Ideal diet for my Mom APoE 3/4 to gain some weight back

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artbellio
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Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby artbellio » Sat Mar 06, 2021 5:55 pm

Hello,
I'm pretty new here. I made my first post https://apoe4.info/forums/viewtopic.php?f=4&t=7421&p=78357&hilit=artbellio#p78357
couple of months ago regarding my mom.

Since then we've experienced some ups and downs.
But in Jan she started a new therapy- which gave her some life.
Last month she started another therapy and seems to be responding well to it. It'll take about 4 weeks to see if she took to it.

She's currently under 60lbs. I'm wondering which is the ideal diet for her (ApoE 3/4) to gain some weight back that she lost after the stroke.
I've been adding olive oil to her foods for her heart and for the extra calories but it doesn't seem like it's enough.
I also make her protein shakes, using grass-fed whey, creatine, & amino acids. Is that ok?

Thank you so much!
I'm here for my mom (3/4), advanced Alzheimer's , just had a stroke in Nov 2020.

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Jenny BC
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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby Jenny BC » Thu Mar 18, 2021 5:17 pm

artbellio wrote:Hello,
I'm pretty new here. I made my first post https://apoe4.info/forums/viewtopic.php?f=4&t=7421&p=78357&hilit=artbellio#p78357
couple of months ago regarding my mom.

Since then we've experienced some ups and downs.
But in Jan she started a new therapy- which gave her some life.
Last month she started another therapy and seems to be responding well to it. It'll take about 4 weeks to see if she took to it.

She's currently under 60lbs. I'm wondering which is the ideal diet for her (ApoE 3/4) to gain some weight back that she lost after the stroke.
I've been adding olive oil to her foods for her heart and for the extra calories but it doesn't seem like it's enough.
I also make her protein shakes, using grass-fed whey, creatine, & amino acids. Is that ok?

Thank you so much!
Hi Artbellio! I was one of the folks that responded to your first post here and I am so happy to hear from you again! I've been wondering how you and your mom are doing. I was thinking about some of the things that helped folks with CHF when I was a naturopathic doc working in Arkansas. One thing that I still recommend is Hawthorne Berry extract. Here is the link with some info for you to review. I always have hawthorne extract in my own home because it also helps lower blood pressure pretty effectively for me and has kept me off bp meds...along with dietary changes of course and losing a bunch of weight! Anyway, I'm really curious about the new therapy that your mom tried in January. Do you feel like telling me more about it and how she's doing now? I still think what you're doing as far as adding olive oil, the protein shakes from grass fed whey, creatine is another supplement I used as an ND, and amino acids (building blocks of proteins) are often beneficial.

I'm also curious about how you are holding up and what you are doing as far as self-care. This role that you are in can be the ultimate life challenge for some and often you caregivers forget to love and care for yourself as much as you do your loved one. Don't forget, our friend. And we are here for you and thinking about you and your mom.

Warmly,

Jenny B-C
Jenny B-C ND, NBC HWC
ApoE4.info Sr Support Intern
National Board Certified Health and Wellness Coach
Naturopathic Doctor

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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby artbellio » Sun Mar 21, 2021 12:41 am

Jenny BC wrote:
artbellio wrote:Hello,
I'm pretty new here. I made my first post https://apoe4.info/forums/viewtopic.php?f=4&t=7421&p=78357&hilit=artbellio#p78357
couple of months ago regarding my mom.

Since then we've experienced some ups and downs.
But in Jan she started a new therapy- which gave her some life.
Last month she started another therapy and seems to be responding well to it. It'll take about 4 weeks to see if she took to it.

She's currently under 60lbs. I'm wondering which is the ideal diet for her (ApoE 3/4) to gain some weight back that she lost after the stroke.
I've been adding olive oil to her foods for her heart and for the extra calories but it doesn't seem like it's enough.
I also make her protein shakes, using grass-fed whey, creatine, & amino acids. Is that ok?

Thank you so much!
Hi Artbellio! I was one of the folks that responded to your first post here and I am so happy to hear from you again! I've been wondering how you and your mom are doing. I was thinking about some of the things that helped folks with CHF when I was a naturopathic doc working in Arkansas. One thing that I still recommend is Hawthorne Berry extract. Here is the link with some info for you to review. I always have hawthorne extract in my own home because it also helps lower blood pressure pretty effectively for me and has kept me off bp meds...along with dietary changes of course and losing a bunch of weight! Anyway, I'm really curious about the new therapy that your mom tried in January. Do you feel like telling me more about it and how she's doing now? I still think what you're doing as far as adding olive oil, the protein shakes from grass fed whey, creatine is another supplement I used as an ND, and amino acids (building blocks of proteins) are often beneficial.

I'm also curious about how you are holding up and what you are doing as far as self-care. This role that you are in can be the ultimate life challenge for some and often you caregivers forget to love and care for yourself as much as you do your loved one. Don't forget, our friend. And we are here for you and thinking about you and your mom.

Warmly,

Jenny B-C




Hi Jenny!
Thank you for your response! I really appreciate it.
I wonder if we can use hawthorne for her since her blood is pretty low now (90's). What do you think?

Well we did a few things in Mid Jan:
Stopped the gabapentin (for the post stroke central pain) sedated her too much.
Took a break from furoseimide-- was dangerously dehydrating her.
Started IV Vit C therapy-10 sessions -this began to bring her back.
Once she was stronger she began Ozone Hydrotherapy- 10 sessions.
She needed more, but that was all we did.

Towards the end of Feb she started another treatment with a new doctor. He created a 10 point list to follow.
Mag injections
BPC-157 injections
A bunch of new supplements
Digoxin for the heart
Exosomes IV therapy -- we should see visible results starting after a month.

She is improving and talking again, and I think it everything we did helped, but maybe it's the exosomes that's repairing her heart and hopefully the brain.
She is still having strong central nerve pain from the stroke in the brain---it's something that needs to be addressed- because it really takes her away. We restarted Full spectrum CBD for that.

She's also began weekly acupuncture sessions.
Daily pressure points using a tens unit.
She continues the photobiomodulation therapy for Alzheimer's (gamma) and stroke (alpha.

I think that's it.
I gotta start the self care--its crucial!
Thank you again for you lovely response.
I'm here for my mom (3/4), advanced Alzheimer's , just had a stroke in Nov 2020.

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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby Jenny BC » Thu Mar 25, 2021 12:50 pm

artbellio wrote:
Jenny BC wrote:
artbellio wrote:Hello,
I'm pretty new here. I made my first post https://apoe4.info/forums/viewtopic.php?f=4&t=7421&p=78357&hilit=artbellio#p78357


I wonder if we can use hawthorne for her since her blood is pretty low now (90's). What do you think?

Well we did a few things in Mid Jan:
Stopped the gabapentin (for the post stroke central pain) sedated her too much.
Took a break from furoseimide-- was dangerously dehydrating her.
Started IV Vit C therapy-10 sessions -this began to bring her back.
Once she was stronger she began Ozone Hydrotherapy- 10 sessions.
She needed more, but that was all we did.

Towards the end of Feb she started another treatment with a new doctor. He created a 10 point list to follow.
Mag injections
BPC-157 injections
A bunch of new supplements
Digoxin for the heart
Exosomes IV therapy -- we should see visible results starting after a month.

She is improving and talking again, and I think it everything we did helped, but maybe it's the exosomes that's repairing her heart and hopefully the brain.
She is still having strong central nerve pain from the stroke in the brain---it's something that needs to be addressed- because it really takes her away. We restarted Full spectrum CBD for that.

She's also began weekly acupuncture sessions.
Daily pressure points using a tens unit.
She continues the photobiomodulation therapy for Alzheimer's (gamma) and stroke (alpha.

I think that's it.
I gotta start the self care--its crucial!
Thank you again for you lovely response.
Wow! I apologize for the delay in my response but in my defense you stimulate so many lines of additional research that it takes me a bit to catch up! I am not complaining though. Not at all! I cannot believe the level of study, thought and care you have taken with your mom. It blows me away and motivates me to learn more so thank you!

You brought up a good point to consider regarding Craetagus / Hawthorne Berry, for instance. It made me consider the mechanism of action to understand how it can strengthen a weak heart and modulate blood pressure. I took another look in The Clinician's Handbook of Natural Medicine 2nd Ed - Pizzorno/Murray/Joiner-Bey. They mention that Crataegus oxyacantha is "quite useful in early stages as sole agent and later stages in combination with digitalis cardioglycosides". The research did indicate a drop in bp in the group receiving the botanical, so I no longer think it would be useful and potentially could lower bp further which of course is not the desired outcome. I wish doctors and patient advocates and patients could have this discussion in this way that we are doing.

Their other recommendations are rooted in improving myocardial energy production because they found that "CHF is always characterized by energy depletion, often from nutrient or coenzyme deficiency". I know this is not news to you or your mom's care team based on the extensive therapeutic interventions you have described, but perhaps this will offer some reinforcement and if there is anything new that you have questions about I am happy to help research more.

* Magnesium - needed to make ATP (energy), low WBC Mg is common in CHF patients, Furesomide pulls it out of the body which might explain why discontinuing that has helped. **Monitor serum Mg in patients with renal impairment and those on digoxin because too much can build up in those cases causing hypermagnesemia
* Thiamine B1 - Furesomide causes this deficiency as well and supplementation is needed if taking Furesomide. The authors say that a significant portion of the geriatric population has a deficiency in B vitamins that are critical for both cardiovascular and brain function.
* L-Carnitine - amino acid essential for transport of fatty acids in the myocardial mitochondria for ATP production. "A dosage 500mg 3x per day for 6 months increases maximal exercise time by 16-25% and ventricular ejection fraction by 12-13%.
* CoQ10 - required by every oxygen requiring cell in the body, muscle and brain require most oxygen. Most know about this one - it's also depleted by statin use and age on a side note. My partner and I take 100mg CoQ10 daily
* L-Arginine - increases flexibility of the vasculature and renal function

That's my follow up on your first sentence :) I am looking forward to learning more about the other therapies you've described. I'm very familiar with IV Vit C therapy for many acute and chronic conditions. Have you heard of an IV Therapy called the Myers Cocktail?
Where are you located geographically if you don't mind me asking?

Look forward to connecting again soon.

Warmly,

Jenny
Jenny B-C ND, NBC HWC
ApoE4.info Sr Support Intern
National Board Certified Health and Wellness Coach
Naturopathic Doctor

artbellio
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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby artbellio » Sun Apr 18, 2021 7:19 pm

Jenny BC wrote:
artbellio wrote:
Jenny BC wrote:
Wow! I apologize for the delay in my response but in my defense you stimulate so many lines of additional research that it takes me a bit to catch up! I am not complaining though. Not at all! I cannot believe the level of study, thought and care you have taken with your mom. It blows me away and motivates me to learn more so thank you!

You brought up a good point to consider regarding Craetagus / Hawthorne Berry, for instance. It made me consider the mechanism of action to understand how it can strengthen a weak heart and modulate blood pressure. I took another look in The Clinician's Handbook of Natural Medicine 2nd Ed - Pizzorno/Murray/Joiner-Bey. They mention that Crataegus oxyacantha is "quite useful in early stages as sole agent and later stages in combination with digitalis cardioglycosides". The research did indicate a drop in bp in the group receiving the botanical, so I no longer think it would be useful and potentially could lower bp further which of course is not the desired outcome. I wish doctors and patient advocates and patients could have this discussion in this way that we are doing.

Their other recommendations are rooted in improving myocardial energy production because they found that "CHF is always characterized by energy depletion, often from nutrient or coenzyme deficiency". I know this is not news to you or your mom's care team based on the extensive therapeutic interventions you have described, but perhaps this will offer some reinforcement and if there is anything new that you have questions about I am happy to help research more.

* Magnesium - needed to make ATP (energy), low WBC Mg is common in CHF patients, Furesomide pulls it out of the body which might explain why discontinuing that has helped. **Monitor serum Mg in patients with renal impairment and those on digoxin because too much can build up in those cases causing hypermagnesemia
* Thiamine B1 - Furesomide causes this deficiency as well and supplementation is needed if taking Furesomide. The authors say that a significant portion of the geriatric population has a deficiency in B vitamins that are critical for both cardiovascular and brain function.
* L-Carnitine - amino acid essential for transport of fatty acids in the myocardial mitochondria for ATP production. "A dosage 500mg 3x per day for 6 months increases maximal exercise time by 16-25% and ventricular ejection fraction by 12-13%.
* CoQ10 - required by every oxygen requiring cell in the body, muscle and brain require most oxygen. Most know about this one - it's also depleted by statin use and age on a side note. My partner and I take 100mg CoQ10 daily
* L-Arginine - increases flexibility of the vasculature and renal function

That's my follow up on your first sentence :) I am looking forward to learning more about the other therapies you've described. I'm very familiar with IV Vit C therapy for many acute and chronic conditions. Have you heard of an IV Therapy called the Myers Cocktail?
Where are you located geographically if you don't mind me asking?

Look forward to connecting again soon.

Warmly,

Jenny



Thank you for that wonderful message filled with goodies...I'm sorry it's taken me so long to reply, I actually started a draft weeks ago, lol. Needs to be edited.
Currently there's been a major issue for my mom. It's post stroke migraines. They come almost everyday and can last for hours 12hrs to 48 hours. And during this time my mom won't eat, drink or sleep. So when they finally stop and she's starting to recover another one starts up again. She's not fully recovering. And it's taking all the energy she has left. I suspect she's about 50lbs at this point.

Right now I'm focusing on addressing the inflammation/damage in the brain that's causing these migraines.

The one thing that can help with her brain is Hyperbaric chamber treatments, but she can't due to the edema in her lungs form the heart failure. (She is currently on a heart treatment-so it'll take some time before she can get the HBOT)
So we are doing acupuncture; stroke protocol to help decrease the inflammation and help with the head pain.

Also her TSH is 16.5! It was 3.3 the day after the stroke in Nov. So she's been prescribed thyroid medication.

Also feeding her nutritionally dense foods that are APOE4 friendly which that can be challenging.
Ideally healthy fattening foods. Just not sure which ones.
She stopped eating savory foods so I've been making her my own concoctions:
Hot dairy-free egg nog: well blended cooked eggs, with hot water, cinnamon (or pumpkin spice), nutmeg, MCT oil and monk fruit powder sweetener.
Steamed eggs "flan" with cinnamon, vanilla and monk fruit powder sweetener.

I could really use some help with foods that can help her gain weight.
Got any ideas?

Thank you so much!
I'm here for my mom (3/4), advanced Alzheimer's , just had a stroke in Nov 2020.

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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby SusanJ » Sun Apr 18, 2021 8:06 pm

artbellio wrote:I suspect she's about 50lbs at this point.


At this low weight I personally would not worry about following the Bredesen recommendations. She needs calories!

She might be having trouble digesting fats, and may need more protein and carbs. If you choose high fiber options, like sweet potatoes or squash, they could easily be blended into a soup with coconut milk for extra fat and calories, for example. Does she tolerate whey? Consider adding a scoop of whey protein to the egg nog.

But, please consider finding a nutritionist who is versed in a keto diet, but who willing to help you find foods that will work to help your mother gain weight. Gaining weight might be a part of controlling the migraines.

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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby artbellio » Sun Apr 18, 2021 11:14 pm

SusanJ wrote:
artbellio wrote:I suspect she's about 50lbs at this point.


At this low weight I personally would not worry about following the Bredesen recommendations. She needs calories!

She might be having trouble digesting fats, and may need more protein and carbs. If you choose high fiber options, like sweet potatoes or squash, they could easily be blended into a soup with coconut milk for extra fat and calories, for example. Does she tolerate whey? Consider adding a scoop of whey protein to the egg nog.

But, please consider finding a nutritionist who is versed in a keto diet, but who willing to help you find foods that will work to help your mother gain weight. Gaining weight might be a part of controlling the migraines.


Thank you so much for your reply Susan!
She really does needs calories. I def need to find a nutritionist.
I'm gonna make the sweet potatoes with coconut milk soup, sounds very tasty and she will like it.
I think the fiber will also help with the constipation she's been having.

I have been wondering about coconut milk, if it's APOE friendly.

You said "Gaining weight might be a part of controlling the migraines." please tell me more about this.

Oh yes I forgot to mention I add grass-fed whey and collagen powder to her egg nog :)
I'm here for my mom (3/4), advanced Alzheimer's , just had a stroke in Nov 2020.

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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby SusanJ » Mon Apr 19, 2021 8:11 am

artbellio wrote:Gaining weight might be a part of controlling the migraines.


I have a family member who gets migraines. Skipping meals and stress are 2 big triggers. Given your mom is still losing weight, she is in a calorie deficit, likely experiencing effects of starvation at her weight, so her body is definitely under stress.

Don't let the perfect - following Bredesen's diet guidelines chapter and verse - be the enemy of the good. Your mom needs as many calories as you can get in her at the moment to offset her low weight. Coconut milk is not going to cause an issue short term, in this push to get weight back on her.

Please do find a nutritionist this week who can help and talk to her doctor, if you haven't already about the weight loss. Her weight loss is not normal and she will not survive on the path she is on. (Sorry to be blunt, but this is a medical emergency for her.)

Let us know how it goes!

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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby NF52 » Mon Apr 19, 2021 9:11 am

artbellio wrote:Currently there's been a major issue for my mom. It's post stroke migraines. They come almost everyday and can last for hours 12hrs to 48 hours. And during this time my mom won't eat, drink or sleep. So when they finally stop and she's starting to recover another one starts up again. She's not fully recovering. And it's taking all the energy she has left. I suspect she's about 50lbs at this point.

Right now I'm focusing on addressing the inflammation/damage in the brain that's causing these migraines.
...I think the fiber will also help with the constipation she's been having....

I have been wondering about coconut milk, if it's APOE friendly....
Hi Art,

Life has not been giving you a "spring break", so never feel you have to apologize for not responding--or anything else!

I hope you don't mind if I offer some tips and ideas from my own experience with my mother and mother-in-law. Feel free to ignore any or all of them. My thought is to focus on the most immediate issues that are causing her pain and discomfort and loss of sleep: headaches and constipation.

While fiber might be good for those of us with digestive systems that sometimes get lazy, it might not be what your mom needs right now. It's hard to know if she has a blockage that's causing the constipation, but it's likely her brain is sending out orders to slow down the energy requirements in her digestive system to conserve its needed fuel for her struggling heart, lungs and brain.

To provide outside reinforcements to help her GI system out, you might try some Dulcolax--it's easy to put in those smoothies you're making and tends to work well in people without interfering with other meds. You might also try a switch to more easily digested nutritious options like protein-enriched bone broth. (That assumes she doesn't have a chocking reaction to clear liquids.) I would guess that her primary doctor has good experience with treating constipation in women her age and can also provide some advice.

Don't worry about coconut milk or ApoE 4 "risks" now--those are things that may have a cardiac impact on the long-term for some people with ApoE 4 because of saturated fat. Your mother's body does not have too much fat of any kind!

The headaches sound like torture for her and while they are a common result after brain injuries of any sort, most doctors would want to relieve that pain. If the source is vascular stroke and not a classic migraine, then they might choose different drugs. I'm assuming a neurologist saw her in the hospital and could either suggest something or refer you to a neurologist or geriatrician who could see her on an expedited basis. Even a low dose of a short-term medication might be enough to let her enjoy food much more!

You haven't mentioned talking with your mother about her values and preferences right now and that is a conversation that I imagine she would love to have with you. Taking the time from planning the array of needs for next six months to encouraging her to talk about the last 70+ years is something I wish I had done more with my mother. I do know that those moments are ones when I saw her smile and be at peace instead of in a state of agitation and discomfort.

A virtual hug from another mother with ApoE4/4
4/4 and still an optimist!

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Re: Ideal diet for my Mom APoE 3/4 to gain some weight back

Postby artbellio » Mon Apr 19, 2021 3:20 pm

NF52 wrote:
artbellio wrote:Currently there's been a major issue for my mom. It's post stroke migraines. They come almost everyday and can last for hours 12hrs to 48 hours. And during this time my mom won't eat, drink or sleep. So when they finally stop and she's starting to recover another one starts up again. She's not fully recovering. And it's taking all the energy she has left. I suspect she's about 50lbs at this point.

Right now I'm focusing on addressing the inflammation/damage in the brain that's causing these migraines.
...I think the fiber will also help with the constipation she's been having....

I have been wondering about coconut milk, if it's APOE friendly....
Hi Art,

Life has not been giving you a "spring break", so never feel you have to apologize for not responding--or anything else!

I hope you don't mind if I offer some tips and ideas from my own experience with my mother and mother-in-law. Feel free to ignore any or all of them. My thought is to focus on the most immediate issues that are causing her pain and discomfort and loss of sleep: headaches and constipation.

While fiber might be good for those of us with digestive systems that sometimes get lazy, it might not be what your mom needs right now. It's hard to know if she has a blockage that's causing the constipation, but it's likely her brain is sending out orders to slow down the energy requirements in her digestive system to conserve its needed fuel for her struggling heart, lungs and brain.

To provide outside reinforcements to help her GI system out, you might try some Dulcolax--it's easy to put in those smoothies you're making and tends to work well in people without interfering with other meds. You might also try a switch to more easily digested nutritious options like protein-enriched bone broth. (That assumes she doesn't have a chocking reaction to clear liquids.) I would guess that her primary doctor has good experience with treating constipation in women her age and can also provide some advice.

Don't worry about coconut milk or ApoE 4 "risks" now--those are things that may have a cardiac impact on the long-term for some people with ApoE 4 because of saturated fat. Your mother's body does not have too much fat of any kind!

The headaches sound like torture for her and while they are a common result after brain injuries of any sort, most doctors would want to relieve that pain. If the source is vascular stroke and not a classic migraine, then they might choose different drugs. I'm assuming a neurologist saw her in the hospital and could either suggest something or refer you to a neurologist or geriatrician who could see her on an expedited basis. Even a low dose of a short-term medication might be enough to let her enjoy food much more!

You haven't mentioned talking with your mother about her values and preferences right now and that is a conversation that I imagine she would love to have with you. Taking the time from planning the array of needs for next six months to encouraging her to talk about the last 70+ years is something I wish I had done more with my mother. I do know that those moments are ones when I saw her smile and be at peace instead of in a state of agitation and discomfort.

A virtual hug from another mother with ApoE4/4



Thank you for all that info I will look into all you recommeded.

The meds that have been prescibed for the pain have made matters worse, one causing anorexia. So I have stopped them and am relying on CBD, Young Living drinks & oils and photo-biomodulation to treat it.
We have started her with a master acupuncturist that is working on pain management, digestion, appetite and post stroke issues.
She is only eating sweet foods. So I figured I'd add cinnamon and things like that.
I stopped making her bone broth as I couldn't figure how to mask it. But I'll figure a way.
I'm thinking about adding grass-fed raw heavy cream. What do you think?

Thanks again
I'm here for my mom (3/4), advanced Alzheimer's , just had a stroke in Nov 2020.


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