APOE 3/4 - Gundry Protocol - Elevated LDL-P and APO-B

[SoCalGuy]

Hello everyone,

I have been lurking while I work on figuring out the best way for me to manage my APOE 3/4. I found out about Dr Gundry's practice and methods back in March and have become a work in progress in adhering to his protocol. Overall I feel like it is working very well for me. I have no real inflammation or blood glucose problems at all. Omega 3 is high but not as high as he would like. The two markers I am struggling with right now are APO B and LDL-P.

The APO B is 128 and has not changed over several years. The LDL-P has remained in the 1600ish range over the past year. Based on my research it seems like it would be preferable to get my LDL-P below 1000. Are there any Gundry disciples here who have had success lowering their LDL-P without medication?

I am open to going on a statin and I have to say the forum interview thread with Tom Dayspring was a huge help. I am working with my doc and want to give it one last try on lowering my LDL-P naturally before I decide to treat it with medication.

Thank you!

[Gillyp]

A warm welcome to the community, SoCalGuy. Thank you for taking the time to share your story with us. I'm so pleased to hear that you are following Dr. Gundry's protocol and that it's working very well for you. Any time we make changes it can be a "work in progress" and it takes both persistence and self-regulation to follow through. You obviously have plenty of both.

I agree and also found the forum interview thread with Tom Dayspring to be very helpful. Having asked about lowering LDL naturally, I'm sure you'll get lots of responses from the community sharing what has worked to lower their LDL-P. Personally I found that adding in more foods high in soluble fiber and phytosterols, and increasing my physical activity, helped lower my LDL. I try to make sure that at every meal I have plenty of colorful vegetables. Everyone is different so you may have to try a few things to see what impact certain changes have on your LDL levels.

To help you use your time on the site more efficiently I just want to make sure you're aware of both the Primer (viewtopic.php?f=33&t=1418) and the Wiki Page (https://www.apoe4.info/wiki/%22How-To%2 ... fo_website). I also find the search feature very helpful when I'm looking for information on a particular topic. Please keep posting and let us know if you are successful in naturally lowering your LDL. Again, welcome to our community.

[SoCalGuy]

A warm welcome to the community, SoCalGuy. Thank you for taking the time to share your story with us. I'm so pleased to hear that you are following Dr. Gundry's protocol and that it's working very well for you. Any time we make changes it can be a "work in progress" and it takes both persistence and self-regulation to follow through. You obviously have plenty of both.

I agree and also found the forum interview thread with Tom Dayspring to be very helpful. Having asked about lowering LDL naturally, I'm sure you'll get lots of responses from the community sharing what has worked to lower their LDL-P. Personally I found that adding in more foods high in soluble fiber and phytosterols, and increasing my physical activity, helped lower my LDL. I try to make sure that at every meal I have plenty of colorful vegetables. Everyone is different so you may have to try a few things to see what impact certain changes have on your LDL levels.

To help you use your time on the site more efficiently I just want to make sure you're aware of both the Primer (viewtopic.php?f=33&t=1418) and the Wiki Page (https://www.apoe4.info/wiki/%22How-To%2 ... fo_website). I also find the search feature very helpful when I'm looking for information on a particular topic. Please keep posting and let us know if you are successful in naturally lowering your LDL. Again, welcome to our community.

Hello Gillyp!

Thanks for your reply. I have read that high fiber foods can be helpful with regard to LDL-P. With the Gundry diet he typically recommends avoiding foods like oatmeal and beans due to the lectin content. I also struggle with stomach discomfort when eating beans. Are there any other soluble fiber foods that you can recommend?

As an aside, I have done one 2 day water fast and one 5 day fast mimicking diet and both seemed to greatly improve everything other than LDL-P and APO B, which really did not improve at all. I am considering doing the 5 day FMD each month as that seems to be the most aggressive form that Dr. Valter Longo promotes. Has anyone done the FMD and seen any changes in their LDL-P?

OK I will stop with the questions . Thanks again for your response! I am looking forward to doing some more testing to see what I can learn and what works for me.

[Gillyp]

All fruits and vegetables contain some soluble fiber so using a selection of more colorful vegetables will likely help. Gundry does indeed suggest staying away from legumes, squash, nightshades and fruit that is out of season. If you don't tolerate legumes then I would certainly listen to your body - it always knows best. Brussels sprouts, avocado's, flaxseeds are some of my personal favorites for soluble fiber.

Fasting does help some people lower LDL's, as well as having many other benefits. I have not personally completed a FMD. I'm not sure I have your self discipline to do so! I'm very impressed with all of the research that you have done and the fact that you are willing to try different things to improve your health. I'm also very interested to hear what you find works for you.

[SoCalGuy]

All fruits and vegetables contain some soluble fiber so using a selection of more colorful vegetables will likely help. Gundry does indeed suggest staying away from legumes, squash, nightshades and fruit that is out of season. If you don't tolerate legumes then I would certainly listen to your body - it always knows best. Brussels sprouts, avocado's, flaxseeds are some of my personal favorites for soluble fiber.

Fasting does help some people lower LDL's, as well as having many other benefits. I have not personally completed a FMD. I'm not sure I have your self discipline to do so! I'm very impressed with all of the research that you have done and the fact that you are willing to try different things to improve your health. I'm also very interested to hear what you find works for you.

Thanks Gillyp. I've been particularly interested in tincup's protocol. I do consume copious amounts of olive oil so I am intrigued by the prospect of replacing it with perilla oil. I have my next doctor's appointment early next month and want to get in one more good test before then.

[SoCalGuy]

So I've violated the Gundry protocol in a few ways; the good news is the results have been worth the deviation. Long story short is I've gone moderate fat (primarily monounsatured), low protein and moderately high carbohydrate intake. I am also taking 5mg of Crestor. My LDL-P has dropped by 25% and I am no longer in the high/danger range for LDL-P. Unfortunately my doctor neglected to measure Apo B this time around so I didn't get any idea of how much Crestor/diet impacted Apo B.

The reason I made these decisions is right now I am more concerned with CVD than AD. I am willing to play the long game with AD although I am being very good about only eating quality, fibrous carbs. I can also say my blood glucose and inflammation markers indicate I am not currently at much risk for insulin resistance. As far as carbs go I am sticking with sprouted wheat bread (2 slices per day), 1/2 cup of uncooked oatmeal (I cook it obviously ), 2 cups of beans (pressure cooked), 1 large sweet potato, and roughly 2-3 cups of white rice.

I'd like to get my LDL-P well below 1000 so I'm likely to add Zetia to my Crestor Rx which Peter Attia and Tom Dayspring talked about during their epic podcast. I do like Dr Gundry's suggestion of getting your blood markers updated every 90 days and I will plan to do so for the foreseeable future to see how my risk factors look for CVD, Insulin Resistance and Alzheimer's Disease.

I'm also going to follow the Valter Longo 5 day fast mimicking diet every 6 months as he suggests in his book. I think that is a great way to continue to minimize inflammation which isn't an issue now however it is something I will plan to continue to pay close attention to in case it becomes a significant risk factor.

[NF52]

So I've violated the Gundry protocol in a few ways; the good news is the results have been worth the deviation. Long story short is I've gone moderate fat (primarily monounsatured), low protein and moderately high carbohydrate intake. I am also taking 5mg of Crestor. My LDL-P has dropped by 25% and I am no longer in the high/danger range for LDL-P. Unfortunately my doctor neglected to measure Apo B this time around so I didn't get any idea of how much Crestor/diet impacted Apo B.

The reason I made these decisions is right now I am more concerned with CVD than AD. I am willing to play the long game with AD although I am being very good about only eating quality, fibrous carbs. I can also say my blood glucose and inflammation markers indicate I am not currently at much risk for insulin resistance...

Thanks for sharing your good news, SoCalGuy!
This is a forum with lots of people who believe that there's no such thing as "violating" a protocol, only finding what works best for you. As someone whose dad died of cardiac arrest at age 67, 8 months after quadruple bypass surgery, I also believe in not tripping over a boulder while climbing the mountain to healthy old age! Great news on the LDL-P! At some point, you may want to pay for a coronary calcium scan, (since insurance won't usually cover the $150. cost) just to give you more good news with hopefully a zero calcium score, and a cardiac age lower than your current age!

[petoeketo]

Hi socal guy. (I'm in LA actually).

I have a 1950 LDL-P eating LHCF and found comfort in Davis Feldman's research. Browse cholesterolcode.com

Certainly this is a contentious topic but LDL-P, according to Feldman is not the most relevant metric to focus on. It, like LDL-C can be manipulated easily by adjusting your fat intake.

I've also done a few FMDs. It's had good results for me but don't expect fasting to improve your LDL-P.

[SoCalGuy]

Thanks for the feedback NF52! I have actually done the coronary calcium scans. My first one back in August 2016 was a zero which was a big relief given my elevated cholesterol levels. I had another one done in July this year and the score went up to 5. So still not a massive concern, but a move in a direction that makes me more acutely aware of the CVD risk factor in the short term.

My CRP has been in the 0.5 - 0.57 range for all of 2018 so I feel like diet and fasting has helped keep this under control. I made an appointment to get my APO B measured in early January and I want to pay very close attention to APO B and LDL-P until they are both in the range Peter Attia has suggested are preferable.

I doubt I will ever have it fully dialed in, but I will do my best to make changes based on the data I receive and attempt to figure out how to best manage the risk factors we all face.

[SoCalGuy]

Hi socal guy. (I'm in LA actually).

I have a 1950 LDL-P eating LHCF and found comfort in Davis Feldman's research. Browse cholesterolcode.com

Certainly this is a contentious topic but LDL-P, according to Feldman is not the most relevant metric to focus on. It, like LDL-C can be manipulated easily by adjusting your fat intake.

I've also done a few FMDs. It's had good results for me but don't expect fasting to improve your LDL-P.

Hello petoketo,

Thanks for your reply! That's cool that you are a local! I am in the South Bay area.

I had been on the keto/fasting protocol since March and am very happy with my C-Reactive Protein and HbA1c assays. I have no danger signs at all when it comes to inflammation or losing insulin sensitivity. My biggest concern right now is my elevated lipids and seeing my CAC go from a zero to a five. It's still quite low but it seems to indicate there could be some calcification going on.

I've read a bunch of Dr. Gundry's articles and watched most of his video podcasts so I know he's a bit of a skeptic when it comes to CAC scoring. So I'm not viewing CAC as being 100% validation that I'm getting some calcification but I am definitely paying attention.

I also listened to Dave Feldman's podcast with Peter Attia and I take Attia's skepticism regarding Feldman seriously given Attia has a pretty big practice where his focus is on much more than TC or LDL-C. That doesn't mean I am writing Feldman off - I think low carb has been validated to a very large extent. I'm just following what the experts say are the warning signs when it comes to heart disease. Both Attia and Dayspring seem to put great value on APO B and LDL-P. However if I start to see signs of becoming less insulin sensitive or inflammation start to become an issue then I'll go back to focusing on those markers and let LDL-P and APO B take a back seat once again.

I have two young kids and my primary goal is to be around to get them to adulthood, ie their mid 20s. Right now I feel like heart disease is the most likely thing to kill me within the next 20 years. If I can get my lipid markers to the 20% percentile like Attia uses as a goal for his patients I'll feel good about that 20 year goal. If I can get those markers dialed in then it becomes about what I can do diet wise to either get off the meds or keep them at the lowest doses possible for as long as possible.

Thanks again for suggesting I check out Cholesterol Code. I will definitely bookmark it and listen to some more podcasts with Feldman to stay on top of his research!