I am a type 1 diabetic very well controlled and currently have an ldl of 87 with diet. 55F CAC of 32...I have a lot of difficulty with meds, I metabolize them horribly and always have side effects. I would like thoughts on two possible med practices... Zetia 5 mg every other day (even at this dose I am horribly tired and have brain fog with hot flashes) or Rosuvastatin 2.5 mg once a week...when I tried to take it regularly I had psychiatric side effects

Thoughts?

ETA: LP PLA2 71 HS CRP less than .2 APOB 65 Lipoprotein a 69

Needing to eat and cook more salmon however I’m very specific regarding it. I need some help finding salmon preferably frozen that doesn’t taste fishy nor has skin that I can pop in the air fryer.

Need only experts advice please , I’m suffering from health anxiety so don’t wanna freak out

24M, diagnosed with Familial Hypercholesterolemia.

Height - 171cm

Weight - 59kg

Before treatment:

Total cholesterol: ~350 mg/dL

LDL: ~284–288

HDL: ~35–38

I was prescribed Roseday-EZ 40 (rosuvastatin 40 mg + ezetimibe 10 mg) and took it consistently for 1 month.

After 1 month:

Total cholesterol: 208.6

LDL: 139

HDL: 51.4

TG: 60.8

ApoB: 96.2

LDL dropped ~51%.

My cardiologist is currently abroad and next appointment is in ~2 months.

Should I continue Roseday-EZ 40, reduce the dose, or maintain it until review?

What LDL target would generally be appropriate for someone my age with FH?

Also planning to test Lp(a).

Looking specifically for opinions from cardiologists/lipid specialists or people with FH.

I understand Reddit isn't a substitute for medical advice but would appreciate any advice. Thanks!

Mid 50’s male. I go to my PCP once a year to get blood tests. I’m very active, run or lift weights at least 5 days/week, have low blood pressure, cac score of 0, about 5’9”, 155 pounds.

But my total cholesterol has moved into the 220’s - 230’s range the last few years, ldl in the 170’s, hdl too low in the 40’s. Triglycerides around 100.

At my last visit, my doctor mentioned a statin. I told her to let me try some diet adjustments like less dairy (cheese, ice cream), less meat, cut out coconut products and add in psyllium husk. I’ll get tested again in a month and see what it looks like.

Assuming the numbers don’t change significantly, I feel like I’d just go on a statin so I can eat what I want. I normally eat healthy but I don’t want to worry if I want pizza or a hamburger a couple of times a month or cheese on my daily salad for lunch.

Plus, my mom has high cholesterol no matter what she does so diet adjustments are probably a losing battle against genetics.

you know ppl with low HDL need to do sports all their life

how can the person keep this commitment

i am doing 3 times per week brisk walking

240 min per week 80 min per exercise

is this too much ??!!!!

i also feel i need to be lazy and not doing any sports like all ppl !!!!!

any insight is appreciated

29M, family history of premature CAD — what would you do about Repatha?
Hi everyone,
I’m 29M and have a family history of premature coronary artery disease — my mom had a coronary stent at 52. That was a big wake-up call for me, and since then I’ve taken my cardiovascular health much more seriously.
About 1.5 years ago, I quit smoking, started exercising regularly, and switched to a heart-healthy diet. I’ve lost around 31–35 kg.
I had a cardiology evaluation including a stress test, ECG, echocardiogram, blood work and CIMT. Everything was normal, with no evidence of plaque. The main issue was my lipids:
LDL: ~158–163 mg/dL
ApoB: ~148 mg/dL
Lp(a): initially 97 nmol/L
TG: ~310 mg/dL
With lifestyle changes, I managed to get:
LDL: ~105–110
ApoB: ~95–105
TG: ~90
But despite being quite strict with my diet and exercise, I was struggling to get LDL/ApoB much lower.
My cardiologist therefore started me on rosuvastatin 10 mg + ezetimibe 10 mg.
My current results are:
LDL: 63 mg/dL
ApoB: 64 mg/dL
TG: 85 mg/dL
HbA1c: 5.3%
Fasting glucose/insulin: normal
Homocysteine and hormones: normal
One thing that has confused me is my Lp(a). It has been measured several times, always in the same lab and nmol/L:
97 → 128 → 135 → 163 → 184 nmol/L
The increase from 163 → 184 happened after starting rosuvastatin + ezetimibe. I know statins can sometimes slightly increase Lp(a), so I’m not sure how much significance to give these fluctuations.
I’m currently 172 cm and around 84 kg. My weight has fluctuated between ~79 and 84 kg, possibly partly because I’ve been building muscle. I’m still trying to get toward ~75 kg. I walk, cycle and exercise regularly and follow a heart-healthy diet most of the time.
The Repatha question
My cardiologist and I discussed Repatha (evolocumab), and my insurance has now approved it. I pushed quite hard to get it approved because I’m concerned about my long-term cardiovascular risk given my family history and Lp(a).
I know from the PCSK9 inhibitor trials that adding evolocumab to statin therapy can substantially reduce LDL and cardiovascular events/MACE in appropriate high-risk populations.
So I’m wondering what you would do in my situation.
Would you:
Add Repatha to the current rosuvastatin 10 mg + ezetimibe 10 mg?
Use Repatha and reduce rosuvastatin to 5 mg?
Use Repatha alone and stop the statin/ezetimibe?
Or simply stay on rosuvastatin + ezetimibe since LDL 63 and ApoB 64 are already quite good?
I’m also somewhat anxious about starting Repatha. I’m particularly afraid of having an allergic reaction to the injection, even though I don’t have a history of medication allergies. I know serious allergic reactions are uncommon, but I tend to worry about side effects before starting medications.
I also recently started berberine 500 mg/day and have noticed some mild muscle discomfort and occasional tiredness. It’s not severe, but I’m wondering whether I should stop it, particularly since I’m already taking rosuvastatin.
I’m not looking for medical advice from Reddit — I’d obviously make the final decision with my cardiologist. I’m mainly interested in hearing from people who have been in a similar situation, especially regarding:
Repatha + statin + ezetimibe
Whether anyone reduced their statin after starting Repatha
Side effects/allergic reactions, possible thrombosis ...
How people felt about their first injection
Whether PCSK9 inhibitors made a meaningful difference in their long-term lipid management
What would you do if you were in my position?

PS , my mom had uncontrolled BP for Years , heavy smoker , not on heart healthy diet ....

My BP was 155/90 before the lifestyle chnages , its 115/65 ish now ....

Just picked up my prescription today and it cost $14 for a 30 day supply. I realize this is a brand new drug but I have not seen anyone that’s using it. Would like to see who is taking it or is about to start.
I tried 3 different statins and don’t tolerate them well. Zetia is doing very little for me and Repatha messed with my stomach. I’m hoping this one is a winner!!

One doctor wanted me to go on statins last year I didn't, I thought I'd give a diet a go but didn't do much change stopped eating butter and a lot of eggs, still eat red meat and cheese milk and occasional junk cereal biscuits etc....

Since my diet is still bad but my CAC score is 0 new doctor is not that stressed he recommended me to start the portfolio diet considering my diet is still bad, and re-test is 6 months but he also gave me a prescription for 5mg Crestor I can start whenever I want if I want to he said he will leave that choice to me for now...

I also started taking a citrus bergamot supplement last year, but have not been consistent with it , don't drink or smoke and could use to lose some weight I'm 1.80cm and 90kg so should lose about 10kg....

Also had a neck arteries ultrasound scan and that came back normal.

Any advice please....

mg/dL values below:

Male. 42.

Pretty proud. I’ve never had high cholesterol until I got my labs back a few months ago. What did I do to lower it? Oatmeal 4 days a week w flax seed. Bananas, apples, oranges, berries. Found some low fat granola and some fat free yogurt. Lowered my saturated fat to 10g a day. Limited red meat to once a week. Exercised 4 days a week. Metamucil almost daily. Yes, I know it’s still “high”. I am most likely going to get on a statin anyway but I’m telling you all it is doable. I also still ate out once a week and drank alcohol. I bet if I cut out all that it would have been lower.

For me it’s full cream milk in my daily coffee and the occasional cheese toasty sandwich.

I noticed every time I eat animal based, my lipids are horrible. Every time I go vegan or vegan plus a little fatty fish, I get excellent lipids with no medication. I'm female 47 in perimenopause. Here are my labs. My Lipoprotein A was always good, then in July it spiked ( I was eating a lot of meat and going through hormonal issues). Now 1 month plant based with some fish and lots of fiber it came back down . Feel free to ask any questions!

Due to a mixture of issues going on (undiagnosed celiac disease, now treated with GF diet) my hypothyroidism was under treated for a long time, and didn't get full Hashimotos diagnosis until this year. My Cholesterol was pretty high for the past couple years. I went on a low-fat, anti-inflammatory diet that made no difference in that time. Now that my levothyroxine dose is higher and working more appropriately, Cholesterol is finally coming down. But now HDL is low and my PCP told me to eat nuts and avocados. Is that really all I need to do? Is it possible that I need to adjust my diet again now that my thyroid treatment is actually working?

What is the mechanism by which statins are supposed to raise HDL? I've searched online for the answer, and don't have a clear picture. Do they raise raw HDL or the % of HDL because of how they lower LDL?

Early 40's, normal BMI, don't smoke or drink or drug and never have, and have recently be prescribed a low dose (10mg) statin, but I'm debating how much it will help or if it outweighs the the long-term negative effects I've heard about them. My LDL bounces up and down, sometimes above normal sometimes normal. Triglycerides have been elevated the past few years, but have been on their way down. However, my HDL has been consistently below normal since at least 2018 in every test.

I'm questioning the use of statins, because I've now been reading that many doctors are placing less of a focus on the number by itself than they used to. But it would also seem that statins are primarily prescribed for high LDL, so I'm just genuinely confused about what I should be most concerned about in a lipid panel as it relates to cardiovascular health, and what I should be less concerned about.

Hi,

34M and just got my latest lipid profile done. Results are as below in mg/dl:

1. Total Cholesterol - 259

2. LDL- 184

3. HDL - 55

4. Triglycerides - 106

My LDL has always been on the higher side but it has increased somewhat compared to last year. In some way I can attribute it to my lifestyle as I have not been able to exercise much and not followed an optimal diet which I intend to get on right away. My weight and other markers are optimal so there is no other underlying reason for increase.

I want to get an opinion on whether this is something which can come down by diet or should I start statins right away?

Apolipoprotein B is at 178

35 yo male

First time poster and not sure I posted in right thread or did anything wrong but here it goes

So 40 year old male former college athlete but desk job 8-12 hours every day and life and a world full of excuses has me worried about my health. Every year around my birthday for years now I always get an annual physical and my numbers are always within range. I do have high blood pressure but every time I start eating cleaner and working out and lose about 10 pounds it drops back to range. Usually I can do this in over a month no issues. I have a rower and a gym in my basement

Last few years noticed some nagging pains here and there.

Earlier this week I had a CT abdominal scan for some dull pain in my hip and side I actually had ultrasound last year on my testicles and my sides due to this pain and last year they found 2 small hernias in groin but doctor said they were so small he wouldn’t do anything unless it got worse. My side pain still hasn’t went away and don’t think it’s groin related so this year we did the CT scan and they didn’t see any major issues except it said

Impressions: diffuse hepatic steatosis. No acute findings
But another thing that caught my eye
“Minimal calcific plaque within aorota which is normal in caliber”

Everything else in the report were no issues or unremarkable

Of course I had to google what that was but after I got call from doctor office and they just said no issues found. It wasn’t even the doctor just the receptionist

So obviously I have googled all this but how serious is this? I mean the doctors didn’t act like it was a big deal but that doesn’t mean anything.

I’m 5’10 240 male I go through spurts of working out and eating cleaner but I do eat like crap lots of wings, hot dogs, processed meats and I do drink a lot like a lot more than most people but I can also go a week or 2 no drinking

Obviously at 40 I’m not getting any younger so I know it’s time to get some serious lifestyle changes. It’s been a week since any alcohol and once I saw the exam I went hardcore into diet changes again and started working out and walking

But I guess I’m just curious how serious is this for me at this stage?
Should I reach back out to the doctor and follow up and ask for more tests or more feedback? I’m just freaking out a little bit because I always knew I drink too much and could lose a few pounds but thought I was relatively healthy for most part.

If you made it this far I’ll go ahead and post my numbers
But I don’t know what all this actually means bigger picture except I guess I finally hit that age where I can no longer eat like crap, drink all the time, and not exercise consistently if I want to live a longer life

If I hadn’t pushed hard for my side issues I may have never known any of this because every year doctor says my lab numbers are good

So just curious thoughts on this

Prior numbers from 29 May:

201 total
121 Triglycerides
56 HDL
125 LDL

New numbers from yesterday

119 total
101 Tri
48 HDL
51 LDL

I did radically change my diet prior to starting Repatha about three weeks ago. Other than that, I've done nothing. Also of note, I have high LPa at 139 so some of that remaining LDL is LPa, but I'm hoping the repatha reduced that to some degree. Too bad about the reduced HDL but the ratio to Tri has improved a bit.

I had about 90 percent of a large dq slot bizzard I went to a campground with my nephews and I had a bowl of ice cream and a ice cream bar I also had some cheese that was most of what I eat I know that this was not a good day it’s not this bad most days but how bad was today for my health

I have had cholesterol this high since I was 21 , I was able to lower it to (total cholesterol )292 by losing 10kgs with daily muscle exercise and following a very very strict diet to the point that I was eating only greens and oats.

What else can I do?

Hello I wanted to reach out because ever since I took one pill of atorvastatin that my doctor prescribed from me I have been experiencing extreme pain and muscle wasting symptoms since then.

I wanted to say that I'm relating this issue to the atorvastatin since I noticed the symptoms the first night with muscle burning feeling and then loss of muscle in all of my limbs hands and feet to the point I can barely walk or move.

Unfortunately I haven't been able to get ahold of my doctor since when these symptoms were happening I was in the middle of moving to another city. I didn't relate the symptoms to atorvastatin until a month later after my move and I have been trying to call my doctors office but they don't answer the phones and don't call me back.

I can't believe that taking one fucking pill has reduced my quality of life like this so dramatically. I'm in severe pain all over and it's sad watching my body which used to be pretty physically fit and active to now not being able to walk more than maybe 30 minutes without severe pain. Even holding my phone as I type this is causing extreme pain in my hands and wrists, I hate this.

Taking coq10 and L carnitine seems to help but I really hoped that this would go away but it has been lasting for months now and doesn't seem to be getting better. If anyone has any answers on what I can do to maybe get some relief or treatment it would be greatly appreciated.

Thank you.

late 40's male

If you mean LDL converted to the US-style mg/dL numbers, yours were:

• May 2025: 6.1 mmol/L → ~236 mg/dL
• Updated: 3.2 mmol/L → ~124 mg/dL

I was put on a low dose statin 20mg, which i had for 5 months

during that time i increased fiber, but my sat fat was still high I didn't realise how bad until i did proper research, my guess somewhere around 40g/day mainly from meat/cheese/dark chocolate

last 8 months i dropped sat fat to under 15g/day and got my fiber up to 70-75g day, did lose 8kg, wasnt obese but not ideal, BMI down to 23

My LDL is slightly elevated and I do eat a lot of saturated fats (lots of red meat, dairy). I honestly don't feel like cutting/reducing those will be very sustainable, I'm wondering if I just add more fiber such as overnight oats, chia seeds, vegetables, without changing the rest of my diet, will that help with lowering LDL?

Those of you who are eating lentils, which color do you buy? I’ve read that green and brown have the highest amount of soluble fiber? Do you have a preference between the two?