6 months - tell me what you know

Deena_Bean

Yesterday I had a very rushed doctor's appointment to discuss my cholesterol. Rushed because my doctor was running behind (because her patients were running behind), and I had to tell her I needed to go because my son had an appointment to get his braces on. So I had about 8 minutes to cram in 'discussion' - which was totally insufficient and I don't feel like I got very much out of it.

She agreed that we can re-run the cholesterol panel in 6 months (so any time after July 1), but because I have a family history of high cholesterol, she's afraid that this may be a problem that will resolve itself..may just follow me around. She suspects that she may need to put me on the dreaded meds. I don't want to go that route, so I want to spend these next 6 months doing the things I need to do to get it under control by myself.

Recap of numbers

2015
Total: 229
HDL: 48
LDL: 143
Triglycerides: 192

2013
Total: 228
HDL: 67
LDL: 129
Tri: 158

My 2013 numbers were reviewed as "don't worry about it because your HDL is high enough to offset your LDL." My 2015 numbers raised an eyebrow and a little concern. She said she was more concerned because I'm fairly "lean", young, and have no other issues (blood pressure is good, I exercise, I watch what I eat, etc.). She acknowledged that the holidays are more of a cheat time (although I did fairly well) and I'm on a relatively new eating plan. So we're re-testing in July.

Obviously I want to steer clear of drugs if possible - but I will take them if I can't fix this (because I don't want to die). I know that time is important with LCHF being relatively new (full blown in December, 1/2 blown in November). So allowing my body to adjust is important. I'm going to be sure I exercise regularly as well. Is there anything else you guys can recommend? Lower carb (I stay under 100 total as a goal now), some kind of grains added in? Any good books? I know it'll take some time, but I'm hoping to find the right combination of things to avoid drugs if possible.

Thanks!

Dragonwolf

Have you had your thyroid checked? I know @KnitOrMiss has found that dysfunctional cholesterol was an indicator of her thyroid issues. Your doctor seems like a good one, so it might be a good idea to give your doctor a call and request TSH, T3, T4, and Reverse T3 tests to make sure there's not something going on with your thyroid (just TSH isn't enough).

Also, before you agree to meds, you'll want to get more details on the LDL. It's usually calculated, instead of directly measured, and the composition changes that happen on low carb can artificially inflate that number. @wabmester I think knows the exact names, but you want the particle size measurements. A low number of big LDL particles is relatively benign, but a high number of little LDL particles is dangerous, but they can both come out to the same number on the standard cholesterol scale, because of the way it's measured.

The decrease in HDL and increase in Trigs is a bit concerning to me. That generally happens the opposite way on this way of eating. However, two years is a long span of time, so it might just be that. Without knowing what you were eating just before low carb, and what your numbers were, then, it's hard to draw any real conclusions. The changes that come with active weight loss, especially on this way of eating, also throws a wrench in the works.

I took a peek at your diet, and I suspect that might be where some of your solutions reside.

One of the things that I noticed is that, while your diet looks good, overall, the sources of your carbs tends to be grains and/or simple sugars -- Sun Chips, barbecue sauce, chili, Atkins bars/desserts, etc. I think it would be beneficial to try to swap those out for more vegetables and less grainy/starchy foods. Trade the chicken and dumpling soup for beef vegetable or chicken vegetable, and the Sun Chips for pork rinds or sliced veggies (with a cream or oil based dip!), for example. The sugar, in particular, is one of the bigger factors in triglyceride levels, so reducing that as much as you can should reflect in your future trig levels, even if nothing else changes (assuming your levels are related to food and not an underlying issue like your thyroid).

One of the things that I found to help break that last of the carb habit (I was at 100g for a while and struggled to drop below it), is to just drop down to 20-50g of carbs at least for 4 weeks. Dropping it that far forces you to consider your carb sources more closely, and doing it for a month helps instill that habit and break the old ones (as the adage I had heard before, says, "28 days makes a habit"). After that, you can go back up to 100g if you feel that's best for you, but try to make up those carbs primarily in non-starchy vegetables and low-sugar fruits.

Your Friday (http://www.myfitnesspal.com/food/diary/Deena_Bean?date=2016-01-22) was a pretty good day, minus the wine (the wine's fine once in a while, but it's known to stall people out if consumed regularly). I'm not a fan of Tootsie Rolls, but as long as you aren't addicted to sugar (as long as you're not craving that Tootsie Roll), it might be okay to include as your "treat."

Give these a try, stay the low-carb course for 6 months, and see how the numbers change at your next blood draw.

CMYKRGB

I started this WOE as a suggestion from my PC doctor to lower my cholesterol. I also subsequently met with a nutritionist. Here's what I learned:

1. High carb diets increase cholesterol if you're a sedentary type, like I am. There's something about carbs that are converted to cholesterol in the liver.

2. Cholesterol recirculates in the blood stream, so once you create the cholesterol, you keep it.

3. There are natural ways to remove cholesterol from your blood. Two foods I specifically recall are oatmeal and lentils. How much you have to eat, I don't know.

If you are recently low carb, chances are good it's NOT the low carb WOE that's raised your cholesterol levels. It's great you have a baseline to compare future cholesterol lab work. My PC doctor indicated it takes much longer than a few months to see dietary changes in cholesterol.

Dragonwolf

CMYKRGB wrote: »

I started this WOE as a suggestion from my PC doctor to lower my cholesterol. I also subsequently met with a nutritionist. Here's what I learned:

1. High carb diets increase cholesterol if you're a sedentary type, like I am. There's something about carbs that are converted to cholesterol in the liver.

2. Cholesterol recirculates in the blood stream, so once you create the cholesterol, you keep it.

3. There are natural ways to remove cholesterol from your blood. Two foods I specifically recall are oatmeal and lentils. How much you have to eat, I don't know.

If you are recently low carb, chances are good it's NOT the low carb WOE that's raised your cholesterol levels. It's great you have a baseline to compare future cholesterol lab work. My PC doctor indicated it takes much longer than a few months to see dietary changes in cholesterol.

I was in agreement until number 3. That strikes me as broscience. Those two foods are often touted as such because of their fiber content, which only has action in the stomach and gut. The bloodstream never enters the equation that I've ever seen.

CMYKRGB

http://www.news.utoronto.ca/lowering-cholesterol-eating-chickpeas-lentils-beans-and-peas

This appears to state that the ratio is improved. It was explained to me that certain foods were "cleaners" because they bonded with cholesterol (I've used that word generically).

FIT_Goat

You are still really early in.

The total number doesn't concern me. It's what I consider "normal." The HDL and trigs are both ungood. (Yeah, I went newspeak there). The HDL should be higher and the trigs should be lower. Thankfully, keto tends to just that over time. It takes a while, like 6 months. So your next blood test will be a much better indicator. You have a very good reason to stay on this and not cheat. You want those trigs to go down. Low HDL and high trigs are ungood. The other way around is best.

Deena_Bean

Thank you, again!
@Dragonwolf - I'm going to try this method (stopping the munching on the sun chips). I don't generally love tootsie rolls, I just finished a couple I had in my candy dish. They're gone now, and won't be replaced. The Atkins bars are a no go, too? I just buy them for the convenience - and they seemed better than a snickers lol.

Thankfully I'm pretty good at buckling down and it sounds like to avoid the meds I should do just that. I'll move my goal to under 50 carbs instead of under 100 and hope that that helps to weed out some of the less desirable choices.

I have heard that to get the cholesterol out you do need to eat things that it will bind to - from what I understand, that's essentially fiber-based things. I'm sure I can fill that with some kind of veggies. I've been eating a lot of salads lately, so that's good news.

A few things about this recent cholesterol test that I think may have played into the numbers are: 1. Fairly recent switch to low carb (prior to that I was eating everything and just trying to control portions, half a$$ed though). 2. The 3 weeks before the test I had done zero (literally) exercise. I was sick and abandoned it from pain/exhaustion - prior to that I was exercising regularly 4 times a week (sometimes more). 3. I had foreign drugs in me (antibiotics and steroids) - no idea if that's relative 4. I was really stressed out about some life things.

So, I have pretty high hopes that I will see better numbers in July. I'm not gonna lie, though, I was tempted to go buy the cheerios because the commercials always tout the lowering cholesterol LOL. I didn't, but I thought it.

@FIT_Goat - my doctor actually said the triglycerides weren't too concerning (which I thought was a weird comment), but in her defense, we were very rushed and I think she may have been looking at my 2013 tri's. I also read that too much red meat's a bad idea. Lots of conflicting information I read, I start to get a little confused about what to eat and not to eat. Maybe I should choose the white meats more than reds, but then I hear about the people that eat all the red meat and are doing awesome. Mind boggling.

Dragonwolf

CMYKRGB wrote: »

http://www.news.utoronto.ca/lowering-cholesterol-eating-chickpeas-lentils-beans-and-peas

This appears to state that the ratio is improved. It was explained to me that certain foods were "cleaners" because they bonded with cholesterol (I've used that word generically).

I looked through the paper and I think you're misinterpreting it (or the person explaining it to you is).

The study does show that replacing certain foods with lentils/pulses is associated with lower LDL. What foods, though?

When you look at the full study, the "control" foods vary, which is actually good for an overview, so we can see what happens when you trade out a food for pulses.

Here are the two charts that are most relevant to this discussion.

This one is the chart of what they replaced, and what they used instead:



This is the results of those trials:


Those numbers vary quite wildly, really, and there are a few that actually went up when pulses were introduced.

The Gravel, et al test went up the most, at 0.15 mmol/L. The real fun part? That was a simple pulse/no pulse study. Hermsdorff was a pulse/no pulse study, too. Relatively similar, based on the information here, except the people are younger. That one saw a 0.35mmol/L decrease, though. A few others that were mixed pulses vs no pulses vary pretty widely, too. Odds are pretty good that if there's a relationship, it's likely among particular pulses, not just all of them.

But what about the one that went down the most? That would be the Jimenez-Cruz study, with a whopping 1.77mmol/L decrease. Wow! What was the comparison? High glycemic foods.

Okay, then, what about comparing something more similar -- low glycemic, high fiber foods. That would be the Jenkins trial, with an average of 0.06mmol/L decrease. Pittaway was also somewhat similar, using whole wheat for the control. 0.18 and 0.20 decrease for each of them. Zhang saw similar decreases when using chicken for the control (what kind of chicken, though? I don't know; given what I know of medical studies, my money's on boneless, skinless breasts).

Then, you've got those 95% confidence intervals. While you have some pretty tight ones -- Shams' -0.02 to +0.06, Pittaway's –0.36 to –0.04, etc. -- some of those have huge intervals. Jimenez-Cruz's, the one with the huge 1.77 decrease, has a confidence interval of –2.42 to –1.12, Anderson III, with a 0.76 decrease average, comes in with a –2.15 to 0.63 confidence interval.

So, can we conclude that replacing certain foods with pulses is generally associated with reduced LDL? Sure. Can we say that it has "unique LDL-cleaning properties"? Not really. For one, if that was the case, numbers would go down across the board, pretty much without exception. For two, their action comes from their action in the gut. The lectins and fiber interfere with the absorption of fats, sugars, and even your own bile acids. You can't assimilate what you don't absorb, and the body needs to use more resources to make more bile acids. The result? Trade out things like high-glycemic foods (aka - sugar) for fiber-packed lentils, of course your health is going to improve. The pulse/no-pulse studies make it look like it's just the addition of the pulses, but what did those people replace? Odds are very good that it's more about what the pulses displaced than the pulses themselves, and this paper actually illustrates that.

http://health.howstuffworks.com/diseases-conditions/cardiovascular/cholesterol/foods-that-lower-cholesterol2.htm (I'm actually not a fan of the article as a whole, because it contains the same correlation-causation error that most have, but it's one of the few I've found so far that actually explains the mechanism of action.)

Dragonwolf

Deena_Bean wrote: »

Thank you, again!
@Dragonwolf - I'm going to try this method (stopping the munching on the sun chips). I don't generally love tootsie rolls, I just finished a couple I had in my candy dish. They're gone now, and won't be replaced. The Atkins bars are a no go, too? I just buy them for the convenience - and they seemed better than a snickers lol.

Thankfully I'm pretty good at buckling down and it sounds like to avoid the meds I should do just that. I'll move my goal to under 50 carbs instead of under 100 and hope that that helps to weed out some of the less desirable choices.

I have heard that to get the cholesterol out you do need to eat things that it will bind to - from what I understand, that's essentially fiber-based things. I'm sure I can fill that with some kind of veggies. I've been eating a lot of salads lately, so that's good news.

A few things about this recent cholesterol test that I think may have played into the numbers are: 1. Fairly recent switch to low carb (prior to that I was eating everything and just trying to control portions, half a$$ed though). 2. The 3 weeks before the test I had done zero (literally) exercise. I was sick and abandoned it from pain/exhaustion - prior to that I was exercising regularly 4 times a week (sometimes more). 3. I had foreign drugs in me (antibiotics and steroids) - no idea if that's relative 4. I was really stressed out about some life things.

So, I have pretty high hopes that I will see better numbers in July. I'm not gonna lie, though, I was tempted to go buy the cheerios because the commercials always tout the lowering cholesterol LOL. I didn't, but I thought it.

@FIT_Goat - my doctor actually said the triglycerides weren't too concerning (which I thought was a weird comment), but in her defense, we were very rushed and I think she may have been looking at my 2013 tri's. I also read that too much red meat's a bad idea. Lots of conflicting information I read, I start to get a little confused about what to eat and not to eat. Maybe I should choose the white meats more than reds, but then I hear about the people that eat all the red meat and are doing awesome. Mind boggling.

I addressed the fiber thing in the previous comment.

The red meat thing is, for all intents and purposes, completely and utterly bunk. The problem is that nearly every study regarding meat doesn't discern between steak and Oscar Meyer hot dogs.

Also, consider this -- early humans lived off of red meat as their primary source of animal-based calories. The Native Americans favored bison and numerous species of deer. The northern Europeans lived on caribou and elk. During the Ice Age, humans favored mammoths and mastadons and other large ungulates.

We were literally born and bred to eat red meat. We survived (and still survive) the most harsh environments and times on it.

The easiest thing to do, really, is take all the conventional wisdom you hear, and do the opposite. I kid you not.

Deena_Bean

Dragonwolf wrote: »

Deena_Bean wrote: »

The easiest thing to do, really, is take all the conventional wisdom you hear, and do the opposite. I kid you not.

That made me laugh, and I can completely see the validity in it. My doctor is pretty good, but I think she's also on board with a lot of things that seem to not be quite on par in my mind. She told me that she thinks my magnesium is fine after agreeing that most people are probably deficient. Uhhh....so I'm a super-woman, or what? My blood test for magnesium was ok, but from what I'm reading (not only here, but in books), that test isn't enough. She also thinks that my insurance wouldn't cover more extensive testing without cause. I would love to have the magnesium ion test done, but I certainly don't want to pay the hundreds it would cost. So that's a little frustrating. Honestly, it seems like I have a lot to figure out on my own - and since I'm not an expert I get a little wary about deciding to do something because it sounds like a good idea.

It seems to me that a lot of doctors find it offensive when the patient actually brings forth knowledge - like we're challenging their knowledge, when really they should see it as helpful for their own career. They don't want to hear that supplementing magnesium may solve a lot of problems. Prescriptions are obviously better, right?! Wrong. Then if you say "well I'm sure I could take a supplement" - they say, "you don't want to take too much, though." (which I know, but without the testing how would I know for real how much and which kind to take).

Sorry, tangent - just another thought I've found myself backed into a corner with.

KarlaYP

I recommend you read the book "Cholesterol Clarity" by Jimmy Moore. It is written in layman's terms making it easy to understand. I was so afraid of the high fat portion of LCHF in the beginning! The brainwashing was holding strong! The true success came after I increased them, and I haven't looked back!

I agree with some above comments that your cholesterol numbers don't look bad. Give this the time it deserves and see what the numbers are at your next test. Meanwhile, try not to be afraid of fat. It's a critical component to this woe, and to overall health!

Dragonwolf

Deena_Bean wrote: »

Dragonwolf wrote: »

The easiest thing to do, really, is take all the conventional wisdom you hear, and do the opposite. I kid you not.

That made me laugh, and I can completely see the validity in it. My doctor is pretty good, but I think she's also on board with a lot of things that seem to not be quite on par in my mind. She told me that she thinks my magnesium is fine after agreeing that most people are probably deficient. Uhhh....so I'm a super-woman, or what? My blood test for magnesium was ok, but from what I'm reading (not only here, but in books), that test isn't enough. She also thinks that my insurance wouldn't cover more extensive testing without cause. I would love to have the magnesium ion test done, but I certainly don't want to pay the hundreds it would cost. So that's a little frustrating. Honestly, it seems like I have a lot to figure out on my own - and since I'm not an expert I get a little wary about deciding to do something because it sounds like a good idea.

It seems to me that a lot of doctors find it offensive when the patient actually brings forth knowledge - like we're challenging their knowledge, when really they should see it as helpful for their own career. They don't want to hear that supplementing magnesium may solve a lot of problems. Prescriptions are obviously better, right?! Wrong. Then if you say "well I'm sure I could take a supplement" - they say, "you don't want to take too much, though." (which I know, but without the testing how would I know for real how much and which kind to take).

Sorry, tangent - just another thought I've found myself backed into a corner with.

If you have the conversation with him again, just look at him like he grew a second head and say, "if I start having bathroom troubles, I'll back off on the magnesium supplementation, then."

Seriously, though, magnesium is water soluble, so it doesn't build up to toxicity. If you're taking in more than you need, the body flushes it out, and it's one of those that really gets flushed out. There's a reason a lot of laxatives are magnesium-based.

Deena_Bean

Dragonwolf wrote: »

Deena_Bean wrote: »

Dragonwolf wrote: »

The easiest thing to do, really, is take all the conventional wisdom you hear, and do the opposite. I kid you not.

That made me laugh, and I can completely see the validity in it. My doctor is pretty good, but I think she's also on board with a lot of things that seem to not be quite on par in my mind. She told me that she thinks my magnesium is fine after agreeing that most people are probably deficient. Uhhh....so I'm a super-woman, or what? My blood test for magnesium was ok, but from what I'm reading (not only here, but in books), that test isn't enough. She also thinks that my insurance wouldn't cover more extensive testing without cause. I would love to have the magnesium ion test done, but I certainly don't want to pay the hundreds it would cost. So that's a little frustrating. Honestly, it seems like I have a lot to figure out on my own - and since I'm not an expert I get a little wary about deciding to do something because it sounds like a good idea.

It seems to me that a lot of doctors find it offensive when the patient actually brings forth knowledge - like we're challenging their knowledge, when really they should see it as helpful for their own career. They don't want to hear that supplementing magnesium may solve a lot of problems. Prescriptions are obviously better, right?! Wrong. Then if you say "well I'm sure I could take a supplement" - they say, "you don't want to take too much, though." (which I know, but without the testing how would I know for real how much and which kind to take).

Sorry, tangent - just another thought I've found myself backed into a corner with.

If you have the conversation with him again, just look at him like he grew a second head and say, "if I start having bathroom troubles, I'll back off on the magnesium supplementation, then."

Seriously, though, magnesium is water soluble, so it doesn't build up to toxicity. If you're taking in more than you need, the body flushes it out, and it's one of those that really gets flushed out. There's a reason a lot of laxatives are magnesium-based.

Hahahahaha. I like you. Good to know that it's hard to cause issues with too much magnesium...well, aside from potty visits.