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NMR's, Cardio-Specific Lab Results

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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Ski
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NMR's, Cardio-Specific Lab Results

Postby Ski » Mon Jan 05, 2015 6:38 pm

So the following is merely for informational purposes for others that may in the future want to consider a similar regime. My latest results were mostly drugs/supplements driven. I will say that I believe(maybe) my LDL-P would have probably been under 700, but I had actually increased my egg consumption in the last month. Food changes are listed in the NMR factors. My doc was aiming for a 60/60/60 target for HDL/LDL/Trig.

Mostly good, the bads are hs-CRP is on the rise and A1C was much higher. Im not sure what to make of the A1C, as my waking glucose is anywhere between 70-80 and this is a big jump from the last one, unless my Homocysteine or Niacin supplements are the cause.
Have a higher than normal Adiponectin level, but thats a new one for me and is reported to be elevated in lean individuals as well. Cleveland Heart says for lean to normal individuals Im within range, so who knows.

A test I didnt include here but which I was very happy about, was Liver enzymes. Ive had the occasional just above normal spikes and was convinced with the added statin and Niacin they would be elevated but they fell within normal ranges.



NMR factors
  • 12/17/2013 - No drugs, moderate fat, low carb
  • 01/29/2014 - On Zetia for 6 weeks plus Bergamot
  • 06/06/2014 - Off Zetia for 2 months. Possible exaggerated response after coming off Zetia according to Doc.
  • 07/15/2014 - Back on Zetia for 1 month.
  • 12/16/2014 - low dose statin/Zetia and Niacin 1000mg.
    From a diet perspective, in the last month I had increased carb intake & eggs but less animal protein. I believe Niacin is the big influencer with this result.





Homocysteine
Supplements taken to reduce level -
http://www.swansonvitamins.com/swanson-ultra-activated-homocysteine-formula-60-veg-caps
http://www.swansonvitamins.com/swanson-ultra-ajipure-n-acetyl-l-cysteine-pharmaceutical-grade-600-mg-60-veg-caps
http://www.swansonvitamins.com/swanson-ultra-methylcobalamin-high-absorption-b-12-2-5-mg-60-tabs

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Re: NMR, Cardio-Specific and other lab results

Postby Juliegee » Mon Jan 05, 2015 7:55 pm

Kudos, Ski :D Thanks for sharing. Amazing drop in homocysteine and cortisol! Overall, you must be very pleased.

Apologies in advance for my many questions. Your lipids with just Zetia are really good. What kind of diet were you on prior to the 1/29/14 test? I notice that your 7/15/14 test was just Zetia as well. How was your diet different at that time? I'm struck by the higher small LDL-P; from 102 to 553.

Your current LDL-P is LOW...and LDL is just 58? Are you noticing any fatigue or impairment in cognition? (I ask as some have experienced these side effects with super low levels.) Could you describe your current diet? Any ideas on how to reduce small LDL-P?

Have you looked into your elevated adiponectin? Strangely high; hard to figure out the implication of that one. Do you have any diet or med changes planned after seeing this result?

An observation from occasionally popping into HeartLifeTalk.com: I noticed that quite a few E4s there eat a relatively LC diet with some statin reducing med or supplement (or a combo.) It appears to be a strategy to address both glucose & lipid parameters. This is a general question to the group: Do we have any evidence that Zetia harms E4 carriers?

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Ski
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Re: NMR, Cardio-Specific and other lab results

Postby Ski » Mon Jan 05, 2015 8:25 pm

Apologies in advance for my many questions. Your lipids with just Zetia are really good. What kind of diet were you on prior to the 1/29/14 test? I notice that your 7/15/14 test was just Zetia as well. How was your diet different at that time? I'm struck by the higher small LDL-P; from 102 to 553.

Im someone that unfortunately can have drastic changes in lipid values through diet alone and I think with that, I have not been able to pinpoint what drops my sm-LDL-P as it is in a constant fluctuation it appears. My diet throughout all these tests really didn't change much except for the really bad one, where I wasn't really being strict but not horrible either.

Juliegee wrote:Do you have any diet or med changes planned after seeing this result?
No

Juliegee wrote:Are you noticing any fatigue or impairment in cognition? (I ask as some have experienced these side effects with super low levels.
No none. I want to add to this as Ive made this comment in the past but when I was experiencing cognitive issues (Bergamot), it was around Jan-March 2014 and you will notice my LDL and Total cholesterol was significantly higher then. This is why it certainly proved in my case, that SERUM cholesterol has nothing to do with cognitive issues! In my case it certainly appears to be that when the cholesterol manufacturing process in the brain gets affected by whatever drug is able to cross the BBB, that the cognitive issues occur.
I will add a disclaimer of "not yet" as only further time will tell.

Juliegee wrote:Could you describe your current diet?

For the most part with in between variations:
Breakfast its either an almond protein shake or steel-cut oats with a banana.
Lunch is a salad with some beans or a corn tortilla with egg and avocado.
Dinner is Salmon with sweet potato and a veggie or bean chili.

Nuts or banana for a snack.

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Re: NMR's, Cardio-Specific Lab Results

Postby Bendra » Fri Jan 09, 2015 6:37 am

Ski - I need to lower my homocysteine from a 12...how long were you taking the supplements for before your latest test?
Thanks for that list.

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Re: NMR's, Cardio-Specific Lab Results

Postby Ski » Fri Jan 09, 2015 9:48 am

@ Bendra - I had been on the supplements for 4 months.

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Re: NMR's, Cardio-Specific Lab Results

Postby GeorgeN » Wed Jan 21, 2015 9:14 pm

I had a repeat CIMT today, a little over 7 months from the first one.

Gundry diet for me – generally follow his Matrix protocol with ApoE4 mods
Matrix diet w E4 mods 1-1-15.pdf
– minimal animal fat (including dairy), lots of unfiltered EVOO, shell and whitefish OK, with emphasis on shellfish.

Eat 2x/day – no snacks. Try to have at least 12 hours between evening meal and breakfast and 3 hours between evening meal and bed.

Breakfast might be 3 free-range eggs lightly cooked in unfiltered EVOO, 2 tbs psyllium husk hydrated in coconut milk with 1/2 cup blueberries & 2 squares of 86% cocao.

Evening meal, guacamole, steamed asparagus, baked plantain chips made from green plantains & unfiltered EVOO, shrimp, salad with spinach, chard, arugula, kale, broccoli, radish, green onion, carrots, parsley, cilantro, avocado, mushrooms, black olives, artichoke hearts, unfiltered EVOO, balsamic vinegar.

Well the CIMT results were behind door number 2 – no change (10-20% on one side, 20-30% on the other with an intima thickness 8 years older than my age). The PA (the practice has a LC focus and the MD is one of Jimmy Moore’s “experts”) was pleased and the short answer is to continue doing what I’m doing. We chatted about ApoE4, and slow saturated fat processing. I asked about high LDL-P in a low insulin environment. She said there was (of course) no data. She did say that, from a clinical standpoint, they rarely saw rapid calcification where elevated LDL was the only risk factor. Rapid calcification is almost always accompanied by diabetes or metabolic syndrome. When she looked at some of my NMR’s under various circumstances, she thought they all looked good (even the 404 below).

I did not pull a repeat NMR for this but here's some of the results from the standard profile I did pull a week ago. Fasting serum ketones 1.1, TC 231, Tg 70, HDL 54, LDL-C 164, glucose 84, insulin 3.8, A1C 5.3. I do test with a CardioCheck home monitor, using glass capillary tubes for sampling. I only sampled Tg's that morning & they were 66. Pretty much spot on with the lab test.

Here are some NMR's I pulled during the 7 months under varying conditions:
(LDL-P, Small LDL-P, HDL, Trig)
Whey protein, MCT, salad 1746, 404, 58, 61;
fasting 36 hours 1286, 237, 58, 94;
carb nite 1393, 206, 48, 55.

I think the reason she, Gundry & others still care about small LDL is because it represents Met Syndrome and insulin/glucose are the keys to problems, in their minds.

The PA said she thought I was doing very well, to keep on doing what I'm doing and to repeat the test in one year.

I did experiment with consuming 540 mcg/day of K2 as MK7. Obviously did not show reversal.

My Lp-PLA2 did increase from 218 to 278. Still puzzled about that. Before the test 7 months ago, my diet was a very traditional animal based LC/HF, with LOTS of saturated fat.

For the future, I'll stay the course, but may add some of the supps Gundry suggests.
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George
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Re: NMR's, Cardio-Specific Lab Results

Postby Juliegee » Wed Jan 21, 2015 10:04 pm

From what I understand, no progression is SUCCESS :D Really interesting comments from your PA. Seems to back recent research that MetS is the driver of CAD/CVD in E4 carriers. Congrats, George. Thanks for sharing.

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Re: NMR's, Cardio-Specific Lab Results

Postby KatieS » Thu Jan 22, 2015 7:19 am

George, did you have a mm of intima thickness? I would suspect that the progression would be so slow that US would be annually, or possibly even less frequently, if the US was normal for age. The tech told me my US was "wide open", but the intima thickness was still 0.6 and 0.7, even with a LDL in the 80s, much lower than the HDL. I know Ornish reversed coronary blockage, but I have not seen evidence that we can reverse carotid calcified plaque. Did you lower your homocysteine like Ski? I am attempting to lower my 10.6 with diet & supplements.

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Re: NMR's, Cardio-Specific Lab Results

Postby Russ » Thu Jan 22, 2015 8:16 am

George, you continue to look analytically like my long-lost twin brother ;-). Thanks for sharing. I'm doing mostly the same things. Somewhat disappointed not to see any impact of K2, but I guess the CIMT is not necessarily related to any calcium (which is the only thing that would deb affected by K2). Meanwhile, we both keep chugging...
Russ
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Eat whole, real, flavorful food - fresh and in season... and mix it up once in a while.

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Re: NMR's, Cardio-Specific Lab Results

Postby GeorgeN » Thu Jan 22, 2015 10:46 am

Julie,

Yes, no progression is success. I'd like regression, but I'm certainly satisfied with no progression.

Kitano,

The thickness was 0.84mm, same as before (I'm 59 years old). The report said this was calculated with 384 points.

I did not resample homocysteine as it was a reasonable 7.4 about the time of the first test (& every test adds cost). Here are some test results from around the time of my first test https://www.apoe4.info/forums/viewtopic.php?f=5&t=570&p=5596&hilit=homocysteine#p5596
Myeloperoxidase - 218
Homocysteine - 7.4 u mole/L
Fibrinogen Activity - 255 mg/dL

I did not have a blood donation for 6 months as I'd pulled my fibrinogen pretty low. On the most recent test it was ~55, but serum iron was a bit high so I immediately gave blood. My donation time increased significantly from before. I'd not been taking fish oil recently, when I was taking it, my donation time was significantly less (like 5 min vs 7.5 min). From a blood viscosity theory of calcification, this is not going in the right direction, so I'll add the fish oil back in.

A bit more history. I'm now down to the weight I was as a sophomore in high school (170#). After that I bulked up to play American football in high school & college. I never lost that weight. About 10 1/2 years ago I ended up with idopathic (lone) atrial fibrillation. Chronic fitness was the likely cause. Among other things, I competed in high altitude races (13 1/3 mile, start 6,300' elev, end 14,200' elev). I'd been a long term vegan with LF/HC diet. I was fit & overweight, 6', 200#. With the afib, I detrained and gained to 210-215#. During the vegan years, a standard lipid test would be like TC 150, LDL 85, HDL 45, Tg 45. Fortunately magnesium to bowel tolerance (4-5g/day), potassium & taurine with an occasional help from on-demand flecainide has kept me in rhythm these 10 years. About 5 years ago, I decided to switch to a traditional meat based LC/HF diet & dropped the weight down to around 180. I didn't retest the lipids till last June. It was then that I saw they were high & the CIMT showed the calcification. At CIMT time I was 185#. So I've lost 15 pounds in the last 7 months and my BMI is 23.1.

I don't have a way to calculate body fat, but the US military uses height, neck and waist circumference http://www.calculator.net/army-body-fat-calculator.html. Using my current 6', 15.25" & 33.5" the result is 15%. This is reasonable. My belly is pretty flat and I carry a lot of weight in my legs.

My exercise training is no cardio. I alternate weeks using the Body by Science "super slow to failure" approach for strength training one week - a quick summary here: http://www.danielseidel.com/notes/2012/08/the-big-five-workout-program/ The other week I use the Military Fitness Program with the TRX body weight straps - modified with the BBS to failure approach - over two days and at their max number of reps: Day 1 https://www.youtube.com/watch?v=Ro_G7kkh4PE Day 2 https://www.youtube.com/watch?v=K5da5-9KpEo For fun I also alpine ski, rock climb, hike, backpack & etc.

My vitamin D 25 OHD goal is 70 ng/mL. Last August I was at 67 and taking about 7,500 IU's D3/day. I dropped back to 6,000 IU's a few months ago and we went into the North American winter. So my 25 OHD level was 53.5 ng/mL last week. I've since upped my D3 intake to 10,000 IU's/day. I do combine this with > 200 mcg/day of K2 MK7, as without the K2 to carboxylate it, the D3 may be counterproductive.

Russ,

I do appreciate what you are doing, too!!
George
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