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My Story and disappointed in CAC scan report from Adventist Ukiah.

Member Forum >> Coronary Disease & Cholesterol Protocol >> My Story and disappointed in CAC scan report from Adventist Ukiah.

docmaas

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Posted: 9/18/2020 3:14:00 AM
 
Not the numbers necessarily but the quality of the report is abysmal when compared to the one from Budoff in 2017.  Ukiah is a small town and my suspicion is that they are offering the test without understanding why someone might want it.  I got the test through the VA.  I’ll probably go back to Budoff or Sinai or some other more sophisticated source if I do it again.

My score with Budoff 2/27/2017 (see attached pdf) was 560 total which he characterized as average for my age and gender.  The latest report from 8/24/2020 is scored at 778 which for progression works out to about 10%/year.  Would I have preferred regression or at least standing still?  Yes of course but when I think of the 25% increase/year estimation this doesn’t look so bad:

25%/year calculation:                              10%/year calculation
02/17/2017         560                               560
02/17/2018         700                               616
02/17/2019         875                               678
02/17/2024       1094                               746  (6 months later 778)

My Story:

I was dx’d with T2D 2014 and immediately started trying to avoid carbs.  In April of 2015 I started regular consumption of Berberine.  In the meantime I also took up swimming for the first time since I got out of a pool 50 years ago.  I made lots of slip-ups in my diet but my a1c continually declined over that period of time from 7.0 at diagnosis to 5.3 in July of 2019.  In 2019 I dropped the berberine and my a1c rocketed back up to 6.3 in just 2-3 months and this while I was even more attentive to carb avoidance.  For me, Berberine worked.

One thing I could never shake though was what is called "delayed reactive hypoglycemia" and Berberine was useless in stemming my initial glucose rise -- that largely turned out to be true for Metformin as well as I learned early this year.  My understanding is that is the when blood glucose exceeds 140 is when the most damage occurs and I would hit that even with minimal carb consumption of either high glycemic foods like potstickers and noodles and sourdough and the occasional furtive piece of candy.  Green vegetables and meats I could handle but fruits and simple carbs both sent my glucose sky high.

While T2D is a big contributor to my plaque issues, an even bigger one is a genetic trait or polymorphism called variously Leu162Val, L162V or rs1800206 of which I was blissfully unaware until I got my 23&me results and found it on Promethease.  It’s fairly rare appearing in only 2-4% of the various populations I’ve seen, most from Northern Europe.  It basically deactivates or blocks PPAR alpha which is responsible for fat metabolization in the liver.  Fibrates work well as agonists of PPAR alpha as do some other medicines and supplements including astaxanthin, gamma linoleic acid, pterostilbene, Arjunolic Acid and other PUFAs including fish oil.  In the Framingham study it was found that normal leu162leu subjects had worse lipids with PUFAs while those with the polymorphism had better lipids with PUFA supplementation.  Interestingly statins are also agonists for PPAR alpha though their side effect profile of muscle pain/cramping is not shared by the fibrates and the way they work.  There are also hints that small dense ldl may not benefit from statins for those with the Leu162Val.  Between this polymorphism and heterozygous apoe3/4 lipids have always been a problem.  Unfortunately it went unrecognized for most of my life. 

Early this year I joined Undoctored.  It took me a while to realize that Diabetes was not a disease that could simply be ameliorated but rather required a significant lifestyle adjustment or even a radical change.  I finally managed to kick the carbs to curb and am now almost a carnivore.  I eat green salads and leafy green vegetables along with some low glycemic vegetables.  I’m eating red meat and fish for protein along with some soybean or black bean protein pasta on occasion.  No wheat/grain products and am taking all the suggested supplements to include 7g/day of fish oil, both Magnesium glycinate and taurate as well as the magnesium water, 5000 iu Carlyle D3, Patricks Komplete K 2x/day, Ubiquinol, a methyl B supplement (homozygous for A1298C), Benfotiamine, 4g Vitamin C, Green Tea polyphenols. 2-3 oz evoo/day and AREDS2 for eyesight.  I eat a lot of saturated fat as yogurt (made from 1/2&1/2) and cheese.  I need to get a better understanding of the impact of saturated fats with the L162V.  Historically they have been warned against but I’m not sure what their status is in view of the evolving understanding of lipidology. 

Right now I’m focused on increasing my fish oil to see if that will impact my small ldl which is very resistant to all the changes I’ve made up to now.  On a day to day basis my fbg is almost always below 90 and very seldom above 100.  My last a1c was 5.3.  While I am interested in keeping it low I long ago read a (iirc) Danish study that correlated all cause mortality to a1c and found a sweet spot above 5.0 on a U shaped curve where those both lower and higher began to have increased risk the further they went in either direction.  I think it was a link from Jenny Ruhl. 

Here is the latest report, scant as it is, from Ukiah Adventist.  I plan to send the Dr. who did the report a copy of my report from Dr. Budoff and request that she look again at the results and create a similar report. 


And here is the 2017 Report from Dr. Budoff:
Calcium scan 02271017 Budoff Maas_Michael .pdf
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Bob Niland

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Posted: 9/18/2020 10:17:22 AM
 
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Posted: 9/18/2020 3:31:17 PM
 
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Bob Niland

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Posted: 9/18/2020 9:24:55 PM
 
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Bob Niland

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Posted: 9/19/2020 8:59:09 AM
Edited: 9/19/2020 9:01:00 AM (1)
 
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Posted: 9/19/2020 1:24:00 PM
 
Thanks for that analysis. 

Mike


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