Baseline NMR results for this 4/4

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cardiolvr
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Baseline NMR results for this 4/4

Post by cardiolvr »

Posting my recent NMR profile test for those looking for 4/4ers samples. I updated the ongoing spreadsheet on apoe4.info with my numbers too (

Current diet is ketoish one (for 3 weeks), 45% non sat fat, 45% protein, 10% carbs, 35% calorie restricted, IF 16/8. Confirmed on ketosis with BHBs ranging 1-3.5. Previous 2 month diet was anything goes diet because of christmas. Exercise 3 days/week with 60mins of HIIT and some resistance training.

My numbers:

Code: Select all

LDL-P 1063
LCL-C 99
HDL-C  53
Trigs  90
TC   170
HDL-P  31.6
LDL-P  305
LDL Size 21.1 
LP-IR Score  26 <=== What's this? Says here insulin resistance score
Male, 42

My comments and thoughts:
* I've had ridiculous triglyceride levels for years. Usually 300+, normally 500, even on good diets. No doubt 4/4 at play there. With experimentation I realized there was a particular weight that would make my trigs go down, about 29 BMI or so.. My trigs don't seem too dependent on diet.

* My LDL-C has always been in the 80-100 range, even with abysmal trig numbers.

* I'm on the train that LDL-C is an opaque marker and LDL-P is a much better indicator for artherosclerosis

* I highly suspect CVD/Inflammatory state/Metabolic syndrome/High blood pressure are causative agents or at least completely correlated with AD. Doing changes that bring the prior down, should bring the chances of AD down too.

* I don't see a place for elevated LDL markers (either LDL-C or LDL-P) regardless of the rest (HDL,Trigs..). Seems pretty clear LDL particle number is a first and necessary step for atherosclerosis. Check out this amazing overview for the current understanding (2019) of artherosclerosis (https://www.ncbi.nlm.nih.gov/books/NBK343489/)

* Current action items for me are getting under 25 BMI and take a more comprehensive look again at lipids and other biomarkers.
APOE 4/4 and hopeful.

diet -> IF 18/6 daily | ketoish 45/45/10 | week fast 4x/year | low carb 40/40/20 | min sat fats.
excercise -> 240 min/weekly +150bpm, strength training
Fiver
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Re: Baseline NMR results for this 4/4

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Hi cardiolvr. Welcome. Thanks for sharing. You'll get loads of good advice about these numbers here. I had a somewhat similar experience. So I'll simply suggest two things to consider. 1. a calcium scan. They aren't very expensive (in my area ~$100) and will give you an idea of how intensely you need to address things 2. the statin question is a big debate, but there is no doubt that even a low dose would help those numbers. When I adopted a keto-like diet my numbers did what many others have done, they looked a bit worse in the "classic sense". But even a low dose statin corrected the numbers. It's a personal choice. Statins do have side effects. Others have good reasons for avoiding them. There is good data supporting their benefits, however. My justification was that I was really doing my part with diet and exercise, etc. And until I figured the next step I needed to get the numbers into a reasonable range. I have been able to reduce the dose quite a bit after learning how to tweek my diet and learning that other things I was doing were helping too. Good luck!
cardiolvr
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Re: Baseline NMR results for this 4/4

Post by cardiolvr »

Fiver wrote:Hi cardiolvr. Welcome. Thanks for sharing. You'll get loads of good advice about these numbers here. I had a somewhat similar experience. So I'll simply suggest two things to consider. 1. a calcium scan. They aren't very expensive (in my area ~$100) and will give you an idea of how intensely you need to address things 2. the statin question is a big debate, but there is no doubt that even a low dose would help those numbers. When I adopted a keto-like diet my numbers did what many others have done, they looked a bit worse in the "classic sense". But even a low dose statin corrected the numbers. It's a personal choice. Statins do have side effects. Others have good reasons for avoiding them. There is good data supporting their benefits, however. My justification was that I was really doing my part with diet and exercise, etc. And until I figured the next step I needed to get the numbers into a reasonable range. I have been able to reduce the dose quite a bit after learning how to tweek my diet and learning that other things I was doing were helping too. Good luck!
Hello Fiver. Thanks for your reply.

1) What's a 'calcium scan'?

2) I'm been thinking hard about statins. I'd really like to see my numbers get better, specially LDL-P and LDL-C. My LDL-C just doesn't seem to be much sensitive to diet at all. Haven't tried keto with full on sat fats but I'd assume numbers would get into the horrid stage quick. Would like to try to try statins.
How likely do you think is to have my PCP prescribe me statins at this point? My numbers are "in range" so I'm sort of expecting he may fight back. I'm with Kaiser Permanente in northern california and sometimes they push back quite a bit about things.
Like you I'm sort at the end of the rope of diet/exercise/lifestyle so I don't think these numbers will get better without extra help.

Thanks in advance
APOE 4/4 and hopeful.

diet -> IF 18/6 daily | ketoish 45/45/10 | week fast 4x/year | low carb 40/40/20 | min sat fats.
excercise -> 240 min/weekly +150bpm, strength training
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Julie G
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Re: Baseline NMR results for this 4/4

Post by Julie G »

Not bad, cardiolvr! Considering your TGs are normally in the 300-500 range, this is a huge improvement. Even your LDL-P is well below the 50%ile. Why do you want to take a statin? :shock:
cardiolvr
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Re: Baseline NMR results for this 4/4

Post by cardiolvr »

Julie G wrote:Not bad, cardiolvr! Considering your TGs are normally in the 300-500 range, this is a huge improvement. Even your LDL-P is well below the 50%ile. Why do you want to take a statin? :shock:
Let me make some emphasis on the how my trigs go from 300+ to the 100s when my BMI goes below 29. I can't tell you if it's because the fat is not there anymore, or simply because the actions taken are the causal elements of the drop... (action taken being the usual, dieting, exercise..) I do it find it remarkable my trigs get so much better under a certain weight.

As for the statin. I view artherosclerosis as an inevitable process for everyone. It's the price for being alive, and if AD or cancer won't kill you, CVD will. It's a non stoppable irreversible process. It's also a process that accumulates little by little overtime and happens to absolutely everyone. In your 20s, 30s, 40s, 50s and beyond, and it's the integral sum in the artherosclerosis chain of events over your lifetime that matters. LDL particles seem like a necessary step for it to happen, although inflammation seems to play an important role too. In terms of levels, an important hint is that half of people with normal lipid profiles have CVD events, so even LDL-C's of 100ish are way too high. LDL-P is probably more telling, but it's a developing story, right now we are settling on good at <1000. What number is good then? I'd say no number of LDL particles is good from an artherosclerosis POV with all we know in 2019. But then you'd die without LDL. So seems that lowering LDL as much as you can without causing trouble would be good. In the world of PCSK9 inhibitors some patients achieve <25mg/dL LDL-C and seem to be fine. So I'm thinking LDL-C of 50ish and LDL-P of 500 sound like reasonable targets, which in my case I suspect are unattainable through lifestyle interventions. The big elephant in the room is of course the effect on statins on brain health and there's tons of conflicting information about this when it comes to AD and APOE4s. But in my case, just a very light dose of statins (once every two days, low dose) maybe enough to nudge those numbers down without risking much.
APOE 4/4 and hopeful.

diet -> IF 18/6 daily | ketoish 45/45/10 | week fast 4x/year | low carb 40/40/20 | min sat fats.
excercise -> 240 min/weekly +150bpm, strength training
JudyH
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Re: Baseline NMR results for this 4/4

Post by JudyH »

Coronary CT Calcium Scan - looks for calcium deposits in the coronary arteries. Insurance often doesn't cover it but it is around $125 in my area.
e3/e4
No family history of AD, they drop dead of heart attacks in their early 40's!
Celiac and Hashimotos
Fiver
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Re: Baseline NMR results for this 4/4

Post by Fiver »

I should have listened more carefully to your story, cardiolvr. Because or situations are a bit similar I jumped right to what I was thinking about for me. Julie's point is well taken, why take anything you don't need. But if you and your doctor think there is a problems with your blood work - now or later - those are two options, of many. The coronary calcium scan is a relatively cheap way to assess the degree of CVD. It's a quick process in a scanner - I almost fell asleep - and it is a good way to gauge how seriously you want to address atherosclerosis. Or, if it is clear, it's one less thing on your mind. I find that there are so few real markers of how we are doing on our journeys that it was nice to have this data. Something to consider. As for the statins - talk to your doctors and read what you can. It's a personal decision. Dr. Bredesen told me that if people really follow his protocol (the diet, I think he was specifically discussing) they wouldn't need statins. But when I started the keto/flex type diet I relied on nuts, EVOO, and occasional dark chocolate - maybe more than I should have - and my lipid panel went the wrong way. After learning how to do the diet better my numbers improved again. As a result I've been able to greatly reduce my dose of a statin. So, that's my story, for what it is worth.
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