Troponin I

[giftsplash]

In the recent Steven Gundry talk https://youtu.be/Bfr9RPq0HFg?t=25m58s

At the 26 minute mark he talks about Troponin I. I am wondering if anyone ever had theirs measured after a heavy exercise. Is he implying that Apoe4 should not indulge in heavy exercise, and would taking a test after heavy exercise be a good marker to see if one should continue the activity?

I would like to bring back the conversation on Crossfit and Apoe4 and heavy exercise in general.

[giftsplash]

Will add an interesting study to the mix.

http://www.ncbi.nlm.nih.gov/pubmed/9468064

Exercise-induced silent myocardial ischemia in master athletes.
Katzel LI1, Fleg JL, Busby-Whitehead MJ, Sorkin JD, Becker LC, Lakatta EG, Goldberg AP.
Author information
Abstract

High-physical activity levels are associated with reduced risk of symptomatic coronary artery disease (CAD). However, there are a number of reports of exercise-related sudden death and myocardial infarction in aerobically trained athletes. This study compared the prevalence of exercise-induced silent myocardial ischemia on maximum graded exercise tests with tomographic thallium scintigraphy in 70 master male athletes (63 +/- 6 years, mean +/- SD) (maximum aerobic capacity, VO2max >40 ml/kg/min) and in 85 healthy untrained men (61 +/- 7 years) with no history of CAD. The prevalence of silent ischemia (exercise-induced ST-segment depression on electrocardiogram and perfusion abnormalities on thallium scintigraphy) was similar in athletes and untrained men; 16% of the athletes (11 of 70) had silent ischemia compared with 21% of the untrained men (chi-square = 0.81, p = 0.36). No athletes had hyperlipidemia, systemic hypertension, or diabetes mellitus. However, the apolipoprotein E4 allele was present in 9 of the 11 athletes with silent ischemia compared with 2 of 32 athletes with normal exercise tests (chi-square = 24, p = 0.0001). These results suggest that older male athletes with the apolipoprotein E4 allele are at increased risk for the development of exercise-induced silent ischemia.

[Nancy]

Oh my goodness! Good to know. I wonder if the results would be different if the ApoE4 athletes were limiting animal fat, sugar, refined carbs etc.

[MarcR]

While Gundry does offer dietary recommendations that are specific to E4 carriers, I think the context for his CrossFit concerns is broader.

Also at AHS 16, Ben Greenfield gave an engaging talk that inspired me to buy his book, Beyond Training. The first sentence of his preface is, "Athletes are unhealthy." He goes on to share his personal overtraining woes and a bunch of referenced research on the topic. There are 3-4 pages just on CrossFit in which he concludes that many gyms encourage unhealthy, counterproductive, and risky training but that CrossFit can be helpful if done well - he calls out Power, Speed, Endurance by Brian MacKenzie as a particularly good guide.

I'm only 75 pages in, but he is making a persuasive case for a focused training regimen that he believes improves both performance and health in a fraction of the time that many professional endurance athletes spend. Training less isn't a side effect - it's central to the strategy. My "bro science" detector hasn't popped up yet - I really like Greenfield's combination of attention to the scientific literature with careful n=1 observations. He seems to me to exemplify the "citizen scientist" approach that many of us here favor.

The overtraining issue is personal for me as I believe that my father's premature decline in health was triggered by excessive marathoning. He was in his early 50s (my current age) when he developed idiopathic atrial fibrillation, which I have since learned is common in seemingly healthy middle-aged endurance athletes.

[MarcR]

Oh my goodness! Good to know. I wonder if the results would be different if the ApoE4 athletes were limiting animal fat, sugar, refined carbs etc.

The level of consensus here regarding sugar and refined carbs is high, but some very bright and knowledgeable people think that limiting animal fat may well cause disease. It's a perennial topic here - the latest thorough discussion was occasioned by a recent article from Dr. Chris Masterjohn.

[Stavia]

Excercising to the point of killing myocardial cells ( basically dead cells leak the troponin) cannot be healthy.
The thing is how much excercise does one need to cause this?
A marathon I know does.
Does an hour of a gym class where one's heart rate goes about 80% of max for age?
Thoughts?

[cdamaden]

"These results suggest that older male athletes with the apolipoprotein E4 allele are at increased risk for the development of exercise-induced silent ischemia."

Maybe if I start to develop AD I should take up marathons... If I get to pick a way to go, I might as well enjoy it.

[cdamaden]

I wonder how strength training might factor in. It appears to have very good benefits for the master athlete.
http://biomedgerontology.oxfordjournals ... M1009.full

http://www.ncbi.nlm.nih.gov/pubmed/19124415

[Tincup]

My Singulex Tropnin I scores from April 2015, Dec 2015 & June 2016 0.7, 0.6, 1.5 - range 0.0-3.7 pg/mL

I intentionally don't exercise the day before my bloods are drawn. In June 2016 case, labs were drawn Tuesday morning. Sunday was 3rd day of 3 day water fast & I rock climbed 5 hours in the sun (but not high heart rate). Ate Sunday evening and Monday evening.

I do know an 80 year old male who'd had a silent heart attack and TIA before becoming a Gundry patient. From memory his first Troponin I was ~58 and several months later, after adopting Gundry's plan it had dropped to ~4.2. I was able to listen to his call with Gundry and Gundry was very pleased with this.

What I don't know is how long after exercise high levels of Troponin I can persist.

Chronic fitness, including races of marathon duration and intensity, was my path to atrial fibrillation 12 years ago. I intentionally do not train with endurance activity now, though those that know me would say I'm still very active. There is a difference.

[Teezer]

My own experience tells me that limited, but vigorous, strength training is beneficial.

I go to a gym three times a week, and I do a short HIIT (high intensity interval training) routine. Short, as compared to the other regular gym rats, is about 1/2 hour. In that time I do around two dozen machine and free-weight exercises. My pause between exercise "sets" is only long enough to get my heart rate to decline to my starting point for the next exercise.

I'm usually breathing too hard to hold a conversation, which is fine, because I'm not a great talker.

Anyway, I've been doing variations on this routine for ~40 years now. So far (at age 74), I do have those memory lapses that are invariably described as "normal aging" by the medical press, but nothing that feels like an "onset" of AD. And those memory lapses (which have been occurring for the last two decades), my 3/4 status, and the fact that my father died with AD at 84, are what caused me to seek out this group.

The experiences of others here have been instructive, mostly in the area of supplements and dietary restrictions. Once those subjects were covered, I haven't had much to talk about, so I don't post very often. But my exercise routine has been very good to me, and I'll endorse regular exercise whenever it comes up.

But moderation is key.