# Ldl-c 22

**URL:** <https://forum.barbellmedicine.com/t/ldl-c-22/14392>\
**Category:** Medical Q&A \[Moderated\]\
**Created:** [March 1, 2024, 4:58pm UTC](https://forum.barbellmedicine.com/t/ldl-c-22/14392 "2024-03-01T16:58:01Z")\
**Posts on this page:** 3\
**Page:** 1

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**Author:** ![quark](https://avatars.discourse-cdn.com/v4/letter/q/5e9695/32.png) [@quark](https://forum.barbellmedicine.com/u/quark)\
**Post date:** [March 1, 2024, 4:58pm UTC](https://forum.barbellmedicine.com/t/ldl-c-22/14392/1 "2024-03-01T16:58:01Z")

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Hi,

Following up on my various cholesterol related posts, I wanted to think you for the information you provide and give an update.

After about two months on Repatha, 20mg rosuvastatin and 10mg ezetimibe, LDL-C was 22mg/Dl (down from122 pre-statin and 62 on 40mg rosuvastatin), non-HDL C was 34 and ApoB was 31. I haven’t gotten my latest Lp(a) numbers, but the last two were about 200, then inexplicably up to 300, so with luck that’s gone back down.

A while back I asked my cardiologist what would be too low and he said it was an unknown. Have you seen any useful research on this?

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**Author:** ![Austin\_Baraki](https://sea1.discourse-cdn.com/flex001/user_avatar/forum.barbellmedicine.com/austin_baraki/32/1095_2.png) [@Austin\_Baraki](https://forum.barbellmedicine.com/u/Austin_Baraki)\
**Post date:** [March 4, 2024, 5:38pm UTC](https://forum.barbellmedicine.com/t/ldl-c-22/14392/2 "2024-03-04T17:38:50Z")

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> **[Efficacy and Safety of Further Lowering of LDL Cholesterol in Patients...](https://jamanetwork.com/journals/jamacardiology/fullarticle/2695047)**
>
> This meta-analysis evaluates efficacy and safety of further lowering low-density lipoprotein cholesterol levels in patient populations presenting with median low-density lipoprotein cholesterol levels of 70 mg/dL or less.

> **[Safety and Efficacy of Extremely Low LDL-Cholesterol Levels and Its Prospects...](https://pmc.ncbi.nlm.nih.gov/articles/PMC5937425/)**
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> The risk of cardiovascular disease has been reported to have a linear relationship with LDL levels. Additionally, the currently recommended LDL target goal of 70 mg/dl does not diminish the CV risk entirely leaving behind some residual risk. ...

[https://academic.oup.com/eurheartj/article/42/22/2154/6104339](https://academic.oup.com/eurheartj/article/42/22/2154/6104339)

[https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32290-0/abstract](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32290-0/abstract)

> **[Safety and Efficacy of Very Low Levels of LDL Cholesterol](https://jamanetwork.com/journals/jamacardiology/fullarticle/2611949)**
>
> This prespecified analysis assesses the safety and clinical efficacy of achieving a very low (\<30 mg/dL) level of low-density lipoprotein cholesterol at 1 month in patients with acute coronary syndrome using data from the Improved Reduction of...

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<div class="post-metadata">

**Author:** ![quark](https://avatars.discourse-cdn.com/v4/letter/q/5e9695/32.png) [@quark](https://forum.barbellmedicine.com/u/quark)\
**Post date:** [March 4, 2024, 11:18pm UTC](https://forum.barbellmedicine.com/t/ldl-c-22/14392/3 "2024-03-04T23:18:41Z")

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Wow! Sounds like very low levels are safe and effective. I wonder why 70 mg/dL is the current US target. FWIW, Lp(a) level was 250 nmol/L, down from the recent 300 but up from 200 from one year ago. With luck direct meds for Lp(a) will emerge from clinical trials in the not too distant future.

Thank you.