High Cholesterol

Has anyone else's LDL cholesterol increased, significantly, upon starting and maintaining the low carb diet? Mind you my HDL is through the roof and my trigs and VLDL are really low. I also improved my HbA1c and am keeping my glucose readings under really good control. But, my doctor is freaking out and is getting upset with me when I tell her that all is fine. I did get a VAP cholesterol done showing her I am pattern A (big LDL mostly).

Replies

  • wabmester
    wabmester Posts: 2,748 Member
    edited June 2015
    She wasn't convinced by the VAP and pattern A? If she wants reassurance, ask for an NMR test and get the particle count -- that seems to be the only real factor in terms of LDL atherogenicity.

    With changes in carb intake, the main difference in LDL is the size. That's due to the way the LDL is loaded up with fat. You get small droplets from carb-induced DNL vs large droplets from dietary fat.

    The large fat droplets cause an increase in LDL *concentration*, but not in number for most people. If the LDL particle count does increase, that could indicate a problem, and lower saturated fat may help.
  • FIT_Goat
    FIT_Goat Posts: 4,224 Member
    My total cholesterol went up and my LDL went up. But, everything else improved a lot.

    It seems like you have the same thing. Everything is really great except the numbers that don't matter. Let your doctor worry. Don't change a thing and don't take drugs.
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    My trigs went down, HDL went up, LDL went up (both calculated and tested) - and had supplement testing done, but I still don't understand the results of the extra test.

    But, I was told that LDL levels during weight loss are not reliable tests. So until I'm done losing weight, I refuse to worry. If my doc tries to push statins, "Thank you for the advice. At this time I choose to decline. If I wish to reconsider, I will let you know." I'm in charge of my health. My doctor having a knee-jerk response without specialized training is not going to change my mind without outdated medical research.
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    My trigs went down, HDL went up, LDL went up (both calculated and tested) - and had supplement testing done, but I still don't understand the results of the extra test.

    But, I was told that LDL levels during weight loss are not reliable tests. So until I'm done losing weight, I refuse to worry. If my doc tries to push statins, "Thank you for the advice. At this time I choose to decline. If I wish to reconsider, I will let you know." I'm in charge of my health. My doctor having a knee-jerk response without specialized training is not going to change my mind without outdated medical research.
  • pedidiva
    pedidiva Posts: 199 Member
    The AHA has changed kits recs for cholesterol treatment. There is a site-- ASCVD risk estimator (free app, too) that addresses this. I think that Tim Noaks addressed this in a you tube video.

  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
    wabmester wrote: »
    She wasn't convinced by the VAP and pattern A? If she wants reassurance, ask for an NMR test and get the particle count -- that seems to be the only real factor in terms of LDL atherogenicity.

    With changes in carb intake, the main difference in LDL is the size. That's due to the way the LDL is loaded up with fat. You get small droplets from carb-induced DNL vs large droplets from dietary fat.

    The large fat droplets cause an increase in LDL *concentration*, but not in number for most people. If the LDL particle count does increase, that could indicate a problem, and lower saturated fat may help.

    This.

    Also, the LDL is rarely a direct measurement, but a calculation based on trigs and HDL. It's known to be inaccurate when trigs drop below 100 (especially if they go way down, like into the 60s or whatever) or rise over 400.

    I'm with the others. Until you get a particle count, there doesn't appear to be anything to worry about and your doctor needs to to be looking at research from this century.
  • ihatetodietalways
    ihatetodietalways Posts: 180 Member
    Thanks for your response. I didn't think I needed a particle number, only the size of the LDL. My trigs are low at 57. I will never go on statins until they show me my arteries are clogged. Actually I am trying to decide whether I should go in for a Calcium score, just to keep the doctor's mouth shut about the statins.