Taking medicine proactively for your health

Shittersfull

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Which rx medications can be taken proactively for your health and wellbeing? In the USA, being your own advocate is the whole game. Pharma advertises them straight at patients, so people end up asking their doctor for a prescription. I am putting a short list together for myself and figured others might be interested in it and want to add to it. Obviously all of this should be prescribed by a Dr and carries potentially serious side effects. That said, I know plenty of people who source them through other channels

1. Tadalafil, an ED drug with well documented cardiovascular upside. Cuts heartattack risk, stroke, dementia, etc.

2. Metformin, the diabetes medicine that may help PREVENT diabetes.

3. Modafinil, cognitive benefits, better memory, appetite suppression.

So, what is on your list, why, and is it working for you.
 
Shittersfull said:

Which rx medications can be taken proactively for your health and wellbeing? In the USA, being your own advocate is the whole game. Pharma advertises them straight at patients, so people end up asking their doctor for a prescription. I am putting a short list together for myself and figured others might be interested in it and want to add to it. Obviously all of this should be prescribed by a Dr and carries potentially serious side effects. That said, I know plenty of people who source them through other channels

1. Tadalafil, an ED drug with well documented cardiovascular upside. Cuts heartattack risk, stroke, dementia, etc.

2. Metformin, the diabetes medicine that may help PREVENT diabetes.

3. Modafinil, cognitive benefits, better memory, appetite suppression.

So, what is on your list, why, and is it working for you.

A few years back I was treated for kidney cancer. While removing it they found several questionable issues, which meant months of tests to rule out cancer elsewhere in my body.

I got put on alprazolam, but my Dr did not refill it since it's short term use only, and swapped in trazadone for my stress/sleep issues.

Trazadone

An antidepressant, trazodone is frequently prescribed off-label at low doses (25 mg to 100 mg) for insomnia, taken roughly 30 minutes before bed. Some patients take it only as needed, while medical consensus and guidelines often question routine or long-term use for sleep, so whatever pattern you land on should be checked with whoever prescribes it. [1, 2, 3, 4]

How Trazodone Works for Sleep

    • Low-dose sedation: A dose of 25–100 mg blocks specific serotonin, histamine and adrenergic receptors, which promotes sleepiness. [1]
    • As-needed use: Members on Mayo Clinic Connect agree that as-needed use works, since unlike depression it does not need a constant buildup of blood levels. [1]
    • Not FDA-approved for insomnia: As a primary treatment for chronic insomnia, the American Academy of Sleep Medicine generally does not recommend it, due to limited long-term safety data and potential side effects
 
Just found out about what Tadalafil does for your cardiovascular system, so I'm on 5mg every other day.

No idea what it's done for my heart and arteries, but down under it's a definite upgrade, and I'm not talking about Australia.

My spouse is not exactly over the moon. Any hint of skin and I'm out there waving the flag like the parade leader, and what back in the day was a quick fix now runs as a full-blown maintenance project.

Modafinil is on the project list too.
 
Shittersfull said:

Which rx medications can be taken proactively for your health and wellbeing? In the USA, being your own advocate is the whole game. Pharma advertises them straight at patients, so people end up asking their doctor for a prescription. I am putting a short list together for myself and figured others might be interested in it and want to add to it. Obviously all of this should be prescribed by a Dr and carries potentially serious side effects. That said, I know plenty of people who source them through other channels

1. Tadalafil, an ED drug with well documented cardiovascular upside. Cuts heartattack risk, stroke, dementia, etc.

2. Metformin, the diabetes medicine that may help PREVENT diabetes.

3. Modafinil, cognitive benefits, better memory, appetite suppression.

So, what is on your list, why, and is it working for you.
1 and 3 get my vote. Metformin seems unnecessary if you're lean, since insulin sensitivity should already be good. If you're not at a healthy weight, GLP-1 drugs are probably the better pick.

Hydrochlorothiazide is also excellent for bringing blood pressure down and shedding fluid retention. Just be careful not to lose too many electrolytes. It also makes you look leaner. Naturally, talk to your doctor before starting anything like this.
 
The evidence for getting LDL cholesterol under 55 keeps getting stronger, and with a good diet alone few people get there, so Ezetimibe makes a lot of sense.

If your blood pressure runs high at all, I'd look at something like Telmisartan. Take readings twice a day and get a baseline. I only did mine in the mornings, and once I ran a proper baseline with both AM and PM numbers it came out higher than I'd assumed. My thinking now is that even slightly raised levels add up over the years

And, of course, number one is Tirzepatide. So many of its benefits land independent of weightloss, inflammation, cartilage, neuro protection, insulation sensitivity, the list goes on.
 
5byfive said:

The evidence for getting LDL cholesterol under 55 keeps getting stronger, and with a good diet alone few people get there, so Ezetimibe makes a lot of sense.

If your blood pressure runs high at all, I'd look at something like Telmisartan. Take readings twice a day and get a baseline. I only did mine in the mornings, and once I ran a proper baseline with both AM and PM numbers it came out higher than I'd assumed. My thinking now is that even slightly raised levels add up over the years

And, of course, number one is Tirzepatide. So many of its benefits land independent of weightloss, inflammation, cartilage, neuro protection, insulation sensitivity, the list goes on.
My lipoprotein(a) runs high, likely genetic. I'm on the standard cardio med stack (statin, plavix, etc) which keeps my overall cholesterol in check, but the LP(a) reading is concerning.

David W, who blogs at "The Incretins", put a Bluesky post up about Lipfendra (enlicitide), a newly approved oral PCSK9i he's excited about for a few of his patients. Worth asking my cardiologist about.
 
5byfive said:

The evidence for getting LDL cholesterol under 55 keeps getting stronger, and with a good diet alone few people get there, so Ezetimibe makes a lot of sense.

If your blood pressure runs high at all, I'd look at something like Telmisartan. Take readings twice a day and get a baseline. I only did mine in the mornings, and once I ran a proper baseline with both AM and PM numbers it came out higher than I'd assumed. My thinking now is that even slightly raised levels add up over the years

And, of course, number one is Tirzepatide. So many of its benefits land independent of weightloss, inflammation, cartilage, neuro protection, insulation sensitivity, the list goes on.

Cholesterol was slightly elevated when I started tirzepatide, so my pcp put me on a low dose of lipitor (10mg). My levels came down as expected, but then they dropped too far. Apparently cholesterol doubles as an "ingredient" for testosterone in guys. Once yours drops too low, the hormonal system reads it as starvation and decides that procreation is off the table 🤣 🤣 🤣. My T levels took a terrible dive and every low-T symptom came with them. Definitely no procreation happening. Anyhoo, I began splitting the lipitor tablets in half, my cholesterol rebounded, and my T levels followed. Who knew?

But my new pcp is against me stopping the lipitor because of the health benefits. I figured she was blowing smoke, so I went and did the research, and sure enough there are huge benefits to statins beyond controlling cholesterol levels. I didn't know that either.

So being on a statin is a good thing, you just have to watch that cholesterol doesn't sink so low that your T production shuts down.
 
Tirz is the one I can vouch for as a great drug to be on right now, but I just picked up some Fosomax and will be asking my doc about it since I broke a bone this year.
 
bamagirl26 said:

Tirz is the one I can vouch for as a great drug to be on right now, but I just picked up some Fosomax and will be asking my doc about it since I broke a bone this year.
Nutritional: get more dairy protein in, with A, D and K intake monitored.

Why MenaQ7 gets a strong recommendation

  • Bone Density: it switches on osteocalcin, the protein that binds calcium into the bone matrix, which strengthens bone overall.
  • Cardiovascular Health: it switches on Matrix GLA Protein (MGP), which blocks calcium from settling in the arteries and so cuts arterial stiffness.
  • High Purity: unlike generic supplements, MenaQ7 is put through rigorous high-performance liquid chromatography (HPLC) testing to keep its biologically active "all-trans" form.
 
Grogu said:

5byfive said:

The evidence for getting LDL cholesterol under 55 keeps getting stronger, and with a good diet alone few people get there, so Ezetimibe makes a lot of sense.

If your blood pressure runs high at all, I'd look at something like Telmisartan. Take readings twice a day and get a baseline. I only did mine in the mornings, and once I ran a proper baseline with both AM and PM numbers it came out higher than I'd assumed. My thinking now is that even slightly raised levels add up over the years

And, of course, number one is Tirzepatide. So many of its benefits land independent of weightloss, inflammation, cartilage, neuro protection, insulation sensitivity, the list goes on.

Cholesterol was slightly elevated when I started tirzepatide, so my pcp put me on a low dose of lipitor (10mg). My levels came down as expected, but then they dropped too far. Apparently cholesterol doubles as an "ingredient" for testosterone in guys. Once yours drops too low, the hormonal system reads it as starvation and decides that procreation is off the table 🤣 🤣 🤣. My T levels took a terrible dive and every low-T symptom came with them. Definitely no procreation happening. Anyhoo, I began splitting the lipitor tablets in half, my cholesterol rebounded, and my T levels followed. Who knew?

But my new pcp is against me stopping the lipitor because of the health benefits. I figured she was blowing smoke, so I went and did the research, and sure enough there are huge benefits to statins beyond controlling cholesterol levels. I didn't know that either.

So being on a statin is a good thing, you just have to watch that cholesterol doesn't sink so low that your T production shuts down.
That cholesterol / low t connection is interesting. I started trt 6 weeks ago.. maybe I didn't need to? Either way, no regrets about being on trt. Now there's another possible reason why my t was low.
 
Shittersfull said:

Grogu said:

5byfive said:

The evidence for getting LDL cholesterol under 55 keeps getting stronger, and with a good diet alone few people get there, so Ezetimibe makes a lot of sense.

If your blood pressure runs high at all, I'd look at something like Telmisartan. Take readings twice a day and get a baseline. I only did mine in the mornings, and once I ran a proper baseline with both AM and PM numbers it came out higher than I'd assumed. My thinking now is that even slightly raised levels add up over the years

And, of course, number one is Tirzepatide. So many of its benefits land independent of weightloss, inflammation, cartilage, neuro protection, insulation sensitivity, the list goes on.

Cholesterol was slightly elevated when I started tirzepatide, so my pcp put me on a low dose of lipitor (10mg). My levels came down as expected, but then they dropped too far. Apparently cholesterol doubles as an "ingredient" for testosterone in guys. Once yours drops too low, the hormonal system reads it as starvation and decides that procreation is off the table 🤣 🤣 🤣. My T levels took a terrible dive and every low-T symptom came with them. Definitely no procreation happening. Anyhoo, I began splitting the lipitor tablets in half, my cholesterol rebounded, and my T levels followed. Who knew?

But my new pcp is against me stopping the lipitor because of the health benefits. I figured she was blowing smoke, so I went and did the research, and sure enough there are huge benefits to statins beyond controlling cholesterol levels. I didn't know that either.

So being on a statin is a good thing, you just have to watch that cholesterol doesn't sink so low that your T production shuts down.
That cholesterol / low t connection is interesting. I started trt 6 weeks ago.. maybe I didn't need to? Either way, no regrets about being on trt. Now there's another possible reason why my t was low.

I'm fairly sure the lipitor did it. December 2024 is when I began tirzepatide and lipitor. This is how my testosterone has trended since. By early 2026 I was sure I was low on T, with the sort of side effects you'd expect, and started looking at TRT and spoke to a couple of clinics.





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Then I realized my cholesterol had gone very low, did some digging and found that cholesterol is needed to make T. After speaking to my pcp I cut the lipitor back.

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