tag:blogger.com,1999:blog-36840063.post2220044903133647388..comments2024-03-27T22:57:00.742+00:00Comments on Hyperlipid: Familial Hypercholesterolaemia; Brown and GoldsteinPeterhttp://www.blogger.com/profile/14527788116058656094noreply@blogger.comBlogger20125tag:blogger.com,1999:blog-36840063.post-68642380696040889682018-02-22T01:47:06.990+00:002018-02-22T01:47:06.990+00:00Alternative explanation - they were not diagnosing...Alternative explanation - they were not diagnosing FH from modern gene score but from cholesterol level. The family history score is closer to the modern gene score.<br />The simple high cholesterol score catches a lot of people who are good at using fat for muscle fuel, and who we'd expect to have low CVD risk.<br /><br />Even if there are no LDL receptors you can lower LDL by shutting down peripheral cholesterol production. Then there is less cholesterol for HDL to transfer to LDL so less LDL cholesterol.<br />No liver involvement needed.<br /><br />But this will only be useful if insulin and leptin are overdriving peripheral cholesterol synthesis. Otherwise - if glucagon and cortisol dominate instead the rate is probably low but optimal, especially given the lack of LDL receptors to bring in any more.Puddleghttps://www.blogger.com/profile/00953398103675945541noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-72379169880759389872008-10-28T16:43:00.000+00:002008-10-28T16:43:00.000+00:00Peter, If the mercury poisoning doesn't kill them ...Peter, <BR/><BR/>If the mercury poisoning doesn't kill them first. <BR/><BR/>"Oh heavy body burden..." :-)gunther gathererhttps://www.blogger.com/profile/15361732213105267048noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-63227588454187665662008-10-28T15:59:00.000+00:002008-10-28T15:59:00.000+00:00Gunther,You have a point. On a 300g/d of protein f...Gunther,<BR/><BR/>You have a point. On a 300g/d of protein from alaskan ringed seal meat, the average intake of iron would be 10 times the current USA RDA. That's assuming they threw away the liver and blood. Then add 15g/d of combined EPA/DHA (a la Ray Peat) and these guys should be dead of IHD and cancer......<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-12353108981909710572008-10-28T15:57:00.000+00:002008-10-28T15:57:00.000+00:00Hi Gunther,I just found my copy of Eades Protein P...Hi Gunther,<BR/><BR/>I just found my copy of Eades Protein Power Life Plan. His chapter on iron is 25 pages long and I found it informative and convincing. But I have no way of knowing how true his statements are. I’m not a nutritionist and his book has very few references although I trust that Dr. Eades has legitimate source material.<BR/><BR/>Not only did our ancestors bleed a lot (internal and external), but they also suffered various bacterial, viral, fungal and other parasitic diseases and parasites, all of whom take their iron needs from the bodies they inhabit thereby depleting the host body of iron. I think the Masai and the Inuit would fall into this category as well. As for other mammals, I have never seen any information about their “iron” status, although I don’t know of any mammal with our life span that consumes significant dietary iron.<BR/><BR/>When Peter is ready to make black pudding (low carb version of course) from his future pig and has “pubmeded” ferritin, I’ll be interested in his take.<BR/><BR/>By the way, Eades suggests a serum ferritin level between 10 and 50 mg/dl.<BR/><BR/>Regards,<BR/><BR/>Philip ThackrayThackrayhttps://www.blogger.com/profile/05733462601434748276noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-60803623348625948882008-10-28T14:55:00.000+00:002008-10-28T14:55:00.000+00:00Hi Philip, It still doesn't add up. This theory is...Hi Philip, <BR/><BR/>It still doesn't add up. This theory is implying that unless you get periodic trauma to your body which depletes you of blood (hence nutrients, minerals, etc.) and/or avoid high-iron containing foods (basically most all animal foods) which are essential to health, you will get heart disease, metabolic syndrome or both. Never mind that intentional bleeding (or looking for a fight for no other reason than in order to bleed?) is never something you see with other mammal groups or with any other animal in general.<BR/><BR/>And it still doesn't explain how the Masai and Inuit have none of these problems despite high iron (and other heavy metal) ingestion. We don't see the Inuit slashing their wrists every two months so they can be healthier.<BR/><BR/>Isn't an implication of paleolithic living supposed to be conservation of nutrients, not spilling them needlessly about the jungle? <BR/><BR/>It would make more sense to say it's the body's retention or inability to excrete these things that's the problem. And from a historical perpective, it's never seemed to be a problem until now (ie. until agriculture and neolithic living, etc.).gunther gathererhttps://www.blogger.com/profile/15361732213105267048noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-48085490592677490142008-10-28T12:54:00.000+00:002008-10-28T12:54:00.000+00:00Gunther,Chapter 8 of Michael Eades’ book Protein P...Gunther,<BR/><BR/>Chapter 8 of Michael Eades’ book Protein Power Life Plan is titled “The Modern Iron Age”. Colpo (see Peter’s comment) and Eades advise against high ferritin levels. Both sources contain interesting non-overlapping information about ferritin and its effects. Russell Blaylock MD is also in the anti-iron camp bigtime.<BR/><BR/>The only way for “modern” man to lower ferritin levels is to avoid consuming high iron content foods and/or giving blood until normal levels are reached (don’t have Colpo’s or Eades’ books nearby and I forget the recommended level.)<BR/><BR/>As Peter pointed out, ancient man would have experienced considerable blood loss through various means. For this reason, we never evolved a mechanism to reduce high iron levels.<BR/><BR/>Philip ThackrayThackrayhttps://www.blogger.com/profile/05733462601434748276noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-78923672641165123102008-10-27T13:51:00.000+00:002008-10-27T13:51:00.000+00:00Gunther,I had a feeling that Anthony Colpo had bit...Gunther,<BR/><BR/>I had a feeling that Anthony Colpo had bits to say about iron and, whatever else I feel about him, he is very good on facts. Checked his comments in The Great Cholesterol Con. His suggestions are that HGs exercised, which reduces ferritin count, they occasionally lost blood through trauma and they frequently lost blood chronically through hookworm infestation. The women probably lost some blood through menstruation but I've read accounts that total blood loss through this route is less in HGs is less than in moderns. Just as well, because hookworm will affect both sexes...<BR/><BR/><BR/>re heavy metals, these two are interesting<BR/><BR/>http://www.ncbi.nlm.nih.gov/pubmed/7804025<BR/><BR/>http://www.ncbi.nlm.nih.gov/pubmed/16635458<BR/><BR/>Of course you have to ask how toxic heavy metals are and, if the toxicity is mediated through free radical generation, how significant is the toxicity in a population which is both normoglycaemic and modest in its PUFA intake?<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-79735893436034645342008-10-27T11:31:00.000+00:002008-10-27T11:31:00.000+00:00Hi Peter,Then maybe the iron discussion centers ar...Hi Peter,<BR/><BR/>Then maybe the iron discussion centers around iron STORAGE problems, and not actually dietary iron INGESTION. So the question to answer is what causes the liver to overstore iron? <BR/><BR/>What does the literature say on iron levels in the Masai and Inuit? OR even mercury levels in the Kitavans and Polynesians, who eat loads of fish? Is this "heavy metal-body burden" issue a real one, or is it just another symptom of eating too much White Man's Food?gunther gathererhttps://www.blogger.com/profile/15361732213105267048noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-85987838263694911242008-10-27T10:35:00.000+00:002008-10-27T10:35:00.000+00:00Hi Chainey,People are very interested in IF! Re th...Hi Chainey,<BR/><BR/>People are very interested in IF! Re the cortisol comment, I think it is the "most" people aspect that matters. Usually it's glucagon. Only if you are unlucky is it cortisol (or metabolically broken in some way???)...<BR/><BR/>Lot of people seeing the elevated fasting BG phenomenon.<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-70758692182482911562008-10-27T10:15:00.000+00:002008-10-27T10:15:00.000+00:00Gunther,Yes, iron is a good facilitator of oxidati...Gunther,<BR/><BR/>Yes, iron is a good facilitator of oxidation and the linkage between excess iron storage and IHD is pretty convincing. But as you point out, carnivores would be in big trouble if that was all there was to it. I think it was Georgette on the Bernstein forum who pointed out that low iron diets were very difficult to achieve healthily and anyone with an iron storage disease needed to get treatment. It's never been something I've looked in to as blood sausage (Black pudding, which I love) in the UK is always gluten based so I don't indulge any more. Once your total protein is down at 1g/kg, your total iron intake will be way below an inuit eating 299g/d. Thinking ahead to when (if) we ever get a pig, I cannot see me wasting the blood so maybe I'll have to go hunting around Pumed more in the future...<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-69553601724212724312008-10-27T09:57:00.000+00:002008-10-27T09:57:00.000+00:00Alex,It is normal for FH homozygotes to be put on ...Alex,<BR/><BR/>It is normal for FH homozygotes to be put on statins. They DO reduce cholesterol levels, but this has to be by over riding the upregulation of HMG CoA reductase which occurs in the liver. A lipophilic statin will probably cause cholesterol deficiency whole body, a water soluble statin probably hits the liver most.<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-51628469935728460662008-10-27T09:43:00.000+00:002008-10-27T09:43:00.000+00:00ItsTheWoo,Yes, this is a very valid point. But wha...ItsTheWoo,<BR/><BR/>Yes, this is a very valid point. But what interest me more is why one person with an LDL of 8mmol/l gets systemic cholesterol deposits (like a rabbit given oral chemical grade cholesterol dissolved in sunflower oil) yet another person with an identical LDL can be asymptomatic. The answer to that question seems quite important to me.<BR/><BR/>There are loads more post in the AGE RAGE and ALE series but it seems to have ground to a halt at the moment.<BR/><BR/>LDL receptor exist to deliver cholesterol to cells. They do this well. If they don't, there are sequences which depend on the composition of the LDL particle and other associated genes linked to the FH gene. B and G do specify that, under statins, HMG CoA reductase synthesis eventually up regulates enough to keep cells set up with cholesterol and it is hyperactive in all people with FH, hence they survive (until put on statins plus torcetrapib or ezitemebe).<BR/><BR/>Peter<BR/><BR/>Oh, and I guess you could draw a parallel with glucose. 5mmol/l is fine, 10mmol/l and IHD is coming...Peterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-57256184576159364432008-10-27T09:19:00.000+00:002008-10-27T09:19:00.000+00:00Hi Matthew,Very interesting link. I'm not sure I w...Hi Matthew,<BR/><BR/>Very interesting link. I'm not sure I would describe CRONies as normal people (or healthy people, I personally did not like having a BMI of 18.5, though on LC I was never hungry, I got there easily and I never dreamed of food), any more than a LC paleo eater is a normal person. Obviously Paul is likely to have achieved all of the benefits of the CRONies without the hunger and without the low cholesterol level. A fasting insulin of 5.1 +/- 2(SD) is the average for a person with a BMI of 26 on the SAD in the study. With an SD of 2 it is possible that a few of the SAD group has insulin levels below 2.0 microIU/ml, but not many.<BR/><BR/>As an aside all we need now is to see now is how well the CRONies do long term, about 100 years should do it...<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-8582371591966117672008-10-27T05:51:00.000+00:002008-10-27T05:51:00.000+00:00off topic: I remember you once writing that you pr...off topic: I remember you once writing that you preferred to stay (just) out of ketosis because you were a bit concerned about cortisol production.<BR/><BR/>I happened to stumble across a comment on this deep in the comments of Dr Eades' archives. Viz:<BR/><BR/>Commenter "Todd": The chemical that the body uses to liberate glycogen and to initiate gluconeogenesis is the stress hormone cortisol, I think. So wouldn’t IF tend to promote higher than usual cortisol levels during the fasting intervals, and is this a good thing?<BR/><BR/>Dr Eades: [M]ost of the time during fasting, the hormone glucagon,which is the counter-regulatory hormone to insulin, drives gluconeogenesis, not the stress hormone cortisol. <BR/><BR/>The above is part of a longer exchange, which you can find <A HREF="http://www.proteinpower.com/drmike/intermittent-fasting/fast-way-to-better-health/#comment-4258" REL="nofollow">here</A>.^https://www.blogger.com/profile/14209117357558394101noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-24676993554809861732008-10-25T23:36:00.000+00:002008-10-25T23:36:00.000+00:00Hi Peter, I'm wondering where iron intake plays a ...Hi Peter, <BR/><BR/>I'm wondering where iron intake plays a role in all of this. The official line is that high iron is supposed to cause CHD and other symptoms of metabolic disorder. But has this actually been proven?<BR/><BR/>And if it were true, wouldn't the Masai be dropping like flies? Ditto for the Inuit.<BR/><BR/>Thanks, Ggunther gathererhttps://www.blogger.com/profile/15361732213105267048noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-17862174314973755012008-10-24T21:20:00.000+00:002008-10-24T21:20:00.000+00:00I am very interested in FH but don't know much abo...I am very interested in FH but don't know much about it. From what I have read, the lack of LDL receptors leads to fatty cholesterol deposits all over the body. This seems to suggest that high LDL does indeed promote plaque formation, but there is individual variation in how sensitive a person may be in forming these plaques. After all, why would outrageous unregulated LDL levels lead to cholesterol plaques on the skin and eyes ...but yet NOT the intima of the vessels in the heart? <BR/><BR/>Even though there is clearly more to the heart disease story than high cholesterol leading to plaque formation, I think it is just as problematic to dismiss the pathogenic nature of LDL all together... unless I'm wrong, it seems plaques form all over the body in people with homozygous FH, and this is simply related to insane levels of LDL floating around in the blood. <BR/><BR/>One must wonder why LDL receptors exist in the first place if LDL were absolutely benign?ItsTheWooohttps://www.blogger.com/profile/12057537399918684119noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-72914173704210617762008-10-24T19:15:00.000+00:002008-10-24T19:15:00.000+00:00Peter I have the Yerushalmy_Hilleboe paper. E-mai...Peter I have the Yerushalmy_Hilleboe paper. E-mail me for a copy "@ gmail.com"mtflighthttps://www.blogger.com/profile/15904999557050546982noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-64780032420803005512008-10-23T20:55:00.000+00:002008-10-23T20:55:00.000+00:00No time for more, got it typowise Alex.Ta PeterNo time for more, got it typowise Alex.<BR/><BR/>Ta <BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-9281652027628097572008-10-23T16:59:00.000+00:002008-10-23T16:59:00.000+00:00Really nice post, Peter. Dumb question: reducta...Really nice post, Peter. Dumb question: reductase vs. synthetase?<BR/><BR/>So, it is not uncommon for homozygous FH patients to get statins?mtflighthttps://www.blogger.com/profile/15904999557050546982noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-73774430192737008662008-10-21T19:21:00.000+00:002008-10-21T19:21:00.000+00:00Nice post. I'd add that McGovern and Carol Tucker ...Nice post. I'd add that McGovern and Carol Tucker Foreman are co-conspirators too.brianhttps://www.blogger.com/profile/09087010559814701433noreply@blogger.com