New Test Results: CAC Score and LDL-P

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Russ
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Re: New Test Results: CAC Score and LDL-P

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Sorry, just been very busy… Nothing really to update, though. Still on hold for call w Gundry, so no news there. The questions we developed were my suggestion to Robb Wolf for a potential podcast w Dr Gundry. Don't know if that's going to happen, but I'll dust off and send them to him later this week. Meanwhile, been almost 2 months since my Gundry blood draw, so will likely go get a new lipid test soon. Still going heavy keto w carb nite, and feeling good anyway...
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Re: New Test Results: CAC Score and LDL-P

Post by Julie G »

I'm happy you're feeling well, Russ! No worries about the wait. IMO, it's MUCH more important for you to get your appointment, than for us to get our questions answered...but it would be AMAZING to have an entire hour of just E4 information via Robb's podcast. Would it help for any of us to broach either or both of them. Perhaps if they knew there was a keen interest???
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Re: New Test Results: CAC Score and LDL-P

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Finally had my call w Dr Gundry yesterday.

First, a couple of other updates to set the stage…

1. Did another LDL-P test 2 weeks ago after 3 months ‘carb nighting” it and came out largely same. TG’s continued to drop a bit (70 > 65) and only notable difference was companion measurement of LP-IR which declined from 77 to 32 (a good thing).
2. But also tested HbA1c which had gone up a bit 5.4 >5.7 (not a good thing) even though intra or post-CN BG measurements. In any case, no notable benefit from CN on these measures anyway, so stopping that for now.
3. I had gone off Vit D3/K2 blend supplement and went to eating more liver, but my 25D fell to 23, so that seems to be not so good. Have added D3 back into regime.

On Gundry discussions, most fits tightly with what we had heard elsewhere, but a few nuances and particulars for my case….

1. Animal Fats - Clearly feels from his clinical experience that animal fats are ‘most lethal’ for E4’s. But note that ‘animal’ doesn’t include fish – especially shell fish which he thinks is ideal for us. He doesn’t say you have to cut out land meats entirely, but treat is as a ‘garnish’ (as others have noted before).
2. Herbivory - He thinks we, being closest to our great ape ancestors are more favorably herbivores. He points out that surviving E4-rcih tribes are least, not most, successful (not sure I buy this).
3. Olive Oil - Olive oils are good for us because polyphenols bind to that pesky oxidizing small dense LDL.
4. LDL-P vs sdLDL - He doesn’t care for LDL-P, but focuses entirely on sdLDL. Mine is currently 37 and his target is <30 mg/dl. He thinks if you get this right, that’s most of the battle. This is done by reducing animal protein/fat. He routinely sees people getting down into 10’s. Did not have time to discuss his reasoning as I was paying by the hour ;-)
5. HDL:TG ratio - Other parameter he feels is best predictor of heart disease is HDL:TG ratio which he says should be a minimum of 1:1. With my HDL now hanging tight at 49, this means my TG=65 still needs to come down. He challenged me to get to 30 where he keeps his.
6. Dairy - One new thing I learned is that he thinks dairy is bad for E4’s regardless whether A2 or A1. He cited a patient he had yesterday that had seen a rise in sdLDL (from 10’s to 30’s) after consuming more goat’s milk/cheese. He cut it out and it dropped back.
7. Vitamin C connections - Another new thing I learned was that Gundry agreed with claim apparently made by Linus Pauling that E4 (and LPa) were advantages for dealing with low vitamin C. In essence, hyper-production of cholesterol heightened cellular repair processes.
8. Omega 3 - Positive that my Omega 3 ratio had gone from 5.6% to 7.5%, but needs to be 10-12% - especially important for E4’s. Keep eating more seafood.
9. Special sterols - My Campesterol #’s were low showing I under absorbed cholesterol, but Desmosterol were high showing I over produced. He suggested that an OTC product called Cholestoff might actually help the former (a bit counterintuitive) and we might go to red yeast rice instead of statin for latter, but no need to go there yet.
10. Uric Acid - Thought my elevated uric acid was due to still too much meet, not going keto, so another sign to cut red meat.
11. MTHFR - I am C/T on C667T. He recommends 1000 mcg daily as helpful and safe for those of us with this marker.
12. Eggs – Pastured are indeed better than “Omega 3” eggs from grocery store. He recommends eating yolks and throwing away whites.
13. IGF-1 – Mine was high in range (172). He recommends lower is better as lower is strongly associated with longevity. He says it’s another sign of too much meat. As I understand, methionine in meat turns on mTOR receptors and we want them off. Can take glycine to block or just reduce meat (he says animal protein <10%)
14. Estradiol – Mine is just a bit high @33 and needs to be below 30. Elevated estradiol is associated with higher incidence of CVD. He recommended combination of Ginko Bilboa (120 mg/2x day) and Devil’s Claw (1000 mg/2x day) to drive this down.
15. Coconut Oil – he confirms he sees coconut oil as good for E4’s.
16. Scans – Thinks Calcium scans are worthless. When a scan is needed, only worthwhile scan is CT coronary angiogram. Importantly, he does not recommend I do further scans at this time (no need to do angiogram – which I consider a good thing).
17. With a Twist – In a funny twist, it turns out we grew up in the same town (Omaha) just a few miles apart and went to the same high school – he graduating 11 yrs before me. A small world moment…
18. FWIW – The Singulex and HDL labs he uses are the former Berkeley Heart Labs team. Berkeley was shut down after acquired by Quest and founders split up to start the 2 new companies which he thinks remain the best place to go.

In summary, he thinks I’m on the right course for now, just need to be more aggressive in reducing meats. Very low inflammation is very positive and few anomalies are tweakable. Suggest retesting markers in ~3 months.

Happy to clarify questions as best I can recall. He did allow me to record the call so that I can go back and check things, but probably not appropriate to upload (and it is really big).
Last edited by Russ on Thu Nov 06, 2014 4:05 am, edited 1 time in total.
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Re: New Test Results: CAC Score and LDL-P

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Russ, what a scribe during your medical call. I'll need to study this further. Perhaps, the A1c increased with higher peaks with CarbNight. I had a 0.3 difference between the local lab and Quest being lower (5.5). For the C677T (also CT), is that 100mcg of Folate?

Since I grew up south of Omaha, my girlfriend's family ran a slaughterhouse, which I still have traumatic memories. The benefit is that I have never eaten red meat since early childhood.
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Re: New Test Results: CAC Score and LDL-P

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Russ one clarification..

"11. MTHFR - I am C/T on C667T. He recommends 100 mcg daily as helpful and safe for those of us with this marker"

100mcg of ?? Does this mean he looked at your 23andme methylation results?

Another thing when he says meat does he mean red meat not including fowl?

"Perhaps, the A1c increased with higher peaks with CarbNight"

doubt that as it is average value over 90 days so a carb nite peak once a week is unlikely to make a difference. You just might have a carb sensitivity where it peaks or bigger meals might also do it so keeping checking BG to find the cause.
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Re: New Test Results: CAC Score and LDL-P

Post by Julie G »

Wow, Russ- epic post. THANK YOU for thinking of us when you should have been focusing primarily on yourself; very kind of you.

I am over-the-moon thrilled with your small LDL-P- 37 :shock: WOW!!!! To be honest, I was unaware that was even possible. You must be drinking EVOO, my friend. I find it VERY telling that both Dr. William Davis and now Dr. Gundry find this the MOST important biomarker for CAD. I can't help but contrast their opinions with that of Michael Rae, a guest scientist with the SENS Research Foundation, who recently weighed in on the topic: viewtopic.php?f=5&t=651 Your LPIR result speaks volumes. Congratulations on the amazing improvements :D

In terms of evolution, E4s who've survived this long are the least successful? That is hard to wrap my head around as well. I'd love to hear you expound on that... I suspected Dr. Gundry would be opposed to cheese for us- even A2. Good to have that confirmation. I have small bits of goat cheese still, but will try to cut back. Pastured eggs are OK, even for E4s? I agree yolks are the most nutrient dense/choline rich, but why throw away the whites?

Thank you so much for sharing my friend. This is certainly the dietary approach that I'm currently using as well- tons of non-starchy veg, dripping in EVOO, with small amounts of fish/pastured eggs for protein. I'm doing my NMR soon (a recent test was botched :? ) to see what effect it's having for me.

Keep up the amazing work; you're an inspiration to us all.
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Re: New Test Results: CAC Score and LDL-P

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Kitano,

One important correction as I see I made a typo in my haste…

11. MTHFR - the suggested dosage of mehtylfolate is 1000 mcg, not 100 mcg as I had previously typed. I have corrected original so as to avoid confusion by others.

FWIW, funny enough, I'm actually actively working in one of my projects on fixing your slaughterhouse nightmares in a way that helps the broader environment and makes good money, too. We're the first finalist listed in this competition… http://climatequest.wisc.edu/finalists/…and see this short video http://vimeo.com/35953300 for a bit of the underlying philosophy from our fearless leader the 'Zen Butcher' ;-).
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Re: New Test Results: CAC Score and LDL-P

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Daily Wagon, I did give him my 23andMe results, but if you look at my actual lab results (which I posted earlier) you'll see that he actually tests specifically for 5 genes via HDL….

APOE (was actually good to confirm 23andMe independently)
Factor V Leiden (G1691A)
Prothrombin Mutation (G20210A)
MTHFR (C677T)
MTHFR (A1289C)

Aside from APOE, of those, my only additionally (moderate) risk is the first MTHFR marker.
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Re: New Test Results: CAC Score and LDL-P

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Julie,

I think there's some confusion in conventions on sdLDL conventions and units? ...so maybe don't be too impressed.

Gundry uses Singulex Labs which reports 'sdLDL' in mg/dL. This is the number that for me is currently 37 that Gundry says should be 30 or less. However when I do my NMR Lipoprofile, they report 'Small LDL-P' (which is what I think we usually talk about?) in nmol/L, where my most recent previous test on 10/15/14 was 1007. I may have some old sdLDL's in old VAP tests… I'll have to go back and see (checked - I don't see reported elsewhere)...

Anyway, don't be too impressed with that number, although I feel like I am indeed absolutely drinking olive oil, I've still got much work to do.
Russ
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Re: New Test Results: CAC Score and LDL-P

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I believe smallLDL can be looked at as a percentage of LDL-P# and what you want is as low a percentage as possible and I think that is one of Dr W Davis objectives.
Now you can test further and see which subfractions of small LDL are high, I had one of those tests a while back which showed that it was low except for 2 sub fractions, can't recall the name of the test too late to check tonight.


from what I gather it seems Grundry lumps our genetic defects into a simplified methylation profile and wonder of those others are common in E4 groups.

so he also checked if you were a hyper-absorber of cholesterol and suggested.
http://www.naturemade.com/supplements/cholestoff

"1800 mg daily of plant sterols and stanols that can help reduce dietary cholesterol"

with diet you can get over 2400 where the benefits kick in.. just do some reading on it.

you can get a lot of that from eating avocados I belief and a lot of plant material too, so that is your ticket to making sure your small LDL stay low and also could reduce the LDL-P#.
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