No changes in lipid profiles

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lsuguru

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I've been using Reta for roughly 6 months, during which I dropped 25 pounds. A few weeks back I had bloodwork done, and I was surprised that my LDL and cholesterol remained elevated with barely any shift. After this cycle, I feel better than I ever have, so I'm curious whether anyone else has seen comparable outcomes.
 
What results are you seeing now, and what did they show before? Also, you brought up a “cycle” — what did that cycle involve?
 
After 6 months I titrated off reta, which I suppose amounts to a cycle. Even so, there were no gains at all when it comes to lipids or heart health. Throughout those 6 months I kept up with exercise and adjusted what I ate.
 
lsuguru said:

After 6 months I titrated off reta, which I suppose amounts to a cycle. Even so, there were no gains at all when it comes to lipids or heart health. Throughout those 6 months I kept up with exercise and adjusted what I ate.
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I'm not surprised either, given that you aren't on any medication to bring down LDL. Weight loss is the main route through which GLP1s might reduce LDL, but that effect isn't assured. There's a genetic factor behind LDL, and that's the reason lifestyle changes alone fail to bring it down for most people. Ask for a prescription.
 
lsuguru said:

I've been using Reta for roughly 6 months, during which I dropped 25 pounds. A few weeks back I had bloodwork done, and I was surprised that my LDL and cholesterol remained elevated with barely any shift. After this cycle, I feel better than I ever have, so I'm curious whether anyone else has seen comparable outcomes.
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Great work on dropping the weight. That said, your lipid numbers might need a longer stretch before they start to shift.

While you're actively shedding pounds, fat stores break down and release a surge of lipids into your system, so blood lipid levels can run high.

Research has demonstrated that GLP1s can enhance lipid profiles, but the effect isn't instant — it tends to develop slowly over time.

Nice job completing your cycle and losing the extra weight. A lot of us stay on Glp's for the long haul since the health advantages go beyond just shedding pounds.

For me, ldl and triglycerides needed more than a year before they reached the healthy range, and fasting insulin took even longer. My metabolism kept getting better even during months when my weight stayed the same.
 
I'll just put it out there: a statin isn't something to be scared of. There was a lot of fear mongering around statins years ago, but the newer options such as pitavastatin and exetemibe are quite good. both are generic now.
 
I’ve never struggled with elevated cholesterol, yet my chest is full of stents. For years I’ve taken 40mg of Rosuvastatin, and about 2 years back, following my most recent stent, I began biweekly Repatha. My LDL sits in the low 20’s.
 
If someone used a statin for 6 months and then quit it, would their LDL be expected to differ from their pre-statin level? Reta lowers LDL (through greater hepatic uptake) during use. Once you stop taking it, that boost to liver LDL uptake is gone.

Asking whether 25 pounds of weight loss ought to have shifted your LDL is fair. What's unclear is how that connects to reta, beyond reta simply being the method by which those 25 pounds came off.
 
Mine got sorted out by Reta in 4-5 weeks — literally every lipid landed in the perfect range after previously being well outside it. Obviously I was also doing cardio every day, lifting weights, and eating a very clean diet. I even started trt, which theoretically ought to have pushed them up, yet Reta canceled that out and brought down my blood pressure, heart rate and a1c.
 
My lipids have generally been fine, though my LDL has been on the high side. I spent 12 months on tirz and 4 months on Reta during the final stretch of my weight loss. I hadn't had labs drawn for more than a year, yet my LDL came back under 100 for the first time in memory. My HDL now sits in the 90s, and my most recent Triglycerides reading was 60. So tirz definitely played a role, but I suspect Reta contributed more.
 
lsuguru said:

I've been using Reta for roughly 6 months, during which I dropped 25 pounds. A few weeks back I had bloodwork done, and I was surprised that my LDL and cholesterol remained elevated with barely any shift. After this cycle, I feel better than I ever have, so I'm curious whether anyone else has seen comparable outcomes.
Click to expand...

Genetics can sometimes outweigh what GLPs do for lipids.

Two things matter most here: how many LDL clearing receptors your liver has (these receptors take LDL out of the bloodstream so the liver can break it down), and how much PCSK9 protein is present, since PCSK9 destroys those receptors.

The way GLPs mostly help lipids, TLDR, is by raising the count of LDL clearing receptors — but when PCSK9 protein is elevated, that effect is limited.

If a statin or ezetimibe does nothing for you, genetically high PCSK9 may be the reason, and a drug like Repatha could be the better option (it used to run $16,000 a year, is far cheaper now, and as of this year is easy to get covered by insurance, at least in the US — with a copay card it should come to no more than $50 / 3 months).

For anyone who hasn't seen it, this animation is a nice illustration of LDL receptors and PCSK9 at work (and 1 minute later in the same video there's another animation covering a different kind of PCSK9 inhibiting drug).

View: https://youtu.be/KgRhCJW7Bhc?t=1097
 
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