Medical testing, PCS9 inhibitors & aging conference–an email to a friend

Hi JJ,

 Have you ever heard of PCSK9 inhibitors?  The PCSK9 protein binds to the liver receptor that binds LDL cholesterol, so if you inhibit the protein more LDL is absorbed by the liver, reducing the amount in the blood. 

 I understand a defect in this system results in high cholesterol, I wonder if this is the cause of your high cholesterol?  Either way this is an interesting article.  Unfortunately, the drugs that inhibit PCSK9 are really expensive (over $1,000 a treatment, with 1 injection needed per month (Alirocumab, one of the drugs has a half-life of 17-20 days).  But costs on things like this come down over time–especially since there is more than 1 drug that works.  It may be cheaper overseas (if you can even get it?)

 This article is where I came across PCSK9.  My LDL is 76, which is good by western standards but still not quite as low as recommended.  The article indicates that getting LDL really low (like less than 20) can be beneficial; to do that I would have to take one of these drugs.  So my target is less than 70 which I can probably do with some minor diet changes and increasing my exercise a bit.

 I am overseas now, just got done with the Undoing Aging conference in Berlin at the end of March.  Aging science is really taking off; the conference was sold out (last year 350 people attended, this year 500).  Next year they are going to have to go to a bigger venue to accommodate more people.  While it is great that the concept is getting so much attention, but I don’t like the larger crowds.  

 After the conference I went to Sri Lanka and did a bunch of medical tests.  Most everything looks really good; with just a few things I don’t like (even if the doctor wasn’t concerned).  A few of my liver profile things were not very good, but I haven’t had time yet to research it and see if it is just normal cycling or if it is something I should try to get back into the optimum range (if possible).  Science has come so far these days that you can biohack a lot of different things; we will see what can be done about the liver.  Speaking of which I suppose you know Joe has cirrhosis of the liver pretty bad?  That is really terrible.  I did a little poking around to see about the possibilities of biohacking it but have not come up with anything that sounded worth trying.  Yet–still looking.

 Another thing my medical review showed up is high BP when exercising.  What I did was fine for my age (doctors say), but I didn’t like having to stop the stress test because of high BP.  I have been having issues with pre-hypertension for a few years now, and have increased my consumption of vegetables, nearly met the DASH diet nutrition level and increased exercise rate.  I am usually within the DASH recommendations for Calcium (1,200 mg) magnesium (500 mg) potassium (4,500 mg) and fiber (30 mg)…but have not succeeded in getting my sodium levels down to the desired 1,500 mg.  Meeting the DASH guidelines succeeded in stopping the increase, but it remains high so I want to exercise more…and eat more vegetables. 

 The last bad thing my medical checkup showed was mild osteoporosis.  Which I was kind of appalled at; I always considered my bones to be extra heavy!  *sigh*.  Nothing really to be concerned about yet, just need to be sure to get enough calcium and vitamin D…and more exercise, especially weight training (which I don’t do much of).  Seems like exercise is the answer to most things I have that are tipping out of balance, I better be sure to get more!  

 Speaking of vitamin D, I started taking 2000 units a day in December, and my previously low numbers have been corrected.  But it is still in the lower end of the scale (after I get home, I want to look up how much is recommended for healthy aging–I don’t have the information here).  Since too much vitamin D is toxic, I won’t take any additional until next winter (rely on sunshine this summer); then I will probably increase to 3000 IU a day and do a test after a month to make sure it isn’t too high.

 How is everything there?  After Sri Lanka I came to Japan for a few days and am now up in the mountains (about an hour train ride) NW of Tokyo, where the ski season has ended and this 1200 room hotel is nearly empty (less than a dozen cars in the parking lot).  I came here for peace & quiet so I could get the notes from the meeting typed in and properly researched.  I don’t expect to get them into a form that could be published, but I wanted to at least get them into the computer before I forget the details I didn’t get on paper.  I took 55 pages of handwritten notes at the Undoing Aging meeting, and have gotten most of them into the computer.  Hope to finish typing them into the computer before I start heading home tomorrow.

 Hope all is well there.  Do you still plan to come up to Alaska?  Our cruise plans are progressing, Tamer coming up next month will be a real help.  I am always concerned when I leave the rental business shorthanded!

 Cheers,  Ray

PS as with all my letters I write that have an aging slant, I will be putting this on my blog, but stripped of any way to identify who you are 🙂



     mmm, Paula?  is that right?  My left ear is a little weak (I sure hate getting old) so I am not sure I heard you right?  Anyhow it was really nice chatting with you.
     That was sure a nice memorial they put on for Quint & Cindy.  I really miss them both, though we did not intersect too much after Mom passed away (before then my family used to eat in the Pioneer’s Home once a week, and Quint would occasionally join us).  It was a nice touch to do both memorials at once.
     The book that I mentioned was:
  • The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline, by Dale E. Bredesen.
     I first heard about Dr. Bredesen’s Alzheimer’s disease protocol about 4 years ago.  I would have been a lot more skeptical except I knew of his work previously, when he was the director of the Buck Institute–a premier research institute in California.  So I feel what he has to say is probably reliable.  The book was a very good read, I will paste in my notes I took below so you can make a more informed decision on whether to buy the book.  If you do all the tests he suggest it would cost more than $8,000–but perhaps you could find a doctor who would recommend the tests and then maybe insurance would pay for it.
     After learning that vitamin D3 was one of the things that was a trigger for dementia I started taking 2000 IU a day.  Usually I am very much against taking vitamins (taking a daily multivitamin will actually shorten your lifespan except in very particular cases!)  I would not take vitamin D3 even now, but everyone in Alaska has low vitamin D3–at least all those I know of who have been tested.  Of course testing should be the basis for treatment (the book has a good formula to figure out how much Vitamin D3 you should take–if you know your numbers).  I will be in Sri Lanka (by India) in April and plan to have my vitamin D3 levels tested then so I will know the optimum dose.  Of course in the summer I will take a lot less, and let the sun make Vitamin D3 for me!
     I am going to do a little testing to see how bad my number are.  I think information is always a good thing 🙂  Testing is pretty cheap in Sri Lanka so I am going to test for inflammation indicators (like C-reactive protein, interleukin-6), cholesterol, vitamin E, homocysteine, fasting insulin, thyroid hormones, B vitamins, heavy metals.  Apparently what is considered a medically reasonable range for many of these is not optimum for brain health, so I recommend getting the book and consulting with a doctor about what the book says before determining a course of action to correct any that are not within the optimum range specified in the book.
     There are a lot of things like leaky gut that can’t be tested for in Sri Lanka (at least not that I know of).  But this will give me an idea of what steps I need to take now so I can talk to a doctor about it reasonably, and if I have symptoms that indicate things like leaky gut I can get the testing done here :).
     I log all the foods that I eat to have a complete picture of my nutrition status.  A few  things that I am typically low on nutrition-wise I have been trying to increase my consumption of, especially B vitamins (low B vitamins are another trigger for dementia, according to the book).  For example I was low on Folate, so I am eating more white beans to assure I get enough.  This and vitamins B6, B9 & B12 are key to reducing homocysteine.  High homocysteine is a major problem in the old because a) they don’t eat enough of these vitamins to keep homocysteine in check and b) sometimes older people don’t absorb as much of these vitamins.  So people get a double whammy with the B vitamins (and some other vitamins).  With my diet logging I could see I was not getting nearly enough of them, and have modified my diet to assure I do.  Which mostly works, but it took a while to change my eating habits.
     If you wanted me to track your foods and send your nutritional levels for a week or so I would be happy to do it–if you didn’t mind my putting the data (unidentified as to who, of course) on my blog (which I am just getting started with; I have a long way to go before I get it working the way I want.)
PS I may put parts of my emails to you on my blog.  Any response you write will not go there unless you give permission.  Of course I won’t put anything in there that would identify anyone but me 🙂

Ray’s notes on The End of Alzheimer’s, by Dale E. Bredesen
Ray’s reading list

Note about identities: I have changed all the names in my blogs…but if anyone wishes me to use their real name I will–and I will also mention that it is their real name.

Recent deaths

Note: My friend Charley used to live in Alaska.  A few years ago he moved to the Dominican Republic where he has a farm in the mountains.  I still occasionally lure him to Alaska with work, like building micro controllers for my used cooking oil burners.  I use these to heat some of my apartment buildings (so much cheaper than heating oil!).   Charley is a great friend and I have known him for nearly 40 years, and I have always appreciated his support for my crazy projects, like the used cooking oil–or working on aging.  This is an email I sent to him earlier today.

Hi Charley,


Not sure if you knew Quint or not, but he died earlier this month.  Did you know he was my Godfather?  I can still remember when I was a child and we kept the old motorhome on his property.  We would stay in it when we were in town from the bush.  He is also the one who taught me amateur radio, so my connection with him goes way back.  I doubt you will be in town, but (just in case) his memorial will be in late January.


And then my Uncle died a couple days ago.


I sure hate death.  So…wasteful.  And distressing!  I know many think death of the old is natural, and death of the young is terrible.  But I think when the issue is with people you don’t know…death of the old is more damaging because you are removing those who are already skilled and many times the loss of those people have a much greater impact to society than when a baby dies.  Think of how much more Einstein could have discovered if he had lived another 60 years!


Both Quint and my Uncle got to be really old.  If they don’t cure aging, I hope I can do as well!  I think they managed to achieve such longevity in part because they remained thinner and because they both remained active and socially engaged.  I also think that fall (up to the winter solstice) is a dangerous time for the very old…all the people I know who are really old have died in this time period (Dad at 85, Mom at 94, Quint at 104?, Uncle at 98…the list goes on…).  I suspect this is because people have a much lower production of hormones during shortening daylight, which makes them more susceptible to (everything).   I think low hormones reduces cellular productivity, which (in the very old) is already defective due to clogging with old proteins, mitochondrial disfunction and the issues with maintaining homeostasis with deficits in protein production.  This reduces their resistance to dying, which means any little thing can push them over the edge.  I wonder if this could be prevented by spending the ‘winter’ in the southern hemisphere?


With Dad it wasn’t so important when he died because of his dementia.  But it seems a cure for dementia has been developed in the last few years, though they are still evaluating the procedure.  But it sounds very promising.  Which is really good for me because dementia is something I have been worrying about a lot the last decade, since those nasty ‘senior moments’ has started occurring more frequently!  But I have started thinking about the things they do to prevent dementia (or even partially cure it), and have been trying to implement a few of them.  I am also thinking about being tested for a bunch of the key things that get unbalanced (leading to dementia), like your zinc/copper ratio.


All this means changing habits, so it is difficult.  But worth it to gain a lot of extra years of useful life!  I have been trying to increase my level of exercise from my pretty low level to the amount recommended in a book I read recently which is 45 minutes a day, 6 days a week.  The book is called Younger Next Year by Chris Crowley & Henry S. Lodge, M.D.  from which I got 4 pages of notes.  In the book they say regular exercise is (nearly) a cure for aging.  At least it can keep you younger for a lot longer!  It was a good read, so if you get a chance you might pick it up.


When I exercise I usually burn around 7-8 kilo-calories (kcal) a minute the whole time I am in the gym.  This includes the total time in the gym, so the average while actually exercising is closer to 10 calories per minute.  I log all my data, so I can figure this stuff out.  It is mostly the number of days that I spend in the gym that is an issue; between the middle of October and the middle of November I was only made it to the gym only 10 days.  The average amount of time I spent in the gym was 46 minutes (so I am doing fine there according to Younger Next Year).  In addition I burn an average of 250 kcal/day walking (I have a pedometer on my phone which logs the majority of my walking).  Here is the total data for those days:
Date Min. exercise time Pedometer calories Kcal in gym Total Cal burn Ave kcal per min. gym
10/22/18 45 305 320 625 7.1
10/23/18 45 152 360 512 8.0
10/24/18 50 387 375 762 7.5
10/30/18 40 324 220 544 5.5
11/01/18 30 274 300 574 10.0
11/05/18 45 198 305 503 6.8
11/10/18 25 235 230 465 9.2
11/11/18 75 233 512 745 6.8
11/12/18 55 197 345 542 6.3
11/13/18 50 216 422 638 8.4
Average 46.0 252.1 338.9 591.0 7.6
So my real issue is getting enough days of exercise, not the duration of each session.  How is your exercise?  I would think you would get quite a bit hiking up and down that mountainous farm!!


Your blog looks like it is coming along.  That was really interesting about all your controllers and your internet of things.  Managing your solar power and your water power must make for a lot of time spent programming.  The veggie oil burners you programmed have been doing much better this winter than last, though we had an issue at the 13p a week ago caused by not heating the lines from the external pump.  They got clogged.  Took us awhile to figure out what was wrong with it.  But no issues with the controllers you built to run them, so that is great 🙂  Baranof has been running so well that we haven’t burned the 50 gallons of heating oil we put in there a month ago!  Normally this time of year that place would have burned probably 600 gallons of heating oil.  The 13p is the one that is really going through a lot of oil though; we have been delivering 250 gallons a week of used cooking oil every week.  So much that we are worried about the supply!  We are going to have to increase the amount we gather if we want to keep this up.


I am going to put this on my blog too, as I am now trying to keep everything I write about aging there.  Hope you don’t mind?  If so let me know and I will remove it!  Should I add a link to your blog?   Of course as I try to improve my blog I will probably rewrite this a bit, as this is just off the top of my head.
We finally got the 10p boiler install done and fired last week.  Just in time too, because the weather has turned cold.  We have not finalized the boiler in 12b yet, but we need to do that really soon because the one in 12a will not keep up when it is below 0 F.  So the next air quality alert (which is more likely with the cold weather) could really pinch (the last one a week ago was not a problem; we shut down the old boiler and started the ‘new’ one in 12a and everything ran fine).  I am just concerned about the high cost of heating oil!  I anticipate burning 50+ gallons a day, which will put a big crimp in my budget whenever we have to run those.


Thinking of you in the tropical weather, here it is -15 F this morning.