MTHFR gene and heart health

So I got my regular TRT bloodwork done, and I asked my TRT doc to check out my LP(a) and the other stuff. Since my Homocystine was high, he decided I should get my MTHFR gene checked out as well.

Good news: the inflammation seems to have gone away, my CRP score and Homocysteine were both within range, so they have gone down considerably since last time they were checked.  This is probably from me taking high dose of L-Mthyl folate and vitamin C.

Bad news: Regarding the MTHFR gene, I am a homozygous mutant with the C677T SNP (also written as T677T).  From what I understand so far, this mutation severely hampers my body's ability to convert folic acid into folate. It affects my body's ability to create folate to about 30% of what a normal person can do. This, in turn, can cause other issues, such as high homocysteine (something I already have!). An important note to make is that people with the MTHFR gene are at higher risk for heart issues, like stroke and heart attack, etc.  So yay, one more thing that puts me at risk.

Going down the whole MTHFR rabbit hole has lead me to learn about Methylation. If you want to learn about it just read this article, but the TLDR version is that it's the metabolic process of switching genes on and off as well as repairing DNA.  

I'm a little confused now because it seems Niacin is good for lowering Lp(a), but it will hinder my ability to methylnate, which is a bad thing ("Avoid taking high doses of niacin (vitamin B3), which can hinder methylation."). So my TRT Dr has be taking 5mg of folate to lower my homocysteine and help my body methylate, while my cardiologist has me taking large doses of niacin to try to lower my LP(a).  Perhaps they are just canceling each other out? What to do concerning this will probably be my biggest question for my Cardiologist.

Shifting focus to more about Hearth health.

Ok so it's been like forever since my last post. 1) who really blogs anymore, amirite? 2) there really hasn't been nothing earthshattering to report. I was broken, I'm now less broken, and yet I'm still in pain because I'm still broken 3) I've kind of moved on with my life.

I'd like to focus on that last part for now.  As I stand here typing this out. I'm experiencing discomfort/pain in my lower back on the right side, and I feel some neck pain also on the left side.  I still feel lower back pain when I squat/deadlfit, but this pain has been moving around. Currently it's now feeling more like my QL/Oblique on my RIGHT side.  Typically in the past the pain has been on my left side. So there's change, which is good. Change means progress is being made. What you don't want is to get a treatment (whatever treatment that may be) and then go right back to feeling the same way.

And yet, with these pains, they are pains that don't really bug me like they used to. These pains are easier to ignore, easier to just accept and move on.  And while I am planning to see Dr. Fullerton at least one more time, I'm also starting to listen to my wife who thinks I just need to accept that I will always be in pain and just move on with life.

I guess what I'm trying to say is that I used to really identify myself by these pains and the overcoming of these pains. I'm starting to move away from that, PRP and these injuries are not as central to my self-identity as they once were.

But I always seem to have an interest in something health-related, and now it is heart related.  ...I guess this should come as too much of a surprise given that I'm now approaching 40.

Because I'm on testosterone replacement therapy, I get regular bloodwork done.  Well, for some random reason my TRT doc decided to not only get the typical cholesterol blood panel, but ordered that my Lp(a) get tested as well.

The Lp(a) is a sub-fraction of a cholesterol particle, I won't go into much detail about it because there's already articles written up about it, like this one: http://www.lipoproteinafoundation.org/?page=UnderstandLpa.

The TLDR version is that LP(a) is super inflamatory, and some people have super high levels despite nutrition and exercise. One famous example is Bob Parker of "The Biggest Loser" who had a heart attack despite taking such good care of himself. Genetically he was predispositioned to have hight Lp(a) levels

From what I can tell, you want Lp(a) to be under 14 mg/dL. borderline is 14-30,  high risk is 31-50, and very high risk is over 50.

The test showed my levels at 80

Seeing this I feel like I am lucky to be alive right now.

So yeah, it seems that I am one of those with the genetic predisposition for high levels.  Since getting these results I've started taking niacin, as it seems to be the only thing that can affect Lp(a) levels.

The test also showed that I had undesirable levels of Apo-b, another kind of protein. My level was 110 with a range being lower than 80.

When I asked my TRT doc about it he seemed unconcerned about it, but this isn't his specialty so I'm going to have to find someone else to ask about this stuff.

I later had more bloodwork done, and while it didn't test the Lp(a) or Apo-b, it showed more inflammation in my blood.

C-reactive protein (CRP) is a substance produced by the liver in response to inflammation. My levels was about three times the range at 20.5 with a range of less than 8

I also had super high Homocysteine levels, which could indicate a deficiency of folate or B12. Doc wants me on 5mg of B12 a day, which I'm currently doing. Again though, this was serious as my levels were 33.2 with a range of under 11.4

All these put me in super high risk of a heart attack, stroke, etc.  I need to figure this stuff out quick before it kills me.  I'm adding in B12 to help with the liver/homocysteine levels, Niacin for the Lp(a) levesl, and Vitamin C to lower the CRP. I'm also trying to remove sugar from my diet, as well as processed grains. Hopefully this will be all that I need, but I may need to try to book an appointment with a specialist in the near future.

Thankfully, my trygicerides are low, my HDL is high, and my blood pressure seems to be pretty good ~120/80.

Man, I am worried though. Really hits home that I could up and leave this earth at any time.  

TLDR: My bloodwork shows that I have tons of inflammation in my blood and am super risk of coronary heart disease (CHD), cardiovascular disease (CVD), atherosclerosis, thrombosis, and stroke.  I have super high Lp(a), Apo-B, C reactive protien, and homocycteine.  I'm changing up my diet, adding in vitamins Niacin, B12, and C to my daily routine. Doing this for a month and then getting re-tested. If that shows problems then I'm calling in a specialist. Pray for me.

Blog po

PRP treatment for the back and hip: Lat, Serratus Anterior, Iliacus, and Rectus Femoris

Alright well I'm feeling pretty good about what just got treated over at proloaustin.  Dr. Fullerton had me flex my back, noticed some atrophy on the left (painful) side, injected some suspected points of injury with numbing agent, and had me flex again.  The difference was pretty substantial, as shown in the pictures.  The pain went away and I felt the muscles in my upper back relax.  Nerve blocking, as I believe it's called, is quite the diagnostic technique.

So he addressed the serratus and perhaps some of the rhomboid or lower trap. What he treated was very substantial, and it felt like this is what is is causing the remaining discomfort I'm feeling.  I don't know if I'll need a second treatment of this area, but this area definitely needed to be treated, so I feel good about that.

With the hip, I showed Dr. Fullerton the exercise that I performed that caused all the damage to my hip.  That proved to be really helpful, and so he wanted to check out my hip flexors.  The psoas actually seemed to be in good shape, but the iliacus was a different story. He also found some lingering damage with the rectus femoris.  I think the iliacus was the last piece of the puzzle as well.

I feel really good, feel really hopeful right now.

Update for PRP treatment of iliacus, serratus anterior, and rectus femoris

So just checking in on how I'm recovering from getting my serratus and iliacus treated with PRP injections

First, I'd like to say that I'm changing up the format of my vlog here. I started out recording this as like the "torn labrum" chronicles, but as I've progressed I've found that the torn labrum in my shoulder was just one, kind of small, piece of the pain puzzle.  So now I'm focusing more on just how a PRP treatment affects me in one specific area.

For example, I've come to realize that Dr. Fullerton works best when he knows what action causes pain. If I tell him "It hurts when I do X" it is much, much, more helpful than saying "It hurts here all the time"

Realizing this, I went in to the last treatment saying it hurts when I do overhand lat pull downs, especially wide grip.  This led to him having me flex, where he saw some asymmetries.  Here's a pic of me flexing.  Then he numbed out the serratus in certain areas with injections of lidocaine and had me flex again. Here's a pic of that.  There was a pretty big difference in appearance, and the pain went away when he administered the numbing agent. This technique is called nerve blocking, I believe.

So with this info he did the PRP injections in my back in those places.  Low and behold, when I went got back into the gym and tried overhand lat pull downs, they no longer hurt. I'm also noticing improvement with my overhead press being more symmetrical.  I also just feel better in general. Like I'm in less pain.

My point with all of this is that the treatment was a success in treating the issue that I presented to Dr. Fullerton. However, it seems like there are still some more underlying issues, as I'm still in pain some all the time, just less so.  The motion that really sets me off is pulling my scapula down, which is what I'm going to present to Dr. Fullerton for next time.

After getting a PRP treatment my body is usually really tight, the muscles respond to the trauma by forming these big knots/adhesions. These are painful, so I try to get them treated with soft tissue work. I've tried dry needling, which has proven pretty helpful, but I'm still left a bit unsatisfied with my PT. So I try other modalities. Like I have seen a chiropractor, and that was really helpful once because they found a rib out of joint and when they put that back in there was substantial pain relief.

The latest modality I'm trying is rolfing. She came recommended by my sprinting coach, so I figured she was legit. She was definitely legit.  She just looked at me and with a glance was like "ok your serratus needs to be worked on". She knew all the problems with my upper body were on my left side. And boy did she find things. Apparently my neck is "special" and she tried very hard to get my sternocleidomastoid to release but wasn't able to get it to release completely. So she recommended that I see an acupuncturist, as the mastoid/neck muscles tend to respond really well to that kind of treatment.

So I went and had that done, and the acupuncturist also did some cupping, and when he placed the cup on my mastoid it provided the most relief I have felt in some time. The day of and the day following I was completely pain free, it was amazing.  Sadly some of the pain has come back, but not completely. So progress is being made, and I'm happy with that.

So with regards to the upper back/neck, I feel like there still might be something going on in the front, something that may be causing my sternocleidomastoid muscle to tighten up. Dr. Fullerton has found damage in the first and second rib as well as the sternoclavicular joint, so perhaps something is still lingering there. The rolfer found some issues with my pec minor and with the levator muscles on my front side.  Maybe this is all in response to the issue that I have in my back, but perhaps not. This is the frustrating thing,  I can't be sure what's the cause and what's the effect. But I will document my symptoms here.

With regards to the hip, I definitely feel better in some regards, my feet now line up symmetrically, and I no longer have that pain in my hip when I go to raise my leg in walking (which was the pain I described to Dr. Fullerton).  So I think the iliacus was the culprit with some of the pain in my hip.

However, I tried doing windshield wipers the other day and the rotation sent a huge, HUGE, shock of pain through my side. So whatever muscles are used with that motion, there's something really wrong with that. Perhaps my obliques? I don't know, I'll take it up with Dr. Fullerton when I see him next.  

So there we have it. Dr. Fullerton successfully treated all the symptoms that I told him was going on. It just turns out that there are other things/motions that caused pain as well.

So I feel like I'm near the end of my pain/prp journey. I know I've felt this way for, like, years now, but I really do feel that I'm nearing the end.  ...In the beginning, after a treatment it felt like I had a new body, it was behaving so differently that I had to spend a lot of time figuring out how to use it.  Now, it's starting to feel like I'm just no longer in pain in that particular area. 

For example, after Dr. Fullerton addressed my glute med, I now squat with a symmetrical stance. It used to be my feet were always staggered a little, now my feet are both underneath me. But that's it. It doesn't feel like things are working completely differently, when I resumed squatting it didn't feel like all kinds of muscles were being used differently. I didn't get random DOMS in odd muscles. Now things just work better and I'm in less pain. 

Pretty much the same story with my shoulder. I can now keep my scapula retracted while pressing, and I'm in less pain, but it's not like my tricep or pec minor is suddenly working differently.

If Dr. Fullerton were to retire and I couldn't see him again, I would be disappointed but I wouldn't feel doomed. The pain that I have in my shoulder is very manageable, though the pain in my hip does flare up from time to time.

For my hip, the location seems to point to the psoas. When I read the symptoms of an injured psoas, my symptoms check off pretty much the entire list. I have some nebulous groin pain, I have pain in my lower back, it takes some effort to stand upright, and the knee on the opposite side doesn't feel like it's working right.

For my shoulder, things are less clear. My upper trap and posterior scalene are tight a lot of the times, as well as my infraspinatus. But if I were a betting man I would say they are responding to issues lower down my back.  Like the intercostals or my lat or both.  Whenever the chiro works those muscles I feel like it's addressing the cause of everything. We will see when I see Dr. Fullerton again.

Now that I have normal testosterone levels, I'm really seeing gains in the gym. I've lost about 20 pounds over the past two months, and all my track times are going down (as you would expect with being lighter) and my strength seems to still be going up. So things are really awesome right now. I don't want to mess with this by taking a month off again, but this nagging hip/psoas pain is starting to get to the point where I think it will be worth it.  I think once pool/track season is at an end I'll get my (hopefully) last treatment from Dr. Fullerton. Feel like a broken record saying that.

So that's where I stand: I'm in a good place, but I feel like I'm *this* close to being 100%, and that excites and scares me a bit.

Seventh PRP treatment for the neck/shoulder

Alright well went had had my trap treated.  Like every other time I've had a treatment, I hope this is the last one.  ...I imagine it really could be because a 40% trap tear HAS to be the main source of my pain/discomfort.  I should also say that Dr. Fullerton treated my first and second rib, and that has helped with the discomfort I have in my neck.  Here's the vid of me actually getting the treatment, very nice of Dr. Fullerton to let me record it.

It's a Traps!!!!

So I just got back from seeing Dr. Fullerton. I saw him simply for diagnostic purposes, because I felt like he was a bit rushed in diagnosing and treating whatever he found, all in one session.  So I thought to see him to just figure out what is wrong, and come up with a game plan from there.  He checked out my shoulder, especially my upper back, and he found that I have torn my trap muscle, in the mid-back area.  This is probably the main source of the pain I’m currently experiencing.  He also checked out the shoulder capsule and the infraspinatus (a muscle that gets needled regularly). If he found anything he didn’t comment on it, but he was mostly excited about finding the tear in the trap. I think he was excited because he found it using techniques with the ultrasound that he had learned about earlier this year.  Secondly, I think he was impressed at the extent of the damage. The tear wasn’t just in the tendon/ligament, it was in the actual muscle belly as well.

He also checked out my hip. While it is so much better than prior his treatments, it still bothers me to raise my right leg to my knee.  He found some damage to the tendon that the adductor magnus attaches to, as well as some damage to where that particular tendon continues on up to the abdominal rectus.  Hopefully the next treatment I get will be my last for that.  …Story of my life right?

I’m not as hopeful that the next treatment for my shoulder/trap will be my last, mostly because I fear there is something going on in the front of the AC joint as well.  Dr. Fullerton is only really able to address one thing at a time, so I understand his focus on the back.  I just worry that I will need yet another treatment after this.

Because of the timing of things, I don’t expect to see him again until around January.  I need to get some other things in order before I go see him again.  But I have hope still; I think I can actually beat this.