Cholesterol/ApoB/LP(a) - Help!

[Liz927]

Hi everyone - nice to meet you all. I am a 50 year old APOE4/4 with limited symptoms currently. I just found this out in May of this year. My father died with Alzheimer's 2 years ago, but we did not know that at the time - it was during the autopsy that was confirmed.

We are very healthy eaters, have moved to more healthy fats than before and plan on going ketoflex in the New Year. I exercise daily. I have had a PET scan, no plaque. I was in a pre-clinical trial for Acumen, round 1 and dismissed due to a pTAU score of .09 - needed .15 to get into the study. There is not heart disease in my family that I am aware of. My calcium score from the summer is 0.

I need some assistance in terms of what medication to push for when I see my doctor on Monday. She is a functional medicine doc I have been seeing for hormones, but she is not an APOE4 expert. I plan on seeing a PreCode doc next year and my husband who is a chiropractor is currently getting Bredesen certification, but he still won't be able to prescribe. I have had high cholesterol for years and finally agreed to 5 mg of Crestor last year when my total cholesterol was over 250 and this was before I knew my APOE4/4 status. As a result of all the reading that I have been doing, I requested more tests - My very awful #s are below.

Thoughts? Suggestions on meds? I really don't want to increase the statin further because that little bit is giving me terrible foot and hand cramping. Thinking of requesting Zetia at a bare minimum. Not sure that insurance will pay for Nexlizet or a PCSK9 inhibitor. Thanks in advance! ~ Liz

ApoB 124
Lp(a) 249
LDL-P 1720
LDL-C 156
HDL-C 36
triglycerides 106
total cholesterol 211
HDL-P 22
small LDL-P 308
LDL size 22
Large VLDL-P 2.1
Small LDL-P 308
Large HDL-P <1.3
VLDL size 40.1
LDL size 22
HDL size 8.6
LP-IR 50

[JD2020]

Hopefully others who know much more than I will respond. I read The Great Cholesterol Myth. It lead me to research about pantethine. I recently posted about preliminary success.

viewtopic.php?t=9071

The book might provide ideas that resonate with you.

[Andrea Hamilton]

Hi everyone - nice to meet you all. I am a 50 year old APOE4/4 with limited symptoms currently. I just found this out in May of this year. My father died with Alzheimer's 2 years ago, but we did not know that at the time - it was during the autopsy that was confirmed.

We are very healthy eaters, have moved to more healthy fats than before and plan on going ketoflex in the New Year. I exercise daily. I have had a PET scan, no plaque. I was in a pre-clinical trial for Acumen, round 1 and dismissed due to a pTAU score of .09 - needed .15 to get into the study. There is not heart disease in my family that I am aware of. My calcium score from the summer is 0.

I need some assistance in terms of what medication to push for when I see my doctor on Monday. She is a functional medicine doc I have been seeing for hormones, but she is not an APOE4 expert. I plan on seeing a PreCode doc next year and my husband who is a chiropractor is currently getting Bredesen certification, but he still won't be able to prescribe. I have had high cholesterol for years and finally agreed to 5 mg of Crestor last year when my total cholesterol was over 250 and this was before I knew my APOE4/4 status. As a result of all the reading that I have been doing, I requested more tests - My very awful #s are below.

Thoughts? Suggestions on meds? I really don't want to increase the statin further because that little bit is giving me terrible foot and hand cramping. Thinking of requesting Zetia at a bare minimum. Not sure that insurance will pay for Nexlizet or a PCSK9 inhibitor. Thanks in advance! ~ Liz

ApoB 124
Lp(a) 249
LDL-P 1720
LDL-C 156
HDL-C 36
triglycerides 106
total cholesterol 211
HDL-P 22
small LDL-P 308
LDL size 22
Large VLDL-P 2.1
Small LDL-P 308
Large HDL-P <1.3
VLDL size 40.1
LDL size 22
HDL size 8.6
LP-IR 50

Hi Liz927
On behalf of the support team and the entire ApoE4 forum, I want to welcome you to our community! I'm so sorry to hear about your father's passing with Alzheimer's, but good to hear you have limited symptoms at this stage.

It sounds as if you are being extremely proactive on many fronts - diet, exercise, labs, consultations with your functional practitioner. These significant lifestyle changes and efforts on your part are sure to move the needle for you and be protective given your ApoE4/4 status. The fact that you have no coronary plaque is no doubt in part due to your heart healthy diet. The fact that your husband is getting certified in Bredesen's PreCode program is amazing. How wonderful to have that support.

I hope you will also find people here at the forum can also be powerful allies in your health journey. In fact, that is what this website is all about. You are absolutely not alone in having "awful numbers". Like JD2020 has already done, people will likely share information about their experience with being healthy while having bad numbers. While they aren't what you wanted to see, it's great that you HAVE the numbers to refer to and are in a position to use that knowledge as a motivator!

One thing you might consider is consulting a cardiologist in addition to your functional medicine practitioner; according to a colleague here your insurance may cover a drug specific to your Lp(a) risk.

It looks like you joined the forum some months ago, but in case you haven't had a chance to explore it, the How-To Guide includes topics such as navigating the forum, private messaging, and searching. One great tip is using the quote (") button when replying to a post. Using the button will automatically alert the member of your response.

You can read about other members' experiences and post your own on Our Stories.

You can browse a wealth of information in both the Wiki and also the Primer , which is a detailed and informative resource written by a practicing M.D. with ApoE4/4.

I hope you find the information and support you need from this community! I have no doubt you will see more members respond to your specific questions about medications. Please reach out if you have any further questions.
Andrea

[floramaria]

I need some assistance in terms of what medication to push for when I see my doctor on Monday. She is a functional medicine doc I have been seeing for hormones, but she is not an APOE4 expert. I plan on seeing a PreCode doc next year and my husband who is a chiropractor is currently getting Bredesen certification, but he still won't be able to prescribe.

HI Liz927, It is great that you are seeing a functional medicine doctor who is helping you with hormones. As for “what medicines to push for” when you see your doctor, I am not qualified to answer that. But I think you are well-positioned to get expert help and advise soon. Once you have a PreCODE Report and are seeing a PreCODE doctor, that doctor will have enough information to evaluate your condition and recommend appropriate supplements and/or medications. Your husband becoming ReCODE certified will give you another expert on your team.

[er21]

Sorry to hear about your father but happy to hear you're getting started with a PreCODE doc soon. Speak to your doctor first, but if you're on a statin and experiencing these cramping feelings, supplementing with CoQ10 can be beneficial. These symptoms often signal CoQ10 depletion, as statins do.

Speak to your doc, but you may find that with dialing in KetoFlex 12/3 (Bredesen Protocol) for 4/4's, your cholesterol labs may optimize without the statin. Red Yeast Rice could be a natural alternative without a lower side effect profile. Hope this helps!

ER