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Hi, from Colorado

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
MattCo
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Hi, from Colorado

Postby MattCo » Sun Aug 11, 2019 5:45 pm

Hi everyone, I'm a newbie. Questions to follow but first my story: I found out I'm apoe 3/4 several years ago but didn't worry about it because my lipid panels were fine (total cholesterol well below 150, triglycerides were fine). So my diet seemed good. I also exercised a lot. Mostly biking and hiking in the mountains. Then my diet went South and my activity dropped and my most recent blood test came back much worse (everything high but hdl's). The doctor said try a low carb/low sat fat diet or else. At the same time my 92 year old, diabetic dad was diagnosed with Alzheimer's. I learned many things, I don't want to go there, so I came here.

In the middle of all this I found out I'm ADHD. BTW, I'm 60. Surprisingly, the adhd might have been good. In a search for dopamine I chose exercise over sugar/alcohol/drugs/other addictive behavior. Since about 8th grade I've had to exercise hard at least once a week to calm things down. Carbs for the brain, mostly bread and pretzels, is my one food based addiction to generate dopamine.

However, over the past year or so I backed off some of the exercise and, in hind sight, might have replaced the exercise dopamine with a not so great diet. I ate more for reasons I couldn't understand. So, less calorie burning plus worsening diet equals bad blood test, I think.

One last detail. After I got my bad blood test I decided to go back to my old ways. I added a lot of fruits and veggies to my diet, got back on my bike and promptly lost about 15 lbs (this happened at the same time I started taking some adhd medication so I'm not sure why this was so easy). This morning I was 177 lbs and I'm 6'4" (bmi 21.5) so I don't need to lose any weight. Everyone looks at me and says my blood lipids can't possibly be bad. Surprise! It's possible my recent changes have put me back where I was, but that leads to my questions...

My insurance has a high deductible, so where can I get a reasonably inexpensive blood test? What do I really need to test for? I want to see what works without waiting a year.

Now that I lost weight I get hungry. When I'm below 177 I am hungry. I can eat and push the pangs away for a bit but that's it. I can wake up in the morning and feel fine, until I get out of bed and walk 10 feet. Then I feel the pangs. Between 177 and 182 I will be hungry by my next meal. Above 182 hunger is not regular. Is this telling me something about my blood glucose or insulin?

Thanks everyone.

NF52
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Re: Hi, from Colorado

Postby NF52 » Sun Aug 11, 2019 6:36 pm

MattCo wrote:Hi everyone, I'm a newbie. Questions to follow but first my story: I found out I'm apoe 3/4 several years ago but didn't worry about it because my lipid panels were fine (total cholesterol well below 150, triglycerides were fine). So my diet seemed good. I also exercised a lot. Mostly biking and hiking in the mountains. Then my diet went South and my activity dropped and my most recent blood test came back much worse (everything high but hdl's). The doctor said try a low carb/low sat fat diet or else. At the same time my 92 year old, diabetic dad was diagnosed with Alzheimer's. I learned many things, I don't want to go there, so I came here.

My insurance has a high deductible, so where can I get a reasonably inexpensive blood test? What do I really need to test for? I want to see what works without waiting a year.

Now that I lost weight I get hungry. When I'm below 177 I am hungry. I can eat and push the pangs away for a bit but that's it. I can wake up in the morning and feel fine, until I get out of bed and walk 10 feet. Then I feel the pangs. Between 177 and 182 I will be hungry by my next meal. Above 182 hunger is not regular. Is this telling me something about my blood glucose or insulin?
...
Thanks everyone.
Welcome, MattCo!

For a newbie, you have a great handle on what has worked well for you in the past, what's helped to move the numbers in ways you and your doctor like and what feels good--and what's not quote optimum. I'm not a registered dietician or nutritionist, but walking 10 feet and then feeling hunger pangs--especially if they're beyond a comfortable level after a 12 hour fast or so, sounds like your body is asking "hey, where's the fuel?"

You may want to check out our Primer , written by a doctor who is ApoE 4/4, with sections on what to monitor and what to prioritize. You may also find some good suggestions in our Wiki on Ketosis and the Ketogenic Diet. Forum users follow a variety of eating plans; some more closely align to the Mediterranean Diet.

Many of us use direct-to-consumer blood labs: See this resource: Direct to Consumer Lab OptionsFor tips on navigating the forum, quoting members, subscribing to topics of interest, and using the Search function, check out the How-To Guide.

Enjoy life in the Rockies!
4/4 and still an optimist!

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Re: Hi, from Colorado

Postby Tincup » Sun Aug 11, 2019 7:35 pm

Welcome. MarcR posted in this thread the lowest cost provider for blood tests I'm aware of. They get you set up to use Quest as the lab. When I did this 6 months ago, I was using an independent phlebotomist to draw some other labs. They can do Quest labs, so tried to use the requisition from the outfit Marc recommended. They could not do that, so I went to a regular Quest location and it worked.
Tincup
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Re: Hi, from Colorado

Postby slacker » Mon Aug 12, 2019 4:43 am

MattCo wrote:My insurance has a high deductible, so where can I get a reasonably inexpensive blood test? What do I really need to test for? I want to see what works without waiting a year.

Hi Matt, and welcome.

I also have a high deductible health insurance. My lab order comes from my out of state out of network functional medicine MD. With my insurance, as long as I have the order draw at Labcorp, I get my insurance's negotiated price. This averages about 20% of "list" price. That being said, it may be very difficult to compare bottom line prices between insurance negotiated and direct to consumer prices.

If you are interested in looking at other direct to consumer labs options, we have a wiki chapter. Click on the title to go to more detailed information.
Slacker
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mike
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Re: Hi, from Colorado

Postby mike » Mon Aug 12, 2019 5:23 pm

MattCo wrote:Now that I lost weight I get hungry. When I'm below 177 I am hungry. I can eat and push the pangs away for a bit but that's it. I can wake up in the morning and feel fine, until I get out of bed and walk 10 feet. Then I feel the pangs. Between 177 and 182 I will be hungry by my next meal. Above 182 hunger is not regular. Is this telling me something about my blood glucose or insulin?

185 is not a bad weight for someone 6'4"...why not try to stick there? Can you tell me your macros - what percent of your calories come from Carbs, Protein and Fat? Carbs tend to increase hunger, while protein and fat tend to lower hunger for longer.
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Re: Hi, from Colorado

Postby MattCo » Mon Aug 12, 2019 10:46 pm

Thanks for all the responses, everyone!

I looked at the labs. I also read a bunch more, including the Primer, and youtube, and .... Talk about overload.

mike, to answer your question about what's wrong with 185 lbs - to be honest, 193 lbs is also fine given my height, but my blood lipids are all upside down. I went and looked at my history. I've been around 190lbs for a good 20 years. Before roughly 2016 my total cholesterol was below 150, ldl a bit above 100, triglycerides about 130. Then over 2 years it all got much worse. Total is 200, triglycerides 230. Yet I still weigh the same and look the same. I'm not sure weight is a good measure. Granted, when I lost 15 lbs people did notice a change. I do know my lipid tests correspond to a change in diet and activity level. For a few years I have been grazing for food starting around 3pm. Hungry or not. That and not exercising as much would explain a lot.

Anyway, I didn't pick 177 lbs. It's more like I decided to eat healthier, the weight is going, and at 177 I was getting hungry. Yesterday I tried to eat less carbs and more, healthy fat and I woke up at 174 lbs. This is getting a bit worrisome.

As for percent of calories from carbs, fat, and protein, I have never tracked it. I probably should change that. I don't like simple sugars Bread and rice, however, are comfort food. Given that I need the dopamine it makes sense. I used to minimize fats. So, to answer your question, my guess is probably more carbs, less fat, and a bit more protein than most.

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Re: Hi, from Colorado

Postby SamNZ » Tue Aug 13, 2019 10:54 am

As for percent of calories from carbs, fat, and protein, I have never tracked it. I probably should change that. I don't like simple sugars Bread and rice, however, are comfort food. Given that I need the dopamine it makes sense. I used to minimize fats. So, to answer your question, my guess is probably more carbs, less fat, and a bit more protein than most.[/quote]

Hi MattCo, Welcome to our site, I appreciate your overload of information, but also need to congratulate you on how magnificently self aware you have become, I really feel that this is 90% of the battle. I am not a nutritionist but am a firm believer that how you feel is really important, some people just have much higher natural metabolisms and need slightly more carbs than others. Creating your own, keto, paleo medditeranean mix diet (quality plant based diet with good fats and proteins) will not put you too far wrong. I think carbs are the negotiable in our diets, but people with a naturally slim build often have a higher metabolism and need to keep up some level of carbs. Again, picking these wisely is the important thing, we want to prevent blood sugar spikes and I would feel that having these during the day, not late afternoon/ evening would be better for you, try to pick carbs with lower GI and remember, that although not for everyone in a lot of people gluten can antagonize the system (quinoa is a great replacement for pasta, heating and cooling rice and potatoes give them more resistant starch so they do not break down and add such a great sugar spike in your blood glucose). This is quite offside but have a look into the Vata body type for aruveydic medicine, they define the body types into 3 distinct areas and suggest better eating plans for each type, here is a podcast aruveydic body type, and an article balancing your body type you might find interesting, it is a bit out there and woo woo so please ignore it if it doesn't sit comfortably!!! Good luck in finding your perfect food plan, wishing you lots of fun experimenting on your journey. SamNZ
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mike
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Re: Hi, from Colorado

Postby mike » Tue Aug 13, 2019 12:02 pm

MattCo wrote:As for percent of calories from carbs, fat, and protein, I have never tracked it. I probably should change that. I don't like simple sugars Bread and rice, however, are comfort food. Given that I need the dopamine it makes sense. I used to minimize fats. So, to answer your question, my guess is probably more carbs, less fat, and a bit more protein than most.

It would be good to see where you are, so tracking for a few days just to get a sense would be helpful. As SamNZ said, looking at the glycemic index of carbs is also useful - how fast does it affect your blood sugar levels. Carbs with lower GI take longer to raise blood sugar. Yams have much lower GI than potatoes. Brown rice is lower than white rice. White flour is bad. Avoid added sugar and corn syrup. Chinese food in the US is exactly the wrong kind of food - full of starch and sugar. You get full, but are hungry very soon after - your blood sugar spikes, then drops and you get hungry. Fats and protein tend to keep you satiated longer, and they don't raise your blood sugar as much. Have you ever been tested for Diabetes? If you eat a lot of carbs/sugar for a long time, at some point you may become insulin resistant, and your blood sugar rises and spikes get worse. If you don't have, then good carbs are okay, but if you have diabetes, then you want to cut out most carbs. If you are losing weight, then add more fats - nuts, avocados, olive oil. I do have diabetes, so try to limit carbs. Macadamia nuts have one of the best fat/carbs ratio and have helped me gain weight when I needed it.
Sonoma Mike
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MattCo
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Re: Hi, from Colorado

Postby MattCo » Wed Aug 14, 2019 2:19 pm

SamNZ wrote:Creating your own, keto, paleo medditeranean mix diet (quality plant based diet with good fats and proteins) will not put you too far wrong. I think carbs are the negotiable in our diets, but people with a naturally slim build often have a higher metabolism and need to keep up some level of carbs. Again, picking these wisely is the important thing, we want to prevent blood sugar spikes and I would feel that having these during the day, not late afternoon/ evening would be better for you, try to pick carbs with lower GI and remember, that although not for everyone in a lot of people gluten can antagonize the system (quinoa is a great replacement for pasta, heating and cooling rice and potatoes give them more resistant starch so they do not break down and add such a great sugar spike in your blood glucose). This is quite offside but have a look into the Vata body type for aruveydic medicine, they define the body types into 3 distinct areas and suggest better eating plans for each type, here is a podcast aruveydic body type, and an article balancing your body type you might find interesting, it is a bit out there and woo woo so please ignore it if it doesn't sit comfortably!!! Good luck in finding your perfect food plan, wishing you lots of fun experimenting on your journey. SamNZ


That's all good to hear. I used to be very good about eating low GI carbs so I'm hoping I can still have some. I'll look at those references, so thanks. I did manage to track my food for yesterday and today. No wonder I'm losing weight. BTW, I make my own sourdough bread and I've read that the fermentation helps break down the gluten. It takes a long time to make and so I don't do it very often. I've also noticed it does not spike my appetite like regular bread. I eat a couple of slices and I'm sated for a long time.

A couple of new questions:

What's the goal? Is it low insulin? And the right lipid numbers?

I read about the low carb diets and the goal seems to be to lose weight and lower insulin. If you've lost the weight and the insulin is good then is there a problem with carbs?

It seems that burning fat involves ketosis no matter what, so why make it a long term state? What's wrong with, say, doing it every night after an evening of fasting and breaking that fast with a mix of healthy foods?

Does the fact that I had a BMI of 21-ish and still have poor lipids have something to do with the apoe4 gene I have? (nobody believes me that I have to start watching what I eat).

Finally, at what point does your body starting using muscle for fuel? I hear it's good to develop muscle but I just don't. I'm wondering if the exercise I do is part of that.

Thanks again.

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Re: Hi, from Colorado

Postby TheresaB » Wed Aug 14, 2019 2:37 pm

MattCo wrote:What's the goal? Is it low insulin? And the right lipid numbers?


Read the Primer: An introduction to ApoE4 biochemistry, and possible prevention strategies but spoiler alert -- GLYCAEMIC CONTROL TRUMPS LIPIDS, EVERY TIME
-Theresa
ApoE 4/4


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