New here and a bit overwhelmed.

[SusanJ]

John, just my 2 cents on the fats. You already eat nuts, but do you eat avocados? They are a great source of fat and calories and can be used in so many ways. Also, make EVOO your friend. Salads will be your vehicle for getting more EVOO in. I was able to decrease the small particles, increase HDL by cutting back red meat and going with a similar percentage. I haven't eaten dairy since 1999, so your cutting out dairy could also make a big difference. I do eat chicken along with fish. I'm also a 3/4.

If you don't already, try using a program like CRON-O-Meter to track percentages. You might be surprised at the amounts given what you eat.

If you can get your insulin levels down with this approach, your A1c might be okay if your fasting BG is in the 80s. Note the HOMA score that George references doesn't look at A1c.

Brain fog? You're making a lot of changes and trying to switch your body to use more ketones. Might resolve with a little time as your insulin normalizes. If not, let us know and we can ask more questions and give some suggestions.

Just take a step at a time. You'll find diet, in particular, is a work in progress for a while.

[Fiver]

Hi John, I'm 45 an started on a statin (generic Crestor) ~6 months ago. I have a good cardiologist and spent a lot of time trying to figure out what would be best for me in terms of future CVD and AD risk. There's so much to read, and I found it hard to come to clear conclusions on many questions I had. In the end one thing seemed clear to me - if nothing else the statin would significantly lower my CVD risk. Those data, at least, seemed overwhelming. I'd hate to eat healthy and exercise and have a sharp mind, only to have a heart attack. This was my thinking, anyway. I had some brain fog (a common side-effect) a few days in and settled on a half dose which doesn't cause brain fog and improves my numbers. So if you've started a statin...or start one in the future...just know that can happen. If it does don't give up, just cut back or switch to another statin.

[KatieS]

John & Tom, rosuvastatin (Crestor) is hydophilic like pravastatin, but has the most potent anti-clotting benefit.

[Stavia]

Interesting Katie. Of course the actual event producing a heart attack is a clot/thrombus occluding the coronary artery. This happens because of microtears in the endothelium covering the plaque, and turbulent blood flow because of the narrowing. Once the tissue underneath gets exposed, there is a risk it will activate the blood's inherent clotting mechanism. (Im writing this for members who may be unaware). Then wham!! the lumen is occluded. This is why aspirin is useful in preventing many of these unavoidable tears progressing to a clot.
Nice to know rosuvastatin might help here. Its currently my favourite statin because it crosses the BBB as little as pravastatin but is more powerful.

[Stavia]

Of course....without evidence one doesnt know if one actually has established atherosclerosis....I have seen many a patient older than 50-55 with a high risk LDL and a zero coronary artery scan...

[Fiver]

My thought re: rosuvastatin was to prevent cholesterol biosynthesis in the liver but not in the brain. Overly simplistic, I'm sure. And I know there are data favoring some of the others that penetrate the brain better. What can I say, I'm a work-in-progress

[Lap]

[quote="John K"]Wow,
...
I don't know how to calculate this "Tg/Hdl (wants it <1 in mg/dL units). Also sdLDL-c (<30 mg/dL) ".
....

Hi John,
You just divide the Tg value with Hdl value.
So in your case

TOTAL CHOLESTEROL-------------387--------------239
HDL--------------------------------------87-----------------48
TRIGLYCERIDES----------------------52-----------------50
LDL-C-----------------------------------290----------------181
CHOLESTEROL/HDL RATIO-----4.4----------------- 5

your TG/Hdl was 52/87=0.60 and the more recent value 50/48=1,04

[Stavia]

Tom, we think currently that we don't want the statin to cross the BBB. We want it to stay in the peripheral circulation to prevent heart disease if the person is at risk. We currently do not believe that lipids are a significant risk factor for AD.

[John K]

I now have a glucose meter and have been checking it for about 24 hrs now. This morning before coffee it was 94 and yesterday I have ranges between 84-104 before and after meals. Ill keep checking for anomalies. 94 in the morning seemed a little high. But overall maybe my blood sugar is already getting better due to diet change.

GeorgeN I was reading your transcript with Dr. Gundy and noticed you talked about Low T and aromatase inhibitors. I have been on Testosterone sub dermal pellets for about 3 years now and this last time I got them I also had an aromatase inhibitor pellet put in as well. My last Lipid test had a serious drop in my HDL and I am thinking that the aromatase inhibitor had something to do with that...

Im still wondering what if any my Epa,Dha supplementation should be with the blood fats panel (attached above). Gundry has said some of these ( serum) fats test are worthless because it only tells what u eat yesterday, I hope this is not the case. Anyway I am currently taking no Epa/Dha supplement.

I just ordered some Niacinamide. Pure encapsulations 500mg.

Also GeorgeN, Dr.Gundry says only 4 oz of animal protein a day. What about plant protein limits? and total daily protein intake? Dr. Gundry has a big dislike for lectins, if u add those to the list of other things we cant eat, not much left. That just took all the good stuff off my salad!

SusanJ, I do use a nutrition tracking app on my phone. Its very handy. I am going to add avocados to my ever so shrinking list of things I can eat.

My short term memory is still pretty bad. Could it be that my brain likes high cholesterol and by cutting it starves the brain of what it needs. I used to eat a lot of eggs and lately non. Im going to eat more today and tomorrow and see if that helps.

Thank you all so much!

John K,

[John K]

I cheated the other night on my diet and had Sushi white (rice, avocado and crab)at diner while at a restaurant. Before diner my blood glucose was 92. When I got back to the car about an hour after the sushi my level was 129. My wife (non ape4) was 128. An hour later I was 142 and she was 106. Hmm. Yesterday I had a banana and a half hour later it was 137. Its very interesting and informative to see how and what causes blood sugar spikes and now I fully understand how I got insulin resistant. Now I just have to fix it.

John K.