Lipid and Keto

Cinnamonhuskies

My diabetic husband (Type 2) and I have been on Keto since Christmas Day. It has brought his blood sugar numbers down, which the Endocrinologist praised. However, his LDL numbers went up and they want to put him on a statin. Neither of us thinks thats wise, we feel that the numbers are high because of being new to the diet. He told the Dr he/d think about it.

Whats everyone's opinion of Keto=high Cholesterol theory?

herblovinmom

I found this great blog post you might enjoy by 2 of the biggest keto educators out there in the internet world. I find it very informative

https://mariamindbodyhealth.com/the-cholesterol-myth/

tcunbeliever

Also - if he's losing weight (which you didn't mention, but is common when diabetics get BSG under control) then the cholesterol testing is not accurate...it can't differentiate between REAL cholesterol and metabolized fat that is circulating from weight loss...you are supposed to be weight stable for 6 months for accurate numbers.

LadyBlanks

I had the same thing happen to me. As long as the HDL is high and the triglycerides are low, he is fine. I agree with tcunbeliever. Since his body is releasing fat, that circulation is skewing his LDL numbers. I would not take the statins.

tcunbeliever

This is worth the read...in my opinion...they now warn that statins can increase your risk of diabetes, not sure what it might do to someone already diabetic, but it seems unlikely to help...

https://ncbi.nlm.nih.gov/pmc/articles/PMC4513492/

maureenkhilde

If your husband just started Keto in December, then his lipids being high have nothing to do with KETO.

I am a type 2 diabetic. My numbers were not good at all in August 2019, because I had fallen off the wagon and was eating carbs all over the place.

But I came to my senses, and went back to eating low carb, not quite Keto I stay around 55-60 carbs per day not net in total. My percentage splits are carbs 17.66%, Protein 30%, Fat 52.34%

So I had all of my blood draws done on 12/19/2019 (had some done in November 2019 as well.)
A1C 6.7 controlled again
Tryglercides 119
Total Cholesterol 100
LDL 36
VLDL 30
HDL 34 (ideally they like to see above 39). But with the fact I am now exercising 45 minutes 6 days a week. Even my Dr. says she gets this is most likely highest it will go. And partially a heredity factor at play. None of my brothers have this same number at normal range. And all of us are exercising.

If it was me, I would push back to Dr, and state you want a full 90 days = full 12 weeks on new way of eating, then redo the blood tests. Then if cholesterol numbers are still proving to be a problem then discuss medication. But first go with the full 12 weeks.

GaleHawkins

Cinnamonhuskies wrote: »

My diabetic husband (Type 2) and I have been on Keto since Christmas Day. It has brought his blood sugar numbers down, which the Endocrinologist praised. However, his LDL numbers went up and they want to put him on a statin. Neither of us thinks thats wise, we feel that the numbers are high because of being new to the diet. He told the Dr he/d think about it.

Whats everyone's opinion of Keto=high Cholesterol theory?

https://ruled.me/the-ketogenic-diet-and-cholesterol/

I see the hyperlink is not working so just search on the link to get to the info.

@Cinnamonhuskies this is something that I had to wade through when I when Low Carb High Fat back in Oct 2014 trying to avoid starting on Enbrel injections for pain manage. Since within 2 weeks of stopping eating/drinking food sources with added sugar and or any form of any grain my pain levels started dropping like a rock after living with Ankylosing Spondylitis (arthritis) pain for most of my life so I never started on Enbrel.

I have posted my story many times but the link above is a quick reference.

While my LDL really shot up so did my HDL (good thing) and my triglycerides dropped like a rock (good thing). It took a few years to get my doctors up to speed over the years but on my annual physical last Aug I had a new doctor actually a DO.

He said while your LDL is still off the charts I see it has been dropping some each year for the last 4 years and the rest of your lab work is great. Since you are 68 and Rx med free with good numbers keep doing what you are doing.

If back in 2015 I had took the doctor's advice and started meds to lower my LDL I am not sure where I would be today but we can not give you medical advice so read read and read.

I drift in and out of ketosis these days but I still do not eat or drink foods containing added sugars or any form of any grain. I actually found MFP trying to learn how to track my level of ketosis without bleeding which is most accurate.

The cheap ones ($10-$15 on eBay) do not filter out the ketones so they do work if not drinking alcohol. High end meters will not work because they filter for ketones to prevent false positives in a traffic stop. There is one with flashing lights for over a $100 for ketones but it is just a jazzed up $10 meter I found. They are all kind of hit or miss so the cheaper the better.

I have used the above type meter from eBay over the years for tracking where I am in ketosis or not. Before making this post I blew a .009 which is very low I know after 5 years of testing with it and the blood meter but any reading tells me I am controlling my carb intake well. For health reasons I try not to eat less than 50 grams of carbs daily because I like fiber from nuts and do Greek yogurt.

I have learned in my case ketosis is not my main objective but eating low carb helps my gut microbiome balance which I deem the most important factor for good health and longevity.

Best of success and remember these kinds of decisions are hard but unknowns can be turned into "knowns" with enough reading of research.

sun_cat

I just listened to this interview the other day: http://lowcarbmd.com/episode-61-dr-nadir-ali-interventional-cardiologist-brings-it which deals with the high LDL issue.

psuLemon

I am in agreement with others. But I will also note a few other things and provide some videos.

First, the correlation between LDL (as a stand along marker) and CVD or all cause mortality is low. Getting LDL down, doesn't necessarily reduce your risk of CVD or all cause mortality. Given that, it's one of the reasons I would never go on a statin. Why would you go on a medication, which can cause side effects in about 20% of people, if it doesn't reduce risk of CVD or all cause mortality, with the except of a few special cases?

Second, you can't base metabolic health off a single number. You need to look at the whole picture. Other things that should be consider: CRP, triglycerides, fasting blood glucose, HDL, blood pressure and family history. Family history is a big one. I have never had a LDL lower than 99. And often it's been 130, currently 178. But my HDL's doubled on keto, triglycerides are 40 and BG is 80 and my BP is 110/60. My 10 year risk is something 1%.

Third, LDL is not even a measured number.. it's estimated. And it's a snap shot at that time. If you measure LDL tomorrow, or a month from now, it could be wildly different. Why because other things can have an impact on that number such as; stress, increased fat consumption the night before, dieting, etc..

Four, if there is high concern, I would ask for a fractionated lipid panel. This would measure the LDL particulate size. Large fluffy particulates are good.

And lastly, there is not much evidence based on people following LCHF or ketogenic diets. Almost all the studies on LDL are based on people following SAD diets. Given the changes that occur during ketogenic diets, which includes high increases in free fatty acids, you would expect to see increases in LDL.

If you do want to work to change things, you could replace foods high in SFA, with PUFA/MUFA. So limit consumption of red meat and consume more fat and chicken. Add a bit more fiber to your diets, and increase exercise a bit. Overall, being lean and exercising are the things that will improve your metabolic health the most.

https://youtu.be/DXKJaQeteE0

https://youtu.be/3CQqEFpDrXI

baconslave

I keep reading that the Trig/HDL ratio is more predictive of CV health than LDL and CAC score. It's been awhile (plus a harddrive death) so does anyone have any links to that info. If I can get enough material I can put this thread in our resources on this topic to be ready to c&p when it's needed later.

sun_cat

https://www.youtube.com/watch?v=qXtdp4BNyOg

canadjineh

@baconslave:
June 20/2019
https://ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.041149

Conclusions:
Measurement of total cholesterol and HDL-C in the nonfasted state is sufficient to capture the lipid-associated risk in CVD prediction, with no meaningful improvement from addition of apolipoproteins, direct or calculated LDL-C.

Nov 20/2019
https://jamanetwork.com/journals/jamacardiology/fullarticle/2755895

Conclusions and Relevance In this study, genetically predicted levels of non–HDL-C were associated with the extent of coronary atherosclerosis as estimated by 2 different methods. The association was stronger than for genetically predicted levels of LDL-C. These findings further support the notion that non–HDL-C may be a better marker of the overall burden of atherogenic lipoproteins than LDL-C.

Just a couple studies (the latest at least), but pretty heavy duty sci.