^^ Only change made between Nov-Mar was restart weightlighting after 6 months, 20-30min daily walking cardio, fish oil, soy lecithin, flax & chia seeds, EVOO, ACV, high fiber diet, cut out most junk food, chicken + fish + dairy for protein. 1 clove raw garlic daily. Sleep is irregular and stress is very high.
Mysterious normalization of lipids from 2012-2015 and again in 2018.
2012-2015: no workout, fast food daily, smoking half pack daily, lot of junk food, low stress + proper sleep + near 10,000 steps walking daily.
For someone with a goal of reducing their cholesterol, you’ve made significant strides.
When that was my goal, I found that employing Metamucil daily seemed to help as well. You already mentioned a high fiber diet, so it may be a non-issue, but I employed it specifically before meals.
Flameout won’t necessarily REDUCE cholesterol, but I imagine it can have a positive contribution to HDL.
I had a GI illness in oct 2024 which required temporarily cutting out fiber from diet (maybe that also negatively affected the lipid profile). Psyllium husk was causing major issues. But I’ve restarted it recently.
I went through the same thing, and completely eliminated fiber from my diet. I’m glad I did, but I imagine my blood lipid profile isn’t one that most would strive for.
Zero fiber almost certainly was not good for your November test. I agree with the others, everything seems headed in the right direction.
After I read your first post I was going to suggest psyllium husk, but you’ve already started it again. I’ve always found regularly eating oatmeal helps me drop my numbers or keep them low – I’m not sure if that’s the oatmeal itself or just the fact that its got a lot of fiber in it. But if you aren’t eating that, you might try adding it. Finally, I have found that being really, really mindful of avoiding saturated fat has always helped me get my numbers down.
You might also think about getting your LP(a) tested, especially if your family history of high cholesterol also includes heart disease.
You likely have a genetic component here… and that doesn’t necessarily mean familial hypercholesterolemia of some sort (defect on LDL receptor or defect with regards to another pathway modulating lipid metabolism)
Genetic predisposition can also predispose one to more pronounced impact from deleterious lifestyle choices
On average diet and exercise can mediate a 10-20% difference for HDL/LDL (although trigs are more prone to influence by diet and lifestyle)
exceptions exist for metabolic syndrome etc wherein lifestyle can mediate a profound difference in terms of normalizing cardiometabolic risk factors
It’s very possible you are uniquely predisposed to lipid destruction from poor lifestyle choices however you have mentioned high cholesterol runs in the family… how high? Your lipids aren’t great. HDL is low, LDL is high, trigs are high (HDL/trig ratio is very important)
Not smoking, not drinking, cardio, certain supplements like psillium husk etc help. Many resort to taking red yeast rice but if you want to avoid meds then you’d want to avoid this as legit RYR is the same as taking lovastatin albeit in an unregulated manner where it’s impossible to know what dose you are on.
Before my mother began statins for the first time (when she was 36), her TC was 20mmol/L (770+ mg/dL). Doc made the lab retest her lipids 3 times to confirm that the numbers are correct. She was otherwise healthy, non obese, never smoked or drank, with a decent diet. That was near 30 years ago. I don’t know about dad but he is also on statins for 10+ years. Grandpa succumbed to a heart attack in his 50s (pretty certain statins were not easily available at the time).
TG:HDL ratio from latest test is at 1.78.
I don’t want RYR for precisely that reason you mentioned. But many of the other ingredients, like garlic and bergamot, also work on the same mechanism as statins (HMG-CoA reductase inhibition), although I don’t know if they have the same side effects hence asking others for their experience.
I read a bunch of studies on soy lecithin and heard from people that it reduces LDL very quickly (something like upto 40% within two months), so i began taking it in Nov 2024. But the test in Mar 2025 did not show anywhere close to a 40% reduction. Later after November i read a major meta analysis on soy lecithin confirming the earlier results but adding that it paradoxically increases the risk of atherosclerosis while increasing HDL and reducing LDL (with the TMAO metabolite rising in the blood, being extremely atherosclerotic). Since then, I’ve cut down on it. Doc said they cannot test for TMAO unless you got some severe metabolic disease. I’m particularly worried because one lady i spoke to said she got a carotid dissection (mini stroke) due to prolonged soy lecithin use (her LDL dropped to 1.0mmol/L).
I think my hepatic LDL receptors (for clearing serum LDL) may indeed be dysfunctional because the LDL drop wasn’t that much despite taking multiple LDL-reducing foods.
2012-2015 & 2018 lipid normalization are the real mystery. The only major difference in these years compared to others is that I was very active in cardio. In 2018, i had a somewhat clean diet with 300+ minutes / week of jogging cardio and 2-3 hours of competitive squash / week. 2012-2015 i walked +10k steps daily, sometimes as high as 27k with avg ~14k. Could cardio alone really make all the difference?
This stuff can be really weird at an individual level, which makes it hard to recommend with regard to specific circumstances. Being familiar with the latest lit on the subject, as you are, can be frustrating when you’re looking for a good direction to go and not finding one.
BUT, if thats what does it for you, then by all means, do it. .
Statins can be tricky/difficult. Theres a lot of mix & match with the treatment recommendations matrix that is used currently. Like, Since a STEMI in 2019 I’ve been on and off numerous meds to find a sweet spot for a while, then something changes and we do it again. Most recently was a beta-blocker that was great for almost 5 years, then started working Way too good.
I really like atenolol and metoprolol. The cardioselective beta blockers work wonders!
I have a genetic condition and my heart sometimes goes a bit nuts secondarily to it
On beta blockers I’m asymptomatic 100% of the time
For lipids I like rosuvastatin
I also like ezetimbe but statins have that added benefit of not only reducing lipid perioxidation but also blocking production of ROS… so it’s not just lowering the cholesterol thst makes statins cardio protective
Outside of statins pcsk-9 inhibitors are also really effective with essentially none of the statin side effects but I don’t think you can qualify for them unless you get a FH/lipid metabolism disorder type diagnosis
Yeah. Metoprolol was great for quite a while, then boom. It floored me like my heart was going to stop completely.
Stopped it, and it has been clear sailing since.
I’ve been hesitant about those. My personal fear is of a bad reaction, and once injected, it ain’t coming back out. Just my own strange twist, I think.
My doc said it isn’t approved yet in Canada or not fully available. And that you can only get it if traditional interventions (like statins) are not working.
Myself, I’m always wary of new drugs due to lack of usage data. The CETP inhibitors were also marketed this way and the first couple phases of trials resulted in what 140,000 premature deaths?
Your family doctor or primary care practitioner is best placed to advise you and do proper tests. More than 1/3 of adults have high lipids.
The goal is to lower the risk of heart problems, so the first things to try are reducing smoking, lose weight if needed (2% weight loss may lower LDL by 6%), control blood sugars and pressure, strength train, and do aerobic exercise for half an hour 3-4 times a week, reduce desserts and saturated fat ratios, and eat more veg, whole fruits, nuts and fiber. Only 1/3 of those with high lipids can fully improve it with diet alone, in many the liver just makes too much LDL. Diet lowered LDL 13% in a 2011 JAMA study.
Statins are good medications and especially important if diabetic, high risk or with a history of MI, stroke or arterial disease. Up to 5% get mild muscle toxicity, but true myositis or rhabdomyolysis is closer to 0.1-0.5% - and these may be lower with fluvastatin. Many lower LDL 20-40%, some are more intense at higher dosage.
Niacin (vitamin B3) is a reasonable alternative if you want something cheap and effective, but many dislike the flushing and itching, which diminishes after a week or so. It lowers both LDL and TG by 10-30%, lowers Lp(a) and raises HDL 25-35% and is better than all the alternatives you mentioned. High dose fish oil may improve TG. Discuss these with your doctor. Unless you are high risk, you likely do not need a PCSK9 inhibitor, though these can lower LDL by 60%.
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