I Changed My Mind on Cholesterol Medications (After 7 Years)
In a Nutshell
After 7 years of refusing statins despite total cholesterol over 700 and LDL near 600—caused by keto-induced lipid energy model in a lean, metabolically healthy body—the speaker now starts ezetimibe and bempedoic acid, not for heart risk, but for their proven neuroprotective effects against Alzheimer's due to carrying two APOE4 gene copies. These drugs reduce amyloid buildup, tau aggregation, and improve brain autophagy independently of cholesterol-lowering. Upcoming coronary CT angiography will test if extreme cholesterol clogged arteries; key lesson: probe mechanisms, embrace uncertainty, and prioritize holistic risk-benefit over rigid guidelines.
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With unmedicated cholesterol over 700 and LDL cholesterol of 574, most doctors never see these numbers. Context: flagged high around 130; 190 raises concern for genetic condition; 300 is alarming; 500 prompts immediate statins or dire warnings. Total over 700 with LDL near 600 is medical case report level, with several case reports on the speaker. Doctors initially thought lab typo. For nearly 7 years, refused medication, tried some experimentally for no more than 6 weeks, experienced unpleasant side effects like with statins: "But I just feel terrible. Just feels."
Ruthlessly chastised for recklessness; Harvard Medical School peer said dumber than riding motorcycle drunk without helmet. Textbooks say 30-year-old with these levels should be dead. Initially terrified, thought early grave, but intensely curious: why so high, what does it mean?
After years of scrutiny, chastised by colleagues, fired by doctors, mocked for refusing statins, changing tone: starting two cholesterol-lowering medications. Not a stunt; not for heart health, but brain health.
Four chapters:
- Chapter 1: 700 cholesterol and not a lab error – initial reaction.
- Chapter 2: Why refused medications for 7 years.
- Chapter 3: Plot twist – what changed, why reconsidering. Three plot twists: (1) taking cholesterol-lowering meds; (2) why (not clear-cut); (3) wait and see.
- Chapter 4: How to think when guidelines don't fit – case study in difficult medical decisions, transparent lens into thinking process.
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