2

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Confused - help on APOE genotype and paleo?

Answered on August 19, 2014
Created September 06, 2012 at 5:30 PM

Just got my results from 23andme and I'm both epsilon2 (at rs429358) and epsilon4 (rs7412). While it does shed some light on my atypical response to paleo (improved HDL and trigs, but drastically increased LDLs, including some of the bad stuff).

My question is: so what now?

I'm starting not to be concerned with LDL as long as my HDL and trigs are good, especially with exercise and if I can keep lower-carb. But my docs freak out at 300+ LDLs even with a great trig/HDL ratio.

Can anyone point me to some good journal articles or other advice and info for my e2/e4 ApoE type? I found lots on E2, E3, and E4, but most specifically leave out e2/e4's like me and results are contradictory.

56bc750affa41124e1142a6e8e239e3d

(145)

on November 24, 2012
at 12:42 PM

Thanks - wow, I totally misread the chart (Table 1) that I had seen elsewhere. You're right, I'm e3/e3, with rs7412 (CC) and rs429358 (TT). BUT... now I'm even more confused. Many months later, I still have giant-high LDL, med HDL, and lowish trigs: respectively, ~300, 54, 98 just yesterday, depending upon the test. I do seem to respond well on the HDL side from coconut oil, which also seems to support my e3/e3. While I think that I'm fine with high HDL and low trigs, I'm mainly trying to get my HMO off my back.

56bc750affa41124e1142a6e8e239e3d

(145)

on October 12, 2012
at 05:40 PM

Thanks Mambo - I dunno if I've got FH, but I know my Dad is on Lipitor and his father died of heart disease. If E2/E4+FH, any advice on where to look to start optimizing my diet for that combo?

56bc750affa41124e1142a6e8e239e3d

(145)

on October 12, 2012
at 05:24 PM

Thanks Mambo - I'll check if I'm FH [but I'll have to find out what that is first! ;-) ] If so, any advice on where to look to start optimizing my diet for that combo?

5e92edc5a180787a60a252a8232006e9

(345)

on October 10, 2012
at 11:18 PM

I'm also Apo E2/E4 but my TC last 3 years has been 150-210. LDL ranged from 70-122. Being E2/E4 doesn't necessarily mean you have familial hypercholesterolimia. It means your LDL responds positively to fat: when I was low-carbing and was meat-heavy and heavy bone broth and dairy, my LDL was 120. When I went heavy starch yams and sweet potatoes, cut out dairy but still ate 50% fat, it was ~70-80. So it's not a curse. The real curse is FH. You may have Apo E2/E4 and FH.

5e92edc5a180787a60a252a8232006e9

(345)

on October 10, 2012
at 11:08 PM

LDL-P is only available from NMR, not VAP. Supposedly, LDL-P has more significance than the particle size that we were led to believe indicates whether LDL is dangerous or not. Read Chris Kresser's most recent Podcast transcript.

56bc750affa41124e1142a6e8e239e3d

(145)

on September 15, 2012
at 06:57 PM

(cont'd) Total apoB100 - calc. 242 H mg/dL <109 LP(a) Cholesterol 2.0 mg/dL <10 IDL Cholesterol 54 H mg/dL <20 Real LDL-Cholesterol 298 H mg/dL <100 Sum Total LDL-C 354 H mg/dL <130 REAL-LDL Size Pattern A/B A A Remnant Lipoprot(IDL+VLDL3) 72 H mg/dL <30 Due to the presence of additional risk factors, consider lowering LDL-C goal Constellation of Lipid Risk No HDL-2 9 L mg/dL >10 HDL-3 35 mg/dL >30 VLDL-3 18 H mg/dL <10 LDL4 46.7 mg/dL LDL3 150.5 mg/dL LDL2 29.9 mg/dL LDL1 71.4 mg/dL Results Received 04/20/12

56bc750affa41124e1142a6e8e239e3d

(145)

on September 15, 2012
at 06:57 PM

I did the Apo E genotype as part of my complete mapping at 23andme.com for my own curiosity, including cholesterol among other things. I also had my particle size assay info done in April 2012. VAP Cholesterol Test --------------TESTS-------------RESULTS--------UNITS--REF. RANGE--- Tot LDL-Chol Direct 354 H mg/dL <130 (Desirable range <100 mg/dL for CHD, Diabetes, or its equivalent) Tot. HDL-Cholesterol Dir. 45 mg/dL >=40 Tot. VLDL-Cholesterol Dir. 29 mg/dL <30 Sum Total Cholesterol 428 H mg/dL <200 Triglycerides-Direct 92 mg/dL <150 Tot. NonHDL Chol(LDL+VLDL) 383 H mg/dL <160

F81d8fea7fbde491211e24c4965245d7

(25)

on September 12, 2012
at 03:57 PM

sorry-I should have put that in comments! I am new at this :)

56bc750affa41124e1142a6e8e239e3d

(145)

on September 06, 2012
at 07:45 PM

Yep, they seem pretty rare, hence the problem with how to proceed and still not set off the Docs. Nowadays I do occasionally do dairy, but not often and no butter (sometimes something like feta at the condiment level, or vary rarely yogurt or cheese). But even when I did no dairy, it didn't seem to help my 300+ LDL levels.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 06, 2012
at 06:10 PM

That is quite the mix, I've never seen 2/4 before. Do you do dairy? Some people have reported that spike in LDL on dairy, but not on straight up animal fat.

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3 Answers

1
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on November 22, 2012
at 05:11 PM

E2/E4 is only 1 percent of the population. First, I'd make sure I'm E2/E4. Lots of people think they're E2/E4 but turn out to be E3/E3. If your E2 is TT and E4 is CC, then you're TC or E3/E3. Go to Disease Risk and find Alzheimer Disease, then click on Technical Report. If you're E2/E4 there, then you're right. It is rare. Most people who're ApoE4 tend to be E3/E4, about 20% of the population.

56bc750affa41124e1142a6e8e239e3d

(145)

on November 24, 2012
at 12:42 PM

Thanks - wow, I totally misread the chart (Table 1) that I had seen elsewhere. You're right, I'm e3/e3, with rs7412 (CC) and rs429358 (TT). BUT... now I'm even more confused. Many months later, I still have giant-high LDL, med HDL, and lowish trigs: respectively, ~300, 54, 98 just yesterday, depending upon the test. I do seem to respond well on the HDL side from coconut oil, which also seems to support my e3/e3. While I think that I'm fine with high HDL and low trigs, I'm mainly trying to get my HMO off my back.

1
E253f8ac1d139bf4d0bfb44debd1db21

on November 22, 2012
at 02:28 PM

Sounds like you could be more sensitive to a high fat diet because your genetics are suited to a diet low in saturated fat. Another way of saying it is that your genetics help you retain fat which means you don't need as much. Suggest you consider a more plant based diet.

0
F81d8fea7fbde491211e24c4965245d7

on September 12, 2012
at 03:52 PM

Did your doctor order the Apo E genotype or did you do it on your own? Do you know what your LDL-p is? My husband also had kick ass trig (35) and hdl (76) but high ldl(192) and very high ldl-p 1720.

I am wondering if fat is a problem with him.

F81d8fea7fbde491211e24c4965245d7

(25)

on September 12, 2012
at 03:57 PM

sorry-I should have put that in comments! I am new at this :)

56bc750affa41124e1142a6e8e239e3d

(145)

on September 15, 2012
at 06:57 PM

I did the Apo E genotype as part of my complete mapping at 23andme.com for my own curiosity, including cholesterol among other things. I also had my particle size assay info done in April 2012. VAP Cholesterol Test --------------TESTS-------------RESULTS--------UNITS--REF. RANGE--- Tot LDL-Chol Direct 354 H mg/dL <130 (Desirable range <100 mg/dL for CHD, Diabetes, or its equivalent) Tot. HDL-Cholesterol Dir. 45 mg/dL >=40 Tot. VLDL-Cholesterol Dir. 29 mg/dL <30 Sum Total Cholesterol 428 H mg/dL <200 Triglycerides-Direct 92 mg/dL <150 Tot. NonHDL Chol(LDL+VLDL) 383 H mg/dL <160

56bc750affa41124e1142a6e8e239e3d

(145)

on September 15, 2012
at 06:57 PM

(cont'd) Total apoB100 - calc. 242 H mg/dL <109 LP(a) Cholesterol 2.0 mg/dL <10 IDL Cholesterol 54 H mg/dL <20 Real LDL-Cholesterol 298 H mg/dL <100 Sum Total LDL-C 354 H mg/dL <130 REAL-LDL Size Pattern A/B A A Remnant Lipoprot(IDL+VLDL3) 72 H mg/dL <30 Due to the presence of additional risk factors, consider lowering LDL-C goal Constellation of Lipid Risk No HDL-2 9 L mg/dL >10 HDL-3 35 mg/dL >30 VLDL-3 18 H mg/dL <10 LDL4 46.7 mg/dL LDL3 150.5 mg/dL LDL2 29.9 mg/dL LDL1 71.4 mg/dL Results Received 04/20/12

5e92edc5a180787a60a252a8232006e9

(345)

on October 10, 2012
at 11:08 PM

LDL-P is only available from NMR, not VAP. Supposedly, LDL-P has more significance than the particle size that we were led to believe indicates whether LDL is dangerous or not. Read Chris Kresser's most recent Podcast transcript.

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