Sterol Absorption and synthesis

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Hepoberman
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Sterol Absorption and synthesis

Postby Hepoberman » Fri Dec 19, 2014 3:29 am

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These markers were assessed by Health Diagnostics Laboratory. Unfortunately, the test has to be ordered by a doctor.

What this means in terms of diet is that I do indeed absorb extra dietary cholesterol. In terms of medication, I would normally have been prescribed a statin and Zetia. Not this time, this was the result of a n=1.

Nine months ago, I was only slightly hyper absorbing sitosterol (a plant sterol). I added several items back on the menu which I assume had at least something to do with the dramatic shift in absorption and production.

I added back Kerry gold butter, cottage cheese, sour cream, and an egg per day. I did this just to make SURE I have to eat like a rabbit (or a cow, actually). I have only guesses as to how saturated fat mediates absorption, I was surprised.

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Re: Sterol Absorption and synthesis

Postby henrypg » Sat Oct 20, 2018 8:40 am

I've been listening to Peter Attia's podcast series with lipet expert, Tom Dayspring. Very dense with great complex biochem and physiology. Wondering where you are in your sterol management?

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Re: Sterol Absorption and synthesis

Postby dcox » Sat Oct 20, 2018 6:34 pm

henrypg wrote:I've been listening to Peter Attia's podcast series with lipet expert, Tom Dayspring. Very dense with great complex biochem and physiology.

Welcome henrypg!

I want to send you a warm welcome to ApoE4.info. I see you joined us back in March, I hope you have been exploring the site and gaining some great information about reversing, preventing and stopping Alzheimer's. We would love to hear your story and what brought you here, as you feel lead you can post on the Our Stories forum. If you have been spending time here I'm sure you have discovered the amazing amount of information as well as the amazing amount of support the community gives its members as we learn and share from our successes and our obstacles.

Here are some great pages, if you haven't discovered them already, to help you make the most of the time you spend here: Wiki Page, where you will find some more in depth topics and a list of practitioners; the Primer, written by Stavia one of our most active members a Doctor, and E4/E4 herself, this is an amazing place to start, or continue learning, as she truly put her heart into writing it; and this page will help you learn how to use the site more efficiently "How-To" Get the most out of the ApoE4.info website.

I'm happy you are enjoying the podcast series with Tom Dayspring, and that you enjoy the biochem and physiology aspects. I can not comment on them directly, as I haven't watched them yet, but as a "science nerd" myself the more we can learn about how our bodies work the more we can do to help ourselves heal and maintain resiliency.

Again, welcome and we look forward to learning more about you and your journey as you share and learn with us.

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Julie G
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Re: Sterol Absorption and synthesis

Postby Julie G » Sun Oct 21, 2018 9:12 am

I've been listening to Peter Attia's podcast series with lipet expert, Tom Dayspring. Very dense with great complex biochem and physiology. Wondering where you are in your sterol management?

Welcome, henrypg! I have many questions and comments that resulted from my seven hour listen to the Dayspring/Attia podcast. One topic is focused on sterol absorption so I'll put it here :D.

To some extent, isn't hyperabsorption of any sterol dependent upon consumption? In other words, even if I'm a hyperabsorber of sitosterol (very common in E4 carriers) and I'm not consuming any around the time of testing, will this show up on my test? Conversely, if I'm ingesting a lot of sitosterol, wouldn't I be more likely to show up as a hyperabsorber? Isn't this test, ultimately, both a reflection of our current diet and how we're reacting to it?

For those who haven't listened (or read show notes), Dayspring & Attia are still very wedded to the idea that plant sterols, sitosterol in particular, is a very BAD player. It's interesting to consider this in the context of Gundry's recommendations. For completely different reasons (lectins), he's also convinced that plants are harmful. Ironically, Gundry is recommending plants super high in sitosterol (EVOO, certain nuts, avocados) and getting good results in our genotype. I'm having trouble reconciling these two schools of thought. If Dayspring is correct, Gundry can't be... and vice versa.

FWIW, the Ezetimibe story told by Dayspring is fascinating. The trial results have conveyed a false impression of it's lack of efficacy due to their poor construction. It makes me wonder if this, as a monotherapy, may be a perfect solution to the sitosterol issue as it upregulates LDL receptors and very safely gets rid of the problem before it can damage the coronary endothelium. Of course, both hyperabsorption of sitosetrol and downregulation of LDL receptors are known ApoE4 issues. One, of many fascinating topics covered. I look forward to any responses.

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Re: Sterol Absorption and synthesis

Postby Jostmeister » Sun Oct 21, 2018 8:27 pm

I just finished listening to the 7 hour podcast too.
My head is spinning a bit. I'm in the process of getting my LDL-C to more normal levels after starting a ketogenic diet they skyrocketed as many others with apoE4 have reported. My first intervention is to reduce my saturated fat intake and increase my EVOO, and retest to see where I end up. I live in Canada and it seems not as easy to get an NMR lipid profile here as it is in the US.
I was thinking of getting a calcium score as a baseline shortly as well, but again not as easily accessible here.

I enjoyed the nuanced discussion about the which statins to use and adding in other medications depending on the patient and his or her individual biomarkers. Look forward to learning more on this subject.
Cheers,
Rob

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Re: Sterol Absorption and synthesis

Postby Julie G » Mon Oct 22, 2018 10:46 am

Welcome, Jostmesiter! I'm glad to see that your head is spinning too ;). Kudos on getting through the whole 7 hours. FWIW, I think your plan moving forward sounds very reasonable. That's exactly what many of us have done.

I'm considering hosting a round table discussion for anyone who's either listened to or read the whole Dayspring/Attia interview. You can find it here. The nuanced discussion of statins and other lipid lowering agents (and how they affect brain health) is of huge importance to us. I'm certainly not an expert in lipidology, but the ApoE4 diet/lipid interaction and potential health implications, etc. are fascinating to me. Would anybody else be interested? I'll copy this in the Meet-up forum to gauge interest.

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Re: Sterol Absorption and synthesis

Postby srbogert » Mon Oct 22, 2018 5:27 pm

Welcome Jostmeister
I see that you joined the site back in April, and this appears to be your first post. i hope you've enjoyed the site and gotten some useful information from it. We're glad that you're posting now. The community relies on everyone joining in the discussion.

I'd just like to reinforce the resource recommendations made by DCox above. The Primer is a great summary about APOE, and the How To Guide will help you with future posts, searches, and more. When you are comfortable, we invite you to share about yourself and your journey in the Our Stories section.

I did appreciate your comment about head spinning. It seems to be a common theme on this board. There is so much new information, and so many smart people coming up with apparently conflicting answers (IE: Dayspring vs Gundry). We really need this forum to help sort things out. You are definitely not alone. Still, I believe that we're making great progress - even if we don't have it all figured out yet.
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Re: Sterol Absorption and synthesis

Postby Ski » Tue Oct 23, 2018 9:13 am

@Julie
I think Dayspring makes the case that
a) phytosterol supplementation is not good versus plant ingestion which is ok.
b) only if you are a hyperabsorber, would potentially ingesting more plant sterols be a potential problem. I assume this to mean if you are NOT a hyperabsorber, your body would not absorb even the additional plant sterol as it has a more natural affinity to cholesterol, not phytosterols or stanols.

In my case which supports their claims, I get a much better lipid lowering effect of a mild dose statin in combination with every alternate day Ezetimibe dose, than a stronger statin used alone.

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Re: Sterol Absorption and synthesis

Postby JimBG » Tue Oct 23, 2018 10:10 am

In my case which supports their claims, I get a much better lipid lowering effect of a mild dose statin in combination with every alternate day Ezetimibe dose, than a stronger statin used alone.


Interesting Ski. Have you tested to see if you are a hyper-absorber? How much improvement did you see? And what dose of statin and Ezetimibe do you alternate? I saw in one of Attia's AMAs that he alternates 10 mg of Lipitor with Ezetimibe if I remember correctly. I am planning on starting on Rosuvastatin 5mg shortly after I see how far down I can get my LDL particle number with diet, exercise and fasting.

I really enjoyed the podcastsand and am overwhelmed by the complexity of it all. I am now listening to it a second time while viewing the notes to try to get it clearer in my mind. A real education.

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Re: Sterol Absorption and synthesis

Postby Ski » Tue Oct 23, 2018 11:53 am

@JimBG

No I did not test, but I have a very exaggerated response to diet in a short period of time, so presume I am. Regardless, from a brain health perspective, the Zetia allows me to use a lower dose statin to achieve a good lipid profile. I use 5mg Rosuvastatin every day with 10mg Zetia every other day. I switched from 10mg Rosuvastatin alone, after reading Daysprings comments some time ago with regards to the potential for increased absorption from using a statin alone and then the whole phytosterol theory. I also get lower numbers anyway than monotherapy of a statin.

The only potential negative that I did not hear them address is the reduced anti-inflammatory effect of a milder statin. However, given the brain health benefit, I decided this regime is more important.


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