For months, my primary care physician and I have been engaged in a polite tug-of-war. The doctor wanted me on a statin. I wanted to see whether lifestyle changes could get the job done without medication.
The doctor had a prescription pad. I had spreadsheets, books and an unreasonable amount of confidence in my debugging skills.
Guess who won?
The numbers: progress, but not victory
My October 31, 2026 bloodwork showed encouraging improvements in several areas. Here's how the key markers compare with November 2025.
| Marker | Nov 2025* | Oct 2026 | Direction |
|---|---|---|---|
| Fasting glucose | 92 | 89 | Improved |
| HbA1c | 5.5% | 5.5% | Unchanged |
| Triglycerides | 104 | 72 | Improved |
| HDL | 40 | 42 | Improved |
| LDL | 162 | 151 | Improved, still high |
| Total cholesterol | 221 | 206 | Improved |
| ApoB | 124* | 105 | Improved, still elevated |
The metabolic numbers are encouraging. Triglycerides dropped from 104 to 72, fasting glucose improved, and HDL edged up. I suspect my two-meal routine and twice-monthly Ekadashi water fasts have helped, although the numbers alone cannot prove that.
LDL and ApoB also came down, but not enough to settle the doctor's concerns.
The metabolic department deserves a pat on the back. The cardiovascular department still has an open ticket.
The stubborn cardiovascular problem
My LDL has been a recurring character in this series. It has survived multiple lifestyle interventions and behaves like a software bug that refuses to disappear.
Then there's my CAC score of 18, which detects calcified plaque in the coronary arteries. It isn't a catastrophe, but it isn't zero either.
ApoB has improved from 124 to 105, but it remains higher than my doctor would like. Clearly, the lifestyle changes have made progress, but haven't resolved the entire problem.
In a LDL marker, it's a number I'd rather see it behave by remaining under 90, not even in the nervous nineties that Sunil Gavaskar was famous for.
One last attempt at negotiation
I wasn't ready to surrender without one final argument.
My triglyceride-to-HDL ratio is now:
72 ÷ 42 = 1.71
I'd been following Dr. Ben Bikman's discussions about this ratio as an indicator of metabolic health. A ratio below 2, particularly below 1.5, is generally considered a more favorable signal.
I presented this as evidence that things were moving in the right direction.
The doctor's counterargument was simple: a favorable ratio doesn't cancel out elevated LDL, ApoB or an existing CAC score.
Fair enough. One good metric doesn't get to overrule the entire dashboard.
I also discovered that the prescription had already been sent to the pharmacy, apparently in anticipation of my next round of counterarguments.
Negotiations were officially over.
The engineer finally agrees
The prescription is for 5 mg of rosuvastatin daily.
I had spent months trying to avoid this outcome. But I've come to accept that lifestyle improvements and medication don't have to be competing strategies.
I'll follow the doctor's recommendation, monitor the response and discuss any future dose adjustments based on the results.
What I won't abandon is the work that got me here:
Two sensible meals a day. I'm not signing up for OMAD.
Two Ekadashi water fasts every month.
Twenty squats after meals, which have often helped bring my glucose reading down by nearly 20 points. Thirty push-ups are a useful alternative.
Morning Sun Salutations.
These habits have helped improve several markers, and I intend to keep them.
The bigger lesson
This journey has taught me that metabolic health and cardiovascular risk are connected, but they aren't interchangeable.
An HbA1c of 5.5%, triglycerides of 72 and a favorable triglyceride-to-HDL ratio are encouraging. But they don't make elevated LDL, ApoB or a CAC score of 18 irrelevant.
I began this journey hoping to outsmart blood sugar. Along the way, I learned that the body runs several interconnected systems. Fixing one doesn't automatically fix the others.
The engineer still wants to measure everything, understand every mechanism and find the least intrusive solution. But sometimes the sensible answer is to combine better habits with medical treatment rather than expect lifestyle alone to solve every problem.
So, the doctor prevailed. The engineer gave up.
At least he did so after reviewing the data.
Measure. Observe. Adjust. Repeat.
Author's Note
This is my personal health journey, not medical advice or a recommendation to start, stop or avoid medication. Cholesterol treatment decisions should be made with your own physician, considering your overall risk profile and medical history.
If you're new to this journey, the earlier episodes cover my experiments with blood sugar, fasting, LDL, ApoB, CAC scoring and the realities of maintaining two meals a day.
The experiment continues. The treatment plan just has one more participant.
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