LPa Score 183. Cardio Disease Prone. Looking to master Inflammation, what Peps?

[Tug Speedman]

Hello group. I come to you in need.

Recently I was digging deeper into my High LDL, Low HDL, general Fat Guy problems. And I decided Goodlabs was going to test "everything" , because I had a coupon. Welp, I popped a High LPa of 183 and Goodlabs report doesnt help because it prints in big bold red letters URGENT.

Info. 51yo Male, on Reta. Down 26lbs in that last 8 weeks, 265lb down to 239lb so far. My chat bot is telling me to just keep dropping the weight before drawing any major hypothesis or conclusion and i agree to retest lipid panel closer to my goal weight of 215lbs. Alot of my bad blood markers are barely out of range. Except High apoB and LPa, which is significant information nonetheless. But the others have a decent chance of coming in range when im skinny boy 4.0 again. 5 years ago i was a jogger, then i got fat again. I will be jogging again by this winter. I only average about 10 miles a week when im IN.

Anywhoo! Since LPa is a stubborn bastard and doesnt love improving through diet and physical change. Im hoping to zero in on the INFLAMMTION aspect of Cardiovascular Events.

My Lair, My Legion, My Gang! What are the peps that help with Inflammation and overall Cardio Protection ? Not looking or hoping for miracles here, I am feverishly doing my part for sure, dropping weight, eating mostly clean, zero liquid sugars for months now, zero fried anything for months now, no smoking but Vaping nicotine, which is next on the chopping block. On Ezetimibe, On 20mg Pravastatin (just started and hate statins), daily Baby Aspirin. And im in the middle of the mito protocol LOL. Any input is greatly appreciated, and i have no secrets, I will share my lab markers with anyone interested. Thank you and Love and Respect to all.

So far, Hexarelin and Humanin seem to have promising traits. Any others?

 

[BBA1969]

You are already on a GLP-1 so that's covered. Reta and Tirz are great for inflammation.

TB-500, VIP and KPV are the next that come to mind for inflammation with the first 2 having also cardiovascular protective properties.

 

[Tug Speedman]

BBA1969 said:


You are already on a GLP-1 so that's covered. Reta and Tirz are great for inflammation.

TB-500, VIP and KPV are the next that come to mind for inflammation with the first 2 having also cardiovascular protective properties.

Click to expand...

I've got a kit of each TB and KPV coming from my KLOW deconstruction efforts. I do have notes that VIP may be theorized in cases of mild COPD, i will dig into it. Thank you for the time

 

[lastresort]

Tug Speedman said:


Hello group. I come to you in need.

Recently I was digging deeper into my High LDL, Low HDL, general Fat Guy problems. And I decided Goodlabs was going to test "everything" , because I had a coupon. Welp, I popped an High LPa of 183 and Goodlabs report doesnt help because it prints in big bold red letters URGENT.

Info. 51yo Male, on Reta. Down 26lbs in that last 8 weeks, 265lb down to 239lb so far. My chat bot is telling me to just keep dropping the weight before drawing any major hypothesis or conclusion and i agree to retest lipid panel closer to my goal weight of 215lbs. Alot of my bad blood markers are barely out of range. Except High apoB and LPa, which is significant information nonetheless. But the others have a decent chance of coming in range when im skinny boy 4.0 again. 5 years ago i was a jogger, then i got fat again. I will be jogging again by this winter. I only average about 10 miles a week when im IN.

Anywhoo! Since LPa is a stubborn bastard and doesnt love improving through diet and physical change. Im hoping to zero in on the INFLAMMTION aspect of Cardiovascular Events.

My Lair, My Legion, My Gang! What are the peps that help with Inflammation and overall Cardio Protection ? Not looking or hoping for miracles here, I am feverishly doing my part for sure, dropping weight, eating mostly clean, zero liquid sugars for months now, zero fried anything for months now, no smoking but Vaping nicotine, which is next on the chopping block. On Ezetimibe, On 20mg Pravastatin (just started and hate statins), daily Baby Aspirin. And im in the middle of the mito protocol LOL. Any input is greatly appreciated, and i have no secrets, I will share my lab markers with anyone interested. Thank you and Love and Respect to all.

So far, Hexarelin and Humanin seem to have promising traits. Any others?

Click to expand...

Green banana

Oat bran

 

[latviantower]

How’s your CRP? That’s a big inflammation indicator and CV risk flag.

Glutathione is the livers best friend - don’t even have to pin it (although I do 150 mg IM daily), but if taking tabs, get the liposomal stuff - it has better bioavailability.

Make sure you’re taking CoQ10 to compensate for the statins tendency to deplete that.

As for your doc’s choice of statin and dose, I would ask a few questions. Rosuvastatin at 20 mg does a significantly better job of lowering LDL than pravastatin - like 50% vs 30%. I have a cardiac calcium score off the charts and I’m on 40 mg atorvastatin - my LDL is down to 40 with no sides. (Taking 300 mg CoQ10, too.) All statins not created equal!

Good luck!

 

[catdog]

Could look into PCSK9 inhibitors

 

[Tug Speedman]

latviantower said:


How’s your CRP? That’s a big inflammation indicator and CV risk flag.

Glutathione is the livers best friend - don’t even have to pin it (although I do 150 mg IM daily), but if taking tabs, get the liposomal stuff - it has better bioavailability.

Make sure you’re taking CoQ10 to compensate for the statins tendency to deplete that.

As for your doc’s choice of statin and dose, I would ask a few questions. Rosuvastatin at 20 mg does a significantly better job of lowering LDL than pravastatin - like 50% vs 30%. I have a cardiac calcium score off the charts and I’m on 40 mg atorvastatin - my LDL is down to 40 with no sides. (Taking 300 mg CoQ10, too.) All statins not created equal!

Good luck!

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Latviantower! CRP 1.7 thank you for asking. I happen to love Glutathione and just came off a bottle finished, my liver AND kidney labs came back great shortly after! I collect boxes of Gluta and i love the stuff. Also looking in to Khavinson peps regarding the cardio benefiting ones.



About the statins, i had a doc 10 years ago put me on 20 Rosuva i was on for a year and had brain fog, tendon pain, and real muscle wasting, my arms got noticably skinny, and i was hoping to go down that trt or shellfish hormone route to buff up, but alas my bloods revealed this and side tracked me from getting my muscles back. Not too bothered by that. Im still large and powerful in my childrens eyes

My new doc now wanted me on statin I told her about my previous experience and thats how i ended up on the water based and lower dose Prava 20mg/day. We have another draw coming in like 1.5 months so were watching closely.

Regarding PCSK9! I do qualify for Repatha, i can even get it free. But my doc says its a biologic and can open me up to resporatory infection, which will screw with my sleep/study/cpap road im now starting to go down. I will explore PCSK9 if the new statin fails miserably at increased dose, to be determined i guess over the next couple months.

Theres also Muvalaplin (oral), and about 4 other very promising RNA therapies in late phase trials showing phenomenal efficacy and scant sides. So i take relief that my childrens chances are on even more solid ground. But anyway, this is why I want to attack inflammation / Stress. Because I believe that driver is a significant one that I can influence. My CAC scan has been ordered.

 

[Habibibi]

The best way for now to control damage done by high lpa is to get ldl/apob as low as possible (low 40s, but lower is always better) . This usually means statins + pcsk9 inhibitors. GLP1s lower hscrp, so that helps.

CAC score is almost always useless : having a low score doesn't mean you don't have unstable plaque, which are more dangerous anyway. Having a high score doesn't mean much either, if you're on a statin your CAC score will increase because statins stabilize plaques, which show up as calcified in the CAC.

 

[Tug Speedman]

Habibibi said:


The best way for now to control damage done by high lpa is to get ldl/apob as low as possible (low 40s, but lower is always better) . This usually means statins + pcsk9 inhibitors. GLP1s lower hscrp, so that helps.

CAC score is almost always useless : having a low score doesn't mean you don't have unstable plaque, which are more dangerous anyway. Having a high score doesn't mean much either, if you're on a statin your CAC score will increase because statins stabilize plaques, which show up as calcified in the CAC.

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"having a low score doesn't mean you don't have unstable plaque".

It is my very limited understanding that this elevated LPa behaves like this unstable plaque and that it responds to inflammation of the endothelium/artery walls, where it can build up and cause issues.

Which is why my interest mainly in this thread is regarding the lessening of inflammation and maintaining an intact endothelial glycocalyx (EGC).

Although I am avert to statin therapy, here i am participating and doing my part because at my age it is no longer about what I prefer. But my intent to be present for as many of my childrens days as possible. I just hope im not too late to make any significant difference. But I will try to the bitter end. Thank you for your response.

 

[JuneBug1956]

You are seriously doing great things for your health. Continue to lose the weight, maybe even a bit underweight. Trying to avoid diabetes will help the picture immensely. Keep going. ( avoid smoking and second hand smokers too…if you don’t already) If you are on Discord navigate over to the Roundtable. Many health practitioners there with the latest up to date educational info.

 

[Tug Speedman]

JuneBug1956 said:


You are seriously doing great things for your health. Continue to lose the weight, maybe even a bit underweight. Trying to avoid diabetes will help the picture immensely. Keep going. ( avoid smoking and second hand smokers too…if you don’t already) If you are on Discord navigate over to the Roundtable. Many health practitioners there with the latest up to date educational info.

Click to expand...

Junebug thank you! I do need the encouragement its been a tough ride all the late nights having to dig into the research. I was perfectly happy researching Peps all night, but now this little side quest pops up. Im on Discrd, and i really need to get into Roundtable it sounds like. Thank you again!

 

[SVT810E]

Tug Speedman said:


About the statins, i had a doc 10 years ago put me on 20 Rosuva i was on for a year and had brain fog, tendon pain, and real muscle wasting, my arms got noticably skinny, and i was hoping to go down that trt or shellfish hormone route to buff up, but alas my bloods revealed this and side tracked me from getting my muscles back.

Click to expand...

Funny thing. It might be worth your while to think about hopping on TRT. It’s actually one of the more effective interventions for dropping Lp(a) with small trials noting consistent reductions in elevated Lp(a) ranging from 25-59%.


https://www.atherosclerosis-journal.com/article/0021-9150(95)05756-0/abstract


Full blown steroid cycles have an even stronger effect on Lp(a) but are probably () a net negative for your cardiovascular health.

 

[Tug Speedman]

SVT810E said:


Funny thing. It might be worth your while to think about hopping on TRT. It’s actually one of the more effective interventions for dropping Lp(a) with small trials noting consistent reductions in elevated Lp(a) ranging from 25-59%.


https://www.atherosclerosis-journal.com/article/0021-9150(95)05756-0/abstract


Full blown steroid cycles have an even stronger effect on Lp(a) but are probably () a net negative for your cardiovascular health.

Click to expand...

I think I saw just a notion of that angle when I was digging around recently. Honestly i hope im just side questing for my health sake and can go back to optimization. But it all fits conveniently together. Thats why ill always love the gym guys and girls. They've been on that front line for a loong time and the data is very deep. Thank you so much SVT!

 

[sfkid]

You try what body builders do.

Ezetimibe - stops uptake of ldl in small intestine

Rosuvastatin - not a typical statin . This only specifically targets ldl production in liver and is not processed by kidneys. No muscle aches , brain fog from this.

Both at low doses are very effective with no sides...

 

[JuneBug1956]

Tug Speedman said:


Junebug thank you! I do need the encouragement its been a tough ride all the late nights having to dig into the research. I was perfectly happy researching Peps all night, but now this little side quest pops up. Im on Discrd, and i really need to get into Roundtable it sounds like. Thank you again!

Click to expand...

Peppy’s too is a great place.

 

[lessthanhalf]

Habibibi said:


CAC score is almost always useless : having a low score doesn't mean you don't have unstable plaque, which are more dangerous anyway. Having a high score doesn't mean much either, if you're on a statin your CAC score will increase because statins stabilize plaques, which show up as calcified in the CAC.

Click to expand...

This is not correct. CAC is extremely accurate at predicting risk of future cardiovascular events, possibly more accurate than angiography ( which is very useful for finding critical stenoses that might need surgery or stenting ) but CAC shows overall plaque burden which is very strongly correlated to long term risk, most infarcts occur at sites that are not major narrowings , occurring at sites that have inflamed plaques that rupture causing clotting and then heart attacks, and the more area of plaque the higher the risk of this happening. CAC is not useful or used really in general to follow up changes, except to repeat it sometimes 5 or more years later if CAC is low. Statins do stabilise plaques, and that is an important function of them. CAC is mostly used to decide on the need for lipid lowering therapy if risk levels from normal assessments are intermediate. If high then treatment is needed anyway and CAC does not add a lot of actionable information. A zero CAC score has a very low long term absolute cardiovascular risk, so it has been studied in terms of real world long term outcomes, which is a much more valid assessment than the possibility of plaques without any calcification being a risk factor.

I had a CAC score done a few years ago that was high 645, and told it was 97th percentile for risk for age at 57, and did quite a lot of reading including the current cardiovascular guidelines for managing coronary artery disease for US and Australia.

 

[Chucky]

Have you had your ejection fraction checked?

 

[GLiPtest]

This is not complicated.

Ezetimibe

Statin (I’d advise Pitavstatin)

Repatha

This will drive your lipids as low as possible, immediately minimize risk, and put you in a position to even have some plaque regression, the majority on statins combined with Repatha do.

If you are asymptomatic, there is nothing you’ll learn from imaging or diagnostics that will be actionable. They don’t do “preventative” stents or bypasses anymore. Because “maximal medical therapy”, the combo I referred to above, provides equal or better outcomes regardless of blockages, if you’re not experiencing chest pain or exercise intolerance.

Repatha will reduce LPa by around 30%. Until the new targeted meds become available for LPa, the only thing you can do is get your LDL / ApoB as low as possible. LPa is a risk multiplier, so getting baseline risk as low as possible makes LPa less relevant.

Consider getting APOE genotype testing. Many of those with high LPa have APOE4, which puts you at significantly higher risk for Alzheimer’s, and knowing early could help you (and your family members who you inherited from / passed it on to) avoid a potential catastrophe.

 

[lessthanhalf]

Chucky said:


Have you had your ejection fraction checked?

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The first thing done was a stress echo, as I had some odd symptoms of weird breathlessness while still very overweight, and it took forever to get it organised and I had already lost a lot of weight by the time it got done. No ischaemia was seen, but it showed an ejection fraction of 50% and mild left atrial and ventricular enlargement, so class b heart failure ( without symptoms but structural changes and mildly reduced ejection fraction, should have been 55%+ ) As best I can find out this has a risk of turning into symptomatic heart failure of 1-2% a year, assuming I take beta blockers and ace blockers and do not regain the 80 kilos I lost, overall this is probably a bigger risk than the risk of heart attacks from the high CAC, as reducing those risks with statins etc is easier. 10 year risk untreated 20-25% MACE , about half that with treatment , statin, ezetimibe, clopidogrel, assuming I do not regain weight, making the GLP drugs literally required to stay alive, as I would guess those risks would skyrocket with massive weight regain.

I have had an echo done every year since or 2 more with no significant changes which is hopefully a good sign. My reading of the science said the CAC and angiogram were probably not needed, but I deferred to my GP and cardiologist's advice. Angiogram showed 15% right coronary artery stenosis and 50% left anterior descending stenosis, so no fixable problems. ( mainly done to see if critical narrowings that could be fixed to prevent worsening heart failure, as the above comment explains I already qualified for maximal medical therapy for atherosclerosis, I was not sure the science supported getting it done, but not much point seeing specialists then ignoring their advice even if you have read the literature, clinical experience cannot be obtained by reading papers)

 

[Blueeyedme]

Your talking about Lp(a) and I have the same problem. The bad news is that is genetic and unrelated to diet, exercise & weight and there is no current treatment. There may be good news on the horizon as there are 3 drugs in Phase 3 trials at the moment. They are Pelacarsen, Olpasiran and Lepodisiran. Be sure to ask your cardiologist about these. In the meantime, I'm sure your doc will be agressively lowering your lipids. Your ApoB numbers are lifestyle related and will come down when you control your weight and lipids. I'm on 40mg Rosuvastatin and a Repatha injection every two weeks and my Total Cholesterol is 83 with LDL at 21. I have nearly a full metal jacket of stents and an awful family history of heart disease. In any event, this isn't something you self-treat with peptides and steroids, you need to be seeing a cardiologist.