Mild Ketosis and MCT for 4/4 with high LDL

[slacker]

Teresa - very clearly and well written! Would you be willing to explain how you went about moving from a high carb to Gundry diet? Many thanks!

[TheresaB]

very clearly and well written! Would you be willing to explain how you went about moving from a high carb to Gundry diet? Many thanks!

Thank-you Slacker and certainly.

In 2011, my doctor wanted to put me on statins because of my high total cholesterol. I hadn’t researched statins, but I knew I didn’t want to take any drug if the issue could be handled organically. I made a deal with him to let me try to lower my cholesterol naturally before prescribing a statin. So I went vegan.

I like to think I wasn’t a “crazy” low fat vegan. I tracked fat and protein intake to try to keep the percentages to caloric intake in line. I knew fat in a diet was important, I stayed away from saturated fats, but made a point of eating fat every day. Although I will confess, my fat intake was often in the form of bread being dredged through olive oil. (Yum!) I did not track carbs at the time, I sort of felt if I got enough protein and fat, the carbs would take care of themselves. I did feel good on that diet and enjoyed eating that way.

Aided by exercise, I got my cholesterol down to a level where my doctor was okay with me not being on statins. So I thought I was healthy and doing the right thing.

In the fall of 2014, I learned my ApoE4/4 status. My husband had already learned his status, 3/4, so he had already started researching this genotype. In addition to discovering this ApoE4.info website and Dr Dale Bredesen, he also found Dr Steven Gundry who had been testing and following ApoE4s for years and set an appointment for both of us. In May 2015 we had our first consult with Dr Gundry. I learned I was not as healthy as I thought.

I had some elevated inflammatory markers (lectins), my Omega-3 index (RBC EPA+DHA) was horribly low, (not a surprise with a vegan diet), my Vitamin D was low, I learned I was heterozygous for the MTHFR mutations so I had a methylation issue, and while my insulin like growth factor wasn’t sky-high it needed to be lower. My A1c was 5.0 back then, so even though I wasn’t tracking my carbs I was still doing fairly well, although my A1c has gone down to < 4.2 since then. My total cholesterol was back up to the level it had been when my previous doctor wanted to put me on statins, but that didn’t bother Dr Gundry whatsoever, what he was concerned with was my HDL to triglyceride ratio which he wanted at 1:1 or better, and my sdLDLs, which were high.

A side note, my total cholesterol isn’t substantially lower now than it was back then. The equation for total cholesterol is: LDL + HDL + (triglycerides/5) . Well when your HDL goes up and LDL and triglycerides go down, the answer for total cholesterol stays about the same, which is what happened to me. My total cholesterol still gets flagged by the lab as “yellow” but I am now unconcerned about that.

Back to May 2015, in the consult Dr Gundry gave us this sheet of paper, which back then he called his Matrix diet, now it’s his Plant Paradox diet, same thing just with minor tweaking over the years. It contained a list of foods that were okay to eat and a list with forbidden foods. He also gave us modifications to that list based on our ApoE4 status: no cheese, no animal protein except for wild caught white fish, wild caught shell fish, or Omega-3 eggs, plus some recommended supplements. More info on Dr Gundry here: https://www.apoe4.info/wiki/Dr_Gundry%27s_Protocol So that’s what I did. Lunch was typically some nuts and a piece of 72% or greater dark chocolate, less than 1 ounce. Dinner was raw jicama sticks to dip in guacamole, a big salad of varied vegetables generously covered in extra virgin olive oil and balsamic vinegar, half an avocado, a small source of protein (sometimes animal, sometimes vegan) a cooked vegetable, and an occasional resistant starch “treat” like yucca fries, plantain chips, purple sweet potatoes. I also started intermittent fasting at that time.

I don’t remember going through any keto flu symptoms. I do remember times of irritability at the end of the day when I wanted to eat, or maybe that’s just my normal sparkling personality. I did struggle with hunger issues. I had to work up to 16 hours until I broke my fast. I tried adding coconut oil to my morning coffee to help me make it through the feelings of hunger, but I was still hungry. I still struggle at times and get hungry, but not nearly as badly. Most of the time now I just “power through” because while uncomfortable, it’s not like I’m ravenous and feel I HAVE to eat, and with the body switching to ketones for energy I don’t feel weak without food.

What has kept me going is seeing real results in my biomarkers as a result of changing my diet, (I'm lucky in that I've not had to reverse cognitive issues), reminding myself of the negative consequences if I do go off track, keeping up with latest findings via this website, certain articles, facebook sites, podcasts, etc, and having a husband who is a true partner in this journey of ours.

[slacker]

Thanks Theresa! I need to print this out and read it every day for motivation. Having a partner who is on the same dietary path is also very helpful (unless it's too super easy for them )

[PBW]

Thanks so much Theresa. I took a break from all the info and have just read your input. My keto levels have settled into the 3-5mm/l range. Your info on how to use the acetone meter was very helpful.

I have been attempting to eliminate the possibility that I was experiencing metabolic syndrome and/or insulin resistance, even though my doctor doesn't think I am a candidate for either looking at my bloodwork over the last 15 years and knowing my nutrition and exercise regimen. However she is not so specific as Dr Bredesen or many others. This is why I was trying to reach ketosis to assure myself that my body could use its fat for fuel!

My body responds positively to sprints and other high intensity exercise. Since I retired I have focused on yoga, biking, walking and swimming at a much lower intensity. I was supporting the healing of 50 years overuse and the consequences. I am now going back to incorporate HIIT very carefully, while continuing sprints, hiking(mtns around Evergreen) swimming and biking on a rotation schedule.

I am still searching for an MD to prescribe testing hopefully covered by medicare supplement. Dr Gundry is no longer taking new patients. Dr Manning in Ev., Co has a 3 year waiting list and suggested I contact the Brain and Behavior Center in Boulder.

For now I am using guidelines from Dr Bredesen's book to address each possible hole in my canopy so to speak. I started with inflammation since I found a 2011 homocysteine test revealing a level of 16. Yikes, so I have added the specific B's to daily supplements. I also have eliminated all lectins per the plant protocol. The only area of diet concern that I am not willing to let go of yet is eliminating diary which I have switched recently to A2( except for the Half and Half in coffee) I also have eliminated some of Dr Noakes guidelines and eliminated all coconut oils, flour, etc. to possibly address LDL(mostly large fluffy)

In January , I will get the following tests:A1C, fasting glucose, blood insulin, hsCRT, homocysteine, hopefully Berkeley Lipids, T3,T4, TSH, estrogen,D3, Omega 3 and 6. and see where I am and then go from there.

What are the reasons you do a yearly 7 day fast?

I include all these details because yours, tincup, Stavia, Susan J, Julie and others details have been very helpful.

[Orangeblossom]

I forgot to reply about the 'keto flu' this is basically if someone going into ketosis and gets side effects - I think it's mainly if you go under 20g cards or into ketosis quite quickly. I think it happens due to the change in having less carbs. To help it, people are advised to make sure they have adequate salt, and potassium. I only experienced this to start with when i did LCHF and dropped to under 20g carbs and it is Ok now on around 50g carbs and intermittent fasting. There is an explanation of it here.

https://www.dietdoctor.com/low-carb/sid ... ductionflu

On this subject is it important for us to still make sure we take salt and potassium rich foods in less deep ketosis does anyone know?