Do greens such as Kale, spinach etc actually increase risk of blood clots ?
So I recently found out that I have CAD in 5 arteries including a medium blockage in my LAD. Was very marginal for a stent but they decided not to at this point because I have a flow of 0.81 / they stent at under 0.8
Anyway I immediately went plant based (Esselstyn) and got my cholesterol deven from 6.6 to 3 in a little over 2 months. LDL down from 3.3 to 0.8 - Also lost about 10kg. I decided last week to order a LP(a) test online - surprised that my cardiologist or the cath lab hadn’t already ? Anyway it comes back at 181 nmol which puts me at an additional 2 x - 3x HA/Stroke risk
My question. Green veg such as spinach, kale etc which contain nitrates which open the arteries and calm inflammation also contain high levels of vitamin K which aids in clotting. Obviously I’m taking an aspirin to reduce my chance of clotting. Does eating a lot of green veg actually increase my chances of a fatal clot if I was to have “an event” or am I missing something? I’m obviously more concerned now than I was now that I know I have LP(a) which is twice as sticky as LDL and clots much faster ….
Anyone have any idea about this? Am I actually increasing my risk with all these “ amazing healthy greens “
Ahhhhh what a life eh …
Please get your LP(a) tested if you haven’t already. There will be a drug out end of next year or in 2026. I’m also trying to get on the Lilly trial…..
Best wishes to all of you !
Mark
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The impression that I've gained from researching (for my own benefit) suitable supplements and vitamins is that it's OK for me to have small portions of such foods on a regular basis, but not vitamin K pills. (I'm on Clopidogrel anti-coagulant.) There seems to be an increased risk if one is taking Warfarin.
Thank for your input. This is exactly what I was looking for. Yes of course our circumstances are all different but it shows that we do need to be mindful of even the healthiest foods. What I don’t understand is how a trial of 198 people with heart disease, many with prior HA, stents etc that went on the esselstyn diet showed only one “event” in 4 years. And these people live on green veg. 6-8 portions a day. Maybe the body only uses the amount it needs whether you have the recommended 120 units or 1000. Or maybe the affects of these greens on inflammation and the nitrates mitigate the extra risks of the high levels of vitamin K from this plant based diet guess I need to do a lot more research !
Hi Taviterry, I hope you don't mind a small correction, Clopidogrel is an anti-platelet medication, used to reduce the risk of clotting that might cause a stroke. Anti-coagulants include apixaban, Edoxaban etc al and warfarin. If Afib is detected then anti coagulants are prescribed to reduce clotting risk. The mechanisms for anti platelet and anti coagulants are quite different. This is important because the query re ion levels and greens is important in the biochemistry. Now my knowledge without checking is being tested at this point, but I believe anticoagulants are more impacted by this discussion.
I don't avoid greens. I do take supplements but not daily, because I have also had my gallbladder removed. I first had an out of the blue severe stroke for which there was no obvious cause. So I was prescribed Clopidogrel and statins although my cholesterol levels were low. I was monitored for evidence of arrhythmia and Paroxysmal AF was detected. Immediately my regime changed from Clopidogrel to Edoxaban.
This gives a rundown on greens , potassium and anticoagulants. It's mainly warfarin that is the one to watch, newer drugs if the xxxxxban variety are not affected.
Thank You so much for your reply. That helps me understand things better. I’m so sorry to hear about your severe stroke and AF. I pray hope things are getting better for you 🙏
Hi Mark, I am sorry to have possibly planted that concern but think Taviterry is correct.
Small portions on a regular basis seems to be the way to go. It would be a pity to rule out greens when they’re so good for you, but it will be interesting to see what others say.
What is the Lilly trial? I hope you manage to get onto it.
No it’s really important to address all of these factors and I think he’s spot on. But there is something we’re not understanding. I’m confused because of what I wrote above to Taviterry. Out of 198 people eating 6 portions a day + none had an event in 4 years …. How so ?
The Lilly trial is for high LPa levels. Have you had yours taken ?
I guess one factor is the impossibility of deciding how much of a prescription pill, how much of a supplement, anyone of us needs, especially with many being only available in a small range of sizes. Recently the hospital noticed my Vitamin D deficiency and my GP immediately suggested that I buy 1,000iu tablets; a few days later the hospital sent around by taxi 800iu pills, and the GP is now prescribing 1000iu.
Likewise, when my ferritin was very low, I was prescribed 322mg ferrous ferritin tablets, then had an iron infusion, that sent my ferritin soaring well above the recommended levels before it dipped slightly; do I resume the tablets at 322mg or at a lower strength.? I'm not due more NHS blood tests until late November, though I may pay for a select few in the meantime.
I nearly fell out big-time with a friend who's a nutritionist when she wanted me to take Omega 3 capsules - contraindicated if one is on anti-coagulants. (Some websites say don't take any, others that a low amount won't hurt.)
Thus the "sensible" amounts of greens or whatever will vary from person to person.
(I'm reading several books about medical "preparation" among professional racing cyclists in the 1990s and 2000s, which embraced legal, borderline and illegal products. At least some of them had the benefit of doctors' supervision and daily tests to check levels - others did not, with disastrous consequences, including death.)
Yes the omega 3’s and anti coagulants - you’re spot on there. I’m glad you only “nearly fell out”and you’re still friends 😁There is so much contraction out there, I guess it’s better to err on the side of caution and avoid any supplements unless proper research backs it up. I guess we need to think about garlic too. What I have heard about vitamin D is that it’s very hard to overdose on it. Body only uses what it needs. Certainly 4000iu seems to be well tolerated.
My ferritin has always been sky high. Used to be 900 but it’s down to 500 now. But my iron is normal so it’s all a little confusing. I think ferritin can also indicate inflammation if it’s not connected to iron directly. Again, it’s all so confusing and we’re all different.
Your current reading sounds fascinating. I had a friend that was on all sorts of stuff that his trainer recommended and he ended up with liver fibrosis. ….
I do my tests with an online company called Selph - they’re absolutely brilliant. Finger prick tests and results in a couple of days. I compared to my labs and they are very accurate.
Do you take any supplements ? I’m on coq10 to mitigate my high statin dosage side effects and I also take vitamin C in its natural form from acerola powder. I add it to my cereals. A lot of people believe CAD is a form of scurvy and vitamin C is meant to be an anti inflammatory so should be pretty safe. I take a teaspoon of it a day (around 1000mg) - but again, there is no money in any of this for the medical profession so just so few proper studies out there …
I've just had a telephone appointment with my GP, which concluded with my asking about taking 322mg ferrous ferritin after my iron infusion. She said that I should have waited for four weeks before starting them again, in fact I've only resumed them three days ago, almost three months later. This might explain my recent fatigue.
Yes I guess that would tie in with your fatique. My partner has similar issues and she also had an iron infusion. Hoping you start to feel a lot stronger asap !
Yes I agree that under normal circumstances that is absolutely the best diet. There is a lot of debate about olive oil and nuts damaging the arteries - I’ve cut it all out though honestly I question my sanity at times. I just hold on to the fact that so many people on this diet with serious disease had zero events. It’s a nightmare to stick to but the only thing that keeps me relatively sane. This is an interesting link if you get a minute. Hope you’re continuing to go from strength to strength 💪
Small correction. Warfarin blocks one of the enzymes (proteins) that uses vitamin K to produce clotting factors. This disrupts the clotting process, making it take longer for the blood to clot. No blood thinning involved.
Slight correction if that’s ok. As Chinkoflight says above, Clopidogrel is an anti- platelet not an anti- coagulant. Quite a difference. Also Clopidogrel often prescribed with aspirin, especially after cabg surgery, for those who can tolerate it. Can be prescribed alone of course, as can aspirin.
I have been taking anti coagulants (warfarin) for five years because of arrhythmia. So regular blood tests to check my INR has been the norm. Initially I was somewhat obsessed with which foods contained Vitamin K , however once I became more relaxed in my approach I found my INR level became fairly constant. I'm also taking clopidogrel since having a stent fitted last December, I'm guessing this will be withdrawn in the next 3 months. I live in Cyprus so following a Mediterranean diet shouldn't be difficult although I'm not a huge lover of salad. I also have bigh cholesterol but cant take statins, just Ezitembi. It is difficult to a degree to balance the nutritional needs of my conditions but my main focus is trying to eat a healthy balanced diet as far as possible.
Hi Art. Thank You so much for giving me a better understanding. I’ll definitely have the INR checked. Yes you should be done with the clopidogrel shortly. Yay ! That’s great news.
I’m trying to figure out if the body only uses what it needs in terms of vitamin K whether you have the daily recommended dose or 10x the daily dose. I’m going to ask a cardiologist next week. I have become a little obsessed.
I’m glad you’re doing well now. I’m very jealous. At least you see the sun from time to time in Cyprus unlike our summer this year here. Good for the vitamin D
Got my LDL down from 3.2 to 0.8 in 2 months on this diet. Yeah I’m not a huge fan but I believe I am giving myself the best chance. It keeps me sane and that’s the most important thing I guess. I’m 2% away from a stent or bypass on my LAD
Lipoprotein A and your risk of CVD is decided at birth as it it is genetic. This increases your risk as it is what makes your cholesterol "sticky" and is usually only tested via referral to a lipid clinic. Mine is 390!
Lifestyle cannot change this as it is related to how your liver processes cholesterol and it can only be controlled via medication. I am under a lipid clinic and my understanding that only Inclisiran ( a 6 monthly injection ) can lower this but it is only offered if your numbers are high enough.
I willl ask my consultant about the Lilly trial.........I haven't heard of this.
here is the link to the Lilly trial of you wish to apply, it’s at stage 3. I know they are still recruiting here. Please check it out and apply if you wish trials.lilly.com/en-US/tria...
Early indications is it can reduce LPA up to 90%
Other than that Inclisiran 20-30% as you say and some evidence TRT can help reduce LPa as well in men that have low T levels
Good point! Oh damn. Coffee too, didn’t know that…. What a life eh. I’ve given up smoking, sugar, live on rabbit food and now I need to give up my coffee …. hey ho !
There are conflicting studies about whether drinking coffee actually causes kidney stones. Some studies actually come up with the opposite result, although the fact remains that coffee can act as a diuretic, thereby increasing the risk of kidney stones in those predisposed to their formation unless care is taken to maintain hydration levels. Do your own research and then decide.
Pun is good. 97? Sounds like you have excellent genes, im sure you’ll get that telegram from the King … sorry for your loss though…. Yes, lots of interesting things going on here ….
oh, how complicated! I’m on aspirin 75 mg, and several other prescription meds. I take supplements including omega 3 for vegans, multivitamins for vegans, pre-/probiotics, zinc. So now I don’t know whether to stop the omega 3! And I eat lots of greens. No need to reply but as I said , how confusing!
Clopidogrel like aspirin, is an antiplatelet not an anticoagulant.
Antiplatelets work by preventing platelets from sticking together and forming blood clots.
There is no restriction on what you can eat.
As others have said anticoagulants work differently, they delay the clotting of the blood.
Neither anticoagulants nor antiplatelets 'thin' the blood.
I am on clopidogrel for life and follow a Mediterranean diet. I take vitamin D on the advice of my Cardiologist.
I don't have obstructed coronary arteries. I am prescribed clopidogrel as my coronary arteries go frequently into spasms altering the way the blood flows through my arteries.
The aspirin you're taking will be doing the same, keeping the blood flowing smoothly and help prevent the blood from forming clots.
My husband has atrial fibrillation and stents, he's prescribed a direct anticoagulant DOAC and clopidogrel.
Thank You so much for your reply. That was the answer I was looking for. Makes a lot more sense now, thank You !
Yes I think vitamin D is really important for the immune system especially during winter.
I’ve heard about CAVS. I have a friend with the same issues. Sounds like you and your cardiologist are on top of things and you’re doing well 👌
Sorry to hear about your husband too … life is not easy. I wish you both well and you’re there to look after each other and have many more happy and healthy years ahead 🙏
I had my LP (a) tested very recently. Mine is 451.
Interestingly, cardiologist suggested I try ketogenic diet. Said increasingly cardiologists are losing confidence in Mediterranean diets and advocating carnivorous based diets cutting out on carbohydrates and of course all processed foods. Does anyone have experience/ thoughts about this rather country approach?
Rosie. I’m not a cardiologist but the last thing I’d do if you have a high LPa is raise your LDL which is what will happen on a carnivorous diet. From my research no diet can reverse LPa but a higher LDL is an added risk factor you don’t want.
I’d get a second opinion, please be careful about raising your cholesterol.
There will be drugs for LPa in the next few years and there are ongoing trials - perhaps you should look into this
I’m ok the esselstyn diet. Only diet that has been proven to stop the progression of CAD. Not easy to follow but I’ve got my LDL down from over 3 to under 1 which will mitigate my risks from the high LPa
I wouldn’t start any new diet without thoroughly checking it out. Have appt with Consultant at Lipid Clinic in two weeks so will definitely be checking it out then. Was just curious as to whether anyone else had been given same advice about ketogenic/ carnivorous type diets.
Do you know if the Esselstyn diet has been peer evaluated? Struggling to find out as I would like to know more about it.
Not peer reviewed but he’s very well respected. He’s written a book prevent and reverse heart disease. A NY times bestseller. Dean Ornish is another pioneer of the wholefood plant based approach. Look esselstyn up online. He’s done a few YouTube interviews. He’s 90 but a picture of health
Yes see what your Lipidologist says but I’m sure the last thing he’d advise is a keto diet which would raise your LDL. It is a risk factor especially in people like us with high LPa. Please let me know what advice they give you
Just noticed your post and find some of it a little confusing. Never heard of Esselstyn but a quick google reveals he is the Author of a book that claims dieting can prevent and reverse CHD. It's entirely up to you of course, but I would suggest you should maybe take this with a large pinch of salt. You say you got your levels down, I presume you were still taking the statin (40mg) at the same time? I find it very difficult to believe from personal experience that diet alone would bring the levels down on their own. I am also not aware of any peer reviewed studies that verify consuming greens have any real benefit in regards to "opening up arteries" or "calming inflammation"? Do you have any links to any such studies? Also, your LDL level seems very low even given you are on a statin, was this a reliable test? I would have thought you would need to be on a higher statin dose to give this reduction although obviously we are all different.
As has been mentioned by other members the best course of action is to eat a balanced diet and get yourself as fit as possible, and don't rely on unproven remedies. Good luck.
well said . there is definitely so much information out there it is so easy to overthink it, keep yourself fit ( if possible). avoid UPF, fat and sugar as much as you can then eat a healthy balanced diet. work with your medical team to get your meds correct, then hope someone up there is watching over you😇 good luck and keep talking to each other👍👍
been following The esselstyn diet for 2 months. Ive loat a lot of weight and My LDL is down from over 3 to around 1. It’s high dose statins and the fact I’m not eating any cholesterol, oil or fat.
Here is a little more on Esselstyn. 198 people with lots of prior events went on the diet and there was not a single event among those that complied. It was published on the NIH website too so it’s genuine. But it’s a tough one to follow
jjspeidel.com/esselstyns-ul...
He is also on YouTube. 90 years old. Sharp as they come. Gives me a little hope that I may avoid worst case scenarios
Please don't pin your health on Youtubers! He is apparently the director of the "heart disease reversal" program, most mainstream cardiologists will conform that it is not possible to reverse heart disease, it is progressive, sadly. Also 198 participants in a study is laughable I am quite surprised you are putting any faith in it!
Concentrate on a proper balanced diet and as much exercise as you can get, and forget quacks on youtube.
Slow yes, reverse, don't think so. In 6 years of looking into this I think all you can hope for is stabilisation of plaque, not a reduction. Personally I think Youtube quacks like this guy are just deflecting people's attention away from what they need to focus on.
Ah, now you are entering into something that I would love to know more about, on a personal level. Seems there are definitely two types, stable and unstable. A very knowledgeable guy on here once described them as being like acne, sometimes it is hard and solid, other times soft and erupts with pus. I had my stents 6 years ago now and have had no further problems so I like to hope I have the stable type. I spent all my life prior to the stents (and therefore no medication) with no problems at all, so I assume no bits ever broke off or burst to cause clots, no HA just LAD finally almost completely but steadily blocked. Other people just have a HA out of the blue and some have further HA's so I assume they probably have less stable plaque? It does make you wonder if the anti platelet meds are actually worth the risk (stroke from bleeding blood vessels etc) although I would never stop taking them or advocate it.
I get your point but it also makes sense to me that a plant based diet would be the lowest in cholesterol, contain more nitrates and fibre. If someone wants to add a little fish, fine, but I can only talk from my own experience. I got diagnosed 10 weeks ago, I have lost nearly 15kg, my LDL is down to 1 - I can walk further without getting out of breath. I think it’s working for me.
I do appreciate your reply though. There are a lot of quacks online but this guy is definitely not a quack. Look at the China study. They don’t have heart disease and tey are essentially vegan which js all this guy is advocating
There are also billions of people around the world that eat protein and the accompanying saturated fats and don't die of heart attacks. Cholesterol is vital to every cell in your body, especially in the healing / immune process, there is no such thing as a disease of too much cholesterol. High cholesterol is a symptom of disease or injury that the body is attempting to heal. it rises and falls depending on the healing needs of the body. if you never ate saturated fats (aka cholesterol) your liver will produce it anyway, eating it aids the liver , the more you eat the less stress on the liver. A second point is your heart is made of protein, and not the vegetable kind, so that is just biology, not opinion. Also the China study is misleading, it is not the lack of saturated fat in the diet, it was their way of life, eg., they eat real food, are more active, no obesity, no smoking or snacking etc.. Also, you will find China has caught up to the rest of the developed world and consequently all the illness that goes along with it.
Yes China has caught up with the rest of the world and one of the reasons are they are no longer living on rice and veggies.
You’re right about disease and injury but once you have an issue, statins will now calcify the issue. LDL and LPa will add to it. I think most professionals would agree that saturated fat is a bad thing under these circumstances and you wouldn’t want to throw more LDL or LPa into the mix. Prior to having these issues I’m sure it’s not a huge problem if you avoid inflammation and make the right lifestyle choice. Sadly I didn’t and this option is no longer available to me. Im sure you’d agree There is no evidence that saturated fat or high cholesterol will improve my situation once it’s there ?
LDL is a protein, it is not good or bad, it is a carrier of many things, including cholesterol, that circulates its contents to all of your cells for repair and function. Inflammation is directly linked to diets heavy in sugar, aka carbohydrates and other harmful life style habits. Fat and protein do not clog arteries, they build muscle. If you want to limit inflammation and all the damage that does to the body, following a vegetarian diet is not what you would choose because it requires a lot of insulin to deal with the sugar. As far as the statement about no evidence, I strongly disagree, in fact there is ample evidence in the scientific community that the cholesterol heart hypothesis is now universally rejected. Google Jason Fung, for current thinking on insulin and inflammation. Another thing you may be interested in is the emerging evidence on the damage seed oils have in the body.
Jack, I am not arguing with you about inflammation. You are correct about this. My point is once the damage is done, all that bad cholesterol will do is Increase that damage. That is why my cardiologist wanted me to reduce my cholesterol levels and a heart surgeon friend of my family told me to get my LDL below 1, which is where it is now. I don’t think these people are idiots but I also understand that prior to my issues had I lived a healthy lifestyle, we wouldn’t be having this discussion. I agree with you, but not in my situation or in a lot of the people here that have had heart attacks or have CAD. A high saturated fat diet is not the solution
There is also LPa which is genetic and is strongly tied to heart disease even in people that are fit and healthy. I think that guy on “the biggest loser” is a great example of how a type of cholesterol can kill you even if you’re doing everything right
VEGAN Esselstyn diet that I follow does not contain a lot of “sugar” - I eat a lot of greens, beans, lentils and occasional brown rice and a little fruit (no juice). My blood sugar levels have come down from 6.3 to 4.1 in 10 weeks….
Thank You for pointing out seed oils. The Esselstyn diet does not allow ANY oil. I will look into Jason Fung too
Finally if you can show me one reasonably sized study that shows that a high cholesterol/carnivore/keto in people with established heart disease like me will slow down progression I’d be most grateful because I was brought up on meat and living like a rabbit isn’t really my first choice - but I do believe it is the best option for me right now
If you really want to know if your argument stands up I suggest you look at the following study : ncbi.nlm.nih.gov/pmc/articl...
If you wish to skip to the bottom you’ll see the following. I suggest you are a little more careful about advising people like me to eat high cholesterol foods. This is a life and death situation for me. I think this pretty much sums up why I have chosen to follow this vegan diet. This is a proper randomised study. Again, bring me one that backs up the stuff which you are advocating here ….
”Similar to the EVADE CAD trial, a recent observational study published in January 2022 demonstrated that more frequent consumption of meat was associated with both a higher CRP and total white blood cell count [32]. This observation may be secondary to the higher concentration of meat-based heme-iron, which is known to induce inflammation when compared to the iron found in plants [33]. Chronic circulation of pro inflammatory mediators over time may predispose individuals to coronary atherosclerotic disease and subsequently, poor cardiac outcomes.”
I am not going to debate diets with you. Studies are observational and opinion, they are not proof or science. I have the same health goals as yourself; we are at different mindsets on how to get there. I offered my opinion in good faith, It would be far to time consuming and likely contentious for me or you to continue to hold up our different opinions. I wish you well.
Hope you are doing well. From my research, LPa is not routinely done here in the UK and NHS as part of the tests, but you can get it done privately. LPa is another marker for potential higher risk for heart disease. However, unlike LDL you cant really control it with medicine or diet. As you have suggested - there are a few medicines in the pipeline that could potentially lower it too, fingers crossed.
I was contemplating getting the LPa test done too, but then I thought - if I cant change it in any way - not sure what the benefit would be except that it would cause more anxiety and stress with little upside for now. Hence, why I have postponed it .
On your diet, appreciate that you have achieved spectacular results with your diet, amazing!
I have a pretty simple take on diet - limit extreme processed or fast food as much as possible but have everything else in moderation. I still have white meat and limited red meat and complex carbs. But good to check with the Dr for food/supplement interaction with medicine just to be sure.
Been doing it for the past 11m and still going strong. If I do it this way, I know i get a bit of everything in my system, good or bad!
Like you, was shocked with CAD at such a young age, but at the same time I still want to enjoy life as much as possible and the illness should not change that.
I wish you the best of luck, I realise it is not an easy journey, you have ups/downs but at least you know where you stand and you're controlling the risk factors as much as possible from your end. Stay strong.
I agree. But my motivation was that if it came back high I could apply for stage 3 of the Lilly trial which is still accepting people in the UK. Their injection appears to reduce LPa by up to 90% - so that was my thinking. But actually better not to dwell on all this stuff at all and I do regret now I got mine tested because in truth I don’t know if I’m going to even get on this trial and if I do if I end up with the placebo …. 😁
My visit to the lipid clinic and resulting LPa test was the most negative experience I have had during my 6 year journey after having severe blockages in my LAD. They basically painted a bleak picture of a high LPa result but told be not to worry as they were sure mine would not be high, then when it was medium they told me not to worry as they were not really sure if it was a risk factor or not as there is not enough data available due to the fact it isn't regularly tested. It took me quite a while to get it out of my system and all the visit did was to instil slightly more of the idea that they don't really understand a hell of a lot, frankly. All you can do is take the mainstream advice and keep yourself fit, and hope for the best, really.
Thanks for sharing this. You’re 100% correct. I’ve had a similar journey with the LPa. Was already stressed because of my 700 LAD calcium score, the blockages / narrowing sand then throwing LPa into the mix. Not great for the head if there is noting we can do right now. Nobody really knows and there are so many different opinions out there. I guess ultimately we know our bodies best and we’re all different. I guess the important thing is I’m here today and I’m doing ok. I can’t enjoy the future today, so I’ll just focus on today. I’ve learned that that’s the most important thing for me. Ok moving to Spain in December is out the window right now but sh*t happens. Perhaps I can dare to dream a little about the future too, but it’s now that matters. I may have many thousands of “today’s” ahead … and I wish the same for you 🙏
Thank You so much for your kind words. Your diet sounds “clean” and you feel good on it. I know I’ve gone a little extreme but I’m sh*t scared to be honest with the high CAC, my diffuse disease in the LAD being so close to needing a procedure and now the LPa. I guess I’m maybe clutching at straws and will need an intervention in the next few years as one cardiologist told me, but even my BP is 110/70 most days, a year ago it was spiking to 170, 180 - haven’t sad a reading over 130, so I’ll keep going with this…. Spot on about dr/food / supplement interactions but sadly my GP seems to know nothing about nutrition and surprisingly nor does my cardiologist. Need to look elsewhere
I understand your point about LPa. I did mine with Selph. Great company online. Results come back fast and match my recent venous GP tests for cholesterol and other markers (not LPa as you say) - yes no point until the end of next year unless yours is really high and you want to get on a trial. There are a few ongoing on stage 3.
If you’re a guy and your Testosterone levels are low having TRT can reduce LPa by 20-30%. I’m low so will try this and report back
Yes it’s a shock but you’re doing amazing. Great attitude and you’ll get through this no matter what. As you say it’s good we are aware.
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