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TheresaB
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Re: Gundry internet ads

Post by TheresaB »

Barbara,

I’m so sorry to hear of your frustrations, but let me start by reminding you I am not a medical professional, I have no formal background, I just read and research, and am fortunate to have a good doctor. Also remember when I talk about my markers, I’m just one datapoint, we’re all different.
Jan18 wrote:I finally returned from traveling and met with my doctor, for whom I have mixed feelings...but that's a topic for another day.
Feeling comfortable and confident with your doctor is important. I know you’re not made of money, so it can be a difficult decision to fire one’s doctor. You have mixed feelings, but the decision is one only you can make.

Did your doctor go strictly by the reference ranges from the lab report? When you say “optimal” is that the doctor’s range or the lab’s range? Reference ranges on lab reports are a statistical construct. Earlier this year a paper reported that only 12% of the population in the US are metabolically healthy, that means that the reference ranges are being established with a population that is overwhelmingly unhealthy. So a person may be in company with many other people, but those people aren’t healthy. With certain markers, my doctor will see that I’m green but he may want me to do better. With others I’ll be red and he won’t be the least concerned. We tell him when there’s been a recent fasting period that or that or there’s been a lot of stress lately, etc. that can explain why some markers are the way they are. Also when one marker seems off, he’ll look at others to put the pieces of the puzzle together. There have been times when one marker is odd, he’ll look at others for a better understanding. A doctor needs to understand lab tests and the patient, not just read a report.
Jan18 wrote:LDL-P went from 2589 to 2030 (but needs to be under 1100, so it's still 2x what it should be.)

VLDL-P is 343 (2x what it should be) since optimal is under 150.
Jan18 wrote:My sdLDL-C got worse! It went from 35 (mildly elevated) to 57! (Didn't I read somewhere that it can go up as you lose weight and not to be freaked out or am I mistaken?)
My doctor (Dr Gundry) doesn’t pay attention to many of the lipid markers on my lab results. My LDL is always high, he’s never said anything about it, it’s one of the markers he passes over. Likely it’s high because I’m ApoE4/4. He says most of those markers are on lab tests an effort to sell statins. (I’ve heard that just about all markers are drawn only if a drug can be prescribed). But I guess he can’t just pick the tests he want, it’s like buying cable, you have to get the set for the one you want.

Lastly, he doesn’t concentrate on just my lipid markers. If your doctor is emphasizing them, I’d say that’s a red flag. Remember what the primer emphasizes about glycemic control trumping lipids every time despite the fact that ApoE4s do tend to run high. You didn’t say anything about HbA1c, fasting glucose, or fasting insulin, if they weren’t tested I’d be very concerned. Let me say again, I’m not a doctor nor do I have any formal training in this area, but the “vibe” I get from how you’ve described your situation centers around insulin resistance and those are key markers for insulin resistance.

My doc likes HDL to Triglyceride ratio, (I also understand ratios are far more telling than individual biomarkers). The desired outcome of HDL to TG is 1:1 or with HDL being higher than Triglycerides. Was this taken? I’m very curious as to what they are. A person with high triglycerides, low HDL, and small dense LDLs is likely to have a fatty liver even if they are a lean/normal weight person. You have high sdLDLs, from what you’ve said in the past, you do seem to be insulin resistant and Non-Alcoholic Fatty Liver disease (NAFLD) is a common result of insulin resistance. This leads to abnormalities in liver function and when people with fatty liver wake up in the morning they tend to have high glucose even though they haven’t eaten for 8-10 hours. Do you happen to have a glucometer to test your morning glucose (or a dual meter that will also measure ketones)? Did your doctor test your liver (hepatic) enzymes?
Jan18 wrote:ApoB is 137 (high) and ApoA-1 is 146 (optimal) and the ratio is .94 and it should be less than .60.
My ApoB is always high, probably because I’m ApoE4, but my ratio is always good. My doc has never looked at my ApoB in isolation, he looks at the ratio. In your case it is high, so that’s something to work on.
Jan18 wrote:My Lp-PLA2 Activity went from 325 (high) to 175 (optimal.) I don't get how this measure of vascular inflammation is great, if my oxidized LDL is still so high. Can anyone speak to this?
My Lp-PLA2 activity has been high on a number of occasions accompanied by an oxLDL in a good range, so I don’t think there’s a direct correlation. Here’s what my doctor said from the transcript of my last consult:
So Lp-PLA2 Activity, that’s the stickiness of your blood vessels popped up as well, so that’s why I was trying to figure out if there was something right around the time of this test. And it doesn’t look like it from reading your notes. Hmm, okay. Yeah your CRP isn’t up, so that’s good, let me jump forward to your myeloperoxidase, no you myeloperoxidase is phenomenally good. Okay, forget I asked.
Jan18 wrote:And here's one she is freaked about: Uric Acid is 7.1 (high) and could mean a gout attack in the future.
Yes, uric acid can go up with fasting and can indicate a future gout attack, but it can say other things too.

Uric acid is also another marker to determine insulin resistance. Go to the wiki on insulin resistance, https://wiki.apoe4.info/wiki/Insulin_Resistance scroll down to the large graphic “Diagnosis Diet – Insulin Resistance Tests” that shows tests for Insulin Resistance. You might also want to read the article that’s linked in the caption.

I’m curious, do you eat a lot of fruit or foods with fructose corn syrup? Fructose corn syrup can be found in many foods that come in packages, even if they’re not sweet. Fructose elevates uric acid. Fructose also contributes to Non-Alcoholic Fatty liver disease (NAFLD). The only organ that can metabolize fructose in significant amounts is the liver and so if overloaded, it will turn the fructose into fat. Of course, NAFLD can occur just from eating too many carbs/sugars, not just fructose, and is a common pre-Type 2 Diabetes condition.
Jan18 wrote:said to increase my magnesium to combat the constipative effects of iron.
Magnesium does help with constipation and many of us do tend to have low levels of magnesium. But I’m curious if there was any discussion on gut biome? Gut dysbiosis will also make it hard to lose weight. Those bad gut bugs love bad foods, makes us crave bad foods. They crowd out good gut bugs. The gut is connected to so many things, including a strong gut to brain connection. Any discussion on increasing soluble fiber to try to encourage more good gut bugs? Prebiotics and probiotics (Dr Gundry discusses gut biome and foods with prebiotics and probiotics in his Plant Paradox book). This is something I’ve personally been trying to work on more lately. A healthy gut also results in more regular, comfortable bowel movements and a happier brain.
Jan18 wrote:Ferritin (20 optimal.)
That’s great!!! Ferritin is a good marker for inflammation and heart disease. I learned about ferritin from Ivor Cummins. He couldn’t get reasonable answers from doctors about his high ferritin, so he dug into the research, and has been able to lower it. I googled Ivor Cummins and ferritin, you may want to read this: Iron is the New Cholesterol.
Jan18 wrote:Free fatty acids went from .86 (high) to .53 (optimal.)
This test is usually done to reflect the acid content in the blood from rancidity of edible fats and oils. But it can also reflect the acid environment that comes with ketosis. My free fatty acids are typically high because I’m typically in mild ketosis. You’re intermittent fasting and I presume you’re calorie restricting, so it’s interesting that the FFA test indicates you’re not making ketones, but if you’re insulin resistant, the insulin resistance can prevent the body’s fat tissue from releasing the fatty acids that are used to make ketones.
Jan18 wrote:My T4 Total and Free, T3 Total and Free and Reverse T3 are all optimal, but my TSH is mildly elevated. She didn't even speak about that. Anyone?
When my TSH started creeping up despite the other thyroid markers looking good, my doc just said he’d keep an eye on it, Sometimes it's best not to react to just one test result, but to see how it trends. When my TSH kept creeping up, he ordered a set of anti-thyroid tests. Fortunately those were negative and I’m now taking 200 mg (four 50 mg pills a day) of organic Spirulina and I add iodized salt to my food, keeping my fingers crossed that my TSH is good on my next test.
Jan18 wrote:I am kind of confused by all of the results and how fast she goes through them and always think of lots of questions AFTER our appointment. She'll take an email or two of questions, but then suggests I come in again to talk and at insurance-UNcovered $360 an hour, that can get really expensive fast. <sigh>
That is expensive. So are our consults that are not covered by insurance, although the lab tests are partially, here’s what we do to maximize our consults. We get the results of the tests before the consults and study them, do some research on the outliers to generate quality questions/areas of concern BEFORE our consult. Before the consult we submit a written summation of dietary practices (like for this next consult we’ll address our gut biome strategies) and a list of supplements (prescription drugs if we took them, because they can distort some results too) so our doc has the whole picture not just the lab results. For the consult, we ask if it’s okay to record the conversation, then I transcribe the recording of the consult for reference later since ears and memory are unreliable, this eliminates, “So what did the doctor say about XXX?”
Jan18 wrote:Every time we do blood tests, they seem to include different tests and I'm not sure why. I wish she would just focus on Bredesen's cognoscopy (is that the word?) and I'm wondering about getting a different doctor. What do you all think?
Purpose of cognoscopy is to identify areas that need to be addressed, you work on first things first, then go to the next layer. Sometimes there are good reasons for adding a new test or a new test gets developed. The tests and labs I've had are different than when I started 5 years ago. We’re always tweaking, us and our doctor, there is no finish line, the body changes, research learns new things, labs discover new, more precise/predictive tests, or the medical director at a lab changes and the doctor doesn't like his/her approach, many things.
-Theresa
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Re: Gundry internet ads

Post by Jan18 »

TheresaB wrote: You didn’t say anything about HbA1c, fasting glucose, or fasting insulin, if they weren’t tested I’d be very concerned. Let me say again, I’m not a doctor nor do I have any formal training in this area, but the “vibe” I get from how you’ve described your situation centers around insulin resistance and those are key markers for insulin resistance.

My doc likes HDL to Triglyceride ratio, (I also understand ratios are far more telling than individual biomarkers). The desired outcome of HDL to TG is 1:1 or with HDL being higher than Triglycerides. Was this taken? I’m very curious as to what they are. A person with high triglycerides, low HDL, and small dense LDLs is likely to have a fatty liver even if they are a lean/normal weight person. You have high sdLDLs, from what you’ve said in the past, you do seem to be insulin resistant and Non-Alcoholic Fatty Liver disease (NAFLD) is a common result of insulin resistance. This leads to abnormalities in liver function and when people with fatty liver wake up in the morning they tend to have high glucose even though they haven’t eaten for 8-10 hours. Do you happen to have a glucometer to test your morning glucose (or a dual meter that will also measure ketones)? Did your doctor test your liver (hepatic) enzymes?
Hi Theresa B,
I posted this back in September I think it was -- on this thread.

"But also have some good results, among which are triglycerides to HDLC ratio optimal, A1c is 5.2 and homocysteine 7. Insulin still high at 11 (down from 16 at one point) and leptin was 59 or 61, again can't recall, but waaaaay too high. She is working with me to lower that and I'm stepping up my exercise program.

My HDL is good, if I recall correctly. My glucose on the last two fasting morning tests were 85 and 92. I do have a Keto Mojo and have tested frequently in the past....waiting for more glucose strips I ordered.

My doctor mentioned my liver markers had "improved" and the test shows them all in "green" and she never mentioned fattly liver disease before....

B.
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Re: Gundry internet ads

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TheresaB wrote:
Jan18 wrote:And here's one she is freaked about: Uric Acid is 7.1 (high) and could mean a gout attack in the future.
Yes, uric acid can go up with fasting and can indicate a future gout attack, but it can say other things too.

Uric acid is also another marker to determine insulin resistance. Go to the wiki on insulin resistance, https://wiki.apoe4.info/wiki/Insulin_Resistance scroll down to the large graphic “Diagnosis Diet – Insulin Resistance Tests” that shows tests for Insulin Resistance. You might also want to read the article that’s linked in the caption.

I’m curious, do you eat a lot of fruit or foods with fructose corn syrup? Fructose corn syrup can be found in many foods that come in packages, even if they’re not sweet. Fructose elevates uric acid. Fructose also contributes to Non-Alcoholic Fatty liver disease (NAFLD). The only organ that can metabolize fructose in significant amounts is the liver and so if overloaded, it will turn the fructose into fat. Of course, NAFLD can occur just from eating too many carbs/sugars, not just fructose, and is a common pre-Type 2 Diabetes condition.

Hi Theresa,
Absolutely not! I buy nothing -- nothing, seriously -- packaged or eat anything that has high fructose corn syrup!!! And I only eat a small amount of berries and not every day. I really eat no other fruit, as I'm not a fruit fan, and Gundry has practically outlawed the other fruit I like, pineapples, as being to high glycemic. Bananas, too. I've even read apples are too high glycemic. So I'm not eating other fruits. But I love my vegetables.

And I track my carbs to no more than 40 g a day, and stay away from refined carbs at that!

This is why I am so frustrated. :(

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Re: Gundry internet ads

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[quote= "TheresaB"]
" We get the results of the tests before the consults and study them, do some research on the outliers to generate quality questions/areas of concern BEFORE our consult. Before the consult we submit a written summation of dietary practices (like for this next consult we’ll address our gut biome strategies) and a list of supplements (prescription drugs if we took them, because they can distort some results too) so our doc has the whole picture not just the lab results. For the consult, we ask if it’s okay to record the conversation, then I transcribe the recording of the consult for reference later since ears and memory are unreliable, this eliminates, “So what did the doctor say about XXX?” [/quote]

Theresa,
I do get my results first so research and think of questions, but I'll also send a written summation of my dietary practices and prescriptions if I've had any before our consult. Recording is a good idea, too!

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Re: Gundry internet ads

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TheresaB wrote:
Jan18 wrote:said to increase my magnesium to combat the constipative effects of iron.
Magnesium does help with constipation and many of us do tend to have low levels of magnesium. But I’m curious if there was any discussion on gut biome? Gut dysbiosis will also make it hard to lose weight. Those bad gut bugs love bad foods, makes us crave bad foods. They crowd out good gut bugs. The gut is connected to so many things, including a strong gut to brain connection. Any discussion on increasing soluble fiber to try to encourage more good gut bugs? Prebiotics and probiotics (Dr Gundry discusses gut biome and foods with prebiotics and probiotics in his Plant Paradox book). This is something I’ve personally been trying to work on more lately. A healthy gut also results in more regular, comfortable bowel movements and a happier brain.
Jan18 wrote:Ferritin (20 optimal.)
That’s great!!! Ferritin is a good marker for inflammation and heart disease. I learned about ferritin from Ivor Cummins. He couldn’t get reasonable answers from doctors about his high ferritin, so he dug into the research, and has been able to lower it. I googled Ivor Cummins and ferritin, you may want to read this: Iron is the New Cholesterol.
Hi TheresaB,

She says I am anemic and I don't have my test results in front of me to tell you the biomarkers she got that from. One tip off was small red blood cell size and then she looked to two other markers.

If my Ferritin is great, why am I anemic? That's why she prescribed iron supplements 3-5x a week.

And she only said to increase my magnesium supplements to combat any constipation I might incur from the iron. I was already taking 400 mg magnesium at night but she said to increase it and I'd know if it was too much if I got diarhhea. But I have no issues with bowel movements and am very regular, every morning and sometimes 2-3x a day.

As far as soluble fiber, what do you recommend, since we cannot have grains? I eat nuts almost daily. I eat strawberries. I eat lots of avocado, spinach, lettuces, mushrooms, asparagus, broccoli, cauliflower, onions. "Soluble fiber is found in oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables. It is also found in psyllium, a common fiber supplement. Some types of soluble fiber may help lower risk of heart disease. Insoluble fiber is found in foods such as wheat bran, vegetables, and whole grains."

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Re: Gundry internet ads

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Jan18 wrote:If my Ferritin is great, why am I anemic? That's why she prescribed iron supplements 3-5x a week.
Ferritin is different than iron. Ferritin is the protein that stores iron, it is not a good marker of iron because it’s also affected by just about anything that causes inflammation, which is why I was happy about your optimal level – as a sign of low inflammation, not anemia. Of course it shouldn’t be the only marker for a reflection of one’s inflammation.

Regarding fiber, I try to get as much and varied as possible, avoiding the no-nos of course.
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TheresaB wrote:
Jan18 wrote:If my Ferritin is great, why am I anemic? That's why she prescribed iron supplements 3-5x a week.
Ferritin is different than iron. Ferritin is the protein that stores iron, it is not a good marker of iron because it’s also affected by just about anything that causes inflammation, which is why I was happy about your optimal level – as a sign of low inflammation, not anemia. Of course it shouldn’t be the only marker for a reflection of one’s inflammation.

Regarding fiber, I try to get as much and varied as possible, avoiding the no-nos of course.
I see, thanks. I read this stuff and much of it doesn't stick until I read it again....worries me about my memory until I remember "studying"....like -- the concept of studying -- in school....yes, Barbara, you need to memorize/learn this stuff....you don't usually read it once and it's down verbatim.....duh! lol And all this "scientific" medical stuff is hard for me to remember. So I do "study" it!

I have other inflammation markers that are good and some that aren't. Have to look at the whole picture. I think that's what I don't like about my doctor....I want her to look at the whole picture and present it like that to me rather than just go through individual markers. When she goes through individual markers, only the bad ones stick with me and I panic!

My last email from her emphasized that my good markers were improving a lot and though I wasn't losing weight as fast I thought/wanted/maybe should be (leptin, insulin) I was becoming "Cindy Crawford" on the INSIDE. ha ha Loved the analogy. And I guess that was her way of looking at the whole picture.
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Re: Gundry internet ads

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Unfortunately Gundry has the right to advertise however he wants and he is choosing to use common standards across the board....vidoes that are way too long to hear the bottom line and his charming and convincing writing and talking style to convince readers and listeners into believing the words.
I am a new patient of his and I personally have chosen to eliminate all his sales pitches from my emails. He seems to be on the cutting edge of research on leaky gut and the many ways it affects our health. Although I am not convinced my time and money are well spent with him as one of my practitioners, I will stay with him for another year or so to see if my oxLDL, homocysteine and now TMAO blood work improve.
My advice is to take in the comments on this thread and continue to do your own personal evaluation of how your own body is responding to the changes you are making and go slowly...only making one change every 3 months or so to know the effects of that change (this is why I am staying with Gundry for at least 2 appts with him). Patience is not one of my strong points. So when I get discouraged to the point of throwing my hands up and screaming what can I eat(no lectins no fruits, no meat, no products with coconut oil(only specific olive, avocado , sesame oils), small fish(3 oz. 2-3 x per wk) reduce cruciferous veggies(per Gundry because my TSH went upper the first time in 20 years), no egg yokes, no dairy( including occasional A-2 homemade yoghurt, sprinkling of parm from Italy), I resort to communicating with friends on this website to bump up my motivation and carry on.
I applaud you for all you done....stay with it and this group is one of the best ways to kick around thoughts and ideas as you travel your path.
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PBW wrote: reduce cruciferous veggies(per Gundry because my TSH went upper the first time in 20 years), no egg yokes, no dairy( including occasional A-2 homemade yoghurt, sprinkling of parm from Italy), I resort to communicating with friends on this website to bump up my motivation and carry on.
I applaud you for all you done....stay with it and this group is one of the best ways to kick around thoughts and ideas as you travel your path.
Hmmmm, my TSH has gone up a little, too....although the other thyroid markers are all good. I eat a lot of broccoli and cauliflower and brussels sprouts. Think I should pare those down a bit? They're recommended for so many other reasons, though....however, going back to the concept that we are all individuals, would you suggest I kind of limit those these next three months to see if my TSH will go down?

Why no egg yolks? They are supposed to be so nutritious. Are you cutting out ALL saturated fat?

Thank you for your words of support at the end!!! You're right that this is a WONDERFUL group of people who accept me as I am, whining and all, and never fail to support, like you!
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Re: Gundry internet ads

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pguyer807 wrote:Hi Jan18,

I am totally hearing your frustration. I have come to the conclusion that the stress of all of the dietary restrictions in and of
themselves has caused me a boatload of stress.

I realize there isn't a one size fits all diet. Keto diets have made me feel more brain fogged
and ill than other attempts at diets.

So I share your frustration and sorry I am not offering a diet solution but the stress of trying to find that perfect diet and
lifestyle can take the joy out of living.
Thank you for making me feel I'm not the only one who gets frustrated, pguyer807. I so appreciate that. I'm back "up" again and trying a few new recipes with almond flour, etc. All it takes is finding one thing that tastes good that is compliant and I get encouraged to find more.

I got so deprived from NO GRAINS whatsoever, that I tried a small bowl of steel cut oats with walnuts, 1 T. of ground flaxseed, and strawberries for my first meal of the day 30 minutes ago and now I need to check my glucose again. It was 89 this morning. I hope it didn't go up more than 30, because that is what I read would indicate a bad food for me.

Here goes......it's 103. I'm assuming I'm okay with steel cut oats occasionally, then?
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