Double 4/4 Thread. Unique health pathways?

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Vikingman
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Double 4/4 Thread. Unique health pathways?

Post by Vikingman »

There is a dramatic increase in AD with the 4/4 double allele. Although there are mostly similar health pathways to follow for both single 4 and double 4/4's there are also unique differences. As a "newbie" it would be great to have a thread focused on the double 4/4. Sifting through all the information regarding both single and double is not the most efficient way to learn about our unique combination. Does anyone else feel this way that has recently discovered they have the 4/4 and sifting through the information? Anyway it would be a boon to have those with advanced knowledge add to the list of differences for us with 4/4.

For Example:
Single 4's are a YES and double 4/4's are a NO for the following I believe.

1. MCT Oil
2. Exogenous Ketones
3. Coconut Oil
4. Omega Three's in Triglyceride Form

So when 4/4's read that the above list is good for APOE 4 and we go buy the supplements in mass we can buy the correct items instead using the products and getting inflammation like a guinea pig only to find out later it is only single 4's. (I know most have had to go though this for themselves but for the newbies it would be nice to know. I know 4/4 is a small subset but it would really facilitate a faster tract for new forum members with 4/4. I am fine doing what ever it takes but the less missteps the better. I know that with the dramatically increased risk of AD for 4/4's that there must have been some major initiative,focus and knowledge that can be distilled down to the newbies in a more concentrated form to digest. :)

Seems that 4/4's don't have as much room for error and are required to have a super healthy diet because health and brain response is much greater for both good and bad nutrition.

Respectfully,

Vikingman
e4/e4
Last edited by Vikingman on Thu Nov 07, 2019 11:23 am, edited 8 times in total.
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TheresaB
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Re: Any possibility to create an e4/e4 thread/forum/category??

Post by TheresaB »

I think you just did. :D
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Re: Double 4/4 Thread. Unique health pathways?

Post by mike »

Vikingman wrote:There is a dramatic increase in AD with the 4/4 double allele. Although there are mostly similar health pathways to follow for both single 4 and double 4/4's there are also unique differences. As a "newbie" it would be great to have a thread focused on the double 4/4
Hi from another 4/4. One problem I see is there is very little research that breaks out results by ApoE variant. I would argue that even the stuff you mentioned is not 100% nailed down by research, at least not for me. In general consuming fats in your meals and having it go through your normal digestive system to produce ketones will be better for you long term, but there could be times where exogenous ketones would make sense. One thing that I believe is well founded - E4s use glucose less well in the brain than E3s, but E4s use ketones better than E3s. Another recent bit of research says that folks who are likely to get AD (4/4s, etc.) later in life show physical brain damage decades prior to AD symptoms. For some reason neurons are dying. It could possibly be due to damage of the blood brain barrier (BBB) and/or lack of fuel to the brain. In the brain, your BBB is mostly blood vessels. So taking care of vascular health is critical. Controlling blood pressure. Controlling blood sugars and their peaks. Exercise is crucial. Recent research suggests that folks who do not exercise when young, but start in middle age get as much protection as someone who always exercised. This means you can still turn things around if you need to. I'm almost 60, and from my recent baseline AD exam, I was told that I "have the brain of a 40 year old" - I believe this is because of exercise, and the need to go on a strict lo carb diet to deal with my 20 years of diabetes - my blood sugar is still high, but my peaks are not bad. Getting into and staying in a mild keto state can provide an alternate source of fuel for the brain, and is also protective of the BBB. I would advise 4/4s to avoid anything with added sugar (including corn syrup and fruit juices) or Man-made fats (Trans). I would get your Insulin Resistance measured (HOMA-IR) and if it is high, you should think about cutting back on carbs.
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Re: Double 4/4 Thread. Unique health pathways?

Post by Vikingman »

Sonoma Mike,

This is great information! Thank you very much. When you say cutting back on carbs you don't mean the complex carbs from Vegetables as well as all the bad carbs. I have been eating a ton of cruciferous vegetables and resistant starches the past month but I wake up in the morning with my hands swollen every day. The only meat I eat is wild shrimp, scallops, sardines, herring , anchovies and wild salmon. Regarding fats are you referring mainly to EVOO and Avocados and Omega 3's in a phospholipid form or more fatty read meats?

What type of brain scan do I need to do to see how much damage is already done? I was also involved in football growing up, basketball and baseball and had the ole noggin bounced around quite a bit. I have been sedentary for the past 19 years because of an injury but I am now cycling and lifting weights. Since I am middle age I would love to work on developing a good vascular system over the next Decade in hopes of having some good results.

I am also drawn to the OMAD one meal a day diet because I just don't get that hungry. For three weeks after learning about my 4/4 I started eating one very healthy meal a day in a 2 hour window. Now I am eating 2 meals a day in a 4-5 hour window.

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SusanJ
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Re: Double 4/4 Thread. Unique health pathways?

Post by SusanJ »

Vikihngman wrote:...I wake up in the morning with my hands swollen every day.
Given your reliance on fish and seafood, you might look for food intolerances that lead to swelling, or also look for problems breaking down histamine (which fish and seafood can be high in). Either possibility might suggest some more work on your GI tract/microbiome.
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Re: Double 4/4 Thread. Unique health pathways?

Post by mike »

Vikingman wrote:When you say cutting back on carbs you don't mean the complex carbs from Vegetables as well as all the bad carbs.
How many and what type of carbs a person can handle depends on the individual. Testing your insulin resistance IR lets you know what your metabolic state is in. If you are trending towards being insulin resistant, then you are heading towards type 2 diabetes. Your body can keep your blood sugars mostly normal even after you begin to get IR, but at some point it can no longer maintain, and your blood sugar begins to go up. If you do not have IR, then you can continue with your current level of carbs. And yes, you start with simple carbs - things that very quickly turn to glucose in your blood. If you do have IR, you might want to get a blood sugar meter and start testing what foods raise your blood sugar. Because of my condition, I try to keep my carbs to under 35 g / day. I do not eat underground veggies. Where you land depends on your metabolic condition. Maybe yams are okay?
I have been eating a ton of cruciferous vegetables and resistant starches the past month but I wake up in the morning with my hands swollen every day. The only meat I eat is wild shrimp, scallops, sardines, herring , anchovies and wild salmon. Regarding fats are you referring mainly to EVOO and Avocados and Omega 3's in a phospholipid form or more fatty red meats?
I personally follow a modified carnivore diet, with dairy, some added low carb veggies, and some added "good" fats, so my diet is quite different from many here. You will need to experiment for yourself. It sounds like SusanJ has some good ideas to try. I do not have stomach issues, so maybe adding some good quality chicken and eggs would be worth a try?
What type of brain scan do I need to do to see how much damage is already done?

An MRI without contrast will generally be needed. If you can get it with an added NeuroQuant that can also be useful.
I am also drawn to the OMAD one meal a day diet because I just don't get that hungry. For three weeks after learning about my 4/4 I started eating one very healthy meal a day in a 2 hour window. Now I am eating 2 meals a day in a 4-5 hour window.
Many folks say this helps. I'm trying to work up to a longer fasting window. 4/4s also seem to be able to do extended fasts - I've done 3 ranging from 13 to 19 days.
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Re: Double 4/4 Thread. Unique health pathways?

Post by Mel »

Thank you for sharing. I do appreciate this site to search for information and recommendations for individuals with ApoE4. As an individual with double 4/4, it can feel overwhelming at times and I do sometimes feel like a guinea pig while trying different dietary approaches. MCT oil, for example, raised my cholesterol/triglycerides levels significantly...although my brain felt sharper than ever! I chose to stop it, however, because my doctor was pushing statins due to my blood work. Upon reading information on this website and others, it appears that the recommendation is to mainly use MCT oil for a short period of time (if needed) and then transition to other types of fats (i.e. unsaturated).

My big question has to do with complex carbs and fiber vs. maintaining a low carb intake. In a video interview with Dr. Bredesen, he mentioned that HIGH FIBER is one of the keys to brain health (helping to regulate insulin, cholesterol and toxins). He commented that years ago, we likely consumed 100 grams of fiber per day compared to modern times (he recommends at least 30 grams of fiber per day). The challenge I find is that the foods that are high in fiber (grains, beans, oats) are not recommended for APOE4 individuals and they would raise .my carb intake to much higher than what would keep me in a mild ketosis that Dr. Bredesen would recommend. Do I assume that the only complex carbs he is recommending would be vegetables (and not grains, beans and oats)?
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Re: Double 4/4 Thread. Unique health pathways?

Post by Melanie R. »

Mel wrote:My big question has to do with complex carbs and fiber vs. maintaining a low carb intake. In a video interview with Dr. Bredesen, he mentioned that HIGH FIBER is one of the keys to brain health (helping to regulate insulin, cholesterol and toxins). He commented that years ago, we likely consumed 100 grams of fiber per day compared to modern times (he recommends at least 30 grams of fiber per day). The challenge I find is that the foods that are high in fiber (grains, beans, oats) are not recommended for APOE4 individuals and they would raise .my carb intake to much higher than what would keep me in a mild ketosis that Dr. Bredesen would recommend. Do I assume that the only complex carbs he is recommending would be vegetables (and not grains, beans and oats)?
Hello Mel and welcome to the site!

You've joined a great conversation, and I hope you are finding value in it. It's true that in modern times our fibre intake has significantly decreased. Many folks do well through a trial of eliminating grains, legumes and oats, for at time, and increasing low glycemic foods like green leafy veg ect.. . I hope you find what works best for you.

If you get a chance while you're on here, feel free to check out the Wiki which has resources for navigating the site, along with our Primer written by Dr. Stavia, a member, in layman's terms.

Once again welcome to the forum. We are glad you are here!

Warm regards,
Melanie
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Re: Double 4/4 Thread. Unique health pathways?

Post by Mel »

Thank you Melanie. I will take a look at your suggestions and look forward to learning more and reading what other Apoe4 individuals have been eating with regards to complex carbs and carb intake in general.
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Re: Double 4/4 Thread. Unique health pathways?

Post by Julie G »

Do I assume that the only complex carbs he is recommending would be vegetables (and not grains, beans and oats)?
He generally recommends that we get our fiber from non-starchy vegetables. It’s pretty easy to reach 30+ grams with just that approach. That said, he does allow limited use of legumes and some grains (like sorghum, millet, buckwheat, and teff) as a resistant starch for some people who don’t experience a glycemic spike. It’s also best for those with Type-3 AD/CIRS to avoid these latter sources (until some healing has occurred) as they can be high in amylose which can serve as a source of fuel for mycotoxins and upregulate MMP-9 which increases the permeability of the blood brain barrier.
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