NMR LipoProfile Test Result Questions

[Blaise]

TheresaB, Yes it is a tradeoff, I am trying to stay more on the longevity side of the line at this point in my life. Trying to keep my IGF-1 and mTOR low while still staying healthy and keep some muscle. I am also curious what Dr. Gundry's thoughts are on developing / maintaining muscle without mTOR and keeping low IGF-1 values. if you do get a chance to discuss it at your next appointment please let us know. What new tests are you referring to that Dr. G is using - does it measure sdLDL? I can't wait to book a consult with him!

My fasted morning glucose floats around 100 or slightly more on low carbs. When I do eat more carbs the previous day it tends to go down into the high 80s. How does your husband measure his insulin? Do you think HBA1c is a good marker for overall insulin levels?

Wow, I couldn't imagine fasting for 7 days! That must have been hard. I found your results very interesting but they do make sense with the things I have learned so far. How does the 7 day fasting triglycerides compare to your normal 12 hour fast tests? Like you said before, maybe the triglyceride level is from the triglycerides coming out of your fat stores to be used as fuel during your fast and not being used by the liver.

It could be that your total and LDL cholesterol levels are high when fasting for 7 days because your thyroid function may be decreased from the long fast. Did you test your thyroid markers after the fast as well? Thyroid hormone regulates LDL receptor activity therefore, maybe your LDL receptor activity is down regulated because your thyroid function is low because of the fasting. Also your PSK9 activity will increase during fasting periods. PSK9 decreases LDL receptor activity as well. Since LDL receptor activity has decreased by two different mechanisms there is more LDL floating around in your blood and thus the high LDL and total cholesterol tests values. Just a thought from all the information I have been learning.

It’s a fine edged sword. There are tradeoffs. Dr Gundry’s approach is tailored to encourage longevity, this includes trying to maintain a low IGF-1 (insulin like growth factor) and not activating mTOR through reduced protein intake, and I know that body builders have (want) high IGF-1 and emphasize protein intake.

I’m not conversant in this subject, I wish I knew more. I know I’m currently under a kind of “cross-fit lite” version of strength training, trying to rebuild some muscle/strength that I lost after three surgeries on my foot. I had a painful situation (still do somewhat, but much better now) and was unable to remain on my feet/walk for any length of time, therefore I was largely inactive and atrophying for about four years. IF we have time to discuss how to best develop/keep muscle mass while keeping a low IGF-1 and other markers that Dr Gundry encourages, I’d like to broach this subject during our next, upcoming consult. I did just get my last blood test results and noticed my IFG-1 did rise slightly from 75 to 79, I don’t know if this is just day to day “noise” or the result of the weight training regimen I adopted since my last blood test. However, I’m not sure we’ll have time, as Dr Gundry added a whole new set of tests this time, and so we have lots to review with the results from the new new lab.

I'd say you have to evaluate your carb intake with your insulin levels. My husband’s fasting insulin was just measured at 2, but his glucose measured 96. Although this glucose level is “green” it still seems rather high, yet given the context, that is to say, his insulin is good, such a glucose marker is really irrelevant.

We are low carb, but not crazy low carb. We eat carbs! Mostly in the form of fiber and resistant starch. My husband estimates he eats about 80-90 grams of carbs a day of which about 50 grams are fiber. I probably eat a little less, but proportionately the same. Yet our insulin levels are good, so we have the latitude for carb intake.

Everyone is different. For YOU, eating carbs may be good for you.

Here’s something else to chew on (pun intended). My husband and I went on a 7 day fast last month. On the 7th day, before we broke the fast, we had blood tests taken.
Me
Total cholesterol 273 (high) [Higher than my usual TC results under normal eating testing conditions]
Triglycerides 85
HDL 71
LDL cholesterol calc 185 (high)

Husband
Total cholesterol 235 (high)
Triglycerides 76
HDL 50
LDL cholesterol calc 170 (high)

Where did all this come from? Not from food, we hadn’t eaten in 7 days!

[Tincup]

What new tests are you referring to that Dr. G is using - does it measure sdLDL? I can't wait to book a consult with him!

He's measured sdLDL (in md/dL) since our first consult. After we have our consult, we'll post our redacted labs. My most recent was 26 mg/dL (his target is <30).

How does the 7 day fasting triglycerides compare to your normal 12 hour fast tests?

Higher, since that is how we fueling. My trigs on day 7 were 79 md/dlL, They usually run in the 50's or low 60's. Most recently, 40.

Typically, I have to eat a high carb meal the night before to get them below 50 mg/dL (where Gundry would like them). We've discussed this and he said it make sense as I'm always at least slightly keto (and have been for 7 1/2 years). Meaning I'm using the Tg's. If I eat a high carb meal, the Tg's stay in storage and I burn glycogen. Gotta get fuel from someplace if you are fasting or keto & the Tg's are my source. The issue with Tg's in MOST people is they represent fat being created from excess carbs. As Theresa pointed out - are you taking them from or putting them in storage. If you've not seen the link to our consult transcript with redacted results from six months ago it is here . Theresa posted about our fast starting here here and continuing in the thread. The redacted labs for both of us are here. The table of our glucose/ketone values during the fast is here.

[MAC]

Yes it is a tradeoff, I am trying to stay more on the longevity side of the line at this point in my life. Trying to keep my IGF-1 and mTOR low while still staying healthy and keep some muscle. I am also curious what Dr. Gundry's thoughts are on developing / maintaining muscle without mTOR and keeping low IGF-1 values.

Blaise, interjecting on muscle. I started reading the Phinney/Volek book "The Art & Science of Low Carbohydrate Living". Parsed briefly re LCHF and muscle mass, but essentially, you can easily maintain muscle mass during weight loss with resistance training, but you might need to up your protein up from say 0.8g/kg on "standard" LCHF and watch your minerals (eg. salt). Will send some further info/references separately.

Re "longevity", I guess you mean all cause mortality...CVD, AD, cancer, etc? My current focus is ONLY AD prevention given my E3/E4 status and maternal AD history, whilst not aggravating other risks. I figure with very proactive LCHF NK dietary management, elimination of all MetS markers, low BMI/body fat, good lipids, and daily exercise, I am not too worried about CVD or other mortality risks...for now.

[TheresaB]

Blaise wrote: What new tests are you referring to that Dr. G is using - does it measure sdLDL?

Dr Gundry has been testing our sdLDL all along, but at our last consult in July 2016 he implied that while sdLDL is a good a indicator, there's now a test that measures the oxidized particles numbers. What he told us:

Now, in general , small dense LDLs are the little particles that like to oxidize, particularly with your gene. [ApoE4]. As long as these guys are under 30, I don’t worry about them. We’ve got a new test that we’ll get for you guys next time that actually looks at oxidized LDL particles that are circulating around, and it’s been very helpful, particularly for a lot of the ApoE4s, to know exactly how many mischief makers are going around. But so far this looks still just fine.

So for our upcoming consult we got kits from 3 labs where we’d only gotten kits from two labs before. Now we’re also being tested by the lab Vibrant in addition to the Singulex and True Health Diagnostics labs. The Vibrant lab results included many test results, 4 pages worth, not just a test marked “ox-LDL” (which is green for me by the way, yipee!) so I anticipate we’ll be spending our next consult learning about these new tests and results and won’t have much time for additional questions. If I can squeeze in a question about longevity/muscle build trade-offs, I will. I make transcripts of our consults and we will share what we learned as we always do.

Blaise wrote: My fasted morning glucose floats around 100 or slightly more on low carbs. When I do eat more carbs the previous day it tends to go down into the high 80s. How does your husband measure his insulin? Do you think HBA1c is a good marker for overall insulin levels?

Glucose 100 in the morning may or may not be good/bad. I know the liver starts to wake up in the morning to release glycogen, and every body is different, and glycogen can be elevated with certain supplements (like niacinimide), yada, yada, yada, and maybe I've just been brainwashed by my husband, but I'm leaning more toward insulin and insulin sensitivity as being the most important measure and if your insulin sensitivity is very good, the highs and lows of glucose don't matter as much. Yes, HbA1c is a very good marker, rather than the “snapshot” that you get with fasting insulin, HbA1c is a "movie" in that it measures your average insulin level over the past 2 to 3 months.

Edit add: you asked how HbA1c gets measured: via our Gundry tests every 6 months and if additional tests are needed via LabCorp.

Blaise wrote: Wow, I couldn't imagine fasting for 7 days! That must have been hard.

It was challenging, but it wasn’t hard. If your read my write up that my husband (GeorgeN) linked to previously, I did prepare myself and work up to it. Nevertheless, even though I was aware that extended fasting can offer many benefits, I probably wouldn’t have done it if I hadn’t had the cancer scare. (I'm basically lazy.) However, now that I did the fast and discovered how non-difficult (I won’t say easy) it was, I plan to do an extended fast once a year.

Blaise wrote: How does the 7 day fasting triglycerides compare to your normal 12 hour fast tests? Like you said before, maybe the triglyceride level is from the triglycerides coming out of your fat stores to be used as fuel during your fast and not being used by the liver.

Here you go:

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Blaise wrote: It could be that your total and LDL cholesterol levels are high when fasting for 7 days because your thyroid function may be decreased from the long fast. Did you test your thyroid markers after the fast as well?

Yup:

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[Blaise]

Thanks for the great information Theresa, George and MAC - and everyone else! I am learning a lot from everyone in this group. I just need find more time to read all this great info with my busy life.