Interesting talk by Dr. Kellyanne Niotis on APOE4, lipidology, and preventive neurology

[anonna]

Wanted to share this recording of the talk Dr. Kellyanne Niotis recently gave to a group of lipidologists on preventive neurology and targeting APOE4. Would be interested to hear anyone's thoughts.

https://www.lipid.org/media/journalclub/selaspeaks04/

[TheresaB]

Wanted to share this recording of the talk Dr. Kellyanne Niotis recently gave to a group of lipidologists on preventive neurology and targeting APOE4. Would be interested to hear anyone's thoughts.

https://www.lipid.org/media/journalclub/selaspeaks04/

Thank-you for sharing and welcome. I look forward to listening to this. I've been interested in Dr Kellyanne Niotis since this Dr Peter Attia interview with her #236 ‒ Neurodegenerative disease: pathology, screening, and prevention | Kellyann Niotis, M.D. which you might also find interesting.

[anonna]

Yes, that interview on Attia's podcast is how I first learned of her. My primary care doctor is eager for me to go on a statin due to elevated cholesterol, but she does not know anything about APOE4 so I am trying to equip myself with more information. This site has been very useful. I am 3/4, female, mid-40s, with a strong family history of both hyperlipidimia and neurodegenerative disease (including my mother's recent death with Alzheimer's). So much of what she discusses in this talk is quite relevant to me and I thought it might be of interest to others.

[NataliaReyn]

Wanted to share this recording of the talk Dr. Kellyanne Niotis recently gave to a group of lipidologists on preventive neurology and targeting APOE4. Would be interested to hear anyone's thoughts.

https://www.lipid.org/media/journalclub/selaspeaks04/

Hello, anonna!

So good to have you here and thank you so much for sharing this with us!
I am one of the Support Team Interns here on the website and would love to officially welcome you since it looks like you have joined us very recently. I can share a few tools/resources to help you get the most out of your experience on the forums.

The Primer is a detailed and informative resource written by a practicing M.D. with ApoE4/4. It includes information about the biochemistry of the ApoE4 gene and offers a variety of research-based prevention strategies.

Some helpful tips to navigate the site include the How-To Guide. It includes topics such as navigating the forum, private messaging, and searching.

If you are interested in learning more about other members check out Our Stories.

Two more tips to improve your experience here:

• If you want to Search for posts on a specific topic, you can use the text box labeled "Search" right under your user name and enter those specific terms.

• To be sure a forum member is notified of your post, just click use the large quotation mark icon in the upper right corner of they post.

Also, I just wanted to say I am so sorry to hear about your mom. I am curious if you feel that you have enough support while you are grieving and looking for answers for you own health concerns. This website can certainly be a great way to connect with individuals with similar stories and we do our best to share what we learn in hopes that it will be helpful to someone else. Also, I am not suggesting you find a new provider but we do have a list of ApoE4-Aware Healthcare Practitioners
should you ever need to expand your care team or simply have a second opinion since you mentioned your provider wants you to start statins. If you ever need a trained Health Coach to support you on your journey to better health (and brain health) or simply someone to help you with accountability and achieving your goals, we have a list of ApoE4-Aware Health Coaches on WIKI as well.
I also just want to acknowledge your love of learning, curiosity and courage to name a few since you said you are trying to gather more information and that's a great first step when we are working to improve our health and focus on prevention. There is so much we can do and there are so many tools and resources available if you need them =)

Again, I am so glad you joined our forum. I look forward to hearing from you in the future. Please feel free to reach out anytime.

Warmly,
Natalia

[SarahB]

Thanks for posting this very interesting talk, science based with actionable tips. Very appreciated. I'd like to hear more from her.

[TheresaB]

Thanks for posting this very interesting talk, science based with actionable tips. Very appreciated. I'd like to hear more from her.

I agree with you that this is a very interesting talk. You said you'd like to hear more from her. Just in case you didn't see my comment above, Dr Peter Attia conducted an interesting interview with Dr Niotis that you can listen to at this link: #236 ‒ Neurodegenerative disease: pathology, screening, and prevention | Kellyann Niotis, M.D.

[TLS]

I am interested to hear if anyone on this site is getting their desmosterol levels checked based on her notes that if it is really low that can be concerning.

[frankiesfriend]

Thank you for posting the link to this very interesting webinar. In response to your question,

I am interested to hear if anyone on this site is getting their desmosterol levels checked based on her notes that if it is really low that can be concerning.

I had my sterol levels measured after listening to an interview of Thomas Dayspring on Simon Hill's Podcast, The Proof. I was happy with the results showing that my moderately high cholesterol is due to over absorption rather than over production, which meant to me that a statin would probably not benefit me.

However, this webinar leads me to think otherwise about the low desmosterol status, as she indicates that low cholesterol production (marked by low desmosterol) is noted in MCI and AD biomarker profiles. Dr. Niotis stated that both low absolute desmosterol and low desmosterol/cholesterol ratios are associated with higher AD. In my case, the absolute desmosterol seems similar to that shown on her slide as a "high" (and I suppose good) number to have if you are an APOE4 carrier. But my report shows that while my Absolute desmosterol is 1 mg/dL, the desmosterol/cholesterol ratio is 0.4, which is low. Thus, the absolute desmosterol is not low, (I guess...possibly?), but the ratio is.

I could take ezetimibe to inhibit absorption. She didn't mention that specifically as a method to increase production, but I wonder if that would be the result. I have resisted this because I worry that the inhibition of cholesterol uptake would not be specific enough, and that I would have impaired absorption of important nutrients. I go out of my way to avoid cholesterol in the diet, but that is clearly not good enough because my Total Cholesterol and LDL are always moderately elevated, although Triglycerides are low and HDL is high.

I have attached my Boston Heart Lab sterol test result. Anyone may feel free to comment, as I am not sure what to do with this information now.

Cholesterol producer-absorber.pdf

[TLS]

Thank you for posting the link to this very interesting webinar. In response to your question,

I am interested to hear if anyone on this site is getting their desmosterol levels checked based on her notes that if it is really low that can be concerning.

I had my sterol levels measured after listening to an interview of Thomas Dayspring on Simon Hill's Podcast, The Proof. I was happy with the results showing that my moderately high cholesterol is due to over absorption rather than over production, which meant to me that a statin would probably not benefit me.

I could take ezetimibe to inhibit absorption. She didn't mention that specifically as a method to increase production, but I wonder if that would be the result. I have resisted this because I worry that the inhibition of cholesterol uptake would not be specific enough, and that I would have impaired absorption of important nutrients. I go out of my way to avoid cholesterol in the diet, but that is clearly not good enough because my Total Cholesterol and LDL are always moderately elevated, although Triglycerides are low and HDL is high.

I am no expert in this area but have heard about plant sterols before. From what I understand, Sisterol levels are from plant sterols. Examples include avocados, nuts and seeds. There are two main genes to review: ABCG5 and ABCG8. Did your doctor mention changing your diet at all before trying a drug? Here is a link to an article that describes sitosterolemia https://www.learnyourlip ... terolemia/ you may want to read to see if it resonates with you.

[frankiesfriend]

[/quote]

I am no expert in this area but have heard about plant sterols before. From what I understand, Sisterol levels are from plant sterols. Examples include avocados, nuts and seeds. There are two main genes to review: ABCG5 and ABCG8. Did your doctor mention changing your diet at all before trying a drug? Here is a link to an article that describes sitosterolemia https://www.learnyourlip ... terolemia/ you may want to read to see if it resonates with you.
[/quote]

Thank you for suggesting sitosterolemia as worth considering. I don't believe I have that since I have none of the symptoms, and my cholesterol is elevated about 20% over "normal", not ten times normal. However, I do eat a mostly plant diet with plant sterols, and that is something that is worth my looking at more closely.

In general, I am confused about the connection between the peripheral and central cholesterol regulation. In her talk, Dr. Niotis stated that they are regulated separately, yet the plasma desmosterol/cholesterol ratio is shown to be one biomarker for AD. I am unsure if anything I do to change that ratio (by inhibiting absorption in my case) would make any difference in the CNS regulation of cholesterol, or if I just live with knowing there is another biomarker that is pushing me down the path toward disease.

I am going to write Dr. Niotis with my question, and I will post any reply I might get.

Thanks again!