Apoe4, Statins, Cholesterol, APOB, LP (A)

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Kay1855
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Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by Kay1855 »

Dear friends,

Does anyone know what science stands on treating high cholesterol parts in APOE4 people?

My througts/ questions:

Apoe4s have problem with lipids transport.
I have high LP(a) around 100mgd
My cholesterol and LDL consider normal for people with out high LP(A)
Total 190-210
LDL 96
Trigs 44
HDL 51
LP(a) 100mgd (258nml)
APoB 90 (0.92)

For healthy 40 yo fit women is good.BUT! here is how my cardiologits calculated my risk:

1. Primary relative ( father) had CVD before 55 +1
2.Primary relative ( father) died from CVD before 55 + 1
3. High LP(a) +1
4. Thickening of cartoid artery (not official plaque but arteriosclerosis started) +1. (CAC is 0)
5. Apoe 4 +1 (Not sure if the last one is in official calculation but she through it saying it does not help)

SO I am with my LDL 96 is a high risk for CVD even though I am fit, great diet and exercise everyday, regular period.
She put me on satins which has to lower my LDL to 69 where I will decrease my risk to low.

I decided to give it a try and surprisingly enough after one month it did not move my LDL, I doubled the dose and after second month it did nothing. Due to other issues I decided to put it on hold.


But the big question how statins affect memory, I am aware that they may affect mitochondria and that's why some recommend Q10, but it was a lot of noise ( even cardiologist mentioned that they used to think that stains may contribute to dementia but not anymore)


Dr. Peter Attia is for treating arthosclerossis aggressively and talks a lot about Alz treatment too, never heard him mentioning statin memory connection.

Could someone please with some science data on this point me to links?

I am not going to go Keto, Carnivore, I tried and it negatively affecting my cholesterol and I am not going to pretend that cholesterol does not matter ( in my case) . I am grain free, junk free, fruits free ( except berries) , plant based mostly. SO I think any change on diest are deminishing returns if any

Also what is dr. Bresden official position on statins?

Recent podcast review studies conclude that statins do not affect memory:

Thank you
Kay
Last edited by Kay1855 on Sat May 20, 2023 10:24 am, edited 1 time in total.
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floramaria
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by floramaria »

Kay1855 wrote: Sat May 20, 2023 10:22 am Does anyone know what science stands on treating high cholesterol parts in APOE4 people?
Hi Kay1855, I don’t think there is really a consensus about treating high cholesterol, or even what constitutes “high”.
To me, your numbers look pretty good. I’m not a doctor, though. My sense is that even among cardiologists, there is a great deal of disagreement. What I have done for myself is to read and make my decisions based on that. We have a great Wiki that may help you to make decisions regarding your lipids and whether you want and/or need to treat.

https://wiki.apoe4.info/wiki/Cholestero ... ng_statins

I just reread parts of it, starting with the link in the Wiki to “Lipids” section in the Primer. There is a lot of excellent information and links to even more information if you want to dive deeper.

As far as I know, when it is determined that a statin is necessary, Dr Bredesen is still recommending a
low doses of a hydrophilic statin combined with ezetimibe. That combo can help lower LDL-P without having negative impact on cholesterol synthesis in the brain. ( paraphrased from pg 126 The End of Alzheimer’s Program.) Book was published in 2020; I’ve also heard him say that more recently.
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by Kay1855 »

FloraMaria,

Thank you so much! Very informative for me.
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by lumia »

I wonder where to find cardiologists--or maybe even doctors--who have knowledge of this? My numbers seems worse than the OP:

LP(a) 158.9 nmol/L (December 2022)
Thickening of cartoid artery: None
----
(The following are about a week ago, all in mg/dL)
Total cholesterol: 227
HDL: 63.9
(i.e. non-HDL of 163.1)
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by Quantifier »

Kay1855 wrote: Sat May 20, 2023 10:22 am
My understanding of the current thinking among cardiologists and doctors of related specialties is that what matters is the total exposure to atherogenic particles over time - ie long exposure to not-so-high levels of ApoB+ particles is equivalent to shorter exposure to higher levels of ApoB+ particles. So they prefer to set lower targets for younger people, especially if some other risk factor is present, such as family history. OTOH, said family history may be less relevant if the relative (such as your father, in your case) had a higher risk lifestyle (for example, my dad smoked from teenage to age 57, when he had a heart attack; he then quit smoking and is now healthy in his 80s, taking only aspirin, no other drugs - I doubt this means much for me).

I looked for information on statins and cognitive effects, and found Effect of Statin Therapy on Cognitive Decline and Incident Dementia in Older Adults (I hope I can link the pdf here )

They had over 18,000 participants, all over 65 years old, with average follow up of 4.7 years. They found no significant differences between statin users and non-users, nor between users of hydrophilic vs lipophilic statins in terms of developing dementia or MCI. However, they did not test for ApoE status, so we do not know if their conclusions apply equally to ApoE4 carriers vs non-carriers.

I have seen a few other papers reporting results in the same spirit, and neither of them recorded the ApoE status of participants. I haven't found reports that stratified participants by ApoE status or that looked specifically at ApoE4 carriers. The advice to prefer hydrophilic statins makes sense, but is not based on patient data (there just doesn't seem to be any). But if in your case the statin didn't work, you may want to look at other types of lipid-lowering drugs, either on their own or in combination with a statin.

Good luck in your search for long term health!
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by Plumster »

Kay1855,

I can't see the podcast to which you refer, so perhaps it is this one, but I was reminded of Dean and Ayeesha Sherzai's recent podcast "Statins and Risk of Alzheimer's Disease" in which they recommend statins when necessary and discuss this meta analysis on statin use and AD.
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by Kay1855 »

Thank you!
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by dewey »

I just listened to a podcast by Dr. Attia that went over multiple studies showing a reduction in risk using statins. It's podcast #251. Have you tried statins again or taken another route?

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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by Glampers »

Hi, I'm 57 and have always had high total cholesterol despite healthy diet exercise low BMI. Learning i'm homozygous for AP0e4 explains a lot about why I could never get it down. My mother was exactly the same in terms of behaviors, and stubborn high cholesterol. My doctor finally put me on a low dose statin as she said they protected from vascular dementia but not Alzheimer's, but since I don't want that one either, I agreed! I also figure that since being homozygous also is associated with heart disease, I want to be an overachiever when it comes to cholesterol. I'm a medical researcher myself and statins are old, known drugs and their safety profile is good. I'm all in.
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Re: Apoe4, Statins, Cholesterol, APOB, LP (A)

Post by Kay1855 »

Yes, i was on statin until couple days ago. I did a test and it does not move it again for me. I dont know what is going on, talk to integrative cardiologist he told me 6 months wont change anything , i am for ibd treatment with bunch of other drugs which may impact my cholesterol unfavorably, so for now I stick with vitamin c lysine proline protocol plus bergamot and lectin free keto diet low/ none saturated fat diet in order to deal with gut issues, when I fix this I will recheck lipids again. For now he told me dont stress out it is inflammation the problem not cholesterol.
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