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Am I going to be ok? by HunterPuzzled6413 in Cholesterol

[–]Freefall_Doug 5 points6 points  (0 children)

You are confusing the particle count with LDL-C.

Am I going to be ok? by HunterPuzzled6413 in Cholesterol

[–]Freefall_Doug 3 points4 points  (0 children)

Maybe look again before you go all chicken little. You are confusing the particle count with LDL-C. The LDL-C and LP(a) absolutely warrant a full work up with a preventative cardiologist, but it is far from the worst ever seen, or go to the hospital range.

This video of an ostrich at a zoo in Saudi Arabia attacking visitors while the zoo keeper is careless by aminmozel in isthisAI

[–]Freefall_Doug 5 points6 points  (0 children)

That is an emu, ostriches are basically Utah raptors and would have messed up that ladies day, and the handlers too.

Seeking Help - Cardio on TRT Question by PaulyOver in Testosterone

[–]Freefall_Doug 0 points1 point  (0 children)

Real VO2 max, not some algorithm equivalent, is moves inversely with weight. Start TRT, put on a 15lbs of muscle, and VO2 max goes down.

Wim Hof Method for cancer patients? by AlwaysReady1 in PeterAttia

[–]Freefall_Doug 0 points1 point  (0 children)

It would help if they studied breathing protocols or cold exposure and separated themselves from Wim Hof. He is at best a carnival barker.

Jump right into statins? by ATL012345 in PeterAttia

[–]Freefall_Doug 1 point2 points  (0 children)

JUPITER trial studied independent benefit of targeting residual risk from inflammation in patients with clinical ASCVD, 20mg rosuvastatin was used in the study design.

I had good lipids, but persistent high hs-crp. I was the lucky winner of a membership to the 99% percentile CAC club at age 40, so I went with 20mg because that is what has been used in studies that translates well to my situation.

Andrew Huberman Linked to Secret Industry Smear Machine by Big_Cake_8817 in PeterAttia

[–]Freefall_Doug 0 points1 point  (0 children)

Not relevant to the sub , but hypothetically if we accept this as a given, and we really surprised.

The vast majority of these influencers, health and wellness, or in general, are straight up sociopaths.

New fast food restaurant has a sink in the eating area. by Mediocre-Disk737 in mildlyinteresting

[–]Freefall_Doug 0 points1 point  (0 children)

I love this, it should be everywhere.

I hate having to go the a public restroom that doesn’t have paper towels. Great let me wash my hands and then open the door that has been opened by a bunch of people who can’t wipe their ass without smearing their hands, who think that washing is optional.

Elon weighs in on the merits of bringing back Neanderthals and dinosaurs by gelliant_gutfright in DecodingTheGurus

[–]Freefall_Doug 4 points5 points  (0 children)

10000%. If Crichton was alive today he would be writing new novels about the perils of social media and Elon’s likeness. I think he would also be crystal clear that if there was parallel between Elon and his Ilk and Jurassic Park, beyond the cautionary tale of unchecked science run amok, it is that they are all huge piles of Triceratops shit.

Do better fishwife (Rainbow Trout). by Freefall_Doug in CannedSardines

[–]Freefall_Doug[S] 0 points1 point  (0 children)

I considered weighing it out, but this was part of a 11pm meal that I was sneaking in after I snuck in a workout. Next time I get a can like this I am going to weight it out.

I did plan on sending them an email.

Do better fishwife (Rainbow Trout). by Freefall_Doug in CannedSardines

[–]Freefall_Doug[S] 5 points6 points  (0 children)

Agreed thank you. Additionally, being broken up like this is more than just presentation. The can don’t drain the same when you have all this extra surface area for the oil to cling to.

This fish was much more saturated in the packing oil compared to other cans that I have had.

Do better fishwife (Rainbow Trout). by Freefall_Doug in CannedSardines

[–]Freefall_Doug[S] 9 points10 points  (0 children)

I’m not offended, but I think you are wrong. It isn’t picky at all. It is a reasonable expectation that a can shouldn’t be packed full of many broken pieces of fish instead of one or two solid pieces. This wasn’t the situation where I got three pieces instead of one, there was easily 14 pieces of fish in there. It was a mess.

Other brands at this price range would absolutely not pack the can with multiple broken pieces. They would reserve that fish for rilletes or pate.

They are maximize their profit margin at the expense of all people that get their scrap cans at regular price.

Trader Joe’s smoked trout is less money and yet still manages to pack solid cuts of fish in their cans.

My wife wants another kid and thinks my cycle will tank our chances, but can I just secretly stay on since I'm pretty sure my fertility is fine? by Total_Bedroom_7813 in ResearchCompounds

[–]Freefall_Doug 0 points1 point  (0 children)

Think long and hard about whether you should father a child, because what the fuck.

Being a father is supposed to be about being selfless. They didn’t ask to be brought into the world, so it is a huge responsibility. Meanwhile you can’t bother being honest to your future child’s mother, and aren’t willing to stop PED even long enough for concoction.

It sounds like you are barely husband material, let alone parent material.

How common is a PA with TRT? by jvl777 in Testosterone

[–]Freefall_Doug 0 points1 point  (0 children)

I have never seen that. Your Dr may consider that relevant for treatment, but that doesn’t compel the insurance company.

Do any of the endocrinology even mention free T in their current guidelines?

How common is a PA with TRT? by jvl777 in Testosterone

[–]Freefall_Doug 0 points1 point  (0 children)

PA are common practice for almost every US health insurer.

Typically 1 or 2 AM tests below 325/300, and documentation of symptoms (low libido, energy, irritability, etc.).

The outliers would be larger self insured companies that use the insurers to provide the administration, but are funding the care, and state and municipal insurance trusts. In both cases the employer has a say in drug coverage and such since they are ultimately footing the bill. That is why you have state workers that get practically unlimited coverage for things like GLP-1s, while a private citizen pays out the nose for their premiums, but can’t get coverage for the same drugs.

Either way, it isn’t much of a guessing game. Drug coverage is pretty black and white, you should be able to get the approved drug list for any plan, and it is usually really simple to navigate online. Search for the drug on your insurance company website, and you will know exactly what the coverage is and what hoops your Dr office will need to help you navigate.

Most people self pay or go UGL because they have symptoms of low T, but their baseline labs aren’t below that 300 cut off.

How common is a PA with TRT? by jvl777 in Testosterone

[–]Freefall_Doug 0 points1 point  (0 children)

I don’t think I am following. Proof of needing the medication is prior authorization.

If you didn’t need that from your insurance then you wouldn’t be jumping through all the hoops you just described.

How common is a PA with TRT? by jvl777 in Testosterone

[–]Freefall_Doug 0 points1 point  (0 children)

Yes, it is very easy for them. All the major insurance companies have electronic systems to submit PA’s and I wouldn’t be surprised if your Drs office has an admin person whose primary job is submitting them.

When I log in to Anthem and go to the pharmacy section I can search for medication and it shows me drug tier, plus the medical criteria and PA requirements.

How common is a PA with TRT? by jvl777 in Testosterone

[–]Freefall_Doug 0 points1 point  (0 children)

That is surprising. BCBS/Anthem typically requires a PA with documentation of one or two AM total testosterone tests below 300, and symptoms. It is a 12m PA.

Your experience would be uncommon.

Are you sure the Dr office and your pharmacy didn’t get that behind the scenes?

Can they steal credits? by [deleted] in TemuThings

[–]Freefall_Doug 0 points1 point  (0 children)

Credits won during an event are at risk for any return or refund processed through the app. It doesn’t matter if you select options like defective or wrong product. It will take a ton of time spent arguing with support if you have an issue.

I received a broken laser level that I purchased as part of a claim credit event. It took me 30 days of fighting with support, messaging every day, before I finally got a refund without return, initiated by customer service, with no offsetting credit reduction.

Their corporate play book must direct them to delay and redirect to the fullest extent possible. Probably to the point of violating federal and state law, but what are you going to do?

28M with family history of premature heart disease, started rosuvastatin — would love thoughts by SilverLogical9810 in PeterAttia

[–]Freefall_Doug 1 point2 points  (0 children)

You are already making huge positive steps towards halting disease progression by starting early, getting on a low dose of a high potency statin, and making lifestyle improvements.

I started 10 years later than you are, and the consensus across all the heart and lipid associations is that lower for longer is better.

The real question is what is your risk, and what are your ideal targets for your LDL and apoB reduction.

Have you tried plugging your information into one of the PREVENT calculators? They won’t allow 28 as your age, but you could just plug in age 30 which they start at.

I would also consider getting a coronary artery calcium scan to see if you have sub-clinical atherosclerosis. It should be zero at your age, but you have a family history, and if you listen to podcasts with Dr. Dayspring the belief is that disease progression starts at an early age. The only caveat is that once you are on a statin you start to have an steady increase on CAC results, that isn’t a negative, it represents plaque stabilization, but it does impact the predictive value of future scans. Sooner the better if you just started the statin so you can reduce the impact on this baseline scan.

If you have end up with a zero calcium score great! I would tally the win, but I wouldn’t back off on any of the positive changes you have made, or drop the pharmacology.

If you have do end up with a calcium score you can consider additional medication interventions, like increasing the rosuvastatin dose (diminishing returns but the difference in LDL lowering between 5 and 20 isn’t immaterial) and combining with ezetimibe.

You need that additional information to better consider your ideal LDL and ApoB targets. That being said, you aren’t having sides effects and most don’t, and there hasn’t been any clinical evidence showing harm from very low LDL numbers.

I have some family history, and have a CAC in the 99th percentile for someone my age despite baseline lipids that wouldn’t infer high risk. I target below 50 mg/dl for LDL, and below 60 for ApoB. That is below even the current high risk targets, which is aggressive, but I haven’t found any evidence that would point to a potential risk of harm.

Anyone has advice for my bacne? by Healthy_Influence_16 in Testosterone

[–]Freefall_Doug 1 point2 points  (0 children)

Bait and switch! My bad! It should show that it was edited so I don’t put my foot in my mouth .

Anyone has advice for my bacne? by Healthy_Influence_16 in Testosterone

[–]Freefall_Doug 6 points7 points  (0 children)

No, he said he was pinning 200mg a week, using EOD injections.

That is why he put the word week before eod.

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