New & Three Questions

[mala]

Hi, first post. This is an excellent forum, thank you all so much!

Im a lean 60 male APOe3/e4. Mum died of AD. I can use some thoughts please. I want to be in ketosis again but dropped out after losing more weight than I feel comfortable with. 5'10", 127lbs all my life, but after 3 months of keto I suddenly dropped to 122.5lbs. Now, after a fortnight of more carbs & no ketosis, I still cant even stay up at 123.

Im also concerned about having too much saturated fat. And a litle thought nags me about too acidic a diet...

I have "End of Alzheimers" & Mercola's "Fat for Fuel" & have also read "Plant Paradox" & Stavia's Intro.

I have osteopenia & am otherwise apparently healthy, busy life including sometimes complex tech trouble-shooting, reasonably physically active (wiry nervy-energy type, was hyper-active, now stuffed by days end). Poor stamina, mostly sleep well, meditate daily & do a potentially spiritual life-practice, good community life & am moderately socially engaged. 14hour overnight fast. Twice a week I run uphill a little to the point of panting exhaustion, usually with a weight vest or ankle weights, pause & repeat say twice more.

Osteopenia, 2015(2011) DEXA scans on same scanner: Spine -2.1 (2011 was -2.3 so it improved), hip -1.7 (-1.6). But I need to stay alkaline (for the bones), Im not testing for that, olives are acidic, olive oil is slightly... Im hoping all the greens balance this out. Reassurance?

I was doing keto from Oct last year, checking with a cheap Greenwon breathalyser, & maintained my weight. Im pretty much vegan. Breakfast lots of fresh grated coconut, 2 small apples, grated flaxseed, cinnamon, coconut milk, sometimes spirulina or chlorella. Green drinks, just leaves & stevia. Lunch & dinner, big salads, raw & cooked veges but not much variety, few olives, lashings of EVOO & a tablespoon of Nutiva raw virgin coconut oil, some hemp protein powder, sometimes some grass-fed butter. Two carb days a week, spaced apart, with green bananas, a little resistant starch root crops. The aim is low carb, moderate p, high fat. No grains or nightshades, no sugar or honey. Supplements: vit B-complex, trace minerals, Mg, Zn, ashwagandha, vit K2, vegan DHA, COQ10. Vit D was 62ng/mL. Have a cronometer account but find it tedious & havent done it for aeons.

I got back into ketosis after the New Year, was still around 126lbs, but was freaked two weeks ago at hitting 122lbs and am now eating more carbs & so have lost ketosis. Added daily 4 medium/lge greenish bananas at breakfast, a few small pieces of resistant roots at lunch & dinner, still lots of EVOO & some delicious coconut oil. Dont feel hungry, but trying to have big meals. I dont snack, last few days a few almonds late afternoon. Im surprised my weight hasn't nudged up, I want to get back to 126 or 127, and would much prefer to do it with muscle than by eating a lot of carbs. Plus, I want to be back in ketosis. I've had a frozen shoulder for 12 months which has prevented upper body weights, now its gradually loosening and I can attempt pullups but not yet pushups. I get very tired from any weight work, even at my modest level.

I may have to accept Im lighter now, while I continue to try to put on more muscle...?

To get back into ketosis, Im scared to eat more coconut fat even though I find it delicious, as I get the sense saturated fat may not be good for APOE4s. I dont like eating more than the seemingly significant amount of EVOO I have now, the taste gets to me, but I reluctantly suppose I can lean into that if i really have to.

Thoughts welcome, how to proceed?

[Julie G]

Welcome, Mala! I share your concern about your weight. You are extraordinarily light for a male. I agree that you need to prioritize gaining weight. That is also a huge risk factor for osteopenia. If you want to maintain ketosis, why not use nuts, avocados, and olives? Healthy fats can help you achieve both of your goals.

[MarcR]

That's a real puzzle you have posed, mala. You seem really well read, thoughtful, and disciplined. The only thing that jumps out at me is vitamin A. I am persuaded by Chris Masterjohn's work on the fat soluble vitamins that we need a balanced supply of A, D, K2, and cofactors Mg and Zn. You are supplementing four of the five - perhaps you might feel better with some supplemental A?

I'm not a user of professional health consultation services. I don't have or want a doctor, and I don't use any other similar services either. Occasionally I will test biomarkers, and recently I sent in a stool sample for a free colon cancer screening after my insurer sent me a kit unbidden. (I'm 55 and intend not to have a colonoscopy ever.) I say all this so that you will see that I would not generally advise someone like you to seek professional health advice.

But I feel well, and you do not. I think if I were in your shoes and had already worked so hard to understand my body and optimize my health, I would seek expert assistance. If you don't find a solution here, you might consider a consultation with Masterjohn.

[Magda]

Welcome Mala to our community.
Thank you for taking your time, and sharing your story.
I see that you have found your way to the PRIMER, and Dr. Bredesen's book as well as Dr. Gundry's, and Dr. Mercola's.

I have similar problem. I lose weight fast on a ketogenic diet, even if I closely monitor my food intake. In general I have hard time building muscle with resistance training being part of my regular schedule.
I have always wondered why, so I've decided to take a close look at my digestion, and absorption. What I found was shocking: SIBO, compromised digestion, and absorption of the nutrients, and high my own muscle/protein breakdown- in general well under nourished . You would think that I has trouble symptoms, but not at all, occasional heartburn and bloating...
What I am trying to say is, that if you feel you consume enough calories to maintain or gain weight the problem might be somewhere else. I would propoly focus on the gut- the basic.

Magda

[Liko]

Hi there Mala, welcome!

I see you're already familiar with the Primer written by Stavia as well as Dr. Bredesen, Dr. Gundry, and Dr. Mercola's work. It looks like you've already made many changes and are living in line with many of the steps outlined in the Primer.

I'm glad to see you making your first post and reaching out to the community for support. Members here share their knowledge, common concerns, and personal experiences from their respective journeys. You've already got a few contributions here and I'm sure more will be coming in to help with your question.

Some additional notes on the site, in case you haven't come across these yet: To search the forums for specific topics, click on the three vertical dots in the upper right of the screen. This is also where you can find the site's Wiki, which features quick links to several topics and resources that may be of interest to you.

Please don't hesitate to post more questions as they come up and contribute to other posts as you feel it. See you around!

[Jan]

Hi mala ... a strong welcome! Wow, I'm impressed with all that you have done already, in your reading and about your health in general. You've gotten great suggestions from site members, and I particularly like Magda's suggestion that you explore possible microbiome (gut) issues. What we 'eat' is one thing, what we 'absorb' can be quite another. To what you've received so far, I would suggest asking your provider about checking your Thyroid (especially thyroid antibodies), and your B12 status (those who follow vegan, or near-vegan, diets sometimes end up low in B12). As you have found, we love helping members with their questions, so we look for more from you.

[chrissyr]

Another welcome!
And another note: Dr. Bredesen has stressed at his last couple of "town hall" meetings that nutrition/trophic support is very important for those at the lower end of the BMI. He feels that longer fasts or deep ketosis should not be at the expense of nutrition/support for the brain.
How do you feel about more avocados and nuts if you feel you can't up the EVOO?

[slacker]

Osteopenia, 2015(2011) DEXA scans on same scanner: Spine -2.1 (2011 was -2.3 so it improved), hip -1.7 (-1.6). But I need to stay alkaline.

Hi Mala;

I realize that the osteopenia may not be your top priority, but has anyone looked into the cause of your low bone mass? Here's a link that describes underlying conditions or medicines that can contribute to the problem. It may be worth a thorough investigation if it hasn't been done already. In your case, it may only be caused by your size. A K2 supplement can be helpful for healthy bone metabolism; it's part of the Vit D and calcium picture. The Linus Pauling institute is a good resource for vitamin and mineral information.

What's your concern about not staying alkaline?

I agree with the others that putting on some weight may be more useful than anything else to start feeling better. I too have had trouble with excessive underweight while trying to keep a nutritional ketosis diet. Once I started eating more, my energy has definitely improved. I'm doing other things as well, so hard to know what to credit. If I'm hungry, I eat. Try to make "good choices" with food, trying bit by bit to increase fats rather than carbs. Avocado, nuts, and olive oil are my go to fats. Still have a ways to go. But have put on some weight. Probably helps that I've up'ed the exercise portion.

Good luck!

[Searcher]

I have osteopenia & am otherwise apparently healthy, busy life including sometimes complex tech trouble-shooting, reasonably physically active (wiry nervy-energy type, was hyper-active, now stuffed by days end).

Thoughts welcome, how to proceed?

Mala,

Your self-description and osteopenia are consistent with hyperthyroidism, which your primary care physician can evaluate/exclude by ordering TSH, free T4 and T3.

[NF52]

I get very tired from any weight work, even at my modest level.

Hi Mala,
This may go under the "dumb question in a response" file: Have you used an app to quantify how much protein you are getting each day? You wrote of increasing your carbs, but still losing weight; I'm wondering if you increased carbs but reduced protein inadvertently? The New York Times just a few days ago covered an article from the British Journal of Sports Medicine titled: A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults.
https://www.ncbi.nlm.nih.gov/pubmed/28698222

Here's some excerpts from the NYT [https://www.nytimes.com/2018/02/07/well/move/lift-weights-eat-more-protein-especially-if-youre-over-40.html ]which may be relevant for you:

Using databases of published research, they looked for experiments that had lasted at least six weeks, included a control group and carefully tracked participants’ protein intake as well as the eventual impacts on their muscle size and strength.They wound up with 49 high-quality past experiments that had studied a total of 1,863 people, including men and women, young and old, and experienced weight trainers as well as novices. The sources of the protein in the different studies had varied, as had the amounts and the times of day when people had downed them....those who did ramp up their protein gained an extra 10 percent or so in strength and about 25 percent in muscle mass compared to the control groups... the sweet spot for protein intake, which turned out to be about 1.6 grams of protein per kilogram of body weight per day...."We think that, for the purposes of maximizing muscular strength and mass with resistance training, most people need more protein” ...says Rob Morton, a doctoral student at McMaster who led the study.
That advice holds especially true for middle-aged and older weight trainers, he says, almost none of whom were getting the ideal amount of protein in these studies...it made no difference if the protein was solid or liquid, soy, beef, vegan or any other.

[emphasis added]

I think the good news is all of this is that, as a male with an ApoE 3/4 profile, your risk of AD is probably far less than your mother's, who may have had lots of health issues you don't have. She also had the added, but not yet entirely understood, risk factor of simply being female. You're active, you're solving complex tech problems, you're socially engaged and spiritually centered, and vegan. So give yourself credit for handling the first 60 years super-well, mala, and give yourself permission to put the scale and the endurance tasks away for a month and go in search of fun proteins!