Question about Keto and cholesterol.

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I got my blood test back and from cholesterol i got:
Triglycerides 67 <150 MG/DL
HDL 37 > or = 40 mg/dL
LDL Calculated 187 <130 mg/dL
CHOL/HDL Ratio 6.4 0.0 - 5.0

Doctor wants to meet me for a little chat about LDL. I do read that Ketoers might have higher cholesterol due to the fat/protein contents and undoubtedly the doctor might ask me to take some pills... I did read about the particle for LDL - should I have her do that test?
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Replies

  • rlengland2014
    rlengland2014 Posts: 98 Member
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    Yes, ask for the particle test . Plus, your cholesterol will change when you're at your maintenance weight.
  • Leonidas_meets_Spartacus
    Leonidas_meets_Spartacus Posts: 6,198 Member
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    What's the trend? Did it go up or down? LDL particle size is important but it means that body is fighting inflammation. Looking at your low Triglyceride value, it might not be serious. I always had high LDL but it had to do with choline defeciency. Ask your Dr to test if you have any defeciency and take those supplements to reduce LDL.
  • Shaselai
    Shaselai Posts: 151
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    Comparing to my test 3 months ago Trig lowered by ~90 points while HDL and LDL are practically the same.
  • FooFatFighters
    FooFatFighters Posts: 37 Member
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    Yes, have your doctor order up a VAP Cholesterol Test. In one blood test my doc said my LDL as a little above average so I asked him to order a VAP test. The results came back and it showed most of the LDL was the big fluffy kind of cholesterol that isn't usually associated with heart disease, the small dense kind is. So I'm actually good. TIME Magazine just had a big article about how fat isn't bad and although you can only read a summary of the article they have a video that talks about the two kinds of LDL cholesterol here: http://time.com/2863227/ending-the-war-on-fat/
  • hookilau
    hookilau Posts: 3,134 Member
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    Hey, good to know!

    In January, my doctor wanted me to start oral meds to lower my LDL, (HDL was within normal limits). Since I was only 6ish months on Keto, I wanted to give it a little more time. So I told him I'd think about it, but that I doubted that I would go on meds. He does not support Keto, or even limiting carbs....he's a 'healthy whole grains' advocate. :laugh:

    I have managed to decrease my A1C & reverse micro albumin by ignoring his advice & doing my own research.

    I should go for an A1C & at the same time, I'll ask for the VAP chol test as described. He was happy with my A1C that went from 9.9 to 6.0, I on the other hand, very much less so :ohwell: .

    With that last reading, he cut my Metformin in half & the control I had been enjoying evaporated over the course of about 4 weeks. I called him & told him I didn't like the trend & he agreed to put me back to my original dose.

    Anyway since I've been enjoying low numbers for several months now, it's time to do the draw :wink: Wish me luck!!!
    Glad I saw this post!!
  • ChoiceNotChance
    ChoiceNotChance Posts: 644 Member
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    My last blood test was around 6 weeks ago. Total chol was high but I don't care about that. My triglycerides dropped way down, my LDL. Wasn't bad and my HDL was 126. Which apparently is crazy good! I'm happy. Stick with it.
  • Athena98501
    Athena98501 Posts: 716 Member
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    I got my blood test back and from cholesterol i got:
    Triglycerides 67 <150 MG/DL
    HDL 37 > or = 40 mg/dL
    LDL Calculated 187 <130 mg/dL
    CHOL/HDL Ratio 6.4 0.0 - 5.0

    Doctor wants to meet me for a little chat about LDL. I do read that Ketoers might have higher cholesterol due to the fat/protein contents and undoubtedly the doctor might ask me to take some pills... I did read about the particle for LDL - should I have her do that test?

    Knowing your VLDL is wise. Total cholesterol does *sometimes* go up with keto, but even in those cases the ratios typically improve. I had all of my numbers improve, mostly in the neighborhood of 25%. My VLDL (said to be the worst) went down by 45%. I was on keto for 5.5 months for my "after" numbers. My unfavorable "before" numbers were eating the type of diet they recommend to reduce cholesterol, ironically enough.
  • Shaselai
    Shaselai Posts: 151
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    I got my blood test back and from cholesterol i got:
    Triglycerides 67 <150 MG/DL
    HDL 37 > or = 40 mg/dL
    LDL Calculated 187 <130 mg/dL
    CHOL/HDL Ratio 6.4 0.0 - 5.0

    Doctor wants to meet me for a little chat about LDL. I do read that Ketoers might have higher cholesterol due to the fat/protein contents and undoubtedly the doctor might ask me to take some pills... I did read about the particle for LDL - should I have her do that test?

    Knowing your VLDL is wise. Total cholesterol does *sometimes* go up with keto, but even in those cases the ratios typically improve. I had all of my numbers improve, mostly in the neighborhood of 25%. My VLDL (said to be the worst) went down by 45%. I was on keto for 5.5 months for my "after" numbers. My unfavorable "before" numbers were eating the type of diet they recommend to reduce cholesterol, ironically enough.


    So you are implying the it might be weird that my ldl and hdl stayed the same? I dont see any other abnormalities from the exam i took nor did the doctor's note mentioned anything else either.... maybe i should watch what kind of fat i eat from now on like maybe more fish and coconut oil instead of fatty pork and beef and chicken with skin?
  • Leonidas_meets_Spartacus
    Leonidas_meets_Spartacus Posts: 6,198 Member
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    Your cholesterol in food doesn't impact your LDL. Get the Vap test done, Higher LDL means your body is repairing cells or inflammation. If you are triglycerides are low, give it a time. On a Keto/ paleo most of high LDL problems according to Drs I talk to are because of lack of nutrients like choline, iodine etc. There is no bad or good cholesterol, LDL is not bad per say, it just means the body is doing it's job with repairing the cells. Treat LDL as a feedback mechanism, it's telling you something might not be right, get a VAP test done. If you aren't eating junk , it's most likely nutrient defeciency.
  • Shaselai
    Shaselai Posts: 151
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    Your cholesterol in food doesn't impact your LDL. Get the Vap test done, Higher LDL means your body is repairing cells or inflammation. If you are triglycerides are low, give it a time. On a Keto/ paleo most of high LDL problems according to Drs I talk to are because of lack of nutrients like choline, iodine etc. There is no bad or good cholesterol, LDL is not bad per say, it just means the body is doing it's job with repairing the cells. Treat LDL as a feedback mechanism, it's telling you something might not be right, get a VAP test done. If you aren't eating junk , it's most likely nutrient defeciency.

    Ok i will request a VAP test done. I am basiclaly looking for the particle size right? If it returns that there are lots of small particles i should be worried? Dont different fats reduce LDL or increase HDL though? That would help a bit no? Any recommendations? I am trying to get in some fish/salmon in every other day..
  • 17JayR
    17JayR Posts: 77 Member
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    You might want to look up the work Gary Taubes has done on diet. He goes into a lot of detail on cholesterol: types, impact of diet on it, and how important is it really.
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    Your cholesterol in food doesn't impact your LDL. Get the Vap test done, Higher LDL means your body is repairing cells or inflammation. If you are triglycerides are low, give it a time. On a Keto/ paleo most of high LDL problems according to Drs I talk to are because of lack of nutrients like choline, iodine etc. There is no bad or good cholesterol, LDL is not bad per say, it just means the body is doing it's job with repairing the cells. Treat LDL as a feedback mechanism, it's telling you something might not be right, get a VAP test done. If you aren't eating junk , it's most likely nutrient defeciency.

    Ok i will request a VAP test done. I am basiclaly looking for the particle size right? If it returns that there are lots of small particles i should be worried? Dont different fats reduce LDL or increase HDL though? That would help a bit no? Any recommendations? I am trying to get in some fish/salmon in every other day..

    The only fats that really affect cholesterol levels are Omega-6 when out of proportion with Omega-3, and artificial trans fats. Both of these affect cholesterol not because they're "bad fats," but because they cause damage to the body. Eating more Omega-3 helps, because it helps balance out the proportion of Omega-6 and Omega-3 fats, which should ideally be a 1:1 ratio.

    Other than that, fats don't really affect cholesterol, particularly the fats you're paying attention to. The fats in meats aren't all saturated fat. In fact, a good quality lard is only about 40%-50% saturated fat. The rest is monounsaturated fat (about 45%), and a little polyunsaturated fats (about 5%). Then, of course, there's the fact that saturated fat isn't bad and does not negatively impact cholesterol numbers (see also: Framingham Heart Study).

    Now, there are some foods that do improve HDL numbers -- including whole eggs -- though as was previously mentioned, that's most likely due to the micronutrients in them, as good quality eggs are packed with Omega-3, choline, iodine, and folate (among others).
  • Shaselai
    Shaselai Posts: 151
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    Your cholesterol in food doesn't impact your LDL. Get the Vap test done, Higher LDL means your body is repairing cells or inflammation. If you are triglycerides are low, give it a time. On a Keto/ paleo most of high LDL problems according to Drs I talk to are because of lack of nutrients like choline, iodine etc. There is no bad or good cholesterol, LDL is not bad per say, it just means the body is doing it's job with repairing the cells. Treat LDL as a feedback mechanism, it's telling you something might not be right, get a VAP test done. If you aren't eating junk , it's most likely nutrient defeciency.

    Ok i will request a VAP test done. I am basiclaly looking for the particle size right? If it returns that there are lots of small particles i should be worried? Dont different fats reduce LDL or increase HDL though? That would help a bit no? Any recommendations? I am trying to get in some fish/salmon in every other day..

    The only fats that really affect cholesterol levels are Omega-6 when out of proportion with Omega-3, and artificial trans fats. Both of these affect cholesterol not because they're "bad fats," but because they cause damage to the body. Eating more Omega-3 helps, because it helps balance out the proportion of Omega-6 and Omega-3 fats, which should ideally be a 1:1 ratio.

    Other than that, fats don't really affect cholesterol, particularly the fats you're paying attention to. The fats in meats aren't all saturated fat. In fact, a good quality lard is only about 40%-50% saturated fat. The rest is monounsaturated fat (about 45%), and a little polyunsaturated fats (about 5%). Then, of course, there's the fact that saturated fat isn't bad and does not negatively impact cholesterol numbers (see also: Framingham Heart Study).

    Now, there are some foods that do improve HDL numbers -- including whole eggs -- though as was previously mentioned, that's most likely due to the micronutrients in them, as good quality eggs are packed with Omega-3, choline, iodine, and folate (among others).

    I see. I also read omega6 seems to come more from processed foods and vegetable oils and possibly non-grass fed animals. With that said and how my diet itself *might not* contribute to LDL then what can i do to reduce it? I am going to see doctor friday for blood work review (basically just the cholesterol) and i think she might suggest me to eat some carbs or pills?
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    I see. I also read omega6 seems to come more from processed foods and vegetable oils and possibly non-grass fed animals. With that said and how my diet itself *might not* contribute to LDL then what can i do to reduce it? I am going to see doctor friday for blood work review (basically just the cholesterol) and i think she might suggest me to eat some carbs or pills?

    See what the results of the VAP have to say (it can dramatically change the meaning of that LDL number), and say that you'll consider her suggestions (whatever they may be), but you want some time to think on them before making a decision.

    How long have you been keto? If it's been a relatively short time, then it's likely that you just need more time. If it's been longer, then as others have said, you probably just need to tweak it to make sure you're not deficient in micronutrients.

    As it stands, though, I'd be hesitant to accept any pills. The statin pushers have pretty much officially gone off the deep end with regard to who should be taking them. Your LDL is (according to conventional medicine) "high," but not quite at the threshold for medicine recommendations, so hopefully she won't be suggesting them quite yet. I'd say try to talk with your doctor to see if you can work on tweaking your lifestyle to work on it and check again in a few months, if she does mention them, though.

    That said, with your low triglyceride levels, I wouldn't be too concerned, and I wouldn't touch anything (except double-checking that you're getting adequate micronutrients, but that's not just for cholesterol levels) until you get the VAP results.

    Here's what about.com has to say about Keto and LDL (emphasis mine):
    Low Density Lipoprotein Cholesterol (LDL) -- "Bad Cholesterol"

    Although there is some controversy on this point, LDL cholesterol is considered "bad" in terms of heart disease risk. The relationship between low-carb diets and LDL cholesterol is more complex than with triglycerides and HDL cholesterol. There are some studies in which LDL is reduced on a low-carb diet, some in which it doesn't change, and some in which it goes up. But there is one thing about LDL changes which is consistent with low-carb diets, and that is that it causes a change in cholesterol particle size.

    What has particle size got to do with it? Evidence is accumulating that the size of cholesterol particles has a lot to do with risk for heart disease. Basically, the smaller the particles are, the greater the risk -- it is thought that perhaps the small particles lodge in the walls of blood vessels more easily.
    The good news for those of us following a low-carb way of eating is that studies of diet and cholesterol particle size have consistently shown that low-carb diets produce larger-sized cholesterol particles. However, a larger-sized particle weighs more than a smaller one. When LDL does go up on a low-carb diet, it may be due to the larger particles, since weight is what's being measured. (A total cholesterol of 200, for example, means 200 mg per deciliter.)

    On the other hand, high-carb diets seem to produce a greater percentage of smaller cholesterol particles in some people. So the total LDL goes down (particles are smaller, so the total is lighter.) While the reading may be low, it can be deceiving as risk goes up in those cases.

    A good way to sort out risk? LDL particle size seems to be strongly correlated with triglyceride level (high triglycerides go with small particle size and vice versa). So if your triglycerides are low, your LDL particles are probably larger.

    http://lowcarbdiets.about.com/od/faq/f/carbcholesterol.htm
  • Shaselai
    Shaselai Posts: 151
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    thanks for the info - i have been in keto 3months a little bit when i took the blood test so not sure if that's considered short or long or "in the middle" as far as cholesterol levels are concerned. I hope my doctor is not too old school - i know that when i mentioned LDL particle sizes (i wanted to take that test last time) she did acknowledge she heard of it but did say it is a "controversial topic" . Not sure to cover her back or she is on the fence about the topic... will know more friday i guess....

    By the way, in terms of micronutrients - is there any tests i should take? I know she wanted me to take a vitamin D test since she says almost everybody might be insufficient in that....
  • Leonidas_meets_Spartacus
    Leonidas_meets_Spartacus Posts: 6,198 Member
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    Your cholesterol in food doesn't impact your LDL. Get the Vap test done, Higher LDL means your body is repairing cells or inflammation. If you are triglycerides are low, give it a time. On a Keto/ paleo most of high LDL problems according to Drs I talk to are because of lack of nutrients like choline, iodine etc. There is no bad or good cholesterol, LDL is not bad per say, it just means the body is doing it's job with repairing the cells. Treat LDL as a feedback mechanism, it's telling you something might not be right, get a VAP test done. If you aren't eating junk , it's most likely nutrient defeciency.

    Ok i will request a VAP test done. I am basiclaly looking for the particle size right? If it returns that there are lots of small particles i should be worried? Dont different fats reduce LDL or increase HDL though? That would help a bit no? Any recommendations? I am trying to get in some fish/salmon in every other day..

    The only fats that really affect cholesterol levels are Omega-6 when out of proportion with Omega-3, and artificial trans fats. Both of these affect cholesterol not because they're "bad fats," but because they cause damage to the body. Eating more Omega-3 helps, because it helps balance out the proportion of Omega-6 and Omega-3 fats, which should ideally be a 1:1 ratio.

    Other than that, fats don't really affect cholesterol, particularly the fats you're paying attention to. The fats in meats aren't all saturated fat. In fact, a good quality lard is only about 40%-50% saturated fat. The rest is monounsaturated fat (about 45%), and a little polyunsaturated fats (about 5%). Then, of course, there's the fact that saturated fat isn't bad and does not negatively impact cholesterol numbers (see also: Framingham Heart Study).

    Now, there are some foods that do improve HDL numbers -- including whole eggs -- though as was previously mentioned, that's most likely due to the micronutrients in them, as good quality eggs are packed with Omega-3, choline, iodine, and folate (among others).

    Omega 6 or omega 3 doesn't directly effect the cholesterol unless in a few when there is a genetic disorder where serum cholesterol is impacted by food. Now you could argue omega 6 can cause inflammation which in turn causes the LDL to raise because the body has to heal the inflammation. However, OP, go get the VAP done to find particle size. I personally monitor triglycerides which are much better indication of fat in your blood stream and heart health. LDL is not bad, its a symptom of something in your body which is causing the inflammation.
  • Leonidas_meets_Spartacus
    Leonidas_meets_Spartacus Posts: 6,198 Member
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    thanks for the info - i have been in keto 3months a little bit when i took the blood test so not sure if that's considered short or long or "in the middle" as far as cholesterol levels are concerned. I hope my doctor is not too old school - i know that when i mentioned LDL particle sizes (i wanted to take that test last time) she did acknowledge she heard of it but did say it is a "controversial topic" . Not sure to cover her back or she is on the fence about the topic... will know more friday i guess....

    By the way, in terms of micronutrients - is there any tests i should take? I know she wanted me to take a vitamin D test since she says almost everybody might be insufficient in that....

    Give it more time, it took me six months to see Ldl come down significantly. If you don't have high blood pressure or if you are not diabetic, its probably not a big risk.
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    The only fats that really affect cholesterol levels are Omega-6 when out of proportion with Omega-3, and artificial trans fats. Both of these affect cholesterol not because they're "bad fats," but because they cause damage to the body. Eating more Omega-3 helps, because it helps balance out the proportion of Omega-6 and Omega-3 fats, which should ideally be a 1:1 ratio.

    Other than that, fats don't really affect cholesterol, particularly the fats you're paying attention to. The fats in meats aren't all saturated fat. In fact, a good quality lard is only about 40%-50% saturated fat. The rest is monounsaturated fat (about 45%), and a little polyunsaturated fats (about 5%). Then, of course, there's the fact that saturated fat isn't bad and does not negatively impact cholesterol numbers (see also: Framingham Heart Study).

    Now, there are some foods that do improve HDL numbers -- including whole eggs -- though as was previously mentioned, that's most likely due to the micronutrients in them, as good quality eggs are packed with Omega-3, choline, iodine, and folate (among others).

    Omega 6 or omega 3 doesn't directly effect the cholesterol unless in a few when there is a genetic disorder where serum cholesterol is impacted by food. Now you could argue omega 6 can cause inflammation which in turn causes the LDL to raise because the body has to heal the inflammation. However, OP, go get the VAP done to find particle size. I personally monitor triglycerides which are much better indication of fat in your blood stream and heart health. LDL is not bad, its a symptom of something in your body which is causing the inflammation.

    Yeah, the inflammation thing was my point with the Omega-6 fats, seems that wasn't clear enough the first time around. :flowerforyou:
  • Leonidas_meets_Spartacus
    Leonidas_meets_Spartacus Posts: 6,198 Member
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    You might want to check this out, the LDL calculations are shown to be higher than actual numbers if the triglycerides are lower than 100.
    http://www.archivesofpathology.org/doi/full/10.1043/0003-9985(2001)125<0404:LTLACO>2.0.CO;2

    Also an easier way is the size of the particle is inversely related ratio of Triglycerides/HDL. If your ratio of Triglycerides/HDL <3.8, its likely that you have big fluffy particles.
  • deoxy4
    deoxy4 Posts: 197 Member
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    Before starting a Keto diet I was eating no grains, minimal dairy, grass fed meat, sardines, salmon and 3-4 servings of fruits and lots of greens and sweet potato but not monitoring my macros. My lipid profile done in June were as follows:

    Total cholesterol: 234
    HDL: 50
    LDL Calculated: 164
    VLDL: 20
    A1C: 5.8
    TG: 102

    I am 61 and based on my age and total cholesterol my doctor wanted to get me on a heavy statin intervention. I told him no go. In the past when I have lowered my fruit intake and at clean I have been able to get my TG under 70 and my total cholesterol to 186. I am not concerned about my profile. I do think I can make improvements by eliminating fruit in favor of low GI vegetables.

    My doctor did not approve and suggested that I decrease my fat consumption so I don't clog my arteries. i.e. beef, lamb, chicken, and suggested I add oatmeal and flax seed to lower my cholesterol.

    I have not decreased my saturated/monosaturated fat consumption, or added oatmeal or flax seed. Over the last month I have eliminated my fruit consumption and adopted a Keto diet and have lost 12 pounds. I don't have another appointment until December. I expect an improved lipid profile. If I am correct, I plan to get a new doctor. I spoke to him about VAP testing and particle sizing and he was generally clueless. Not the future direction I want to follow.