Advice on LDL-P, ApoA1-ApoB ratio & Coagulation Factors

[Jan18]

Hi Everyone,
Here are my latest results run through Cleveland Heart Lab and Quest (which my Functional Medicine Doctor uses). I'm asking for your advice (especially if you are a physician -- Stavia!) on the LDL-P, ApoA1-ApoB ratio, and Coagulation Factors. My doctor suggests I start Zetia for the LDL-P and ApoB. She also suggests Nattokinase for the Coagulation Platelet Function (product Nattoxym). She is always quick to suggest supplements instead of other interventions, though, some of which I returned (like digestive enzymes that upset my stomach; topical progesterone for sleep when my progesterone is already within range and I only had a recent bout of sleeplessness corrected in a couple of days by adhering to circadian rhythms and exercise; and pregnenolone, which was low but is now seemingly corrected by eating according to Bredesen's guidelines). Unless something else besides his diet protocol could have raised my prenenolone when it was too low?

So I wanted your opinions on her recommendations, if you wouldn't mind. I'm wondering what Bredesen and Apollo Health would say about those concerns?

Thank you!!!

INFLAMMATION
Myeloperoxidase 237
Lp-PLA2 Activity 119
hs-CRP 1.7
Microalbumine/Creatine UND
ADMA 77
SDMA 93
OxLDL 56
F2-Isoprostane/Creatine <0.74

LIPIDS
Cholesterol, Total 250
HDL 61
Triglycerides 68
LDL Chol, Calculated 173
Chol/HDL-C 4.1
Non-HDL 189
TG-HDL-C 1.1
LDL-P 2080
Small LDL-P 773
LDL Size 20.9
HDL-P 36.7
Large HDL-P 8.5
HDL Size 9.2
Large VLDL-P <1.5
VLDL Size 43.9
ApoA1 159
ApoB-ApoA1 ratio .82

METABOLIC
Glucose 74
Insulin 4.5
HbA1c 5.0
Homocysteine 6.6

FATTY ACIDS
Won't list, as they are excellent (she gives them an A+)
Also didn't include other test results, as they were not problematic.

COAGULATION/PLATELET FUNCTION
11dhTxB2/Creatine 5585
11dhTxB2 1508
Creatine/urine/random 27
Fibrinogen Antigen 407


P.S. I scored a 99/100 on Memory, 86/100 on Executive Function, and 90/100 on Processing Speed for my age group (I'm 71) on Apollo Health website's cognitive function assessment, so if I join them, I'd be on PreCode (which I guess I'm actually doing more than already) not ReCode.

[Julie G]

I look forward to expert opinions, but wanted to congratulate you for doing so well on your cognitive testing! i also see lots of good stuff in your blood work. I like that your oxLDL is below 60, your HDL is relatively high, your homocysteine is excellent and your hbA1c is good. Your TG:HDL ratio and fasting insulin are right on the cut-off perhaps leading to higher small LDL-P. You may want to continue optimizing metabolic health. Your hs-CRP is high suggesting some widespread inflammation. Did you test shortly after a COVID vaccine? Lots of folks are seeing temporarily elevated inflammatory markers for a few weeks post-vaccination. If not, consider evaluating gut health to rule out "leaky gut", look for hidden dental issues, etc. Kudos on being proactive and doing so well.

[NewRon]

Your TG:HDL ratio ..... right on the cut-off perhaps leading to higher small LDL-P.

Is that not a very severe interpretation?

If lipid values are expressed as mg/dl (like in the US);

TG/HDL-C ratio less than 2 is ideal

TG/HDL-C ratio above 4 is too high

TG/HDL-C ratio above 6 is much too high

https://www.docsopinion.com/2014/07/17/ ... hdl-ratio/

Am I missing something here?

[Julie G]

Is that not a very severe interpretation?

If lipid values are expressed as mg/dl (like in the US);

TG/HDL-C ratio less than 2 is ideal

TG/HDL-C ratio above 4 is too high

TG/HDL-C ratio above 6 is much too high

https://www.docsopinion.com/2014/07/17/ ... hdl-ratio/

Am I missing something here?

I certainly didn't mean to be "severe". To clarify, all of my comments were based upon Dr. Bredesen's recommended values vs. standard reference ranges/interpretations. We have a pretty large body of evidence suggesting TG/HDL ratios are strongly correlated with metabolic health and ultimately cardiovascular disease and dementia. Many people think this ratio can even serve as a proxy for advanced lipids. That said, Jan's score is right above Dr. Bredesen's recommended value of <1.1.

[NewRon]

I meant 'severe' wrt the criteria posted by Sigurdsson His ideal TG/HDL ratio is less than 2.

It appears Dr Bredesen's ratio is much more 'severe' at 1.1

[Jan18]

Your hs-CRP is high suggesting some widespread inflammation. Did you test shortly after a COVID vaccine? Lots of folks are seeing temporarily elevated inflammatory markers for a few weeks post-vaccination. If not, consider evaluating gut health to rule out "leaky gut", look for hidden dental issues, etc. Kudos on being proactive and doing so well.

Hi Julie,
Thanks! (By the way, I'm still not getting notifications that I have answers to my posts....not in my email or spam folders...who do I contact again to correct that? I just checked this site today and found some answers, much to my great relief!)

I tested fully 2 months after my second Moderna shot, so I don't guess it was that. I have arthritis (one TKR and need another one and arthritis in other joints from a car accident when I was 18 y.o.) so my doctor said that could account for the inflammation. Just went to my dentist and all looks great. But I do keep pressing my functional medicine doctor for a leaky gut assessment! I asked for that 3 years ago when I first went to her and she said it was expensive, so we'd do all the covered stuff first and then if needed, we'd do that. I get frustrated with her. I searched on Apollo's site for other Bredesen-trained physicians here, but didn't see any. I'd like to have that test done! When I first went to her, I wanted ALL of the cognoscopy tests he recommended done, but she didn't do them all. I've been frustrated with her for three years and don't see an alternative doctor around me.

Thanks for the encouragement.

She has now recommended nattokinase for my coagulation factors, saying they were high and I was at risk of blood clots. I may take my results (done by Cleveland Clinic Heart Lab) to a cardiologist I saw once here. He was going to put me on statins according to my cholesterol levels, until I suggested we do the coronary calcium test first to see the condition of my heart/cardiovascular and he agreed. My EKG and stress test were fine and my calcium score was 0 five years ago and is still 0 as of last summer. So no statin.

But that leads me to the Zetia my functional med dr. wants me to take to lower the LDL-P and the ApoB. I would like a second opinion on that, too, so maybe my cardiologist can weigh in. She said Zetia targets the over-absorption of cholesterol in the gut. And she is recommending just starting with it 2 days a week and then we'll redo bloodwork to see how effective it is being.

Hoping someone with medical expertise here can weigh in on the Zetia and nattokinase.

Thank you again!!!

Barbara

[Jan18]

To clarify, all of my comments were based upon Dr. Bredesen's recommended values vs. standard reference ranges/interpretations. We have a pretty large body of evidence suggesting TG/HDL ratios are strongly correlated with metabolic health and ultimately cardiovascular disease and dementia. Many people think this ratio can even serve as a proxy for advanced lipids. That said, Jan's score is right above Dr. Bredesen's recommended value of <1.1.

Here I thought my ratio was "right on" but it is lacking, then. My functional medicine doctor said it was great.

How do I improve that ratio? I thought my triglycerides were great! How do I raise HDL more? That is, according to Bredesen's protocol?

[NF52]

...(By the way, I'm still not getting notifications that I have answers to my posts....not in my email or spam folders...who do I contact again to correct that? I just checked this site today and found some answers, much to my great relief!)Barbara

Hi Barbara!

I hope I can help with the notification issue, with a few suggestions:

1. The easiest way to do this is to "subscribe" to any topic on which you have posted. You can do that by clicking on the wrench at the top of any topic page. Check out the screen shots on our How-To: Subscribe to topics wiki.

2. You can also change your default settings to be notified of any replies to your post. This will lead you through it: How-To: edit your User Profile You want to open the Board Preferences and then click on the left side tab for "Edit Posting Defaults" and select "yes" for Notify me of replies by default.

3. The software can assume that if you don't "open" a notification, you don't want any more on that topic. The way to avoid that is to clear out notifications when you log on. If you see any number next to the bell icon by your user name, you have unread "notfifications". Click on the bell and then click again on "mark all read". That tells the software that you are ready to be notified again!

If this doesn't work, feel free to reach out to the tech team at tech-team@apoe4.info

[Jan18]

Hi Barbara!

I hope I can help with the notification issue, with a few suggestions:

1. The easiest way to do this is to "subscribe" to any topic on which you have posted. You can do that by clicking on the wrench at the top of any topic page. Check out the screen shots on our How-To: Subscribe to topics wiki.

2. You can also change your default settings to be notified of any replies to your post. This will lead you through it: How-To: edit your User Profile You want to open the Board Preferences and then click on the left side tab for "Edit Posting Defaults" and select "yes" for Notify me of replies by default.

3. The software can assume that if you don't "open" a notification, you don't want any more on that topic. The way to avoid that is to clear out notifications when you log on. If you see any number next to the bell icon by your user name, you have unread "notfifications". Click on the bell and then click again on "mark all read". That tells the software that you are ready to be notified again!

If this doesn't work, feel free to reach out to the tech team at tech-team@apoe4.info

Hi NF52!
I remember you sending this before and thought I'd clicked "subscribe", but I evidently didn't. I'm sorry! I will also follow the default link, as perhaps I didn't do that before. I'd not seen any numbers by the bell icon, so I guess I didn't address the issue properly.

Thank you so much again for taking time to "refresh" me!
Barbara

[Jan18]

...(By the way, I'm still not getting notifications that I have answers to my posts....not in my email or spam folders...who do I contact again to correct that?

If this doesn't work, feel free to reach out to the tech team at tech-team@apoe4.info

NF52,
I just double checked the default section under Board Preferences, and I do have every option of how to be notified checked! So I'm not sure why I didn't get email notifications? Or was that because I forgot to first "subscribe" to my thread?

I am on a Macbook Air now instead of my old HP PC. Is that causing an issue?

Barbara