New here and a bit overwhelmed.

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
John K
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New here and a bit overwhelmed.

Post by John K »

Hello all,

My name is John and I am 46 y.o. married father of two girls ages 5 and 9. I recently had my annual physical to find that I had my usual high Cholesterol. But this time the Dr. called me and wanted to put me on a Statin. Well i didnt like the sound of that since im very fit
5-9 160 lbs and exercise 3-4 times a week. I also eat pretty well. So, told the dr. no and start researching and got a bunch of additional test including 23&me. Turns out i'm Apoe 3/4.
Ive been on a Peleo diet for the past 5 years where I eat a lot of red meat, butter and eggs(5 every morning fried in butter). Yes I know but I felt great.
Since my blood tests and reading up I have shifted to a Mediterranean diet. I felt better at first (More energy) but know I can think. I fell like im zoning out and i'm very forgetful.
Here are some Lipid numbers. The second date was after 6 weeks of mediterranean diet and Dr. Gundry's power

-----------------------------------------1/17/2017-----3/1/2017

TOTAL CHOLESTEROL-------------387--------------239
HDL--------------------------------------87-----------------48
TRIGLYCERIDES----------------------52-----------------50
LDL-C-----------------------------------290----------------181
CHOLESTEROL/HDL RATIO-----4.4----------------- 5
NON-HDL CHOLESTEROL-------300---------------191
LDL-P#--------------------------------2271-------------1859
LDL SMALL---------------------------212---------------299
LDL MEDIUM------------------------354---------------308
HDL LARGE-------------------------6184--------------4318
LDL PATTERN SIZE---------------226.1--------------228
APOLIPOPROTEIN B-------------185----------------123
LIPOPROTEIN A--------------------12------------------14
HS CRP--------------------------------0.2-----------------0.8
LP PLAC2 ACTIVITY----------------241---------------180

Other test I did:
Omega-6/Omega-3 Ratio 7.1
Hemoglobin A1c 5.6
Homocystien 10.5
Iodine 39.7 Low
Insulin 12.8
Magnesium 5.2
Vit D 25-hydroxy 56.3
1,25 DI-OH Vit D 61.9
Oxyd LDL 81

I was most troubled that my HDL dropped so much. My LdL c dropped but I still has a ways to go. I guess I have to give it more Time?

Also my Insulin and HBa1c are like pre diabetic but I don't eat much sugar at all and not many carbs. No corn, wheat very little rice. What gives?

I dont Know if I can keep up on this diet with the brain fog. Any suggestions would be great I recently order some active Folate and a B complex, hopefully that will help. I also ordered some Ceylon cinnamon and Thorne Research - LipoCardia.

Also...Stupid question. With Lipid numbers this bad why would a statin be bad???

Any feed back would be greatly appreciated.

John K
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Re: New here and a bit overwhelmed.

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John K wrote:Ive been on a Peleo diet for the past 5 years where I eat a lot of red meat, butter and eggs(5 every morning fried in butter).
Certainly not everyone will agree, however my wife and I are patients of Dr. Gundry. He's sampled all his patients for ApoE4 for ~15 years and then sees what happens. We've had 4 consults with him at about 6 month intervals. We've posted all our results as well as transcripts of our hour long visits with him. The most recent is here and has links to the others.

I used to eat like you and did have increased lipids. Gundry pays attention to Tg/Hdl (wants it <1 in mg/dL units). Also sdLDL-c (<30 mg/dL) & oxLDL (<60 - U/L). He told us he's observed that E4's will spike sdLDL (which are most likely to go to oxLDL) on animal saturated fat (including dairy). Also coconut fat. He allows us up to 4 oz/day from shell fish, white fish or omega3 or pastured eggs as animal products.

My wife and I eat a high mono fat, keto diet.

One thought - as I always look for endpoints - is do a 4 or five day fast and see what happens to your insulin (and glucose) - we did a 7 day. Another is to get a glucometer (my T1 diabetic friends suggest a Contour Next as a good combination of accuracy and low strip cost - can be had on eBay with strips ~$25/100) and test fasting blood sugar with against what you ate the day before. A significant portion of my calories come from the nuts he allows us (like pistachio, macadamia, pecan, walnut, hazelnut). I saw I could lower my fasting glucose by lowering my nut intake and weighing before I ate so I was sure I was controlling portions. My fasting glucose is now ~82-83 mg/dL. My insulin was in the ~2 range before, so not bad and ~1 at the end of the fast. My wife posted on the fast in a series starting here and our fasting labs (including ketones & glucose) are linked the Gundry post linked above.

My non-medical intuition is the excess protein may be converting to glucose an that is the reason for the insulin and A1C values. I'm more worried about insulin than cholesterol per se, but your oxLDL values would cause me to rethink a high sat fat diet in light of what Gundry told us.

Gundry wants our omega3 index at 10 or above and has us on at least 1g/day of DHA from fish oil.
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Re: New here and a bit overwhelmed.

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Wonder if your brain fog could be "keto flu" as you changed diets? see here.

HOMA is your fasting glucose times your fasting insulin divided by 405. The average for this country is 1.75, which is too high, you want to be at 1.0 or lower, anything over 2.5 is insulin resistant. With your insulin level, your HOMA score would be likely in the 2.5 to 3 range.

I'd also get a CAC scan before I took a stain (which can make the insulin resistance worse). I'll like to a reference when not on my phone.
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Re: New here and a bit overwhelmed.

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This is a thread on calcium scans. Ivor Cummins has discussed calcium scoring numerous times. He also writes about insulin vs cholesterol as a risk for heart disease.

From this FB thread I didn't read the paper, but risk factors are likely MESA risk factors.
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Re: New here and a bit overwhelmed.

Post by KatieS »

John, LipoCardia contains phytosterols which taken as a supplement instead of whole foods might be be harmful. I was unable to find our previous thread on phytosterols.

Your LDL-C and P are concordant with a normal lp(a). Perhaps, your doctor is concerned with additional risk factors such as family history, hypertension or sleep apnea (check if you snore), as this would tilt the scale towards starting a low-dose statin. Since I have all the above, I'm on a hydrophilic statin at age 64. At 46, the CAC might be a little early to reveal calcified plaque, but I agree with George.
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Re: New here and a bit overwhelmed.

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KatieS wrote:John, LipoCardia contains phytosterols which taken as a supplement instead of whole foods might be be harmful. I was unable to find our previous thread on phytosterols.
Gundry tested us for this and for both Theresa and me, phytosterol supplements are contraindicated.
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Re: New here and a bit overwhelmed.

Post by Stavia »

Dayspring alerted us to the phytosterol issue. E4s tend to be hyperabsorbers of sterols. Phytosterols are preferentially absorbed. They appear to confer a significant risk for atherosclerosis (various mechanisms) in amounts higher than can be achieved by a plant based diet alone ie with phytosterol supplements. As they are not the same molecules as cholesterol they do not show up in a normal lipid panel. Because they are preferentially absorbed, as their amount in the blood rises the cholesterol might fall, but this does not automatically mean the risk of heart disease is lowered. The body is complicated.
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Re: New here and a bit overwhelmed.

Post by John K »

Wow,

Thanks for all the helpful information GeorgeN, KatieS and Stavia.

First off George my CAC score is 0 and my HOMA score is 2.59. My Glucose a couple of months ago was 82.

I've learned the hard way on the saturated fats. Earlier this year before I knew I was 3/4 I was drinking Bullet proof coffee (Coffee with grass feed butter and MCT oil) for mental clarity and it tasted good too. I was also hoping it would increase my LDL p size. So in 1 month my LDL c went from 190 to 290. I also agree your Gluconeogenesis theory. I eat a lot of Protein. I start the day lately with 30 mg protein smoothie and after that, well Im a true carnivore. Guess that will have to change. You didn't mention chicken in your list of allowable animal proteins??? Whats you thoughts on venison?
I've been thinking about getting a Glucose meter so Ill do that now. And I was think about fasting too. I read your wife's log of her 7 day fast and was relieved to see i could still have Coffee. I will get the meter and become familiar with it and my levels first. And probably order the book she did. One reason I was considering a fast is because my blood fats test is so out of wak. (attached below) so out of wak my Dr. told me to stop taking my Epa dha supplement which I found odd. He said I have High Omega 3 ( I thought that was good but maybe to much). I do eat a ton of nuts.
Blood tests2.pdf
I don't know how to calculate this "Tg/Hdl (wants it <1 in mg/dL units). Also sdLDL-c (<30 mg/dL) ".

So, I'm wondering what my macros should be. Im thinking 50% Fat, 20% Protein, 30% Carb.(leafy greens no starchy stuff) ? dont know how ill get 50% of my cal from fat with such a limited selection thou?

I'm actually looking forward to the fast to hopefully rest some of my Levels.

KatieS, thank you for the info on Lipocardia I think ill return it and save 90$. And as to my Dr. and Statin's, I just think he old, set in his ways and recommends them to anyone with high Cholesterol. I had to practically bet for these extra blood tests.

I have been drinking more water today and feel much more with it, hopefully I continue down that path.

Again Thanks a million!

John K
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John K
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Re: New here and a bit overwhelmed.

Post by John K »

KatieS wrote:John, LipoCardia contains phytosterols which taken as a supplement instead of whole foods might be be harmful. I was unable to find our previous thread on phytosterols.

Your LDL-C and P are concordant with a normal lp(a). Perhaps, your doctor is concerned with additional risk factors such as family history, hypertension or sleep apnea (check if you snore), as this would tilt the scale towards starting a low-dose statin. Since I have all the above, I'm on a hydrophilic statin at age 64. At 46, the CAC might be a little early to reveal calcified plaque, but I agree with George.
My wife say I snore only on occasion and I use a sleep tracking watch which say I sleep pretty well.
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Re: New here and a bit overwhelmed.

Post by KatieS »

John, continue to have your wife gauge your snoring because having E4 predisposes us to sleep apnea even when we're thin, not the sleep apnea stereotype.In my 40s, I snored occasionally unless I had a cold, only to have the snoring increase in my 50s. Still I always sleep like a log.
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