 Moscarpone… I'd like to preface this blog post by apologizing for its length, including links to several long articles. Also, for anyone who doesn't know me, I'm a vocal and enthusiastic supporter of low-carbohydrate diets, but I always strive to be balanced in my writing. I'm very nonconfrontational and don't like "getting into it" with people who disagree with me. However, I expect I'll receive plenty of negative feedback from this article because of the controversial topic. Cholesterol Results From June 2013 through November 2013 My cholesterol levels have always been higher than average. LDL has ranged from 120s-150s as far back as I can remember, long before I began following a moderately carbohydrate-restricted diet back in 2011. In June of last year, I reported my NMR (Nuclear Magnetic Resonance) LipoProfile results after almost a year of consuming a very-low-carb ketogenic diet (VLCKD) containing less than 50 grams net carb per day. I was very happy with these values and frankly a little surprised that I achieved them while eating delicious, satiating foods. Lipid Profile from November 2013 In November of last year, I had a standard lipid profile done as part of lab work for my annual physical: Total Cholesterol: 300 LDL-C: 160 HDL-C: 128 TG: 56 My numbers had increased, but I wasn't terribly concerned about the LDL-C, since on a few occasions it had been nearly that high in the past. Seeing a total cholesterol of 300 was a bit troubling, but I knew it was partially due to having extremely high HDL (Apparently high levels of some types of HDL can also be problematic, although I didn't realize this at the time). Looking back, although I wasn't tracking my intake online regularly back then, I'm pretty sure I was eating the same or perhaps a little more fat than when I had the NMR done five months earlier. Nutritional Ketosis Experiment At the beginning of January, I decided to experiment with lowering my carb intake further in order to achieve nutritional ketosis. I didn't want or need to lose weight, but after speaking with a few people who'd reported improved mental focus and energy on minimal carbs and ketone levels between 1.5-3.0, I was intrigued. For the record, I felt great prior to this experiment: no symptoms of adrenal fatigue, excellent blood sugar control, lots of energy, good sleep, etc. But was there a possibility I could feel even better in deep ketosis? I'm a curious type, so I decided to try it for a few months. I had a ketone meter but didn't test very often because the strips are ridiculously expensive. But when I did check prior to this experiment (first thing in the morning, the only time I've ever tested), my ketones ranged between 0.4-1.0 mm. I began tracking my intake on My Fitness Pal, as many of my clients were doing. I lowered my net carbs to roughly 20 grams per day, although total carbs were often still around 50 grams because I ate a lot of avocados, unsweetened cocoa powder, and high-fiber vegetables like cauliflower. However, my consumption of berries dropped from 1-1.5 cups per day to 5 or 6 every morning at breakfast. I tried to keep protein around 70-80 grams daily (I'm 5'8" and 125 lbs, so this isn't all that low), and I ate more fat in order to maintain rather than lose weight. I never drank bulletproof coffee or added lots of butter or coconut oil to my food. But I did eat a fair amount of cheese, cream cheese, ricotta, and moscarpone, and I began using heavy cream instead of half-and-half in my coffee and tea. I still ate vegetables at every meal, although smaller amounts. I tested blood ketones a couple of times a week in the morning, and results ranged from 1.2-1.8. After 3 months of eating this way, in all honesty, I didn't feel any different. I still felt great, slept great, etc., but I can't say I had more energy or experienced any cognitive benefits. My weight stayed the same, and my blood sugar control remained good. However, my lipids had definitely changed, and not for the better. Cholesterol Results from April 2014 I had an NMR drawn at the end of April, and this time I'll admit to being more than a little upset when I saw the results: I ordered this NMR through a different lab, so there are a few additional labs (mainly VLDL related) that weren't included in the one from June of 2013. I was really surprised by how much my cholesterol had gone up since the prior test. My first thought was that perhaps my thyroid levels were off. (I have hypothyroidism that was diagnosed shortly before I went low carb, but my levels have been stable for the past few years on desiccated thyroid). However, I didn't feel at all hypothyroid and wasn't scheduled to have my thyroid labs re-checked until summer. "Why Are You Concerned When You Have Such High HDL-C, Low Triglycerides, and Large, Fluffy LDL-C?" While I've always been comfortable with higher than ideal cholesterol levels, having an LDL-C over 200 is a different story. The highest value I'd ever seen prior to last December was 158, I believe, about eight years or so ago when I was still following a low-fat, high-carbohydrate diet. But as far back as I can remember, my LDL-C was in the mid 120s to 150s regardless of what I ate, and my total cholesterol was never more than 260. My first NMR was the one last year, so I don't know what my LDL-P values were prior to 2013, but I'm assuming they were above the optimal range, although likely not over 1600. You can see that my LDL and total cholesterol each went up about 100 points and my LDL-P increased by 700 points in a 10-month period. My triglycerides even went up somewhat, although 60 is still pretty low. Although it's my understanding that LDL-C in an NMR is measured directly rather than by using the Friedewald equation (maybe a lipid expert can confirm this), when I plugged my numbers into an online calculator that estimates LDL-C, I got exactly the same number as in the NMR report, 221, for the Friedewald equation and 182 for the Iranian formula (The Iranian formula is believed to be more accurate when triglycerides are over 400 or less than 100). You may be wondering what LDL-P is, since it's not reported in a standard lipoprotein profile and most doctors don't order it. Dr. Axel Sigurdsson does a great job explaining everything you ever wanted to know about it in his post about LDL-P, but I'll try to give a quick summary. LDL-P is a measurement of the number of LDL (low-density lipoprotein) particles in your blood which carry cholesterol, triglycerides, and another type of fat called phospholipids. According to lipidologists (experts in the field of cholesterol and other lipids), LDL-P is the strongest predictor of risk for cardiovascular disease (CVD) and future cardiac events. Total cholesterol greater than 300 and LDL-C greater than 190 are also associated with significant CVD risk. High levels of LDL-C are prone to oxidation, and oxidized LDL has been linked to the development of arterial plaque and coronary artery disease (CAD). Sometimes people have normal LDL-C and high LDL-P or vice versa (the term for this is discordance), but most people with very high LDL-C have high LDL-P as well. These findings are from recent studies, not decades-old research reported by Ancel Keys. I want to make it clear that this type of dramatic elevation in LDL-C and LDL-P doesn't occur in most people who adopt a very-low-carb, high-fat diet. I've seen estimates that somewhere between one quarter and one third of low-carbers experience this. I've met and read about several who have. Most people who eat VLCKDs see their cholesterol rise only slightly, not at all, or even decrease, remaining within or near the normal range. I've met plenty of folks like this as well. I've also spoken with people who tell me their LDL cholesterol has always been over 200 and didn't really change after switching to a VLCKD. This is in sharp contrast to what happened to me: going from relatively stable LDL-C between 120s-150s to 221 within a very short period of time. Of course, many things can affect a person's cholesterol levels, including stress, illness, and injury. Aside from familial hyperlipidemia (FH), there are other genetic disorders of lipid metabolism. Some people's livers produce large amounts of cholesterol (hyper secretors), while others absorb a lot of cholesterol from food (hyper absorbers), and some have both of these issues. My past lipid profiles didn't suggest FH, and I haven't been tested to see whether I have increased hepatic cholesterol production or increased intestinal absorption. I assume I'm probably a hyper secretor, since my levels were higher than average even during my 10 years as a low-fat vegetarian who ate a lot of egg whites but very few yolks or other cholesterol-containing foods. I do have a family history of heart disease on both sides. My maternal grandfather suffered four heart attacks (the last one fatal), and my maternal grandmother also had coronary artery disease (CAD). My dad's brother has had two heart attacks, and his mother had CVD and died of a stroke. My mom has been on statin therapy since she was diagnosed with CAD ten years ago. (I'm not going to debate the risks vs. benefits of statin therapy in this post, but I'm not a big fan except in certain instances.) You may be wondering what kind of diet my relatives followed. Given that they all grew up and spent their entire lives in Switzerland (with the exception of my mom, who immigrated to the US at age 19), they obviously weren't following the Standard American Diet, but they weren't low-carbers either. My grandfather smoked and had diabetes, and my mom smoked for many years, but my other relatives didn't, and all were moderately active. I've never had a calcium scan or a carotid-intima thickness test(CIMT) to check for atherosclerosis but am looking into having these done. Even if they show no disease at this point, my goal is obviously preventing CAD, heart attack, and stroke in the future. My NMR results indicate I have the large, pattern A type of LDL with a low number of the more atherogenic small LDL particles (small LDL-P). This is definitely a good thing. However, although I've heard large, fluffy LDL characterized as "harmless" and even "protective," I'm having trouble finding convincing evidence supporting this assertion, especially in the setting of cholesterol levels as markedly elevated as mine. In fact, the authors of the Multi-Ethnic Study of Atherosclerosis (MESA) study summed up their findings as follows: "Contrary to current opinion, both small and large LDL were significantly associated with subclinical atherosclerosis independent of each other, traditional lipids, and established risk factors, with no association between LDL size and atherosclerosis after accounting for the concentrations of the two subclasses." Subclinical atherosclerosis is the period when changes are happening in the arteries but the hallmarks of atherosclerosis (i.e., plaque and fatty streaks) haven't developed to the point where the disease can be diagnosed. It's been pointed out that no studies have been conducted on people following VLCKDs who have very high LDL-C and LDL-P levels, and that's certainly fair to say. However, according to many MDs with expertise and/or personal experience in this area, we really don't know whether CVD risk is lower in low-carbers with cholesterol elevations of this magnitude. What Do The Experts Say About Very High LDL-C and LDL-P? I studied lipid metabolism in college as part of the coursework required to become a registered dietitian, but I'll be the first to admit that I have no expertise in that area. I think it's important to listen to the experts in this field since they best understand all of its complexities, including the genetic variations that influence cholesterol levels and the development of CAD. Keep in mind that the physicians listed below are all advocates of carbohydrate restriction to some degree. Dr. James Underberg is a lipidologist and hypertension specialist in New York City who told me that he has seen similar dramatic increases in total and LDL cholesterol in some of his patients following a carbohydrate-restricted diet. One of the interventions he recommends in these cases is replacing a portion of dietary saturated fat with monounsaturated and polyunsaturated fat sources. Although technically not a lipid expert, Dr. Rakesh "Rocky" Patel is very familiar with current lipid research as a family doctor in Arizona with hyperlipidemia who treats many people with diabetes and metabolic syndrome. He recommends the CarbNite (cyclical low-carb) method for most of his patients and also follows this approach himself. Back in the fall of 2012, he wrote a fantastic blog post entitled Does LDL-P Matter? in which he described improvement in his carotid intima thickness despite a significant increase in LDL-C and LDL-P after switching to a carbohydrate-restricted diet. When I received my NMR results from April, I asked him if we've learned any more about very high lipids in the context of a VLCKD since he wrote that piece. He responded: "Not really. It really is an understudied issue. Unfortunately, all the trials in the literature involve the Standard American Diet. Really, I think that before we engage in any discussion regarding cholesterol, one has to establish if atherosclerosis is present in any form. So using testing like CT calcium scoring, carotid intimal thickness testing (CIMT), and genomic scoring (Corus CAD, Cardiodx) becomes imperative and certainly provides context to the lipids." Dr. Axel Sigurdsson is a cardiologist who practices at a large university hospital as well as a private heart clinic in Iceland. In my opinion, his Doc's Opinion blog provides some of the most balanced, easily understood information about lipids and cardiovascular disease online. I described my experience to him and asked for his thoughts. His response: "I've seen this lipid response (a very high jump in LDL-C and LDL-P) a number of times in individuals who adopt a low carb/ketogenic diet with relatively high amounts of saturated fat. It seems that a certain percentage of people react in this way. In fact, the lipid response to this type of diet may be genetically determined. Of course, we know that high LDL-C and LDL-P are associated with increased risk of CHD (coronary heart disease). However, nobody really knows what it means in this metabolic situation (nutritional ketosis) and to what degree it is associated with increased risk. Some claim it's not, but I think the evidence is lacking for such a conclusion. On the other hand, we also know that many people with high LDL-C and high LDL-P never have CHD. Of course, you may be one of those people. However, it is difficult to ignore altogether the possibility that high LDL-C and LDL-P may increase the risk of atherosclerotic problems." Lipidologist Dr. Thomas Dayspring wrote an excellent article about a woman who had an experience similar to mine on a low-carb, high-fat diet, although her case involved weight loss as well. The article is available from his Lecture Pad series, and I highly recommend reading it in its entirety. (You'll have to register to view it, but registration is free). Although it may not always seem like it, he's actually quite supportive of carbohydrate restriction, particularly for people with metabolic syndrome. I didn't discuss my case with him, but here are two quotes from that article: "We now recognize that the cholesterol usually gains arterial entry as a passenger inside of an apoB-containing lipoprotein (the vast majority of which are LDLs) and the primary factor driving LDL entry into the artery is particle number (LDL-P), not particle cholesterol content (LDL-C)." "Could the low-carb crowd be outliers and in them we can ignore LDL-C and LDL-P? The advocates of those diets say there is no study showing harm of elevated LDL-P and LDL-C in patients who have eliminated or drastically reduced their insulin resistance and inflammatory markers by low carbing. That is true, but what they want to ignore is that there is no data anywhere that shows they are an exception. Their belief is that by reducing all other atherosclerotic risk factors and normalizing their arterial wall and endothelial biology, that apoB-containing lipoproteins like LDL cannot enter the arterial wall. Although LDL-C and LDL-P in plasma are high, none of the cholesterol content of the apoB particles gains entry into the arterial wall. Is that plausible??? Sure! But is that also erroneous or wishful thinking? Sure? Does one want to bet their CV health or life on a plausible theory? Some do and some do not. Seems to me the first step is to do what this woman did: adjust the nutritional regimen." He also states that when ketone bodies are present in excess, they can enter the cholesterol synthesis pathway, thereby increasing serum cholesterol levels. While I agree with Dr. Dayspring on several issues, I disagree with his position (stated in another great article, Understanding the Entire Lipid Profile) that cholesterol-lowering medication is indicated for everyone with LDL-C greater than 190. I think nutritional intervention should be tried first, as it seems to be effective for at least a portion of people willing to do it. Some of you may have seen spikes in cholesterol similar to mine after being on a low-carbohydrate, high-fat diet for a short period of time or possibly after a few years. You may not be that concerned, and I can understand that given the many positive effects LCHF can have on health, including certain cardiac risk factors. I also think there are still a lot of unanswered questions regarding the risk of elevated cholesterol in the setting of low insulin levels and optimal blood glucose control. But based on the evidence we do have, along with my strong family history of heart disease, I just wasn't comfortable with my numbers. And although I haven't seen this happen in any of my clients yet, I'd definitely recommend some sort of dietary intervention for them if it occurs in the future. Dietary Changes and NMR Results from June 2014 Over the past two months I made a few small but significant changes to my diet in an effort to lower my cholesterol levels: 1. I cut back on saturated fat, particularly dairy fat and coconut oil, which contain the types of saturated fatty acids with the greatest potential to raise cholesterol. 2. I increased protein back to my previous intake of about 100 grams per day. 3. I doubled my net carb intake from 20 grams to 35-45 grams per day. 4. I began having chia seeds almost every day. 5. I ate sardines 4-5 times a week. I still eat plenty of saturated fat, including some dairy fat. I drink coffee and tea with half-and-half (only 1 gram of carb in 2 Tbsp), always order Insalate Caprese made with fresh mozzarella at Italian restaurants, and continue to eat eggs cooked in a little butter for breakfast every other day. I still have burrata, ricotta, and moscarpone occasionally and continue eating red meat about 3 times a week. My total fat intake now ranges from roughly 80-100 grams per day, which is about 50-65% of my total caloric intake. That's still a LCHF diet! And in my case, it's also a mildly ketogenic one, since when I've checked my ketones in the morning (again, I only do this sporadically), they've been 0.4-0.8. Personally, I don't see the need to be in ketosis for my own health; to control my blood glucose, I eat a low-carb diet which just happens to be ketogenic. My weight hasn't changed (which was my goal), energy levels are good, sleep is excellent, etc. I just received my new NMR results from labs drawn earlier this week: My LDL-P and LDL-C are still higher than I'd like, but they've dropped considerably in a short period of time. I'm especially impressed by the 44-point drop in my LDL-C. My HDL decreased a bit as well but is still quite high. Considering this occurred in less than two months, I'm pretty happy with these results and hope they continue to improve until they return to the "Above Optimal" to "Borderline" ranges, which I consider normal for me.
As I said at the beginning, I'm a strong proponent of a low-carbohydrate lifestyle. I don't think that's ever going to change. But I feel it's important to look beyond the benefits and address the changes in lipids some people experience that could potentially have adverse effects. This was an n=1 experiment, of course. Remember, most people won't experience extremely high cholesterol levels on a VLCKD. But for me and others who do, I don't believe in shrugging it off and dismissing the results of studies because their subjects weren't following a carb-restricted diet. As a dietitian, I just can't say, "Go ahead and eat as much butter, cream, and bacon as you want. It doesn't matter how high your LDL-C and LDL-P are as long as you're eating low carb and your other markers are low," even if that's what many want to hear. Because we just don't know at this point. Maybe one day there will be evidence demonstrating that VLCKDs are cardioprotective even in the setting of significant hyperlipidemia. I truly hope that's the case. But in the meantime, I'm going to eat a low-carb diet that keeps my lipids in a range I feel more comfortable with. ***UPDATE: Recent NMR results, cardiovascular disease risk and what I eat References 1. Otvos JD, et al. Clinical Implications of Discordance Between LDL Cholesterol and LDL Particle Number. J Clin Lipidol. 2011 Mar-Apr;5(2):105-13 2. El Harchaoui K, et al. Value of low-density lipoprotein particle number and size as predictors of coronary artery disease in apparently healthy men and women: the EPIC-Norfolk Prospective Population Study. J Am Coll Cardiol. 2007 Feb 6;49(5):547-53 3. Cromwell WC, et al. LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study - Implications for LDL Management J Clin Lipidol. 2007 Dec;1(6):583-92 4. Mora S, et al. LDL particle subclasses, LDL particle size, and carotid atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2007 May;192(1): 211-7 5. Waterworth DM, et al. Genetic variants influencing circulating lipid levels and risk of coronary artery disease. Arterioscler Thromb Vasc Biol. 2010 Nov;30(11):2264-76 6. Moriel P, et al. Lipid peroxidation and antioxidants in hyperlipidemia and hypertension. Biol Res. 2000;33(2):105-12 7. Ohlsson L. Dairy products and plasma cholesterol levels. Food Nutr Res. 2010 Aug 19;54 8. Mensink RP, et al. Dietary saturated and trans fatty acids and lipoprotein metabolism. Ann Med. 1994 Dec;26(6):461-4
211 Comments
6/20/2014 04:07:04 am
Very cool! Pretty much the same thing I see with my patients (and myself)
Ana
6/20/2014 04:10:28 am
Its so interesting that you had this experience. Low carb made my numbers drop significantly....and I usually have high cholesterol. This is something to investigate further for sure! 6/20/2014 04:29:20 am
Thanks, Ana! Lipid response to carb restriction is so individual. Some people do see their numbers go down. I'm glad to hear that's what happened in your case!
Anna
6/20/2014 05:19:21 am
Thank you for sharing your results. It is nice to hear other people's approaches. I have been low carb (approx 30g net) for 3 years. My last numbers were Total Chol=277, HDL=85, LDL=171, Trig=105. I do not have comparison numbers because I never had a test before. I was concerned about all the numbers except the HDL. Compared to my previous diet (high carb low fat vegetarian) I suddenly started to eat a lot of red meat, eggs and high fat dairy along with non-starchy vegetables. (There's not much good fish in my region.) The blood test results made me doubt what I was doing. My solution came spontaneously, as my appetite and overall interest in food decreased over the years. I eat very little now, although my macronutrient ratios have probably remained the same. I will be curious to see my next results. 6/20/2014 07:07:58 am
Thanks so much for commenting and sharing your story, Anna. I wish you had a baseline prior to starting low carb just to see if your numbers improved, got worse, or stayed the same. I hope your next set of labs shows improvement all around.
Jill
12/29/2016 04:10:58 pm
Anna, I had a similar experience but I did have a baseline lab test so was shocked at my results. After almost 1 year in keto I feel fantastic, lost weight, great energy, sleep well but my total cholesterol went from 208 to 273 however my triglycerides dropped 85 to 66 which is good, my hdl went up 71-85 which is good but my ldl direct? also shot up 120 to 175 but my vldl dropped 17 to 13. My doctor is concerned but in researching more factors in CV disease it seems that the most important factor is total chol/hdl and mine is 3.2. Am i just looking for the answers I want? Any comments on this? 12/29/2016 05:58:26 pm
Hi Jill,
Gretchen
6/20/2014 05:37:33 am
1. Why was your first LDL-P labeled High when it was in the Moderate range? 6/20/2014 07:13:00 am
1. I think it's just flagged as High for being above the normal range. Note that in my second set of labs, the LDL-C was flagged as High even though it was actually in the Very High Range. 6/20/2014 06:22:41 am
Nice post and well summarized. I do think that in the end, genetic variation is gonna be probably what we are looking at, so i do agree with Dr. Siguurdson. I will be very interested in seeing some studies regarding subclinical athero. for yourself once they come back 6/20/2014 07:14:18 am
Thank you so much for the feedback, and for answering my questions the day I emailed you in a somewhat frantic state :)
charles grashow
6/20/2014 06:41:20 am
1) When do you expect to get another NMR test? 6/20/2014 07:20:50 am
1. I'm not sure right now. It will probably depend on how my labs look when I get my next basic lipid profile in a few months. I do want to have the other studies done (calcium score and CIMT), and they're probably fairly expensive and not covered by insurance.
charles grashow
6/20/2014 07:36:08 am
You might research supplements like berberine, amla, bergamot, pantethine 6/20/2014 07:48:25 am
Sorry, Charles -- I'm unable to reply to replies, but I hope you see this. I appreciate the supplement information and the references. Thank you.
NM
6/20/2014 06:55:39 am
I think the data are actually in: watch Ivor Cummins's lecture on cholesterol: https://www.youtube.com/watch?v=fuj6nxCDBZ0 6/20/2014 07:28:43 am
Thanks so much for your comments and for sharing the video, NM. I don't have time to watch it today but will definitely try to view it sometime soon. 7/11/2014 12:17:08 pm
Exceedingly warm there NM, infectious agents perhaps playing their interactive part also - but I'm too impatient to wait 10 years for answer! ....so currently triangulating existing study data (such as it is with all the design flaws) to firm up on hypothesis - output will be in next seminar, and depending on the the direction the problem solving process dictates, may very well be titled "Insulin - the Rosetta Stone" :) 7/11/2014 01:47:48 pm
Thanks very much for responding here, Ivor! I very much enjoy and appreciate your work and look forward to seeing what you have in store for us next :) 7/14/2014 07:02:32 am
Rather thank you Franzizka - for opening up such a timely and fascinating discussion, enabled by the excellent tracking of your response data versus inputs; on hols currently, but with 5 kids in tow I'm not reaching research goals(!) - will get there though.....! 7/14/2014 07:14:29 am
Wow, I didn't know you had 5 kids. No idea how you manage to get so much research done and put together such amazing presentations, but we are all very appreciative of your efforts.
Andy Benkert
6/20/2014 06:59:44 am
Thanks for posting this, as I have noticed some of my lipid numbers moving in the wrong direction as well. While my triglycerides and HDL are fabulous, my LDL and overall numbers are not and I have been making some changes to my diet as well. My doc recommends statins, but I'm not comfortable with that at this point. Since I have been eating a lot of coconut oil, I think I will follow your lead and drop that for a while to see if it will help make a difference. I sure hope so, and hope, as you do, that our dietary choices will some day prove to be beneficial despite the numbers. But along with you, I'll do what I can to keep those numbers low. :-) 6/20/2014 07:30:34 am
Sounds like we had very similar responses, Andy! Thanks for sharing your own experience. I wish you the best of luck on your next lab test, along with good health in general!
Galina L.
6/20/2014 07:09:50 am
Franziska, 6/20/2014 07:50:02 am
Thanks so much for sharing, Galina! Always a pleasure to hear from you!
eddie
6/20/2014 07:10:00 am
Hello, 6/20/2014 07:53:04 am
Thanks so much for sharing your story, Eddie! I'm very glad your health has improved so much on LCHF and that you can now eat foods which previously caused such GI distress. I'll have to look into the testing you recommend. Sounds interesting!
eddie
6/20/2014 09:01:46 pm
I will also say.....my insulin resistance was super LOW the NMR use to give you the real low numbers I was a 4 now they dont give you reading below 25 My inflammation crp is .07 and my inflammation in GI markers is down one count was 1300 below normal is under 600 today Im a 97 For my cardiac calcium score is a 1 Im 41 years old. Feel great... Me Im willing to roll the dice. As my particles LDL-P have gone up Ive felt better,. may sound strange. When my gut was a mess my heart would flutter. no more. I think these docs have no clue-----just as they have NO clue in gut problems and diseases.... to me heart disease is a leaking of bad bacteria and yeasts into the blood stream due to a bad gut...and the cholesterol is attacking and clogging up the site of inflammation. if you read certain bacteria are antimicrobial --and eating LC your changing your microbiome. It wouldnt surprise me in the future, that the fat turns on the microbiome as a hunter mode ...if you have no issue the particles are flooding around in mass ready(actually protecting you)....time will tell.
Carly
6/20/2014 07:26:39 am
I just got results back after trying to eat Keto and my HDL numbers jumped up wonderfully, triglycerides are crazy low...but my LDL's are still higher than they should be. I was put on a statin three months ago, so they did go down some from last time, but I had hoped to see a bigger drop. Doc wants me to stay on the statin but I'm tempted to continue the LCHF diet without it and retest. I've seen the same theories out there on particle size and not much science behind it yet. I really enjoyed your story and hope to follow it more! 6/20/2014 07:55:18 am
Thanks very much for your nice feedback and for sharing your story, Carly! It's amazing to see how individualized lipid response to keto and carb restriction can be. Good luck with everything! 6/20/2014 08:04:41 am
Hi Franziska 6/20/2014 08:08:20 am
Always great to hear from you, Eddie! Thank you so much for the compliment. As well, I truly appreciate your support. Yes, low carb is the way to go for people with diabetes. Your BG numbers and A1c say it all.
charles grashow
6/20/2014 08:18:18 am
10/5/12 6/20/2014 09:46:37 am
Wow, amazing changes in your LDL-C and LDL-P! Thanks for sharing.
charles grashow
6/20/2014 09:32:18 am
http://atvb.ahajournals.org/content/34/7/1341.full 6/20/2014 09:49:45 am
Interesting! Just read the abstract so far and will read the rest soon. Thank you.
Lisa
6/20/2014 11:32:04 am
Great post, with lots of valuable information. I'm going to take some of your suggestions on board.
JB
6/20/2014 12:02:35 pm
NM, thanks for linking that vid. It was a really excellent presentation, and that specific data on insulin vs. LDL particle was new to me, so thanks for that.
marcus volke
6/20/2014 09:56:49 pm
It's pretty well established that ketogenic diets lead to low thyroid and that because thyroid hormone is needed to upregulate ldl-receptors the result is that LDL cholesterol spends too much time circulating in the blood, leaving it vulnerable to oxidative damage which in turn can lead to atherosclerosis and elevated LDL.
ed
6/20/2014 10:25:00 pm
explain my disappearance of crohns diease and ulcer colitis No one has a clue why its gone....I can tell you in testing my yeast levels went down. and insulin resistance low now , but particles went up.. 6/20/2014 10:25:37 pm
Hi Marcus,
marcus volke
6/21/2014 01:01:40 am
Thanks for your reply franziska. I think low thyroid becomes more common the longer you stay on a keto diet. That would explain why short term studies show that people eating keto diets have good cholesterol or even improve their cholesterol, but in the long term high ldl is very common. That is also consistent with your experience, your cholesterol gradually deteriorated over years of carb restriction. So given that background i think its premature to attribute your soaring ldl cholesterol to safa intake especially when the literature does not support an association between safa intake and poor hdl to ldl ratios. 6/21/2014 02:55:26 am
Thanks, Marcus. You may very well be right. I'm still encouraged that my lipids improved quite a bit by increasing my carbs to only about 20 grams. Interested to see what they're like next time I get them tested. 6/24/2014 12:54:52 am
Correction in my response to Marcus: It should say "increased carbs by 20 grams" rather than "to 20 grams."
Lance
6/24/2014 12:14:31 am
Thanks for this post. Some folks on LCHF diets try to cycle carbs / insulin in order to maintain the thyroid function. They would once a week or prior to an intense exercise session eat carbs for either thyroid or athletic performance reasons. I don't get the sense that many if any on this post cycle carbs, but I wonder if the carb cycling is effective or not, whether that would show up on thyroid tests and ldl-c tests. Likely there are subgroups of all of the above, but as a new low carber with increased ldl-c, thanks for your post as it gives me something to think about. Figure my increase may be mostly fat loss, but checking on thyroid is probably something I need to do in the event as my fat loss slows, my ldls don't improve. Thanks Franziska for this post as many of us are struggling with this issue. 6/24/2014 12:51:46 am
Thanks so much for your comments and sharing your own experience, Lance. In Dr. Patel's article on LDL-P I linked to in my blog post, he confirmed that he follows a cyclical VLC diet, yet his LDL-C and LDL-P numbers are quite high. I don't believe he has any thyroid dysfunction, however. I think it's important to have thyroid labs done periodically regardless of diet, though, as changes can happen within months. Again, I appreciate your comments and hope that your lipids improve.
Galina L.
6/25/2014 03:48:13 am
Not everybody believes that eating a LC diet is detrimental to the thyroid function, but a weight loss resulted from any weight-loss regimen may cause a hypo-thyroid symptoms in many people. 6/21/2014 12:14:05 am
A great reasoned discussion with particle numbers. BRAVO. I think different genomes respond to different diets. Folks with insulin resistance clearly benefit from LCHF diet. I hope the ADA comes around to this conclusion soon. To know if your diet works for you it is critical to get CAC & CIMT at baseline and follow CIMT every two or three years. Here is my report. https://docs.google.com/document/d/1a0Rp9WV1dSrbs_n5cXNv6TgdFZxdUBYUk95D5cYb61I/edit#heading=h.938fr74lv4ue Caution: False negative CAC in folks under 60 yo common. CIMT quality questionable. I have used different labs with different results but I posted KUMC as the most consistent and reliable for CIMT. Fran, I input your data of TC 280, HDLc 92, age 47, normal BP, no smoking, no DM into ACA/AHA risk calculator: http://clincalc.com/Cardiology/ASCVD/PooledCohort.aspx and found your 10 year risk to be 1.6% but your lifetime risk is 50%. If you have sub-clinical plaque on CAC or CIMT I would suggest trying Atorvastatin 10 mg a day and get LDLp < 1,000. My lipids & weight & statin intake did not change on LCHF but I stopped gaining weight. I actually decreased exercise over this 3.5 year period. Of course I am a big advocate of statins. I understand some folks just don't want to take them, 6/21/2014 12:41:31 am
Thanks very much for the nice feedback, Brian! Thanks so much for all of the information and suggestions. Wow, a lifetime risk of 50%. I will look into having the tests you recommend. As I said, I have mixed feelings about statins and am hopeful that I can bring my lipids down to reasonable levels by dietary means. Thank you so much again for your comments! Very much appreciated.
First a personal disclosure. I am an engineer. In the past I followed official recommendations blindly. I am sure that following and promoting them I got to hurt some of my most near, dear kin. I don't delegate preventive care to anyone anymore. 6/26/2014 01:34:37 am
Thanks very much for your comments and sharing your story, Andres. I appreciate all of the information and your insights.
eddie
6/26/2014 05:16:28 am
Andres,
eddie
6/21/2014 01:50:57 am
Brian Edwards,
marcus volke
6/21/2014 10:29:28 am
Fungi actually thrive on ketones, ketogenic diets exacerbate fungi and also adversely effect gut microbial diversity.
eddie
6/21/2014 12:08:24 pm
Ive heard that one................too many times """ fungi eating ketones.""" The problem its not as simple as that.. Depends on your PH , other bacteria..(which most are missing many strains from all the antibiotic use---why they have yeast overload to start with) too much fat and LC will kill many bacteria. If your missing many SURE it will eat ketones.....thats a lame answer --there missing many bacteria that would suppress them-- due to the over use of antibiotics....add in to much you lose your good bacteria and add in antibodies to yeast/fungus--- from all the penicillin.. foods with similar antibodies -gluten, soy and casein all look like yeast/fungus adding in the up tick of allergies and gluten issues.... diabetes... something no one talks about.... Im sure when you dig like I said above youll find YEAST as the cause with low good bacteria... investigate your type 2.... L@@K up akkermansia bacteria.. up this bacteria(eats real inulin) , and lower you yeast... Im sure your A1C will change and statins are also ant ifungal
marcus volke
6/21/2014 11:20:21 pm
So eddy, if i understand you correctly your solution to the problem of too little good bacteria and too much fungi is to starve the good bacteria even more and feed the fungi by staying on a ketogenic diet? 6/21/2014 03:23:57 am
Fran, Thanks for sharing your results and thoughts. Unfortunately, we are left with expert opinion in 2014 regarding rising LDL-P on VLCKD diets and cardiovascular risk. 6/21/2014 03:55:48 am
Hi Jeff, 6/21/2014 09:24:30 am
Can't reply to your reply because Weebly set up the comments section this way, but thanks :)
Tom McQuinn
7/3/2014 09:31:02 pm
Hi Jeff (I was your alternate cameraman on the low carb cruise). 7/4/2014 08:58:07 am
Tom, A Long thread here and you have already made some great comments. Regarding the calcium heart scan, I do hope that you went to a reputable facility. As in any imaging test, performing and interpreting requires a bit of art and skill.
Tom McQuinn
7/9/2014 07:17:45 pm
Thank you, sir. Yes, hopefully it was a reputable facility doing the CT cardiac score. It was recommended by my doctor so I'm fairly comfortable with that choice. They said they don't farm out the interpreting and the work is done by a local physician. 7/9/2014 10:44:33 pm
Congratulations on the great calcium scan results! Let us know what happens with the Cleveland Heart Labs testing.
eddie
7/9/2014 11:50:09 pm
Tom,
Tom McQuinn
7/10/2014 08:36:36 am
Eddie - Here you go. The difference between 2013 & 2014 was I started taking fish oil twice a day.
eddie
7/12/2014 12:21:16 am
Tom,
charles grashow
6/21/2014 06:16:21 am
http://www.drsinatra.com/what-is-the-best-heart-healthy-diet-plan 6/21/2014 09:23:04 am
Thanks, Charles. Unfortunately, that is exactly the diet I followed for many years until I discovered my postprandial blood glucose reached 160s-190s after meals. Lowering my carbs significantly allowed me to keep BG under 140 at all times. My fasting blood glucose has always been and remains quite low, in the high 70s to low 80s.
marcus volke
6/21/2014 10:23:17 am
Having said that if i am right then eating more safa would still probably exacerbate the problem. If your ldl receptors are working properly then they will clear dietary cholesterol readily and your cells will adapt by producing less endogenous cholesterol. 6/21/2014 10:44:53 am
Thanks for clarifying. Your reasoning makes sense. I do think both upping the carbs and protein while lowering saturated fat a bit helped both for thyroid function and perhaps via reducing ketone concentration, since they can be used in cholesterol synthesis. Yes, I certainly wish I'd tested thyroid and adrenal function back in April. 6/21/2014 09:20:43 pm
“Sometimes when talking to someone about their cholesterol, I ask them to ask me what my cholesterol is. Then I answer: “I have no idea, because I never have it checked.” That’s not because I take an ostrich-like stance on matters that relate to my health – it’s because the great likelihood is that knowing my cholesterol numbers would not lead to me having a different view on my health or have any bearing on how I live my life. End of.” 6/21/2014 11:05:58 pm
Thanks for your comments, Eddie. While I respect those doctors and their opinions, I have equal respect for the opinions of the doctors cited in my article and the ones who have posted here, who disagree that very high cholesterol levels do not increase risk of heart disease. So there is no harm and may be great benefit in modifying my diet the way I have. Thanks, as always, for your support.
David
8/11/2014 01:34:13 pm
Dr. Dwight Lundell has said that cholesterol is no indicator of CHD. I've also read that 200-250 may be an optimal range for total cholesterol. (Assuming HDL 60+ and Trgs 75 or lower) Seems odd that someone can have a TC of 220 and they are put on a statin. Will it reach a point that cholesterol is not even used for diagnosis?
Tom McQuinn
6/21/2014 09:59:42 pm
Wow. There are a lot of parallels to my own experience here. I have been LCKD for 2 years. My doctor belongs to the particle size school of thought regarding LDL but I am not convinced: 6/21/2014 11:01:16 pm
Hi Tom, 6/26/2014 09:17:50 am
Good luck with 23andMe! (Responding to your post below because I can't reply to your reply and there are already so many responses to Marc's initial one)
Tom McQuinn
6/28/2014 12:06:11 am
Yeah, that's one long thread! I've followed link after link until my eyes are ready to bleed. I really hope the Irish guy with the stats showing that high LDL-P with low fasting insulin is harmless is correct! My fasting insulin was 4 (range 3-14). 6/28/2014 12:50:11 am
I hope Ivor is correct as well! My fasting insulin has been below the usual range ever time I've measured, right around 1.
charles grashow
6/21/2014 11:19:29 pm
@Franziska 6/21/2014 11:31:39 pm
Thanks very much, Charles. I am actually very interested in this test. I wish I could order it myself, but it looks like it requires a physician's order. I'll discuss it with my doctor at my physical next month.
charles grashow
6/22/2014 12:18:50 am
@Franziska
eddie
6/22/2014 02:04:56 am
I had planned on doing this test next month----same place be interesting to compare results
eddie
6/22/2014 12:32:16 am
marcus volke
6/22/2014 11:01:50 am
Well im glad to hear you're feeling better eddie. Ketogenic diets can be therapeutic for crohn's and any condition related to gut dysbiosis and small bowel overgrowth. Generally these diets remove food toxins and stomach irritants which can be problematic if you have a permeable gut (i.e grains). Fibre can also be antagonising to a sensitive gut. The other reason they work is that starve the pathogens, including the SIBO pathogens. The downside is that you also starve the good bacteria and possibly feed fungi.
eddie
6/22/2014 12:28:44 pm
THANKS, NEED MY FRIEND
marcus volke
6/22/2014 01:55:27 pm
Thats fantastic eddy, it sounds like you know what youre doing. Can you tell me how you increased your levels of akkermansia bacteria? Did u take a probiotic form and prebiotic to feed them? How Did you fix your gut barrier integrity? Just diet and probiotics?
eddie
6/22/2014 11:16:42 pm
Marcus,
marcus volke
6/23/2014 12:04:04 pm
Thanks for the info. So you didnt actually take an akkermansia probiotic at all? 6/23/2014 03:22:58 am
Congratulations on a well thought out discussion Too simplistic for some to comment such a response is genetic as every single chemical reaction in the body is under genetic control, and thus everything is influenced by genes. I have that found most folks with your response have evidence of induced cholesterol synthesis which is evident if one measures desmosterol or lathosterol in serum. If so the therapeutic approach has to be reducing the synthesis by dietary alteration (reducing or changing type of fat or for those unwilling to do that or do not have a response at moderate to high lifetime risk for CAD, a cholesterol synthesis inhibitor (statin) 6/23/2014 04:09:28 am
Thank you so much for your comments, Dr. Dayspring. Thanks very much as well for your LecturePad series, where I found the case study that prompted me to make modifications to my diet that got my numbers moving in the right direction. Such a fantastic resource.
eddie
6/23/2014 06:16:17 am
Dr DAYSPRING,
My cholesterol went really really high recently too - total 10 at its peak and 7.5 LDL (285) 6/23/2014 10:08:59 pm
Thanks so much for sharing your story and experience, Julianne. Here in the US, oxidized LDL testing requires an order from a physician, unlike the NMR, which anyone can order on his or her own. Most doctors don't order oxidized LDL for their patients, but of course I'd really like to know the status of my own. It's good to know that the majority of your husband's LDL wasn't oxidized, but I'm sorry to hear about yours. I'm so glad to hear that making those dietary changes resulted in improved sleeping and stable weight. Good luck on your next round of lab tests! 6/24/2014 12:52:54 am
Julianne, The oxLDL test is part of the CHL testing and also HDL lab does most of the panel. We are getting a lot of unexplained high oxLDL results and they just lowered the threshold on that test. I think the full panel is helpful.
Julianne
5/27/2015 09:43:37 am
Just a follow up, dropping out animal fats, butter and coconut oil, increasing starchy root veg carbs, taking a couple of supplements, - hesperidin, my LDL went down to 4. I also had my hsCRP done and it was 1 - so fine.
charles grashow
6/24/2014 12:50:25 am
@Franziska
charles grashow
6/24/2014 02:54:05 am
@Jeffry Gerber, MD @Franziska Spritzler 6/24/2014 03:44:31 am
Charles, I'm not really qualified to opine on that but will say that it sounds like a reasonable postulation. I'd love to hear the doctors weigh in on this.
Marc Rouleau
6/24/2014 04:52:41 am
Franziska, thanks for the excellent blog post and for supporting an incisive commentary discussion. 6/24/2014 06:12:45 am
Mark, thank you so much for the nice feedback and all of the insightful and helpful information. I will definitely check out the ApoE4 Forum. I did have the 23andMe genotyping done, but I didn't see anything regarding ApoE4, only that I do not have FH. Thank you very much again.
Marc Rouleau
6/24/2014 06:34:38 am
The two SNPs of interest are rs429358 and rs7412. If you log in and choose the "BROWSE RAW DATA" option from the "Franziska Spritzler" dropdown, you can find your values. The nexus of those two SNPs define your two ApoE alleles: 6/24/2014 06:44:24 am
Mark, thanks again for the information. I downloaded my info to Promethease, and it appears I do not have the ApoE4 gene, although I do have several SNPs indicating my risk for CAD is 1.5 times higher than average. According to the report, I am Apo E3/E3. 6/24/2014 06:46:12 am
I just wanted to add, I am ApoE e3/3, so that is not a contributing factor for me. My cholesterol has been completely fine up until post menopause. I also have a client whose results are similar to mine - high HDL, low TG, high LDL and ox LDL. We got our tests through Imupro. Another aspect could be fish oil supplementation. Although my husband supplements he used OmegaRx which is batch tested for oxidation. I was using fermented codliver oil. My client - I have yet to check. 6/24/2014 08:05:44 am
Mark, thank you again for that guidance with interpreting the Apo E information. Although in my 23andMe data is states I do not have the Apo E4 gene and on Promethease it states I am E3/E3 in the Alzheimer section, when I enter the SNPs as raw data, I get 2/4. So I'm a little confused at this point but am grateful that there's so much information that will allow me to sort it all out. Thank you so much again! 6/24/2014 08:07:58 am
Hi Julianne,
Marc Rouleau
6/24/2014 02:28:38 pm
Franziska, to be 2/4 you would have 6/24/2014 09:39:44 pm
Thanks, Mark. It didn't make sense to me either, and I was going to look further into it today but now realize that I incorrectly transposed the letters. I am indeed a 3/3.
Tom McQuinn
6/26/2014 08:52:29 am
Here I go down another rabbit hole. I just ordered the 23andMe test. Fingers are crossed!
Julianne
5/27/2015 09:48:16 am
I am ApoE3/3 and my LDL went up to 7.5 with low carb, high fat diet
charles grashow
6/24/2014 09:01:06 am
I am also ApoE e3/3,
charles grashow
6/25/2014 12:52:07 am
http://www.atherosclerosis-journal.com/article/S0021-9150%2814%2901164-2/abstract 6/25/2014 01:18:55 am
Thank you, Charles. I'm going to put the full text of the article on my rapidly growing reading list. But the abstract of this new study looks quite interesting.
eddie
6/25/2014 05:55:13 am
Charles
charles grashow
6/25/2014 09:28:04 am
http://www.lecturepad.org/pdf/tomdayspring/human_lipid_transportation_system.pdf 6/25/2014 10:41:41 am
Thanks, Charles. Great stuff on LecturePad.org. Highly recommended!
eddie
6/25/2014 12:02:51 pm
So one more question, If one has surgery and there cut open Like I was....do to a fistula,, 7 inches long and 5 inches deep and left open to heal.. 6/25/2014 12:16:37 pm
Hi Eddie, It's my understanding that cholesterol often temporarily increases after surgery or injury as part of the healing process, yes.
eddie
6/25/2014 10:56:05 pm
Franzika Spritzler, 6/26/2014 12:49:28 am
Hi Eddie,
eddie
6/26/2014 01:26:44 am
I may be crazy but for me it seems the krill or fish has lowered my small ldl p.... I eat almonds and walnuts and seem to see more up tick witg the avacado..... fish seened to lower small ldl p not total ldl p....maybe crazy
Lance
7/8/2014 06:22:48 pm
Just an interesting tidbit from a recent interview with Dr Steven Gundry: 7/8/2014 10:23:55 pm
Thanks so much, Lance. Listening to it right now, as I was alerted by someone on Twitter as well :) This hasn't been brought up yet in this thread, so I very much appreciate you sharing this.
eddie
7/8/2014 11:26:23 pm
I d like to know why even test SMALL LDL-P it seems several of these docs like DAYSPRING are focused on the the TOTAL LDL PARTICLES 7/9/2014 01:40:57 am
Thanks, Eddie. I think your last line says it all, and at least until we have evidence showing us otherwise, that's what I'm trying to do.
eddie
7/9/2014 02:14:20 am
Franziska 7/9/2014 02:42:18 am
Hi Eddie.
eddie
7/9/2014 03:33:39 am
what did your total LDL P particles start at as well the small LDL p 7/9/2014 03:46:49 am
Eddie, 7/14/2014 06:57:47 am
Great article! Special thanks for always listing your sources!
gary l
7/15/2014 07:03:51 am
I have very similar data total 283, HDL 76, LDL Iranian 166, TG 66, apo B/A1 0.68, LDL P 1577, LDL size 22.3, LDL pattern A, LDL large 69 %. My TG/HDL ratio has gone from 3.2 to 0.9 when switching to low carb. Unfortunately all current recommendations based on averages of a population that uses a SAD diet and these values most likely not relevant for very low carb people. It would be helpful if someone asked for us low carb people to volunteer our data and perhaps collect a 1000 data points to get our averages and compare those values to SAD members. For me personally, I will never go back to eating pizza or pasta etc. I have never felt so good in my whole life and I eat very few carbs while going from 26 % to 15% body fat. Thanks for your blog. 7/15/2014 07:46:24 am
Hi Gary,
gary l
7/16/2014 06:28:03 am
Most long term population studies are difficult to do because of compliance. With us low carbers compliance is typically not a problem since once we see the positive effects of the diet on weight and blood chemistry not to mention the feeling of well being we won't revert to a SAD diet. In my case compliance is even more assured since I had a myocardial infarction Feb 2012 with a SAD diet. They said I died twice during the operation to install the stent. My nickname on the third floor of intensive care was "miracle man". Fortunately the stars were in alignment for me that sunny day. On low carb, my blood pressure went from 143/89 to 115/75 and my trigs from 290 to 66 as well as a doubling in HDL and I no longer suffer chest pains. So for me to go back to eating carbs would be life threatening. 7/16/2014 07:25:29 am
Wow, what an amazing story! So happy to hear about all of the improvements you've seen as a result of following a low carb way of eating. I wish you a healthy and happy long life.
Judy
7/25/2014 06:18:34 am
Got labs back in today and I feel like you. Except I don't have the partical size numbers. I have been doing VLCKD for 6-8 weeks now. 7/25/2014 10:51:24 pm
Hi Judy,
Judy
7/26/2014 09:53:44 am
Thank you so much for taking the time to respond to my post. I only lost about 3 pounds and don't really need to lose weight. That is what also surprised me about my numbers. I would have expected it if I had lost a lot of weight. Before I started (5'2) I weighed 115 # and now weigh #112, so no major weight loss. 7/26/2014 10:28:16 am
My pleasure! I'm glad you're enjoying low-carbing but also recognize that lipids can change and should be monitored every 6-12 months. I'm hoping to get my LDL level back to where you're currently at ;)
Judy
7/29/2014 02:34:40 am
I walked in and the asked me why I was there? I explained that he wanted me to come back because of my lab results. Soon as he got my labs pulled up, he said we need to get you on cholesterol medicine. Whoa!!!!! Didn’t even talk with me about my diet or ask any questions, suggestions to try and lower it with diet. Mind you, he doesn’t know me, unlike my former doctor of 24 years who moved. 7/29/2014 06:33:37 am
So sorry to hear that your doctor isn't supportive or even aware of the benefits of LCHF. Any chance you can find another doctor in your area who's more progressive and knowledgeable?
Lance
7/29/2014 06:43:59 am
Lotsa your issues are discussed here: 7/29/2014 07:14:42 am
Hi Lance,
kapka
8/15/2014 01:07:45 pm
Franziska, thank you for the information, and sharing your experience. 8/15/2014 10:27:10 pm
Thanks very much for your commons, Kapka! The LDL-C itself isn't the biggest concern; it's the LDL particle size (LDL-P). But if you're not happy with the LDL-C number, reducing saturated fat a bit might help.Best of luck to you! 11/19/2014 12:53:14 am
Thanks for the post where we come to know more details on lipid test with nice pictures and sharable information......
Mihir
12/4/2014 03:47:29 am
i ran across your website after getting my most recent lab results. 12/4/2014 06:32:10 am
Hi Mihir,
Mihir
12/4/2014 06:41:20 am
thanks Franziska. (by the way, the LDL in june 2014 was supposed to be 151, not 51).
Mihir
12/18/2014 07:05:05 am
Just thought I'd post back. current LDL-P is 1638. you mentioned you started taking chia seeds daily. my doctor said something about them as well. but, i forgot to ask how much to take. how many did you take? 12/18/2014 07:57:29 am
Hi Mihir,
Sandra Lucia Soares da Silva
1/9/2015 02:56:59 am
Sam
1/14/2015 07:19:09 am
Hi Franziska , 1/14/2015 10:58:42 am
Hi Sam,
Sheryl
2/4/2015 10:27:58 pm
This was an awesome, awesome article. Thank you. I have cholesterol issues as well, and that is why I'm following a sensible low carb (weight maintenance will be moderate carb), way of eating with an eye on fats. So refreshing to read this. My days of pork rind nachos are now long gone. 2/4/2015 10:41:18 pm
Thanks so much for your comments, Sheryl! Each person needs to find what works best for him or her, and it sounds as though you've got it figured out. Best of luck to you!
kelly
2/8/2015 08:36:07 am
hi there, 2/8/2015 12:23:19 pm
Hi Kelly,
kelly
2/9/2015 11:09:18 am
Awesome. Please keep us updated ;) 2/9/2015 11:26:03 am
Funny you should say that -- the first line of the book I just published reads:
Mark Buster
3/29/2015 12:41:44 pm
Curious as to why you're not getting NMR, or can LDL-P be obtained without? Thought is that with possibility of LDL-P being in discordance with LDL-C, one would be more concerned with the former. A drop in C means nothing.
kelly
4/21/2015 06:34:53 am
You'll need the NMR if LDL-P is a target you think is worth watching and manipulating downward, right? 4/21/2015 08:36:53 am
Hi Kelly,
kelly
4/21/2015 09:33:07 am
Doh! I totally missed that. Thanks for mentioning it. Going to read it now ;) I'm hoping the tweaks you made in your diet made a difference in LDL-P...
George
3/21/2015 06:11:04 am
Hi Franziska, 3/21/2015 06:57:14 am
Hi George,
Rio nellas
3/24/2015 07:02:41 am
Rio
3/24/2015 08:54:56 am
hi I'd like to know what test should I get for cholesterol and how will I know if the test is ok? 3/27/2015 07:22:16 am
Hi Rio,
Ellen Divers
3/25/2015 03:20:32 am
Really glad to have found this discussion as I was surely unpleasantly surprised at my labs yesterday after LC keto diet! I'll throw my data points into the mix because I can tell you how was eating before three of my last test results. Let me preface by saying I am a 52-year old female low-carber (have been for 15 years), generally keeping my carbs around 50 to maintain a normal weight. APo-E 3/4, blood type A.
Marc Rouleau
3/25/2015 10:46:01 am
Ellen, thanks for sharing your results. I hope you'll drop by http://apoe4.info/forums/ sometime as we are a community of ApoE4 carriers like yourself who are interested in optimizing health to prevent / delay / reduce our tendencies toward Alzheimer's and cardiovascular disease. Member strategies vary along the entire spectrum from low-fat veganism to very low carb / ketogenic. From your post above, I think you would fit in well there. 3/26/2015 10:38:51 am
Thanks so much for your comments and for sharing your story, Ellen! I agree with your plans and second Marc's suggestion to check out the ApoE4 forums -- a wonderful, supportive community. Best of luck to you!
James
4/29/2015 03:19:26 pm
Dear Ms. Spritzler, 4/29/2015 10:09:08 pm
Hi James,
Eric R.
5/2/2015 03:27:33 pm
Great post. I am trying to find out where /how to get the absorption versus production markers (campesterol,sitosterol, lathosterl)ordered. I called my local hospital and they were clueless. I normally order my labs online at walk in lab . com but not finding where to order these. I'm also wondering how much the test costs as a cash payer. Glad to see there are others whose ldl-p and LDL-C went from bad to worse on lchf diet. I was so bummed. Feel and look better than have in 20 yrs but with LDL-C 300 and ldl-p of 2500 I Had to leave ketosis behind. Trying to just go paleo and begin taking plant sterols (Cholestoff )to see if that helps. 5/4/2015 03:24:10 am
Thanks so much for the nice feedback on my post and for sharing your story, Eric. I believe you'll need to see an MD who uses Health Diagnosic Laboratory (HDL, Inc) testing in order to get the absorption testing. They can't be ordered by the patient. It's my understanding that insurance might cover most of the charges, but don't quote me on that. Low-carb Paleo or even moderate carb Paleo is still a healthy way of eating. In fact, for most people I'd argue that it's significantly better than strict leto. I wish you the best of luck in improving your LDL-P and LDL-C.
Michael
5/4/2015 01:48:43 am
Found your article, while doing research after a recent cholesterol test. Rewinding a bit, I was suffering from chest pains, and due to a recent loss in the family, anxiety (or curiosity) got the better of me, and I went for a blood test. Turns out that my LDLs are high (but no advanced blood work was done). It seems my HDLs are 58, LDLs 147, TG 60, total 217. I'm 31 years old BTW. My recent loss wasn't much older then I am (42). And was way more fit, went from being unfit, to super hero fit with two years on keto, then to a vegan (still very fit) for a year before the incident. 5/4/2015 03:41:51 am
Thanks for sharing your story, Michael. I'm very sorry for your loss.
Mallen
9/11/2015 11:39:18 am
1 full year following a no sugar, no wheat, virtually no grains (occasional white rice, oat meal), no alcohol, little dairy, high fat (80%) low carb (30-50g daily) moderate protein (@80g daily) Low cardio 2.5 mile run once a week, 4 x 20 second sprints once a week, lifting heavy twice a week, standing desk 3-5 days a week, walk a lot.
Hi Franziska, 12/13/2015 05:30:04 am
Hi Alex,
Hi Franziska,
Tim Foxon
3/14/2016 05:56:58 pm
Hi Franziska. I put a long post on the fb group Optimizingnutrition which may clarify some parts of the problem. I'll post it below, sorry its quite long....:)
Tim Foxon
3/14/2016 05:59:39 pm
Nope, looks like it was too long. Sorry, if interested try Optimizingnutrition. Thanks. 3/14/2016 06:11:27 pm
Hi Tim,
nas
3/22/2016 02:39:40 am
Hello there, I had my cholesterol tested two weeks after starting my keto diet. 3/22/2016 05:51:00 am
Hello Nas,
Nas
3/22/2016 12:13:58 pm
Thank you Franziska :)
Robert Whigham
7/11/2016 08:05:05 pm
It may relieve your mind to take a look at the latest post by Peter at Hyperlipid. http://high-fat-nutrition.blogspot.com/2016/07/arteriosclerosis-6-and-subbotin.html 7/12/2016 09:37:31 am
Thanks so much for your comments and the link to Peter's post, Robert. Very intriguing theory! I appreciate you taking the time to share.
kelly trosper
7/12/2016 10:29:01 am
And let's not forget Dr. Joseph Kraft's argument that "Hyperinsulinemia IS Diabetes IS Heart Disease..." He backed that up with the data from his life's work in his book "Diabetes Epidemic and You."
Fabiano
11/28/2016 02:09:30 pm
Congratulations! Great post! My total cholesterol is now 376, and I am a bit scared, but your post has clarified many points. I´d love to know you have reached the normal levels and how long did it take to achiev it? 11/28/2016 05:16:31 pm
Thanks for your kind words, Fabiano. I'm sorry to hear that your cholesterol has increased. I have a follow-up blog post written one year later that shows all values returned to my normal range: http://www.lowcarbdietitian.com/blog/category/cardiovascular%20disease
Greg
2/13/2018 05:10:26 am
Check out Dave Feldman's work, and his definition of a "lean mass hyper-responder." You'll find excellent videos of his on YouTube. Your previous self (as described here, according to your labs) suggests you fall into that category. I wrote a couple of years ago about my own high LDL. At one point it went up to 7.5mmol/L. With more carbs, and cutting saturated fat and switching to more monounsaturated fats it came down to 4.5 to 5.5. Still far higher than I would like. I heard about a person getting fantastic reduction using Psyllium fiber - I added 1 -2 teaspoons at each meal, with a glass of water. I've just had my lipid results back - LDL is now 3! My total is down from 8 to 5.2. HDL down slightly to 1.7, and TG 1.2 slightly up. Given high HDL might also be problematic as you pointed out, I'm not worried. My ration total:LDL is now 3.1 down from 3.8. So all in all a massive improvement. Your comment will be posted after it is approved.
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