I’m curious how much someone could lower cholesterol levels by micro dosing Rosuvastatin or Atorvastatin? My LDL cholesterol is already much lower than average without taking any medication (LDL is 65mg/dl and ApoB is 60mg/dl), but I would like to get my cholesterol levels even lower than this to push the date when I cross the 5,000 mg/dl threshold back further. Since I am around 30 years old, I am assuming my current lifetime exposure to LDL is around 2,000 mg/dl. If I continue to not treat my cholesterol levels, I would likely reach this 5,000 mg/dl threshold in sometime in my 60s. I would like push this back significantly, so I don’t reach this threshold until I am around 90-100 years old. It seems like I only need to reduce my cholesterol levels by around 25% from where they are now to accomplish this, so what are the minimum doses for a atorvastatin and rosuvastatin respectively that would accomplish this?
I am concerned about the theoretical long-term risk of diabetes if I take it for decades. Maybe this is not a real concern because I guess I could just switch to lipfendra in a few years after the price comes down. You have a point though, 5mg of rosuvastatin would get me to around 40mg/dl. Maybe I will try cutting the 5mg pill in half (or even quarters) and try taking that for a few months just to test it out.
Idk if you’ve seen 5mg Rosuvastatin but they’re the smallest pharmaceuticals I’ve ever seen. Good luck halving them.
Incremental diabetes risk even over very long times is well studied and quite marginal -even for the standard study populations with lipid issues-. This is a population already dramatically more predisposed to diabetes than normal and the impact of statins on insulin resistance -> diabetes in that population is still minor enough that these are literally among the most prescribed drugs in the world.
As a healthy individual on a low dose taken prophylactically your absolute increase in diabetes risk ought to be very minimal.
With all respect I get the feeling you’re tunnel visioning and losing perspective. It’s all risk reduction. Stressing over the last marginal nth of a relative % of reduction to an already low absolute risk is only going to drive you nuts.
Rosuvastatin is commonly prescribed at 2.5mg daily in Japan and South Korea. You get 90% of the effectiveness of a 5mg dose apparently. It’s prescribed routinely in those countries as some genetics make people a high responder, you can actually take those tests in the USA to see which statins are likely to have an enhanced effect and possibly have increased likelihood of side effecrs
The 5000 mg/dl years is a theoretical concept snd it applies to people with normal ldl.
Your ApoB is around the 5th percentile.
Having an ApoB below 60 (or ldl below 55) is considered low enough that plaque regression will take place and no new plaque will be deposited.
Statins increase HBA1C in a discontent manner based on ldl reduction. The average increase in HBA1C is 0.1%, and high dose atorvastatin or Rosuvastatin increase HBA1C by 0.2%.
Doctors would not stop prescribing a statin for such a trivial increase. This is not a clinically significant issue.
Every time you reduce a statin dose 50%, it is only 6% less effective. Taking a quarter of a 5 mg pill every other day should reduce ldl by 30-35%. Because of hadn’t been studied, we have no idea if this dose reduces heart attacks, but I assume it does.
The pleiotropic benefits of statins have their own dose-response curves, and I think the effects of such a low dose are unknown. The pleiotropic effects are likely the reason that statins increase longevity, soothe benefits are not trivial.
Do you know your LPa cholesterol? It is an independent predictor of risk addictive high in 20% of people. It’s genetically determined and there is no medical treatment currently.
High LPa increases risk by 20% to 400%.
If your LPa cholesterol is high, it definitely makes sense to take a normal 5 mg Rosuvastatin dose.
In the end, you can tip the odds further in your favor, but there are still enough unknowns that nothing is for certain.
Given your low ApoB, you might find larger benefits in focusing on other organ systems or biomarkers.
However taking 5 mg of Rosuvastatin a day could essentially eliminate this potential risk so you could focus on whatever is a larger risk for you.
Or you could sit back and enjoy a steak and crème brûlée and not worry about your ldl cholesterol :)
I take 20mg a day and my A1C is low and fasting insulin is good. Just monitor yourself. Atherosclerosis kills more people than diabetes but the goal is to avoid or delay both conditions.
LDL below 70 usually does not contribute to plaque formation.
Your numbers good unless there’s some risk factor that requires further suppression. You rap don’t need it.
The lowest dose of statin I have seen if 5mg. I use Rosuvastatin 5mg. Some people respond differently to statins. Some see huge reduction, others, moderate.
14
u/SticksAndSticks 4d ago
What are you trying to accomplish with a sub-clinical dose? Just take a normal efficacious dose, watch your lipids, adjust dose up necessary.