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diet plan - NAFLD, APOE 3/4, POTS

Answered on August 19, 2014
Created September 17, 2012 at 7:56 PM

I'll try and keep this concise. I'm currently 6ft and 205 lbs. Late last year I was diagnosed with NAFLD (mild/moderate) as the result of the Dr finding elevated ALT levels in blood work. I've been dealing with some chronic light-headedness lately and went to the cardiologist to help me figure things out. Here's my diagnosis: I was over-medicated for hypertension (Dr changing meds - removing diuretic). I have POTS (Postural orthostatic tachycardia syndrome). I believe the combination of being over-medicated and slightly dehydrated was bringing out my POTS symptoms (light headed, nearly passing out, etc). In the course of testing, I also found out I'm APOE 3/4.

So, I'm trying to work out a diet that covers NAFLD and APOE4. I'm basically thinking that I should be doing paleo but with low saturated fat. I'm also looking into intermittent fasting (16/8). Any suggestions or thoughts?

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2012
at 08:26 PM

Many herbs are estrogenic. They only mention it in relation to women and things like breast cancer and endometriosis. Being a guy, and lacking a uterus I doubt you'd have to worry about endo, I think the concern would be if there was already an estrogen sensitive condition in the body, taking a lot of Milk Thistle extract could make it worse. It is also the kind of thing that is taken for a short while, so there shouldn't be a long term impact on hormone levels, and a better functioning liver would also reduce the chance of developing higher estrogen levels from storing excess body fat.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on September 19, 2012
at 11:24 AM

I haven't looked into Milk Thistle before. What do you make of this connection to estrogen? http://www.livestrong.com/article/522996-does-milk-thistle-increase-estrogen-levels/

74f63b494d834b1880d316b8ef4dd079

(0)

on September 17, 2012
at 08:43 PM

It's been hard to find a straight answer on saturated fats and apo e4. I haven't yet looked into the supplements so thanks for the suggestion - I'll definitely check it out.

74f63b494d834b1880d316b8ef4dd079

(0)

on September 17, 2012
at 08:41 PM

Thanks for the response - I agree that after i get the proper diet and exercise plan dialed in, BP may not be an issue. As of now I'm pretty focused on reducing refined grains and sugars as you suggest, but am thankful for the affirmation.

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2 Answers

2
Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on September 17, 2012
at 08:11 PM

For the NAFLD, you probably want to go lower-carbohydrate - specifically watch the fruit intake. (Fructose does a real number on the liver. A little bit of fruit is okay, but there's a reason NAFLD is getting so common now -- think huge glasses of OJ every morning, HFCS in everything...)

Lower-carbohydrate might also help your hypertension. Elevated insulin levels can trigger higher aldosterone levels, which cause your body to retain sodium (and therefore water, which would increase blood volume ---> higher blood pressure).

As for the E4, I'm not sure about where you should look to be in terms of saturated/mono/poly fats, but reducing refined grains/sugars is KEY, regardless of your dietary fat makeup.

Basically, you'll be doing yourself a huge service by adopting a Paleo lifestyle, and going a little lower on carbs, at least at the beginning. Not everyone needs to be lower-carb, but with E4, I think that's a good way to go. You'll find a sweet spot. (And honestly, in the Paleo world, a "higher carb" level is still lowER carb than what most people eat on the standard American diet.)

74f63b494d834b1880d316b8ef4dd079

(0)

on September 17, 2012
at 08:41 PM

Thanks for the response - I agree that after i get the proper diet and exercise plan dialed in, BP may not be an issue. As of now I'm pretty focused on reducing refined grains and sugars as you suggest, but am thankful for the affirmation.

1
6120c989fd5b69f42a0834b69b87955b

(24553)

on September 17, 2012
at 08:13 PM

I know this is a controversial point of view considering the Apo E research, but the more I look into it, and experiment with it, the less problematic saturated fat (from pastured ruminant meat, not dairy) seems to be for NAFLD and Apo E4 folks. Whatever you do don't go on that less than 5% fat diet they often prescribe, I crashed and burned in a bad, bad way.

What I've found to help:

  • Liver supporting herbs and supplements like Milk Thistle, Dandelion, and NAC
  • Avoiding PUFAs
  • Avoiding refined fructose
  • Making sure you aren't magnesium defficient
  • Exercise
  • Some fasting (once you have been doing the other things for a while and it becomes easy)

74f63b494d834b1880d316b8ef4dd079

(0)

on September 17, 2012
at 08:43 PM

It's been hard to find a straight answer on saturated fats and apo e4. I haven't yet looked into the supplements so thanks for the suggestion - I'll definitely check it out.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2012
at 08:26 PM

Many herbs are estrogenic. They only mention it in relation to women and things like breast cancer and endometriosis. Being a guy, and lacking a uterus I doubt you'd have to worry about endo, I think the concern would be if there was already an estrogen sensitive condition in the body, taking a lot of Milk Thistle extract could make it worse. It is also the kind of thing that is taken for a short while, so there shouldn't be a long term impact on hormone levels, and a better functioning liver would also reduce the chance of developing higher estrogen levels from storing excess body fat.

Cbdc8318738324492f2d5918868ce4c9

(1211)

on September 19, 2012
at 11:24 AM

I haven't looked into Milk Thistle before. What do you make of this connection to estrogen? http://www.livestrong.com/article/522996-does-milk-thistle-increase-estrogen-levels/

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