2 replies to this topic

[sgupta]

Hi all,

So I've recently had a few health concerns (fortunately seemingly non-serious), and I'm really hoping this is just fear and I'm fine. I am seeing a primary care physician (have another appointment in a couple weeks), and I've also been working ~8 months on some really good lifestyle changes in general (a good exercise program, more whole foods, vitamins and supplements in reasonable doses without going overboard, etc.).

As a quick introduction, my anxieties about health started with some random muscle twitching after starting a rather intense exercise program last year. Fortunately, most of the potential serious causes of twitching seem unlikely at this point, and I now believe it to be either an electrolyte imbalance (which is being tested for) or perhaps BFS, a benign condition. This all lead to me realizing my blood pressure is a bit higher than it should be; it was borderline hypertension, and while it's still considered pre-hypertension, I've lowered it a lot through exercise (now a bit more moderate - I think I overdid it at first), eating healthier, and healthier supplement choices.

That said, I ran across some studies the other day that really concerned me. Years ago (in my 20's) when I started supplementation, along with some other things (arganine, fish oil, a good multivitamin, and some stimulants/fat burners I've since cut out). I used a rather heavy does of Soy Triple Lecithin (7200mg per day at its peak with a phosphatidylcholine content of 2,520mg), and I was on this for several years (guessing around 7-8). At the time, there appeared to be evidence that it cleared arteries of plaque, protected the liver, was great as a sexual supplement, was good for the brain, and helped with fat loss. Seemed like a win-win.

But I came across a Cleveland Clinic study (2011) and then a followup (2013) indicating that when choline (and carnatine, which I also took for a while, though not as long and not nearly at this dosage [there's still a little bit in a blood pressure health blend I take]) were metabolized by the gut, they created something called TMAO, which actually leads to atherosclerosis.

This has caused me a lot anxiety, given the dosage and period of time, and I've been wondering if I maybe caused longterm and irreversable damage as far as plaque buildup in my arteries. To be honest, I'm a bit freaked out.

There are a few comforting things. My supplement was soy lecithin; whereas as far as I can tell, this study used animal (meat/egg) choline + a choline supplement. A previous study seemed to indicate that lecithin/phosphatidylcholine did not create TMAO in the gut in lecithin form, so this seems contradictory, and I'm not sure what to believe here... Also, other foods than the ones tested (such as fish) are very high in TMAO itself, and we know that fish is anything but heart-unhealthy. Also, they tested genetically modified mice that were already prone to atherosclerosis, and the human sample was fairly small.

I've also seen anecdotal stories of soy lecithin being used to clean arteries successfully, after heart attacks, and for much longer durations than I was on it (30 or 40 years), but obviously anecdotes are anecdotes. Though if you search just for soy lecithin, it's still being touted as something that's good for cardiovascular health. (It's one of the reasons I started taking it, as my dad died of a heart attack and atherosclerosis in his 50's).

The good news is, right now, overall, I feel pretty good. Exercising is going well, I'm slowly losing weight (still have a ways to go), I don't have chest pains/shortness of breath/numbness/anything too alarming, my resting heart rate when getting up is good. I can touch my toes (as a few recent articles indicate that's a good sign as far as atherosclerosis, though I'm not sure how much stock to put in that simple of a test) and sexual health is good (which I think might be an indicator if there was a major problem). Aside from slightly elevated blood pressure (which is still under stage 1 hypertension and sometimes fairly normal; in the morning, in fact, sometimes it's under 120/80 now) and cholesterol numbers I'm still waiting on (last time was slightly elevated but nothing I was told was alarming), I seem to be healthy.

So, I guess I'm asking, how worried should I be that I really caused damage? Are there any tests that can be done that can alleviate my fears?

Thanks all for listening, and sorry this was so long. This anxiety is just driving me a bit bonkers!

Warmly & To Good Health,
Shaun

[hav]

It's far from certain that tmao leads to heart disease. I think all that is known is that high long term levels of tmao are associated with heart disease. Which is different from the normal short term rise in tmao levels as choline is ingested followed by their drop in levels as they are cleared, usually by kidney excretion. Lecithin may show a short term increase in tmao levels, but if levels return to normal and some cholesterol is also cleared in the process, there may be a net gain in cv health. I think if you wanted to evaluate your cv risk based on tmao levels as a factor, you should test them the same way you do CRP, HDL, and/or LDL levels... after the normal fasting period.

Howard

[sgupta]

Hi Howard,

I agree a lot is still unknown about TMAO. The fact that seafood should be higher, but is known to be heart healthy, is a big one, but there seems to be some conflicting data on whether lecithin itself, uncontaminated, leads to TMAO increase in the first place.

You make a good point about testing after a fast; I had quite a lot of blood work done recently after fasting (should get the results at my appointment the 19th), but I have no idea if this is something they tested - I doubt it, but hopefully there's some good data there regardless. But I may ask about tests to detect that (or even plaque) if it puts my mind at ease.

Some of the other things I used during that time (arginine and fish oil, for example) could have also had a cardiovascular protective effect.

So from your post, I guess you think it's at least possible that the lecithin might have actually benefited me, if anything, but nothing's certain until more is know.

Thanks. I'm feeling a little less nervous about things. Nothing I can do to change what I took previously now, and I'm doing a lot of the right things, and I'm talking to a doctor.

Any other comments/thoughts/opinions very much appreciated!