Drae's got Labs!

[Julie G]

What she said in consecutive order:
1 mg, 800 mcg, 20 mg. YMMV

[SusanJ]

Drae, I highly recommend you start the B12 first, for at least a week, then put in the folate. When you add the folate, I'd suggest start with 400 mcg for a few months, then move up to 800 if you feel okay (ie. no side effects: upset stomach, busy brain) and your labs (folate and homocysteine) aren't quite where they need to be. If you can test, go with what the lab markers are saying (homocysteine, folate and B12 in particular).

I'm very conservative these days with B vitamins, to avoid side effects, and honestly research hasn't looked at the very long-term effects of methylfolate supplementation (just folic acid, which is a difference beast altogether). Safety studies have mostly looked at high doses in depression treatment (up to 15 mg/day), but only for 12 months.

As I've said in other posts, I'm becoming very conservative about pushing systems we don't understand well with megadoses of vitamins that are orders of magnitude beyond what is food. Sometimes they might be necessary based on genetic variants, but we should all be testing and tweaking as we go.

[Julie G]

Good cautions, Susan... but remember that Drae was already doing the Bs as outlined in this thread when she got this Hcy level.

[Searcher]

Drae, just noticed that you wrote

"Bulletproof Brain Octane Oil (C8 MCT), just started this three days ago, seems to increase energy. Have worked up from 1/2 teastpoon to 1 tablespoon with no ill effects. Suggested dose: 3 tablespoons daily. I am seriously overweight (25 years, but losing weight) and insulin resistant (for 40 years). Not sure how much I need this, or how much I should take. Looks to me like it alone would be a $70 monthly hit to my budget which is an issue."

MCT induces insulin resistance, and does so to almost the same extent as long-chain fatty acids (surprisingly).

https://academic.oup.com/jcem/article/97/1/208/2833397

The ill effects which are hidden may be as important as those you perceive easily. Until your insulin resistance and hyperglycemia abate, the $70/month expenditure on MCT is probably doing you more harm than good. I would try cutting it out and see whether you can live without it for now.

[Julie G]

MCT induces insulin resistance, and does so to almost the same extent as long-chain fatty acids (surprisingly).

https://academic.oup.com/jcem/article/97/1/208/2833397

The ill effects which are hidden may be as important as those you perceive easily. Until your insulin resistance and hyperglycemia abate, the $70/month expenditure on MCT is probably doing you more harm than good. I would try cutting it out and see whether you can live without it for now.

FWIW, Dr. Bredesen would disagree with your suggestion, Searcher. Those who are insulin resistant are MOST at risk of reduced cerebral glucose utilization, especially E4 carriers as we're already predisposed. In plain English, this is a condition where there is plenty of glucose available, but the brain is unable to effectively use it as fuel creating a neuronal shortfall. He recommends the use MCT specifically in this case until the insulin resistance (glycotoxicity) is resolved. MCT helps create ketone bodies that can supply almost immediate fuel to the brain.

Once insulin sensitivity has been restored as noted by an in range hbA1c, fasting glucose & insulin, he would recommend E4 carriers to wean off of the MCT and continue a mildly ketogenic approach with a 16 hour daily fast, exercise, and a low carb diet using primarily MUFAs (high polyphenol EVOO, avocados) and PUFAs (nuts, fish) and lots of non-starchy vegs. Any hypercaloric diet can lead to insulin resistance. It's worth noting that Drae is losing weight and reports a desire to continue on this path.

[drae]

If your caloric requirements are 2,000 (wild guess), at 20%, you'll need 100 grams of carbs per day.

Help, please. I went into the chronometer profile macronutrient targets. Do I set it to custom? I also selected moderate.

I did that, and put in 15% protein, 20% carbs and 65% fats.

Then I went back to the diary page and it showed for me

2010 kcal
75.4 g protein
100.5 g carbs
145.2 g fats

Does this sound right? It sounds like your wild guess numbers to me. =)

Now, do I need total carbs or net carbs, and if net carbs, alcohol sugars counted?

Thank you!
Drae

[Julie G]

Yes, custom. Decent ratios. Total carbs. YGG!

[Julie G]

Be sure that you also opted to LOSE weight; either one or two lbs per week depending upon how aggressive you want to be.

[Searcher]

Julie, olive oil, avocado, nuts all suffice for ketosis when they are combined with a low-carb diet, physical activity and a 12 hour (or longer) fast. MCT won't do any better than those unsaturated fats for ketosis. The big difference is that MCT increases insulin resistance, as demonstrated in the study cited. Insulin resistance is an unnecessary price to pay for ketosis, which is available without MCT.

Interestingly, ketosis offers smaller gains in cognitive performance to APOE4 carriers with Alzheimer's than to non-carriers with Alzheimer's.

https://www.ncbi.nlm.nih.gov/pmc/articl ... figure/F4/

APOE4 carriers (even as young adults) show upregulation of the ketolytic enzyme succinyl-CoA:3-ketoacid CoA transferase (SCOT) and ketone-utilizing enzyme acetoacetyl-CoA synthetase (AACS).

https://content.iospress.com/articles/j ... /jad151205

Alterations in brain energy metabolism among APOE4 carriers appear to extend beyond glucose metabolism to include ketone metabolism.

Anyhow, ketosis is available without inducing insulin resistance by using unsaturated fats instead of MCT.

[drae]

Be sure that you also opted to LOSE weight; either one or two lbs per week depending upon how aggressive you want to be.

Set it to 1 pound per week, agreeing with Gundry that the faster it comes off the faster it comes back.

Drae