Tuesday, December 7, 2010

Your Brain Loves Cholesterol (Don't Go Too Low)


I'm beginning to feel less small and alone in the world.










* not really


  1. Emily, I don't consider you "alternative," and that's a compliment. You are in the time-honored mainstream of logical, scientific exploration. You're a pioneer, a little ahead of the pack.

  2. And this is exactly why I sent you the link. A mind immeasurably superior to my own was able to decipher all of that and turn it into something I can understand!

    Thanks! Oh, and congrats on getting a front page header on PaleoHacks!

  3. Another wonderful post! As a side note, I've seen Dr. Lake speak, and he's a brilliant and very kind man. You are in good company, Emily (and based on what I've read on your blog, so is he!) Keep up the fantastic work....

  4. Steve - thanks! Psychiatrists as a group, especially on the East Coast, are conservative and, to some extent, snarky (too much time spent with people, I guess ;), however, as we do tend to deal with the "whole" patient and lifestyle, I've found most psychiatrists I've talked to in person to be surprisingly open and interested in my ideas. The primary care doctors (having been burned too many times, perhaps, by studies of vitamins) tend to tell me that vitamin D is a fad, that low fat has to be the way to go, etc. I don't have a lot of contact with cardiologists (and though I make fun of them, they save lives every day!! I just wish they would release their death grip on the lipid hypothesis.)

    Jamie - my mind is hardly "immeasureably superior" to most, certainly not to your own - pretty much I'm just as smart as the latest research paper I'm reading... and I greatly appreciate the papers and links you pass along!

    Joyful - No one gets to be the chair of APA anything without being an exceptional clinician, so I'm certain Dr. Lake must be an amazing fellow.

  5. Oh great trying to get dinner on and I see this. It strongly reminds me of this post on my blog.


    This thing drove me around the bend and now, with this citation, it's back!

    If dinner is late, I'm blaming you guys.

  6. Michael - I need to take another long look at the paper and then think on it.

  7. Okay - so if you think of diabetes as a fat storage disease, you've got straight up type ii where you store fat too easily, then you have type I where immune attack on the beta cells means you can't store fat, then you've got type ii kta-prone where no one knows exactly what is going on, but you're more on the not able to store fat side than storing fat too easily. So if *somehow* you can manage to pack on some pounds, you can shift yourself to becoming more like a straight up type ii, which ironically enough is curative for your fat storage problem and will normalize blood sugars, because you're able to bypass the whatever-it-is fat storage problem by storing fat too easily as more like a type ii. That's my stab at you previous post paradox, Michael. It is a different issue than cholesterol making in the brain, and the wording of the paper makes me think it is low low insulin that is the problem - so type I diabetes or advanced type ii with beta cell burn out.

  8. Emily, this is why your blog got me stewing.
    For the past month or so I’ve searching around for an endocrine mechanism that can be suppressed by hyperglycemia. This is because by the sheerest of luck, I found a little trick that allows me to turn on my 1st phase insulin response and conversely, suppress it. I don’t know if this will work on anyone else but it does give me a window into this type of diabetes.
    I won’t go into all the gory details but if you wish to read more details about it. You can read it here.
    The 1st phase would get depressed by hyperglycemia. My readings would then match my early readings before I took insulin. (100 to 160)This led me to take another look at the idea that it was the loss of beta cells and the subsequent insulin insufficiency which was responsible for my blood sugar numbers.
    If, in the space of a week, I could reduce the numbers down to normal blood sugar numbers between 80 and 120, this is hard to ascribe to beta cell growth. It is known that the KPD’s who recover to near normal blood sugars have been shown to have c-peptide numbers that were low normal even though they had just went DKA. Also buried in the pile, I remember them challenging the body with drugs to see if they could get a glucagon response, again normal.
    What seems to be the case to me is that rather than system deterioration, what happens in the case of sudden onset type 2 diabetes is rather a metabolic derangement. This makes sort of sense when you think of how abrupt this comes on and also how quickly it can be resolved, especially by insulin. Nothing matches insulin in the resolution of KPD. It could be viewed as a intact system malfunctioning because some control element has been lost and the parts of the system no longer coordinate. This was my thinking anyway.
    I’ve been digging about looking for something that effects glucose metabolism that is sensitive to the effects of hyperglycemia, can be fixed by insulin and can be affected as well by a PGE2 inhibitor. This is why I showed such interest in Jamie’s article. This article seems to suggest that the hypothalamus is a good candidate. What’s your take?

  9. Michael, the hypothalamus is an obvious place to look, as one small thing can go wrong there and throw the whole metabolism out of whack. Something that also randomly occurs to me would be some sort of issue with the insulin receptors. I believe I read somewhere that they can be differentially spliced depending on the environment and maybe some signal goes wrong in type ii kta where some of the receptors get screwed up, or possibly there is an autoimmune attack that ebbs and flows on the receptors? It isn't bad enough to make them completely nonfunctional, but more insulin could therefore be nearly curative. I've only had a change to quickly scan Jamie's paper a couple of times - Ill look more closely at their discussion of insulin in the hypothalamus and see what I can make of it.

  10. Dear Emily, is it possible to change cholesterol levels in the brain with statins? This recent research says the brain is shield from external colesterol and produces all it needs. Please correct me if I'm wrong. Love your blogue!


  11. O Primitivo - most of the brain's cholesterol is made by the brain. In fact, the neurons seem to forgo making their own cholesterol because they need all the energy they can get keepi g the ions flowing - they outsource to the astrocytes - it is clear that some lipophilic statins (like simvastatin) readily cross the blood-brain barrier. The most study showing statins interfering with serotonin receptors was done in hamster ovary cells, however. Also, according to some autopsy studies I linked in a long-ago post, they found the free cholesterol types and amounts to be rather similar between the brain and the rest of the body, though e brain has a lot of cholesterol in the synapses and myelin also. I think putting all thAt info together would suggest that the brain and body aren't entirely separate when it comes to lipids - after all we spend a lot of time thinking about ApoE, too, which is how some bodily cholesterol gets to the brain.

  12. One more thing - one of the links you kindly left discusses how the overall turnover of cholesterol in the brain is very slow - this is true - most of the cholesterol is in the myelin and the turnover is slow, however, turnover in the synapses is quite fast.

  13. Thanks for these explanations. Here is a great cholesterol article: http://raypeat.com/articles/articles/cholesterol-longevity.shtml

  14. Although I knew that eggs are healthy. But now, I'm going to eat more eggs to reduce some of the burden of the liver and brain in making the essential cholesterol. Not sure if I'm right. Does eating more eggs give more cholesterol to the brain?

  15. Hi Emily, I remember the eggs are bad for you hype as a kid (I'm almost 70), and my Mom said, "How can eggs be bad for you when they make a whole chick? Nonsense!" So I ate eggs for breakfast with whole wheat toast for the rest of my life, and little did I know, the whole wheat toast wasn't such a good idea. Paleo (with fat from dairy) is working great for my Ironman training, and health in general. It's the old big lie phenomenon all over again. Great blog. Cheers, Kevin aka FitOldDog


