skipped beats and magnesium

Question, I have had AFIB since 2014, had an ablation in 2017 and been doing good taking magnesium daily until today. Not quite full blown afib but it is not going away and it is starting to scare the life out of me. I have heard that you can't take too much magnesium but what is really healthy because I just took another one and it hasn't helped.

MH

I take 200mg 3x a day usually. My system is very tolerant of it, and I believe it, with taurine and potassium via my diet keeps my heart really quiet. That and all the great work done by Dr. Natale and the good folks in Austin.

Ok, that makes me feel better because I take 200 mg 2x a day now and use the topical spray in the morning so taking the two today should not hurt. Thanks!

Assuming you have healthy kidneys, it all comes down to bowel tolerance. As long as you don't take so much that you're experiencing loose stools then it's OK. You don't want to go to the point where you're having those issues because it means you're actually losing electrolytes rather than gaining them.

800 mg/day really isn't that much. I take it routinely with no problems. Remember that supplements aren't as potent as prescription pharmaceuticals so it's best to make minor adjustments and give them time before drawing any conclusions about whether or not it has been effective.

Yes - Good observation, Wolfpack.......always remember the healthy kidney qualifier.

Remember, too, that when there is optimal Mg in heart cells, then potassium is what regulates the time between beats and low potassium can cause PACs skipped beats. It's easy to get plenty of potassium, but can be quite difficult (for some) to maintain optimal IC Mg.... often due to high stress which can be mental, emotional, physical or also, too much calcium intake which blocks magnesium.

Just remember that for some, it can take several months (and longer) to get the Mg dosing right and then to consistently keep the IC Mg levels optimized.

I’ve been taking high doses of mag for over 14 years. It is a cornerstone of my afib remission program. I’m unusual, but I routinely take 3-5g a day without issue.

What Wolfpack said about heathy kidneys.

George

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GeorgeN
I’ve been taking high doses of mag for over 14 years. It is a cornerstone of my afib remission program. I’m unusual, but I routinely take 3-5g a day without issue.

What Wolfpack said about heathy kidneys.

George

It's surprising, because 3-5g is well above the recommended dose... but we're all so different!
I'm taking Mg (malate/bisglycinate) to bowel tolerance (for me, it's less than 1g/day!) for months and, until recently, I still had lots of ectopics and sometimes short afib episodes (less than 2h, often less than 1h).
As I sometimes had cramps in my feet, I thought there was something wrong. Taking Mg is one thing, but having it going where it should seems to be another one.
I found this thread, and I began lowering my Ca consumption and taking D3 and K2 vitamins. I then began taking some equisetum arvense, which contains Silicium and is supposed to help Mg and Ca going where they should.
I'm fine for a full week now, which is pretty rare for me: very very few ectopics and no afib.

It's too soon to be delighted, but...

George,

Back in the old days, you were among those from whom I learned good stuff. I recall that you were an endurance athlete and continued doing stuff, albeit at lower intensity.

I too take lots of magnesium - 1.8 grams daily - and tolerate fairly well. but I'm intrigued by the Jigsaw slow release, which advertises better absorption and less digestive mischief. Do you have any experience with that option?

Steve

Quote
steve n.
George,

Back in the old days, you were among those from whom I learned good stuff. I recall that you were an endurance athlete and continued doing stuff, albeit at lower intensity.

I too take lots of magnesium - 1.8 grams daily - and tolerate fairly well. but I'm intrigued by the Jigsaw slow release, which advertises better absorption and less digestive mischief. Do you have any experience with that option?

Steve

Steve, no I don't. I can take many grams of mag at one time without bowel issues.

I think, like many things, the body adapts over time. Hence my bowel tolerance has increased over these 14 or so years.

I haven't done an Exatest since I started taking mag. I did do one right before I started. As I recall, my mag was just below the bottom of the range and calcium was high. In the last few years, I've done RBC mag and I come out in the high 7's (6.5 is supposed to be the top of excellent). I tried backing off what I take to lower it and started getting afib breakthroughs. I know Dr. Joe Mercola and chatted with him about it. He said we just don't know what is optimal for you. @Johnny has a great looking Exatest and it is obviously working for him. <[www.afibbers.org]

I'm sure I urinate out huge quantities. The mag gets past the bowel, but I seem to need to have a gradient to get it into the cells. I've chatted with a variety of docs about it and nobody has a good answer.

All I know is I need to take large quantities to stay in NSR and I don't seem to have any negative consequences from doing so. My wife (non afibber) has a bowel tolerance just above 200 mg mag/day. Hence we are all very different.

George

Quote
GeorgeN

George,

Back in the old days, you were among those from whom I learned good stuff. I recall that you were an endurance athlete and continued doing stuff, albeit at lower intensity.

I too take lots of magnesium - 1.8 grams daily - and tolerate fairly well. but I'm intrigued by the Jigsaw slow release, which advertises better absorption and less digestive mischief. Do you have any experience with that option?

Steve

Steve, no I don't. I can take many grams of mag at one time without bowel issues.

I think, like many things, the body adapts over time. Hence my bowel tolerance has increased over these 14 or so years.

I haven't done an Exatest since I started taking mag. I did do one right before I started. As I recall, my mag was just below the bottom of the range and calcium was high. In the last few years, I've done RBC mag and I come out in the high 7's (6.5 is supposed to be the top of excellent). I tried backing off what I take to lower it and started getting afib breakthroughs. I know Dr. Joe Mercola and chatted with him about it. He said we just don't know what is optimal for you. @Johnny has a great looking Exatest and it is obviously working for him. <[www.afibbers.org]

I'm sure I urinate out huge quantities. The mag gets past the bowel, but I seem to need to have a gradient to get it into the cells. I've chatted with a variety of docs about it and nobody has a good answer.

All I know is I need to take large quantities to stay in NSR and I don't seem to have any negative consequences from doing so. My wife (non afibber) has a bowel tolerance just above 200 mg mag/day. Hence we are all very different.

George

Interesting about your Exatest George. Mine in 2010 gave 31.8 Mg (range 34-42) and 7.0 Ca (range 3.0 - 5.0) - pretty abysmal. I'm certain my own heart irritability (familial on mother's side) arises as a result of Ca and Mg handling abnormalities across the cell wall channels. My serum levels are always MOR. Do you have the info to hand as to exactly what your own tested levels were? I recall your previous brie-eating frenzy dramatically fertilised the ground for AF for you and this obviously ties in with your high Ca levels as tested. Maybe I need to revisit the Mg deal...... I suppose I'd kind of given up on it a bit thinking:
a) My IC results were so bad there was/is no way I could try and counter it as it's likely a familial/genetic thing;
b) What MG supplementation I have tried over the years has made zero difference whatsoever to either AF or ectopics (although I likely just didn't stick with it long enough - too impatient Type A personality...);
c) I recall PC (Pat Chambers) here on this forum years ago getting Exatests before and after about a year of furious Mg supplementation and his results had hardly shifted for the better.
But it's certainly stood you in good stead - and with you and I both having a history of high Ca levels what works for you...??. I suppose the question is.... how much of your excellent record is down to Mg supplementation and how much to everything else you do - not least your strict keto approach?? I'm slowly getting there with the keto, most obvious carbs pretty much out but I do still eat a lot of fresh pineapple, raspberries and cherries and really don't fancy giving those up! Somewhat unbelievably, I still struggle a bit with the wine.... at the moment 4 days mid-week nada but I still get tempted at weekends (10-20 units - yes I know.... way too much). This is now Friday and the challenge for this weekend is no booze at all despite a fairly heavy social agenda....not easy!!

EDIT: BTW; what is your own current Mg (and K) protocol these days please George?? I am going to have another go with this. OK so maybe my IC levels of Ca and Mg are way out of whack. But I always see AF as something that happens when one - via whatever means - reaches the 100 level. If I'm on 98 as I write, then maybe thorough Mg supplementation might not set me right IC levels-wise but it might drop that 98 to 96! At least I know - from Prof Jais - that I've got no signs of fibrosis (he found no low-voltage areas whatoever and this I am encouraged by) so maybe the supplementation is worth another shot as aforementioned.

Best regard to you and yours George,
Mike



Edited 1 time(s). Last edit at 02/22/2019 08:43AM by mwcf.

Hi George - When you were talking with Dr. Mercola about the individual variations in Mg optimization, did he happen to mention anything about the potential for damaged Mg receptor sites in the cell's outer layer due to ROS damage?

It's well known that, when talking about mitochondrial issues, the ROS damage plays a significant role, but it's often not emphasized that the health of cell membranes can influence whether or not the nutrient actually gets in the target cells... meaning just because you take an abundance, doesn't mean it actually reaches (in this case) the heart cell's interior where it can function.

That finding is well-researched and documented when discussing the topic of Lipid Replacement Therapy (LRT) by repairing the cell's phospholipid layer.

The magnesium advocate, Carolyn Dean MD - notes this

Reactive oxygen species (ROS)

Partially reduced oxygen free radicals cause injury to cell membranes and other cell constituents.

- lipid breakdown products

These include unesterified free fatty acids, acyl carnitine, and lysophospholipids, catabolic products that are known to accumulate in injured cells as a result of phospholipid degradation. They have a detergent effect on membranes. They also either insert into the lipid bilayer of the membrane or exchange with membrane phospholipids, potentially causing changes in permeability and electrophysiologic alterations. [www.humpath.com]

While the well-known researchers on LRT, Garth L. Nicolson, Ph.D. and Rita Ellithorpe, M.D. write with a focus on mitochondrial health, it makes sense to consider that would be useful for those who have limited or mixed success with optimizing magnesium... given that it may not be able to access inside the heart cells.

From the classic report Intro, two clips that emphasize this focus:

Lipid Replacement and Antioxidant Nutritional Therapy for Restoring Mitochondrial Function and Reducing Fatigue in Chronic Fatigue Syndrome and other Fatiguing Illnesses* Garth L. Nicolson, Ph.D. and Rita Ellithorpe, M.D.

The Institute for Molecular Medicine, Huntington Beach, California, US
Journal of Chronic Fatigue Syndrome 2006; 13(1): 57-68.

One of the most important changes in tissues and cells that occurs during aging and chronic degenerative disease is accumulated oxidative damage due to cellular reactive oxygen species (ROS). ROS are oxidative and free radical oxygen- and nitrogen-containing molecules, such as nitric oxide, oxygen and hydroxide radicals and other molecules [1]. Critical targets of ROS are the genetic apparatus and cellular membranes [1,2], and in the latter case, oxidation can affect lipid fluidity, permeability and membrane function [3,4].

Damage to membrane lipids can impair fluidity, electrical properties, enzymatic activities and transport functions of cellular and organelle membranes [1-6]. [www.immed.org]

It's certainly worth consideration for those who tend to be refractory to optimizing magnesium easily and consistently as well as those who accumulate an abundance of ROS damage from endurance exercise and other sources of cell damage from oxidative stress.

Jackie

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mwcf
Interesting about your Exatest George. Mine in 2010 gave 31.8 Mg (range 34-42) and 7.0 Ca (range 3.0 - 5.0) - pretty abysmal. I'm certain my own heart irritability (familial on mother's side) arises as a result of Ca and Mg handling abnormalities across the cell wall channels. My serum levels are always MOR. Do you have the info to hand as to exactly what your own tested levels were? I recall your previous brie-eating frenzy dramatically fertilised the ground for AF for you and this obviously ties in with your high Ca levels as tested. Maybe I need to revisit the Mg deal...... I suppose I'd kind of given up on it a bit thinking:
a) My IC results were so bad there was/is no way I could try and counter it as it's likely a familial/genetic thing;
b) What MG supplementation I have tried over the years has made zero difference whatsoever to either AF or ectopics (although I likely just didn't stick with it long enough - too impatient Type A personality...);
c) I recall PC (Pat Chambers) here on this forum years ago getting Exatests before and after about a year of furious Mg supplementation and his results had hardly shifted for the better.

Mike, I got that Exatest around Sept 2004. I posted the results here, but unfortunately that database got lost when Hans upgraded. I probably have the paper copy someplance, but I haven't seen it in years. Thanks to Jackie, Erling, PC and many of the others here then, that was one of the first tests I ordered and it gave me insight to the direction I should go to keep my afib in remission.

Quote
mwcf
But it's certainly stood you in good stead - and with you and I both having a history of high Ca levels what works for you...??. I suppose the question is.... how much of your excellent record is down to Mg supplementation and how much to everything else you do - not least your strict keto approach?? I'm slowly getting there with the keto, most obvious carbs pretty much out but I do still eat a lot of fresh pineapple, raspberries and cherries and really don't fancy giving those up! Somewhat unbelievably, I still struggle a bit with the wine.... at the moment 4 days mid-week nada but I still get tempted at weekends (10-20 units - yes I know.... way too much). This is now Friday and the challenge for this weekend is no booze at all despite a fairly heavy social agenda....not easy!!

EDIT: BTW; what is your own current Mg (and K) protocol these days please George?? I am going to have another go with this. OK so maybe my IC levels of Ca and Mg are way out of whack. But I always see AF as something that happens when one - via whatever means - reaches the 100 level. If I'm on 98 as I write, then maybe thorough Mg supplementation might not set me right IC levels-wise but it might drop that 98 to 96! At least I know - from Prof Jais - that I've got no signs of fibrosis (he found no low-voltage areas whatoever and this I am encouraged by) so maybe the supplementation is worth another shot as aforementioned.

Mike, my basics are: a) lots of magnesium, b) very modest calcium intake, c) avoid intense endurance exercise, d) use PIP flecainide to convert when I do go out of rhythm.. I did a) & c) , and b) unintentionally long before becoming keto adapted. So I can't credit the keto. I should note, while I maintain keto adaptation and am almost always making some ketones, my ovo pegan low lectin (no grains, legumes, night shades, seeded veggies or processed food) way of eating is not so low carb as many who are in ketosis. Two years ago did a two week Cronometer.com study with a gram scale, tracking everything. My carb intake was min 88g/day, mean 123 g/day and max 180 g/day with 50-60g of that being fiber. (fibre). Early on, I would wake up at 3 AM hot and sweaty. It took me years to understand that this could be nighttime hypoglycemia. As my afib would typically come on at 3AM (ish), this could have been a trigger. Since becoming keto adapted in 2009, this no longer occurs (still may wake up, but not hot & sweaty). I do look at glucose and insulin control as the foundation of overall good health (per the work of the late Dr. Joseph Kraft <[www.afibbers.org] ). I look at the other stuff I do, cold baths, being out in the sun with few clothes winter or summer, exercise within the constraints of it not being long combined with intense and so on as part of my experiment to have health span and life span coincide as closely as possible. I'm well aware that what I do has risk and I don't advocate that anybody follow. I will try many things and use myself as my control, my EP said this was a perfectly valid approach when I originally suggested my approach as a Plan B to his "just stay out of rhythm" suggestion.

I currently take 3-5 grrams of mag/day. Can be mag hydroxide that I make into a solution that is about the concentration of milk of magnesia. I tend to use this on multi-day fasts as it is purely an electrolyte. I can mix the mag hydroxide liquid with organic apple cider vinegar which makes magnesium acetate in a 2:7 ratio <[www.dropbox.com] , can be di-magesium malate from an equine supplier (but made by Albion) <[shop.performanceequinenutrition.com] , can be magnesium citrate, glycinate, oxide, chloride or just about any other form. As I've written, any mag works for me in sufficient quantity. I have recently been adding 2 tsps of potassium citrate powder to a lister of water and drinking it over the course of the day. Potassium does not appear to be crucial for me when magnesium is optimized. I do want the citrate as it helps prevent kidney stones, which I had two of 20 years ago and recently found I had another - showed up on a virtual colonoskopy. After many years taking K cit, I got lax, so started it up again. I also take 1/2 tsp of taurine powder.

Quote
Jackie
When you were talking with Dr. Mercola about the individual variations in Mg optimization, did he happen to mention anything about the potential for damaged Mg receptor sites in the cell's outer layer due to ROS damage?

Mercola and I did not chat about this. However thank you for giving me something else to dig into. I know Carolyn Dean suggeted her MgCl2 water was good at this. I bought some ,but didn't see any difference and not any difference between my own MgCL2 water (expect hers was much more expensive).

Cheers

George

Quote
GeorgeN


I look at the other stuff I do, cold baths, being out in the sun with few clothes winter or summer, exercise within the constraints of it not being long combined with intense and so on as part of my experiment to have health span and life span coincide as closely as possible. I'm well aware that what I do has risk and I don't advocate that anybody follow. I will try many things and use myself as my control, my EP said this was a perfectly valid approach when I originally suggested my approach as a Plan B to his "just stay out of rhythm" suggestion.

I'm a huge fan of cold water immersion - cold showers, ice baths and swimming in the ocean all year (not an option for those not on the coast, I know). Without carbs I can stay out in the sun for long periods of time with no sunburn - and I'm paper white, fair-skinned. When I was a kid, I'd sunburn when I was too close to a lamp, now it's totally different.

Thank you George for all the information.

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Jackie

Hi Jackie, in your link <[www.immed.org] they talk a lot about chronic fatigue syndrome. I don't exactly have that. For example, on the evening of Feb 14, I was in UT, planning to ski Alta on a powder day the next morning. As I was by myself, I did an experiment. I only ate tins of sardines and oysters for the day (as I only eat once per day). About 350 calories. Then I skied the steeps all day. I drove to Park City, where I would meet my daughter, son-in-law and work colleagues to ski the next two days. I checked my blood sugar out of curiosity. It was 31 mg/dL (1.7 mmol/L). Beta hydroxybuterate was 1.5 mmol/L. Now my neurologist climbing buddy has already told me that the only people he's seen with serum glucose in the 30's are comatose. I have to explain they aren't adapted. Then I proceeded to ski with the 29 year olds the next two days. One of them is a US Skii aerials Team. Another with us was a female Division I hockey player. I chased them down the steeps without any rest. They were always the ones who wanted to stop, rest and/or eat.

I do a lot of things to work on my mitochondria (hard to figure out how to test). I always do exercise or sport activities 15 or more hours fasted. To encourage apoptosis, mitosis, autophagy and mitophagy, in addition to the daily 22 hour fast, I periodically water fast 5-7 days. I also pay attention to the fats I eat. I test serum omega 3 & 6 concentrations & etc.

Per

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mwcf

Another thing I focus on is sleep and avoiding sleep apnea. Years ago, I noticed that the patterns on heart rate vs. time graph recorded overnight suggested possible apnea (an afib risk and I try to investigate, explore and extinguish any risks). To mitigate this, I started taping my mouth shut. Here is a reference <[www.snoring.ie] using this tape <[correctbreathing.com] .

I also use nasal breathing as a governor. I do all exercise (and all life in general), including HIIT (Tabatas), breathing through my nose. This includes skiing at high elevation. I am never out of breath. More references in this post <[www.afibbers.org] . I've done this for a number of years. It has made me aware of breathing of those I'm around. Many breathe through their mouth.

Jackie, from my reading it is interesting. ROS are can also be signaling molecutes and have postive benefits. It is all in context. Also beta hydroxybuterate (also can act as a signaling molecule) can reduce production of ROS.

All very interesting, But I don't fit the bill of CFS.

Per

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jonnyS

post on RBC vs Exatest (and an excellent one at that!) consuming Jigsaw SRT magnesium malate (time-release). This is the study the company quotes <[www.tandfonline.com] and they use RBC mag as their metric. I always test in the high 7's.

I also tested mitochondrial function through a company formed by Dr. Laslo Boros of UCLA and the lab they use. Results were not perfect, but not bad and did show improvement after an intervention lowering body deuterium levels.

Have many more questions than answers regarding cellular functioning, magnesium and my heart. Just know what emprically works for me to stay in NSR.

Cheers,

George

Amazing values George! Have you had a genetic test and analysis? Bet you are not an AppE 4/4
Doubt we could find anybody with that sort of determination/willpower? It's a lot more than i'd be able to manage.
Thanks for the detailed post - something to aim for

Nasal breathing: check out my friend Brian MacKenzie's work at Power Speed Endurance (not necessarily for athletes) and the Oxygen Advantage. Really good information that relates to ANS regulation and heart rate.

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Joe
Amazing values George! Have you had a genetic test and analysis? Bet you are not an AppE 4/4

3/4 married to a 4/4 actually. I posted about addressing this <[www.apoe4.info] . When I tested myself in 2014, I looked around and asked who has clinical experience with these SNP's? Turns out Steven Gundry in Palm Springs had been testing all his patients for ~15 years at that time. One of his observations is that saturated fat increases sdLDL & oxLDL in 4's. In the above link, there is a link to what we do address this. (I'm well aware Gundry has a supplement business - this is not what this is about. He is an excellent clinician. He considers us all voluntary participants in an ongoing study. Lastu summer, our labs went to 25 pages from 5 different companies. Many of the metrics are not commonly tested.) 4's are prone to inflammation. This is an issue with both heart and brain. Hence Gundry tests many inflammatory markers and we try to stay well in range on all of them. As a cardiologist and cardiothoracic surgeon, we've discussed my afib experiments. He thinks they are very interesting.

A disclaimer. A poster several weeks ago noted (without naming me) that much of what I do carries risk and are not supported by RCT's (randomized controlled trials). I concur., this is true. I am well aware of the risks I take and I investigate them thoroughly before taking those risks. For example, when I keto adapted 9.5 years ago, I knew that the process could disrupt my electrolytes and trigger an afib event. This did happen, once. I was willing to take the risk. Going from a 1000 watt heat lamp sauna to my 45 deg F bath caused runs of PAC's. I stood up and they went away. I rethought my process and started going in slowly into the cold water. I stand, then sit, then go in up to my neck without any issue.

If someone is on meds, the fasting can cause issues.

Quote
MadMax
Nasal breathing: check out my friend Brian MacKenzie's work at Power Speed Endurance (not necessarily for athletes) and the Oxygen Advantage. Really good information that relates to ANS regulation and heart rate.

I concur that Patrick McKeown's Oxygen Advantage is a great reference. I will look into Brian's work.

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MadMax
Without carbs I can stay out in the sun for long periods of time with no sunburn - and I'm paper white, fair-skinned.

Interesting. Per Dr. Gundry, I keep my 25OHD (vitamin D) level > 100 ng/nL. I knew that would help with the sun, didn't realize the lower carbs would also. Went in for my annual skin check by my dermatologist. He said my skin looks excellent. I told him I do the inverse of what his profession recommends - I stay outside as much as possible with no sunscreen and in as few clothes as possible. He told me it is obviously working and to keep on doing what I'm doing. I'm also fair skinned.



Edited 1 time(s). Last edit at 02/26/2019 07:31PM by GeorgeN.

George:

Does Dr. Gundry have any advice for Atrial Fib.?

Liz

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Elizabeth
George:

Does Dr. Gundry have any advice for Atrial Fib.?

Liz

Hi Liz,

My wife & I consult with Gundry for an hour. 4 or so weeks before our meeting we get our labs drawn. We also prepare documents for both of us that contain any other tests we've done in the prior six months, any supplements or drugs we are taking, how we specifically implement his diet and any other stuff we are doing. It is in this that I tell him what I'm doing for my afib. He thinks it is great and has never suggested I do anything different nor have I asked. He thinks I'm an entertaining patient. He's also friends with Mercola. Mercola has never suggested any other afib approach for me. In fact, both think my control and approach are outstanding. Our hour goes quickly with about 3/4 of it spent going through all the labs on each of us. Then we have prepared a series of other questions for him. I'm usually ripping through them with him. In fact my wife has chided me for not letting him take the lead at times. I just try to extract as much info as I can in the time allotted, and afib has never been a priority. We are focussed on the long game of how to maximize overall health span.

George.

Liz,

From my perspective, the controllable factors of CHA2DS2–VASc include:

diabetes
congestive heart failure
vascular disease
hypertension

I look at our program with Gundry as helping to keep these factors at bay.

By doing this, it helps mitigate the stroke risk of afib.

George

Glad you brought it up, George. They are always talking about chronological age which is only relatively relevant?
[www.youtube.com]
Is he wrong? I don't think so.

Forgot about your post on your ApoE status Wonder if your wife is keto adapted as well and how she is faring? Don't answer if this question is too intrusive.

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Joe
Wonder if your wife is keto adapted as well and how she is faring? Don't answer if this question is too intrusive.

Yes, we basically follow the same program. She fasts 16 hours a day & her mid-day meal is some nuts. Neither of us test ketones/glucose frequently as we really don't need to. We both tested immediately after having our blood drawn for our Gundry labs in January. She was 1.3 mmol/L beta hydroxybuterate, I was 1.0. If either of us do a 7-day water fast, our glucose drops fairly quickly into the 50's (mg/dL) and ketones > 4. Neither of us need to adapt. As I recall the lowest I've seen her blood sugar is 38 mg/dL and ketones in the high 7's. My lowest glucose sampled is 31 mg/dL and ketones 7.9 mmol/L.

Fasting is harder for her than me, which may be a sex difference. As I still lack a full frontal lobe at age 63 (maybe a male issue?), I'm much more likely to try many different things. Her labs also look excellent. She's run her A1c as low as 4.1%. She runs her blood pressure around 90/60.

George:

Thank you for both of your replies---I couldn't respond last night and only until now, my computer, T.V. and phone were all out. We had one heck of a wind storm, blizzard last night and it is cold, I don't see how you could go outside with just your shorts on because it is cold.


From my perspective, the controllable factors of CHA2DS2–VASc include:

diabetes
congestive heart failure
vascular disease
hypertension

I suppose some docs would say I have hypertension due to this new BP ruling. My systolic runs in the 130s and 140s, my diastolic is always good, I don't take any BP meds, don't have the other 3.

Liz



Edited 1 time(s). Last edit at 02/25/2019 09:05PM by Elizabeth.

Hi George,
Thanks for the post on the values of your wife's tests!
Looks like i would have lost betting on 4/4s not being suitable for keto adaption.
Must have gotten the wrong impression from listening to Peter Attia M.D. mentioning that some people aren't candidates for a keto diet like his friend, Zubin Damania, M. D. for example.

George:

Do you really think that the protocol that you are following is really healthy? If you are fasting and don't eat much, how does your body get enough nutrients?

Liz

Quote
Joe
Hi George,
Thanks for the post on the values of your wife's tests!
Looks like i would have lost betting on 4/4s not being suitable for keto adaption.
Must have gotten the wrong impression from listening to Peter Attia M.D. mentioning that some people aren't candidates for a keto diet like his friend, Zubin Damania, M. D. for example.

Haven't listened to that episode. I'm guessing what Attia may be referring to is that many who eat a keto diet, do it with a high saturated fat diet. Dr. Gundry's clinical experience is that this may be sub-optimal for E4's. This is because he's observed the high sat fat will increase sdLDL & oxLDL in E4's. The fat in our diet is primarily from mono's. You can see what is in it in the link below in my response to Liz.

Quote
Elizabeth
George:

Do you really think that the protocol that you are following is really healthy? If you are fasting and don't eat much, how does your body get enough nutrients?

Liz

Liz, we did a two week Cronometer.com study with a gram scale two years ago (as a beta tester for an engineer friend in Australia who was building an app).

Here are the results:

Item	Average	Minimum	Maximum
Energy (kcal)	2167.46	1800.55	2495.41
Carbs (g)	122.11	87.89	179.42
Fiber (g)	51.30	44.36	66.14
Protein (g)	52.04	34.61	69.84
Fat (g)	       175.04	142.54	212

My BMI is 24, I'm not a stick. I also pay attention to nutrient density. I pay attention to Bruce Ames' "triage theory" of nutrition <[www.bruceames.org] . Dr. Terry Wahls <[terrywahls.com] implemented Dr. Ames' idea by consuming high quantities of leafy veggies with 1/3 greens, 1/3 colored all the way through with at least 3 colors and 1/3 sulphur containing veggies as part of her program to put her very aggressive MS in remission. We eat this way choosing off Gundry's list (linked here <[www.apoe4.info] ) Also, all our lab results for 7 consults are linked also. A year ago we did DXA scans (bone density, fat, muscle). My T score was 0.3 - means my bone density is 0.3 standard deviations above a the mean for a 30 year old male (I'm 63). Also the fat level in my core and and all my limbs was at the 1% percentile for my age.

The list of all I ate over the two weeks (two week totals) is posted here <[www.apoe4.info]



Edited 3 time(s). Last edit at 02/26/2019 07:52PM by GeorgeN.

Lots of vegetables and a little fruit, I know you said you eat eggs but I don't see any meat listed, I thought you did eat meat. I wonder why it is that I have to eat meat to get my protein without it I have no energy. I do eat veggies and fruit but couldn't live on it. From what you have said you can do all that you do on what you eat is amazing.

Liz

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Elizabeth
Lots of vegetables and a little fruit, I know you said you eat eggs but I don't see any meat listed, I thought you did eat meat. I wonder why it is that I have to eat meat to get my protein without it I have no energy. I do eat veggies and fruit but couldn't live on it. From what you have said you can do all that you do on what you eat is amazing.

Liz

Hi Liz,

Per Gundry, because of our E4 status (and minimizing saturated fat), the animal protein we eat are eggs (omega 3 or pastured), shell fish and white fish. We don't consume dairy, pork, fowl, lamb, buffalo or beef. We limit our animal protein to around 20g/day (~a 4 oz serving) and two-three days out of seven are vegan. Gundry has us not eat grains, legumes, nightshades or seeded veggies (except by pressure cooking everything except grains and also skinning/seeding nightshades & seeded veggies). This is because he says these foods have lectins which we aren't adapted to. He told us he's gotten elderly folks off lectins and watched their serum protein increase without increasing the amount of protein, especially animal, that they eat. He's convinced it is a gut absorption issue (why elderly need to consume more protein). He knows Valter Longo & we chatted specifically about Longo's recommendation that those over 65 increase their protein by 10%. He doesn't think it is necessary if you fix the gut. Many of his fancy tests look at the gut and inflammation.

The lack of fruit (except avocados) is to minimize fructose. He said we could get a juicer, juice fruit, throw away the juice and eat the pulp (we haven't bothered).

I can't say Gundry is right, but our labs do look good.

I can also say that energy is not an issue for me. I skied 24,000 vertical feet on the steeps at Aspen Highlands before noon today, then went on a 3 mile hike with my wife who has a muscle injury that prevents her from skiing right now (she had a bad ankle sprain).

George, imagine if everybody decided to eat like you - Lots of hospital space could be used for low cost housing and doctors would have to get part time jobs
I can see the value in what you are doing but i am doubtful i could do it for any length of time. Managed keto for a few weeks but i like fruit too much. My longest fast (prior to AF) was 5 or 6 days which was ok. Not game to do it now because of fear of triggering AF and my BMI is 20
I do not eat for 14 to 16 hours in a 24 hr period. Fingers crossed it's enough for autophagy to kick in and some new cells after?
Also weary about fasting because of slightly high TSH.

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Joe
George, imagine if everybody decided to eat like you - Lots of hospital space could be used for low cost housing and doctors would have to get part time jobs
I can see the value in what you are doing but i am doubtful i could do it for any length of time. Managed keto for a few weeks but i like fruit too much. My longest fast (prior to AF) was 5 or 6 days which was ok. Not game to do it now because of fear of triggering AF and my BMI is 20
I do not eat for 14 to 16 hours in a 24 hr period. Fingers crossed it's enough for autophagy to kick in and some new cells after?
Also weary about fasting because of slightly high TSH.

We've had slightly high TSH and on our most recent labs, Gundry checked for anti-thyroid antibodies. These were negative and all our other thyroid values are in range. Hence he suggested we consume more iodine (he'd already put us on iodized sea salt) in the form of a few grams/day of spirulina.

On ketosis, a "feature" of E4's is lowered brain glucose utilization which can be seen decades before cognitive issues surface (even in the 30's). Dale Bredesen MD, of the Buck Institute and UCLA <[www.amazon.com] suggests mild ketosis for E4's as the ketones provide an alternative brain fuel that has a different utilization pathway. My wife and I can't tell the difference between serum beta hydroxybutyrate levels of 0.3 mmol/L and 7.5 mmol/L. However we know people who feel they need a level of at least 1.0 mmol/L to have their brains functioning well. One of my friends who is in this category is President of ApoE4.info, Julie Gregory. She has a BMI of 18. She started seeing cognition issues at before age 50, but reversed them. She now thinks she was "TOFI" (thin on the outside, fat on the inside - visceral fat) prior to changing her diet/llifestyle. She did drop weight from a BMI of 19 to 18. <[www.youtube.com]

Powerful presentation - thank you for the link!