New E3/E4, terrible blood results

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
sozdds
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New E3/E4, terrible blood results

Postby sozdds » Sun Oct 02, 2016 9:12 am

I am newly diagnosed A3/4 with some disturbing blood results.First some background. I am a 59.5 year old male. I am 6 ft tall and 155 lbs with 31 inch waist. So I look very healthy. Was diagnosed as prediabetic in 2009 when my FBG was 120 at regular dr visit. Was prescribed aerobic exercise and was told I could probably delay type 2 diabetes for a few years. Was completely stunned. At that time I had reached my max weight of 180. Started doing research and testing blood sugars. Eventually started cutting carbs and running 25-30 miles a week. Completed 2 marathons. Weight stabilized at 165. Was able to stop BP med 5 years ago. Learned over time that my metabolic syndrome probably started in early 30's. Started taking BP medicine at 30, had gout attack at mid 30, kidney stone about every 10 years, HDL always around 30, LDL and TC borderline high, high TG most of my life.Had all of the metabolic syndrome except for the large waist. But always considered myself healthy. My main concern is that my dad died from Parkinsons and dementia, and my mom is currently in locked down memory care with dementia. Dad had Parkinsons start at 70, with dementia adding in over time and died at 77, about 5 years too late. Mom entered memory care unit at age of 77, and is still alive at 81. I wanted to do anything I could do to lessen the chances of dementia. So until Feb of this year I was convinced I could only delay diabetes. Then I read about IF. That led me to Jason Fung, then LCHF, then LCHF ketogenic. Started eating LCHF,IF, and 2-3 day extended fasts. Weight bottomed out at 149 and has stabilized at 155, which was my weight in college.However weight loss was not a goal, prevention of diabetes and dementia was the goal. Was very pleased at how things were going, trying to be patient about reversing insulin resistance. Tried to stay in ketosis, usually blood level about 0.6 except on 2-3 day fast when it could reach 4. A1C stayed in 5-5.5 range. Pesky dawn phenomenon, morning FBG 100-110, but usually postprandial high of 110. Oh yea, stopped taking my statin in Mar 2016 wo telling dr. Started pravastatin 40 mg in 2008.
Went in for my physical in Aug. Dr wasn't thrilled about statin and TC was 280 LDL 200. Pre-statin my highs had been 250 and 150. My HDL was 61 and TG was 88, both never better. He's excited and wants to resume statin. I said I'm not willing unless I have further testing, having never had anything but standard lipid panel. He referred me to a lipidologist. I thought I would be vindicated there. First visit had blood drawn. He was doing all the tests we salivate about plus more. $3000 worth that's supposed to cost me $325. Also had CIMT done at first visit. First hint things may not go as well as planned. Right carotid that of a 48 year old, left carotid that of a 76 year old, thickened but fortunately no visible plaque. Second visit 3 weeks later to discuss results. The BG numbers were great. FBG=80 (although artificially low due to 1 week ZC), A1C=5.4, fasting insulin=4, TG=155 ( not so good, however 3 weeks earlier TG=88). Also thyroid levels normal.CRP=0.8, homocysteine=13, omega 3 index =4.6. Now for the very, very, very, very disappointing part. Lipid and inflammatory numbers were terrible. I have not seen worse results from anyone else. TC=376, LDL-C=271, ApoB=265, LDL-P=>3500, small LDL-P=1635, Lp-PLA2=>600, Lp(a)=89. And for the cherry on top I am apoe 3/4. Was completely blown away. He says very high risk for heart attack and stroke. Feeling much less immortal now. Was immediately put on 40 mg of crestor, even though I am very antistatin and afraid of what it might do. I felt I had no choice for now. And he's sure 1 drug won't do it. Had coronary artery calcium scan on Friday. Will get the results this week. See lipidologist again in 3 months.
Sorry for the length. Guess I just needed to vent. Plus I'd be interested in any suggestions. Couple of possible confounding factors. Happened to try ZC for the week before the test as I've never had the good emotional results from ketosis and wanted to try no carbs for 2 weeks. So my saturated fat level was up before the test. With the apoe 4 gene I may not be able to handle so much SF. But I know I can't handle the carbs, and you're only supposed to eat so much protein, so what am I supposed to eat? Lipidologist was on board with lchf, and was happy with my lifestyle.I also started drinking coffee in Feb for the first time in my life. Last couple of months BPC. Also had to stop running last Nov but still walk 35 miles week plus HIIT 2x wk and lift 2x wk. Cut out beans in Feb as I was kind of following Tim Ferris slow carb diet up till then.
Will try to post blood results if I can. Am cutting down on SF, stopping BPC, trying to run again if my knee will allow. I IF everyday, lunch at 11:30A and supper at 5:30P. I only supplement with 400 mg magnesium now. I just didn't expect such lousy results, although I did expect A4. So I would appreciate any suggestions or analysis. Grateful this forum is available and thank you in advance.
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Re: New E3/E4, terrible blood results

Postby sozdds » Sun Oct 02, 2016 9:38 am

More results.
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Re: New E3/E4, terrible blood results

Postby slacker » Sun Oct 02, 2016 9:56 am

Dear sozdds;

Welcome to our website. I understand your frustration and shock at your current results, especially since you've tried so hard to make healthy changes. You will find support here for your continuing journey. I'd like to suggest starting with Newcomers Forum, Getting Started Primer, Intro to ApoE4 - it is written by a physician member and will provide a good foundation. As you read through the other indexes, you will find that members don't always agree on each approach, but the discussion is respectful and illuminating. You might find member posts on Dr Steve Gundry's suggestions especially helpful; he is a heart surgeon and tends to be more focused on lipids and heart health, while still factoring in ApoE4. He has published a book and has a website.

One request; can you try to post your lab results again so they display horizontally? Easier to read and review for those of us with old necks... ;)
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Re: New E3/E4, terrible blood results

Postby SusanJ » Sun Oct 02, 2016 10:40 am

soz, so sorry to hear about your parents, and that your results are frustrating, but glad you're here.

Slacker's suggestion to read through the intro is a good one. It might help ring some other bells for you. We have some folks working directly with Dr. Gundry, so they might be a good resource for you.

As you're finding, many of us e4s find that saturated fats are not our friends, and therefore many of us limit SF and focus on EVOO and avocado for healthier fats.

The other thing you might want to read more about is perhaps you both hyperabsorb and hypersynthesize cholesterol. Start here for some insight:

viewtopic.php?f=5&t=1891&p=21330&hilit=hyperabsorber#p21330

You can search this site for other discussions we've had about this. It might be part of the explanation. You can also search for statins. We do have members who take statins and we've found some will be more brain friendly than others.

Keep asking questions and I hope we can help you to find some positive next steps.

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Re: New E3/E4, terrible blood results

Postby Stavia » Sun Oct 02, 2016 11:35 am

Hi Soz and welcome. We hear and acknowledge your distress. It's completely understandable.
If I were in your shoes I'd immediately repeat the NMR off zero carb, say around 50ish grams. Is that enough with your IF for you to stay in a bit of ketosis ?
And what to eat? Its possible to do this without huge amounts of sat fat by using avocado, nuts, fatty fish, olive oil literally. You may be one of us that has an exaggerated response to sat fat.
The coronary calcium scan is going to be the metric that determines the urgency of your response to this information.
We are here for you :)

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Re: New E3/E4, terrible blood results

Postby slacker » Sun Oct 02, 2016 11:49 am

Soz;

In my experience, NMR is a Labcorp laboratory company test for specialty lipids that is similar to the Health Diagnostic laboratory company tests your doctor ran. I am assuming that the testing methodology for the two labs is equivalent. It's possible that they both outsource to the same tertiary lab...

It is hard for me to put my desktop on its side to easily read your results 8-)
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Re: New E3/E4, terrible blood results

Postby KatieS » Sun Oct 02, 2016 12:07 pm

Welcome Soz. It's so difficult to hear bad news with the overhang of fearing your parent's history. You have made excellent strides impacting lower insulin, A1c and TG levels. Also, coffee might be preventative with PD as well as dementia. Since your MTHFR homozygous & Hcy 12-13, our Hcy thread can lead you towards testing & supplements to lower. Of the 3 statins (P, SV & R) I've been on, rosuvastatin (Crestor) seems to lower incredibly without side effects after 4 months. Did the lipidologist mention fish oil or co-Q (statins deplete)? Update us on the calcium scan. You are so brave to go forward with all these testing.

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Re: New E3/E4, terrible blood results

Postby sozdds » Sun Oct 02, 2016 12:48 pm

Thanks for the responses so far. When I asked the lipidologist about CoQ10 he said it was very controversial. He recommended not taking it unless side effects develop. However he also said it was ok if I was more comfortable taking it. No fish oil rec yet. I've been eating salmon once/wk and am going to add another time/wk. Also plan to add sardines 2x wk. Is hcy homocysteine? I have avocado almost daily, eat lots of nuts, and evoo. But for awhile I had been eating lots of butter and sour cream. Also was eating the fattiest hambuger with all the drippings for 2 weeks while trying ZC, mostly hamburger, eggs, and cheese. I now believe that was a big mistake for me. Have now added back 20-50 g carbs/day.

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Re: New E3/E4, terrible blood results

Postby Stavia » Sun Oct 02, 2016 1:30 pm

Yup homocysteine is hcy.
As far as I know, at worst coQ10 is neutral rather than harmful. The controversy is if it is beneficial to add it to a statin. Mainstream medicine says no, because there are no RCTs showing real endpoints benefits, functional medicine says yes, because there are plausible biological mechanisms to believe this.

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Re: New E3/E4, terrible blood results

Postby Stavia » Sun Oct 02, 2016 1:34 pm

And yup it is likely beneficial to increase your omega3s from fish or supplements. Once a week IMO is inadequate. 4 times a week better but IMO not enough by itself, it won't give you 7 grams a week (it is usually recommend that e4s have at least a gram a day- I know its arbitrary but it's generally accepted) unless your portions are huge.


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