I’m not your physician and I haven’t even seen you. Please don’t ask me whether or not you must go on a statin or not.
I’m definitely not going to be offering something past basic info and my nonexpert interpretation of the literature that ought to by no means be relied upon to make any form of therapy selections.
As talked about, think about requesting a referral for a lipidologist.
I’ll point out there isn’t any human information to information wholesome people for long-term statin use (ie threat of tendinopathy), neither is HDL actually a resolved concern. There may be such a gross oversimplification on the immunological operate of lipoproteins general. AFAIK, Attia most likely hasn’t talked about it a lot in any respect. I don’t assume he’s ever gone over statins, MMP, cartilage, and collagen. Or immunology a lot.
There may be some proof to even counsel some subtypes of HDL are atherogenic. We actually don’t know as a lot as Attia claims.
We will see right here biglycan which is a proteoglycan that pulls apoB and apoE is in 100% of lesions – however apoE is current in nearly 100% of lesions, apoA1 in 100%, and apoB, the supposed initiator, based on Attia, is barely current in 90%. Should you perceive the fundamentals of lipidology and assume Attia’s non-expert speculation was flawless, it ought to be 100% apoB – not 90%.
Now this doesn’t imply anybody ought to cease a statin if they’re indicated for one by their physician or that apoB is irrelevant. I discussed the weekly dosing with elevated “hepatoselectivity” as an possibility to cut back threat of myopathy (or potential cognitive dangers by avoiding particular statins which will considerably cross BBB) in these the place it’s indicated by their physician to speak with their physician about the advantages vs dangers in statin switching – significantly these with threat enhancing components for atherosclerosis.
It simply means the mechanism isn’t as clear as purported and there’s a whole lot of actual gaps. It’s simple to promote a vastly simplified story – “do one thing” in wholesome individuals and pay me 6 figures per affected person as VIP medication, which has documented dangers of its personal. If there isn’t an enormous threat we’re lowering – why commerce one potential small profit for a number of potential dangers? There are different choices that may be tried first. And even then Attia appears to have been off statins himself – I’m wondering why since he doesn’t seem to have defined it regardless of his “religion” in statins. Now if there was higher proof within the context I’m in search of or I’m indicated for it – I’d severely think about taking a statin. I’m not claiming statins are tremendous dangerous medicine both – they’re comparatively “secure” general assuming excellent situations and utilization.
Appears to me that many individuals can doubtlessly decrease LDL from say 100-130 to 70-90 with say 12-15g 100% psyllium husk from meals (particularly when you’ve got low soluble fiber consumption), 5 grams of 100% cocoa bits from meals, and/or “excellent” life-style components alone – when you’re aiming for some goal. Should you’re not discordant – there most likely isn’t vital potential profit in absolute threat discount from a goal of 70-90 by means of each day mixed statins/ezetimibe to say a goal 55 in “wholesome” individuals (55 could also be a extra cheap goal in sure excessive threat sufferers with historical past) with no threat components. When Attia claims statins are so-called “compound curiosity” as an funding, that doesn’t bear in mind different systemic dangers. If his place seems to be true – why not take the route of “compound curiosity” with the bottom potential dangers?
