您是否注意到随着时间的推移，您对Tirz产生了耐受性？

[Superchicken1]

我的印象是，很多服用口服合成代谢类固醇的人都会避免服用他汀类药物，尤其是作为预防用药，因为他们知道口服合成代谢类固醇可能对肝脏有害。他们会服用其他药物，比如利尿剂或补充剂来降低胆固醇。更何况，他汀类药物对肌肉健康也并非最佳选择。

不，他们常备他汀类药物和其他处方药。不过，他们也用GLP/GIP类药物治疗肝脏疾病、血糖问题和控制体重。

我丈夫正在服用这种药，同时还服用依折麦布，他的医生对这种药的疗效印象深刻。当他告诉我医生是从类固醇减害论坛上了解到这种药时，医生非常惊讶。我从他们那里学到的健康和治疗知识比任何医生都多，哈哈。他们真的很聪明。

 

[Superchicken1]

谢谢。我查阅了药物性肝损伤等级（DILIrank 2.0）数据集， https://www.fda.gov/science-researc...induced-liver-injury-rank-dilirank-20-dataset 。您说得对。这些数字（5 或 3）表示可能导致的损伤的严重程度。

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再参考另一个来源，Livertox [ https://www.ncbi.nlm.nih.gov/books/NBK548236/ ] 将阿托伐他汀评为 A 级：

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Livertox [ https://www.ncbi.nlm.nih.gov/books/NBK548065/ ] 将匹伐他汀评为 D 级： 附件 8592

我已经停止服用他汀类药物，并通过类似电子邮件的电子信息告知了我的心脏病专家。假设立普妥确实是病因（我相信很可能如此），那么我可以和心脏科医生讨论，鉴于我体重减轻以及我之前服用他汀类药物导致肝损伤的病史，是否还有必要继续服用他汀类药物。如果他建议我换一种他汀类药物，我大概会照做。

There are other options for cholesterol control. My husband uses ezetimibe, clinically has about a 20% reduction in LDL. It’s what he started on before adding the pita, and it worked, but 20% wasn’t enough. Now he’s using the pita 3x a week and he’s good. I knew he wouldn’t push for the ezetimibe on his own and just sourced it from India pharma. There are also pcsk9 inhibitors and bempedoic acid. Sometimes insurance can be obnoxious on coverage for these things, and want you to fail all other statins first. Filling the rx, then “developing a side effect” until you meet the requirements for coverage is a workaround. The other option is to use telehealth for the rx, then an in person dr is more likely to go along with it if it’s a med you’re established on.

Just throwing ideas out.

 

[thelastistaken]

Geez. Makes sense about the Lipitor being the culprit, but it is a wake-up call since it is such a popular drug. (For a similar reason, guys on oral AAS seem to avoid statins.)

I would disagree that AAS users avoid statins. AAS users who care about their bloodwork take red yeast rice, essentially the same thing. Commenting as someone who has been in this realm for the past decade.

 

[BigGuy]

Talking out my ass, but my feeling on tolerance is that tirz counteracts the signals my body is normally giving with regards to hunger, and those signals increase with every pound I lose. So it seems like if I did not change weight, the effect would stay the same -- i.e. not tolerance per se, at least not the way it works with many other drugs.

So based on my unscientific theory, Dwight's body is giving such strong "FEED ME" signals due to the amazing weight loss that it is difficult to get enough effect from tirz to adequately counteract it.

Personally, I am not quite at a plateau yet but I think I'm close. I've gone from 284 to 201, and I've been sitting around at 201-204 for the past couple weeks. The trend still looks like it is headed down, but veeeeery slowly. I've been doing 5mg twice a week, until this morning when I ratcheted it up a little to 5.5mg. I feel like my appetite suppression has been basically okay, and if I overeat just a little I still pay dearly with nausea (pulling off a Dwight-style 6000 Calorie day would probably put me in the hospital right now), just not really losing like I was. Still have 25 lbs to lose, for sure, so I'd like to keep chipping away at it.

Congrats on the 80+ loss! I am in the same boat where splitting 10mg is boarding on not being enough but I’ve only lost 45ish. I really don’t want to keep going up and max out too early but, in the same breath, I don’t want to waste time, money and meds sitting on 10. Looking into (and already researching some) stacking but will likely just upping old faithful. Then come up with a new plan when the hard stall hits.

 

[texmexpep]

I stacked by adding reta to my tirzepatide. But now my ALT levels are 10 times the upper limit of normal. While the doctor believes that reta is probably not the cause of my increased ALT levels, I agree and am following his recommendation to stop taking reta until my levels return to normal. My hepatologist and I both believe that Lipitor (atorvastatin) is the likely cause of my liver problems. I stopped taking Lipitor But considering my liver problems, I'm not going to continue risking things by taking reta, an unapproved drug. If my ALT levels return to normal, I will start start reta again and see what happens.

Thank you for sharing your research!

 

[Calm Logic]

I would disagree that AAS users avoid statins. AAS users who care about their bloodwork take red yeast rice, essentially the same thing. Commenting as someone who has been in this realm for the past decade.

Many people in general are reluctant to be on statins, as are many doctors (including cardiologists) reluctant in prescribing them (for better or worse). I just overhead in the ER last month, the staff mentioning that stains can lower testosterone levels (which is true, but only slightly).

Also, not many bodybuilders want something that can interfere with muscle building, even if the odds of that are low. On the positive side, regarding pravastatin, it is not only gentler on the liver, it is also less likely to cause muscle pain.

Many AAS users are on reta, likely decreasing the need for statins anyway, or at least the higher doses of statins. OTOH, some AAS users/abusers prefer an LDL below 70, so they can feel more comfortable with the cardiovascular risks of steroid ab/use.

While we are on the subject, it is at least a little crazy to optimize lipid values only to potentially wreck the entire cardiovascular system with chronic steroid use outside of TRT. Yes, a plant-based diet and statin use would be harm reduction, but true harm reduction is to avoid the steroids, or at least to avoid chronic, long-term use. Calcium scoring is also important, but I think there may be damage that evades many of these tests, even an echocardiogram. A cardiac MRI would be ideal.

 

[Superchicken1]

很多人普遍不愿服用他汀类药物，许多医生（包括 心脏病专家 ）也不愿开具此类药物（无论好坏）。上个月我在急诊室无意中听到工作人员提到，他汀类药物会降低睾酮水平（这是事实，但影响很小）。

此外，即使可能性很低，也很少有健美运动员想要服用会影响肌肉生长的药物。就普伐他汀而言，它的优点在于不仅对肝脏更温和，而且不太可能引起肌肉疼痛。

许多合成代谢类固醇（AAS）使用者都在接受睾酮替代疗法（TRT），这可能降低了他们服用他汀类药物的需求，或者至少降低了服用较高剂量他汀类药物的需求。另一方面，一些AAS使用者/滥用者希望低密度脂蛋白胆固醇（LDL）低于70，这样他们就能更安心地应对类固醇滥用带来的心血管风险。

说到这里，为了优化血脂而长期在TRT之外使用类固醇，最终可能损害整个心血管系统，这种做法至少有点疯狂。是的，植物性饮食和服用他汀类药物可以降低危害，但真正的危害降低在于避免使用类固醇，或者至少避免长期慢性使用。钙化评分也很重要，但我认为可能存在一些损伤无法通过许多检查（包括超声心动图）检测到。心脏磁共振成像将是理想的检查方法。

我想指出的是，匹伐他汀（pitavastatin）的副作用比其他他汀类药物少得多，包括肌肉疼痛。

我不明白你的逻辑。既然知道使用合成代谢类固醇（AAS）的风险，为什么优化血脂就成了疯狂之举？不优化血脂才更疯狂。减少危害是指减少药物使用的危害，并找到减轻负面影响的最佳方法，而不是完全戒断。据

我所知，使用合成代谢类固醇的人群比任何其他人群都更了解自身的心血管和代谢指标。他们关注的不仅仅是血脂。

 

[Calm Logic]

感谢您指正关于他汀类药物中带字母“p”的拼写错误。

我偶尔尝试使用像Anavar这样相对温和的类固醇药物的限制因素在于，你不知道自己不知道什么。总有一些更昂贵的检测方法可以做，比如端粒长度检测。

https://academic.oup.com/ejendo/article/188/2/236/7031076

所以，就我个人而言，我更倾向于关注像 SS-31 这样的肽，我更关心的是它们的潜在益处，而不是潜在的危险。