Our first guest: Dr. Thomas Dayspring...

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Re: Our first guest: Dr. Thomas Dayspring...

Postby Tincup » Wed Oct 05, 2016 8:37 pm

I tested as a hyper absorber of sterols. Dr. Gundry said not to worry, just don't take sterol supplements, same as Dr. Dayspring.
Last edited by Tincup on Thu Oct 06, 2016 9:31 am, edited 1 time in total.
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Re: Our first guest: Dr. Thomas Dayspring...

Postby Nancy » Wed Oct 05, 2016 10:02 pm

I am grateful that we have lots of new research available to us, but also that most of us are able to have testing done. I think one good way to figure out what is best for us individually is by trial and error: trying certain diets, then having the tests done. I can't wait to see what, if any, changes my new eating habits will have on my labs next month. I also plan to check for calcium build up at some point. There is also wisdom in using common sense. Removing all produce from our diets cannot be good for us.
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Re: RE: Re: Our first guest: Dr. Thomas Dayspring...

Postby Stavia » Thu Oct 06, 2016 1:54 am

Nancy wrote: There is also wisdom in using common sense.


Exactly Nancy. Well said.

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Re: Our first guest: Dr. Thomas Dayspring...

Postby Julie G » Thu Oct 06, 2016 1:14 pm

By "provocative," I meant thought provoking ;). Once again, thanks to all who've weighed in.

IMO, Dr. Dayspring's statement is open for interpretation. I suspect both Gene and Stavia have touched upon important facets of his message. He's definitely not suggesting that we limit vegetables just medical foods with plant sterols, BUT he doesn't mention EVOO specifically which is very high in beta-sitosterol.

This link actually suggests it has the highest concentration found in any food.
Beta-sitosterol is found in plant-based foods, such as fruits, vegetables, soybeans, breads, peanuts, and peanut products. Beta-sitosterol is also present in bourbon and oils, such as olive, flaxseed, and tuna. Plant oils contain the highest concentration of phytosterols. Nuts and seeds contain moderate amounts of phytosterols, while fruits and vegetables generally contain the lowest phytosterol concentrations. For example, roasted peanuts contain 61-114 milligrams per 100 grams, 78-83% of which is in the form of beta-sitosterol. Peanut butter contains 144-157 milligrams per 100 grams. These values indicate that peanut products are a good source of phytosterols, specifically, beta-sitosterol. Avocados have also been identified as a good source of beta-sitosterol.[Emphasis mine]

This link suggests that beta-sitosterol constitutes 90-95% of the sterols in olive oil.
The amount of total sterols in extra virgin olive oil found by different groups varies between 113-265 mg/100g oil (5;6). Two factors influencing this amount are the cultivar and the degree of ripeness of the olives (5). By far the major sterol in olive oil is ß-sitosterol, constituting up to 90-95% of total sterols (5;6)[Emphasis mine]

Given that some members (like myself) use it with other foods also high in beta-sitosterol to achieve ketosis, it's certainly worth examining. This could be particularly relevant for those who hyperabsorb sitosterol. George, I actually find Dr. Gundry's take very comforting because he IS specifically recommending a ketogenic diet with plant fats to a hyperabsorber of sitosterol, whereas I'm pretty certain that Dr. Dayspring had no idea some of us were using EVOO so liberally.

Has anyone seen the recent paper below? Using a huge dataset, Dr. Dayspring separates folks by APOE genotypes and examines cholesterol absorption & synthesis biomarkers. Not surprisingly, (in general) E4 carriers were found to be hyperabsorbers, especially of beta-sitosterol. It's remarkable, however, to see the enormous difference between genders after menopause. Women's absorption skyrockets, while men's takes a nosedive. Pure speculation on my part, but I can't help but wonder if women's increased cerebral hypometabolism at that time triggers an increased absorption of sterols in an effort to compensate by creating KBs.

Biomarkers of cholesterol homeostasis in a clinical laboratory database sample comprising 667,718 patients
http://www.sciencedirect.com/science/ar ... 7415003645

Also, earlier in this thread, Dr. Dayspring suggests that low desmosterol levels are correlated with AD. Additional research seems to back him up and suggest that desmosterol is emerging as a promising biomarker. Good news for those with high levels!

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Re: Our first guest: Dr. Thomas Dayspring...

Postby GenePoole0304 » Thu Oct 06, 2016 3:56 pm

Well then my whole point is then we should not try to use functional foods to increase sterols if we over absorb them. There was someone here that reported after high intake of evoo that their LDLP# increased which is possible from its high sterol content question!
so over using advocados for us my not be beneficial or functional foods like sterol enriched butters and many other foods.

I found this study which explains what is happening. That is why DrD says to take a baseline reading. Probably best to be done then on a diet near the norm. Now we may not all be affected to the extreme case cited but to other varying degrees, so it still can be a concern. Yes sterols are all over but my moto is not to over consume them.

Now from a book you can see what DrD is talking about and what I meant. It says rare but another book cites 100ès of variations due to genetic defects around that area.

https://books.google.ca/books?id=vUwuAA ... E4&f=false

There is a way to avoid this problem and it is to take zietia.


Am J Cardiol. 2005 Jul 4;96(1A):10D-14D.
Cholesterol and plant sterol absorption: recent insights.
von Bergmann K1, Sudhop T, Lütjohann D.
Author information
Abstract

The recent discovery of transporters in the intestinal mucosa and the canalicular membrane has given new insights into the regulation of intestinal absorption as well as the biliary output of cholesterol and plant sterols. The 2 adenosine triphosphate (ATP)-binding cassette (ABC) half-transporters ABCG5 and ABCG8 are expressed in the mucosa cells and the canalicular membrane, and they resecrete sterols, especially absorbed plant sterols, back into the intestinal lumen and from the liver into bile. Defects of either of these cotransporters lead to the rare inherited disease of phytosterolemia, which is clinically defined by hyperabsorption and diminished biliary excretion of plant sterols. Furthermore, it has been recently demonstrated that the Niemann-Pick C1-Like 1 (NPC1L1) transporter is most likely responsible for the transport of cholesterol and plant sterols from the brush border membrane into the intestinal mucosa. Ezetimibe interferes with NPC1L1, reducing the intestinal uptake of cholesterol and plant sterols. These new findings contribute to our understanding of cholesterol and plant sterol concentrations in serum, and the effect of dietary and drug intervention to reduce serum concentrations of sterols.

https://www.ncbi.nlm.nih.gov/pubmed/15992510

Juliegee that is a recent paper and nice to see DrD still working on this problem as he is the expert. It was a few years ago that I discovered this and then it was only a possibility. You can understand why he says few understand the complex subject.

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Re: Our first guest: Dr. Thomas Dayspring...

Postby Nancy » Thu Oct 06, 2016 9:48 pm

It is good to know. Thank you. When get my new labs next month, if I see a big problem from eating all this olive oil and avocado, I may cut back. I also have a bottle of zetia that I was prescribed along with a statin in January, but I only took them for a week because of the side effects. They were bad. But maybe the zetia alone would be ok.
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Re: Our first guest: Dr. Thomas Dayspring...

Postby Julie G » Mon Oct 10, 2016 10:45 am

Zetia (Ezetimibe) can effectively lower LDL-C, but doesn't seem to have any effect on actual CVD events. Even when combined with a statin, the benefit appears to be negligible leading me to have doubts about this approach. Mechanistically, it makes sense for hyperabsorbers, but the data just isn't there...

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Re: RE: Re: Our first guest: Dr. Thomas Dayspring...

Postby Stavia » Mon Oct 10, 2016 11:03 am

Juliegee wrote:Zetia (Ezetimibe) can effectively lower LDL-C, but doesn't seem to have any effect on actual CVD events. Even when combined with a statin, the benefit appears to be negligible leading me to have doubts about this approach. Mechanistically, it makes sense for hyperabsorbers, but the data just isn't there...

Agreed Julie. I only use them or prescribe them under shared care situations with cardiologists in two circumstance. The first situation is combination with a statin in those with familial hyperlipidaemias at very high risk, where the baseline numbers are extremely high and statins are unable to get the numbers down enough. We're talking totals of 9mml/l or more even (350). There are no trials in these persons and the population data cannot be accurately extrapolated to them.

The second is alone in those at high-risk due to previous events who are completely intolerant of statins due to liver effects or rhabdomyolysis. But in this latter situation I am very aware that there is no evidence that further events are prevented.
.
Things may be different in the US and it may be used more liberally. This is the British-based medical approach to ezetimibe.

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Re: RE: Re: Our first guest: Dr. Thomas Dayspring...

Postby slacker » Mon Oct 10, 2016 2:10 pm

Stavia wrote:
Juliegee wrote:Zetia (Ezetimibe) can effectively lower LDL-C, but doesn't seem to have any effect on actual CVD events. Even when combined with a statin, the benefit appears to be negligible leading me to have doubts about this approach. Mechanistically, it makes sense for hyperabsorbers, but the data just isn't there...

Agreed Julie. I only use them or prescribe them under shared care situations with cardiologists in two circumstance. The first situation is combination with a statin in those with familial hyperlipidaemias at very high risk, where the baseline numbers are extremely high and statins are unable to get the numbers down enough. We're talking totals of 9mml/l or more even (350). There are no trials in these persons and the population data cannot be accurately extrapolated to them.

The second is alone in those at high-risk due to previous events who are completely intolerant of statins due to liver effects or rhabdomyolysis. But in this latter situation I am very aware that there is no evidence that further events are prevented.
.
Things may be different in the US and it may be used more liberally. This is the British-based medical approach to ezetimibe.


I agree with Juliegee, but I don't think that the analyses showing that ezetimibe doesn't have an effect on actual CVD events separated out hyperabsorbers. I suspect that everything is lumped together. So we just don't know.
Here are links to the industry funded IMPROVE-IT trial, where ezetimibe was or wasn't added to simvastatin after an acute coronary event requiring hospitalization.

https://www.ncbi.nlm.nih.gov/pubmed/26039521
http://www.nejm.org/doi/full/10.1056/NE ... articleTop

Over a median of 6 years, risk of MI and stroke reduced by 2% (number needed to treat 50), while the rates of death from cardiovascular causes and from any cause were similar in the two groups.

Stavia; in the US anyone can prescribe ezetimibe with or without a statin (primary care, endocrinology, cardiology...etc). Ezetimibe is typically prescribed if the person's LDL is not "at target" or if they don't tolerate or won't take a statin. Interestingly, one of the FDA indications for ezetimibe is "familial sitosterolemia, homozygous"! In 18 years I have never seen hyperabsorbability tested (until joining this august group), so in the US, it is probably in the purview of lipidologists such as Dr Dayspring. The drug most likely received the indication purely on reduction of sitosterol levels, not cardiovascular outcomes. It is the person's insurance company who decides whether the drug is covered or not. I don't think that Zetia is generic yet, and average cash out of pocket price for a 30 day supply is $300. Most people will not pay out of pocket at this price.
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Re: Our first guest: Dr. Thomas Dayspring...

Postby Nancy » Mon Oct 10, 2016 10:48 pm

I remember either the zetia or statin being expensive, my copay that is. Not quite that high, though, maybe because of my insurance. I guess I'll just wait for my November labs to decide. The statin caused muscle pain and lots of twitches, even at night. Extreme fatigue and brain fog, as well.
I'm hoping the mct oil and fruit i eat don't have a bad effect on my labs...getting anxious, now, a bit :? But I am going to keep doing what I've been doing to see.
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