5 Steps to prevent Heart Disease

Thursday, May 9, 2019

Compare stopping Atorvastatin first replacing with Nicotinic acid 1,000 mg then adding on Zetia a month later

I think the chart above is difficult to digest.
I will try to help.
It was very difficult to get all the numbers and dates in order.
I hope I didn't make any major mistakes.
Let me know if I did.

I circled two boxes in green (green)
I think these two colu\ns are the most interesting. Follow yellow lines.

The inexpensive ROUTINE LIPID PANEL vs. NMR ADVANCED LIPID test (both done) 5-1-19
Non-fasting blood sample.
 It's a good way to see how your body handles the triglycerides post prandial

Notice how close the
TC (total cholesterol) 171 to 175
TG(triglycerides) 118 to 113
HDLc 61 to 63
nonHDLc (my favorite) 110 to 109
No discordance here, despite my Diabetes Type 2

Not much difference between the two lab techniques. 
It gives me confidence in the reliability of the inexpensive local lipid lab.
This brings me to the first two columns on your left.
The experiment is about the effect of
Atorvastatin (Lipitor) 10 mg  vs Nicotinic acid (Enduracin) 1,000 mg

Lipitor does better in every category, evenith HDLc, TG and non-HDLc!

No doubt a statin is better than Enduracin. 

Always start treatment with low dose statin.  If not contraindicated. 

Enduracin is still a good add on drug for synergy even at 1,000 mg.  
See the Compell trial. 

Then to reach target add Zetia. 

Some might ask me,
"Why take a statin.  Your non-HDL is not so bad at 110."

I know I have atherosclerosis via CAC and CIMT

I also am high risk with type 2 Diabetes mellitus. 

I would like to keep my non-HDLc less than 70-80 

Both LDLp's were done on statin.

I would like to keep my LDLp less than 1,000

Next phase of experiment is to add Zetia to niacin.


No statin, on  Endur-acin 1,000 mg a day. 
TC 171
LDLc 86
HDLc 61
Remnants 24
TG non-fasting 118

6-12-19 After 12 day Mediterranean cruise. 
 No statin, on Endur-acin 1,000 mg a day and Zetia

TC. 152
LDLc 76
HDLc 59
Remnants 18
TG fasting 85

I find this interesting. 
Enduracin and Zetia do a good job without statin. 
I thought my cognitive exam was better this year compared to last year.
Cognitive exam for Alzheimer's yesterday link.

Some might argue Statins are good anti-inflammatories for AZ. 
However if it is all about how low you can go with LDLc,
perhaps the two drugs without statin is better?

I am waiting for my LDLp to return in a couple of days

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