help interpreting markers - Julie? George? anyone else?

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Stavia
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help interpreting markers - Julie? George? anyone else?

Post by Stavia »

I have no idea where to put this so I'm sticking it here. Need expert advice please.

Ok, been off HFLC for a month (raised my sugars but will retrial later), went back to modified Mediterranean, 1200 calories a day (10 -20% CR) approximately 20% protein, 40% carbs (not more than 100 grams a day, usually around 70grams) and 40% fat (only avocado, nuts, EVOO, fatty fish). Low cholesterol/saturated fat. Minimal egg, zero red meat. Lost another 2 kgs in the last month, I'm now down 10kgs (22 pounds) since my diagnosis in April and BMI 25 finally. I'm actually feeling amazing. Heaps of energy, thinking very clearly. Not hungry. At all. Its a very easy diet to follow, I am aiming for lifetime sustainability.
I'm trying to find the fat/carb ratio that keeps me in mild ketosis but doesn't cause insulin insensitivity. n=1 of course ;)

My latest markers:
I did a fasting blood draw, still waiting on the insulin. It might only be through after I leave for Hawaii tomorrow.
But here is what I have so far:
I am in mild ketosis yay: beta hydroxybutyrate 0.6mmol/l.
HbA1C bounces between 32 and 34 (5.1 and 5.3). I keep checking it 'cos I want it to be lower.
Fasting glucose 4.5 (81). I have a narrow glucose range normally, I don't think I've ever gone below 4.2 (75) in my life, and I don't spike more than 6.7 (120) after meals even with starchy carbs

Lipids interesting:
HDL: after decades of low HDL (on VLFHC), usually less than 0.9 (38), on the higher fat and lower carb its now 1.28 (50). wow. wow. un-believable.
LDL as expected is at 3.6 (139).
Triglycerides gratifyingly down to 0.6 (53)
yes I know I need an NMR but I cant get one until next year May when I'll be in the US again. No NMR available in Hawaii.
My chol/HDL ratio is now 41. ( :( )

ok brainy expert friends, what do you think?
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LillyBritches
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Re: help interpreting markers - Julie? George? anyone else?

Post by LillyBritches »

I'm no expert, but those levels sound great to me. You're the doc, hon. You know they're good! :)
I'm just a oily slick in a windup world with a nervous tick.
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Stavia
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Re: help interpreting markers - Julie? George? anyone else?

Post by Stavia »

I dont like my LDL. Or my stretched tummy.
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Re: help interpreting markers - Julie? George? anyone else?

Post by LillyBritches »

Stavia, hon - I wouldn't EVEN worry about that LDL. My markers are almost identical to yours (biochemical sisters lol). That new study just came out, too, that said LDL might be a good guy.

You should get at least a VAP panel to see if your particles are fat and fluffy (type A) or tiny (Type B). Mine are A...A is GOOD. I'll bet yours are, too.

As far as the tummy - lol! Can we talk? Let's do a tummy tuck holiday together. ;)
I'm just a oily slick in a windup world with a nervous tick.
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Julie G
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Re: help interpreting markers - Julie? George? anyone else?

Post by Julie G »

Amen Lilly. YOU'RE the expert Stavia That being said (non-expert me) applauds you!!! :D You have much to be proud of, my friend.

I'm a little surprised to see that you're in ketosis with that many carbs, but you probably move in and out throughout the day. Your CR and exercise contribute here- kudos!

Congrats on the HDL rise and TG drop.THAT (in the absence of advanced lipids) tells us the most about your particle size; moving in the right direction- YAY. Much research indicates TG/HDL ratio is most closely linked with CAD and all cause mortality risk.Your ratio of 1.06 is awesome. Look at how much that has moved! Share your insulin and homocysteine level too- if you did that one.

Remember way back when...when I said ApoE4 would end up being a good thing? You're living proof, Stavia. Keep up the great work.
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Re: help interpreting markers - Julie? George? anyone else?

Post by Tincup »

Stavia,

A1C may be higher than actual average serum glucose. The EAG assumption is a RBC life of 6 weeks. "Researchers found that the lifetime of hemoglobin cells of diabetics turned over in as few as 81 days, while they lived as long as 146 days in non-diabetics." So your cells may be living longer and therefore exposed to glycation longer. http://chriskresser.com/why-hemoglobin- ... ble-marker

As Julie points out, your TG/HDL ratio is near 1 (using md/dL units). This is considered fantastic!! {edit} This should insure that on an NMR test, your small LDL-P should be a minor fraction of total LDL-P. Also meaning that LDL-P size should be pattern A (knowing that data suggest that only particle count, not size should matter).

Data on calcium regression in CIMT or CT calcium are coincident with weight loss ( http://circ.ahajournals.org/content/121/10/1200.long ) as well as Patel http://azsunfm.blogspot.com/2012/09/fon ... amily.html Attia comments on Patel's post "Peter Attia September 26, 2012 at 9:58 AM Really great post and case study. I wish I could say we "knew" the answer to this question, but clearly we need more work to evaluate the clinical meaning of elevated LDL-P or apoB in the context of a radically different diet (and hormonal milieu) than originally studied. I look forward to incorporating this work into my subsequent work." Also Jimmy Moore showed CT calcium of 0 with LDL-C double yours http://livinlavidalowcarb.com/blog/jimm ... 2013/18256

Do you have access to actual disease tests - CIMT or CT calcium? In my opinion, direct disease or wellness state is a better indicator than correlated blood tests.

Enjoy Hawaii!

Cheers!
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Stavia
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Re: help interpreting markers - Julie? George? anyone else?

Post by Stavia »

thanks guys. Its been very rewarding getting into increasingly smaller jeans lol.

Julie: I'm delighted I'm in mild ketosis. My insulin a month ago was 8 and my homocysteine was 11. I've repeated only the insulin yesterday 'cos I have to pay for insulin and homocysteine, all the other tests are free on the national health system. It's not back yet as of tonight.

Lilly: No VAP in my country either :(

George: yes I can access Coronary Calcium scoring @$400 but wouldn't expose myself to the radiation as whatever the finding it wouldn't change my current management. Plus no heart disease in my family at all, both parents no heart disease up to mid and late eighties. Carotid intimal thickness...hmm...around $250 mebbe....prolly wouldn't change my management either.

So.....can I be happy for now with the HDL/TG ratio and leave it as is until next year when I get to the States for an NMR?
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Re: help interpreting markers - Julie? George? anyone else?

Post by LillyBritches »

Lilly: No VAP in my country either :(

Crap on the no VAP. :(

George: yes I can access Coronary Calcium scoring @$400

$400??? Whoa. I paid $100 here. However, our healthcare costs are insane, whereas I know yours aren't. I'd take your healthcare system any day over the US's.

Plus no heart disease in my family at all, both parents no heart disease up to mid and late eighties.


Pffffttt...you're golden, then, woman!

So.....can I be happy for now with the HDL/TG ratio and leave it as is until next year when I get to the States for an NMR?

Personally, I think you can be freakin' ecstatic. :D
I'm just a oily slick in a windup world with a nervous tick.
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Stavia
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Re: help interpreting markers - Julie? George? anyone else?

Post by Stavia »

And WHY did my HDL rise?
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Stavia
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Re: help interpreting markers - Julie? George? anyone else?

Post by Stavia »

OMFG
NAILED MY INSULIN
Fasting insulin.....drum roll....3.2mU/l (5.0 -13.0) !!!!!!!!!
Im ecstatic. Could cry with joy. Heart pounding.
>>>>Dances<<<<

But everyone is asleep....cries...
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