I'm still taking 500mg of extended-release niacin twice a day, and am tolerating it reasonably well. I just dropped the NSAID I was taking with it to suppress flushing, and things seem ok, but I probably need to double the dose of the niacin yet. I dropped the 10mg Lipitor due to muscle pain. I have a bottle of a newer hydrophilic statin called Livalo (pitavastatin) that is supposed to be a lot better with respect to side effects, but I haven't started it yet. I think that given the state of my coronary arteries, I might nuke the whole statin idea.
I still have some concern that the atherogenicity of lp(a) is more of a problem for cerebral arteries than coronary, and have a couple pieces of family history that back that up: My younger, healthier brother had some carotid plaque show up on ultrasound, and there's a history of stroke and TIA's on my mother's side. I'd like to get a carotid ultrasound to see what's going on there.
- Wasn't particle side relevant to LDL rather than HDL in the VAP test? I assume I also succeed to skew LDL toward pattern A (large) with a low carb diet. I think that was the most important change I made as also reflected in my low TG level.
- Is it the first time you test your calcium score? I also have it low (3, not zero unfortunately) but I am happy at least to have it maintained so after 5 years. It is recommended to always test the calcium score on the same machine.
- Have you checked any change in your homocysteine and liver enzymes after supplementing with high doses of niacin? I am also considering this. I am giving a try with RYR before possibly use niacin (or a statin). Fortunately my lp(a) seems in check.