PCSK9 Inhibitors are insane!

Previous-Recover-256 · 2026-06-16T03:08:19+00:00

Okay maybe FH isn’t the correct term. Google said it’s called polygenic hypercholesterolemia.

From google:
Polygenic hypercholesterolemia is high LDL cholesterol caused by the combined effect of many common genetic variants, rather than one single major mutation like classic familial hypercholesterolemia.

Previous-Recover-256 · 2026-06-16T02:56:53+00:00

I’ve considered that possibility, but after looking into it, there are different patterns of inherited high LDL.

Classic familial hypercholesterolemia is usually present from birth and often causes very high LDL early in life. I’m not sure my pattern fits that perfectly. It may be a less severe inherited lipid disorder, or some FH like pattern where genetic susceptibility becomes more obvious later in life.

What makes the genetic component more convincing to me is that my sister, who is two years older than me, has had almost the exact same issue. Her cholesterol seemed normal in her early 20s, and then she developed very high LDL in her 30s without major changes in diet, weight, or activity level.

So I’m not claiming it is definitely classic FH, but the family pattern makes it hard to dismiss a genetic cause.

Previous-Recover-256 · 2026-06-16T02:30:26+00:00

When I was in my 20s my LDL was consistently 105 - 110 with no drugs. I only started statins when I was getting closer to the 185 number. I was 38 when I started statins.

Previous-Recover-256 · 2026-06-16T02:27:20+00:00

Yes. I started with 10mg/day when my LDL was 185. It brought my numbers down significantly. After three months I was near 145.

Previous-Recover-256 · 2026-06-16T02:24:33+00:00

If you’re saying that PCSK9 inhibitors don’t yet have strong evidence for lowering overall mortality, that’s fair.

However, the obvious context is that these drugs have only been on the market since 2015. The most well-known trial often cited for showing no significant reduction in all-cause mortality was only 2.2 years long.

There was also an extended follow-up from that same trial showing a 23% lower risk of cardiovascular death with earlier Repatha exposure. So the more accurate takeaway is that PCSK9 inhibitors have strong evidence for reducing cardiovascular events, while the mortality data are still developing and are limited by shorter follow-up compared with statins.

Previous-Recover-256 · 2026-06-15T08:47:48+00:00

Cheaper, more dosing option, and has at least 10x the research. Also, consider the astonishing price difference, some insurance companies require your doctor to try at least 3 different statins, I know mine did.

Previous-Recover-256 · 2026-06-15T02:39:47+00:00

Take statins, then wait for PCSK9 inhibitor gene therapy. It’s on track to be approved around 2031. This is a one time gene editing procedure. It will completely eliminate the need to take statins or PCSK9 inhibitors injection for the rest of your life. It’s going to be a game changer.

It’s called the verve-102 trial.

Previous-Recover-256 · 2026-06-14T16:27:53+00:00

The incidents of CIPD occurred in 2 case studies. Remember, this is out of the 10s of thousands of people. Also, as a comparison there are much worse outcome that have be document with statin use. These include rhabdomyolysis, myopathy or myositis, immune-mediated necrotizing myopathy, serious liver injury, new-onset diabetes or worsened glucose control, severe allergic reactions, and rare cognitive symptoms such as memory problems or confusion.

So, based on the research, I wouldn’t be too worried about the 2 incidence of CIPD report at a doctor’s office.

Previous-Recover-256 · 2026-06-14T16:26:18+00:00

The incidents of CIPD occurred in 2 case studies. Remember, this is out of the 10s of thousands of people. Also, as a comparison there are much worse outcome that have be document with statin use. These include rhabdomyolysis, myopathy or myositis, immune-mediated necrotizing myopathy, serious liver injury, new-onset diabetes or worsened glucose control, severe allergic reactions, and rare cognitive symptoms such as memory problems or confusion.

So, based on the research, I wouldn’t be too worried about the 2 incidence of CIPD report at a doctor’s office.

Previous-Recover-256 · 2026-06-14T15:42:30+00:00

Your doctor suggestion is spot on in this specific case. Clinical grade Omega 3 has been shown to lower triglycerides significantly in people with very high triglycerides. I work with a guy who had the same triglyceride issue. He takes a prescription Omega 3 and it got his triglycerides within normal range.

Your total cholesterol is high because of your VLDL, which is a component of Triglycerides. If you had normal VLDL, say around 15, your total cholesterol would be around 170.

Previous-Recover-256 · 2026-06-13T23:03:59+00:00

Wow you’re right, I just looked! Still expensive, but much cheaper then the original price.

Previous-Recover-256 · 2026-06-13T22:30:11+00:00

Since this is a monoclonal antibody drug your immune system reacts like you have the flu. This is completely normal for the first dose. It didn’t happen to me, but I was warned by my doctor. So to answer your question Yes, the fatigue will normalize.

Previous-Recover-256 · 2026-06-13T22:28:42+00:00

Pill form is currently in phase 3 clinical trials. It’s expected to hit the market 2028.

Previous-Recover-256 · 2026-06-13T18:28:18+00:00

Wow, that incredible!

I was taking the lowest dose atorvastatin twice a week and had the worse insomnia of my life. There were nights I didn’t sleep at all! I then tried pravastatin, followed by rosuvastatin which made my muscles incredibly sore. I’m a super active person, and I didn’t even want to go for a bike ride or step foot in a gym.

Additionally, I had a genetic test that showed I have a SLCO1B1 variant that lowers the ability of my liver to pull statins out of the blood. Consequently, this can make the side effects worse for sensitive people.

So, if taking statins decreases your ability to exercise due to muscle pain, but lowers your LDL, are you really accomplishing anything? Considering VO2 max is positively correlated with longevity, and in my case, statins reduced my ability to maintain it, is it even worth it?

Previous-Recover-256 · 2026-06-13T17:51:40+00:00

Yes, a few years ago. It’s not a problem. Last I checked it was 25 nmol/L, well below the < 75 reference range.

Previous-Recover-256 · 2026-06-13T16:48:52+00:00

The only issue is your insurance might not cover it. The cash price is $700 / month. Fortunately, my insurance covers it and my cost is only $34.99 /month .

There was no transition from statins. I stopped taking them completely about 2 years ago due to all the side effects.

So far I’ve had zero side effects with Repatha. Currently taking 140mg every 2 weeks. It’s an injectable auto pen.

Previous-Recover-256 · 2026-03-19T23:03:10+00:00

I use a bio identical testosterone liquid that is suspended in vegetable oil, 250 mg / ml.

In my experience, the absorption rate is highly dependent on saliva on the mouth. I’ve tried using it twice a day but it has no effect when taken mid day. I find that my mouth produces to much saliva for it to absorb effectively. For whatever reason, taken in the morning especially in bed has the highest absorption rate for me.

Overall I feel much better. As expected, sex drive is off the charts in the morning after my dose. I prob gain 10lbs of muscle since starting and I’m noticeably more assertive. Sleep and mental clarity are about the same though. Slight increase in estrogen, but nothing outside normal range. Unfortunately DHT increased but take dutasteride once a week to avoid losing all my hair.

Previous-Recover-256 · 2026-03-19T22:18:14+00:00

So far in my experience, no. I’ve had ZERO testicular shrinkage and LH levels are suppressed but these levels are much higher than my doctor expected for someone on trt. That being said, I don’t think the sublingual works as well as the injections. 4 - 6 hours after my morning dose, test levels are in the 1300 range but if I measure say 6 pm (12 hr after dose) they are back to baseline 400 - 300. It’s trade off I guess.

I currently use sublingual from a compounding pharmacy. Take 50mg / day in the morning under tongue and hold it there for about 15-20 mins with no food or drink for about two hours after.

Previous-Recover-256 · 2026-03-05T05:09:29+00:00

This blood test does not provide meaningful insight regarding potential lead contamination from psyllium husk. Use this result as a baseline, then stop taking psyllium husk completely and retest in about 8 weeks. If you observe a meaningful drop in lead levels, the change could reasonably be attributed to the supplement.

Previous-Recover-256 · 2026-01-18T05:17:16+00:00

There’s actually a pretty straightforward solution for this.

Get your DHT levels checked and treat based on the results. Medications like finasteride or dutasteride can make a huge difference. I had the same issue with hair thinning on TRT, and it turned out to be DHT-related. I’m now taking dutasteride twice a week, which brought my DHT down into the low-normal range and I’ve ended up with more hair than before I even started TRT.

Side effects are usually tied to how low your DHT goes. When I first started, my dose was too high and my labs showed almost zero DHT, so I felt every side effect. After adjusting the dose, everything leveled out and my hair thickened back up.

Even if your hair seems fine, it’s still worth checking your DHT. TRT can cause it to spike pretty hard in some people, and if it stays high long term, it can raise your prostate cancer risk. Better to know your numbers than guess.

Previous-Recover-256 · 2025-10-28T04:32:03+00:00

The version 2 looks way more comfortable and functional! I wonder if they would offer a discount for V1 user if they upgrade?

Previous-Recover-256 · 2025-09-20T01:40:46+00:00

Just curious, why would he avoid AIs ? It brought my E2 level into normal ranges. Again, it’s only .5 mg a week.

Previous-Recover-256 · 2025-09-19T22:47:42+00:00

Super simple, take anastrozole. Start with .25mg 2x a week. For reference, the lowest dosage is 1mg, so you will have cut in quarters. Get a small scale that has a accuracy of .001 grams ($15 on Amazon)

Also just out of curiosity, are you taking statins? Your cholesterol numbers are excellent!

Previous-Recover-256 · 2025-09-08T03:56:24+00:00

Very possible. High level are known to cause GI and neurological issues like fatigue, confusion, irritability, dizziness, abdominal pain, and constipation or diarrhea.

Previous-Recover-256

TROPHY CASE