Martini night at The See No Evil bar in Topeka, KS

Martini night at The See No Evil bar in Topeka, KS

Oh wait that is every night. 

I  learned that a Sapphire Martini is different as it is more herbal.

That's why a different vermouth might be used. 

See My favorite vermouth link

See my Bon Vivant diet link

Autumn in Topeka 2019

November 9, 2019
After a freeze and some wind most of the leaves fell off. 

October 30, 2019

My New Bon Vivant diet with modified Intermittent Fasting

My attempt at Intermittent Fasting

Fasting glucose (finger stick) 124
CGM 116
Ketones 4.0

BREAKFAST
One egg cooked in butter 7-9 AM
100 calories 0.5 g CHO 8 g Fat 6 g protein


Diet Pepsi
Snapple diet Tea
CGM 131 at 10:40 AM
Poweraide with Premium Clear Protein drink
90 calories 20 g protein

CGM 116 at 12:15 PM
LUNCH
Caffeinated coffee w one dark chocolate
1 square 60 calories 14 g CHO 3 g fiber 15 g fat Protein 2 g

Gym workout
presently I walk treadmill 20 minutes and stretch for back
PROTEIN20
60 calories 15 g protein

CGM 129 at 3:50 PM
 3.5 oz large salad 
160 calories 14g CHO 3.0 g Fiber 1.50 g saturated fat.
here then:
CGM 142 at 4:33 PM

DINNER

8 OZ BEEF FILLET 
560 calories 62 g protein

Butter 2 pats
200 calories 

CGM 170 7:43 PM


After Dinner Gin Martini
135 calories 20g ETOH 0 CHO
4 garlic stuffed large olives
40 calories 4 g CHO 1 g Fat

8 oz red wine

160 calories 22 g ETOH 4 g CHO
360 calories 4 oz cheese

CGM 171 at 8:22 PM 

Total calories:

100

 90

  60 

  60

160

560

200

160 

  40

360

total: 1630 calories 

Please note:

Basal Metabolic Rate : 1761 calories 

Moderate activity (5,000 to 8,000 steps):

2,642 Calories 

I have a daily deficit of 1,000 calories a day

Why don't I lose weight.

Answer:

I am a reduced obese with the Sponge Syndrome

Validation of Sponge Syndrome link

I have been down to 208 lbs but next day I can jump up to 213 lbs. 
I will cut down to one block of chocolate now. 
I will just have one egg instead of one yogurt. 
Less carbs more calories. 
I have been 200 lbs but it is very difficult for me to stay there due to the Sponge syndrome. 

My goal is 200 lbs which means I will jump  back and forth to 205 lbs if I am lucky or very consistent. 
While watching TV at night I am not so hungry as bored with some cravings. 

I will eat popcorn, almonds, or pistachios as a snack. 

I have cut down on my snacking due to using a
 Continuous Glucose Monitor (CGM).
It is a helpful motivator to turn away from snacks.  

My true help with appetite is:
Victoza 3.0 mg injection
Belviq 20 mg day
Metformin 500 mg a day.
Caffeine 
My true help with my Diabetes Mellitus type 2:
Invokana 300 mg 
Lost 30 l lbs on Invokana without change of diet or exercise link

Recent BIA's

Products I use with nutrition information



Propel water below



 20 gram protein drink with Poweraide Zero to bridge lunch 




15 gram protein drink which I take during my workout at gym
















I compare 3 vermouths for my Classic Gin Martini link

Insulin references in The Hungry Brain. by Stephen J. Guyenet

I have Stephan J. Guyenet's book, The Hungry Brain.

I missed his references to the central action of Insulin on the brain.

In his tweet below he writes, "The effect of insulin seems to be smaller and less consistent though."

I guess he is comparing it to low levels of leptin action on the brain?
My article on the paradoxical effects of insulin link

Excerpts:
1-Although many factors affect fat cells, the hormone insulin exerts dominant anabolic control. (peripherally)

2- Catabolic state of uncontrolled diabetes despite elevated blood glucose

I have tried to figure insulin and leptin effect in lean, obese and reduced obese. Article from Aug 2017

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583684/

Probiotics for Alzheimers ?

My only experience taking probiotics was when I had horible diarrhea on a Viking Cruise to
Cambodia.

It cleared up my diarrhea in one night.

I have had to decrease my metformin from 4,000 mg to 1,000 over the last year because of intermittent diarrhea.
I have decided to take probiotics daily to to try to increase my metformin.
Heck it might even help me lose weight.
I decided to spend $13 at SAMS rather than Mercola's $140 bottle.


This is what Dr. Dale Bredesen in his book The End of Alzheimers.

People need probiotics according to Dr. Bredesen unless they have leaky gut syndrome. 

I spoke to my Endocrinologist about Probiotics this week.

He said it helped his bowel movements.

He found Sam's to have the cheapest product.

The pharmacist suggested the Gummies below:
















The excerpts below are from The End of Alzheimers p 203






30-50 billion CFU (colony forming units)

My Sams product has only 3 billion CFUs at a cost of $13.

Here is a high price alternative






UPDATE Jan 26, 2021

I sent in a stool sample to Thryve to determine which bacteria I lack in my stool.  On sale it cost $100.  

Instructions were very clear and not messy at all. 

AZ: : "Who are they then?"

From tweet below:
"I often hear people say that a person suffering from Alzheimers is not the person they knew.
I wonder to myself - Who are they then?"






Let me clear up a myth.

"People don't change."

In Shakespearean plays it is shown how people progress in their characters.

I have changed with my Alzheimer’s disease,

I am 33 months since my diagnosis.

I try to be philosophical as I was in the epilogue of my Year One book below:

Check homocysteine level for Alzheimers ?

In The End of Alzheimer’s by Dr. Dale Bredesen advises my homocysteine should be less than 7.
If it is not I should take:
 methycobalamin 1 mg
methyfolate 0.8- 5mg
PSP 20- 50 mg
Above is also if B 12 level less than 500


My lab's range is that normal is up to 15.





l


 As you can see from my blood work below, 
I don't need more Vitamin B or folate. 
Because of my testosterone my hematocrit has been high three times.

Testosterone for Alzheimers ?

In The End of Alzheimer's  by Dr Bredesen on p 209 he advises the above: ONE and TWO

ONE
Free testosterone is low if it is less than 6 pg/ml, take more testosterone.

This test better in obese?

My free testosterone results.  They were acceptable in Dr Bredesen's criteria and in normal limits in my lab range below

TWO
Lately I have had total testosterone testing see below.

These more recent tests were lower than the 500-1000 level that Dr Bredesen would like to see.
Bredesen writes that levels less than 300 are very low.

Thus my endocrinologist and I decided to increase my 100 mg a week to 150 mg a week,
 even though normal levels are 86 to 780 ng/dL on in my hospitals lab

The endocrinolgist that fired me link 
also she didn't want me taking testosterone because my Hct and Hgb was a little high. 

I asked my urologist (a professor at KUMC that specialized in testosterone) about the risk of stroke.

The urologist was not concerned as I was on a blood thinner. 

How to improve my glucose level without adding insulin

In The End of Alzheimer’s by Dr. Bredesen advises that:
Fasting insulin should be less than 4.5
Fasting glucose should be 70-90.
Hgb A1c should be less than 5.5

Excerpts from The End of Alzheimers:



I don't disagree with DESS.
Diet (ketotic)
Exercise 150 minutes a week.
Sleep 7-8 hrs a day (with CPAP if needed)
Stress reduction (always)

on p235 I don't agree with:
Alpha lipoic acid
N-acetlycysteine
Cinnamon
Berberine
Metformin is a good idea.

The best thing to do is lose weight and then maintain that weight loss.
I have not been on insulin for many years.
I run a high Hem A1c  of 7.5

I am now trying a new strategy.
I am using a CGM (continuous glucose monitoring) to see what food raises my glucose the most.

I went to my Endocrinologist today to help me evaluate ReCODE by The End of Alzhehiers,

My Endocrinology visit today was very productive.  

He ordered a hsCRP on my request.

The lab told me my insurance might not cover it and it might be $100 out of my pocket. 

I told my Doc I had hurt my back 2 months ago in Poland and it had not cleared up.
He found it might be covered with lumbar back pain. 
As an infectious disease Doc we would do CPR to look for osteomyelitis. 
Dr Bredesen advises getting hs-CPR and it should be less than 0.9.

Mine was higher than this.
I think it was due to my back pain from muscle inflammation.
My prior tests have not been elevated. 
I will check on it in 4 months.

I had a patient with very high hsCRP.  It was after she had her teeth cleaned.

I am surprised with all the items listed by Dr Bredesen for inflammation I was surprised he did not list chronic gingivitis or bad teeth.

As an Infectious Disease specialist I would be consulted for fever of unknown origin.  I would find these country people with very bad teeth. In Idaho I was friends with a dentist who went into ENT. 
He happily wound take the patient with no insurance to the OR and pull out all their bad teeth. 



CPR  is not often used by family Doctors as it it consider non-specific. (many things can raise it)

However in infectious disease this is the test that we used to decide whether to stop long term antibiotics in the treatment of osteomyelitis.


In The End of Alzheimers, Dr Bredesen says to treat hs-CRP if greater than 1.0 on p 235.

Dr. Bredensen advises specialized pro-resolving mediators for one month (SPM)

I can't find in the book what SPM is?

I will simply baby my back with stretches and exercise for a few months and check it again

Check Vitamin levels of B12 and Folate and TSH according to THE END of Alzheimer’s

On p 167 of Dr Dale Bredesen's book The End of Alzheimers he advises having a high level of folate at 10-25.
At this point I don't want to take any more supplements and I believe my level is normal.



Dr Bredesen Advises B12 levels to be 500 to 1500.



I doubt I will take B12 supplements as I eat a high meat diet. I have consistently had normal levels over the years. 




Dr Bredesen advises TSH level on p 168 that TSH should be less than 2.0 
Again my TSH is less than 4.0.   That is in normal range. I discussed this with my endocrinologist. 
I am not going to take thyroid.