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  #196   ^
Old Tue, Sep-17-19, 23:13
Meme#1's Avatar
Meme#1 Meme#1 is online now
Posts: 11,271
 
Plan: Atkins DANDR
Stats: 210/188/160 Female 5'4"
BF:
Progress: 44%
Location: Texas
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Everybody needs to see this. Those images are very interesting with the side by side comparisons.

Quote:
Originally Posted by khrussva
As you already know, back in May I had my first follow-up CAC scan done. The results were unbelievable (almost literally). I was not provided any copies of the images as many labs do -- only the reports with the Agatston Scores were given to me through my doctor. But I wanted to see the images for myself so I requested copies of both scans on CD. It took them a while to get around to it, but I finally did receive them. Although the image slices of my heart are a bit fuzzier than I expected, I do feel better about my results. With my layman's eyes I see less calcium in the 2019 images. It looks like my 54% calcium reduction in 28 months may very well be real. Why don't you take a look for yourself?

I created a PDF with a side-by-side comparison between my 2017 and 2019 CAC scans, matching the slice of my heart as best I could. The calcium is the bright white specs. I started the sequence one slice before the first calcium appeared and ended it on slice after the last calcium appeared. bright white specs. I started the sequence one slice before the first calcium appeared and ended it on slice after the last calcium appeared.

http://www.idsimis.com/lowcarber/cac-2017vs2019v3.pdf

Once loaded, flip through the pages to see each slice of my heart. So what do you think? There's no way to quantify how much calcium is there from the images, but from what I'm seeing there are fewer calcium specs on my 2019 scans. That's what I wanted to see.

BTW: I will be having a CIMT scan done next week. That is an ultrasound that measures soft plaques in the arteries of my neck. I'm hoping for good results. I'll post that info when I have it.


Wow, That's really one for the record books Ken. I'm sure none of them have ever seen such a reduction in Calcium. Most patients probably just get worse and worse..

Last edited by Meme#1 : Tue, Sep-17-19 at 23:22.
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  #197   ^
Old Wed, Sep-18-19, 02:45
s93uv3h s93uv3h is offline
Posts: 1,293
 
Plan: Atkins & IF / TRE
Stats: 000/014.5/015 Male 5' 10"
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  #198   ^
Old Wed, Sep-18-19, 10:16
khrussva's Avatar
khrussva khrussva is online now
Posts: 7,584
 
Plan: My own - < 30 net carbs
Stats: 440/213/210 Male 5' 11"
BF:Energy Unleashed
Progress: 99%
Location: Central Virginia - USA
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Thanks, Meme. I too find the images quite interesting -- with a touch of creepy, though, as they are images of my own heart slice by slice. I'm just happy that what I'm doing appears to be working for me.

Since my CAC follow-up in May I did find a few other anecdotes of people who have reduced their calcium scores. That was reassuring. They all appeared to be doing exactly what I'm doing - LC/Keto diet + supplementation recommendations by the likes of Ivor Cummins, Dr. William Davis and others. But to be fair and balanced on this subject not all anecdotes out there are positive. Dave Feldman pointed me to this story that happened to hit the twittersphere last May. It's pretty much the opposite of my experience.


Accelerated Coronary Calcification with a Ketogenic Diet: A Worrisome Case Study

And HERE are my results.

I don't doubt the facts in this story. By the lipid changes and weightloss reported it sure looks like the guy was doing proper keto. His trigs were great on keto. His Trigs/HDL ratio was outstanding. However, his LDL-C & LDL-P were off the charts high... just like mine are on keto. He is clearly what Dave Feldman would call a Lean Mass Hyper Responder. The guy is a little younger than me, his initial CAC score was lower than mine, and I don't doubt that his went up and mine went down. The problem that I have with this story is that Keto is strongly implied to be the driving force behind this guy's 40% calcium increase in 10 months. I doubt that very much.

Given that the facts in this article are correct, what is known is that the guy was doing keto and the guy had a huge increase in his calcium score at the same time. Take keto out of the equation. Had the man not changed his diet, but had the two calcium scans done on the same dates would the results have been different? Better? Worse? We don't know.

One fact that I have learned through my experience the past few years is that plaques come first, then comes the calcification -- usually later in life. My cardiologist told me that he sees plaques in teenagers and that plaques build up over our lifetime. Calcification doesn't start for most men until after they've reached their 40's and it is typically later than that for women. So what is the driving force behind plaque calcification? I think that is the important question that needs to be answered. In this alarming article keto gets the blame. Maybe it contributed to the problem. Maybe not. Or maybe keto had nothing at all to do with it.

I can't say for sure why I got the results that I did regarding my artery calcification while this other guy had the opposite thing happen. We both had plaques in our arteries long before keto. I think everyone would agree with that. Maybe the difference is supplementation. The story does not mention any supplements that this guy was taking. I don't know for sure, but I suspect that my daily D3, K2 and magnesium regimen may have had something to do with it. On keto my CRP (inflammation) is in the low risk category and my metabolic health is top notch. Again I don't know for sure, but I would hope that my plaque formation days are over. Given my lifestyle changes as a whole, the calcification process seems to be reversing, too. This article says that after the 40% increase in his CAC score, the subject changed his diet. I wish him success. But if the cause of his issue was some deficiency that does not get addressed, then he may very well end up with the same results on the new diet.

Another thing to consider is the timing. This guy had both of his scans done within the first 18 months of starting keto. I didn't have my first CAC done until 2017 when I had already been eating LCHF/Keto for 3 years. I'd lost all the weight and corrected most all of my metabolic health issues long before I had that first scan. I've wondered what my CAC score would have been back in 2013 just before I started my LCHF lifestyle. I've speculated that it would have been much higher than my 2017 score of 347. But maybe I'm off the mark on that. Perhaps at age 50 my calcification had just gotten started. I wasn't doing any supplementation during those first few years, either. So who knows? My story could have been just like the guy in this article. It is quite possible that my CAC went up during the first year or two of keto. What would I have done had I been in the same situation? Probably something stupid. Maybe it is good that I didn't have my first scan until 2017.


Quote:
Nonetheless, the case is worrisome that others who are following the ketogenic diet are not being followed with the measurements this man had and may also be experiencing elevations of lipid fractions, inflammation, and coronary calcification.

Medical practitioners should be cautious about advising the ketogenic diet and should monitor the status of their patientís cardiometabolic and vascular status very carefully if they are following it.

I didn't realize that cardiovascular disease was exclusive to those following a ketogenic diet. Oh yeah, it's not. Perhaps the author of this article should consider it worrisome that not enough people -- on any diet, including SAD -- are having screening such as the CAC done that could alert them to CVD long before symptoms, such as sudden death, occur. Having CVD without knowing it is a problem. Figuring out what to do about CVD once it is known is another problem that needs solved. It's going to take a lot more quality clinical trials, case studies, anecdotes and N=1s before any of us truly know what causes what.

Last edited by khrussva : Thu, Sep-19-19 at 09:30.
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  #199   ^
Old Wed, Sep-18-19, 10:25
bkloots's Avatar
bkloots bkloots is offline
Posts: 9,431
 
Plan: Atkins/LCHF
Stats: 195/162/150 Female 63in
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Location: Kansas City, MO
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Quote:
Perhaps the author of this article should consider it worrisome that not enough people -- on any diet, including SAD -- are having screening such as the CAC done that could alert them to CVD long before symptoms, such as sudden death, occur. Having CVD without knowing it is a problem. Figuring out what to do about CVD once it is known is another problem that needs solved. It's going to take a lot more quality clinical trials, case studies, anecdotes and N=1s before any of us truly know what causes what.
Right. There are way too many variables to assign cause to diet--especially a short-term diet.

That said, call it Keto or whatever you like, a way of eating that mandates fresh meats, fresh vegetables, good fats, very low starch, no sugar can't be all that unhealthy.

Carry on, Ken!
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  #200   ^
Old Wed, Sep-18-19, 11:16
teaser's Avatar
teaser teaser is offline
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Posts: 13,743
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
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Location: Ontario
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High cholesterol absorption by sterol analysis sort of jumps out at me. Most people will not get hypercholesterolemia from eating eggs. Some will. We have to be careful with case studies/anecdotes. I hope the healthful plant-based diet the patient was placed on wasn't high in plant-sterols, that would be pretty stupid and potentially dangerous.

I think due to the efforts of Ivor Cummins and Dr. Davis etc., keto dieters are probably at least somewhat more likely to ask their doctor about getting a calcium score done than the general population. We have more data points than this one.

Quote:
Concern about data from epidemiologic studies reporting on diets described as low-carbohydrate has been expressed due to an association with higher mortality rates.


Lol at this... Kahn has been in discussion with enough low carb advocates to stick in that "described as low carbohydrate." We all know when it comes to epidemiology, that does not mean actually low carbohydrate. Generally it means the sort of high fat, but not all that low in carbohydrate diet that almost everybody agrees sucks.

Even exercise in excess has been associated with increases in calcification.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179497/

Quote:
Background
Long-term marathon running improves many cardiovascular risk factors, and is presumed to protect against coronary artery plaque formation. This hypothesis, that long-term marathon running is protective against coronary atherosclerosis, was tested by quantitatively assessing coronary artery plaque using high resolution coronary computed tomographic angiography (CCTA) in veteran marathon runners compared to sedentary control subjects.

Methods
Men in the study completed at least one marathon yearly for 25 consecutive years. All study subjects underwent CCTA, 12-lead electrocardiogram, measurement of blood pressure, heart rate, and lipid panel. A sedentary matched group was derived from a contemporaneous CCTA database of asymptomatic healthy individuals. CCTAs were analyzed using validated plaque characterization software.

Results
Male marathon runners (n = 50) as compared with sedentary male controls (n = 23) had increased total plaque volume (200 vs. 126 mm3, p < 0.01), calcified plaque volume (84 vs. 44 mm3, p < 0.0001), and non-calcified plaque volume (116 vs. 82 mm3, p = 0.04). Lesion area and length, number of lesions per subject, and diameter stenosis did not reach statistical significance.


Of course people who run marathons are going to be eating more (probably) compared to a weight-matched control. I wonder about long runs fueled by fructose-goop.
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  #201   ^
Old Mon, Sep-23-19, 07:13
khrussva's Avatar
khrussva khrussva is online now
Posts: 7,584
 
Plan: My own - < 30 net carbs
Stats: 440/213/210 Male 5' 11"
BF:Energy Unleashed
Progress: 99%
Location: Central Virginia - USA
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FYI: I'm having a CIMT (carotid artery ultrasound) done today. It will be interesting to see how my soft plaques are doing and how this correlates to my improved CAC (heart calcium) score over the past 2 years. I'll report the results back here when I have them. Hopefully it will be good news.
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  #202   ^
Old Mon, Sep-23-19, 07:23
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 3,108
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
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Location: Herndon, VA
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Focusing on a good score . . .
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  #203   ^
Old Mon, Sep-23-19, 09:50
Meme#1's Avatar
Meme#1 Meme#1 is online now
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Plan: Atkins DANDR
Stats: 210/188/160 Female 5'4"
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Thanks for spelling this all out Ken!
I bet you're exited to see this score after the CAC was so good...
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  #204   ^
Old Tue, Sep-24-19, 07:54
khrussva's Avatar
khrussva khrussva is online now
Posts: 7,584
 
Plan: My own - < 30 net carbs
Stats: 440/213/210 Male 5' 11"
BF:Energy Unleashed
Progress: 99%
Location: Central Virginia - USA
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A quick recap on the Carotid Intima-Media Thickness (CIMT) test that I had today...

The images were so cool --much more detail compared to the image slices on my CAC scans. I wanted a copy, but it turns out that this would be a special request. The tech said that he would need permission from the head honcho at the clinic and he was not there. I put in a written request.

So about the actual results: It was a mixed bag. They did detect a "small" nodule on my thyroid along with little bits of calcification. I don't know what he meant by "small". They suggested a more detailed assessment of my thyroid function. To date all that I have done is the basic TSH with results in the neighborhood of 2.

My arteries were completely clear of calcium and mostly clear of plaque. The technician did image one small soft plaque that was not causing any problem with blood flow. Blood flow was good in all the areas that he could check. So I guess I'm happy to learn that my carotid artey is not loaded with plaque.

As for the main purpose of the test -- Intima-Media Thickness, my scores fell between the 50th and 75th percentile for my age, ethnicity, and gender. I don't really know what that means as of yet, but I suppose that it could have been worse. I was amazed at how clear that inner lining of the artery appeared in the images. It looked like a reasonable thickness to me. I need to learn more.

I did not meet with their cardiologist as I thought I would. The post-procedure consultation included in the $175 fee was with the tech that did the imaging. He suggested that I make an appointment with the cardiologist and that I should consider a follow-up scan in a year or two. This clinic was the closest one that I could find that did the CIMT without a doctor's prescription. I had to do a little road trip to get there. The cardiologist has a private practice and appears to be interested in diet and nutrition as a means to halt, prevent, or reverse CVD. I may consider making an appointment with him.

So that's how it went. I'm still digesting it. And I really do hope that they send me the dicom image files. As I said before, they were quite interesting.
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  #205   ^
Old Fri, Sep-27-19, 10:49
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 3,108
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
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All in all, good news regarding and confirming the CAC score.

I have listed the set of recommended thyroid tests to provide a full and accurate function profile:
- TSH
- Free T3
- Reverse T3
- Free T4
- Zinc RBC
- Selenium
- Iodine (urine load test)
- Thyroid antibodies

Good luck with this. As you know, a simple TSH test requires context and additional information. Hope this helps.

Certainly, the presence of the nodule may require additional investigation.
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  #206   ^
Old Sat, Oct-12-19, 22:01
Meme#1's Avatar
Meme#1 Meme#1 is online now
Posts: 11,271
 
Plan: Atkins DANDR
Stats: 210/188/160 Female 5'4"
BF:
Progress: 44%
Location: Texas
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Quote:
Originally Posted by khrussva
A quick recap on the Carotid Intima-Media Thickness (CIMT) test that I had today...

The images were so cool --much more detail compared to the image slices on my CAC scans. I wanted a copy, but it turns out that this would be a special request. The tech said that he would need permission from the head honcho at the clinic and he was not there. I put in a written request.

So about the actual results: It was a mixed bag. They did detect a "small" nodule on my thyroid along with little bits of calcification. I don't know what he meant by "small". They suggested a more detailed assessment of my thyroid function. To date all that I have done is the basic TSH with results in the neighborhood of 2.

My arteries were completely clear of calcium and mostly clear of plaque. The technician did image one small soft plaque that was not causing any problem with blood flow. Blood flow was good in all the areas that he could check. So I guess I'm happy to learn that my carotid artey is not loaded with plaque.

As for the main purpose of the test -- Intima-Media Thickness, my scores fell between the 50th and 75th percentile for my age, ethnicity, and gender. I don't really know what that means as of yet, but I suppose that it could have been worse. I was amazed at how clear that inner lining of the artery appeared in the images. It looked like a reasonable thickness to me. I need to learn more.

I did not meet with their cardiologist as I thought I would. The post-procedure consultation included in the $175 fee was with the tech that did the imaging. He suggested that I make an appointment with the cardiologist and that I should consider a follow-up scan in a year or two. This clinic was the closest one that I could find that did the CIMT without a doctor's prescription. I had to do a little road trip to get there. The cardiologist has a private practice and appears to be interested in diet and nutrition as a means to halt, prevent, or reverse CVD. I may consider making an appointment with him.

So that's how it went. I'm still digesting it. And I really do hope that they send me the dicom image files. As I said before, they were quite interesting.


I forgot to say congrats on all the good news Ken!!!
You're getting younger by the day...no kidding.
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  #207   ^
Old Thu, Oct-17-19, 16:21
Ilikemice's Avatar
Ilikemice Ilikemice is offline
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Posts: 725
 
Plan: Paleo-ish general LC
Stats: 151/122/118 Female 64 in
BF:
Progress: 88%
Location: Middle Tennessee
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Hi. Don't post as much as I used to, but got a coronary calcium CT today (why not, $50!) and the score is zero. Just another data point to add. I'm 57 and low-carber for close to 18 years.
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  #208   ^
Old Thu, Oct-17-19, 19:57
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Posts: 12,168
 
Plan: atkins
Stats: 255/214/153 Female 5'8"
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Progress: 40%
Location: Massachusetts
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ken, re the nodule on the thyroid. While its important to define if that nodule us a problem, know that the reflex action is to remove that thyriod. You have two, so the thinking is taking one is ok.

Having had one of mine removed, I can say there is a reason for two. And replacing thyroid hormones adequately and correctly is a problem. IF a doctor can be convinced to follow you, IF you can get a doc to understand the problems..... getting the right hormone support takes monthes, even years to get right.

While removal might be necessary, doing everything to keep both thyroids would be my recommendation.

In my case, A nodual can be benign. I wish now a biopsy
had been suggested, or I had been more vocal about keeping my thyriod. Docs do what is fast and easiest. No looking ahead at the damage and side effects.
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  #209   ^
Old Fri, Oct-18-19, 06:26
khrussva's Avatar
khrussva khrussva is online now
Posts: 7,584
 
Plan: My own - < 30 net carbs
Stats: 440/213/210 Male 5' 11"
BF:Energy Unleashed
Progress: 99%
Location: Central Virginia - USA
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Quote:
Originally Posted by Ilikemice
Hi. Don't post as much as I used to, but got a coronary calcium CT today (why not, $50!) and the score is zero. Just another data point to add. I'm 57 and low-carber for close to 18 years.

Congratulations! Isn't that a nice confirmation about your lifestyle choices over the past few decades?
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  #210   ^
Old Fri, Oct-18-19, 10:27
Ilikemice's Avatar
Ilikemice Ilikemice is offline
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Posts: 725
 
Plan: Paleo-ish general LC
Stats: 151/122/118 Female 64 in
BF:
Progress: 88%
Location: Middle Tennessee
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Quote:
Originally Posted by khrussva
Congratulations! Isn't that a nice confirmation about your lifestyle choices over the past few decades?



Thanks! Yes, yes it is. Motivating too!
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