A Little Help w/the numbers and a Note of Caution

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
maddanwill
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A Little Help w/the numbers and a Note of Caution

Postby maddanwill » Tue Feb 27, 2018 8:38 am

https://docs.google.com/spreadsheets/d/ ... sp=sharing

Friends,
I could use a little help with the numbers ....i have been following anti-AD protocol since May 2017 when I realized that I was a 3/4 and my mother's autopsy indicated both vascular dementia and AD. I also felt impaired cognitively. Since May I have lost weight, started strength and cardio, taken out sugar and flour/gluten. My diet has consisted mainly of fish, chicken, pistachios, walnuts, salads, avocados, almond butter, eggs, and limited dairy. I have not been vigilant in eliminating sat fats (getting mostly from commercial salad dressings and animal protein) and I think that is indicated in my bloodwork. I also had a sobering moment when my Calcium score was 58 with an 86% (59 yo female 3/4, with MTHFR and other methylation SNP's).

So I just did the attached panels with primary care and was more than a little disappointed...will eliminating sat fats greatly reduce my LDL's? Why is my fasting insulin so low at 2.4? Does anyone have any rec's re Magnesium...when I supplement with it my stools are very loose to the point of diarrhea. I eat a ton of salads and veggies which cause my stools to be very soft without the magnesium. How does one balance low carb/ketosis/low protein/low sat fat with getting enough calories? I feel if I up my carbs I take myself out of ketosis which has been running .6-1.0. I have no talent/passion with food prep...I am not a planner. Has anyone discovered a food delivery service that caters to A4's?

I would also like to add a word of caution to folks implementing the protocol...when I started this program I went full tilt. I was working out and restricting calories because I was not comfortable with new diet food planning and prep. It was easier to just not eat alot. Well, my homocysteine went through the roof (17) and my RT3 and TPO numbers also skyrocketed putting me in a severe hypothyroid state. I think my body felt that I was in starvation mode and down regulated everything for survival. So I am still climbing out of that hole with Cerefolin (prescription B vitamins to reduce homocysteine) and T3 supplementation. I thought my cognitive was much better with the Cerefolin but now I think I have slipped back. Not sure why.

Sorry if I am all over the board here (no pun intended!). These questions have been rolling around in my brain for some time now. Any comments/help would be very appreciated. This forum has been my greatest resource since starting this journey.

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Julie G
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Re: A Little Help w/the numbers and a Note of Caution

Postby Julie G » Tue Feb 27, 2018 10:48 am

{{{Maddanwill}}} Sorry that you're struggling with this. I agree that going VLC too quickly can affect the thyroid. There's been much debate about whether or not this is pathological or simply a consequence of revving the engine at a slower idle, possibly a sign of optimal health? My TSH also started to creep up as I adopted this approach and I responded by taking a tiny (1/4 grain twice daily of WP Thyroid 65mg); 50% less than my FMP recommended. I got terrific gains. I'm much warmer, my LDL is low (despite my low carb/keto approach) and I generally feel better. Because E4 carriers already have reduced LDL receptor activity and cholesterol clearance, IMHO, it simply makes sense to optimize this within reason.

No worries about the low insulin. Yours is enviable. You mention losing too much weight. What is your current BMI? How much have you lost in total? Your numbers aren't awful by any means, but I do see some things moving in the wrong direction. I'd really like to see your HDL higher and TGs lower. Your HbA1c could also be a bit lower. I would definitely toss any commercial salad dressing from your diet (added sugar & unhealthy engineered fats) and transition toward using good quality, high polyphenol EVOO and balsamic vinegar. It tastes so much better too! My guess is that further replacing SFA with health MUFAs and PUFAs (EVOO, avocados, olives, nuts, fish) will also help to further improve your lipids. BTW, Dr. Gundry only uses sdLDL and yours falls within his acceptable range. He'd likely tell you to keep up the great work ;).

You already know that your homocysteine is too high. This is one of those biomarkers that we tend to focus on as higher levels are strongly correlated with cognitive decline, hippocampal atrophy, and an increase in white matter hyperintensities. You mention eating quite a bit of of animal foods. I wonder if going vegan for at least one meal or even for 1-2 days per week could also help make a difference?

Your magnesium levels are too low. When supplementing, definately avoid magnesium oxide as that version will further loosen stools. I'm unsure if magnesium threonate increases serum magnesium levels. Does anyone know? It makes sense that it would and this is the version recommended by Dr. Bredesen to improve cognition. (Be careful as it had inexplicably the opposite reaction for me.) Another version to consider would be magnesium citrate. I sometimes use a beverage version called "Calm." It's mildly sweetened with stevia and is quite relaxing.

Kudos to you for quantifying where you stand and for working to move things in the right direction. Keep up the amazing work and share your journey. We're all learning with you. -xo

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Re: A Little Help w/the numbers and a Note of Caution

Postby Fiver » Tue Feb 27, 2018 11:37 am

Hi Maddanwill. You're from one of my favorite places.

You said: "I would also like to add a word of caution to folks implementing the protocol...when I started this program I went full tilt. I was working out and restricting calories because I was not comfortable with new diet food planning and prep. It was easier to just not eat alot."

I agree. I've heard Dr. Bredesen say that the specifics of the diet were not his specialty, because he's not a nutritionist, and I know there are others working with him to provide more guidance about how to start a ReCODE-like diet in the near future. There are enough differences in the recommendations for other, similar type diets that it can be confusing. With the overnight fasting and ketosis it is easy to just not eat as much and not feel too hungry. Easy to drop weight when you might not want to. And easy to load up on saturated fats. I'd bet that it is normal to have some test numbers improve while others get a little weird. Good for you for checking them and adjusting.

It's a process. It helps to use cronometer.com or something similar to log foods, just enough to see how it adds up for you.

I'm no expert but it seems to me that half the battle is just getting rid of the excess sugars and eating "real" foods, including the non-starchy veggies, without replacing the calories with saturated fats.....while getting enough calories.

Until they start making 100% omega-3 crunchy snack chips....and someone should really get on that....we'll have to find a workable balance.
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Re: A Little Help w/the numbers and a Note of Caution

Postby ncjlhp » Tue Feb 27, 2018 2:41 pm

Maddenwill, Thanks for the words of caution about going full tilt! I just can't think of how to eat under the protocol so I just eat a leafy salad and an olive. I need recipes and ingredients and time to think. Meanwhile, I am kind of afraid to eat. Not good.

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Re: A Little Help w/the numbers and a Note of Caution

Postby maddanwill » Tue Feb 27, 2018 4:51 pm

Julie, thank you for your response. My BMI is 22 and I lost 25 pounds in about 4 months.

When you say...

Julie G wrote:My TSH also started to creep up as I adopted this approach and I responded by taking a tiny (1/4 grain twice daily of WP Thyroid 65mg); 50% less than my FMP recommended. I got terrific gains. I'm much warmer, my LDL is low (despite my low carb/keto approach) and I generally feel better. Because E4 carriers already have reduced LDL receptor activity and cholesterol clearance, IMHO, it simply makes sense to optimize this within reason.


What do you mean that we should optimize this within reason? Optimize our thyroid function? Is there a trade off between thyroid function and low LDL?

Also, has anyone had any experience in reducing their CAC (Calcium scan score)? I am meeting with my doc in a couple days and would like to understand different approaches.

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Re: A Little Help w/the numbers and a Note of Caution

Postby Searcher » Tue Feb 27, 2018 5:02 pm

ncjlhp wrote:I just can't think of how to eat under the protocol so I just eat a leafy salad and an olive. I need recipes and ingredients and time to think. Meanwhile, I am kind of afraid to eat. Not good.


nc,

Please, please, please eat.

You appear to be on a very low calorie diet with little or no protein. This is a recipe for cardiac muscle atrophy. People die of that.

Please eat, anything at all, while you think. You have gone for decades without worrying excessively about what you eat. A few weeks or months more will not hurt you unduly.

Did I mention - please eat.

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Re: A Little Help w/the numbers and a Note of Caution

Postby ncjlhp » Tue Feb 27, 2018 5:23 pm

Searcher,
Thank you. You are right and I reacted badly. I found Casein A2 cheese, roasted a big cauliflower and added some protein. Also made organic kale chips with olive oil- very delish. I need recipes, seriously. Where can I get them? I am not a person who can get by without cooking and eating well. I do have to change my ways, but I will eat. My tolerance for not eating lasted 4 days- lol! When I saw the food pyramid ( Dr Gundry) and the second tier said skip a meal, I couldn't believe it! I have never skipped a meal, I love food. My BMI is good, so that is not a problem. I have always been low carb- maybe too high saturated fat. But, recipes- please.

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Re: A Little Help w/the numbers and a Note of Caution

Postby Fiver » Tue Feb 27, 2018 7:01 pm

There is a lot of motivation for us. And not too many "indicators" to tell is when we're doing things right. Or when to slow down. Careful not to overdo it. It's easy to do. Just take it slowly and think long term. (I should take my own advice BTW)

Remember that in his original studies Bredesen recommended "a choice of anti-inflammatory diets" (pretty flexible) and...if I recall the wording...."none of the subjects could completely follow the whole protocol". Most still had good outcomes anyway. The FINGER study showed a general Nordic diet plus exercise and socializing was effective, even in e4s. So it seems a generally smart diet - something like these - works. To stick with it long term we have to make it livable.

Hopefully, your doctors will give good advice re: other things you can work on.

How are you in other areas? Sleep, stress, exercise, etc? You are approaching the time of year when Charleston will be in full bloom and the weather is great to be outside. Exercising on the beach will make us all jealous!

Just my thoughts. Some folks have made some serious changes - but probably over time, with good advice and monitoring.
Concerned, but hopeful. Introverted, but will talk about science.

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Re: A Little Help w/the numbers and a Note of Caution

Postby slacker » Wed Feb 28, 2018 9:00 am

There is now a wiki entry of recipes from our members; it is a work in progress. Please keep in mind that our members do not all follow the same nutrition plan - some are vegan, some eat meat, some avoid saturated fats from animal and plant sources, others are not concerned about saturated fat intake. Some follow the Bredesen approach, some follow Gundry, others have created their own path. "It's a journey!" We all have started somewhere, and made adjustments over time based on our personal beliefs and priorities. And try to support each other along the way.

It is very important that low weight individuals focus on consuming enough food to avoid underweight and under nourishment. This is one of my personal struggles. My "issues" definitely worsen when I'm not putting enough fuel in the tank.

There is not currently a Bredesen approved recipe book. Dr Mary Kay Ross, a functional medicine MD and Bredesen provider, suggests food plans from Dr Mark Hyman or Dr David Perlmutter as good places to start. They both have several published books, and possibly recipe info on their websites as well.
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Re: A Little Help w/the numbers and a Note of Caution

Postby slacker » Wed Feb 28, 2018 9:06 am

maddanwill wrote:When you say...

"My TSH also started to creep up as I adopted this approach and I responded by taking a tiny (1/4 grain twice daily of WP Thyroid 65mg); 50% less than my FMP recommended. I got terrific gains. I'm much warmer, my LDL is low (despite my low carb/keto approach) and I generally feel better. Because E4 carriers already have reduced LDL receptor activity and cholesterol clearance, IMHO, it simply makes sense to optimize this within reason. "

What do you mean that we should optimize this within reason? Optimize our thyroid function? Is there a trade off between thyroid function and low LDL?



When the thyroid is underactive, LDL cholesterol can go up. I'm referring to the standard LDL test, not necessarily the LDL particle number, size, or density. So with optimized thyroid function, the standard LDL result can improve (decrease) as well. I am not familiar with thryoid affect on the specialty LDL lipid tests. Perhaps someone else knows....
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