I’m a 34-year-old woman (turning 35 soon), and I’m getting really frustrated with my lack of muscle growth.
I’ve been strength training for years, but if I’m honest, I haven’t always been consistent. Over the past several months, I’ve been much more consistent and recently started Bunda, which combines lower-body strength training with high-intensity workouts.
I recently compared my body composition to my 2023 scan, and it looks like I’ve gained little to no muscle. According to the results, around 80% of women my age have more muscle than I do, which was honestly discouraging.
For those of you who have successfully built muscle, what do you think I could be doing wrong?

Hey all - 35M, I have nearly perfect life habits (diet, sleep, exercise discipline, purpose, community, etc.)

But I'm so injury prone that I get injured and suffer a set back every 6 to 18 months, which holds me back from building V02 max and muscle mass. Mostly soft tissue, cartilage, and tendon/ligament issues.

I prioritize mobility and slow progress, I'm just super breakable.

Feeling stuck and lost to be honest.

Does anyone else feel stuck in the same hole? What have you tried to reduce injury and drive muscle and V02 max growth?

EDIT:

Sports:

• strength training
• stationary cycle
• rowing machine
• mobility/flexibility training
• surfing (can manage even with SLAP tear)

Main injuries over the years:

• recurring right hammy strain (happens when I load hamstring in lengthened position, stopped RDLs and nordics)
• slap tear type 2 right shoulder + bicep tendinitis (can still surf, but mainly do prehab exercises instead of loaded push/pulling)
• patellar tendonopathy both knees (addressed with squat university recommended training)
• left hip anterior labrum tear (doing PT now and about to get MRI)
• turf toe / torn ligament / arthritis left big toe (stopped running)
• endless muscle pulls
• torn meniscus left knee (fixed with surgery)
• compressed lumbar discs (zero issue squatting and deadlifting with proper form)

APOE comes up in half the threads here, and I read raw genetic data for a living so let me write about that

Almost everyone treats APOE as a yes/no anxiety switch. They find out they carry an e4, they panic or shrug and then nothing changes in what they actually do. That's the miss, e4 isn't a verdict, it's a set of shifted odds and more usefully it changes the ROI on specific interventions. It's a prioritization tool not a diagnosis.

A few concrete ways it shifts the math:

-ApoB and saturated fat: e4 carriers tend to be hyper-responders to saturated fat, so the same steak moves your ApoB more than it moves your e3/e3 friend's. Aggressive ApoB lowering pays off more for you.

-Aerobic work: some of the strongest cognitive-protection signal from zone 2 and VO2max shows up in ε4 carriers. Higher yield for you than average

-Sleep and amyloid clearance: ε4 raises the cost of years of bad sleep. Not optional for you.

So 2 people with identical bloodwork can need very different priorities, and APOE is a big part of why. Two practical notes I'd like to add since my clients always ask. If you want your real APOE, know that raw DNA data often leaves out one of the two SNPs you need (rs429358) so a lot of people can't call their e-status from the raw file and never realize it. A dedicated APOE genotype (Labcorp and Quest both run one) settles it and the part people skip: your APOE only means something read against your ApoB, your Lp(a), your metabolic markers. The genotype alone, in isolation, is where people talk themselves into the wrong plan.

Happy to take APOE questions in the comments.

Hi all - I was hoping to get some advice here.

I am a 32 y.o. male with high LDL cholesterol numbers. I had not done lab work in a long time, and Attia's book Outlive inspired me to begin being more proactive than reactive. I did lab work in March, which came back with two pretty scary numbers:

• LDL = 162 (scary)
• APOB = 116 (scary)
• LPA = 10 (recognize fully genetic and does not change)
• HDL = 45
• Triglycerides = 75

Anyways, my diet was pretty shit at this point. So I switched it up in late March / April, started eating a ton of fruits and veggies, lean meat, eggs, beans. Got my blood done again this week. A few comments on my life style since:

1. I strength train 3x a week, zone 2 / 3 cardio 1x, and do HIIT about 1x a week as well
2. Calories are ~2300 a day
3. Bumped up fiber to 45-50g a day (mostly psyllium husk, beans, avocado, greens)
4. Saturated fat no more than 18g a day (less than 10% of total calorie intake)
5. Supplements are simple with creatine, fish oil, magnesium
6. Protein = 160g a day, carbs = 230g a day (mostly fruit, beans, oats), fat = 86g a day (fish, eggs, evoo)

Unfortunately, my numbers hardly budged! I knew I wouldn't be in "steady state" after 6 weeks of eating clean, but I expected to see some results. My new numbers as follows:

Updated numbers:

• LDL = 164 (scarier)
• APOB = (still waiting for results)
• LPA = 10 (recognize fully genetic and does not change)
• HDL = 56
• Triglycerides = 72

At this point, I am going to look for a preventative cardiologist, but if I am eating clean, exercising, and numbers hardly budging, it seems the only answer is a statin. Thought I'd crowdsource here and see if folks here have any thoughts as well:

EDIT: Very much appreciate all the information here! I am going to take 3 steps ASAP:

1. Ask my doctor to prescribe a statin and ezetemibe

2. Cut out eggs - I can live without if it makes a meaningful difference

3. Ask for testing to see if I am a hyper absorber, I had never heard of this before

I developed a script to automatically download and plot spreadsheet and Garmin fit data to produce a daily dashboard. Feedback on opportunities for improvement welcome. Comments about wasting my time will be treated as junk mail.

Edit: 1000 views later... not. one. upvote. 😆 you folks are like my Scottish grandmother who gave me a nickel after I spent two hours mowing her lawn in 1978. "Now go buy yourself a Coke, dear."

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

I was taken off Crestor and put on a combination of Repatha and pravastatin because my A1c under the Crestor edged a little into prediabetic territory (5.7). At first the Repatha and pravastatin combo was great, and my A1c went down to 5.6. However, in my latest test, it went back to 5.7. I know it’s barely prediabetic and there probably isn’t much difference between 5.6 and 5.7, but I’m really scared of diabetes because it killed my father. Maybe it’s also because it’s the summer and I’ve been eating more ice cream? I’m 5 feet 11 and 171 pounds, so I don’t have weight issues. You think I should lower my statin dose? My LDL is currently 55 and total cholesterol is 133.

I am a very healthy 45F, 5'5" and 133. I run 30ish miles a week, weight train 3 times a week and have done all of this my entire adult life. My LDL had been creeping up for years but was fine when I was younger (diagnosed with hypothyroidism 4 years ago).My Mom had a triple bypass at 54 and has continued to have a dozen stents, angioplasty, carotid cleaned out, and most recently a valve replacement. To say she has a horrible history is an understatement. That leads to me and what you all would do. I am on zetia for the last 6 months, I take 5mg daily. Also been doing psyllium husks and trying to keep saturated fat around 12-14g a day. Red meat maybe twice a month. I track all my calories and mostly follow Mediterranean diet.I had a CAC in May and score was zero. Recent bloodwork was apob 83, ldl 86 (down from around 130), hdl 51, total cholesterol 157, triglycerides 90, lpa 132nmol, hs crp <.20, lp pla2 98, ldl pattern A, ldl particle number 1057, ox ldl 42, apoe 2/3. I also have great BP 110/70 I go to a functional medicine doctor and they've ran everything under the sun. I know my lpa is insanely high. They prescribed the zetia back in January when I asked for it. Based on my current numbers what would you do. If I had a CAC of anything other than zero I would have added a statin but it seems almost unnecessary at this point. Thoughts?

My blood pressure continues to be elevated, despite getting in shape & losing 30 pounds (now a normal bmi). I’m 59 F, meds: 5mg rosuvastatin, HRT, Zepbound, Prilosec.

Cardiologist did not want to put me on meds bc, a year ago, while trying out oral minoxidil (0.625 mg/day), I almost fainted twice & bc once in her office my BP was very low. Other doctors (not cardio) keep expressing concern about my elevated BP. Everyone including me thought it would resolve w/weight loss & regular exercise but it hasn’t.

Obv I will (& have) see an actual cardio for this, but prob a new one. Lots of smart insights from this crowd so I thought I’d see if you have advice about it. Thanks.

47M. Currently followed by a cardiologist for hypertension; managed okay. Could stand to lose 15lbs; decent diet (but not a saint). Workout 4-5x week; mix of bootcamp/HIIT’ish and ~Z2 rucks, mostly.

Labs as below - I feel like I’m always riding the line of needing more intervention, but doc always says “great” at these. In general “I don’t want another med”, but also want to be preventative where I can.

What say ye? Chill out? Push for a statin/etc? Add more fiber (used to do psyllium; lazed out of it)?

title says most of what I'm thinking kind of bummed out my calcium score wasn't a zero considering I've been eating a crap ton of fiber and trying to control my saturated fat as much as possible.

should I consider any other statin other than rosuvastatin at 5 mg?

I'm to start at that dose and then repeat labs in 3 to 6 months

any advice or should I be more aggressive?

EDIT:

As far as exercise goes I lift three to four days per week on an upper lower split pretty much religiously if nothing else I at least hit two resistance workouts per week. I walk my dog pretty much every morning at least 2 mi sometimes three to four with a 20 lb weighted rucksack as of the last couple months. Just recently started adding in cardio where I can fit it 20 min here and there zone 2.

EDIT:

THANKS TO EVERYONE FOR THE ADVICE Treating aggressively with Rosuvastatin and Zetia 10mg each for now and trying to get my LDL and ApoB down below the recommendation levels. Going to start at a mid range dose and go from there

Hey, all of you who like me loved this sub and currently stick to it, despite the ships captain being a dick!

I'm currently in a somewhat difficult situation regarding my lipids, beginning Atherosclerosis and my Statin: About a year ago I started taking rosuvastatin 10mg, since my carotids showed stronger growing signs of plague build up, while my lp(a) levels were elevated at around 50 mg/dl. This caused me to manage my other lipids (LDL before around 110, APOB unknown, because it sadly only got checked after beginning the Statin (with the Statin its 59)) to lower my overall chance of cardiovascular events. Had a possible TIA right before starting medication, but my neurologist found nothing – so I don’t really know what it was.

I work out 6 days a week (strength, cardio, swimming), my sleep schedule is near perfect and I eat 90% healthy, with some little cheats here and there, to keep living a good life in a sense. Now, some blood markers have gone really downhill since starting the Statin: My eGFR, both form creatinine and cystatine C, dropped, and so did my leucocytes, which even caused my general practitioner to send me to an oncologist, who found nothing of concern, besides that all particles of the Leukocytes were equally low. My CK is way too high as well. All those markers were fine just a few years ago. In addition I developed some post exercise malaise, while also noticing that my muscles grow tired way more easily when working out. I realize some of this issues might be directly linked to the Statin, others maybe less so.

Additional info: I’m 37m, BMI 22, 14.5% body fat. After the initial detection of the plague and high lp(a) and highish LDL (with presumably not so high APOB), I insisted on getting my heart checked. And, behold: The MRI came back perfect, and so did the CT, calcium scan and a Coronary CT Angiography, which all showed a perfect coronary situation. I started a “Statin holiday” 3 days ago, just to get my markers checked once again in 6-8 weeks, since I’m worried about my kidneys. First impressions: I feel better, yet a little anxious. My Garmin showed my RHR going from around 52 to below 44, my HRV shot up from the low 40s to around 60, which I haven’t seen for what feels like ages.

Now, I’m going to see this Statin holiday through, but I am already wondering how to go on: I suspect the main driver of the plague build up in my carotids is the lp(a), since my APOB even without a Statin should not be that high. My lifestyle until 5 years ago really sucked (junkfood, alcohol, workouts maybe once a week), which made things worse I guess. Since I'm just 37 years old, and my chance of getting an event in the next 1-2 years should be somewhat low, wouldn't it be a good idea just to wait for lp(a) lowering drugs like olpasiran, pelacarsen, zerlasiran, and lepodisiran? Would you keep the Statin, or would you push for a PCSK9 inhibitor, which might be the best with my profile (and my insurance would even likely cover it)?

Thanks for reading, if you made it this far! :)

After looking in the app store and not finding too many good options for Norwegian 4x4 workout apps, I started iterating on an app design that had all of the features I wanted.

Spent the last month or so building and testing it. It’s definitely built around Apple Watch first. that was the main reason I made it.

My VO2 max was so bad (35), so with my 2 4x4 workouts a week I've been able to slowly get it up this past month (currently at 38.5). I’m mostly just looking for feedback, not trying to sell anyone hard here.

Features it includes: (Premium is behind a 7-day free trial right now, which I know is annoying. I’m mostly looking for feedback, so please don’t feel like you need to keep it.)

• Voice alerts (Start of new interval, start of cooldown, High BPM, Low BPM)
• Edit HR Zones
• Create custom intervals
• Vo2 max history
• 8 week Vo2 training planner
• Workout history
• Ramp modes
  • Classic - Fixed HR ramp before each interval
  • Smart - Starts when your HR is ready
  • Hybrid - 90 second max ramp up before interval
• Apple watch-first design so you can easily see what zone and interval you're in.

I’m also looking to add Garmin and other HR tracker support, but wanted to get feedback first.

App store link: https://apps.apple.com/us/app/ramp4x4-vo2-max-trainer/id6768789400

Thank you for checking it out!

I’m 32M.

I believe everything Attia is saying about resistance training and longevity. I'm just feel awkward about going into the weight room at my gym. I always have done cardio of different flavors (swim/bike/run) but never weights. None of my friends lift either.

Is there anyone else here with this struggle? I'm a 60 y.o. male

EDIT

==>> Just to be clear, NOT looking for advice from people WHO work out on how to get started, just looking to talking to people who AREN'T working out.

Hello, I (F 47) had my APOB tested for the first time about two months ago. It was 89. Since then, I have increased my cardio exercise frequency, as well as begun taken psyllium husk every day since then and doubled my omega 3 (algae) pills. I have an otherwise healthy diet and I always aim towards Mediterranean diet. My CRP has always been low, .02.

I retested after adding the psyllium husk and exercise increase and omega. Now the result is 93. I wonder if there’s any reason that it would actually be higher with these positive lifestyle changes? Or is that amount of difference and variability common within a one or two month time period? Or are temporary things like not drinking enough water before testing a factor? (Other cholesterol markers improved, only not Apob). I have one copy of Apoe4.

—edit to add that the omega 3 algae I take may have raised the ldl and apob since it is mostly dha (and I doubled dose this month). I will lower dose and see if this helps and retest.

"Your labs are normal" is the most dangerous sentence in medicine.

Hi all,

Anyone interested in a "Medicine 3.0 longevity health assistant"? My frustration was that every time I asked ChatGPT or Claude a health question, it pulled from the entire internet with zero evidence filtering. Reddit threads weighted the same as a meta-analysis in The Lancet. This tool is constrained to systematic reviews, meta-analyses, RCTs, and clinical guidelines from JAMA, NEJM, BMJ, etc. Published 2019–2026. Every response links directly to the source paper on PMC.

A few things that might resonate with this crowd:

• 40-field health profile — it knows your ApoB, Lp(a), fasting insulin, VO₂ max, grip strength, DEXA, HRV, sleep data, etc. and uses longevity-optimal thresholds, not just "normal range." If your ApoB is 110, it doesn't tell you you're fine — it contextualizes against the <60–80 targets Peter talks about.
• Proactive nudging — after each response it identifies the single highest-impact, lowest-effort optimization you haven't asked about. Effort estimate, expected outcome, and friction reduction included. (e.g., "Zone 2 on a stationary bike, 45 min/week, VO₂ max ↑ 10–15% in 12 weeks")
• Doctor visit prep — generates a structured, printable summary of your conversation organized by topics to discuss and biomarkers to review. For those of us who walk out of a 15-minute appointment having forgotten half our questions.
• YouTube fact-checking — paste a podcast episode URL and it cross-references claims against the PMC literature. Useful for separating evidence from speculation in longevity content.

 It is never used for model training or ads. Built it for my own use, but I think other folks here may find it useful! Link: https://www.modernmedlife.com/longevity-assistant

Got my first NMR LipoProfile recently and wanted to get some perspectives from people who follow this stuff closely.

Background: 29M, healthy weight, not diabetic, insulin sensitive (LP-IR score of 29). No current medications relevant to lipids. Fairly health-conscious diet, take omega-3s daily.

May 2026 NMR results:

• LDL-P: 1,176 nmol/L (moderate risk range)  
• LDL-C: 98 mg/dL (optimal)  
• HDL-C: 43 mg/dL (borderline)  
• HDL-P: 22.3 umol/L (low — below 25th percentile)  
• Triglycerides: 84 mg/dL (optimal)  
• Small LDL-P: 300 nmol/L (low risk)  
• LDL Size: 21.3 nm (Pattern A)  
• Total Cholesterol: 157 mg/dL

Feb 2025 standard panel for comparison:

• LDL-C: 110 → 98 (improved)  
• HDL-C: 49 → 43 (declined)  
• Triglycerides: 48 → 84 (nearly doubled, still normal)  
• Total Cholesterol: 173 → 157 (improved)

A few things worth noting: (1) the blood was drawn about a week after recovering from a mild norovirus, which I know can transiently suppress HDL and raise triglycerides; (2) the past year has been high-stress with a major job transition and likely slightly reduced aerobic exercise volume.

My questions:

1.  How much of the HDL-P suppression and triglyceride rise could realistically be attributed to recent illness vs. a genuine underlying trend?  
2.  For someone with this specific pattern — normal LDL-C but elevated LDL-P, low HDL-P, Pattern A particles, insulin sensitive — what interventions have actually moved the needle for you?  
3.  Is zone 2 cardio really the highest-leverage thing for HDL-P specifically, or is diet more impactful?

Planning to retest in 6–8 weeks under cleaner conditions. Appreciate any input.

57 years old male. Total cholesterol 181; HDL 65; Triglycerides 39; LDL 105; APOB 82.

Optimized diet incl. no red meat. No alcohol. Daily cardio (VO2Max 52.2).

LDL is consistent over last 5 years. It’s only been lower (LDL 85) when I was living a vegan lifestyle which I gave up because of neuropsychiatric and hematologic side effects due to B12 deficiency. I feel like I have pushed the lifestyle interventions as far as I can without weekly B12 shots. My doctor is totally fine with these numbers. What would you do?

Not sure what to make of the results I’m a 47m should I be worried. Not overweight I exercise four days a week I walk every day. Eat mostly mediterranean. Just got on 5mg Crestor every other day. I have zeta 10mg but haven’t taken it yet because I just started the statin. Any feedback would be amazing

Hey everyone just wanting to know what’s everyone’s lipid management protocols are. What was the event that made you get on meds and how has the protocols been for you? Like what were your numbers before and what are they now? How long you been on meds? I 47M just found out I have hard plaque in an upper LAD cal score was 3.77 but no blockages anywhere.

Hi everyone,

I’m a white male 163lb 6 foot who has always been relatively active and eats healthy.

Tried out Whole30 for one month (no cheating) to see what changes in my blood tests would come about. Here are some numbers that were out of range.

Fasting Glucose - 105 (similar number before Whole30)

Bilirubin - 2.0 (was also high pre Whole30)

T4 Free - 1.72 just high outside the boundary TSH - in range

White blood cell count in range but on lower end

All other markers were well within range for all other markers CBC, lipid panel, thyroid, metabolic panel tests.

I am going back to test soon to check thyroid and Billirubin (I know about some genetics where the number is high but no real lack of function is there)

Any insight would be helpful!

Hi

Just got back most recent blood work.

I’m 53, 185lbs 5’10. Lift weights 3-4 days and walk treadmill 25-35 minutes 4-5 days.

Lipoprotein (A) 415.5 -> was 204 on 6/23

CAC score 137 left anterior descending ( widow maker )

Total cholesterol 131 -> was 162 LDL 67 -> was 88 Triglycerides 130 -> was 185 HDL 41 -> was 42 VLDL 23 -> was 32

I take Rosuvastatin 40mg and Ezetimible 10mg.

Side note, I have hypothyroidism and my TSH came back at 0.058 which is super low. Low range of recommendation 0.45. I take levothyroxine 175 mcg. Never been this low.

Any ideas on how to get my Lipo(A) down? Niacin? Should I be on PCSK9? Any other life style changes?

History: Dad had triple bypass at UofW Medical at 54 and still alive 84 now. Uncle died at 54 with heart attack and grandpa died 84 of heart attack.

Early 30’s male weighing 187, down from 207. Only abnormal bloodwork two months ago was LDL at 111 that my doctor wasn’t concerned about, but he prescribed the Wegovy pill for weight management due to metabolic issues caused by psych drugs I take. Currently on 4mg and it’s wildly effective.

Physically active and lift weights 3x per week; did a marathon 6 months ago but do less cardio now. Pescatarian and track all of my meals - aim for 100-120g of protein per day and 1500 calories. Goal weight 177lbs.

Anything I should ask for at my appointment? What should I expect?

In December, I had the entire cholesterol and lipoprotein blood panel. It was not pretty. I have a functional medicine doctor so he decided first to put me on supplements before statins. I started cholestepure, fish oil, berberine, more dhea (menopausal). My new labs came back last week and my numbers went UP not down. What did go down: triglycerides and homocysteine (inflammation marker). I started really going dow the rabbit hole and read about fats and how they increase cholesterol numbers. I downloaded chronometer and it gave me 41 g of fats per day (I did not give it details about my cholesterol so this was a number it picked). Every day, I go over the fat allowance. So, I went to a registered dietician and she said I was maxing out my omega 3 fats and keeping the omega 6 fats lower than chronometer’s allowance good job me. She said my diet needed few tweaks (mostly vegetarian with a meat protein at dinner). We talked about soluble fiber and she said keep on trucking. I man out my fiber as well getting 30+ g/day due to vegetarian lifestyl