My APOE journey

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
User avatar
ArcticWolf
Contributor
Contributor
Posts: 23
Joined: Sun Aug 07, 2016 3:06 pm

Re: My APOE journey

Post by ArcticWolf »

As I mentioned above, over the years I've tried to do my own in-depth review of the current research on Alzheimer's, neuroscience, depression and ADD. I also wanted to share some of the strategies that I have been trying to help my brain and daily life. This has included supplements, diet changes, and exercise. Here is a brief overview:

Supplements

I guess I have read *a lot* of studies over the last ten years and so am have constantly been attempting to find the right mix of supplements that will protect/repair my brain from neurodegeneration and also help on a daily basis to improve mood, brain fog, memory, energy level and ability to focus. This has included:
  • General multivitamins/minerals
    B-12
    High-potency B complex
    Niacin
    Niacinamide
    D-3
    Magnesium
    Fish oil
    Krill oil
    Phosphatidylserine
    St. John's wort
    Bacopa
    Ashwagandha/Rhodiola complex
    Gingko biloba/Panax ginseng
    Green tea extract
    Cinnamon
    True (Ceylon) cinnamon
    Curcumin
    Longvida curcumin (CurcuBrain)
    Resveratrol
    Mushroom extract complex
    Lion's mane mushroom extract
    ALCAR
    ALA (alpha-lipoic acid)
    L-Tyrosine
    Theanine
    Choline & inositol
    Licorice root extract
    Baby aspirin
    Ibuprofen
    Probiotics (currently taking PRO-15 by Hyperbiotics)
Though this is a long list, through the years I typically have always tried to limit my daily supplement stack to 4-5 of these at a time. My goals have been to find ways to improve my lipid profile and HDL levels, improve brain blood flow and vascular function, improve mitrochondrial function, improve glucose metabolism and control, increase BDNF and NGF levels, repair the blood-brain barrier, reduce oxidative stress and inflammation, improve AB and tau clearance, augment my gut microbiome with more beneficial bacteria species, and improve neurotransmitter levels/systems (particularly serotonin, dopamine and acetylcholine).

To be honest, I haven't noticed perceptible benefits from many of these (not in the way I have from a SSRI or ADD stimulant, for example), so naturally I'm always curious if what I'm taking is helping or hurting. I also often wonder if I'm fixing one pathway or upregulating some process with one supplement while simultaneously defeating that improvement with another supplement.

Diet Changes

Diet has been a little tougher for me to crack. I'm definitely a meat and carbs kinda guy, and I think I die a little bit each time I read the "optimal" diet guidelines for E4's :lol: . I just have never really been into vegetables as much more than a side dish (optimally slathered in gravy or cheese) and honestly it pains me to think of a life without bread, pasta, cheese, steak and orange juice. I've always been able to eat what I wanted and not gain weight. Though after thirty I started to get a little pot belly like my dad--most likely a lot of visceral fat around my organs, i.e the "skinny-fat" person.

That being said, I've tried to focus on trying to make better choices every year with my diet. This has included more salads and green stuff (I do like broccoli and asparagus), trying to avoid fast food and processed food as much as possible, cutting out soda and soft drinks except as a rare treat, buying mostly whole grain products, eating 3-4 servings of fish every week (sushi, cooked or smoked salmon, and tuna), avoiding processed meats, limiting red meat to once or twice per week (typically lamb), eating lots of berries and enjoying carbs and starchy foods in moderation.

I've also tried some intermittant fasting (IF), which is sometimes by default since I don't always eat breakfast. I have found that I think much more clearly on an empty stomach (up to the point of famishment lol), whereas right after a meal my postprandial dip kicks my ADD into overdrive while I fight off fatigue and a complete loss of any motivation.

One thing I’ve almost eliminated has been alcohol. While I enjoy having a few beers socially every once in awhile, I would always feel cognitively impaired for the next day or two—particularly if I overimbibed. This tendency has gotten worse the older I’ve gotten and I so I was not surprised to learn of the connection of alcohol use as a risk factor for Alzheimer’s.

Exercise

Exercise is also a bit of a challenge for me. I spend most of my week behind a desk and one of my hobbies is video games (multi-player online games with friends) where I can sit for another few hours several times a week. I attempt to make it to the gym twice a week and usually focus on weight-lifting vs. cardio both given my body build and the supposed benefits of resistance training on BDNF levels. I know I can do better here and more daily activity is a continuous goal for improvement.


Thanks again for reading. Any thoughts or suggestions would be greatly appreciated!
User avatar
Stavia
Contributor
Contributor
Posts: 5255
Joined: Tue Apr 29, 2014 6:47 pm
Location: Middle Earth

Re: My APOE journey

Post by Stavia »

Arctic, you are asking some very good questions.
I am very tired after a jam packed day so will just mention a few things briefly. please don't take this as criticism, rather as help thru the apoe4 lens from someone who really cares and walks the walk.

1.your trigs are too high and your HDL too low. We would recommend running your trigs under 100. This can be achieved by reducing carbs dramatically. Obviously you have to eat so usually fat goes up which will raise your HDL You are clearly very carb sensitive. Please read RU42s posts and his trig journey. You will see how he struggled with change and did beyond expectations.

2.Your bilirubin is probably Gilbert's which is clinically non significant. Fatty liver does not cause isolated raised bilirubin. Fatty liver causes raised GGT ALT and AST.

3. you have to prioritize sorting out your sleep. The strategies are on my.primer.

4. your general diet is better than before but not optimal. Whole grains are still carbs without considering other factors and commercial sushi is full of sugar. Have a look at my conference blog today where Aaron spoke about drivers and extinction strategies for unhealthy food eating. It will also soon be on the AHS YouTube channel

5. exercise is crucial. its probably the single most important thing we can do. sorry but that's the truth. I had to give up my World of Warcraft raiding at endgame level until 2am in the morning. Our guild was ranked 3rd on server and I was highest dps on single target. I understand. I really get it. It still hurts to not be there and I miss it sooo much still years later. But its your life here honey.
Silverlining
Senior Contributor
Senior Contributor
Posts: 366
Joined: Wed Oct 30, 2013 4:14 am

Re: My APOE journey

Post by Silverlining »

With regard to your list of supplements, have you tried or considered NAC (n-acetylcysteine)? That's one of the few I take every day no matter what, along with curcumin.
User avatar
ArcticWolf
Contributor
Contributor
Posts: 23
Joined: Sun Aug 07, 2016 3:06 pm

Re: My APOE journey

Post by ArcticWolf »

Thanks for the feedback Stavia! Good to know that the bilirubin isn't an issue. My Glob, ALT and AST were fairly low in the normal range (2.2 g/dL, 15 U/L and 17 U/L, respectively).

Yes, my HDL is too low and was one of the first things I tried working with my doctor on a several years ago (I think around 2008). With both diet changes, exercise and Niacin, I was frustrated that I could only see my number increase only a few mg/dL. I know I can do better on diet, but I'm curious if I would need to go all the way to a ketogenic diet to really reach the target of trigs <100. I have to be honest that the debates and theories on various "optimal" diet and nutrition approaches leaves me throwing my hands up quite often. I do however look forward to the Aaron's YouTube presentation to find new strategies on eliminating unhealthy eating. And sleep and exercise are a major focus for me right now to try to develop a better set of routines and habits, which is not the easiest thing for an ADD'er.

And most importantly, thanks for sharing that you're a fellow WoW raider! :D I'm a druid tank and luckily since moving the west coast, my guild's raids run from 6-8 pm so luckily it doesn't get too late. The big question: Horde or Alliance? :lol:
User avatar
ArcticWolf
Contributor
Contributor
Posts: 23
Joined: Sun Aug 07, 2016 3:06 pm

Re: My APOE journey

Post by ArcticWolf »

Silverlining wrote:With regard to your list of supplements, have you tried or considered NAC (n-acetylcysteine)? That's one of the few I take every day no matter what, along with curcumin.
Hi Silverlining--no I've never considered NAC or read much about it. After looking into it today I see how it may be beneficial in terms of addressing oxidative stress and the modulation of inflammatory pathways, as well as altering DA release (particularly to the striatal neurons) all of which may also help me with depression and/or attention. Thanks for the tip!

In terms of my supplement list above, you could say that my approach has been similar to the Dr. Bredesen's MEND protocol (before that even existed) in trying to "fix all the leaks" in my roof. However, it would really be great to know which are giving me the most "bang for the buck" so to speak and not have my kitchen cupboard filled with so many bottles of pills lol.
User avatar
Stavia
Contributor
Contributor
Posts: 5255
Joined: Tue Apr 29, 2014 6:47 pm
Location: Middle Earth

Re: My APOE journey

Post by Stavia »

Gnome rogue. Because I could have pink hair. Called LittleStavia. My guild used to call me LS. I know troll rogues were better but....ugly.
I was soooo good on interrupts. I could solo the Mt Hyjal adds. Used to practise for hours.
omg I miss those days.
sniff
User avatar
Stavia
Contributor
Contributor
Posts: 5255
Joined: Tue Apr 29, 2014 6:47 pm
Location: Middle Earth

Re: My APOE journey

Post by Stavia »

Ok back to r/l as we used to call it.

There is nothing wrong with your liver. You do not have fatty liver with those enzyme levels.

Higher fat is the only way you could raise your HDL and lower your trigs. You may not need to be fully ketogenic but you may need a level of carbs that optimises your trigs that will put you in nutritional ketosis anyway. Tweak and test. Less starchy carbs and more fibrous carbs. Always. Its probably IMO the single most effective thing you can do with your diet.
Sorry but whole grains are starchy carbs too.

Sustainable changes. Small steps, bed them in, let them become a habit, add another one.
I agree your first priority is to develop structure and routines. Its the rest of your life here.
progranulindefect
Contributor
Contributor
Posts: 142
Joined: Sat Jun 25, 2016 8:26 pm

Re: My APOE journey

Post by progranulindefect »

ArticWolf said: "I tried some ADD medications of the next few years, and while they helped me with focus and motivation (Adderall was incredible btw), they didn’t necessarily address my memory deficiencies and the side effects of each began to be unbearable."

my daughter has ADD. She was on Vyvanse and is now on Adderall (about 2 years). can you tell me what bad side effects you had from adderall?

my daughter has similar problems with sleep, going way way back to preschool (she is now 18). melatonin won't always work for her and often gives her a headache. we did find out that a smaller dose - 1mg is better than 3mg (which can make you too groggy). i've read that a lot of doctors specializing in ADD have their adult patients take some of their stimulants close to bedtime, and it helps with sleep. we haven't tried this- but you probably need a doctor who specializes in adults with ADD/ADHD. my husband is a night owl- he finds a glass of wine (only one!!!) helps him go to sleep. another thing that helped my daughter was getting up early and doing exercise in the morning sun. she had been on a weird run where her eating was out of control- she kept on feeling hunger, but whatever she ate wouldn't satisfy her, so she ate til her sides hurt. and her sleeping was all messed up. the field hockey started at the end of august, and she loves that, so she made herself get up to practice with the team. that got her on a good sleep schedule and took care of the compulsive eating. i think the effects of morning light plus exercise plus the social aspect were very important in helping her. lastly, she uses a fan all night as white noise to block out other sounds and to help her fall asleep.

*re cholesterol numbers. if you eat higher fat, you need to eat lower carb. i have eaten like this since about 2009. i made a recent change by including coconut oil, and it may have improved my HDL (there were other factors), but also caused me to gain belly weight (i am female, but have always gained weight on my belly). and i didn't see improvement in memory.

high fat low carb 2015-->'16 adding 1 tbsp of coconut oil w/ coffee + using salad dressing with Coconut oil
total cholesterol- 190---->193
HDL----------------88------>96
Triglycerides-----51------->46
LDL---------------92-------->88
vitamin d last year was only 19, then got it up to 34, so that might have helped. i was also anemic last year and cleared that up. so coconut oil, and an increase in vita d and normalizing iron were all factors associated with higher hdl looking at 2015 to 2016
User avatar
ru442
Contributor
Contributor
Posts: 706
Joined: Sun Mar 20, 2016 8:52 am

Re: RE: Re: My APOE journey

Post by ru442 »

ArcticWolf wrote:Thanks for the feedback Stavia! Good to know that the bilirubin isn't an issue. My Glob, ALT and AST were fairly low in the normal range (2.2 g/dL, 15 U/L and 17 U/L, respectively).

Yes, my HDL is too low and was one of the first things I tried working with my doctor on a several years ago (I think around 2008). With both diet changes, exercise and Niacin, I was frustrated that I could only see my number increase only a few mg/dL. I know I can do better on diet, but I'm curious if I would need to go all the way to a ketogenic diet to really reach the target of trigs <100. I have to be honest that the debates and theories on various "optimal" diet and nutrition approaches leaves me throwing my hands up quite often. I do however look forward to the Aaron's YouTube presentation to find new strategies on eliminating unhealthy eating. And sleep and exercise are a major focus for me right now to try to develop a better set of routines and habits, which is not the easiest thing for an ADD'er.

And most importantly, thanks for sharing that you're a fellow WoW raider! :D I'm a druid tank and luckily since moving the west coast, my guild's raids run from 6-8 pm so luckily it doesn't get too late. The big question: Horde or Alliance? :lol:
Wolfie... my diet is varied and not as strict as Stavia and others, I've been able to reduce my trigs significantly and increase my hdl greatly with diet. My other numbers also support my particular diet and exercise, I take very few supplements and rely on my mostly whole food diet for my nutrients. What supplements I do take are based on regular testing in six week imcrements as I adjust meds and/or diet. As I refine my diet and regime I will reduce testing to six months.

My approach given the ancestrial gene is a hunter gatherer approach.... eating what is freshest and readily available to me and affordable. Most importantly I rarely eat ANYTHING proceesed, even veggies. I buy fresh (local farmers in season, else organic if at all possible, but rarely frozen or canned, unless time is an issue ). All my meat is pastured... no grain at all. NO GRAIN AND NO SUGARS OF ANY KIND. I don't go out for dinner and if I do it's fish (fresh or shellfish) and salad (bring my own evoo and balsamic vinegar).

I fast minimum of 12 hours each day... it took about 2 months to reach ketosis (mild imo... not an over achiever on this one), and while I don't test for this I am fairly confident I have acheived this based on body mass and need for food intake prior to 12pm (I generally don't eat until lunch... and don't need to as I am using already available fat and energy stores... I.e. usually not even hungry). I rarely eat "breakfast", just don't need it (but do need coffee!!).

As to the liver issues, I also had high ferritin levels and a fatty liver when I began this journey (and as Stavia pointed out likely storing fat in other organs as I'm a fairly skinny guy as is). Was tested for hepatic seatosis which was negative. In short this supports the fact we 4's are generally hyper absorbers of the bad fats. Changing diet can dramatically improve many things....

The point being... I am not a picky eater, I love variety of protein and veggies at the right proportions. I've been able to achieve my "balance". At the same time I've been able to keep animal protein in play (hard to give up, and for some really bad), at limited quantities and very high quality for good fats (bison, wild game, beef and pork local only pastured not grain finished ). I continue to get 70-80% of my calories and fat from green veg, evoo or evao, nuts, avocado etc. I don't buy into lectin intolerance ( ala Dr. Gundry) at this time, so I do embib in many of the items on the forbidden list especially fresh produce at this time of year (tomatoes, corn, etc). Should I begin to encounter cognitive issues down the road I will certainly revisit this aspect of my diet. But I absolutely abstain from grain and sugar, and zero processed food has passed these lips in over 6 months (ok I have cheated.... but Stavia can chime in.... skip a meal if you want a cheat!! Ice cream can be hard to resist)

If you would like some ideas on my diet pm me... I'd be happy to share. Or if folks would like I in can post, just can't promise as I am terribly busy and can't promise a av quality post, but here to and share.

Sent from my SM-T217S using Tapatalk
Male 4/4 56 yrs., "Live, Laugh, Love"
User avatar
ArcticWolf
Contributor
Contributor
Posts: 23
Joined: Sun Aug 07, 2016 3:06 pm

Re: My APOE journey

Post by ArcticWolf »

Stavia wrote:Gnome rogue. Because I could have pink hair. Called LittleStavia. My guild used to call me LS. I know troll rogues were better but....ugly.
I was soooo good on interrupts. I could solo the Mt Hyjal adds. Used to practise for hours.
omg I miss those days.
sniff
Pinked-haired gnome rogue...love it! I'm a night elf druid.
Stavia wrote:There is nothing wrong with your liver. You do not have fatty liver with those enzyme levels.
That's a relief to know!
Stavia wrote:Higher fat is the only way you could raise your HDL and lower your trigs. You may not need to be fully ketogenic but you may need a level of carbs that optimises your trigs that will put you in nutritional ketosis anyway. Tweak and test. Less starchy carbs and more fibrous carbs. Always. Its probably IMO the single most effective thing you can do with your diet.
Sorry but whole grains are starchy carbs too.
Ok...I can definitely try for more fats and work further to eliminate starchy carbs. I've been focusing mainly on cooking with olive oil and coconut oil, and sticking with butter vs. vegetable oils. I've also become a big fan of avocados and guacamole recently, so I'm hoping that's providing me with more good fats as well.

I also need to find a new PCP since I really haven't had one since I moved at the end of 2013. The checkup I had in January 2015 was with a random doctor under my plan at the time. Ideally I would like to work with a functional or holistic practitioner, but not sure if there's one in my immediate area. At the very least, I'd like a doctor who will at least listen and work with me.
Stavia wrote:Sustainable changes. Small steps, bed them in, let them become a habit, add another one.
I agree your first priority is to develop structure and routines. Its the rest of your life here.
Yes, small steps tend to work best for me...I tend to get overwhelmed with too much or too many things at once.

Thanks Stavia and Elune be with you! :D
Post Reply