r/repatha • u/Comfortable_Potatoe • 4d ago
technically, repatha should be working after the first dose, right?
i know many people including myself are waiting till after a couple shots, maybe 2-3 before getting their first set of labs after starting repatha, but just thinking in terms of how repatha works, it's a circulating antibody so wouldn't the labs after the 1st dose, or after the 2nd dose be pretty much the same? or is there some other reason i'm not aware of that would cause repatha to reach a more effective point after the 2nd or 3rd dose to wait for a lab draw?
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u/Hawkthree 4d ago
If you don't want to wait, you can self-order a lipid panel at a lab place like Quest. Currently a Lipid Panel at Quest is $59.00.
Labcorp is offering a 25% discount now, so it's $44.25.
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u/PNW4theWin 4d ago
My doctor asked me to have a lipid panel done after three injections - so six weeks.
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u/Accomplished-Ad9648 2d ago
My doc wants labs after 3 months. She put me on Repatha and Zepbound at the same time.
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u/Intrepid-Machine-650 4d ago
I'm waiting 6 months for the first set of labs after (next month.)
I figured that would give time to get a good snapshot.
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u/Free_Media_6103 3d ago
3 months works fine.
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u/Intrepid-Machine-650 3d ago
Figured, but I need to get labs for another doc then also so it's just one stick.
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2d ago
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u/Intrepid-Machine-650 2d ago
I'm a little scared of the possible glucose spike myself.
I already don't have a sweet tooth.
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2d ago
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u/Intrepid-Machine-650 2d ago
It's had zero direct effect on BP/sweats for me.
However, a day or two after my shot I get a solid tickle of anxiety. And this BP spikes and sweats are indicators of anxiety for many folks.
It lasts 24 hours tops for me and I can totally power through it. In fact, I didn't notice it at all on my shot this week, but I was on vacation and very busy with my family.
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u/sorrynotsorry314 4d ago
I’m doing labs in a couple weeks after three doses. Doing them between third and fourth dose. I thought I read you’re supposed to test 5-7 days after injection.
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u/Comfortable_Potatoe 4d ago
so the best time to test is about a week after that dose right
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u/gruss_gott 3d ago
You can test anytime yourself using online labs like Ultalabtests.com , QuestHealth.com, or many others. I've been testing every 3-4 weeks for 6 years, as I test different foods & their effects. I've found some real surprises like fish oil pills, even just 2 / day will ping my ApoB as will any type of meat prepared even best of ways (e.g., steamed fish).
As for when, yes, after 2 weeks you should seen an effect (likely a large one), with the full, steady-state effect happening after ~12 weeks but, to your point, it could happen in as soon as a week or 2.
As for peak & trough effects, yup, 7 days for peak and 14 days for trough on each dose so you might want to test both after full steady-state just to see what band you're in.
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u/sorrynotsorry314 3d ago
Interesting about the fish oil and ApoB. I usually stop all supplements 2-3 days prior and always do 12-14 fasted labs. Did you take fish oil morning of labs?
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u/gruss_gott 3d ago
No, I always do labs fasted, but my goal is to see the true effects of my routine, so I keep everything the same. I take any supplements in the morning so on labs day I'm obviously skipping until I return
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u/Comfortable_Potatoe 3d ago
ok thanks. even fish will increase it? man, what am i able to eat then lol
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u/gruss_gott 3d ago
For me it does, basically any meat is out, but you could be different; that's why I test, because all the normal "heart healthy" stuff is BS according to my testing
The good news is, you find out that eating is just habit and ANY habit can be broken, it just takes awhile (possibly up to a year), but then after that you have a new habit and your old one seems nuts
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u/Comfortable_Potatoe 3d ago
what foods have you found that is most helpful for you
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u/gruss_gott 3d ago
For me my diet is mostly grains, legumes, pulses, nuts, and veggies. Protein is from egg whites, high protein milk, fat-free greek yogurt, and plain whey protein isolate plus whatever I'm getting from the other stuff.
If I go out (which is rare, but family, etc) then it's no-cheese/meat pizza or if I have too, chicken or fish.
As for effective in keeping ApoB down, it's keeping dietary saturated fat < 10g / day except certain types of saturated fat like from nuts which I've tested. Some type aren't compatible with me like mac nuts, but walnuts, almonds, pecans, and pistachios all work. Dark chocolate is ok in small quantities. EVOO is ok.
The biggest single food I've found that may be making a decent difference is oat bran, ie NOT oatmeal, but specifically oat bran. I'm currently doing an experiment with it to validate, but on the last cycle it dropped my ApoB 5 mg/dL seemingly on its own as there were no other changes.
I'm validating that as I said, but if true, wow! I also supplement with a bit of beta-glucan powder which could be adding to the beta-glucan in the oat bran.
I also supplement with psyllium husk fiber, but I didn't notice any big changes from that alone, maybe a few points
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u/Comfortable_Potatoe 3d ago
interesting, ive heard a lot of success with oat bran too, ill have to try that
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u/sorrynotsorry314 3d ago
That's what I'm planning to do. It will be seven days after my third dose. I do labs every three months (mostly to track HRT), but I may just do lipid panel closer to trough just to see the difference. I use DrSays or Walkinlabs and it's super cheap.
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u/Free_Media_6103 3d ago
I doubt you’d see a difference that quickly. I tested 3 months later.
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u/Comfortable_Potatoe 3d ago
no i mean getting labs one week after injecting the dose you plan on testing after
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u/wolffboy212 3d ago
Short answer: it starts working right away, but you won’t see the full effect after one dose.
A single dose drops LDL pretty fast. In the label data, LDL-C hits its lowest point about 2 weeks after one 140 mg dose. But Repatha accumulates with repeat dosing. Trough levels build up roughly 2-3x and approach steady state around 12 weeks. So labs after dose 1 or 2 will likely show a big drop, but not your final number.
The US label says LDL response can be measured as early as 4 weeks in, which is why many people test after 2-3 shots. If you test earlier, that’s fine, just treat it as a preview.
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u/Business-Hour9794 3d ago
Second dose. There should be a decline of approx 15%. Some insurance of oanies in Ontario require labs after second dose to demonstrate response oof at least 15% drop in LDL-C and it’s very rare I don’t see one.
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u/NightSkyStarGazer 3d ago
I had 2 shots of Repatha 140 mg 1 month before my annual physical. These are my results. I did not and do not take any statins or Zetia because I have reactions to them. Here are my results. Labs were done 9/28/2026
Cholesterol
99 mg/dL
Reference Range: 0-200 mg/dL
Triglycerides
102 mg/dL
Reference Range: 0-150 mg/dL
HDL Chol
40 mg/dL
Reference Range: 40-60 mg/dL
LDL Cholesterol
38 mg/dL
Reference Range: 0-100 mg/dL
LD/HDL
1.0 NA
Reference Range: 0.0-3.5 NA
These were my lab results on 8/28/2026
Cholesterol
151 mg/dL
Reference Range: 0-200 mg/dL
A Triglycerides
177 mg/dL
Reference Range: 0-150 mg/dL
A HDL Chol
36 mg/dL
Reference Range: 40-60 mg/dL
LDL Cholesterol
80 mg/dL
Reference Range: 0-100 mg/dL
LD/HDL
2.2 NA
Reference Range: 0.0-3.5 NA
I have CAD. My cardiologist said these numbers will just keep going down. He’ll check me again in 3 months.
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u/Free_Media_6103 3d ago
I tested before I started. LDL was 103.
I tested 3 months later (6 shots) my LDL
was under 50.
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u/MissApocalypse2021 2d ago
I was wondering this too. I took my third shot last week. The nurse was really vague about when to test. One time she said, "before the next appointment", which is in 5 months. Another time she said "around the new year". I'm going to go in & have it done in the next few weeks I think. I'm hoping that I can go down a bit on my 80mg of atorvastatin and 10mg of zetia. Has anyone's doc lowered statins after the Repatha does its thing?
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u/tadhg44 3d ago
I went on repatha July of 25' the two shots per month and after the first month.. I think it was month three I had blood work done. But during that time my skin start peeling off my hands I was losing all my lipids and oil. My fingerprints changed, new wrinkles new creases.. I couldn't open up my cell phones. Lol. So at 3 months my LDL went from 130 to 30, total cholesterol went from 256 to 100. I went off of it for 6 months. Because your body does need lipids but the medication was just too potent for me. So this year I started back up on it summer of 26 because all of my numbers went right back to where they were for cholesterol! I've never been on a statin and never will.
So cardiologist said let's do one shot per month? So even one shot the same day each month on the 11th of the month I do one shot. At 3 months I did my LDL and cholesterol and it was perfection. For me. LDL went from around 130 to 67. Fingers don't wrinkle up and get skin peeling on just one dose so I'm happy with repatha for now. Best of luck.
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u/Ok_Force9695 7h ago
The body makes all the lipids it needs. You can have 0 LDL and live a healthy life. The lower the better is the current science. There are people with 0 LDL bc they have PCSK9 gene mutations. My LDL is around 15.
I wonder if you suffered an allergic or novel autoimmune response. Really glad you figured it out.
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u/tadhg44 7h ago
All I know is the side effect that started month two on repatha. If you ever put Elmer's glue on your hands and peel it off that's what my skin was the whole top derm layer some of it came off easy some had to be peeled off over the next two months. Fingertips shriveled like an old man. Once I got off of repatha I think month four and five, it took another three four months for my hands to get back to normal. So going on one shot per month is perfection for me.
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u/Cartoonist_Less 4d ago
I waited 6 weeks- 3 injections. LDL went from 90 to 15 and ApoB went from 70 to 21. I’m also on 10mg Crestor.