Karin, your wealth of practical information is greatly appreciated. Can you share what brand/nutraceutical you use for Quercetin and Fisetin. Many many thanks for everything you do.
Thanks Patti, the brands I've been using are: Thorne: Quercetin Phytosome and Genogna Liposomal Fisetin. In liposomal form much better bioavailability, but I'm sure other brands available same way.
So Excellent! You offer so much to 4/4s and you are appreciated.
I take Qualialife Senolytic for 2 days a month and it has the Quercetin and Fisetin you use (from the 2015 Mayo Clinic study) and also 7 other curated ingredients to synergistically improve the formula. My son, the original formulator of Qualia had recommended Dasatinib for me but when I read the possible side effects one of them was too dangerous for me (I once had all my white blood cells wiped out and was close to death for in ICU for weeks so I chose not to risk the Dasatinib). I appreciate that you crefully say that this is what you do and others need to evaluate carefully for themselves. Karin Dee is a rock star.
wise choice to be cautious with Dasatinib. It’s definitely a potent drug and I can’t emphasize that enough. I’m glad I did research before I blindly took a 100mg pill prescribed. Didn’t do it, and surely saved myself what would have been a very miserable time!
Really enjoyed this! I especially appreciate your “not rewriting guidelines, but describing what actually happens in clinic” approach: start with patient goals, address secondary causes, then treat the lipoprotein phenotype with stepwise intensification until targets are met.
A few points you highlight that I think are hugely important (and often missed):
1. Preference-sensitive primary prevention: naming the category-error risk of over-interpreting short-term population risk as an individual destiny is exactly right. This is where shared decision-making belongs, not rigid thresholds.
2. ApoB-centered thinking: keeping the focus on apoB-containing particle burden as the central atherogenic driver makes the “why” of statins + add-on therapy immediately intuitive, especially in mixed phenotypes where LDL-C alone can mislead.
3. Smart, selective biomarkers: your use of Lp(a) and apoB when the context suggests concealed risk (TG elevation, central adiposity, dysglycemia) is a very clinician-forward way to avoid both undertreatment and unnecessary escalation.
4. Targets with a reality check: borrowing the clarity of ESC-style targets while acknowledging that “Group 4” is intentionally omitted because preferences dominate; this is the balance most real-world practice needs.
Also loved the practical notes on fasting vs non-fasting lipids and repeating TG elevations fasting to clarify phenotype. Thank you!
Thank you so much for this! Again, you’ve knocked it out of the park with your clear explanations. Is there benefit from pulsing Quercetin and Fisetin without Dasatinib? I would like to try Dasatinib but unsure how to approach getting a prescription.
Thanks Alisa, I take Dasatinib now because I still have a supply from Dr. Green. When that's gone, I'll stick to the Q&F only.... unless I become symptomatic. Yes, there is plenty of research on both of these flavonoids to support their use and not strictly as a senolytic either. https://pubmed.ncbi.nlm.nih.gov/40147710/
Karin, your wealth of practical information is greatly appreciated. Can you share what brand/nutraceutical you use for Quercetin and Fisetin. Many many thanks for everything you do.
Thanks Patti, the brands I've been using are: Thorne: Quercetin Phytosome and Genogna Liposomal Fisetin. In liposomal form much better bioavailability, but I'm sure other brands available same way.
So Excellent! You offer so much to 4/4s and you are appreciated.
I take Qualialife Senolytic for 2 days a month and it has the Quercetin and Fisetin you use (from the 2015 Mayo Clinic study) and also 7 other curated ingredients to synergistically improve the formula. My son, the original formulator of Qualia had recommended Dasatinib for me but when I read the possible side effects one of them was too dangerous for me (I once had all my white blood cells wiped out and was close to death for in ICU for weeks so I chose not to risk the Dasatinib). I appreciate that you crefully say that this is what you do and others need to evaluate carefully for themselves. Karin Dee is a rock star.
wise choice to be cautious with Dasatinib. It’s definitely a potent drug and I can’t emphasize that enough. I’m glad I did research before I blindly took a 100mg pill prescribed. Didn’t do it, and surely saved myself what would have been a very miserable time!
Really enjoyed this! I especially appreciate your “not rewriting guidelines, but describing what actually happens in clinic” approach: start with patient goals, address secondary causes, then treat the lipoprotein phenotype with stepwise intensification until targets are met.
A few points you highlight that I think are hugely important (and often missed):
1. Preference-sensitive primary prevention: naming the category-error risk of over-interpreting short-term population risk as an individual destiny is exactly right. This is where shared decision-making belongs, not rigid thresholds.
2. ApoB-centered thinking: keeping the focus on apoB-containing particle burden as the central atherogenic driver makes the “why” of statins + add-on therapy immediately intuitive, especially in mixed phenotypes where LDL-C alone can mislead.
3. Smart, selective biomarkers: your use of Lp(a) and apoB when the context suggests concealed risk (TG elevation, central adiposity, dysglycemia) is a very clinician-forward way to avoid both undertreatment and unnecessary escalation.
4. Targets with a reality check: borrowing the clarity of ESC-style targets while acknowledging that “Group 4” is intentionally omitted because preferences dominate; this is the balance most real-world practice needs.
Also loved the practical notes on fasting vs non-fasting lipids and repeating TG elevations fasting to clarify phenotype. Thank you!
Thank you so much for this! Again, you’ve knocked it out of the park with your clear explanations. Is there benefit from pulsing Quercetin and Fisetin without Dasatinib? I would like to try Dasatinib but unsure how to approach getting a prescription.
Thanks Alisa, I take Dasatinib now because I still have a supply from Dr. Green. When that's gone, I'll stick to the Q&F only.... unless I become symptomatic. Yes, there is plenty of research on both of these flavonoids to support their use and not strictly as a senolytic either. https://pubmed.ncbi.nlm.nih.gov/40147710/