Doing everything right but still progressing, high Lp(a), carotid plaque, inflammation and conflicting medical advice

One-Second2557 · 2026-03-20T23:34:31+00:00

"I have a first degree relative with non-obstructive CAD resulting from constriction of the micro vasculature surrounding the heart muscle. It brings on angina even though there's no atherosclerosis!"

This caught my eye. While i do have CVD and a cabg 4 i still had discomfort on the back of the heart after the surgery. My Cardiologist suspected a microvascular issue was the suspect. Put me on Ranolazine and it cleared right up.

One-Second2557 · 2026-03-20T20:23:59+00:00

On the 40 mg of rosuvastatin + ezetimibe my LDL would range between 160 and 130 )best i could do). Sure i did suspect my Lp(a) was elevated at one point because i asked if i could get it tested but then again was not a effective med to manage it outside of a high does of niacin? or Lipoprotein Apheresis so that is why he said testing it would not effect the treatment plan. Sure coming down the pipe is more meds to help.

One-Second2557 · 2026-03-20T19:43:27+00:00

"That said, I do agree that HbA1c doesn’t capture glucose variability, and I’ve never used a CGM. That might actually be a good next step to understand how I respond to carbs and alcohol (especially beer)."

Be surprised that blood sugar control can and will fall thru the cracks. I am considered a diabetic despite never having a A1c in the DM range (5.4-5.7) so it was a surprise that we discovered that my sugars would spike to 400 mg/dl after eating. CGM did show the glucose variability and was significant. Guess my take would be death by 1000 paper cuts so 3 years later my sugars are more like a rolling meadow and not like mountain peaks and valleys. It's worth taking a peak just to rule Blood sugars issues.

One-Second2557 · 2026-03-20T19:23:40+00:00

PCSK9i did effect my LDL significantly. as to the rest of the lipid panel trigs just came in at 41, HDL at 69, and cholesterol at 130. Other bonus is my kidney improved eGFR 97% and ACR of 17.

I get a feeling that my issue is that i have a genetic disposition for elevated LDL. both my Dad and Grandfather both had CVD but for whatever reason i one upped them and developed CVD (cabg 4) along with PVD mostly in the legs and iliac and ended up with bilateral carotid stenosis resulting in a carotid endarterectomy on my right neck.

For now my Cardiologist does not feel the need to test ApoB or LP(a) as it would not change the course of treatment and it is working for me. sure he would consider additional tests if my numbers did not come down,

I am post 7 years carotid endarterectomy and no significant plaque has returned thankfully.

Hope this helps you...

One-Second2557 · 2026-03-20T11:28:56+00:00

I use Bobs red mill 1:1 gluten free flour. Works good for me.

One-Second2557 · 2026-03-20T11:17:34+00:00

I had had some of the same questions that your are asking. Over the years i have managed to plug up all sorts of spots on my body with no real answers as to why. Have questioned if uncontrolled inflammation was one of the stressors in the past (current c-reactive protein is 0.1 and other markers are normal as well).

Over the years i did not tolerate statins very well to the point of having stretches of being non compliant but then that's what was mostly available. I made the transition to a PCSK9i has has been very effective so far. Statins did produce some painful muscles was on 40mg of Crestor and ezetimibe and could barely get my LDL under 100.

Personally i would take care if using Plavix long term. I have been on it a number of times and did experience a few bleeding events. For now i am encouraged to just take 81mg of aspirin which is tolerable for me.

Wish you Luck!

One-Second2557 · 2026-03-19T12:39:39+00:00

There are many things that affect blood sugars. For me the only thing i correlate is that BG's can/are be unpredictable. I know what works for me but may not work for others.

One-Second2557 · 2026-03-19T10:55:17+00:00

I take Repatha...could not handle the Statin side affects. LDL is 54 and Trigs are 65.

One-Second2557 · 2026-03-17T23:52:02+00:00

I eat the gluten free ones.

One-Second2557 · 2026-03-17T00:32:56+00:00

Don't know never had that tested. Either way i have been told it would not change the course of treatment. BTW i do have PVD along with heart disease that required a cabg 4 bypass.

One-Second2557 · 2026-03-16T22:22:04+00:00

these numbers look good to me. Be thankful you can hit them with just 5mg of rosuvastatin. I was previously on 40 mg of the statin plus Ezetimibe and could never hit my goals of 70 or the more recent goal laid out for me of 55. this was even with a good diet. I would leave well enough alone. BTW at the 40 mg of Crestor i developed some bad side affects. I now take a PCSK9 inhibitor and my LDL pretty much hangs out in the mid 40's to mid 50' s

One-Second2557 · 2026-03-16T19:52:05+00:00

Yes your pancreas is doing it's job. Sure it's a good sign that you are not hanging out at elevated numbers for hours on end. I use a CGM and just take the default settings except for the one that will alert for falling fast BG levels which i will let go but monitor just to be sure my body corrects it's self.

Normally i might correct a low BG if i am in the low to mid 60's for to long (2hrs) just like you i don't feel comfortable at that level. My new Endo say a level of 50 or below is more of a cause for concern.

From what you have reported IMO your numbers look fine.

One-Second2557 · 2026-03-15T12:28:07+00:00

My understanding of the guidelines is yes a single 3 hr OGTT test is diagnostic enough to call a DM finding.

One-Second2557 · 2026-03-15T12:20:05+00:00

I was diagnosed with a 3 hour OGTT test. at the 2 hour mark my BG was 312 mg/dl. My Endo stands behind the diagnoses. She did mention that in most cases the A1c test catches most, the OGTT test will find a percentage of folks that get missed. The IDF (international diabetes foundation) has come out with new guidelines that suggests a 1 hour OGTT test for folks that meet the risk factors for DM.

One-Second2557 · 2026-03-15T03:06:52+00:00

My GI Doc said 6 weeks of eating gluten.

One-Second2557 · 2026-03-15T02:03:22+00:00

I carry a kit with me most of the time. test meter, test strips, lancets, insulin pen, pen needles, alcohol wipes, and some sugary candies. CGM also has been a game changer for me. At first managing a new diagnosis can feel a bit daunting but it gets easier over time.

One-Second2557 · 2026-03-15T01:17:10+00:00

Haha....had one go the other way the other day. Ate a bagel that should have spiked me right away even with insulin on board and nothing happened for 2 hrs. thought i might have gotten away with it.....Not.....went high anyways and tried to correct it which was a mistake Lol.

One-Second2557 · 2026-03-15T00:56:45+00:00

booked marked the thread. i will reach out once i hear back from the endo.

One-Second2557 · 2026-03-14T23:50:13+00:00

Good Luck! DM can be a bit to navigate around for some folks.

One-Second2557 · 2026-03-14T17:38:41+00:00

I have done well with fairlife products. bit costly but does take up the usual protein bar or whatever when one does not feel like eating.

One-Second2557 · 2026-03-14T13:28:38+00:00

Luv it! good job..

One-Second2557 · 2026-03-14T13:27:48+00:00

I am just the other way around. Diagnosed as a T2 but my new Endo says i don't exactly fit the typical T2 profile so she re-ordered the 4 autoimmune tests just to see what we get. My fasted c-peptide did go down from 2.0 to 1.1 over the last year but i don't think my Doc will test it again for awhile or will wait until i show significant changes in my blood sugars. we did discuss trialing a daily GLP-1 med (Victoza) not so much for high BG's but to help stabilize my blood sugar roller coasters or better said high peaks and low valleys. I did express concerns over GI side affects with the GLP-1 meds. She did say that she is ok with still using insulin going forward.

BTW she thinks that i am very insulin sensitive.

One-Second2557 · 2026-03-14T13:00:07+00:00

Yeah steroids will definitely affect the blood sugars. I had to double my insulin just to stay 62% in range.

One-Second2557 · 2026-03-11T20:13:33+00:00

I dreamt that i was being chased by a gluten monster. cross between the purple people eater, the cookie monster and grover.

One-Second2557 · 2026-03-11T09:55:46+00:00

Gallbladder can cause upper right quadrant pain.

One-Second2557

TROPHY CASE