u/The_Illa_Vanilla

I wanted to share my results because I know how discouraging it can feel to discover you have high cholesterol or very high Lp(a), especially if you also can’t tolerate statins.

I started Repatha about two-three months ago and honestly wasn’t sure what to expect, especially after how sick statins made me. Here are my before and after numbers:

LDL-C: 135 → 70
ApoB: 115 → 68
Non-HDL: 174 → 94
LDL particle number: 2,002 → 936
Small LDL: 299 → 130
Medium LDL: 446 → 173
Triglycerides: 254 → 163
HDL: stayed at 65
Lp(a): 247 → 230 nmol/L

My LDL particle count dropped by more than half, and my small and medium LDL are now within the normal range. Seeing that was honestly amazing. It wasn’t just the standard LDL number improving. The overall number of potentially harmful particles in my blood came way down too. I think of it like the traffic on a jammed freeway literally being cut in half (best way I can visualize it lmao).

My Lp(a) is still extremely high, which I expected since Repatha usually only lowers it modestly. It’s basically just going to be an uphill battle the rest of my life, so I’m very open to the idea of medically pushing my LDL as low as possible.

Because of my Lp(a), my doctor would still like my LDL closer to 55. We’re going to give Repatha and some lifestyle changes a few more months (I’ve transitioned primarily to a vegetarian diet which I really don’t mind at all) then possibly add ezetimibe if my LDL stays around 70. It sounds like that could lower it another 15 to 20% and potentially help my triglycerides a little as well.

I’m sharing this mostly to encourage anyone who feels stuck after not tolerating statins or who is nervous about starting a PCSK9 inhibitor. Everyone responds differently, but not tolerating one medication doesn’t mean you’re out of options. I went from feeling pretty discouraged about these numbers and resigning to the fact I’d likely experience a major cardiac event in my lifetime to seeing a major improvement in only a couple of months.

Has anyone here combined Repatha with ezetimibe? I’d be interested to hear how much additional improvement you saw and how you tolerated it.

I wanted to share my results because I know how discouraging it can feel to discover you have high cholesterol or very high Lp(a), especially if you also can’t tolerate statins.

I started Repatha about two-three months ago and honestly wasn’t sure what to expect, especially after how sick statins made me. Here are my before and after numbers:

LDL-C: 135 → 70
ApoB: 115 → 68
Non-HDL: 174 → 94
LDL particle number: 2,002 → 936
Small LDL: 299 → 130
Medium LDL: 446 → 173
Triglycerides: 254 → 163
HDL: stayed at 65
Lp(a): 247 → 230 nmol/L

My LDL particle count dropped by more than half, and my small and medium LDL are now within the normal range. Seeing that was honestly amazing. It wasn’t just the standard LDL number improving. The overall number of potentially harmful particles in my blood came way down too. I think of it like the traffic on a jammed freeway literally being cut in half (best way I can visualize it lmao).

My Lp(a) is still extremely high, which I expected since Repatha usually only lowers it modestly. It’s basically just going to be an uphill battle the rest of my life, so I’m very open to the idea of medically pushing my LDL as low as possible.

Because of my Lp(a), my doctor would still like my LDL closer to 55. We’re going to give Repatha and some lifestyle changes a few more months (I’ve transitioned primarily to a vegetarian diet which I really don’t mind at all) then possibly add ezetimibe if my LDL stays around 70. It sounds like that could lower it another 15 to 20% and potentially help my triglycerides a little as well.

I’m sharing this mostly to encourage anyone who feels stuck after not tolerating statins or who is nervous about starting a PCSK9 inhibitor. Everyone responds differently, but not tolerating one medication doesn’t mean you’re out of options. I went from feeling pretty discouraged about these numbers and resigning to the fact I’d likely experience a major cardiac event in my lifetime to seeing a major improvement in only a couple of months.

Has anyone here combined Repatha with ezetimibe? I’d be interested to hear how much additional improvement you saw and how you tolerated it.