Eztemibe reduced LDL but not ApoB

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spokanecathy
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Eztemibe reduced LDL but not ApoB

Post by spokanecathy »

Hi everyone,
I took the Boston Cholesterol Balance test and discovered I'm a big hyperabsorber but normal producer of cholesterol. Since my LDL particle account was over 1,600, I decided to take Ezetimibe. The drug dropped my LDL from 192 to 115, but my Apob remained unchanged at 125. I'm confused about why this happened and can't find any information in the literature to explain this. By the way, my HDL remained high at 97. I am insulin sensitive with an IR score of less than 25 and TG of 70. I'm wondering if the Apob count consists of VLDL particles; however, if that's the case, I'm not sure how to reduce them.

To address my hyperabsorption of plant sterols, I only eat 1/2 avocado twice per week. I also gave up pistachios, cut back on macadamia nuts, and just eat one Brazil nut per day. I'm also wondering if I should completely give up eggs. I'm using a little coconut cream in my coffee each morning and wondered if that's worse than just using half and half. I know I should drink my coffee black, but coffee is one of the greatest pleasures of my life, so I'd rather give up anything else but my "creamer." :lol: Have any hyperabsorbers out there figured out which foods increase your ApoB? Would half and half be a lesser evil than coconut cream in my coffee since I absorb plant sterols? Thanks in advance for any wisdom you can share!
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SusanJ
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Re: Eztemibe reduced LDL but not ApoB

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spokanecathy wrote:Have any hyperabsorbers out there figured out which foods increase your ApoB?
Coconut products always raise my lipid numbers. Can't speak to dairy because I can't eat it without problems. I switched from coconut milk to flax milk (Good Karma, unsweetened) with good results. It might be worth a try.
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Re: Eztemibe reduced LDL but not ApoB

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spokanecathy wrote: Fri Jun 02, 2023 5:53 am To address my hyperabsorption of plant sterols, I only eat 1/2 avocado twice per week. I also gave up pistachios, cut back on macadamia nuts, and just eat one Brazil nut per day.
Hi spokanecathy,

Our doc tested us in 2015 and as I wrote in this post
Desmosterol – both (my E4/4 wife & I) are hyper manufactures of cholesterol
Sterol absorption – both are hyper absorbers – so should not take plant sterols to lower cholesterol, can be detrimental."

He told us that eating plant food would not be an issue, only taking the sterol supplements.
Here is a search on
plant sterol
for our site. There is a fair amount of historical discussion.
Tincup
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Re: Eztemibe reduced LDL but not ApoB

Post by Jane S »

spokanecathy wrote: Fri Jun 02, 2023 5:53 am Hi everyone,
I took the Boston Cholesterol Balance test and discovered I'm a big hyperabsorber but normal producer of cholesterol. Since my LDL particle account was over 1,600, I decided to take Ezetimibe. The drug dropped my LDL from 192 to 115, but my Apob remained unchanged at 125. I'm confused about why this happened and can't find any information in the literature to explain this. By the way, my HDL remained high at 97. I am insulin sensitive with an IR score of less than 25 and TG of 70. I'm wondering if the Apob count consists of VLDL particles; however, if that's the case, I'm not sure how to reduce them.

To address my hyperabsorption of plant sterols, I only eat 1/2 avocado twice per week. I also gave up pistachios, cut back on macadamia nuts, and just eat one Brazil nut per day. I'm also wondering if I should completely give up eggs. I'm using a little coconut cream in my coffee each morning and wondered if that's worse than just using half and half. I know I should drink my coffee black, but coffee is one of the greatest pleasures of my life, so I'd rather give up anything else but my "creamer." :lol: Have any hyperabsorbers out there figured out which foods increase your ApoB? Would half and half be a lesser evil than coconut cream in my coffee since I absorb plant sterols? Thanks in advance for any wisdom you can share!
Hello spokanecathy!

With your interest in learning, putting the bits of info together, and implementing it in your life, you sound like someone who will love exploring the forum!

Here's a link to a 2022 article AHA Journal article that notes that high ApoB can result from causes outside of LDL, including high triglycerides and insulin resistance. Since you've ruled those out, you might want to consider a simple blood test for Lp(a). Lp(a) tends to be highly inherited and far less affected by diet, so maybe that creamer in your coffee is fine.

Most of the research on lowering this has been in people who have already had a heart attack ("secondary prevention"), so it's not clear yet what the long-term benefit of aggressive treatment for those with overall good IR and LDL scores would be. All this is a good topic to discuss with your doctor.

As a Support Team Intern, I'd like to welcome you to the forum. I'll share some tools/resources you can use to explore the site, helping you get the most out of your experience.

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. One great tip is using the quote (") button when replying to a post. Using the button will automatically alert the member of your response.

If you are interested in learning more about other members, you can check out Our Stories. And you can a bit about your journey there, too, if you'd like.

I'm so glad you joined and look forward to meeting up with you in future posts. Please feel free to reach out anytime.

Take care.

Jane
-- Jane --
(daughter, granddaughter, and niece of people who lived with Alzheimer's)
Functional Medicine Certified Health Coach
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spokanecathy
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Re: Eztemibe reduced LDL but not ApoB

Post by spokanecathy »

Thank you for that information, Jane! I will explore all of those resources.

I should have mentioned in my original post that my Lp(a) is 36.5. I'm starting to think that perhaps the lab test results were wrong because if my Lp(a) is low and I'm insulin sensitive, there isn't any logical explanation (that I can think of) for the discordance between my LDL-C and Apob. I think I will retest and see what happens! (I used a home cholesterol test kit that perhaps wasn't the most accurate.) Thanks!
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Re: Eztemibe reduced LDL but not ApoB

Post by spokanecathy »

SusanJ wrote: Fri Jun 02, 2023 9:47 am
spokanecathy wrote:Have any hyperabsorbers out there figured out which foods increase your ApoB?
Coconut products always raise my lipid numbers. Can't speak to dairy because I can't eat it without problems. I switched from coconut milk to flax milk (Good Karma, unsweetened) with good results. It might be worth a try.
Thank you, Susan! I would not have considered flax milk and will give it a try!
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Re: Eztemibe reduced LDL but not ApoB

Post by spokanecathy »

SusanJ wrote: Fri Jun 02, 2023 9:47 am
spokanecathy wrote:Have any hyperabsorbers out there figured out which foods increase your ApoB?
Coconut products always raise my lipid numbers. Can't speak to dairy because I can't eat it without problems. I switched from coconut milk to flax milk (Good Karma, unsweetened) with good results. It might be worth a try.
Thank you, Susan! I would not have considered flax milk and will give it a try!
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Re: Eztemibe reduced LDL but not ApoB

Post by spokanecathy »

Tincup wrote: Fri Jun 02, 2023 10:51 am
spokanecathy wrote: Fri Jun 02, 2023 5:53 am To address my hyperabsorption of plant sterols, I only eat 1/2 avocado twice per week. I also gave up pistachios, cut back on macadamia nuts, and just eat one Brazil nut per day.
Hi spokanecathy,

Our doc tested us in 2015 and as I wrote in this post
Desmosterol – both (my E4/4 wife & I) are hyper manufactures of cholesterol
Sterol absorption – both are hyper absorbers – so should not take plant sterols to lower cholesterol, can be detrimental."

He told us that eating plant food would not be an issue, only taking the sterol supplements.
Here is a search on
plant sterol
for our site. There is a fair amount of historical discussion.
Thank you for those links! I appreciate the wealth of information you shared.
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Re: Eztemibe reduced LDL but not ApoB

Post by spokanecathy »

Hi everyone, I thought I would update my post since my recent lab test results show I finally decreased my ApoB to 80 (from 125 in March). Hooray! My LDL also dropped further from 192 in March to 102 recently. I guess my body just took a while to adjust to the Ezetimibe.

I have a new question, though: My HDL continues to climb from (97 in March to 108 recently). I've read about the U-shaped relationship between HDL and adverse outcomes, but I've never been able to find suggestions for lowering super-high HDL. Has anyone ever found information on this topic? Thanks!
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Re: Eztemibe reduced LDL but not ApoB

Post by Plumster »

spokanecathy wrote: Sun Aug 20, 2023 11:59 am Hi everyone, I thought I would update my post since my recent lab test results show I finally decreased my ApoB to 80 (from 125 in March). Hooray! My LDL also dropped further from 192 in March to 102 recently. I guess my body just took a while to adjust to the Ezetimibe.
Good news! I can't answer your question, but do you have any side effects with Ezetimibe?
e3/4 MTHFR C677T/A1298C COMT V158M++ COMT H62H++ MTRR A66G ++ HLA DR
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