Hi Ellen! I saw Dr Davis in August before my news of apoE 4/4. I went to seek his help since my small LDL had climbed over 1,800. I've been researching and still trying to find everything out. Less than 5% of the population are 4/4's. 4/4's have brains that are more adapted to ketosis.
From what I have read, these are some of the perameters for apoE 4/4's:
More than 1,000 mg Fish oil a day may be problematic, probabaly 500mg is a better range. This was a real shock to me, the thought that maybe fish oil is not good for everyone!
There is one other person on the TYP forum who is a double 4, her numbers have been most improved by: Total fat about 20% of total calories, keep effective carbs (starch+sugar) to 60 gms/day, that means a lot of veggies and a lot of lean meat and egg whites. Saturated fat goal is to stay <7% of total calories.
ApoE4/E4's have ancient bloodlines... most died off during the agricultural revolution since this bloodtype does not thrive on a grain based diet. That is why only >5% of our population is this genotype. ApoE 4's roots go WAY back, past the paleolithic hunters (high meat, high fat diet), to our simian ancestors (nuts,seeds,lots of veggies,lots of fiber,small amount animal protein (grubs).
Apo E/4 has many effects other than just elevated cholesterol and LDL's: it impacts the immune system, membrane biochemistry, etc. etc. It is very easy to be in a pro-inflammatory state, so I am paying particular attention to antioxidants --both in foods (LOTS and LOTS of high fiber greens and other dark colors; Of course....NO refined sugar or rapidly metabolizable starches; NO industrial oils; etc.) and supplements. My melatonin levles are way low and I've been taking melatonin as it is a strong antioxidant for the nervous system.
One issue I'm grappling with at the moment is what to do about fat soluble supplementation. Since double 4's have impaired absorption and metabolism of all the fat soluble supplements, this makes it a greater challenge to get enough...even with supplementation. I've been on Life Extension super-K 100-mcg, Now Foods bio E complex 600IU's plus tocotrienols and 12,000IU's of D. I'm not sure how much A to take to balance these other FS vitamins, i've been on 10,000IU's 3X per week so far.
I am also taking a lot of niacin (1,000mg immediate release) for the lipids. Taking phosphatidyl serine & 5 mg vinpocetin for brain health. 500mcg iodine (from kelp) per day to optimize thyroid levels.
Curcumin and vitamin D3 might help lower risk of Alzheimer's. Alcohol....any amount is not good.
The good news is that in epidemiologic studies, the increased cardiovascular risk of apo E4 was eradicated if the lipids and other risk factors were optimized.