4

votes

So - I'm Apoe 2/4. What now?

Answered on August 19, 2014
Created February 08, 2012 at 6:03 PM

Well, this is kind of a kick in the nuts. You may remember my other posts:

Had a heart attack - need suggestions http://paleohacks.com/questions/68443/had-a-heart-attack-need-suggestions#axzz1ljPwKOeh

and Got my VAP test results - now what? http://paleohacks.com/questions/75930/got-my-vap-test-results-now-what#axzz1ljPwKOeh

Well, I just received my 23andme results and as I (and others here) suspected I am Apoe 2/4. So this pretty much explains it all, right? No sleep apnea, infection, leaky gut, Takotsubo cardiomyopathy, or autoimmune disease.

Two weeks ago I had another lipid panel done after a few months of reduced red meat and eggs. Again, massive changes. Here's the results:

TC 139 (was 232) LDL 87 (was 160) HDL 30 (was 34) TGs 111 (was 188). Glucose 96 hsCRP 2.3 (worked out 12 hrs earlier and came down with a stomach virus 2 days later) A1c 5.0

So, anyone have advice on what to do not to piss of my genes again?

7b91be6e22d4e2960f40935e306bdee5

(245)

on September 07, 2013
at 01:28 AM

I have not contacted Masterjohn. What would be the best way to contact him?

3864f9a2af09b1b447c7963058650a34

(3703)

on February 16, 2012
at 10:57 AM

Robb covers leaky gut in a very Paleo v3.0 way. You can also step it up a notch and self diagnose by ordering the best DNA pcr test known as the GI function profile by metametrix for a black/white picture and to rule out parasites, bacterial and/or yeast overgrowth. Personally if your mom had metal in your mouth and so do you, since you've discovered the APo E4 carrier status, Consider the high value of seeking add'l help for assessing the 'total metal burden' and consider the merit for yourself and family in its reduction if it's significant, for maximal long term health as studies show.

3864f9a2af09b1b447c7963058650a34

(3703)

on February 16, 2012
at 10:49 AM

Berger, Have u read Robb Wolf's short but epic tome yet? Your bp's actually sound a ton better! The hardening doesn't occur overnight, thus depending on the person improvement of endothelial function takes 1 wk (see Frasetto's Paleo BP insulin study) or 2 yrs. replacing the magnesium that is depleted helps too. I think Robb covers mag supplements. I like mag malate, tauroate, glycinate, and citrate...

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 14, 2012
at 09:59 PM

If you are still reading, I want you to solve my puzzle. In english (as opposed to Quiltish) what needs to be done for leaky gut?

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 14, 2012
at 09:58 PM

Grace, you still reading this? BP isn't that good - 120's over 80's though.

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 10:13 PM

Sorry BILE not ' bike'

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 10:12 PM

...digest fat poorly as a result of insufficient bike acids, gastric acidity and/or lipase (fat 'cutters') insufficiency. This is when a good integrative practitioner like Christian or I solve parts of a medical puzzle and when supplements fill in until the system picks up the ball again. Mat Lalonde and Robb Wolf advise a lot of digestive enzymes and other helpful tools. This why and damage ( obviously, like a myocardial infarction in a young specimen) is actually freakingly common in this present day. Actually teens and twenty olds are also presenting with premature heart disease.

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 10:06 PM

You are 2/4. That is extremely unique. Celebrate your ancestry. It is pretty bad**ssed IMHO!!!! You need the right tools and understanding to wield your genetics to the advantage and potential that exists. Perhaps I see that more than just a pair of bruised balls! Congrats with the improved BP. So the numbers were 110/70s mostly?? Personally I don't consume a ton of fat but by American standards my sat fat intake is high because I consume about 25-40% sat fat and cw would want only 8-10%. It's all relative. A lot of S.A.D. Damaged fOlks actually may not be great fat burners or...

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 09:56 PM

Art Devany quoted my bud Chridtian Wernstedt who is a blogger at Modern Paleo. Cholesterol values are semi-useless ther is a complex relationship between inflammation and cholesterol. Just FYI but you may want to consider a consult with Christian who is one Of the few Paleo practitioners that I see eye to eye with. He understands 23 and me data, APo e4 and metal burdens toxicity and safe ways tO remediate. http://arthurdevany.com/articles/20111223

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 09:49 PM

Berger. You helluv funny. I hope ur nuts recover. I don't put much merit in the LDL value. I missed this thread on e4 but read psrticularly ambimorph's post. http://paleohacks.com/questions/87136/should-everybody-be-tested-for-apoe4-before-going-high-fat-paleo#axzz1lurSsqRJ

3c6b4eed18dc57f746755b698426e7c8

(5152)

on February 09, 2012
at 05:05 PM

Berger, that's probably more eyeopening than your ApoE4 result. VT could be due to blood thickness and/or hypertension. Now I can't remember what your readings were but you may have had elevated markers in your lab results.

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 09, 2012
at 04:52 PM

Thanks Patrick. I've actually been changing things up/testing myself over the past two years. Re exercise, I wholeheartedly agree with you. Re diet, my lipids seem to go haywire when I eat a lot of red meat and eggs. Thanks for your insight.

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 09, 2012
at 01:07 PM

I have no clue what you're asking or where to find those answers on 23andme. The only other risk that jumped out at me was that I have a very elevated risk (39.8%) of Venous Thromboembolism. Not sure if this is because of the e2/e4 markers or something completely different. I will go back and look at the Sinatra link. Thanks.

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 09, 2012
at 01:02 PM

Hi Grace - I am actually relieved that I at least know why this diet hasn't "worked" for me. Thats not to say I'm now anti fat, it just helps to know there's a reason my ldl/tgs skyrocketed eating high fat. BP seems fine (had a home monitor but returned it bc wife said I was being ocd about it - I was) but the readings I took with it were normal. HDL seems to bounce between 30-40 which I know by paleo standards is pretty bad, but I'm not sure I'm going to worry about it.

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 09, 2012
at 12:53 PM

Thanks for the link. Looks like that will keep me busy for a while.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on February 09, 2012
at 02:51 AM

My up vote is from the ..."i don't actually believe these tests provide any actionable data" realm. I'm thoroughly unconvinced that eliminating meat and eggs in an all out effort to change these numbers will result in better quality or quantity of life.

9d43f6873107e17ca4d1a5055aa7a2ad

on February 09, 2012
at 12:26 AM

have you read this thread?http://paleohacks.com/questions/87136/should-everybody-be-tested-for-apoe4-before-going-high-fat-paleo#axzz1lps2ilgk

9d43f6873107e17ca4d1a5055aa7a2ad

on February 09, 2012
at 12:13 AM

While staying positive is good, when you have specific genetic info you can use that to make specific changes to customize your diet. So things that might work for normal people, might not work for someone with APOE 2/4. Sadly, ignorance does not equal bliss for most. I'm surprised this answer has gotten upvoted so much. Maybe because some of the implications for having this allele imply that standard paleo dietary recs might not be best for everyone?

9d43f6873107e17ca4d1a5055aa7a2ad

on February 09, 2012
at 12:01 AM

have you tried contacting Chris Masterjohn?

3864f9a2af09b1b447c7963058650a34

(3703)

on February 08, 2012
at 11:53 PM

What are the rest of the results of the 23and me results? Are you an under methylation? Retinol? Any ancient genes? What polymorphisms? Did you read the link I posted earlier on Dr Sinatra and heavy metals, which APo e4 tend to accumulate more the non-e4 population???!

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 08, 2012
at 06:51 PM

I really appreciate your kind words. But I'm 36. I've got a lot of years ahead of me and want to feed my body the right food. This is a game changer and I want to learn all I can about whats going to nourish me and whats not. I also have a 4 year old that I dont want to see end up the same place my father and I both were at 34. I am a happy low stress guy, but I couldn't shake the fact that I had a heart attack as a healthy 34yo. Now I know why. And want to find out the best way to prevent another. For the sake of my father, myself, and my son.

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5 Answers

9
Ca1150430b1904659742ce2cad621c7d

(12540)

on February 08, 2012
at 06:15 PM

The best answer I can give you may not be right for everyone (and I'm honestly not trying to be a smart-alec or be dismissive... truly... this is a real response after years of dealing with similar news myself), but it's made a WORLD of difference to me over the past 6 months. Stop getting tests. Instead, start listening to your body. Every single one of us probably has some genetic anomaly that scientists can prove will make us sick. Heck, I have a genetic anomaly that doctors told me would result in my death within 2 years -- 10 years ago!!!

Let go of the stress. Start moving around for the joy of moving, and living every day for the joy of living. Eat good food, and don't beat yourself up over the occasional treat... just keep it VERY occasional. Listen to your body and feed it when it's hungry, move it when it's feeling sluggish, let it rest when it's tired.

It's my opinion that NOTHING will keep you alive longer than your life-cycle is supposed to be... when it's time for your energy to pass on to a different state, you're going to go, regardless of your apparent state of health. I've come to think, personally, that JOY is the "magic bullet" for good health. When we're happy, we're healthy -- and if getting tests does anything for most people, it makes us worried, not happy... so rather than checking numbers, strive to find a joyful state where what you do to your body makes you feel as good as you possibly can -- then laugh... a LOT... instead of getting bogged down in worrying about what's going to set you off next.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on February 09, 2012
at 02:51 AM

My up vote is from the ..."i don't actually believe these tests provide any actionable data" realm. I'm thoroughly unconvinced that eliminating meat and eggs in an all out effort to change these numbers will result in better quality or quantity of life.

9d43f6873107e17ca4d1a5055aa7a2ad

on February 09, 2012
at 12:13 AM

While staying positive is good, when you have specific genetic info you can use that to make specific changes to customize your diet. So things that might work for normal people, might not work for someone with APOE 2/4. Sadly, ignorance does not equal bliss for most. I'm surprised this answer has gotten upvoted so much. Maybe because some of the implications for having this allele imply that standard paleo dietary recs might not be best for everyone?

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 08, 2012
at 06:51 PM

I really appreciate your kind words. But I'm 36. I've got a lot of years ahead of me and want to feed my body the right food. This is a game changer and I want to learn all I can about whats going to nourish me and whats not. I also have a 4 year old that I dont want to see end up the same place my father and I both were at 34. I am a happy low stress guy, but I couldn't shake the fact that I had a heart attack as a healthy 34yo. Now I know why. And want to find out the best way to prevent another. For the sake of my father, myself, and my son.

2
3864f9a2af09b1b447c7963058650a34

(3703)

on February 08, 2012
at 11:46 PM

Hey Berger6697

Nice update!

Do you think these results help or hinder?

How are your BP readings now at home?

APo e2 tends to predispose to lower hdls but to me it is hard to tell why the hdls appear mildly suppressed despite the strong work and effort concentrating on diet, lifestyles and stress reduction.

I suspect that some degree of leaky gut and gut dysbiosis exists, which are detracting the immune system (and hdls as these are the sentinels and warriors of the immune system).

G

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 09, 2012
at 01:07 PM

I have no clue what you're asking or where to find those answers on 23andme. The only other risk that jumped out at me was that I have a very elevated risk (39.8%) of Venous Thromboembolism. Not sure if this is because of the e2/e4 markers or something completely different. I will go back and look at the Sinatra link. Thanks.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on February 09, 2012
at 05:05 PM

Berger, that's probably more eyeopening than your ApoE4 result. VT could be due to blood thickness and/or hypertension. Now I can't remember what your readings were but you may have had elevated markers in your lab results.

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 10:06 PM

You are 2/4. That is extremely unique. Celebrate your ancestry. It is pretty bad**ssed IMHO!!!! You need the right tools and understanding to wield your genetics to the advantage and potential that exists. Perhaps I see that more than just a pair of bruised balls! Congrats with the improved BP. So the numbers were 110/70s mostly?? Personally I don't consume a ton of fat but by American standards my sat fat intake is high because I consume about 25-40% sat fat and cw would want only 8-10%. It's all relative. A lot of S.A.D. Damaged fOlks actually may not be great fat burners or...

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 09, 2012
at 01:02 PM

Hi Grace - I am actually relieved that I at least know why this diet hasn't "worked" for me. Thats not to say I'm now anti fat, it just helps to know there's a reason my ldl/tgs skyrocketed eating high fat. BP seems fine (had a home monitor but returned it bc wife said I was being ocd about it - I was) but the readings I took with it were normal. HDL seems to bounce between 30-40 which I know by paleo standards is pretty bad, but I'm not sure I'm going to worry about it.

3864f9a2af09b1b447c7963058650a34

(3703)

on February 08, 2012
at 11:53 PM

What are the rest of the results of the 23and me results? Are you an under methylation? Retinol? Any ancient genes? What polymorphisms? Did you read the link I posted earlier on Dr Sinatra and heavy metals, which APo e4 tend to accumulate more the non-e4 population???!

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 10:13 PM

Sorry BILE not ' bike'

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 10:12 PM

...digest fat poorly as a result of insufficient bike acids, gastric acidity and/or lipase (fat 'cutters') insufficiency. This is when a good integrative practitioner like Christian or I solve parts of a medical puzzle and when supplements fill in until the system picks up the ball again. Mat Lalonde and Robb Wolf advise a lot of digestive enzymes and other helpful tools. This why and damage ( obviously, like a myocardial infarction in a young specimen) is actually freakingly common in this present day. Actually teens and twenty olds are also presenting with premature heart disease.

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 09:49 PM

Berger. You helluv funny. I hope ur nuts recover. I don't put much merit in the LDL value. I missed this thread on e4 but read psrticularly ambimorph's post. http://paleohacks.com/questions/87136/should-everybody-be-tested-for-apoe4-before-going-high-fat-paleo#axzz1lurSsqRJ

3864f9a2af09b1b447c7963058650a34

(3703)

on February 09, 2012
at 09:56 PM

Art Devany quoted my bud Chridtian Wernstedt who is a blogger at Modern Paleo. Cholesterol values are semi-useless ther is a complex relationship between inflammation and cholesterol. Just FYI but you may want to consider a consult with Christian who is one Of the few Paleo practitioners that I see eye to eye with. He understands 23 and me data, APo e4 and metal burdens toxicity and safe ways tO remediate. http://arthurdevany.com/articles/20111223

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 14, 2012
at 09:58 PM

Grace, you still reading this? BP isn't that good - 120's over 80's though.

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 14, 2012
at 09:59 PM

If you are still reading, I want you to solve my puzzle. In english (as opposed to Quiltish) what needs to be done for leaky gut?

3864f9a2af09b1b447c7963058650a34

(3703)

on February 16, 2012
at 10:57 AM

Robb covers leaky gut in a very Paleo v3.0 way. You can also step it up a notch and self diagnose by ordering the best DNA pcr test known as the GI function profile by metametrix for a black/white picture and to rule out parasites, bacterial and/or yeast overgrowth. Personally if your mom had metal in your mouth and so do you, since you've discovered the APo E4 carrier status, Consider the high value of seeking add'l help for assessing the 'total metal burden' and consider the merit for yourself and family in its reduction if it's significant, for maximal long term health as studies show.

3864f9a2af09b1b447c7963058650a34

(3703)

on February 16, 2012
at 10:49 AM

Berger, Have u read Robb Wolf's short but epic tome yet? Your bp's actually sound a ton better! The hardening doesn't occur overnight, thus depending on the person improvement of endothelial function takes 1 wk (see Frasetto's Paleo BP insulin study) or 2 yrs. replacing the magnesium that is depleted helps too. I think Robb covers mag supplements. I like mag malate, tauroate, glycinate, and citrate...

1
315cb49f2d961ee2541442122455096d

on February 09, 2012
at 03:42 PM

Being a 2/4 is not that bad. What you should know (if you don't already) is that the APOE2 allele is actually protective against a lot of APOE related diseases (e.g. heart disease, Alzheimer's disease, stroke, etc). Since you are an APOE2/4 heterozygote, this means you have a protective gene and an a high risk gene which essentially cancels each other out. There is one camp that believes the APOE4 allele is dominant, however the evidence is very weak. There is more evidence to support the idea that the APOE alleles work in a co-dominant fashion, thus APOE2/4 is esentially neutral.

So far every intervention has failed to show any imporvement in removing risk from APOE4 carriers, with one exception. Recently a trial from Wash Univ showed that routine exercise actually benefited APOE4 carriers with respect to overall cognition. I have been studying the APOE link with disease for many years and strongly believe that lifestyle is the strongest predictor of modifying risk for APOE4 carriers. What does this mean? It's common sense, no man made drug currently exists that can help you. There is only one pill (the hardest one to swallow for Americans) that can help you. That pill is routine exercise (>30 min/day walk/jog or equivalent), a healthy diet (no fad diets, just a well balanced diet made up of predominantly fruit and vegetables supplemented with free range meat/fish and very little if any man made foods), coping mechanisms for reducing stress, a good night sleep and healthy social network.

7b91be6e22d4e2960f40935e306bdee5

(245)

on February 09, 2012
at 04:52 PM

Thanks Patrick. I've actually been changing things up/testing myself over the past two years. Re exercise, I wholeheartedly agree with you. Re diet, my lipids seem to go haywire when I eat a lot of red meat and eggs. Thanks for your insight.

0
6a625f7492539afb535d465d9227dc95

on February 13, 2013
at 03:17 PM

Hi I just had a Berkley test done by my own request. I don't eat fatty food, don't smoke, no known history of heart disease in the family. I am 48 year old female. and I asked for the test because I suffer from panic attacks so I figured removing all physical fears would help reduce the stress of my panic induced fears. All my numbers were very good accept my tryglicerides were a bit high 228. The doctor didn't think my number were worthy of any treatment. I have an APOE Genotype 2/4 and I am not exactly sure what that means to me. I know it is not the Average marker, but I really could not grasp what the doctor was saying and how he waived it off with such ease. Please...if anyone could help me understand just what this means to my health and what I should do I would appreciate it.

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