u/SilverLogical9810

Hi everyone,
I’m 29M and have a family history of premature coronary artery disease — my mom had a coronary stent at 52. That was a big wake-up call for me, and since then I’ve taken my cardiovascular health much more seriously.
About 1.5 years ago, I quit smoking, started exercising regularly, and switched to a heart-healthy diet. I’ve lost around 31–35 kg.
I had a cardiology evaluation including a stress test, ECG, echocardiogram, blood work and CIMT. Everything was normal, with no evidence of plaque. The main issue was my lipids:
LDL: \~158–163 mg/dL
ApoB: \~148 mg/dL
Lp(a): initially 97 nmol/L
TG: \~310 mg/dL
With lifestyle changes, I managed to get:
LDL: \~105–110
ApoB: \~95–105
TG: \~90
But despite being quite strict with my diet and exercise, I was struggling to get LDL/ApoB much lower.
My cardiologist therefore started me on **rosuvastatin 10 mg + ezetimibe 10 mg**.
My current results are:
LDL: **63 mg/dL**
ApoB: **64 mg/dL**
TG: **85 mg/dL**
HbA1c: **5.3%**
Fasting glucose/insulin: normal
Homocysteine and hormones: normal
One thing that has confused me is my Lp(a). It has been measured several times, always in the same lab and nmol/L:
**97 → 128 → 135 → 163 → 184 nmol/L**
The increase from 163 → 184 happened after starting rosuvastatin + ezetimibe. I know statins can sometimes slightly increase Lp(a), so I’m not sure how much significance to give these fluctuations.
I’m currently 172 cm and around 84 kg. My weight has fluctuated between \~79 and 84 kg, possibly partly because I’ve been building muscle. I’m still trying to get toward \~75 kg. I walk, cycle and exercise regularly and follow a heart-healthy diet most of the time.
**The Repatha question**
My cardiologist and I discussed **Repatha (evolocumab)**, and my insurance has now approved it. I pushed quite hard to get it approved because I’m concerned about my long-term cardiovascular risk given my family history and Lp(a).
I know from the PCSK9 inhibitor trials that adding evolocumab to statin therapy can substantially reduce LDL and cardiovascular events/MACE in appropriate high-risk populations.
So I’m wondering what you would do in my situation.
Would you:
**Add Repatha to the current rosuvastatin 10 mg + ezetimibe 10 mg?**
Use Repatha and **reduce rosuvastatin to 5 mg?**
Use Repatha alone and stop the statin/ezetimibe?
Or simply stay on rosuvastatin + ezetimibe since LDL 63 and ApoB 64 are already quite good?
I’m also somewhat anxious about starting Repatha. I’m particularly afraid of having an allergic reaction to the injection, even though I don’t have a history of medication allergies. I know serious allergic reactions are uncommon, but I tend to worry about side effects before starting medications.
I also recently started **berberine 500 mg/day** and have noticed some mild muscle discomfort and occasional tiredness. It’s not severe, but I’m wondering whether I should stop it, particularly since I’m already taking rosuvastatin.
I’m not looking for medical advice from Reddit — I’d obviously make the final decision with my cardiologist. I’m mainly interested in hearing from people who have been in a similar situation, especially regarding:
Repatha + statin + ezetimibe
Whether anyone reduced their statin after starting Repatha
Side effects/allergic reactions, possible thrombosis ...
How people felt about their first injection
Whether PCSK9 inhibitors made a meaningful difference in their long-term lipid management
**What would you do if you were in my position?**

PS , my mom had uncontrolled BP for Years , heavy smoker , not on heart healthy diet ....

My BP was 155/90 before the lifestyle chnages , its 115/65 ish now ....

Hi everyone,
I’m 29M and have a family history of premature coronary artery disease — my mom had a coronary stent at 52. That was a big wake-up call for me, and since then I’ve taken my cardiovascular health much more seriously.
About 1.5 years ago, I quit smoking, started exercising regularly, and switched to a heart-healthy diet. I’ve lost around 31–35 kg.
I had a cardiology evaluation including a stress test, ECG, echocardiogram, blood work and CIMT. Everything was normal, with no evidence of plaque. The main issue was my lipids:
LDL: \~158–163 mg/dL
ApoB: \~148 mg/dL
Lp(a): initially 97 nmol/L
TG: \~310 mg/dL
With lifestyle changes, I managed to get:
LDL: \~105–110
ApoB: \~95–105
TG: \~90
But despite being quite strict with my diet and exercise, I was struggling to get LDL/ApoB much lower.
My cardiologist therefore started me on **rosuvastatin 10 mg + ezetimibe 10 mg**.
My current results are:
LDL: **63 mg/dL**
ApoB: **64 mg/dL**
TG: **85 mg/dL**
HbA1c: **5.3%**
Fasting glucose/insulin: normal
Homocysteine and hormones: normal
One thing that has confused me is my Lp(a). It has been measured several times, always in the same lab and nmol/L:
**97 → 128 → 135 → 163 → 184 nmol/L**
The increase from 163 → 184 happened after starting rosuvastatin + ezetimibe. I know statins can sometimes slightly increase Lp(a), so I’m not sure how much significance to give these fluctuations.
I’m currently 172 cm and around 84 kg. My weight has fluctuated between \~79 and 84 kg, possibly partly because I’ve been building muscle. I’m still trying to get toward \~75 kg. I walk, cycle and exercise regularly and follow a heart-healthy diet most of the time.
**The Repatha question**
My cardiologist and I discussed **Repatha (evolocumab)**, and my insurance has now approved it. I pushed quite hard to get it approved because I’m concerned about my long-term cardiovascular risk given my family history and Lp(a).
I know from the PCSK9 inhibitor trials that adding evolocumab to statin therapy can substantially reduce LDL and cardiovascular events/MACE in appropriate high-risk populations.
So I’m wondering what you would do in my situation.
Would you:
**Add Repatha to the current rosuvastatin 10 mg + ezetimibe 10 mg?**
Use Repatha and **reduce rosuvastatin to 5 mg?**
Use Repatha alone and stop the statin/ezetimibe?
Or simply stay on rosuvastatin + ezetimibe since LDL 63 and ApoB 64 are already quite good?
I’m also somewhat anxious about starting Repatha. I’m particularly afraid of having an allergic reaction to the injection, even though I don’t have a history of medication allergies. I know serious allergic reactions are uncommon, but I tend to worry about side effects before starting medications.
I also recently started **berberine 500 mg/day** and have noticed some mild muscle discomfort and occasional tiredness. It’s not severe, but I’m wondering whether I should stop it, particularly since I’m already taking rosuvastatin.
I’m not looking for medical advice from Reddit — I’d obviously make the final decision with my cardiologist. I’m mainly interested in hearing from people who have been in a similar situation, especially regarding:
Repatha + statin + ezetimibe
Whether anyone reduced their statin after starting Repatha
Side effects/allergic reactions, possible thrombosis ...
How people felt about their first injection
Whether PCSK9 inhibitors made a meaningful difference in their long-term lipid management
**What would you do if you were in my position?**

PS , my mom had uncontrolled BP for Years , heavy smoker , not on heart healthy diet ....

My BP was 155/90 before the lifestyle chnages , its 115/65 ish now ....

29M, family history of premature CAD — what would you do about Repatha?
Hi everyone,
I’m 29M and have a family history of premature coronary artery disease — my mom had a coronary stent at 52. That was a big wake-up call for me, and since then I’ve taken my cardiovascular health much more seriously.
About 1.5 years ago, I quit smoking, started exercising regularly, and switched to a heart-healthy diet. I’ve lost around 31–35 kg.
I had a cardiology evaluation including a stress test, ECG, echocardiogram, blood work and CIMT. Everything was normal, with no evidence of plaque. The main issue was my lipids:
LDL: ~158–163 mg/dL
ApoB: ~148 mg/dL
Lp(a): initially 97 nmol/L
TG: ~310 mg/dL
With lifestyle changes, I managed to get:
LDL: ~105–110
ApoB: ~95–105
TG: ~90
But despite being quite strict with my diet and exercise, I was struggling to get LDL/ApoB much lower.
My cardiologist therefore started me on rosuvastatin 10 mg + ezetimibe 10 mg.
My current results are:
LDL: 63 mg/dL
ApoB: 64 mg/dL
TG: 85 mg/dL
HbA1c: 5.3%
Fasting glucose/insulin: normal
Homocysteine and hormones: normal
One thing that has confused me is my Lp(a). It has been measured several times, always in the same lab and nmol/L:
97 → 128 → 135 → 163 → 184 nmol/L
The increase from 163 → 184 happened after starting rosuvastatin + ezetimibe. I know statins can sometimes slightly increase Lp(a), so I’m not sure how much significance to give these fluctuations.
I’m currently 172 cm and around 84 kg. My weight has fluctuated between ~79 and 84 kg, possibly partly because I’ve been building muscle. I’m still trying to get toward ~75 kg. I walk, cycle and exercise regularly and follow a heart-healthy diet most of the time.
The Repatha question
My cardiologist and I discussed Repatha (evolocumab), and my insurance has now approved it. I pushed quite hard to get it approved because I’m concerned about my long-term cardiovascular risk given my family history and Lp(a).
I know from the PCSK9 inhibitor trials that adding evolocumab to statin therapy can substantially reduce LDL and cardiovascular events/MACE in appropriate high-risk populations.
So I’m wondering what you would do in my situation.
Would you:
Add Repatha to the current rosuvastatin 10 mg + ezetimibe 10 mg?
Use Repatha and reduce rosuvastatin to 5 mg?
Use Repatha alone and stop the statin/ezetimibe?
Or simply stay on rosuvastatin + ezetimibe since LDL 63 and ApoB 64 are already quite good?
I’m also somewhat anxious about starting Repatha. I’m particularly afraid of having an allergic reaction to the injection, even though I don’t have a history of medication allergies. I know serious allergic reactions are uncommon, but I tend to worry about side effects before starting medications.
I also recently started berberine 500 mg/day and have noticed some mild muscle discomfort and occasional tiredness. It’s not severe, but I’m wondering whether I should stop it, particularly since I’m already taking rosuvastatin.
I’m not looking for medical advice from Reddit — I’d obviously make the final decision with my cardiologist. I’m mainly interested in hearing from people who have been in a similar situation, especially regarding:
Repatha + statin + ezetimibe
Whether anyone reduced their statin after starting Repatha
Side effects/allergic reactions, possible thrombosis ...
How people felt about their first injection
Whether PCSK9 inhibitors made a meaningful difference in their long-term lipid management
What would you do if you were in my position?

PS , my mom had uncontrolled BP for Years , heavy smoker , not on heart healthy diet ....

My BP was 155/90 before the lifestyle chnages , its 115/65 ish now ....

Would you consider Repatha for my mother despite LDL being 49 because of high Lp(a)?

My mother is 55 and had an MI at 53, followed by one stent. She is currently doing well, her blood pressure is controlled, and her EF is 61%.
She is currently taking rosuvastatin 20 mg + ezetimibe 10 mg, along with bisoprolol 7.5 mg, Co-Valsartan 12.5/160 mg and aspirin 100 mg.
Her latest blood tests show LDL-C 49 mg/dL, ApoB 55 mg/dL, non-HDL 66 mg/dL, triglycerides 90 mg/dL and HDL 45 mg/dL. However, her Lp(a) is \*\*185 nmol/L\*\*.
Her LDL and ApoB are already very well controlled, but I’m concerned about the elevated Lp(a), especially given that she has already had an MI at a relatively young age.
I’m wondering whether it would make sense to discuss \*\*Repatha (evolocumab)\*\* with her cardiologist despite her LDL already being below 55 mg/dL. From what I understand, PCSK9 inhibitors can lower Lp(a) by around 20–30% in addition to lowering LDL, and there is outcome data in people with established cardiovascular disease.
Would you consider Repatha on top of the statin + zetia in this situation, or would you stay with rosuvastatin + ezetimibe because her LDL and ApoB are already excellent?
We’re also currently working on weight loss, diet and exercise to improve her HbA1c, which is 5.74%.
I’d especially appreciate experiences from people with high Lp(a) and previous MI who have used Repatha, particularly if their LDL was already below 55 mg/dL.
Fasting Glucose and Insulin, Homa IR , Homocysteine ,ALT , AST , Creatinine , eGFR all perfect .Thanks

My mother is 55 and had an MI at 53, followed by one stent. She is currently doing well, her blood pressure is controlled, and her EF is 61%.
She is currently taking rosuvastatin 20 mg + ezetimibe 10 mg, along with bisoprolol 7.5 mg, Co-Valsartan 12.5/160 mg and aspirin 100 mg.
Her latest blood tests show LDL-C 49 mg/dL, ApoB 55 mg/dL, non-HDL 66 mg/dL, triglycerides 90 mg/dL and HDL 45 mg/dL. However, her Lp(a) is \*\*185 nmol/L\*\*.
Her LDL and ApoB are already very well controlled, but I’m concerned about the elevated Lp(a), especially given that she has already had an MI at a relatively young age.
I’m wondering whether it would make sense to discuss \*\*Repatha (evolocumab)\*\* with her cardiologist despite her LDL already being below 55 mg/dL. From what I understand, PCSK9 inhibitors can lower Lp(a) by around 20–30% in addition to lowering LDL, and there is outcome data in people with established cardiovascular disease.
Would you consider Repatha on top of the statin + zetia in this situation, or would you stay with rosuvastatin + ezetimibe because her LDL and ApoB are already excellent?
We’re also currently working on weight loss, diet and exercise to improve her HbA1c, which is 5.74%.
I’d especially appreciate experiences from people with high Lp(a) and previous MI who have used Repatha, particularly if their LDL was already below 55 mg/dL.
Fasting Glucose and Insulin, Homa IR , Homocysteine ,ALT , AST , Creatinine , eGFR all perfect .Thanks

My mother is 55 and had an MI at 53, followed by one stent. She is currently doing well, her blood pressure is controlled, and her EF is 61%.
She is currently taking rosuvastatin 20 mg + ezetimibe 10 mg, along with bisoprolol 7.5 mg, Co-Valsartan 12.5/160 mg and aspirin 100 mg.
Her latest blood tests show LDL-C 49 mg/dL, ApoB 55 mg/dL, non-HDL 66 mg/dL, triglycerides 90 mg/dL and HDL 45 mg/dL. However, her Lp(a) is **185 nmol/L**.
Her LDL and ApoB are already very well controlled, but I’m concerned about the elevated Lp(a), especially given that she has already had an MI at a relatively young age.
I’m wondering whether it would make sense to discuss **Repatha (evolocumab)** with her cardiologist despite her LDL already being below 55 mg/dL. From what I understand, PCSK9 inhibitors can lower Lp(a) by around 20–30% in addition to lowering LDL, and there is outcome data in people with established cardiovascular disease.
Would you consider Repatha on top of the statin + zetia in this situation, or would you stay with rosuvastatin + ezetimibe because her LDL and ApoB are already excellent?
We’re also currently working on weight loss, diet and exercise to improve her HbA1c, which is 5.74%.
I’d especially appreciate experiences from people with high Lp(a) and previous MI who have used Repatha, particularly if their LDL was already below 55 mg/dL.
Fasting Glucose and Insulin, Homa IR , Homocysteine ,ALT , AST , Creatinine , eGFR all perfect .Thanks

My mother is 55 and had an MI at 53, followed by one stent. She is currently doing well, her blood pressure is controlled, and her EF is 61%.
She is currently taking rosuvastatin 20 mg + ezetimibe 10 mg, along with bisoprolol 7.5 mg, Co-Valsartan 12.5/160 mg and aspirin 100 mg.
Her latest blood tests show LDL-C 49 mg/dL, ApoB 55 mg/dL, non-HDL 66 mg/dL, triglycerides 90 mg/dL and HDL 45 mg/dL. However, her Lp(a) is **185 nmol/L**.
Her LDL and ApoB are already very well controlled, but I’m concerned about the elevated Lp(a), especially given that she has already had an MI at a relatively young age.
I’m wondering whether it would make sense to discuss **Repatha (evolocumab)** with her cardiologist despite her LDL already being below 55 mg/dL. From what I understand, PCSK9 inhibitors can lower Lp(a) by around 20–30% in addition to lowering LDL, and there is outcome data in people with established cardiovascular disease.
Would you consider Repatha on top of the statin + zetia in this situation, or would you stay with rosuvastatin + ezetimibe because her LDL and ApoB are already excellent?
We’re also currently working on weight loss, diet and exercise to improve her HbA1c, which is 5.74%.
I’d especially appreciate experiences from people with high Lp(a) and previous MI who have used Repatha, particularly if their LDL was already below 55 mg/dL.
Fasting Glucose and Insulin, Homa IR , Homocysteine ,ALT , AST , Creatinine , eGFR all perfect .Thanks

My mother is 55 and had an MI at 53, followed by one stent. She is currently doing well, her blood pressure is controlled, and her EF is 61%.
She is currently taking rosuvastatin 20 mg + ezetimibe 10 mg, along with bisoprolol 7.5 mg, Co-Valsartan 12.5/160 mg and aspirin 100 mg.
Her latest blood tests show LDL-C 49 mg/dL, ApoB 55 mg/dL, non-HDL 66 mg/dL, triglycerides 90 mg/dL and HDL 45 mg/dL. However, her Lp(a) is 185 nmol/L.
Her LDL and ApoB are already very well controlled, but I’m concerned about the elevated Lp(a), especially given that she has already had an MI at a relatively young age.
I’m wondering whether it would make sense to discuss Repatha (evolocumab) with her cardiologist despite her LDL already being below 55 mg/dL. From what I understand, PCSK9 inhibitors can lower Lp(a) by around 20–30% in addition to lowering LDL, and there is outcome data in people with established cardiovascular disease.
Would you consider Repatha on top of the statin + zetia in this situation, or would you stay with rosuvastatin + ezetimibe because her LDL and ApoB are already excellent?
We’re also currently working on weight loss, diet and exercise to improve her HbA1c, which is 5.74%.
I’d especially appreciate experiences from people with high Lp(a) and previous MI who have used Repatha, particularly if their LDL was already below 55 mg/dL.
Fasting Glucose and Insulin, Homa IR , Homocysteine ,ALT , AST , Creatinine , eGFR all perfect .Thanks

Hi everyone,
I’m currently taking rosuvastatin + ezetimibe for cholesterol management, and I’m considering adding berberine 500 mg once daily to help with weight loss and improving glucose/insulin sensitivity.
Has anyone here taken berberine together with rosuvastatin and ezetimibe?
Did you experience any side effects or muscle pain?
Did your doctor or pharmacist have any concerns about this combination?
Did you notice any benefits for weight loss, blood sugar, or cholesterol?
I’d really appreciate hearing about your experiences. Thanks in advance!

Hi everyone,

I’m honestly a bit confused by what I’ve been seeing with my Lp(a) over the past year, and I wanted to share my story in case anyone has experienced something similar or can help me make sense of it.
For a long time I’ve had pretty persistent gut issues — bloating, gas, diarrhea, reflux, and what was diagnosed as esophagitis at one point. There were even periods where my abdomen would get so distended that it felt like it was affecting my breathing. Along with that, I’ve had ongoing gum inflammation on and off as well.

About a year ago I started trying to take control of my health more seriously. I began taking esomeprazole and psyllium husk around the same time, mainly to try to improve my gut symptoms. After a couple of months on them, I checked my blood lipids, including Lp(a), and at that point my values were around 44–45 mg/dL, which translated to roughly 97 nmol/L. Were checked in both units.

At that time, my gut symptoms were still present but somewhat manageable.
Later on, when I started feeling a bit better overall in terms of digestion, I stopped both the esomeprazole and psyllium. I continued monitoring my bloodwork because I was actively trying to improve everything through lifestyle — diet, exercise, Quit smoking , weight loss, the whole picture.

This is where things started to confuse me. Over the next several tests, my Lp(a) began to climb rather consistently: 128 nmol/L, then 135, then 148, then 155. After I saw it as 155nmol/l , and realized that Diet didnt really bring my LDL less then 100mg/dl ,Eventually I started lipid-lowering therapy with rosuvastatin and ezetimibe(5/10), but despite that my Lp(a) continued to come back even higher, around 163 and most recently 183 nmol/L. (on 10/10 crestor +Zetia)

What makes this especially puzzling to me is that everything else in my metabolic health has improved dramatically during this time. I’ve lost about 38 kg over the past 1.5 years, I exercise regularly, I cycle several times a week, and I’ve been eating a mostly whole-food plant-based diet. My triglycerides dropped from 300 to around 90, LDL went from 165 to 64, and ApoB from 140 to 64. HDL from 30 to 59mg/dl. Fasting insuline , Glucose and Hba1c -Perfect!
So overall, everything seems to be moving in the right direction except Lp(a), which is doing the opposite.

Because of my ongoing gut issues, I’ve started wondering whether chronic inflammation might be playing a role here. I’ve read that cytokines like IL-6 can influence Lp(a), and I can’t help but wonder if persistent gut inflammation or something related could be pushing it up. I also noticed subjectively that when I was taking psyllium regularly, I looked less puffy and my face seemed less swollen, while after stopping it my gut symptoms and that “swollen” feeling seemed to come back.

Given my family history — my mother had a cardiovascular event and received 1 stent at 54 — I’m quite motivated to get my risk as low as possible. Right now I’m considering continuing to optimize gut health and then retesting Lp(a) again once things stabilize. If it stays elevated, I’m even considering whether adding a PCSK9 inhibitor like evolocumab might make sense to further reduce ApoB and overall risk.

I guess my main question is whether anyone has seen anything like this — a fairly noticeable rise in Lp(a) over time in the context of chronic gut or inflammatory issues — or whether this is simply genetic baseline showing variability and I’m overinterpreting it.( But still , which number is my true genetic baseline , something Genetic and can raise up to 140%)

Any insights would really help.

PS . My BP improved from 160/90 to 118/62 ish , And HR from 110-120 ish to 65-70 ish .

Hi everyone,

I’m honestly a bit confused by what I’ve been seeing with my Lp(a) over the past year, and I wanted to share my story in case anyone has experienced something similar or can help me make sense of it.
For a long time I’ve had pretty persistent gut issues — bloating, gas, diarrhea, reflux, and what was diagnosed as esophagitis at one point. There were even periods where my abdomen would get so distended that it felt like it was affecting my breathing. Along with that, I’ve had ongoing gum inflammation on and off as well.

About a year ago I started trying to take control of my health more seriously. I began taking esomeprazole and psyllium husk around the same time, mainly to try to improve my gut symptoms. After a couple of months on them, I checked my blood lipids, including Lp(a), and at that point my values were around 44–45 mg/dL, which translated to roughly 97 nmol/L. Were checked in both units.

At that time, my gut symptoms were still present but somewhat manageable.
Later on, when I started feeling a bit better overall in terms of digestion, I stopped both the esomeprazole and psyllium. I continued monitoring my bloodwork because I was actively trying to improve everything through lifestyle — diet, exercise, Quit smoking , weight loss, the whole picture.

This is where things started to confuse me. Over the next several tests, my Lp(a) began to climb rather consistently: 128 nmol/L, then 135, then 148, then 155. After I saw it as 155nmol/l , and realized that Diet didnt really bring my LDL less then 100mg/dl ,Eventually I started lipid-lowering therapy with rosuvastatin and ezetimibe(5/10), but despite that my Lp(a) continued to come back even higher, around 163 and most recently 183 nmol/L. (on 10/10 crestor +Zetia)

What makes this especially puzzling to me is that everything else in my metabolic health has improved dramatically during this time. I’ve lost about 38 kg over the past 1.5 years, I exercise regularly, I cycle several times a week, and I’ve been eating a mostly whole-food plant-based diet. My triglycerides dropped from 300 to around 90, LDL went from 165 to 64, and ApoB from 140 to 64. HDL from 30 to 59mg/dl. Fasting insuline , Glucose and Hba1c -Perfect!
So overall, everything seems to be moving in the right direction except Lp(a), which is doing the opposite.

Because of my ongoing gut issues, I’ve started wondering whether chronic inflammation might be playing a role here. I’ve read that cytokines like IL-6 can influence Lp(a), and I can’t help but wonder if persistent gut inflammation or something related could be pushing it up. I also noticed subjectively that when I was taking psyllium regularly, I looked less puffy and my face seemed less swollen, while after stopping it my gut symptoms and that “swollen” feeling seemed to come back.

Given my family history — my mother had a cardiovascular event and received 1 stent at 54 — I’m quite motivated to get my risk as low as possible. Right now I’m considering continuing to optimize gut health and then retesting Lp(a) again once things stabilize. If it stays elevated, I’m even considering whether adding a PCSK9 inhibitor like evolocumab might make sense to further reduce ApoB and overall risk.

I guess my main question is whether anyone has seen anything like this — a fairly noticeable rise in Lp(a) over time in the context of chronic gut or inflammatory issues — or whether this is simply genetic baseline showing variability and I’m overinterpreting it.( But still , which number is my true genetic baseline , something Genetic and can raise up to 140%)

Any insights would really help.

PS . My BP improved from 160/90 to 118/62 ish , And HR from 110-120 ish to 65-70 ish .

Has anyone seen a large drop in Lipoprotein(a) from taking psyllium?
I’m trying to understand a change in my Lp(a) levels and whether it could be related to gut health and inflammation.
My Lp(a) went from 183 nmol/L to 97 nmol/L. Same lab, same units. The main thing that changed during that period was that I was taking psyllium regularly.
I have longstanding issues with gas and significant abdominal bloating/distension. Psyllium helped a lot with those symptoms. After I stopped taking it, my Lp(a) later measured 183 nmol/L again.
I know Lp(a) is considered largely genetic and usually stable, and I also know psyllium is mainly used to lower LDL cholesterol rather than Lp(a). But I’m wondering whether there could be an indirect effect through inflammation.
My theory is:
Psyllium improved my gut symptoms.
Improved gut function reduced systemic inflammation.
Lower inflammation (possibly lower IL-6 signaling) reduced Lp(a) production.
Stopping psyllium reversed that effect.
I realize this is speculative, and I haven’t measured IL-6 or hs-CRP alongside the Lp(a). I’m curious whether anyone has:
Seen meaningful changes in Lp(a) after improving gut health?
Come across research linking psyllium, gut inflammation, IL-6, and Lp(a)?
Experienced large swings in Lp(a) that couldn’t be explained by genetics alone?
Would appreciate any insights or references.

Has anyone seen a large drop in Lipoprotein(a) from taking psyllium?
I’m trying to understand a change in my Lp(a) levels and whether it could be related to gut health and inflammation.
My Lp(a) went from 183 nmol/L to 97 nmol/L. Same lab, same units. The main thing that changed during that period was that I was taking psyllium regularly.
I have longstanding issues with gas and significant abdominal bloating/distension. Psyllium helped a lot with those symptoms. After I stopped taking it, my Lp(a) later measured 183 nmol/L again.
I know Lp(a) is considered largely genetic and usually stable, and I also know psyllium is mainly used to lower LDL cholesterol rather than Lp(a). But I’m wondering whether there could be an indirect effect through inflammation.
My theory is:
Psyllium improved my gut symptoms.
Improved gut function reduced systemic inflammation.
Lower inflammation (possibly lower IL-6 signaling) reduced Lp(a) production.
Stopping psyllium reversed that effect.
I realize this is speculative, and I haven’t measured IL-6 or hs-CRP alongside the Lp(a). I’m curious whether anyone has:
Seen meaningful changes in Lp(a) after improving gut health?
Come across research linking psyllium, gut inflammation, IL-6, and Lp(a)?
Experienced large swings in Lp(a) that couldn’t be explained by genetics alone?
Would appreciate any insights or references.

I was told that Repatha contains polysorbate 80, which can very rarely cause serious allergic reactions, including anaphylaxis. I have also heard claims that polysorbate 80 may be linked to thrombosis and that it was present in the AstraZeneca COVID-19 vaccine. Because of this, I am worried about taking Repatha, even though it has been prescribed to me.

Can anyone clarify whether these concerns are supported by evidence? Is there any reason for someone without a known polysorbate 80 allergy to be afraid of taking Repatha? Any reassurance or information would be appreciated.

I was told that Repatha contains polysorbate 80, which can very rarely cause serious allergic reactions, including anaphylaxis. I have also heard claims that polysorbate 80 may be linked to thrombosis and that it was present in the AstraZeneca COVID-19 vaccine. Because of this, I am worried about taking Repatha, even though it has been prescribed to me.

Can anyone clarify whether these concerns are supported by evidence? Is there any reason for someone without a known polysorbate 80 allergy to be afraid of taking Repatha? Any reassurance or information would be appreciated.

I was told that Repatha contains polysorbate 80, which can very rarely cause serious allergic reactions, including anaphylaxis. I have also heard claims that polysorbate 80 may be linked to thrombosis and that it was present in the AstraZeneca COVID-19 vaccine. Because of this, I am worried about taking Repatha, even though it has been prescribed to me.

Can anyone clarify whether these concerns are supported by evidence? Is there any reason for someone without a known polysorbate 80 allergy to be afraid of taking Repatha? Any reassurance or information would be appreciated.

Hi everyone,

I’m a 28-year-old male. After my mom had a premature heart attack (NSTEMI with one stent placed in the LAD), I started taking my health much more seriously. Over the last few years, I quit smoking, lost 38 kg (84 lbs), started exercising regularly, built muscle, cycle to work instead of driving, swim moderately, and follow a mostly Mediterranean diet. I’ve also reduced saturated fat and increased my fiber intake.

I’ve always had high LDL cholesterol since my teens, typically in the 150–167 mg/dL range, but I largely ignored it when I was younger. As far as family history goes, my mom had an NSTEMI in her early 50s and received one LAD stent. She was a heavy smoker and had uncontrolled high blood pressure for many years. One grandmother died at 83 after having multiple ischemic strokes, while my other grandmother died at 75 from kidney disease and a hemorrhagic stroke and had untreated high cholesterol.

After my lifestyle changes, I was able to lower my LDL to around 109–120 mg/dL without medication. I then checked additional markers and found my ApoB was 120 mg/dL and my Lp(a) was 97 nmol/L. What surprised me was that my Lp(a) continued to rise on repeat testing despite not taking any medications at the time. It went from 97 to 128, then 140, and then 148 nmol/L.

I eventually saw a cardiologist and underwent an ECG, echocardiogram, stress test, and CIMT, all of which were normal. My cardiologist prescribed rosuvastatin 5 mg and ezetimibe 10 mg. After six weeks, my LDL dropped to 64 mg/dL, my ApoB dropped to 61 mg/dL, but my Lp(a) increased to 168 nmol/L. The rosuvastatin dose was then increased to 10 mg while continuing ezetimibe 10 mg.

I recently repeated my labs. My LDL remains 64 mg/dL and my ApoB is now 64 mg/dL, but my Lp(a) has increased again to 183 nmol/L. My kidney function, liver enzymes, platelets, vitamin D, and hs-CRP are all normal. My HbA1c increased slightly from 5.1% to 5.3%, but my fasting glucose is 83 mg/dL and fasting insulin is 8. My CK is mildly elevated at 189 with the upper reference limit being 171.

Overall, I have very few side effects from rosuvastatin and ezetimibe. Occasionally I notice mild muscle aches and perhaps some mood swings, but nothing significant. My cardiologist was able to get Repatha approved for me, and now I’m trying to decide whether it’s really necessary to start it.

I’m particularly interested in hearing what others would do in my situation. Would you start Repatha given my age, family history, and rising Lp(a)? Would you continue rosuvastatin 10 mg and ezetimibe 10 mg and simply add Repatha, or would you lower the rosuvastatin dose back to 5 mg if Repatha is added? Would anyone consider stopping rosuvastatin and using Repatha instead?

Part of my hesitation comes from reading negative experiences online involving Repatha, including reports of increased blood pressure, elevated blood sugar, severe muscle pain, and other side effects. Before my lifestyle changes, my blood pressure was around 155/90 and my resting heart rate was typically 95–110 bpm. Today my blood pressure is usually around 120/65 and my resting heart rate is 65–70 bpm, so I’m naturally cautious about adding another medication when I’ve worked hard to improve my health.

I’d really appreciate any insight, opinions, or personal experiences. Thank you.

Hi everyone,

I’m a 28-year-old male. After my mom had a premature heart attack (NSTEMI with one stent placed in the LAD), I started taking my health much more seriously. Over the last few years, I quit smoking, lost 38 kg (84 lbs), started exercising regularly, built muscle, cycle to work instead of driving, swim moderately, and follow a mostly Mediterranean diet. I’ve also reduced saturated fat and increased my fiber intake.

I’ve always had high LDL cholesterol since my teens, typically in the 150–167 mg/dL range, but I largely ignored it when I was younger. As far as family history goes, my mom had an NSTEMI in her early 50s and received one LAD stent. She was a heavy smoker and had uncontrolled high blood pressure for many years. One grandmother died at 83 after having multiple ischemic strokes, while my other grandmother died at 75 from kidney disease and a hemorrhagic stroke and had untreated high cholesterol.

After my lifestyle changes, I was able to lower my LDL to around 109–120 mg/dL without medication. I then checked additional markers and found my ApoB was 120 mg/dL and my Lp(a) was 97 nmol/L. What surprised me was that my Lp(a) continued to rise on repeat testing despite not taking any medications at the time. It went from 97 to 128, then 140, and then 148 nmol/L.

I eventually saw a cardiologist and underwent an ECG, echocardiogram, stress test, and CIMT, all of which were normal. My cardiologist prescribed rosuvastatin 5 mg and ezetimibe 10 mg. After six weeks, my LDL dropped to 64 mg/dL, my ApoB dropped to 61 mg/dL, but my Lp(a) increased to 168 nmol/L. The rosuvastatin dose was then increased to 10 mg while continuing ezetimibe 10 mg.

I recently repeated my labs. My LDL remains 64 mg/dL and my ApoB is now 64 mg/dL, but my Lp(a) has increased again to 183 nmol/L. My kidney function, liver enzymes, platelets, vitamin D, and hs-CRP are all normal. My HbA1c increased slightly from 5.1% to 5.3%, but my fasting glucose is 83 mg/dL and fasting insulin is 8. My CK is mildly elevated at 189 with the upper reference limit being 171.

Overall, I have very few side effects from rosuvastatin and ezetimibe. Occasionally I notice mild muscle aches and perhaps some mood swings, but nothing significant. My cardiologist was able to get Repatha approved for me, and now I’m trying to decide whether it’s really necessary to start it.

I’m particularly interested in hearing what others would do in my situation. Would you start Repatha given my age, family history, and rising Lp(a)? Would you continue rosuvastatin 10 mg and ezetimibe 10 mg and simply add Repatha, or would you lower the rosuvastatin dose back to 5 mg if Repatha is added? Would anyone consider stopping rosuvastatin and using Repatha instead?

Part of my hesitation comes from reading negative experiences online involving Repatha, including reports of increased blood pressure, elevated blood sugar, severe muscle pain, and other side effects. Before my lifestyle changes, my blood pressure was around 155/90 and my resting heart rate was typically 95–110 bpm. Today my blood pressure is usually around 120/65 and my resting heart rate is 65–70 bpm, so I’m naturally cautious about adding another medication when I’ve worked hard to improve my health.

I’d really appreciate any insight, opinions, or personal experiences. Thank you.

Hi everyone,

I’m a 28-year-old male. After my mom had a premature heart attack (NSTEMI with one stent placed in the LAD), I started taking my health much more seriously. Over the last few years, I quit smoking, lost 38 kg (84 lbs), started exercising regularly, built muscle, cycle to work instead of driving, swim moderately, and follow a mostly Mediterranean diet. I’ve also reduced saturated fat and increased my fiber intake.

I’ve always had high LDL cholesterol since my teens, typically in the 150–167 mg/dL range, but I largely ignored it when I was younger. As far as family history goes, my mom had an NSTEMI in her early 50s and received one LAD stent. She was a heavy smoker and had uncontrolled high blood pressure for many years. One grandmother died at 83 after having multiple ischemic strokes, while my other grandmother died at 75 from kidney disease and a hemorrhagic stroke and had untreated high cholesterol.

After my lifestyle changes, I was able to lower my LDL to around 109–120 mg/dL without medication. I then checked additional markers and found my ApoB was 120 mg/dL and my Lp(a) was 97 nmol/L. What surprised me was that my Lp(a) continued to rise on repeat testing despite not taking any medications at the time. It went from 97 to 128, then 140, and then 148 nmol/L.

I eventually saw a cardiologist and underwent an ECG, echocardiogram, stress test, and CIMT, all of which were normal. My cardiologist prescribed rosuvastatin 5 mg and ezetimibe 10 mg. After six weeks, my LDL dropped to 64 mg/dL, my ApoB dropped to 61 mg/dL, but my Lp(a) increased to 168 nmol/L. The rosuvastatin dose was then increased to 10 mg while continuing ezetimibe 10 mg.

I recently repeated my labs. My LDL remains 64 mg/dL and my ApoB is now 64 mg/dL, but my Lp(a) has increased again to 183 nmol/L. My kidney function, liver enzymes, platelets, vitamin D, and hs-CRP are all normal. My HbA1c increased slightly from 5.1% to 5.3%, but my fasting glucose is 83 mg/dL and fasting insulin is 8. My CK is mildly elevated at 189 with the upper reference limit being 171.

Overall, I have very few side effects from rosuvastatin and ezetimibe. Occasionally I notice mild muscle aches and perhaps some mood swings, but nothing significant. My cardiologist was able to get Repatha approved for me, and now I’m trying to decide whether it’s really necessary to start it.

I’m particularly interested in hearing what others would do in my situation. Would you start Repatha given my age, family history, and rising Lp(a)? Would you continue rosuvastatin 10 mg and ezetimibe 10 mg and simply add Repatha, or would you lower the rosuvastatin dose back to 5 mg if Repatha is added? Would anyone consider stopping rosuvastatin and using Repatha instead?

Part of my hesitation comes from reading negative experiences online involving Repatha, including reports of increased blood pressure, elevated blood sugar, severe muscle pain, and other side effects. Before my lifestyle changes, my blood pressure was around 155/90 and my resting heart rate was typically 95–110 bpm. Today my blood pressure is usually around 120/65 and my resting heart rate is 65–70 bpm, so I’m naturally cautious about adding another medication when I’ve worked hard to improve my health.

I’d really appreciate any insight, opinions, or personal experiences. Thank you.

Hi everyone,
I’m a 28-year-old male. After my mom had a premature heart attack (NSTEMI with one stent placed in the LAD), I started taking my health much more seriously.
Over the last few years I:
Quit smoking
Lost 38 kg (84 lbs)
Started exercising regularly
Built muscle
Cycle to work instead of driving
Swim moderately
Follow a mostly Mediterranean diet
Reduced saturated fat and increased fiber intake
I’ve always had high LDL cholesterol since my teens (typically 150–167 mg/dL), but I largely ignored it when I was younger.
Family history is somewhat mixed:
Mom: NSTEMI in her early 50s, one LAD stent, heavy smoker, uncontrolled hypertension for many years
Maternal grandmother: died at 83 after multiple ischemic strokes (had 3 strokes total)
Paternal grandmother: died at 75 with kidney disease and a hemorrhagic stroke, had untreated high cholesterol
After my lifestyle changes, I was able to lower my LDL to around 109–120 mg/dL without medication.
I then checked additional markers:
ApoB: 120 mg/dL
Lp(a): 97 nmol/L
What surprised me was that my Lp(a) kept increasing on repeat testing despite no medications:
97 nmol/L
128 nmol/L
140 nmol/L
148 nmol/L
I saw a cardiologist and had:
ECG
Echocardiogram
Stress test
CIMT
Everything was normal.
My cardiologist then prescribed:
Rosuvastatin 5 mg
Ezetimibe 10 mg
After 6 weeks:
LDL: 64 mg/dL
ApoB: 61 mg/dL
Lp(a): 168 nmol/L
The dose was then increased to:
Rosuvastatin 10 mg
Ezetimibe 10 mg
I just repeated my labs:
LDL: 64 mg/dL
ApoB: 64 mg/dL
Lp(a): 183 nmol/L
HbA1c: 5.3% (previously 5.1%)
Fasting glucose: 83 mg/dL
Fasting insulin: 8
hs-CRP: normal
Kidney function: normal
Liver enzymes: normal
Platelets: normal
Vitamin D: normal
CK: 189 (upper limit 171)
I have essentially no significant side effects from rosuvastatin + ezetimibe. Occasionally I notice some mild muscle aches and maybe some mood swings, but nothing major.
My cardiologist has managed to get Repatha approved for me, and now I’m trying to decide whether it’s really necessary.
Questions:
Would you start Repatha in my situation?
Would you stay on rosuvastatin 10 mg + ezetimibe 10 mg and add Repatha?
Would you lower rosuvastatin back to 5 mg and add Repatha?
Would you stop rosuvastatin altogether and use Repatha instead?
One reason I’m hesitant is that I’ve read a lot of negative experiences online involving Repatha, including reports of increased blood pressure, elevated blood sugar, severe muscle pain, and other side effects.
For context, before my lifestyle changes:
BP was around 155/90
Resting heart rate was 95–110 bpm
Now:
BP is usually around 120/65
Resting heart rate is 65–70 bpm
Given my age, family history, current LDL/ApoB levels, and rising Lp(a), would you personally start Repatha if you were in my position?
I appreciate any insight or experiences. Thanks!