UPDATE: I finally reduced my CAC Score {seemingly good news}

(Joey) #1

Here’s an update on a thread I started in May 2021 (link provided below).

SHORT VERSION: Yes, my overall CAC Agatston SCORE decreased from May 2021 to Jan 2022 - declined from 207 to 157. Although still higher than my first two scans (2019 & 2020), Agatston scale aggregate level of calcification has clearly headed downward. (Same hospital, same CT machine each time.)

FYI, I’ve been minimal-carb keto while taking the following daily supplements: K2 (“Koncentrated K” by Pat Theut), D3 (and plenty of sunshine, weather permitting), fish oil tablet, and a single Brazil nut. Otherwise, healthy active LMHR; no Rx.

FWIW, I eat 2MAD to full satiety (plenty of fat/protein/green veggies) and exercise most every day (alternate HIIT strength vs HIIT cardio).

Test scores aside, I’ve never felt better, stronger, healthier in my life since going keto in mid 2019. Am closing in on 65 yrs old.

If you want the longer background and give 'n take from the forum, review the earlier post link below.

@Janie Let you husband know that my (n=1) experience suggests: yes indeed, it is possible to lower one’s CAC Score.

CONFESSION: I remain both curious and slightly skeptical of CAC Score results - which only measure calcified (hard) plaque as opposed to more dangerous (soft) plaque. Moreover, the density of plaque and the various subcomponents are not clearly addressed in an (aggregate) Agatston Score.

In my case, I continue to see some arteries with declining calcium and others with increasing calcium measures … same blood, same diet, same supplements, same exercise … yet somehow certain arteries get “better” while others get “worse?” I suspect there are measurement errors and limitations at play - especially at relatively milder calcification levels where statistical degrees of freedom likely come into play. YMMV.

My calcium score result
(Bob M) #2

Very nice description. And congratulations, I think?

If you want something more “natural” for vitamin k2, natto is very high in it.

(Joey) #3

Ha! Well put (I think).

Yes, I would like something more natural (and cheaper) for Vit K2. Haven’t gone out of my way yet to find natto given how disgustingly awful it’s been described.

BTW, my two initial non-zero rising Agatston CAC Scores were obtained after I’d already gone keto. Safe to assume that after decades of low-fat (= high-carb) eating, the various effects of systemic inflammation were taking their toll in (undiagnosed) ways I’d never recognized.

One might then wonder: why did those calcification levels continue to rise for two years of diligent low-carb eating, until now?

This leads to my hypothesis (= wishful thinking?) that I had been accumulating levels of soft plaque from systemic inflammation… and that cutting out the carbs - plus introducing K2/D3 - helped my body begin to heal those arteries through calcification.

Eventually, the soft plaques were sufficiently calcified that the K2/D2 and generally reduced inflammation permitted serum calcium to be utilized where it was meant to be … in my bones, as encouraged by my HIIT strength training, which has built muscle mass and promoted stronger bone density.

If my musings on this subject are correct it implies that, for many of us, moderate levels of arterial calcification is the cure - not the disease. Sure, too much calcification leads to arterial blockage. A potential killer.

But at lower levels, calcium deposits represent the “scab” protecting the (soft plaque) wounds we’ve inflicted from past dietary habits.

Context is everything. Perhaps it’s similar to how higher cholesterol levels measured in carb-restricted eaters is not an inherently dangerous sign. On the contrary, perhaps it’s an indication of how one is now distributing energy. [See Feldman’s wonderful work: Cholesterol Code.] As an aside: I happen to be a low mass hyper responder (LMHR) when it comes to cholesterol. My latest HDL is now 119 with Trigs at 52, for a 0.4x ratio of Trig/HDL(!)

To be clear, I’m not saying that a zero CAC score is not a wonderful thing. But it’s also wise to recognize that one cannot be too certain of a zero score being entirely healthy … inasmuch as there may be soft plaque from years of low level inflammation that is NOT getting calcified. And therefore, one may be at greater risk for a stroke waiting to happen (from meandering soft plaque coming loose in the absence of calcification).

Disclaimer: I am practicing without a license. I am not a doctor, nor a researcher. I am simply a guy with the test results as shared above, and with three opinions about most every topic. :vulcan_salute:

(Joey) #4

My wife’s CAC score is now in. Here’s another brief update:

Having also risen steadily over the prior 3 CAC scans since changing our eating habits, my wife’s Agatston score came back essentially unchanged - i.e., no meaningful change since the last test.

Perhaps we’ve both reached a new level of calcification stability on low carb. In effect, n=2.

If you’re curious, she, too, has been taking K2/D3/fish oil/Brazil nut (1) daily.

But in fairness, she is not quite as “100% diligent” in uninterrupted carb-restriction. Besides occasional oatmeal, fruits, and even honey on avocado for breakfast/lunch, she otherwise sticks to the low carb menu … as we simply don’t have sweets, breads, rice, pasta, potatoes, etc. in the house.

Hard to know precisely which aspect of what we’re doing has stopped the calcification. I’m certainly more consistent in my low-carb eating, TMAD, exercise habits and - as shared earlier in this thread - my CAC score actually declined in a meaningful way.

(Bob M) #5

All of that seems possible. And the CAC is relatively new, but even if you don’t increase, that’s basically unheard of. The trend is always larger, at least for studies I’ve seen.

I know you think that the CAC even for zero scores is not great, but every study I’ve seen indicates that if you have a CAC score of zero, your chance of having heart disease is very low. Is it zero? No. But it’s super low.

Of course, what you’re doing is unusual, so it’s hard to tell what reversing (any part of) your score will do. We all hope it does something good.

As for natto, I personally think it’s good. The Japanese supposedly stir it 100 times to create a “paste” almost. I don’t do that. I just add some (wheat-free, naturally brewed) soy sauce to the beans and eat them.

Then again, I’ve eaten/drank all kinds of nasty stuff in my former body building life. Metabolol and other pre/post work out drinks; many different proteins or other drinks; too many things to mention. So, I’m not the best gauge of what tastes good or bad.

(Joey) #6

Just to clarify, I do not think a zero score isn’t great. If I’ve given a different impression along the way, that’s my poor communication!

Given the choice, I’d rather have a zero than my non-zero score.

Any ambiguity I reserve toward the CAC score framework stems from the incomplete picture (hard vs soft) of plaque and the significance of each type along the progression of risk for heart blockage vs stroke, etc. Just struggling to make sense of the research on this. Perhaps I shouldn’t do this aloud :wink:

@ctviggen You inspire me! I’ll bump natto back up higher on my list of bucket list keto foods to try. Next time I see it on the shelf I shall give it far more serious consideration - especially as a vehicle to use more of our stock of high sodium soy sauce. :+1:

(Bacon is better) #7

There is never going to be any perfect way of measuring, if only because of conceptual concerns such as these. Not only that, but the human body is a dynamic system, and no measurement can do more than provide a snapshot of the state of the system at a single moment. And given that, in most cases, we don’t even know the full implications of what it is we’re measuring, the picture gets even more complicated.

(Joey) #8

So true.

Moreover, one of the consequences of our choice of metrics is our subsequent compulsion to manage toward them. ("You can’t manage what you can’t measure," say the best-paid consultants).

Having developed blood tests for cholesterol, we produce drugs and diets to manage our apparent/momentary levels.

Being able to measure prostate activity markers (PSA) produces a market for surgeries and other questionable interventions with life-changing consequences.

And now, DNA testing during pregnancy has been reported to be 85% inaccurate - producing far more false positives than true positives - creating untold anxiety and stress over “what to do” about the results.

Needless to say, we still need to measure stuff. But applying a “measure” of healthy skepticism (and humility) as we consider our action plans seems wise.

(Bacon is better) #9

And the flip side of this is the temptation to manipulate the metric, rather than treat the underlying condition. The classic example of this is testing students to see how much of the material they are retaining. So the goal then becomes getting a good grade on the test, rather than actually learning the material. And no one sees any problem with that. In fact whole industries are based on teaching people techniques for getting good test scores, when it would actually be easier to simply learn the subject.

(Jane) #10

Thanks, I will let him know and I am happy for you. I won’t repeat my CAC this year but at some point we will pay for him to have another scan.

(Robin) #11

Great disclaimer. I could use that on a tee shirt.


Hey, well done Sheriff. This is good news thanks for sharing. On my last CAC my results were 100% worse :face_with_raised_eyebrow:. Different machines, different hospitals, different states in the country. First score was 0. 3 years later score was 1. I’m probably due another CAC this year.

It’s a challenge to ask one’s body to deliver the calcium to the correct places. When we talk calcium on these forums, I always wonder about oxalates. In doing so wonder on pursuing a more modern keto WOE that is oxalate low.

(Bacon is better) #13

Oh, my goodness! You’re going to die! Get on a statin, quick!! :grin:

(Alec) #14

Come on, Paul, get with the program: everyone should be on a statin. They are a wonder drug that should be in the water supply and put in all fatty foods to overcome the high cholesterol that is inevitable when you eat fat. We must murder all cholesterol, it is evil.

(Bacon is better) #15

Not only that, but statins prolong life. David Diamond does an analysis of pharmaceutical company data on statins and shows that there is a statistically-significant effect on lifespan. If you take a statin, you can expect to live about five days longer than you would otherwise. Yay! :grin:

(Alec) #16

I am surprised that was the result… but it was using pharma industry collected data. About as reliable as a certain governments dietary guidelines.

(Joey) #17

Who knows … perhaps your body got around to covering some undetectable soft plaque with much-needed calcium to render it harmless? I suspect there’s more to this stuff than we yet appreciate. From 0 to 1 in three years sounds like rounding error anyhow. KCKO, brother.

(Robin) #18

Tempting. But those 5 days are spent in total brain fog and whole body muscle cramps. I’m going to have to think on that one…


Congratulations - this is inspirational for the rest of us.

Have you had a cardiac function test? After my result (333) the cardiologist performed a static functional test (pumped me full of something to raise my heart rate). Highest rate was 140. He said that despite the calcification, I had no impairment to function, and so should continue to exercise, which I do.

I have to say, it wasn’t a pleasent experience though - doing breath holds at 140 bpm - and the beta-blockers they gave me to come back down resulted in 48 hours in bed. However, I’m glad I did it as the information was very useful.

(Joey) #20

And congratulations to you on this excellent outcome. Sounds like you’re getting top flight medical attention. :+1:

No, I haven’t had a test like you’ve described. And frankly, your description of the experience doesn’t make for good marketing material :wink:

When I do my high-intensity sprint workouts a few times weekly, I do check my pulse rate immediately after the activity spike. It’s comforting to know where my BPM max’es out, but there’s nothing more scientific than that going on down in my basement workout room. (I typically max out somewhere between 140 to 150… being in my mid-60s this seems about right?)