Is anyone on an Ezetimibe (Zetia) mono therapy?

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grommet
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Is anyone on an Ezetimibe (Zetia) mono therapy?

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I just got my heart balance test results back and unsurprisingly I'm showing as a slight hyperabsorber (screenshot attached).

Would it make sense to get a Zetia Rx for this use case? I'm currently on a super low dose Crestor (5 mg, 3x week) because I don't want to impact Desmosterol production due to my double ApoE4 status. Curious what others are doing to down regulate cholesterol on the absorption side of the ledger.

Thanks in advance!

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Re: Is anyone on an Ezetimibe (Zetia) mono therapy?

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Dr. Thomas Dayspring (who y'all know) recommended in the Attia podcast that he wants to see Desmosterol > 1 for his ApoE4 patients, hence my question.
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Re: Is anyone on an Ezetimibe (Zetia) mono therapy?

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Would it make sense to get a Zetia Rx for this use case? I'm currently on a super low dose Crestor (5 mg, 3x week) because I don't want to impact Desmosterol production due to my double ApoE4 status. Curious what others are doing to down regulate cholesterol on the absorption side of the ledger.
Hi grommet. I noticed that no one has responded to your question despite the fact that we've had lots of discussion about this. We've even had Dr. Dayspring join us on the site to answer E4 questions. Have you tried putting "zetia" in the search engine? I get over 17 pages of hits.

I'm a hyperabsorber as well as many of our E4 members, but don't feel the need to do anything about it as my lipids always look really good, i.e. ratios, LDL-P, etc. Would you mind sharing more of your results with us? I notice your overall cholesterol is quite low. Perhaps your overall risk is low enough that additional Pharma isn't necessary.
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Re: Is anyone on an Ezetimibe (Zetia) mono therapy?

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Julie G wrote: Fri Mar 03, 2023 12:26 pm I'm a hyperabsorber as well as many of our E4 members, but don't feel the need to do anything about it as my lipids always look really good, i.e. ratios, LDL-P, etc. Would you mind sharing more of your results with us? I notice your overall cholesterol is quite low. Perhaps your overall risk is low enough that additional Pharma isn't necessary.
Thanks for the response. My results are excellent, actually. Without statins, ApoB is 67 mg/dL, Trigs 65, HDL-C 61, LDL-C 91. The issue is my Lp(a) is higher than I'd like at 87 nmol/L so I'm taking Dr. Peter Attia's advice (who probably got it from Dayspring) to drive ApoB into the ground in order to take ASCVD risk off the table completely.

Oh, and my wife is also a double ε4 carrier if you can believe it, and her Lp(a) is double mine putting her at much higher risk. So I'm kind of asking for both of us.

Dayspring says a "baby dose" of a statin won't affect Desmosterol production but he *did* say he'd like to see production above 1 mg/L for ApoE4 carriers which I'm slightly below, hence my question. And yes I'm probably over-optimizing but isn't that what we do here? :D
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Re: Is anyone on an Ezetimibe (Zetia) mono therapy?

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I am on the same journey, doing my cholesterol balance test next week. I am either a hyper absorber or responder or both. Through low saturated fat diet I was able to bring my numbers into a better place but still LDL is 140 and Apoeb is 100, lp(a) and others are great. Once I get the test back I will try to refine my diet based on that. If I am hyperabsorber then I plan to propose Zetia as a mono therapy. My wife's sister is on it as a single therapy in Japan. If I have to take a statin, it will be Pravastatin at 20 mg to start as it is hydrophilic and less likely to cross the blood brain barrier (so is Livelo and Crestor).
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Re: Is anyone on an Ezetimibe (Zetia) mono therapy?

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Issadore wrote: Fri Mar 17, 2023 12:31 pm I am on the same journey, doing my cholesterol balance test next week. I am either a hyper absorber or responder or both. Through low saturated fat diet I was able to bring my numbers into a better place but still LDL is 140 and Apoeb is 100, lp(a) and others are great. Once I get the test back I will try to refine my diet based on that. If I am hyperabsorber then I plan to propose Zetia as a mono therapy. My wife's sister is on it as a single therapy in Japan. If I have to take a statin, it will be Pravastatin at 20 mg to start as it is hydrophilic and less likely to cross the blood brain barrier (so is Livelo and Crestor).
Hello Issadore,

I applaud you on your focus in gathering more information about yourself, as well as making lifestyle changes and learning about various treatment options.

As a Support Team Intern, I'd like to welcome you to the forum. Thanks for posting! I'll share some tools/resources you can use to explore the site, helping you get the most out of your experience.

The Primer is a detailed and informative resource written by a practicing M.D. with ApoE4/4. It includes information about the biochemistry of the ApoE4 gene and offers a variety of research-based prevention strategies.

Some helpful tips to navigate the site include the How-To Guide. It includes topics such as navigating the forum, private messaging, and searching. One great tip is using the quote (") button when replying to a post. Using the button will automatically alert the member of your response.

If you are interested in learning more about other members, you can check out Our Stories.

I'm so glad you joined and look forward to meeting you around the forum. Please feel free to reach out anytime.

Warmly,

Jane
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Re: Is anyone on an Ezetimibe (Zetia) mono therapy?

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Issadore wrote: Fri Mar 17, 2023 12:31 pm I am on the same journey, doing my cholesterol balance test next week. I am either a hyper absorber or responder or both. Through low saturated fat diet I was able to bring my numbers into a better place but still LDL is 140 and Apoeb is 100, lp(a) and others are great. Once I get the test back I will try to refine my diet based on that. If I am hyperabsorber then I plan to propose Zetia as a mono therapy. My wife's sister is on it as a single therapy in Japan. If I have to take a statin, it will be Pravastatin at 20 mg to start as it is hydrophilic and less likely to cross the blood brain barrier (so is Livelo and Crestor).
Thanks for the reply! Please post your results if you decide to go down the Zetia route. I would love to see how that moves the needle for hyperabsorbers specifically.

On a related note, I had pretty good results taking 2.5 mg/day rosuvastatin with a 30% reduction of LDL-C down to 66 mg/dL. But my ApoB didn’t budge! It was already great @ 66 mg/dL but I expected a similar drop. I’m perplexed!
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