Is a Keto Diet safe for someone with advanced atherosclerosis?

petpro · 2018-07-17 20:41:01 UTC

Received a very high CT Calcium Score, nearly all sources suggest high carb low-fat diet. I feel great on a Keto Diet! Any evidence out there?

Q66 · 2018-07-17 20:51:37 UTC

Sounds like your problem is calcium and not fat.
Research and talk to your doctor about vitamins D3 and K2.

D3 gets calcium to various organs in your body.
K2 pulls calcium out of soft tissue and organs and into bones.

I do not give medical advice, but this is a good place to start your research.

Also see: https://articles.mercola.com/sites/articles/archive/2013/06/17/heart-healthy-cheese.aspx

kib · 2018-07-17 21:16:16 UTC

This very long article eventually speaks about Dr. William Davis and his Track Your Plaque program. Around 1/4 of the way through, right after What Does Calcium Look Like, it talks about suggested strategies for reducing your score, including niacin and vitamin D.

ETA: I’m sorry, I have to admit that all twenty pages of this doesn’t seem to really address diet, keto or otherwise. My MO is to use his suggested protocol in combination with keto, because I feel my calcium score is probably as high as anyone else’s my age, but that’s definitely an N=1 (and a lousy experiment at that because I don’t have a baseline yet!)

I do feel keto is generally on the right track for reducing heart disease, between its theoretical autophagy stimulation, reduction of arterial stiffening, insulin leveling and inflammation lowering, but whether it’s safe for you or not is obviously not my call.

petpro · 2018-07-17 21:34:45 UTC

I appreciate the information, my Calcium score is 979 (62 years old). I feel great on a modified Keto Diet and have no symptoms. I agree… evidence tends to point to it being the right move. There’s just a slight fear factor. I’m leaning towards continuing with strict monitoring.

Cheers

Q66 · 2018-07-17 21:36:14 UTC

Great resource, thanks.

Q66 · 2018-07-17 21:46:29 UTC

Phil –

I had a heart attack 10 years ago, so I can understand your concern. That’s why I enjoy the research and taking more responsibility for my own health. The low fat diet hasn’t worked for me, and my meds have only increased for 10 years under the care of a cardiologist.

I listed to my body very closely since my heart attack, and have felt very good while on keto, and feel that my health has improved along with the weight loss. But at the same time, I don’t believe everything I hear or even read on this forum. At the end of the day I have to be a cynic and a questioner.

Good luck.

petpro · 2018-07-17 22:38:55 UTC

It seems that it starts with endothelial damage/inflammation, the cholesterol/calcium (found in the plaque) are the repair team. The process is very complicated and still not completely know. My aim is to stabilize plaque and slow progression if possible. I have been taking both D3 and K2, most doctors and so-called experts have told me to go on a low-fat diet.

Cheers

petpro · 2018-07-17 22:49:25 UTC

That’s another question, to take or not take Statins? It seems there is evidence that statins work not by lowering cholesterol but by lowering inflammation. Keto Lifestyle lowers inflammation so it would seem to be protective. Yes…It’s a good idea to be skeptical and question advice.

Thanks

Victoria_Powell · 2018-07-18 13:07:46 UTC

I’m on the same path, but developed angina symptoms at age 63, which progressed until I found the little known and mostly overlooked treatment of EECP (enhanced external counter pulsation) at age 65, when I could hardly walk upstairs without pain. It is NOT a cure, but for sure is a natural bypass. The bad news for you is that silent cardiac disease is worse than what I have because you can’t “feel” it coming on. More of these patients die or have a damaging MI “out of the blue” so mortality in angina sufferers is apparently lower. So in that sense I’m lucky I knew sooner how much trouble I was in. I’m also an avid exerciser and continued to exercise, stopping every set at the gym to wait 30-60 seconds for the pain to subside. So I stayed fit, other than cardiac fit, but eventually couldn’t raise my heart rate even a little without pain. I would, were I you, find a way to get this treatment, which is benign, non-invasive, FDA approved, and insurance covered, and actually revascularizes your heart, makes new microvessels throughout the muscle, without damaging the diseased arteries. It operates to stimulate growth factor and stem cells for this angiogenesis. It has a shearing effect on the endothelium, also apparently helpful, and assists in dilation. It’s a regenerative procedure that elite athletes here and there know about, and I think it can increase your VO2 max. I’m planning to blog about it at whatnobodytoldme.com. I’m still looking for a keto-intelligent cardiologist to assist me with the questions you have, how to achieve autophagy, and/or reversal of the disease. I do take a tiny dose of generic Crestor, as my numbers are high, my particles are small and dense mostly, and there is endothelial benefit at small doses, I believe. I weigh 110 and take 5 mg 3 x week. So I think I’m a TOFI and I know I’m a hyperresponder to keto but love the feeling and struggling with how to manage the disease and stay as fit as I can. I’m now beyond skeptical because I spent a fortune figuring this out, including flying to the Cleveland Clinic for angiography and NO ONE TOLD ME about EECP even though they had it there on campus. It was also available to to me locally and neither of my two cardiologists told me about it. And they are of course, also, continuing to recommend low fat, and ignored my insulin status. Really disappointed in the medical establishment–I get that they are allopathic, but how the system dosed me up on high calcium supplements (and I even asked my doctor if that could damage my heart and he assured me “no, different mechanism” without mentioning I should be on K2), etc…

Q66 · 2018-07-18 13:37:32 UTC

Victoria –

Appreciate your insights and info. The EECP is certainly intriguing. You also bring up an excellent point about “silent cardiac disease.”

And what I would share with this forum about my own heart attack is that chest, arm or jaw pain is not always the sign. Sometimes it can be back pain, or in the shoulder blades, which it was for me. As I understand, warning signs for women is often back pain. The reason being, your heart does not have the same kind of pain nerves, so the discomfort is felt in other areas of your body.

So it’s important to listen to your body, especially as you get older and are overweight. I was 44 when I had my heart attack, and met a number of other people in cardiac rehab that were in their 40’s as well, including a few in their late 30’s. And some of these people looked healthy and unlikely heart attack victims. So its not always people in their 50’s, 60’s and 70’s.

Good luck and good health.

Q66 · 2018-07-18 13:57:52 UTC

Phil –

It appears you’ve been doing your homework, and are fortunate to have an awareness of your condition.

Came to some of the same conclusions about statins. And I have been on them for a while. My cardiologist advised me to take for D3, which I have, but said nothing about K2. I had to discover that on my own.

With respect to the low fat vs. LCHF diet, my own experience is that I’ve tried to follow the recommendations for the low fat for years. Not to say I haven’t eaten my share of takeout and junk as well as drank. I was a big fan of the french fry and Dairy Queen. I did some unhealthy things. But I didn’t become overweight and develop a heart problem because I ate lots of rib eye steaks, bacon and eggs and full fat products. Quite the opposite.

I’ve been on keto since mid May, and will admit, trying to eat the extra saturated fat, especially in the beginning, did cause me concern. Am I doing the right thing? Well, I have lost a good deal of weight, and feel good. I pay very close attention to how I feel. I’m reading up and watching lots of YouTube videos on keto and heart disease. So right now, I’m just taking it day by day.

Be well.

petpro · 2018-07-18 14:37:31 UTC

I must say I was excited when I found out that patients with dangerously blocked arteries are able to grow new blood vessels to bypass the blockage. I have been sent down a rabbit hole of research, which I soon found can become completely overwhelming. If there is something I can do to enhance this process… I’m in! There is so much I don’t know for sure, I have not confirmed a blockage. At this point, I don’t want a cath angiogram and I would prefer not to take Statins. I feel there is a large question mark on both. In some ways, you are luckier but I can’t say I’m looking forward to getting angina I have had a great life and at this point, I value quality over longevity. I will investigate EECP… thanks. I’m still unsure whether I got in this position due to Familial hypercholesterolemia, Environmental factors, or possibly both (More research). I found a cardiologist who could may be able to help (https://lowcarbcardiologist.com/). I was prescribed Lipitor 40mg, I took them for 2 weeks out of fear. After regrouping, I stopped and went on a modified Keto Diet, I had my blood work down yesterday and waiting for the results. LDL was 257(HDL/TRG 1.37. I weigh 150 lbs, walk for 1 hour per day and lift light weights 30 minutes per day. I’ working on getting a CT Angiogram and a second opinion. I have discovered that most cardiologists have ‘a narrow way of thinking’. I felt I was being bullied into invasive procedures and pharmaceuticals. It does seem that the fundamental problem is not high LDL but Inflammation. There is some great information on this, looking at it as an engineering problem. Yes… I’m also disappointed with the medical system. It’s not a ‘Health Care’ system … it’s a ‘Sickness Care’ system. I have been taking K2 and Ubiquinol for a long time. I stopped taking calcium supplements and work on getting calcium from my diet alone. I will certainly be following your blog, I have discovered that I actually enjoy research, investigation and thinking outside the box. There must be many others who find themselves in this same situation.

Victoria_Powell · 2018-07-19 02:08:52 UTC

Yes, Phil, I think there are a lot of us. What occurs to me is that the keto “movement” was ignited by the younger and up to 40 and 50- something successful guys like Ivor Cummins, Peter Attia, Gary Taubes, Jason Fung, Rhonda Patrick, etc. and these slightly younger but energetic and tech friendly folks are into PREVENTION, having had the wake-up calls of looking up from their success and noticing bad labs or overweight or such. While many people are also trying to follow their lead, I’ve noticed a dearth of info for those of us who are coming from behind and already have the disease. In a sense, it’s much more acute when you add age as a risk factor, because that one is inevitable. So my task was to know that partly this was time catching up, and also it puts you squarely in the hands of the allopaths. You have a disease, now let’s treat it. American medicine isn’t preventive historically or educationally. It is a triage model, a trauma model, acute sorting. So you and I are the patients not currently having acute interventional needs and are farther down the list of concerns compared to someone presenting in an ER with an MI and needing a few or more bypasses. Then you add in the compensation system that rewards the doctors who do procedures over those who think and prescribe. It is hard to blame them, but “health care” and “wellness” are really new words and concepts that they are trying to “stuff” into a different model. For those who do think and prescribe, the pharma machine is embedded and rightly so in many medical minds, because they honestly have eradicated and cured many deadly diseases. The current state of affairs also has some of that kind of research going on, but these dollars are not trivial, and we do live and function in a for-profit society. Which is why we are here looking for all the alternatives, discussed with transparency and open-mindedness. Still, in my case, I know I’ve come across something the entire keto/longevity community should know about, and which is not trivial, but watching Peter Attia throw tires around recently and seeing the biohackers and longevity seekers advocate HIIT, they are a bit still living in the “diet and exercise” world, including fasting, supplements, exogenous ketones, etc. all of which are really important and have my attention, but once you have the disease, your question becomes, what ELSE can I do. When the doctors don’t answer you with anything and then you find they have something this good, it’s damning IMO. Thanks so much for sharing, there are lots of videos of patients’ experiences with EECP if you go to the facebook pages of Legacy Heart Care. I’m not there yet, but I will be! They have about 7 or 8 treatment facilities around the US. Lipids are another whole story, I do suggest Peter Attia’s blog to understand that, and Ivor Cummins and Dave Feldman, although the autophagy questions are tough and there is precious little I can understand down that rabbit hole so far. LDL is not the number that matters, but defintely worth pursuing the learning about that I think. My question is “Can your system remove plaque once it’s there, and how can you encourage that process?” Next, “how can you measure it’s reduction or removal accurately and safely?”

Victoria_Powell · 2018-07-19 02:17:29 UTC

Hey Q66, curious if anyone mentioned EECP for you during cardiac rehab? It’s covered by most insurance, and indicated post MI, post stents, post bypass. Makes me furious they don’t offer it to patients, especially young ones. Part of the problem is that when Medicare approved it in 1999, for some weird reason they decided it should FOLLOW interventions, even though it is non-invasive, which logically would make you think, try that first, like medications, BEFORE surgeries or stents. The “first do no harm” oath. Hoping that will change, and it has some because it was recently approved for CAD and shortness of breath, I think, but it’s pretty illogical and you still hear doctors say “I wouldn’t recommend it until after interventions have been exhausted.” I saw two Duke cardiologists on Youtube actually say that. My question is how could that attitude EVER be good for a patient? You won’t try a non-invasive conservative treatment first? Insert unladylike expletive here. Thanks for your comments!

Q66 · 2018-07-19 14:46:26 UTC

Never heard of EECP until I heard about it from you.

petpro · 2018-07-20 00:11:40 UTC

I just found that out… the insurance will pay for a Cath angiogram ($4000) but they will not pay for a CT angiogram ($1000).

petpro · 2018-07-20 01:26:43 UTC

Absolutely! It is a ‘Sickness Care System’, not a 'Health Care System. The Stenting/Statin model is out of control.

The full long-term effects of Statins are still unknown. There’s not much chance of me getting EECP through my insurance. I feel as good now as I did 20 years ago, I have no CVD symptoms. Yes …there are some incredibly dedicated and motivated individuals working on this from many different angles. Looking to discover the ‘Truth’. Doctors, in general, don’t seem to have any knowledge of LDL particle size or the importance of testing. It seems that calcium may actually be a stabilizing factor within plaques. I would like to get a CT angiogram to discover the locations and severity of any blockages. Did you get important information from your CCTA? I want to find out… what is the best strategy for slowing CVD progression and stabilizing plaques.

Victoria_Powell · 2018-07-20 02:52:14 UTC

I’m not surprised. The patient information pages skip that and other non-invasive treatments. If you go to the Mayo Clinic, even the Cleveland Clinic, patient information pages, and lots of other major hospitals, including WedMD and American Heart Association, they go straight from medical management (pharmaceuticals) to stents and surgery. I’m a tax lawyer, and I’m not allowed to be outdated in my profession, it would be malpractice and I’m not dealing with life and death. Why can cardiologists get away with not telling patients about this option that has been around for 50 years and paid for by insurance for almost 20? Why can they get away with recommending low fat diets that don’t work and hurt people? Why can they get away with ignoring a Joseph Kraft and letting thousands of people be deceived about their insulin status? My dad was a pathologist, and he prevented us as kids from eating “Red dye No 2” 20 years before the FDA banned it as carcinogenic. He said the medical literature was clear back then. It should not take this long to change dangerous advice… Lucky for us, though, we now have the internet and can turn it into a force for change, one person at a time.

Victoria_Powell · 2018-07-20 03:35:33 UTC

I had two coronary CTA’s about 10 years apart. They revealed an anomalous artery formation in my heart, but that isn’t the cause of my disease. The disease did not show up on either study. When I continued to complain of increasing angina on exercise, I finally decided to go get a cath with the support of my local cardiologist. That was the definitive study for me showing a narrow LAD, my disease is localized there, and my LAD was probably also congenitally kinda small. During this last 3 years, none of the doctors mentioned the more advanced lipid and insulin tests I now think I need, although when I discovered my very high cholesterol in my 50’s (after an insurance exam!) I did get lipids fractionated and don’t remember anything except I was told I wasn’t either in the safe category of genetic low risk, nor conclusively high risk. At that time I didn’t know what it meant, so I ignored it… I took a dose or two of the statins they gave me at the time, but quit from muscle pain right away. I don’t recall at this moment which tests I’ve decided I need, the more I’ve read, the more confusing it becomes, so I have been trying to find a really sharp cardiologist to follow me and help me. Sadly, I tried to go see Dr. Nadir Ali in Texas (check his youtube) but his office staff decided I was a problem because I wouldn’t back off on requesting more advanced tests, and I honestly believe they talked him out of seeing me, because they called me back and told me he referred me to another doctor. The referral was to Dr. Brett Scher in CA, who has a new “fitness/nutrition” consulting practice that is cash pay, and he was nice enough to call me but told me he wouldn’t be providing medical advice in that setting. I only need his medical advice, and told him I didn’t mind flying out to see him, but he was clear the insurance reimbursement would not enable him to spend much time with me. So frustrating, right? But honestly I was not convinced he could actually go deep on the lipid/autophagy/plaque stablilization questions you and I both have. Reversing the disease for me is priority 1, then 2 would be slowing progression. I’m not giving up. Rhonda Patrick and the longevity folks are all about sulphoraphane, so I’m adding nutrients and behaviors that stimulate autophagy. It’s another thing to understand whether you want to stablize or stiffen the plaque and some doctors seem to think that can be protective. I’m probably also going to try autologous IV stem cell, and may try the lithotripsy External Shock Wave Therapy, saw some papers on that as well. I also visited with a neurosurgeon, they are implanting neurostimulators now to treat angina, but I’m not going there, as it seems to be more symptom relief than disease treatment.

petpro · 2018-07-21 00:18:45 UTC

Hi, Victoria…they usually stent an artery with a 75%+ blockage. When I got a high CT Calcium score in my 40’s, They told me to go on a low-fat diet and eat plenty of fruits and vegetables. I was in the 80th percentile. Yeah… looks like we are both viewed by most cardiologists as ‘troublemakers’. I spoke to Dr. Brett Scher yesterday, I’m still looking for a second opinion. Yes…I’m just starting to go through the frustrations that you have been experiencing. I have actually stepped up my exercise, including weight training. Logically it makes sense that it would help to stimulate collateral vessels (natural bypass). In a similar way that EECP works. OK … so I may be taking a bit of a risk, I’d rather burn out than fade away! I admire your determination to find a solution. Atherosclerosis can advance as much as 30% per year … yikes! The reality is that just one small unstable plaque can end anyone. For 30% - 40% of individuals, death is the first sign of heart disease. Get my blood work results soon, I’m hoping my keto modified diet has improved my ratio’s. Took a swim and jacuzzi today … life’s good. I’m motivated to keep it that way.