Interventions had OPPOSITE impact on lab results!

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jcosmo
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Interventions had OPPOSITE impact on lab results!

Postby jcosmo » Mon Nov 27, 2017 5:48 pm

I'm sorry, I know I haven't even posted an intro yet... I learned that I have one E4 allele (the other is E3) a few months ago and I've been lurking here for a little over a month now, trying to read as much as I can in the evenings after work. Right now, I'm slowly working my way through the large "Dr. Steven Gundry with diet recommendations for ApoE4" thread.

At the end of October, I had an NMR Lipoprofile done. Almost all values were worse than they were a year earlier when I had my first NMR done. I decided to implement a few changes and retest in another month...

1. I tried to limit cheese to no more than 2 ounces of goat cheese daily, and cut it out entirely for the 10 days before the 2nd test.
2. I started sprouting broccoli seeds and ate 100-130 gm broccoli sprouts every morning for 30 days leading up to the 2nd test.
3. I decreased saturated fat intake and increased monounsaturated fats. Used to fry 2 eggs in butter every morning, but this was replaced with a salad of sprouts, avocado, and olives. I also started eating a spinach/mushroom salad every afternoon with 2-3 tbsp EVOO and dramatically decreased my intake of coconut oil.
4. Ate asparagus 3-5 times/week roasted in 1 to 1.5 tbsp avocado oil and 1 oz macadamia nuts at least 5 days out of 7.
5. Went from 1-2 glasses of wine 2-3 nights per week to 1 glass or less per week.
6. Started taking 100 mg resveratrol daily about 2 weeks before the 2nd test.

Increasing vegetable intake, choosing monounsaturated fat over saturated fat, and decreasing/cutting out dairy are Gundry recommendations... so I was shocked when I got the 2nd set of results. Any idea what happened or how I can reverse it?

Test ------------------------ 10/26/17 ---------- 11/24/17
LDL-P .......................... 1968 High ...........1853 High
LDL-C .......................... 159 High ............. 154 High
HDL-C ......................... 70 ......................... 55 (!!!)
Triglycerides .............. 98 ......................... 194 High (!!!)
Cholesterol, Total ...... 249 High .............. 248 High
HDL-P (Total) .............. 38.4 ...................... 30.6
Small LDL-P ................. 725 High ............. 654 High
LDL Size ....................... 21.4 ..................... 21.2
LP-IR Score .................. 30 ........................ 53 High (!!!!!)
(^Ins. Resistance Marker, should be < or = 45)
HgbA1c ........................ 4.9 ....................... not tested

The results of the first NMR Lipoprofile from 12/02/16 (~5 months after starting a ketogenic diet):

LDL-P: 1354 High
LDL-C: 141 High
HDL-C: 80
Triglycerides: 112
Cholesterol, Total: 243 High
HDL-P (Total): 34.9
Small LDL-P: <90
LDL Size: 21.3
LP-IR Score: <25
HgbA1c: 5.2

I am not diabetic, but both my parents are, and both of them are on statins. I'm doing everything I can to AVOID having to go on statins and would greatly appreciate any insight anyone can provide!!!
Adrian, 3/4

jcosmo
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Re: Interventions had OPPOSITE impact on lab results!

Postby jcosmo » Mon Nov 27, 2017 6:26 pm

Another change I forgot to mention: I started taking kelp supplements every other day (200% daily value of iodine) since I read that the sulforaphane in broccoli sprouts can interfere with the uptake of iodine, and I know poor thyroid function can also increase LDL. I added a thyroid panel to the most recent NMR LP and all parameters were WNL:

TSH: 3.160
Thyroxine (T4): 6.2
T3 Uptake: 30%
Free Thyroxine Index: 1.9
Adrian, 3/4

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Re: Interventions had OPPOSITE impact on lab results!

Postby jcosmo » Mon Nov 27, 2017 8:35 pm

I think I might've posted this in the wrong forum... sorry! Could a moderator please move this to Our Stories?
Adrian, 3/4

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SusanJ
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Re: Interventions had OPPOSITE impact on lab results!

Postby SusanJ » Mon Nov 27, 2017 8:38 pm

Moved. I'll let some of our other more lipid-aware folks provide some feedback.

One question though, have you lost weight in the past year? Sometimes it takes a while for lipids to settle down if you've lost weight.

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Re: Interventions had OPPOSITE impact on lab results!

Postby circular » Mon Nov 27, 2017 8:44 pm

jcosmo just here to congratulate you on your applied focus, even if you're not seeing the results you want ... yet. With that sort of determination I think you'll get it sorted what works best for you. The examples of people in whom a widely accepted protocol doesn't work are very valuable. I'll be interested to see how this shakes out. I wish I had an explanation and look forward to reading others' thoughts.

Thanks for mentioning broccoli sprouts and iodine. I make my own BSs too, and am also on Lugol's iodine hoping it will continue to shrink my thyroid nodule. I didn't know the sprouts might interfere with iodine absorption. I never would have guessed. Will look it up ...

Welcome!
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: Interventions had OPPOSITE impact on lab results!

Postby Julie G » Tue Nov 28, 2017 5:09 am

jcosmo, how frustrating! If it's any consolation, most of your changes are relatively small and can be attributed to test variation. I'm also wondering about your weight. Is it stable? Your lipid profile looks as though you have an abundance of energy. Are you fasting? Exercising?

I agree that focusing on your thyroid function is a good idea. Your TSH is higher than optimal. A healthy thyroid helps with LDL-receptor activity and cholesterol clearance. Do you have a good physician you can work with to optimize this?

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Re: Interventions had OPPOSITE impact on lab results!

Postby TheBrain » Tue Nov 28, 2017 5:39 am

jcosmo,

I’m sorry that your efforts are giving you the opposite results you’re looking for.

Earlier this year, I took Dr. Alan Christianson’s Thyroid Reset course. He’s a well-respected naturopath who is board-certified in endocrinology. He says the optimal range for TSH is .5 to 1.5. He would say yours is too high.

I’m not sufficiently familiar with the other thyroid tests you had done to comment. I usually get tested for TSH, free T3 (fT3), free T4 (fT4), and sometimes reverse T3 (rT3). This is the basic testing that Dr. Christianson recommends.

I had a TSH of 0 for many years, with my fT3 and fT4 scraping the bottom of the range. Dr. Christianson says this odd pattern is almost always due to being overmedicated. I became convinced to work with my doctor to gradually lower my dose. Per my last tests, my TSH is now in that optimal range, but my fT3 and fT4 are below range. In a Q&A call, Dr. Christianson said something else is going on now (because those levels should have come up), perhaps LPS endotoxemia, heavy metals, mineral deficiencies, etc. I’m trying to address LPS endotoxemia on my own and working with a FM practitioner to look at other potential causes.

Meanwhile, my lipids have risen. For example, my total cholesterol is now 255. (I used to be one of those people with a TC of 168.) I suspect my low thyroid hormones are to blame. That makes me wonder if you might be experiencing a similar issue.

In my case (per http://www.yourmedicaldetective.com/public/523.cfm), my HDL-to-TC ratio and my triglycerides-to-HDL ratio are optimal. So I’m not too worried about it. I’m more concerned about improving my fT3 and fT4 levels.

I’m curious to hear what forum members who know more about lipids have to say about your situation. Are you on a ketogenic diet? You didn’t say, but it sounds possible.

If you are, maybe your rising lipids are all about that, or maybe it’s a combination of the ketogenic diet and low thyroid. (I’m on a ketogenic diet.)
ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!

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Re: Interventions had OPPOSITE impact on lab results!

Postby jcosmo » Tue Nov 28, 2017 7:00 am

Thanks to all who responded! I've been on a ketogenic diet since July 2016, with one higher-carb day each week to boost leptin levels and thyroid function. I started doing this when I read Kiefer's "Carb Nite Solution" and used to go high enough to kick me out of ketosis but now I get the extra carbs from berries and vegetables, and aim for 2-3x my usual net carb intake, which is normally up to 20 gm.

I looked at my food logs from the month leading up to my very first NMR lipoprofile in December of 2016, and my daily diet included a LOT more cheese (A1 and A2) and coconut oil. It also included more fish and eggs, compared to the last 30 days. Saturated fat made up more than half of my total fat intake. Protein intake was a little higher, and calories were occasionally lower, though I wasn't doing intermittent fasting yet. Maybe I should go back to that...

My weight is mostly stable. I've stayed within the same 5-lb range for the last 4-6 months. I don't get a lot of exercise, though I know I really should. I often just don't have the energy at the end of the day. I try to go 16 hours between the last meal of the day and the first meal of the next day, but if I don't have time to prepare/eat the last meal during the work day then I sometimes only go 12 hours between dinner and breakfast.
Adrian, 3/4

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Re: Interventions had OPPOSITE impact on lab results!

Postby jcosmo » Tue Nov 28, 2017 7:06 am

I had a doctor-ordered TSH and a lipid panel drawn this morning for an appointment with the doctor's PA next week. I'm sure she'll want to put me on a statin... I want to ask for a referral to a specialist instead. Should that be a lipidologist or a practitioner of functional medicine? (I'm not sure if this has any impact on lipids but I also have the homozygous MTHFR C677T variant.)
Adrian, 3/4

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Re: Interventions had OPPOSITE impact on lab results!

Postby TheBrain » Tue Nov 28, 2017 8:00 am

jcosmo, a TSH test by itself doesn't give much information, if I'm understanding you correctly. If that's all your doctor ordered thyroid-wise, then he/she is probably fine with the lab's reference range, which is not optimal.

I should mention that thyroid antibodies are often tested with thyroid hormones as well, at least when ordered by a doctor who is savvy about the thyroid.
ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!


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