I started Atkins or Low Carbohydrate High Fat diet in 2011
Here are my lab since 2013. Routine Lipid Panel. Not expensive, usually covered by insurance.
Routine Lipid panel 10-28-19 on very low dose Lipitor (atorvastatin)
I break the generic 10 in half. I started Lipitor 5 mg on 10-20-2019
I have BMI 30 and take Lovastatin 5 mg, Zetia 10 mg and Enduracin (nicotinic acid 1,000 mg)
All low doses and inexpensive. At low doses rare to have side effects.
New National Lipid guidelines came out to lower triglycerides in high risk patients.
In 2010 I published The Tubby Theory from Topeka
Goals:
non-HDLc less than 80
LDLp less than 1,000 or 750
Triglycerides less than 150.
(I now advise getting Triglyceride level less than 100 Non-fasting)
Over the ensuing 10 years the guidelines have caught up with my advice.
The idea of treating earlier to prevent complex plaques which are resistant to the therapy later caught on.
I called this the Multiplier Effect link
1- use multiple medications in low doses to avoid side effects
2-use them early at the first sign of positive CAC or high LDLp
In recent years two great medical advances have been made:
1-PCSK9 inhibitor drugs
From wiki
These are great drugs and apparently very safe.
However in 2009 I proposed Topeka Triple Therapy to achieve very low levels of LDLc or nonHDLc or LDLp or apoB with very low cost and safety as low doses are used synergistically.
1-Lowest dose statin (many generic now)
One month later,
2-Endur-acin (nicotinic acid 1,000 mg) OTC
One month later,
3-Zetia (now generic)
Goals to get non-HDLc less than 80 (don't need expensive advanced lipid testing for this)
My goal was to give the public an inexpensive way with less side effects to get very low non-HDLc.
It was generally believed if at an early age LDLc was kept below 100 it would help prevent progression of plaque.
It was also believed if LDLc was kept below 75 it might reverse plaque accumulation.
I liked low dose nicotinic acid as it was shown to lower LDLc as well as triglycerides and raise HDLc.
Endur-acin was a wax matrix preparation that did not cause significant flushing.
In my patients I follow glucose levels carefully and never had to stop the niacin because of increased glucose.
Finally, I would give 1,000 to 4,000 mg of Lovaza (now generic) to lower triglycerides.
The new drugs are great.
They have the trials behind them.
Please try the less expensive Topeka Therapy first.
Here are my lab since 2013. Routine Lipid Panel. Not expensive, usually covered by insurance.
Routine Lipid panel 10-28-19 on very low dose Lipitor (atorvastatin)
I break the generic 10 in half. I started Lipitor 5 mg on 10-20-2019
I have BMI 30 and take Lovastatin 5 mg, Zetia 10 mg and Enduracin (nicotinic acid 1,000 mg)
All low doses and inexpensive. At low doses rare to have side effects.
New National Lipid guidelines came out to lower triglycerides in high risk patients.
In 2010 I published The Tubby Theory from Topeka
In patients with a positive CAC and one risk factor
I advised aggressive treatment to prevent further plaque
and even regression of plaque.
Goals:
non-HDLc less than 80
LDLp less than 1,000 or 750
Triglycerides less than 150.
(I now advise getting Triglyceride level less than 100 Non-fasting)
Over the ensuing 10 years the guidelines have caught up with my advice.
The idea of treating earlier to prevent complex plaques which are resistant to the therapy later caught on.
I called this the Multiplier Effect link
1- use multiple medications in low doses to avoid side effects
2-use them early at the first sign of positive CAC or high LDLp
In recent years two great medical advances have been made:
1-PCSK9 inhibitor drugs
From wiki
2-Ethyl eicosapentaenoic acid
From Wiki
These are great drugs and apparently very safe.
However in 2009 I proposed Topeka Triple Therapy to achieve very low levels of LDLc or nonHDLc or LDLp or apoB with very low cost and safety as low doses are used synergistically.
1-Lowest dose statin (many generic now)
One month later,
2-Endur-acin (nicotinic acid 1,000 mg) OTC
One month later,
3-Zetia (now generic)
Goals to get non-HDLc less than 80 (don't need expensive advanced lipid testing for this)
My goal was to give the public an inexpensive way with less side effects to get very low non-HDLc.
It was generally believed if at an early age LDLc was kept below 100 it would help prevent progression of plaque.
It was also believed if LDLc was kept below 75 it might reverse plaque accumulation.
I liked low dose nicotinic acid as it was shown to lower LDLc as well as triglycerides and raise HDLc.
Endur-acin was a wax matrix preparation that did not cause significant flushing.
In my patients I follow glucose levels carefully and never had to stop the niacin because of increased glucose.
Finally, I would give 1,000 to 4,000 mg of Lovaza (now generic) to lower triglycerides.
The new drugs are great.
They have the trials behind them.
Please try the less expensive Topeka Therapy first.
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