Russ - I agree - AWESOME post!! THANK YOU!!! I'm winding down right now...but suffice to say I'm VERY glad your numbers are continuing to look outstanding. Sooooo intensely awesome that you spoke to Dr. G! Think I'm gonna follow your lead and make an appointment with him.
One quick question: surely he's referring to a link between high estradiol and CVD for males, right? Good Lord, please tell me that's so. lol I mean, that's one of the things thought to be CVD-protective for females of childbearing years.
New Test Results: CAC Score and LDL-P
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Re: New Test Results: CAC Score and LDL-P
I'm just a oily slick in a windup world with a nervous tick.
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LillyBritches
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Re: New Test Results: CAC Score and LDL-P
I think I just google-answered my own query:
http://www.lef.org/magazine/2008/11/dan ... le/page-01
Looks like high estradiol in males is the baddie per above...
HOWEVER, and now I remember, because I wrote Dr. Trutt about this (and it's fairly recent)...high estradiol has also been linked so sudden cardiac death in females (heart rhythm disorder: prolonged QT interval):
http://www.heartrhythmjournal.com/artic ... 5/abstract
And this is the very subject of one of my aforementioned (in another thread here) frantic emails to Dr. Trutt. His excellent response re the above study:
Yeah I saw this yesterday. I can't get the full paper yet because it's not yet available on PubMed (it's too recent), so you have to take all this with a big grain of salt because I can't see any details.
(Of course, the internet newsfeeds really couldn't care less about "details," they just vomit out the headline and leave it to the masses to sort it out.)
My take is this:
First of all, again, let's get back to the basics: for women who start HRT within ten years of menopause, HRT lowers their risk of death FROM ANY CAUSE by 40%.
That includes women who die from sudden cardiac death.
This is why I emphasize all-cause mortality as the "measuring stick" on whether or not to use a therapy: If I told you "HRT lowers the risk of Alzheimer's" you might read this article and say "but it might cause sudden cardiac death!" Instead, I am telling you (and so is the Endocrine Society) that HRT lowers the risk of death from ALL CAUSES combined. Therefore, whether or not this article is correct, the average woman is MUCH better off using HRT. We have plenty of ten year studies on HRT, and 40% fewer women died when they took HRT.
Having said that, what is this article talking about? Are there some women who may want to be more careful with their estrogen levels?
Since I can't see the whole article, I can't tell you for sure. This is an observational study. I don't know what else they looked at besides hormone levels, or what the patient population was, or their ages... or anything. 54pg/mL is not a high estradiol level at all. Before menopause, women routinely walk around with levels of 200-300 -- and in pregnancy as high as 7000pg/mL! So why would THESE women drop dead with a level of 54? I can't tell you without seeing the paper... (and I can't promise that I will be able to tell you even when I CAN see the paper).
If I had to guess, though, here is what I would throw out there:
Estradiol may mildly prolong something called the "QT interval" on an EKG (see my highlighted parts in the attached paper, also very recent).
Mildly prolonged QT interval is harmless. Severely prolonged QT interval can indeed lead to sudden cardiac death. However, that likely only applies to women who have inherited "long QT syndrome."
In this study, for all we know ALL of the women who died may have had congenital prolonged QT syndrome. That may be why they are the ones who died.
Women with prolonged QT intervals who then ALSO go on a medication that prolongs the QT further are particularly at risk.
For a list of medications that can prolong the QT interval, go here: https://www.crediblemeds.org/everyone/d ... ital-lqts/
Will they add estradiol to this list? Who knows. This article is too preliminary.
I can tell you that in the ER we never, ever look at that list when prescribing antibiotics or other meds, and it is NOT standard of care to get an EKG and check the QT interval on anyone that you are writing any prescription for.
The only time we try hard to get an EKG first is when we have to inject an antipsychotic into a violent psychiatric patient, because the antipsychotics are particularly problematic in this regard.
(You can imagine our success rate in telling a violent psychotic patient to "be still, we are just applying some electrodes to your chest." Most of the time we just forgo the EKG and cross our fingers.)
So, I don't feel that it is necessary to now get an EKG on every woman who may start HRT. However, if more data comes out to clarify this, we may ask if women have prolonged QT syndrome.
However, this is important: note PAGE 6 from the same paper attached to this email: both testosterone and progesterone shorten the QT interval and thus may very well negate any estrogen effect on QT interval-- one more reason to balance all three hormones!
Here is the quote from the attached paper:
"Combined treatment with estradiol and progesterone reduces the risk of drug-induced arrhythmias [related to prolonged QT]. Similarly, testosterone reduces the risk of drug induced [arrhythmias]."
This may be why, in this same article that you linked, people with higher testosterone levels did better.
He continued in a follow up email:
I just spoke to [Dr. Trutt's partner in his practice], and he points out that I may be jumping the gun in even trying to interpret this, for a few reasons:
1) It's in a journal neither of us have ever heard of before. In other words, this study was not deemed worthy of publication by any well-respected journal
2) We have no real info yet because we can't see the study-- I can't even tell you if these women were on HRT or what age they were
The problem is that even bad studies can now make the news even before the study is published, which puts us at a huge disadvantage in trying to tell people how to interpret them. So, the best approach may be to say, "this may not even be worth commenting on. We will see what happens when more info comes out."
http://www.lef.org/magazine/2008/11/dan ... le/page-01
Looks like high estradiol in males is the baddie per above...
HOWEVER, and now I remember, because I wrote Dr. Trutt about this (and it's fairly recent)...high estradiol has also been linked so sudden cardiac death in females (heart rhythm disorder: prolonged QT interval):
http://www.heartrhythmjournal.com/artic ... 5/abstract
And this is the very subject of one of my aforementioned (in another thread here) frantic emails to Dr. Trutt. His excellent response re the above study:
Yeah I saw this yesterday. I can't get the full paper yet because it's not yet available on PubMed (it's too recent), so you have to take all this with a big grain of salt because I can't see any details.
(Of course, the internet newsfeeds really couldn't care less about "details," they just vomit out the headline and leave it to the masses to sort it out.)
My take is this:
First of all, again, let's get back to the basics: for women who start HRT within ten years of menopause, HRT lowers their risk of death FROM ANY CAUSE by 40%.
That includes women who die from sudden cardiac death.
This is why I emphasize all-cause mortality as the "measuring stick" on whether or not to use a therapy: If I told you "HRT lowers the risk of Alzheimer's" you might read this article and say "but it might cause sudden cardiac death!" Instead, I am telling you (and so is the Endocrine Society) that HRT lowers the risk of death from ALL CAUSES combined. Therefore, whether or not this article is correct, the average woman is MUCH better off using HRT. We have plenty of ten year studies on HRT, and 40% fewer women died when they took HRT.
Having said that, what is this article talking about? Are there some women who may want to be more careful with their estrogen levels?
Since I can't see the whole article, I can't tell you for sure. This is an observational study. I don't know what else they looked at besides hormone levels, or what the patient population was, or their ages... or anything. 54pg/mL is not a high estradiol level at all. Before menopause, women routinely walk around with levels of 200-300 -- and in pregnancy as high as 7000pg/mL! So why would THESE women drop dead with a level of 54? I can't tell you without seeing the paper... (and I can't promise that I will be able to tell you even when I CAN see the paper).
If I had to guess, though, here is what I would throw out there:
Estradiol may mildly prolong something called the "QT interval" on an EKG (see my highlighted parts in the attached paper, also very recent).
Mildly prolonged QT interval is harmless. Severely prolonged QT interval can indeed lead to sudden cardiac death. However, that likely only applies to women who have inherited "long QT syndrome."
In this study, for all we know ALL of the women who died may have had congenital prolonged QT syndrome. That may be why they are the ones who died.
Women with prolonged QT intervals who then ALSO go on a medication that prolongs the QT further are particularly at risk.
For a list of medications that can prolong the QT interval, go here: https://www.crediblemeds.org/everyone/d ... ital-lqts/
Will they add estradiol to this list? Who knows. This article is too preliminary.
I can tell you that in the ER we never, ever look at that list when prescribing antibiotics or other meds, and it is NOT standard of care to get an EKG and check the QT interval on anyone that you are writing any prescription for.
The only time we try hard to get an EKG first is when we have to inject an antipsychotic into a violent psychiatric patient, because the antipsychotics are particularly problematic in this regard.
(You can imagine our success rate in telling a violent psychotic patient to "be still, we are just applying some electrodes to your chest." Most of the time we just forgo the EKG and cross our fingers.)
So, I don't feel that it is necessary to now get an EKG on every woman who may start HRT. However, if more data comes out to clarify this, we may ask if women have prolonged QT syndrome.
However, this is important: note PAGE 6 from the same paper attached to this email: both testosterone and progesterone shorten the QT interval and thus may very well negate any estrogen effect on QT interval-- one more reason to balance all three hormones!
Here is the quote from the attached paper:
"Combined treatment with estradiol and progesterone reduces the risk of drug-induced arrhythmias [related to prolonged QT]. Similarly, testosterone reduces the risk of drug induced [arrhythmias]."
This may be why, in this same article that you linked, people with higher testosterone levels did better.
He continued in a follow up email:
I just spoke to [Dr. Trutt's partner in his practice], and he points out that I may be jumping the gun in even trying to interpret this, for a few reasons:
1) It's in a journal neither of us have ever heard of before. In other words, this study was not deemed worthy of publication by any well-respected journal
2) We have no real info yet because we can't see the study-- I can't even tell you if these women were on HRT or what age they were
The problem is that even bad studies can now make the news even before the study is published, which puts us at a huge disadvantage in trying to tell people how to interpret them. So, the best approach may be to say, "this may not even be worth commenting on. We will see what happens when more info comes out."
I'm just a oily slick in a windup world with a nervous tick.
Re: New Test Results: CAC Score and LDL-P
LIlly, Yes - absolutely! Dr G was very explicit that high estradiol linked to CVD is a guy thing 
Russ
E3/4
Eat whole, real, flavorful food - fresh and in season... and mix it up once in a while.
E3/4
Eat whole, real, flavorful food - fresh and in season... and mix it up once in a while.
Re: New Test Results: CAC Score and LDL-P
Russ,
Are you signed up for Bredesen's study? If so, it will be interesting on the integration. I think Gundry and his approaches are complementary.
How long was your call with Gundry?
As to Vit C, a friend who is into this sent me the following the other day when I mentioned my CIMT results. I've yet to follow up and read the books or act on Levy's protocl:
Colorado cardiologist, Thomas E. Levy, MD, JD, has been writing about the importance of vitamin C as preventive for illness…. and has segments addressing arterial calcifications in his books and talks.
I recommend two of his books on C… the most recent is Primal Panacea and the other is Stop America’s #1 Killer…. He has another titled… Curing the Incurable…. which is also excellent. They all overlap somewhat but the underlying focus is that vitamin C in high enough dosing cures virtually everything and is also preventive.
In Panacea – he specifically addresses in Chapt. 4 atherosclerosis and says:
ALL coronary arterial blockages have a solitary root cause!
Then, the very newest is Death by Calcium which is also excellent and at the end, he includes observations on how vitamin C deficiencies affect health.
Dr. Levy worked as a consultant to the LivOn Laboratory people when they developed the liposomal delivery form of vitamin C… As I mentioned, most people don’t have access to the high dosing like upwards of 100,000 mg of IV C that he reports on as being highly curative so the LipoC is perfect.
I order what I call “ LipoC” from both LivOn and iHerb… and have been using it for over two years. http://www.livonlabs.com/
One packet delivers 1,000 mg of the liposomal C.
The substitution equivalencies (Lipo C equivalent to C as ascorbic acid
1,000 mg = 3,000 – 4,000 mg powder
2,000 mg = 8,000 – 10,000 mg powder
3,000 mg = 12,000 – 18,000 mg powder…. (page 133 of Primal Panacea)
Typically, no bowel tolerance issues or stomach distress.
I‘d suggest you order several boxes today…along with the books, but start taking the C immediately… while you are reading …. Never travel without it.
A tip for consuming the LipoC… Best taken on an empty stomach although apparently some say it doesn’t matter. I’d think it might.
Tear off the top of the packet. Fold in 3rds or half and squeeze the contents down into a small glass of water… I use about 3 ounces. The LipoC gel is thick and gooey… and will clump at the bottom of the glass or cup. It doesn’t taste horrible but it isn’t great tasting, either… but I ignore that as a minor.
Swirl the contents so the gel is moving in the water… and then toss it down the hatch…Cowboy Style … like you were pounding back Tequila.
Otherwise, it sticks to the cup and you have to scoop it out with your finger and then lick that off. Sometimes that happens anyway. I put in 3 packets at a time and it still works easily.
If you have the time… there are a number of Thomas Levy MD YouTube presentations
https://www.google.com/search?q=Thomas+ ... hannel=nts
And his website is…. http://www.peakenergy.com/index.html
Lots of goodies there.
An excerpt from Death by Calcium…
The Cause of All Disease: A Unified Theory (p 329)
Overview
As mentioned at the end of the introduction, osteoporosis is really a chronic focal scurvy or severe vitamin C deficiency of the bones. And even though this book is primarily concerned with osteoporosis and the negative health consequences of calcium ingestion, the explanation of what causes osteoporosis falls quite nicely under a more general explanation of what causes all disease. Understanding these common denominators to all diseases allows for the reasoned, optimal choice of treatment for any given patient.
The clinical goal for all diseases is the same: Lessened oxidative stress in a given organ or target tissue. Clinically speaking, all diseases will respond very positively to the practical suggestions offered in Chapters 16 through 18 unless secondary organ and/or tissue damage has advanced beyond the point of allowing a reasonable measure of reversal. Minor protocol modifications are usually necessary in the treatment of different diseases, however.
In this book, he emphasis the importance of eliminating or reducing significantly the oxidative stress factor… and free radical damage … and talks about the benefits of limiting calcium influx into cells. Also covered… calcium channel blockers effectively treat many degenerative diseases and that…
“increased intracellular calcium levels are always accompanied by increased intracellular oxidative stress and are probably the primary cause for it.” Then he talks about the effectiveness of calcium channel blockers …and has a chapter on Magnesium as nature’s calcium channel blocker… which we already know about.
Are you signed up for Bredesen's study? If so, it will be interesting on the integration. I think Gundry and his approaches are complementary.
How long was your call with Gundry?
As to Vit C, a friend who is into this sent me the following the other day when I mentioned my CIMT results. I've yet to follow up and read the books or act on Levy's protocl:
Colorado cardiologist, Thomas E. Levy, MD, JD, has been writing about the importance of vitamin C as preventive for illness…. and has segments addressing arterial calcifications in his books and talks.
I recommend two of his books on C… the most recent is Primal Panacea and the other is Stop America’s #1 Killer…. He has another titled… Curing the Incurable…. which is also excellent. They all overlap somewhat but the underlying focus is that vitamin C in high enough dosing cures virtually everything and is also preventive.
In Panacea – he specifically addresses in Chapt. 4 atherosclerosis and says:
ALL coronary arterial blockages have a solitary root cause!
Then, the very newest is Death by Calcium which is also excellent and at the end, he includes observations on how vitamin C deficiencies affect health.
Dr. Levy worked as a consultant to the LivOn Laboratory people when they developed the liposomal delivery form of vitamin C… As I mentioned, most people don’t have access to the high dosing like upwards of 100,000 mg of IV C that he reports on as being highly curative so the LipoC is perfect.
I order what I call “ LipoC” from both LivOn and iHerb… and have been using it for over two years. http://www.livonlabs.com/
One packet delivers 1,000 mg of the liposomal C.
The substitution equivalencies (Lipo C equivalent to C as ascorbic acid
1,000 mg = 3,000 – 4,000 mg powder
2,000 mg = 8,000 – 10,000 mg powder
3,000 mg = 12,000 – 18,000 mg powder…. (page 133 of Primal Panacea)
Typically, no bowel tolerance issues or stomach distress.
I‘d suggest you order several boxes today…along with the books, but start taking the C immediately… while you are reading …. Never travel without it.
A tip for consuming the LipoC… Best taken on an empty stomach although apparently some say it doesn’t matter. I’d think it might.
Tear off the top of the packet. Fold in 3rds or half and squeeze the contents down into a small glass of water… I use about 3 ounces. The LipoC gel is thick and gooey… and will clump at the bottom of the glass or cup. It doesn’t taste horrible but it isn’t great tasting, either… but I ignore that as a minor.
Swirl the contents so the gel is moving in the water… and then toss it down the hatch…Cowboy Style … like you were pounding back Tequila.
Otherwise, it sticks to the cup and you have to scoop it out with your finger and then lick that off. Sometimes that happens anyway. I put in 3 packets at a time and it still works easily.
If you have the time… there are a number of Thomas Levy MD YouTube presentations
https://www.google.com/search?q=Thomas+ ... hannel=nts
And his website is…. http://www.peakenergy.com/index.html
Lots of goodies there.
An excerpt from Death by Calcium…
The Cause of All Disease: A Unified Theory (p 329)
Overview
As mentioned at the end of the introduction, osteoporosis is really a chronic focal scurvy or severe vitamin C deficiency of the bones. And even though this book is primarily concerned with osteoporosis and the negative health consequences of calcium ingestion, the explanation of what causes osteoporosis falls quite nicely under a more general explanation of what causes all disease. Understanding these common denominators to all diseases allows for the reasoned, optimal choice of treatment for any given patient.
The clinical goal for all diseases is the same: Lessened oxidative stress in a given organ or target tissue. Clinically speaking, all diseases will respond very positively to the practical suggestions offered in Chapters 16 through 18 unless secondary organ and/or tissue damage has advanced beyond the point of allowing a reasonable measure of reversal. Minor protocol modifications are usually necessary in the treatment of different diseases, however.
In this book, he emphasis the importance of eliminating or reducing significantly the oxidative stress factor… and free radical damage … and talks about the benefits of limiting calcium influx into cells. Also covered… calcium channel blockers effectively treat many degenerative diseases and that…
“increased intracellular calcium levels are always accompanied by increased intracellular oxidative stress and are probably the primary cause for it.” Then he talks about the effectiveness of calcium channel blockers …and has a chapter on Magnesium as nature’s calcium channel blocker… which we already know about.
Last edited by Tincup on Fri Nov 07, 2014 1:34 pm, edited 1 time in total.
Tincup
E3,E4
E3,E4
Re: New Test Results: CAC Score and LDL-P
George - Many people have tried the Vit C angle with no positive change. A ND doctor I saw had many patients who tried it with no success, so I think its one of those maybe/maybe not scenarios.
Re: New Test Results: CAC Score and LDL-P
George, think you meant to address this to Russ. We've both had challenging ca scans so it can be easy to confuse us. The information you provided is useful to me, so thanks! I'll probably read a bit this weekend. Will reload my reading material early next week and might pick up some of the vitamin c information as it has been one of those "one day I'd like to explore that POV" topics for a while. I am signed up for the study, and am glad that the approaches are complementary as I may try to sign on with Gundry as I lose a few pounds. Not sure I'll be accepted in the study as I'm APOE4 4 and have two prior TBIs. If the goal is case studies, I might get preferentially included... if it is statistics, I'm probably preferentially excluded. I am starting mental exercises as a result of my increasing awareness of APOE 4 4 challenges with TBI, Alzh, etc. Thanks all... I'd rather face this thing head on then be clipped from the side when I wasn't looking!GeorgeN wrote:Lance,
Are you signed up for Bredesen's study? If so, it will be interesting on the integration. I think Gundry and his approaches are complementary.
How long was your call with Gundry?
Russ, Thanks for sharing this information. Very well done on all your improvements and progress! I have to rededicate myself to reduce my few remaining vices and your information really helps me focus. Heavy Whipping Cream in my coffee is my new focus... I enjoy thick flavorful coffee or hot coffee with HWC... so the french press is coming out!
Thank you both/all for sharing so liberally. Really appreciate how quickly the search function on this site allows someone to quickly get up to speed on POV on certain topics. Thats in large measure because so many are so willing to share their approaches / rationale. Thanks!
Re: New Test Results: CAC Score and LDL-P
Lance, just to clarify- even if you are NOT picked for the official study, Dr. Bredesen has very generously offered to follow us/provide his clinical expertise to each of us for as long as we are willing to follow his protocol. So whether it's official or unofficial; you're in 
Re: New Test Results: CAC Score and LDL-P
Julie,Juliegee wrote:Lance, just to clarify- even if you are NOT picked for the official study, Dr. Bredesen has very generously offered to follow us/provide his clinical expertise to each of us for as long as we are willing to follow his protocol. So whether it's official or unofficial; you're in
Sorry didn't mean to sew confusion. There is a ton of value of being in. Finding specialized medical expertise to deal with our APOE4 specific issues is no small feat. The alignment between Dr. Bredesen's protocols and many of our practices is awesome and indicative that we and the good Dr. are likely on the right track. Except with being in the study, we'll have experts optimizing things that frankly many of us now are "putzing" around with, and perhaps missing things.
Thanks again for all you've done to get us to this point. I look forward to having a doctor drive while I sit in the back seat for a bit.
Cheers,
Lance
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Welcomeaboard
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Re: New Test Results: CAC Score and LDL-P
George, Lance, Hep, very interesting and informative posts in various threads today as well as many others.
Your posts led me to the citric acid cycle or Tca or krebbs cycle. There is a connection of ATP and AD and Parkinson's where the mitochondria do not have the proper amount of ATP. This ramping up of vitamin c amounts looks like something that may help or work? All of you seem to be very well informed in areas that may lend some ideas or knowledge? I would like to see what you think or know in this area. Thanks
Your posts led me to the citric acid cycle or Tca or krebbs cycle. There is a connection of ATP and AD and Parkinson's where the mitochondria do not have the proper amount of ATP. This ramping up of vitamin c amounts looks like something that may help or work? All of you seem to be very well informed in areas that may lend some ideas or knowledge? I would like to see what you think or know in this area. Thanks
Re: New Test Results: CAC Score and LDL-P
WA,
I think this is the reason for all the fuss about ketones, whether through carb/protein restriction, MCT's or keto salts. The ketone metabolism uses different pathways than glycogen, hence helps this "fuel" problem you are describing. I posted what my friend sent me on Vit C, I'm not too knowledgeable on it.There is a connection of ATP and AD and Parkinson's where the mitochondria do not have the proper amount of ATP.
Tincup
E3,E4
E3,E4
