Repatha along with pravastatin 10 mg and ezetimibe

@astohrer Hi what can you take for the high lp(a)?

@auntdina there is no treatment for high Lp(a) yet, though there are some in the research pipeline. Some people respond to a healthy diet and exercise, some respond to medications such as statins or Repatha. Mostly this is a genetic problem that is not controllable.

I thought to give a bit more information about my particular situation with regard to my cholesterol. I was unlucky in the roll of the genetic dice in that my father was 100% Northern Italian and he had the apo A-I Milano gene. His cholesterol never went above 130 his entire life, and he exercised very little and ate whatever he liked. I have heterozygous hyperlipidemia inherited from my mother. Her cholesterol was 300+ most of her adult life, and like me, she could not tolerate statins.

In my own case, I had three episodes in my mid forties that caused my cardiologist to put "allergic to statins" on my charts after trying four different statins over a two year period because the muscle pain was constant. My GP continued to argue with me and told me it was all in my head, so I fired her. The first two episodes involved muscle spasms in my neck that briefly cut off my carotid artery and caused me to pass out in the middle of lifting weights. In both instances I woke up on the floor. Fortunately, I was using a machine and the floor was rubber. The third instance was when I was doing my morning 3.2 mile run with hills. I was going down hill full speed when both of my quads locked up sending me flying onto the road and causing road burns on my hands, forearms, and knees. That episode was the one that caused my doctors to take me off of statins. Mind you, at that time I was lifting weights four days a week (heavy four day split), and running six days a week (I should also add that I kept this workout routine or ones similar to it for the last twenty two years and never had another episode involving my muscles seizing up, so I am confident that it was the statins). My body fat percentage was 11% and I was watching my diet with lots of vegetables, fruits, legumes, whole grains, and fish with the occasional steak. However, even with that heavy workout routine my cholesterol was just under 300.

As you can imagine, I am thrilled to be on Repatha and am only disappointed that it was not available when I was in my mid forties; it might have saved me from having four stents.

From my last lipid panel, Dec 15, 2025:
Cholesterol 108
Triglycerides 84
HDL 50
VLDL Calculated 17
LDL Calculated 41
Cholesterol/HDL Ratio 2.2
LDL/HDL Ratio 0.8

I will be seeing my cardiologist in February and will post any pertinent updates.

I don't know how to post a comment independently so I am attaching it to my last comment. I was asked how I am doing on Repatha and I just had a lipid panel so I want to share the information. First, let me say that there are still NO side effects whatsoever. I am working out as hard as ever, swimming 3 miles per week, and riding my mountain bike on hills 3 days a week. I also do a lot of work in my garden throughout the week.

Anyway, this last blood test is from April 28, 2026. I have been on Repatha since August 17, 2025 --- just over 8 months. I decided to go off of my restricted Ornish diet completely since December. Prior to that, from August 17 until my first blood test I was eating 2 meals a day on the Ornish plan, and 1 meal a day whatever I wanted. For this blood test I decided to test the efficacy of Repatha by going on a full Mediterranean diet with not restrictions. All the olive oil, nuts, avocados and seafood I want, along with lots of whole grains and fresh vegetables and fruits. So on this new diet here are the results. (I am listing the last test next to this one)

Total cholesterol:
12/15/2025___106
04/28/2026___128

HDL cholesterol:
02/15/2025___50
04/28/2026___57

VLDL calculated:
02/15/2025___17
04/28/2026___29

LDL calculated:
02/15/2025___41
04/28/2026___42

(Triglycerides stayed the same)

So, my cardiologist is happy and I am pleasantly surprised at the results given that if I had eaten like this in the past my cholesterol would be well above 300, my LDL over 150, and my HDL only at 35. The Repatha seems to be doing what it is supposed to do and I feel great.

@dacquistapace so happy you posted. Today I am going to my doctor who has made it clear, due to my inability to tolerate statins, Repatha is my next choice. I cannot tell you how nervous I am to try it, side-effects is my 2nd name.

@swilkins1974 I completely understand your nervousness! I rejected my previous cardiologist's attempts to get me on Repatha for almost a year because of the reports I had read on Drugs.com. She told me that none of her patients had reported side effects, but like you, because of my intolerance of statins I was skeptical. I wish I had taken her up on it sooner because within a week of her second attempt to get me to try it I had an angiogram that showed 60% blockage in the LAD, a 90% blockage in a side artery to the right, and 70% blockage in a side artery to the left. The surgeon put two stents in the LAD that day to allow flow to the 70% blocked artery, and also to allow him to go in if necessary and stent that artery. I went back 3 weeks later for the 90% artery. Then we waited for a month and monitored my symptoms. He decided to put a stent in the small artery with 70% blockage because I was still having some shortness of breath. I started on Repatha with him two months later after my strict adherence to the Dean Ornish Reversal diet failed to get my numbers low enough. For most people without existing heart disease a total cholesterol of 168 and LDL of 108 would be great. He wanted me to get below 70 on the LDL and below 150 on the total. As I said, there are no side effects whatsoever. The best part is I can eat normally again as long as I keep an eye on two things: saturated fat < 8 grams per day, and alcohol no more than two drinks per day, preferably one (I am Italian so red wine with dinner has been part of my life for decades).

You can go back and read my post about my experiences with statins over the years. I would recommend you try the Repatha. I had severe side effect with statins and, if Repatha was going to cause them, I would get them. My previous cardiologist moved away from the area, but my surgeon took me on as a patient so I am in good hands. I wish you all the best!

Thank you. Saw my endocrinologist today and we are going forward with Repatha. 😎