Friday morning at the MTSU stadium for stairs. I again one upped myself but won't likely try that again for a while. I may not be able to do another stair session at MTSU til Dec 4, but I can always run hills in Sewanee. In fact, I measured out distances of 100, 150, 200, and 250m on the steep at Roark's cove rd. So, maybe next Friday I do some Halloween hills.
Weather at the stadium couldn't have been better, mid 50ºs and hazy sun. No wind.
Stretches, drills
15 x stadium stairs
It was tough. I took a bathroom break at 10, and came back to do the last 5. Last few I was sitting down for a brief rest in between. I did start off with 6 consecutive. Halfway up, there was a knee high gate that caused me to stop, step over, and lose momentum.
I did my yearly testing blood work. This was may yearly physical, so not the self testing from Ulta. Lipids were pretty much the same as in Sept.: Total Chol - 210; LDL and TriG, both 140; HDL up a bit to 46, and fasting glucose - 82. I'm not worried about my lipids, even though my ration is far from ideal at 4.59.
I am worried about my liver. My AST and ALT were up a lot compared to my pre op panel in Jan. An increase from 21 and 26 - to - 60 and 61. Never been that high in decades, and up so quickly. All the rest of my liver function tests were normal and I'm asymptomatic, aside from the cyst detected.
So, I'll see what the Dr says. I may cut out the bergamot and niacin supplements and retest in a month or so. Really inexplicable. Makes me suspicious of the few supplements I am taking - collagen and a glucosamine complex. Maybe contaminated? Also, see what the MRI says. My friend Al sent a note of caution about taking unnecessary action on such things. An intervention like a biopsy or unnecessary surgery could make it worse. Anyway, nothing pressing but bears watching.
My weight has been decent, generally around 143 and lighter after training.
Today, Saturday, last warm day, I processed that dead tree I cut down on Tues into firewood.
Told you so on all counts. Bergamot and niacin supplementation can cause liver injury. Supplements should be avoided and restricted to medically indicated. For instance calcium for osteopenia. Chondroitin is especially risky as typically derived from animal cartilage and can have heavy metals contamination. And it doesn’t do anything. Once again decision making…
ReplyDeleteFasting blood sugar is good but you probably fasted for 24 hours or more so there is no baseline. You have to follow the protocols for which the normal limits were derived from or the results may not be meaningful. You cannot find any published literature on normal blood sugar range for a 36 hour fast. The reference is just an overnight fast and for the preceding 3 days mixed meals with at least 150 grams of carbs daily. Blood tests are not competitions.
ReplyDeleteMy fast was about 12 hrs.
Delete82 is really good then. Mine was 90, A1c is 6. I’m on a SGLT2 for proteinurea CKD (preserved GFR so far at 88, trying to keep it that way) SGLT2 are a diabetes drug that they found reduces CKD progression and reduces CVD mortality. Without that my fasting glucose and A1c would be higher.
DeleteMy first ever A1c test was 5.5. My hsCRP was 0.2. I think some of these tests are occasionally anomalous.
DeleteYes if you take a suite of tests each with multiple parameters (say CBC or CMP) normal healthy people will have some out of normal range. Which is why GP’s don’t like extra tests and specialists narrow the test to only they need. For instance urologist call for BMP not CMP. They don’t want to chase false signals. Risk is that a real signal could be there and missed.
DeleteI’m starting on GLP1 to preserve beta cells and further reduce CVD risk. There are two drugs proven to slow, and in some cases, prevents the transition from pre diabetes to diabetes. GLP1 is the preferred as it has few side effects and also significantly lowers MACE risk. Lean people, like me, who transition to diabetes typically fair worse as there isn’t the metabolic syndrome contribution, it just shitty pancreas function. So when lean fit people present with overt type 2 diabetes their pancreas is in worse shape than the typical overweight sedentary patient and haven’t that knob to play (weight loss etc). . Basically it’s like diabetes 1.5. Anyway GLP1 should help A LOT.
Delete60 and 61 is indeed a significant shift and now you do have something to worry about. Stop all supplements and retest in 3 weeks. Highly likely it will be resolved.
ReplyDeleteYes, that's the plan.
DeleteBTW... the ALT/AST test is one of the cheapest ULTA has. $10 plus draw fee.
DeleteWhat is your cystatin c level!
DeleteNever had that one, I don't think.
DeleteMuch better predictor of GFR than creatinine. Is not influenced by muscle mass or diet. Creatinine and cystatin c both are measures of function, which is rare in blood tests. For instance liver blood tests tell you nothing about how well you level works, just if it’s injured. So knowing how well your kidneys function with accuracy is important. Especially if creatinine is on the high side of normal. Or if you are entering old age as stable creatinine may mask renal function loss as it correlates to muscle mass. So if you are losing muscle and creatinine is stable kidney function is declining.
DeleteA second recommendation is urine protein to creatinine ratio. This is a marker for proteinurea. You’ve taken substances that could have damaged kidneys causing proteinurea. Both recreational and supplemental. My proteinurea might have been caused by that stuff Minehan sent so many years ago.
DeleteCreatinine is on the high side of normal 1.3 mg/dL. But is has remained exactly at that level for several yrs (1.1- 1.3)
DeleteI wonder about that stuff and what damage it may have caused. Nasty sht. However, Tim survives.
DeleteConsider a financial advisor. I’ve learned so much. I’ve built an excel spreadsheet that has all forms of income federal state and capital gains tax projections IRMAA brackets columns for marginal tax rate and IRMAA thresholds as well as growth columns for Roth, cash, IRA and brokerage (stocks) for modeling when to take SS and which order to withdraw money. Of course has RMD predictions as that is the most critical piece. You can download a free right capital planning software for 90 days from Kevin Lums you tube video, I forget which one. I started with that but it doesn’t come with a user manual so I didn’t understand fully how to use it or the output so I built my own. Another option is to use the right capital sheet and have a AI buddy open and ask questions on how to use it. I figured that out later and that helped. But you know AI you have to cross check ask the question a different way as it can seem right but be wrong.
DeleteAn example of how having actively managed account helps: in the half of my IRA that is managed they rebalance periodically to keep it at 50/30/10 (stocks/bonds/derivatives like gold rare earths real estate). As technology and stocks are driving the portfolio value up my bond holdings go up as they are taking some of that profit and buying bonds. Also as they equal weight the sectors they sell some of the shares that are going up fast and buy shares of sectors that are falling or not going up as fast, like utilities which will gain from AI. Returns will not be as great for this approach but stock market swings are evened out. But still at 12 percent gain since end of May which rivals the DOW with significantly less technology exposure so less risky
DeleteI don’t think you comprehend what creatinine of 1.3 could mean. It’s like running a quarter mile in 120 seconds vs 60 seconds. It suggests you lost half your nephrons as it takes a significant loss of nephrons to put you out of normal range. That said, you have very high muscle mass for your age and BMI. So that explains at least some of it. Cystatin C will answer if it is an issue or not. 1.3 creatinine is MUCH worse than your highly likely temporary excursion for liver enzymes. They show injury not function. Livers recover as they have great regenerative capacity. Once nephrons are lost they are gone forever. Also as they are lost there is adaptation called hyperfiltration which improves measured function and gives the appearance of improvement or stability because the endogenous tests measure better but it results in inflammation and a series of cascading effects and accelerated decay. Again, you have a lot of muscle mass so the 1.3 is likely not as bad as it looks. But between the liver likely minor injury from supplements and creatinine at 1.3, creatinine is the one that needs better understanding. Just test cystatin c. And don’t listen to whoever had disparaging comments about me being unlicensed. Certain topics I have a deep understanding of this is one. Cystatin c and be done with it, probably.
DeleteCopilot: Yes, combined supplementation of niacin and bergamot may pose a risk to liver health, especially under certain conditions. Here's a breakdown of the evidence:
ReplyDeleteNiacin (Vitamin B3) and Liver Injury
High doses of niacin, especially extended-release formulations, are well-documented to cause hepatotoxicity, including:
Hepatitis
Liver failure
Cholestatic liver injury
Decompensated cirrhosis in extreme cases [medicalnewstoday.com], [journals.sagepub.com]
Liver damage has been reported at doses as low as 500–750 mg/day, with serious effects more likely at 1,000–3,000 mg/day. [medicalnewstoday.com]
Bergamot and Liver Health
Bergamot (often used for cholesterol management) has antioxidant and anti-inflammatory properties, but:
Some studies suggest it may interact with liver enzymes or affect liver function.
Long-term safety is not well established, and more research is needed to determine safe dosage and duration. [wellgreenherb.com]
Combined Use: Potential Risks
While there are no widely reported cases specifically linking niacin + bergamot to liver failure, combining two substances that affect liver metabolism could:
Increase the burden on the liver
Amplify hepatotoxic effects, especially if either is taken in high doses or from low-quality sources
Complicate diagnosis if liver injury occurs, making it harder to pinpoint the cause
Yea, I wonder about supplement contamination. The most recent supplement that I started taking this yr was a collagen powder. I had been taking bergamot since late Oct 24 and my ALT and AST tested fine in Jan, however I changed brands in Dec. I'm definitely going to stop supplements and retest.
DeleteI am going to stop bergamot and retest but interestingly, a study showed that bergamot was used to treat high liver enzymes and fatty liver. https://www.lipidjournal.com/article/S1933-2874(15)00171-3/fulltext
DeleteA decision making question: when stocks tanked in April did you panic and pull out and miss out on historic gains?
ReplyDeleteNot completely, but I am quite conservative - my large fund (about 80% of my holdings) is in equities less than 50%, about 30% US equities, 20% foreign. I'm pretty happy with where I am and I feel less vulnerable, even though my gains since April 1 have been about 7.5%, not bad for 6 mo. But, my smaller equity fund the gains were 3x+ that in the same amount of time, so I lost out on some growth for sure. I would definitely bet on a correction of 25% or 10K in the Dow in the next yr or 2. Everything points to it.
DeleteYou will live to 95. So you need a wealth preservation strategy AND a growth strategy. A little more exposure to the US market is warranted. Certainly need a good bit in bonds. At current spending levels I can live for 6 to 7 years on CD’s, (retired without taking SS) so I’m certain I can ride out any corrections. I won’t touch IRA’s it the market tanks, it will recover. Separate from CD’s I have two IRA’s. I’m 50/40/10 (stocks/bonds/derivatives like gold and real estate) in one IRA fund. It is managed by an advisor and strives for equal weight across all sectors (technology healthcare energy utilities etc). So it rebalances periodically. It is designed for growth with preservation. That fund is only 10 percent technology weighted. So it won’t be terribly volatile. The other IRA, about the same size, is about 70/30 with 30 percent technology. I manage it. It is growing quite a bit faster but will be much more volatile. But the risk doesn’t matter I’ll just wait it out if stocks tank. Each IRA is about the same size. Part of wealth strategy is having enough diversification that you can hold funds that lost value and sell ones that retained value, if needed. Or live off of bonds or cash until stocks recover. Sequence of returns. Anyway it is highly likely I’ll have much more money at death than I have now. My advisor also gives me grief about the cash as it is as I’m leaving a lot on the table by not investing it. I’ve also a golden opportunity next year if I retire as the current tax laws and the greater senior deductions with the big beautiful bill will allow, if I retire and don’t take SS, to take up to about 150K in capital gains tax free from my company stock holdings. As the stock basis is about 130 on a 200 dollar stock that’s about 275k I can convert to cash or invest in a new fund without paying a penny in tax. But that only works if you haven’t income. So the plan is to work to my next stock RSU date which is mid February. That is motivating as they are projected at 25K. I can put 75 percent of my check towards 401k (until you hit the yearly limit) So with employer matching I’ll get another 15k in my 401K and between Amy and I another 16K in IRA in 2.5 months. So basically I will be reporting ZERO income for 2026, which allows the tax harvesting on the stocks I mentioned above and one last big contribution to IRA’s. I think I will turn the Micron stocks into a technology ETF, which will then have a high basis. That is why they call it tax harvesting. Basically sell stocks that you would normally pay capital gains on and immediately re invest at a higher basis so there will be less gains, or losses to offset other income, when selling in the future.
ReplyDeleteMedical practitioners are not allowed to provide personalised medical advice to (anonymous) individuals over the internet. Same applies to financial advisors. I take it you are therefore unqualified in either discipline.
ReplyDeleteYou are right. Qualification is a formal process including certification to certain standards, sometimes licensing, etcetera. So from that perspective I am certainly unqualified.
DeleteBut I am still right :-)
Delete