Ketosis for APOE ε4s

Insights and discussion from the cutting edge with reference to journal articles and other research papers.
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Brian4
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Re: Ketosis for APOE ε4s

Post by Brian4 »

Julie G wrote:Dr. Bredesen's recommendation to use our KetoFLEX 12/3 diet + long daily fast + daily exercise is for those who are experiencing either insulin resistance or symptoms of cognitive decline with ketosis as a short term goal and restoration of metabolic flexibility as the longer term goal. That said, it's not a bad plan for anyone.
Totally agree. And by the way, what an excellent, easy-to-follow health plan! (Sorry I missed the event yesterday – couldn't move my other meeting. :( .)

And another "by the way": I'm impressed and delighted by how much has been happening around here while I've been buried in work with RaDVaC (an open-source SARS-CoV-2 vaccine project). Kudos to you and this amazing group.

Brian
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Julie G
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Re: Ketosis for APOE ε4s

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And another "by the way": I'm impressed and delighted by how much has been happening around here while I've been buried in work with RaDVaC (an open-source SARS-CoV-2 vaccine project). Kudos to you and this amazing group.

Brian
Thank you for your kind words, my friend. By working with our terrific team, we've all come a long ways. Of course you're tackling another major health challenge facing humanity. ;) I look forward to learning more about your latest project. -xo
MiniJunkie
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Re: Ketosis for APOE ε4s

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I spent 4-5 months on a Keto diet - at the time it was to lose weight, get pre-diabetes in check, and theoretically to be part of an anti-Alzheimer's regime :) I did lose quite a lot of weight, and felt better in general. Since then, I've fallen off the wagon...I still eat low-carb, but don't count carbs or "try" to achieve Ketosis.

My question is: when researching and partaking in the Keto diet, I got the impression there's no "mild" Ketosis - you are either in it, or not. Is that incorrect?
49M, married with 3 kids, my mother has advanced Alzheimer’s, and I am 4/4
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Tincup
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Re: Ketosis for APOE ε4s

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MiniJunkie wrote:My question is: when researching and partaking in the Keto diet, I got the impression there's no "mild" Ketosis - you are either in it, or not. Is that incorrect?
A few thoughts.

There are a number of ways to get into ketosis, including restricting carbohydrates, fasting & exercise. For example, Dr. Peter Attia recounted when he was exercising like a fiend, he could consume something like 600 g of carbs/day and still be in ketosis.

I've been "keto adapted" since 2009. I've had periods of time where I was consuming up to 180 g carbs a day and would test > 0.4 mmol/L BHB (beta hydroxybutyrate) on a morning finger stick test.

Virta Health is medically prescribed keto diet coaching for T2 diabetes remission. Their data suggest that people will present with lower BHB after having been on a keto diet for an extended period of time, presumably the body gets better at using BHB, so less floating around.

I've never "unadapted" in 12 years. If I start an extended fast, my glucose just drops and my ketones increase, with no "keto flu" symptoms. In my case, once the "machinery" turned on, it never turned off. This may be individual. The only way to tell would be to test.

Mark Mattson, PhD used to run a lab at the NIA (National Institute of Aging) and has studied this for many years. In this several year-old podcast, he notes that even BHB levels as low as 0.2 mmol/L are material.
Mark Mattson: It turns out there's two phases of ketone production that occur. As soon as the
glycogen source in the liver are depleted, you get an increase from way down,
below micromolar levels up to about two to 300 micromolar. They stay up in
that level for between 10 up to 24 hours, and then there's a second bigger
increase in ketones, where they go up into the millimolar levels.
Dave Asprey: That's over what timeframe was the second spike?
Mark Mattson: Beginning about 24 hours of complete fasting. My ketone levels, in the late
morning, I get up to around the two to 300 micromolar level. Then actually, I
haven't measured them after exercise, I should. I'm expecting to go up getting
closer to the one millimolar level or above during the exercise. I think a lot of
people will find that if they use the ketone strips, even after 12, even 16 hours
of fasting. They may look and say, "My ketones aren't up at all," but probably
they are up. It's just below the lower limited detection of those ketone strips.
Source p 17.

So there is my two cents...
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Re: Ketosis for APOE ε4s

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Brian4 wrote:Anyway, I know a lot of people here think that ketosis can help APOE-ε4s. Can someone explain why? The more reasons I have for continuing to eat like a chipmunk, the better.
Brian, I can think of a number of reasons why 4/4s should be in ketosis. 4s are able to metabolize ketones better than 3s, so it serves as a secondary brain fuel and keeps neurons from dying. Ketones burn cleaner than glucose and are less oxidative, so better for many things in the brain and the Blood Brain Barrier (BBB). This is especially critical for anyone with metabolic syndrome who have greatly fluctuating blood sugars; the high sugars result in quick neuron damage, while the low sugars lead to long term neuron damage. The only protection the brain has is to desensitize the BBB to glucose, blunting the highs, but leading to slower damage over time.

I'm also a study of n=1. I've gone down a 6 year road of stricter low carb. A long term T2D and a brain stem stroke 7 years ago that resulted in my diabetic meds to no longer work led me to start this journey. At first I noticed much less swings in my sugars, resulting in much less brain fog and greater ability mentally. I also started walking much more and weight training with a PT. Overall health improved - lost weight, better eyesight and gums. The only thing that did not improve was my A1c, with my levels staying in the 9s. I went to an extreme low carb diet (~10 gr/day) and saw my ketones go from the .5 - 1 range to the 1.5 - 2.5 range, only to see my A1c hit 10 for the first time. I believe that I'm a special case because of my stroke. I think for most T2D this would have cured their T2D / Metabolic Syndrome. It's a different story, but I did an experiment on myself and dropped my A1c down from 10 to 6.7 in 6 months, confirming my belief that I was no longer a normal T2D.
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Brian4
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Re: Ketosis for APOE ε4s

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I've never "unadapted" in 12 years. If I start an extended fast, my glucose just drops and my ketones increase, with no "keto flu" symptoms. In my case, once the "machinery" turned on, it never turned off. This may be individual. The only way to tell would be to test.
Hey Tincup. That's been my experience as well. I recently completed a five-day fasting-mimicking diet, and around 36 hours into it, my ketones were measuring 5–8 mmol/L (8 was an outlier though), and my glucose was 41–47 mg/dL. I felt great.

For me, my fairly tight eating window (front-load food intake, start 3 hours after waking, take last bite of a light meal 9–9.5 hours after waking) means the machinery never "gets out of shape". It does get a respite after my heavy breakfasts (which are not ultra–low carb), but then needs to kick into gear again that same evening.

Brian
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