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FDA approves new kind of cholesterol pill

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Re: FDA approves new kind of cholesterol pill

#41

Post by jghn »

rubiquity wrote: post #36
pinkmuffinere wrote: post #26

Earlier quoted context omitted.

It’s possible the comments have changed, but I see nothing in the thread about mass loss. I do agree about weight though — losing weight is largely diet. > Go from obese to not obese and the median person's cholesterol will drop quite a bit. This is really interesting, I don’t think I’ve heard that before. Do you have a source you could share? Edit: this doesn’t necessarily prove you wrong, but this paper argues ther…

There isn't. I'm 15% body fat, eat healthy (avoid saturated fats, prioritize fiber), exercise 5-6 times per week, and have hypercholesterolemia. I, along with my parents, have very high LDL and ApoB and nothing I can do about it in terms of diet, exercise, or weight. I'm also not uncommon. They suspect as much of 30% of the population could be like this. There's a lot of ignorance in this thread.

There's a difference between always being hypercholesterolemia as a fit person and being obese and losing a bunch of weight when it comes to these conversations.

It's one f those things where some people's "I can't help it!" claims are true, but many are not. That doesn't invalidate the first category even though most people in the category are in the latter.

Re: FDA approves new kind of cholesterol pill

#42

Post by shermantanktop »

dev_l1x_be wrote: post #27
hankbond wrote: post #6

What is the current state of understanding on high cholesterol as a leading or trailing indicator of poor health? I vaguely remember reading one theory that cholesterol was used by the body to mitigate arterial damage from other causes?

You should check which part of your body has the most cholesterol.

How would I check the parts of my body for that?

Re: FDA approves new kind of cholesterol pill

#43

Post by jghn »

pinkmuffinere wrote: post #39
jghn wrote: post #35

Earlier quoted context omitted.

for the most part mass == weight on Earth. Triglycerides & HDL are affected by weight (tho more triglycerides than anything else), e.g. Wing 2011.

> for the most part mass == weight on Earth. The thread above us discusses neither mass nor weight. Here it is copied in full -- I encourage you to use ctrl-f > mediumsmart 1 hour ago > One could eat healthy instead of course but hey, the good life. > shlant 1 hour ago > you didn't read the article did you? Or are you actually here to claim that people with hypercholesterolemia just need to eat better? > Do you have…

[flagged]

Re: FDA approves new kind of cholesterol pill

#44

Post by stavros »

eternauta3k wrote: post #19
hankbond wrote: post #6

What is the current state of understanding on high cholesterol as a leading or trailing indicator of poor health? I vaguely remember reading one theory that cholesterol was used by the body to mitigate arterial damage from other causes?

Peter Attia had a great series of blog posts on this before his fall from grace: https://peterattiamd.com/the-straight-dope-on-cholesterol-pa... He also had a series of podcast interviews about this with Tom Dayspring. I believe his explanations are all mainstream, except he favors treating LDL and LP(a) more aggressively than normal doctors

Wait, why did he fall from grace?

Re: FDA approves new kind of cholesterol pill

#45

Post by grep_name »

barnacs wrote: post #25
hankbond wrote: post #6

What is the current state of understanding on high cholesterol as a leading or trailing indicator of poor health? I vaguely remember reading one theory that cholesterol was used by the body to mitigate arterial damage from other causes?

It turns out LDL has different subfractions based on size. Normally, the liver produces large ones which shuttle fat around the bloodstream, lose their payload and shrink then the liver reabsorbs them and the cycle continues. The problem appears to begin when these LDL molecules hang around for too long. They are damaged by external factors in the bloodstream (eg. glycation due to high blood glucose, oxidation due to…

I have heard this too, and that cholesterol measurements are flawed because they don't account for particle size. That you can actually have better 'numbers' but worse results, if you reduce particulate size but also overall volume. It's frustrating that the science behind cholesterol is constantly in wild flux, but at any discrete moment you're expected to accept whatever the momentary consensus is.

Interestingly, my dentist, who also has a bit of a fixation on cholesterol on a personal level and is educated on the matter, has said that a heart calcium scan is the best way to determine what someone's target cholesterol number should actually be, and that it should not be the same from person to person.

This was after I voiced my frustration to him at having made lifestyle changes to get my cholesterol down in order to avoid getting put on statins (not wanting yet another daily drug if I can avoid it), getting the my number below the target of 110, only to shortly after that find out that they'd lowered it to 70. I talked to my endocrinologist about it, and she basically said "yeah, those numbers are more-or-less unachievable. But we want to be extra careful for type 1 diabetics, so we hold them to a higher standard. Either way, everyone gets put on statins at some point anyway, so who cares?"

I'm absolutely allergic to "everyone goes on x medication, so stop whining and go on x medication" as a medical argument, and will probably just deal with being labelled non-compliant over this one unless my cholesterol reaches a level I actually personally find to be too high at this point. Which sucks to have to do, but hey, it's my body after all, and so far doctors have failed to make a convincing case for me personally here.

Re: FDA approves new kind of cholesterol pill

#46

Post by h2aichat »

deanc wrote: post #20
mediumsmart wrote: post #7

One could eat healthy instead of course but hey, the good life .

Many people have high cholesterol due to genetics. In these cases even if you ate a 100% perfect diet it would only impact 25% of your cholesterol levels - which any physician would not be satisfied with.

That's the good news! It fixes that genetic problem (PCSK9 Inhibitor)

Re: FDA approves new kind of cholesterol pill

#47

Post by messel »

stavros wrote: post #44
eternauta3k wrote: post #19

Earlier quoted context omitted.

Peter Attia had a great series of blog posts on this before his fall from grace: https://peterattiamd.com/the-straight-dope-on-cholesterol-pa... He also had a series of podcast interviews about this with Tom Dayspring. I believe his explanations are all mainstream, except he favors treating LDL and LP(a) more aggressively than normal doctors

Wait, why did he fall from grace?

I didn't know either, not sure of veracity but https://share.gemini.google/0YDt55yyfITs

Re: FDA approves new kind of cholesterol pill

#48

Post by Scoundreller »

grep_name wrote: post #45
barnacs wrote: post #25

Earlier quoted context omitted.

It turns out LDL has different subfractions based on size. Normally, the liver produces large ones which shuttle fat around the bloodstream, lose their payload and shrink then the liver reabsorbs them and the cycle continues. The problem appears to begin when these LDL molecules hang around for too long. They are damaged by external factors in the bloodstream (eg. glycation due to high blood glucose, oxidation due to…

I have heard this too, and that cholesterol measurements are flawed because they don't account for particle size. That you can actually have better 'numbers' but worse results, if you reduce particulate size but also overall volume. It's frustrating that the science behind cholesterol is constantly in wild flux, but at any discrete moment you're expected to accept whatever the momentary consensus is. Interestingly, m…

You might be missing out on any benefits from statins that are independent of the cholesterol reduction. It’s non-zero and debatably substantial.

Re: FDA approves new kind of cholesterol pill

#50

Post by sneak »

It works via the same mechanism as an incredible drug called Repatha (generic name evolocumab), but Repatha is quite expensive, requires refrigeration, and must be injected subcutaneously every two weeks. The news here is that this is administered orally.
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