter your data (or a patients data) it gives guidelines for the need for treatment of cholesterol and blood pressure. For people with elevated lipids and a 7.5% chance of cardiac disease in 10 years
treatment is recommended. It is my understanding that for people with diabetes of history of heart disease a goal of 70 for ldl for people without diabetes or history of heart disease
less than 100 is good.
A calcium score is a noninvasive test ( at CT scan) that can give you an idea if you are prone to developing plaque and need aggressive treatment.
statins and repathia are very safe. repathia is expensive and likely will not be covered by your insurance unless you have failed statins





https://www.cvriskcalculator.com/
RE: Statins  
River Mike : 12/2/2022 8:06 am : link
In comment 15928418 bmgints said:
Quote:
Statins are very safe medications relatively speaking (all medications have side effects and you should see how many issues are seen in ICUs due to Tylenol). Statins have much larger and longer evidence base of efficacy compared to repatha in terms of reducing cardiovascular events.


THIS ^^^^
This muscle pain can be a very serious issue (rhabdomyolysis), but changing statins and finding the right one and/or dose should resolve that.
I'm 40, below average weight and in shape  
Metnut : 12/2/2022 8:56 am : link
and have always had very high cholesterol. Started taking a statin (crestor/rusovostatin, 5mg daily) 6 months ago, and the results have been dramatic. LDL went from very high to average within a month. Zero side effects.

The new statins are "better" than the older ones and have less side effects (if any). Often, the smallest dose is enough to make a big different and there's significant case of diminishing returns when the dose is increased (it's the higher doses that often result in side effects).

I'll also add that many of the studies you'll see on the internet used the first generation of statins and the medication has been improved since then.
I've also gotten my cholesterol under control  
Dr. D : 12/2/2022 10:28 am : link
by reducing my weight. I know some people don't want to hear it, but getting my weight where it should be, not only got my cholesterol to where it should be, but also my blood pressure. And I have less back & leg pain, etc. And I look better (to my wife and that's also a good thing (if you know what i mean)).

As I said on a recent thread, I eat everything I want. Everything I've ever eaten, I just eat slightly smaller portions. The hardest part is the first month or so (eating less than norm). After that, the stomach shrinks along with appetite, and it's much easier (saves money on food too).

I avoid all prescription meds as much as possible. There are good reasons to resist statins. I have a friend who had kidney cancer. He's certain it was due to the statins he was taking and I don't doubt it. They have been linked to cancer.

Not familiar with the other one, but don't doubt there will be side effects. The only side effects from getting your weight to where it should be, are all positive.
RE: I've also gotten my cholesterol under control  
Rick5 : 12/3/2022 12:07 pm : link
In comment 15928649 Dr. D said:
Quote:
by reducing my weight. I know some people don't want to hear it, but getting my weight where it should be, not only got my cholesterol to where it should be, but also my blood pressure. And I have less back & leg pain, etc. And I look better (to my wife and that's also a good thing (if you know what i mean)).

As I said on a recent thread, I eat everything I want. Everything I've ever eaten, I just eat slightly smaller portions. The hardest part is the first month or so (eating less than norm). After that, the stomach shrinks along with appetite, and it's much easier (saves money on food too).

I avoid all prescription meds as much as possible. There are good reasons to resist statins. I have a friend who had kidney cancer. He's certain it was due to the statins he was taking and I don't doubt it. They have been linked to cancer.

Not familiar with the other one, but don't doubt there will be side effects. The only side effects from getting your weight to where it should be, are all positive.

You are lucky. I have never been overweight, and even a very strict diet has basically no effect at all on my cholesterol levels.
Thanks for everyone's help.  
Ron from Ninerland : 12/3/2022 2:30 pm : link
I shot up with Repatha about 24 hours ago. So far no side effects. With my insurance its $20 a month. We'll see how it goes.

The research that I've seen shows Repatha is very effective at lowering LDL, more so than statins and it does not effect the liver function.

As for whether Repatha or Statins reduces the risk of heart disease, those studies are more murky. I wish these studies were more focused. If you're doing 2 and half packs a day, have CPOD or uncontrolled diabetes then LDL is the least of your problems. If there are carefully controlled studies of people with high lipids and no other problems and bad habits, I'd like to see it.
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