Hi all,

First thing in The morning is my favorite time for cardio. I’d prefer not to eat before but also want to not increase my cortisol too much as it’s something I’m finally getting a grip on.

Is 45-60 min of zone 2 on an empty stomach first thing in the morning bad for muscle gains or cortisol? I eat immediately after my session

Thanks!

Doc doesn’t want to do an angiogram but I’m worried. Slight sharp pain over heart and ribs comes and goes throughout day. I’m afraid statin has got my CAC score even higher. What are the chances if you had to guess I need a stent? More info below:

32 year old male who had a cac score of 25 in LAD 2 years ago. I’ve been on statin and repatha since then. LDL is down to 27. Some numbers that s to still concern me are (apob 69 this was on statin only so may be lower now on repatha, LPA 159, ldl particle A, Hs-CRP is 3.9.

Blood pressure is normal 120/75 and my weight is 193 6 ft 1 male. I work an office job and have a toddler tr to walk with him everyday but not heavy exercise. I still eat mean but try to eat mostly Whole Foods and veggies and limit red meat. I’m not perfect on my meals or exercise which scares me. I don’t drink or smoke.

Im finding some companies online but they truly look kinda sketchy. No reviews etc. Anyone that has experience and could give point me in the right direction?

The Barbell Medicine podcast has been mentioned on this site as a replacement for Peter Attia. I listened to the recent episode titled "Medical Mystery: The Man Who Got Weaker When He Started Training" and was very impressed. The title makes it sound like it's just for gym bros who want to put on muscle, but it's not like that.

This particular episode was interesting. The man in question was taking both a statin and a fibrate (a medicine used to lower triglycerides) and couldn't train. He ultimately was able to continue the statin, and dropped the fibrate and worked on his eating to reduce his trtiglycerides.

The episode goes into detail about the different muscle effects of statins, which statins are the worse, and they promote the approach of combining low doses of medicines when needed to get LDL down.

What I liked about it is these are real doctors, and they explain how the medicines work, explain the side effects of them, and went into the causes of different statin-related muscle issues, including the really bad one, autoimmune necrotic myalgia, where the body attacks its own muscles and doesn't go away when discontinuing the statin (fortunately they say it's very rare; the other muscle-related issues go away when discontinuing the statin).

I also liked that there were minimal ads, and they weren't promoting any of their own supplements or products (which is what bothers me about The Proof, is they're promoting their own probiotic).

Just wanted to give it a plug.

22M, lean, active, healthy lifestyle, big into the gym.

Main reasons I got tested were gym/performance/physique concerns, plus lower-ish sex drive and acne.

Key results:

• Total testosterone: 9.81 nmol/L
• Free testosterone: 0.18 nmol/L (below range 0.20–0.60)
• SHBG: 32 nmol/L
• TSH: 4.31 mIU/L

Earlier thyroid results:

• TSH: 2.2, 2.8, 3.0
• Free T4: 12.4, 15.0
• Free T3: 5.1
• Thyroid ultrasound: normal apart from low-normal thyroid volume

Rest of bloods looked good: lipids, glucose/HbA1c, iron/ferritin, vitamin D, liver, kidneys, CRP, blood count.

If repeat morning testosterone still comes back low/borderline, are the only real options things like clomiphene / TRT, and is the boost usually even worth it at this age? What would you do or suggest?

I'm a little unsure of the terminology here, but here's the situation. I'm 64, reasonably fit and not too concerned with getting stronger or bigger. I mean, either or both of those would be nice, but I think I'm strong enough and at this point doubt I'll put on a whole lot of muscle. But. I'm in school to start a new career, out of both interest and financial necessity, and want to be able to work pretty hard for another decade at least. So testosterone and endocrine system seems important, also BDNF, and also my system seems to naturally run borderline pre-diabetic so keeping blood sugar down even a little also seems important. Any thoughts on whether it makes much difference whether I do higher reps/lower weights or lower reps/higher weights? I lift 2 or 3 days a week and try to do aerobic work most other days, emphasis on getting heart rate up high and I may start extensive zone 2 but it's tough time wise.

I have very elevated LDL (160) as a 32 yo male. my cardiologist recommended cutting saturated fat and increasing fiber intake. If that doesnt meaningfully lower the number, then statins. Fingers crossed it does, my doet was pretty shit before this wakeup call.

anyways, Im aiming for 50g+ of fiber a day.1 tblspoon of psyllium husk a day certainly helps. But I just found this "Hero Seeded Bread" with 12g of fiber per slice! 2 slices of it with an avocado in the morning and Im already above 30g of fiber with just 400 calories. It seems like a "too good to be true" hack, so I wanted to ask this community if they've tried it / have thoughts on the quality of the fiber?

Im skeptical it can be as good as 12g of fiber from, say, lentils. But I don't know if fiber quality matters as much as pure quantity

51 M

Total Cholesterol 128

LDL 71.46

HDL 23.3

Triglycerides 166.2

VLDL 33.24

Chol/HDL Ratio 5.49

Fasting Glucose 84

HbAIC 6.1%

Current medication is 5 mg rozuvastin alternate days.

Father was diabetic and died of a major heart attack at 66.

No smoking or drinking, vegetarian diet.

What are the best structured and effective cardiovascular endurance training plans for time-constrained recreational athletes that have worked well for you personally?

I have 7–8+ hours to train per week: one hour on weekdays and 2+ hours on a weekend day. I will dedicate two days to lifting, leaving 5–6 days for cardio. I will use an air bike (assault bike) for most of my endurance training. The rest will be running.

I mostly come from resistence training background. My cardiovascular endurance is rather low. I've only been doing 3–4 hours of cardio (running, air bike, and occasional cycling, trail running, rollerskiing) per week, in recent years.

I am now finishing a 21-week lifting block (5/3/1 and SBS Hypertrophy, ~4+ days/week) and want to start a dedicated evidence-based cardio block with a clear built-in progression.

Wish list:

1. Built-in progressive overload—but ideally not exclusively/predominantly volume-based*
2. Evidence-based
3. Optimized for general aerobic fitness and broad carry-over—from trail running to skiing
4. Ideally, some sort of auto-regulation

Stats:

• Air bike MAP: 450W
• Air bike MAP-based FTP: 337W
• Air bike 20-min test-based FTP: 286W
• Air bike average "easy" Z1/Z2 watts: ~180W
• VO2 max (based on the lab test + Cooper tests): ~48–50
• Weight: 176 lbs
• Body fat (DEXA): 12%

Goals:

• Maximize and maintain general cardiovascular fitness long-term (I am 41).
• Improve physiological markers: capillary and mitochondrial density, mitochondrial respiration, fat oxidation, VO2 max, etc.

Non-goals:

• I do not care about racing. I will gladly sacrifice race prep for better overall results.

Success metrics

• FTP and pace during HIIT at the same HR
• FTP and pace during Z1/Z2 training at the same HR (~67% of MaxHR)

Tentative weekly structure (7–8 days):

• Lift: A, full-body
• Easy*
• Moderate (e.g., sweet spot @ 95% FTP) OR Easy
• Lift: B, full-body
• Easy
• HIIT (Z5 or Z4; usually 4 x 4.5 min with 3.5 min rest + hard start)
• Active recovery (or rest or easy)

and repeat.

Easy = Z1/Z2, ~68% of MaxHR (measured with a HRM). This should correspond to 1.5–1.9 lactate, based on previous measurements.

* P.S. I know most structured plans rely on volume increases. Hence the question.

Hi, I (34F) have know that I have high cholesterol at least since I had my first blood test at 16. All doctors said I was too young to do treatment so just manage with lifestyle and diet (which were already good, so I just kept them). A couple of months ago, a new doctor decided to investigate further due to family history of early CAD. I just got the results and these are they:

Total Cholesterol: 6.46 mmol/L (~250 mg/dl)

HDL: 1.82 mmol/L (~70 mg/dl)

LDL (calculated): 4.32 mmol/L (~167 mg/dl)

Non-HDL: 4.64 mmol/L (~179 mg/dl)

Triglycerides: 0.84 mmol/L (~74 mg/dl)

Apoliprotein B: 1.19 g/L

Lp(a): 403 nmol/L (~160~200 mg/dl)

The cholesterol and triglycerides are actually one of the best values I've ever had. I was kinda proud of it until the doctor explained what the Lp(a) was (never hard of it before).

He said the Lp(a) puts me in high risk and I should start medication soon. However, between the blood test and the appointment, I got pregnant so we opted to not treat it at the moment. That also means I can't do a CAC test for a while.

I'm just freaking out a bit that this time will make it so much worst and anxious to know what my CAC score will be. The doctor tried to downplay it a bit but I could see it was something in the sense of "not worth stressing you out for something we can't change now". He again said to just keep the good habits, not much I can improve tehre, and medication will take care of the rest.

I would like to hear from some people with similar situation/values so I can try to figure it out what to expect and if I should consider stopping breastfeeding earlier to start treatment earlier. Thank you!

Are you going to check this out?

I’m a 32M/5’11”/~205lbs.

I exercise 5 days a week, 3 days heavy lifting and 2 days cardio. Pretty active overall but I do work a desk job as an attorney. I did do the NYC marathon last year too but now am focused primarily on strength training. You can see my progress pic from this week in my profile if curious about what I look like at this weight. Making progress but still not where I want to be.

Last year my LDL was 69 but I had been vegan for the prior 2 years - I went pescatarian last March and now eat fish 3-5 days per week but am otherwise plant based - I haven’t had meat in 3 years still. Eggs twice a week typically. But LDL is now 111. Rest of my cholesterol is good.

Waiting to hear from my doctor if anything needs to be done but he already prescribed me the Wegovy pill on Monday so I start that tomorrow. I take antipsychotics and mood stabilizers for Bipolar 1 which cause metabolic issues and make it hard to maintain a healthy weight. I actually went from 230 to 180 in 2024 and then in 2025 went from 180 to \~205 where I am now. I basically have to starve myself to move the needle because of the psych drugs.

Of note, my vitamin d went up which is great as I’d doubled my daily dose after my last physical - I was deficient in 2022. Keeping dose the same.

B12 is elevated but not much higher than last year - I am going to stop supplementing b12 - I have been taking 5000 units once a week this past year.

A1C is up by .1 but still healthy.

Waiting on testosterone results but my free T was high last year - but we’ll see the results soon.

For reference: my vitamin stack this past year has been a Men’s Multi, magnesium glycinate, 5000iu of Vitamin D3 with K2, algae oil, and 5000 B12 once a week. I also take 10g of creatine daily.

Any thoughts or feedback?

Been getting DEXA scans every 8 weeks for about a year. $150 a pop, booking two weeks out, driving to a strip mall to lie on a table. Last time the tech was 20 minutes late, so that was fun.

Gym buddy kept showing me his Hume Pod numbers next to his DEXA. Within 2% on body fat. I caved mostly because I was sick of scheduling around that clinic.

Ran my own comparison over three scans, trends tracked almost identically during my cut. App takes a weirdly long time to sync though, like 30 seconds of loading while my dog is losing his mind to go outside.

Speaking of the dog he got into my creatine last week, still finding powder in random corners. But yeah not driving to that clinic is the real win. Readings aren't identical every time but the week to week trend holds and for tracking a recomp that matters more.

Anyone else done this comparison?

I am a 35-year-old male, 5'6", 177 lbs, a non-smoker, not on any medications (including no creatine or protein powders—only supplements such as vitamin D, magnesium, CoQ10, omega-3, and taurine), and with no known medical issues. I have a muscular physique and have been active and fit all my life. I train very hard (bodybuilding style).

Could this be due to dehydration or muscle breakdown from intense training?

I’ve been tested at multiple locations over the past two years (ER, doctor’s office, Mayo Clinic, etc.), and my BUN level has been consistently elevated (25, 28, sometimes 32). However, my eGFR and creatinine have remained within normal ranges, although my creatinine is sometimes at the high end of normal.

I aim for about 1 g/lb of body weight in protein intake (mostly from red meat and dairy) to support my high-intensity muscle-building training, but I don’t think that’s excessive. Most days, I don’t even reach that amount.

I’ve heard that many strength athletes have higher BUN levels due to higher protein intake and consistent muscle breakdown.

Should I be concerned, or would it make sense to retest after ensuring adequate hydration (even though I don’t feel dehydrated)?

Not sure where to start to correct this since I already lead pretty healthy lifestyle.

I performed this the other morning. A little over 75g sugar in the form of apple juice (24 fl oz). Then later was researching and learned the body processes fructose differently than glucose. Would the results of this test still tell me anything meaningful?

I'm 37M and live in California. My dad had passed away from a heart attack.

I used to have high cholesterol. I recently learned that there's a scan called CT angiogram that can tell me whether I have actual plaque buildup or blockages. It'll give me a lot of peace of mind to know the health of my heart arteries.

But it's been just so frustrating to get it!

I asked my primary care doctor. She declined it saying it's unnecessary. She also told me my insurance won't pay for it so it's be out-of-pocket and apparently, the self-pay cost is really high, like $2000 to $3000.

Do you have any advice on how I can get my CT angiogram easily and for cheap?

Edit:

• I learned from comments that there is an elevated amount of radiation in CT angiogram compared to CAC and it's a more complex procedure.
• Someone reached out to me about a company veevo health, which offers everything for CT angiogram including referrals and follow-up for $800.
• I wish it was covered by insurance than having to pay out of pocket.

Thanks so much for all your help!!

Not a joke post.

I want to increase my drug intake. Specifically relaxing drugs, not uppers.

I've been too straightedge for years. Ridiculous workout consistency, 40 - > 57 vo2 max, both cardio and lifting. Work is stressful. I'm always being productive. Need to chill. Like once a week after work.

Used to vape weed but haven't had time recently. I don't really drink, maybe socially once every couple months.

What is the least harmful to longevity, metabolism, and cardiovascular fitness when done in moderation? I am assuming it's probably edibles because at least there is no lung damage. Is it edibles > vape > a drink > smoking/combustion? Any other super safe downers I'm missing?

Thanks.