Our first guest: Dr. Thomas Dayspring...

[marthaNH]

Thank you. I think your attitude is very sensible. I won't be surprised to see myself doing the same once I've got a little more data on how my blood sugar is behaving.

[Stavia]

Thank you. I think your attitude is very sensible. I won't be surprised to see myself doing the same once I've got a little more data on how my blood sugar is behaving.

Actually........thinking it through....the life of an LDL particle is 3 days. So one could fast for 3 days and do an apob and this will measure what is being synthesised by the liver and reabsorbed. So the difference between apob in a fed state and in a 3 day fast state would reflect the contribution of absorbed sterols - both phytosterols and cholesterol. Because the contribution of dietary cholesterol is 15%ish, you could allow for this, and if there is a difference in apob this would be the phytosterols?
Yes?
No?
Hmmmm

[marthaNH]

You lost me at "3 day fast."

[SusanJ]

Stavia, many thanks for working through this for all of us. I haven't had much time lately to devote to these deep dives, but I did find a couple of interesting pages that might help people figure out if this might be a problem for them without doing a test.

Researchers know that sitosterolemia (elevated plasma levels of plant sterols due to increased intestinal absorption and reduced biliary secretion of neutral sterols) "is related to mutations in either of the two ATP-binding cassette (ABC) half-transporters. ABCG5 or ABCG8."
http://www.ncbi.nlm.nih.gov/pubmed/1464 ... t=Abstract

SNPedia lists the mutations on these transporters and their effects on LDL, HDL and TGs:
http://snpedia.com/index.php/Rs6756629

I looked at the snps for higher LDL, and found that I am either hetero or homozygous for several. And it makes sense since my dad (presumably the source of my e4) had a heart attack in his 60's, and both my parents had gall bladder problems. Some of these snps might also help explain my higher HDL levels.

This makes me want to get the test done and I've pinged my doctor, so hopefully I can get it when he orders the tests needed for the Bredesen study. This feels very important for me to know and might help me figure out why my lipids went south last fall with a change in diet.

[Julie G]

Add my thanks to the list AGAIN, Stavia. I greatly appreciate you breaking it down. I clearly hyperabsorb SOMETHING as my LDL rose dramatically when I shifted to a higher fat diet. By knowing whether I'm responding more dramatically to cholesterol OR plant sterols, I should be able to tweak and improve numbers...

Thanks also, Susan. I love a good SNP dive to improve my health

[Tincup]

Actually........thinking it through....the life of an LDL particle is 3 days. So one could fast for 3 days and do an apob and this will measure what is being synthesised by the liver and reabsorbed. So the difference between apob in a fed state and in a 3 day fast state would reflect the contribution of absorbed sterols - both phytosterols and cholesterol. Because the contribution of dietary cholesterol is 15%ish, you could allow for this, and if there is a difference in apob this would be the phytosterols?
Yes?
No?
Hmmmm

Extending - how about having a vegan, a no phytosterol/all ghee (cholesterol) and a fasted (all at least 3 day) fed state for comparison...

[Stavia]

Actually........thinking it through....the life of an LDL particle is 3 days. So one could fast for 3 days and do an apob and this will measure what is being synthesised by the liver and reabsorbed. So the difference between apob in a fed state and in a 3 day fast state would reflect the contribution of absorbed sterols - both phytosterols and cholesterol. Because the contribution of dietary cholesterol is 15%ish, you could allow for this, and if there is a difference in apob this would be the phytosterols?
Yes?
No?
Hmmmm

Extending - how about having a vegan, a no phytosterol/all ghee (cholesterol) and a fasted (all at least 3 day) fed state for comparison...

Feel nauseous at the thought of it but ok....
Actually I'd rather fast

[Tincup]

Stavia,

I'm having a blood draw on Tuesday for a consult with Dr. Gundry. His panel request is more extensive than anything I've ever done by many multiples. A huge emphasis on inflammation, but many other areas of inquiry. I relistened to his January podcast/interview. Not oxidizing LDL is an emphasis of his vs. pure lipid levels (though he tests for many different fractions), though I don't see that specific test requested (oxLDL). Julie's oxLDL results were stellar as are the cardiac results Gundry published. I'll be interested to see my results, as well as his interpretation. My scheduled consult isn't till the first part of July, however they said once my results are in, they'd put me on the list for an earlier slot.

[Stavia]

Very interesting George. Can't wait to hear what he says.
Good luck! Let us know what your results are.

[Gilgamesh]

Dr. Dayspring,

Jumping in very late (I've been on a sabbatical of sorts, to which I'll be returning later today) just to thank you for your participation here.

Beyond the extremely useful content of what you've provided, I especially appreciate -- and I think many of us here feel the same way -- the simple fact that you've been willing to share complicated research details with us, which manifests a kind of respect not often seen in physicians or researchers. It drives us up the wall to approach a researcher with a question, and get a response of the form: "Sorry, we simply don't know." Period. Or, "No Cochrane Review has been done, so we'll have to wait." There are plenty of states of knowing between utter ignorance and utter certainty. We are trying to make decisions based on all the information out there, and you have shown us an unusual degree of respect in sharing so many research findings, along with your own speculation about them. It is very much appreciated. It will make our decisions -- it obviously already has! -- about prevention significantly more informed, and could very well save a few lives (or at least brains!).

Best,
GB