Particle count, not LDL-C, is what enters the artery.
Board certified in Clinical Lipidology & Obesity Medicine · Licensed in all 50 states & DC
Each atherogenic particle carries one apoB. ApoB counts particles. LDL-C estimates cholesterol mass. Discordance is common, especially with high triglycerides or low LDL-C on treatment.
Set an ApoB target from lifetime risk, CAC, Lp(a), and family history. Intensify until the particle count is down — not until the LDL-C 'looks okay.'
High-intensity statin, ezetimibe, PCSK9 monoclonal antibodies, Leqvio (inclisiran), Lipfendra (enlicitide). Chosen when indicated. Cost of medication is not in the membership.
We prescribe FDA-approved brand and generic drugs to the pharmacy you choose. No compounding.
High-intensity statin first when tolerated. Ezetimibe as add-on or when statin dose is limited. This is still the highest-evidence, lowest-friction start.
Evolocumab (Repatha) is a monoclonal antibody. Inclisiran (Leqvio) is siRNA given twice a year after loading. Both when ApoB remains above target.
FDA-approved 16 July 2026. First oral PCSK9 inhibitor (Merck), adjunct to diet and exercise for LDL-C in adults, including heterozygous FH. Prescribe when indicated.
Medication cost is not included in membership. No compounded medications. Eligibility is confirmed at signup.
Direct-pay lipidology. Cancel anytime. Licensed in all 50 states and DC. Labs and imaging are billed to your insurance; medication is billed at your pharmacy.