Introduction 

Managing your heart health is crucial, especially when it comes to specific markers like Apolipoprotein B, or ApoB for short. You might have heard a lot about LDL cholesterol being the bad guy, but did you know ApoB is actually a better predictor of heart disease? In this post, I’ll walk you through how I managed to lower my ApoB levels by 34% without any drugs or causing insulin resistance. We'll dive into whether diet, exercise, and hormone optimization have an impact on ApoB levels.

ApoB plays a huge role in your cardiovascular health. It's the main protein found in several lipoproteins like LDL, VLDL, and IDL, which carry cholesterol and triglycerides through your bloodstream. These can lead to plaque buildup in your arteries and eventually, heart disease. Lowering ApoB is a big deal because it can seriously cut down your risk of heart problems.

My approach was informed by some thoughtful and well-respected experts but even more by the evidence in peer-reviewed journals. I’ll share exactly what I did, the amazing results I got, and the solid science behind it all. And don’t forget to check out the video I’ve embedded here where I dive deep into my journey and show you how you can do it too!

My Approach to Elevated ApoB Levels

Step 1: Testing My Apolipoprotein B Levels

First things first, I had to get my ApoB levels tested. This isn't a test most doctors automatically order, so I specifically asked my hormone optimization doctor to include it in my labs. If you're thinking about doing this, be aware it might not be covered by insurance. The cost ranges between $45 and $110 – not too bad considering the valuable insights it provides. When my results came back, my ApoB was at 161 mg/dL, which is in the "very high" risk category. That was my wake-up call to make some changes.

Step 2: Evaluating ApoB Lowering Drugs

There are several drugs out there that can lower ApoB, like statins and PCSK9 inhibitors. However, I had concerns about potential side effects, especially with statins possibly causing insulin resistance. PCSK9 inhibitors, although effective, come with a hefty price tag of around $500 a month. Weighing the risks and costs, I decided to explore non-drug options first.

Step 3: Making Necessary Dietary Changes

I started by researching diet and heart risk, and I found consistent recommendations to reduce saturated fat intake. Here's what I did:

  • Cutting Back on Saturated Fats: I decreased my consumption of grass-fed beef, limited processed meats, and switched from chicken thighs to chicken breasts. I also used olive oil instead of butter.
  • Increasing Healthy Fats: I doubled my fish oil supplements from 2 grams to 4 grams a day, ate more salmon, and added nuts and flaxmeal to my diet.
  • Adding Fiber: More salads, leafy greens, and a daily blueberry smoothie with whey protein and hemp hearts became staples in my diet.

Step 4: Supplements

I made some strategic changes to my supplements:

  • Fish Oil: As mentioned, I increased my fish oil intake to boost omega-3 fatty acids.
  • Berberine: This supplement has solid evidence for helping maintain stable blood glucose levels, which is crucial for avoiding insulin resistance.

Step 5: Maintaining Exercise

I kept my exercise routine pretty much the same. My daily regimen includes a mix of cardio and resistance training, but I didn't make any major changes specifically aimed at lowering ApoB. Interestingly, research indicates that exercise alone doesn't significantly impact ApoB levels, which aligns with my experience.

My Apolipoprotein B Results

After about 10 months of these lifestyle changes, I got my blood drawn again. The numbers were nothing short of impressive:

  • ApoB Levels: Dropped from 161 mg/dL to 106 mg/dL – that’s a 34% reduction!
  • LDL Cholesterol: Went down from 173 mg/dL to 126 mg/dL, marking a 27% decrease.

Insulin and Glucose Levels

One of my major concerns when adjusting my diet and supplements was the potential impact on insulin and blood glucose levels. I’m happy to report that both remained stable throughout this period:

  • Fasting Insulin: Maintained at a healthy level (1.8uIU/mL and 2.5uIU/mL), indicating no onset of insulin resistance.
  • Fasting Blood Glucose: Consistently within the optimal range (81mg/dl and 90mg/dl), reinforcing that my dietary changes didn’t negatively affect my glucose metabolism.

Key Insights from My Experience

  1. Dietary Adjustments Matter: Reducing saturated fats and incorporating more omega-3 fatty acids from fish oil and flaxmeal played a pivotal role in lowering ApoB. This aligns with numerous studies suggesting that diet significantly influences lipid profiles.
  2. Supplements Can Help: Strategic supplementation, like increasing fish oil and adding berberine, can provide additional support in managing cholesterol and glucose levels. These supplements are backed by research for their effectiveness in lipid metabolism and insulin sensitivity.
  3. Exercise is Essential, But Not Directly for ApoB: While exercise is indispensable for overall cardiovascular health, my experience and research suggest it doesn’t directly lower ApoB levels. However, regular physical activity supports weight management and overall metabolic health, which are indirectly beneficial.
  4. Consistency is Key: Achieving these results required consistent effort and adherence to the dietary and supplement regimen. Quick fixes are rare in managing biomarkers like ApoB; sustainable changes yield the best outcomes.

Practical Takeaways

This journey has reinforced the importance of a holistic approach to health. Here are some practical tips based on my experience:

  • Get Tested: Start with a clear picture of your ApoB levels through a blood test. Knowing your baseline helps in tracking progress.
  • Focus on Diet: Prioritize reducing saturated fats and incorporating healthy fats like omega-3s. Include plenty of fiber-rich foods to support lipid metabolism.
  • Consider Supplements: Fish oil and berberine can be valuable additions to your regimen. Always consult with a healthcare provider before starting any new supplement.
  • Stay Active: Maintain a consistent exercise routine. While it may not directly lower ApoB, it supports overall cardiovascular health and helps manage weight.

Disclaimer

My attempt to reduce my apolipoprotein B by changing my diet and supplement regimen is what's called an "N=1" experiment. I came up with a hypothesis, something I believed might be true, and made some changes to test it. Many viewers on my YouTube channel have pointed out that I changed too many things at once, making it hard to pinpoint what actually made the difference.

I totally get that criticism. My experiment has limitations from a scientific standpoint. There were too many variables to draw definitive conclusions. But remember, this wasn't just an experiment – it's my life! My wife and I eat the same meals, and we can't control our diet and lifestyle as strictly as a clinical trial would require. Plus, multiple ApoB tests aren't exactly budget-friendly.

Get Help with Your ApoB

If you're concerned about your ApoB levels and overall heart health, consider reaching out to a hormone optimization specialist. These healthcare providers are trained and experienced in managing heart health risks and can help you develop a personalized strategy. To find a qualified specialist, visit my referral page. By connecting with an expert, you can take proactive steps to optimize your health and reduce your cardiovascular risk.

Apolipoprotein B Research

> ApoB Causes Atherosclerotic Cardiovascular Disease (ASCVD)

  • European Heart Journal: This study discusses the direct role of ApoB-containing lipoproteins in the development of ASCVD, indicating that ApoB is essential for the formation of atherosclerotic plaques, leading to cardiovascular disease.URL: https://academic.oup.com/eurheartj/article/38/32/2459/3745109
  • Atherosclerosis: Another paper emphasizes the critical role of ApoB in initiating and progressing atherosclerosis, from the initial fatty streaks to complex plaques, ultimately leading to clinical cardiovascular events.URL: https://academic.oup.com/eurheartj/article/41/24/2313/5735221
  • > ApoB - Better Biomarker for ASCVD

  • Journal of the American College of Cardiology (JACC): This article reports that ApoB is a superior marker of cardiovascular risk compared to LDL-C, highlighting that ApoB directly measures the number of atherogenic particles, providing a more accurate risk assessment.URL: https://www.acc.org/latest-in-cardiology/articles/2021/07/21/12/42/apo-b-residual-cv-risk-after-acs-and-effects-of-alirocumab
  • Atherosclerosis: This study shows the greater predictive value of ApoB over LDL-C in determining cardiovascular risk, particularly in patients with discordant ApoB and LDL-C levels.URL: https://academic.oup.com/clinchem/article/67/11/1440/6372218
  • > Dietary Saturated Fat and ApoB

  • American Journal of Clinical Nutrition: This study demonstrates that replacing saturated fats with unsaturated fats significantly lowers ApoB levels, thus reducing cardiovascular risk.URL: https://academic.oup.com/ajcn/article/110/4/912/5544940
  • Journal of Lipid Research: Findings from this journal support the impact of dietary modifications on lowering ApoB, emphasizing the role of dietary fat quality in managing cardiovascular risk.URL: https://www.jlr.org/article/S0022-2275(20)31288-9/fulltext
  • > Exercise and ApoB Levels

  • Circulation: Research in this journal indicates that while exercise improves overall cardiovascular health, it does not significantly impact ApoB levels, suggesting that dietary and pharmacological interventions are more effective for ApoB reduction.URL: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.045682
  • Journal of the American Heart Association: This study confirms the minimal direct effect of exercise on ApoB levels, reinforcing the importance of diet in managing ApoB.URL: https://www.ahajournals.org/doi/10.1161/JAHA.119.014652
  • > ApoB Targets

  • European Heart Journal: This journal recommends specific ApoB targets to reduce ASCVD risk, with levels below 80 mg/dL for high-risk individuals and below 60 mg/dL for very high-risk individuals.URL: https://academic.oup.com/eurheartj/article/38/32/2459/3745109
  • American College of Cardiology Guidelines: These guidelines provide target ApoB levels to achieve optimal cardiovascular outcomes, aligning with the recommended thresholds.URL: https://www.acc.org/latest-in-cardiology/articles/2021/07/21/12/42/apo-b-residual-cv-risk-after-acs-and-effects-of-alirocumab
  • > Optimal Hormones and ApoB

  • Journal of Clinical Endocrinology & Metabolism: This study highlights the influence of optimal thyroid hormone levels on lipid metabolism and ApoB reduction.URL: https://academic.oup.com/jcem/article/106/2/450/6053708
  • Menopause: Research in this journal indicates that optimal estradiol levels in women are associated with improved lipid profiles and reduced ApoB levels, demonstrating the benefits of hormone optimization on cardiovascular health.URL: https://journals.lww.com/menopausejournal/Abstract/2020/02000/Effect_of_hormone_therapy_on_lipid_profiles_and.12.aspx
  • With over 26 years of experience as a licensed pharmacist in Utah and Colorado, I specialize in hormone optimization and menopause management. I hold certifications in Advanced Bioidentical Hormone Replacement Therapy (ABHRT) from Worldlink Medical, C4 Hormone Replacement Therapy from the Professional Compounding Centers of America and the American Academy of Anti-Aging Medicine, and I am a Brain Health Coach certified by Amen Clinics.

    I also share my expertise on my Simple Hormones YouTube channel where my videos have been viewed over 950,000 times and over 18,000 viewers have subscribed.

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