High Cholesterol on Keto Diet? Is That Necessarily a Bad Thing?
DittoDan
Posts: 1,850 Member
In my other post on my blood work, I mentioned that I will post my Lipids. I had the blood drawn and the test results came back yesterday. My doctor's office called me and we played phone tag all day.
Finally I talked to a lab assistant this morning and they told me that I have to come in for my "bad" results. I first asked for a paper copy of my results and she said she couldn't give them to me. She said it will be posted on the website, but it takes a week. They wanted me to come in. So I asked her what looked bad and she said my cholesterol was high, my vitamin D was low (and has been for months, but I was seeing if there was a dynamic with LCHF that would "correct" it). And she said something else was bad, but I forgot what she said.
So I scheduled an appointment for Monday morning.
Lipids are a topic I am least knowledgeable about. I read and I read, and I get confused. Somewhere I read that a LCHF diet will actually increase your cholesterol, but if your LDL increased and your HDL decreased that it was ok. And I think there is a Keto website where you can calculate lipids or has a formula or ? I think there is a ratio ~ that if it is maintained, its ok for your cholesterol to be high?
Now, if you can help me sort this out (by Monday) I will go into the docs office and probably educate him. I doubt he knows this stuff. DragonWolf constantly teaches her doctors about PCOS, and I am thinking I may have to do the same with Lipids & LCHF. He is a conventional doc, but he does approve of my weight loss strategy Keto/LCHF (but he also approved/agreed to me doing Bariatrics)
So I am counting on you nice people to give me some ammo or websites that I can print out and take with me to the Monday morning appointment.
With all that said, I do not assume I am right, maybe I am doing LCHF wrong? IDK. But it can't hurt to know as much as I can. It could be that I need to adjust a few things and move forward.
Thank you,
Dan the Man from Michigan
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I'm not the best to explain, but I'd start with Jimmy Moore and go through his book if you have the time. Here's a link on his blog why he's not worried about high cholesterol: http://livinlavidalowcarb.com/blog/my-total-cholesterol-is-326-and-why-i-dont-need-to-take-lipitor-or-crestor-to-lower-it/23810
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What usually happens on this type of diet is that triglycerides go down, HDL goes up, and LDL goes up too.
The first two are good, the latter is ambiguous. You need to ask for a VAP test that gives the size of the LDL. Even though the number of LDL particles increases, the size also tends to increase, and the large fluffy LDL is less atherogenic than the small dense kind.
LDL is a pretty good predictor of CVD, but it's still controversial. Does the quantity or quality matter more?
Edit:
This might be too technical, but it's a good read:
http://eatingacademy.com/cholesterol-2/the-straight-dope-on-cholesterol-part-ix
What matters is LDL-P, and that diverges from LDL-C in cases like ours -- metabolic syndrome. Ask your doc to measure apoB, which should give him a better picture than LDL-C.0 -
What usually happens on this type of diet is that triglycerides go down, HDL goes up, and LDL goes up too.
The first two are good, the latter is ambiguous. You need to ask for a VAP test that gives the size of the LDL. Even though the number of LDL particles increases, the size also tends to increase, and the large fluffy LDL is less atherogenic than the small dense kind.
LDL is a pretty good predictor of CVD, but it's still controversial. Does the quantity or quality matter more?
Edit:
This might be too technical, but it's a good read:
http://eatingacademy.com/cholesterol-2/the-straight-dope-on-cholesterol-part-ix
What matters is LDL-P, and that diverges from LDL-C in cases like ours -- metabolic syndrome. Ask your doc to measure apoB, which should give him a better picture than LDL-C.
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I think I first heard about this from Ggary Taubes and think that wabmester is right on. There are a few tests where we are starting to learn that the classic total numbers don't tell you much about what is really going on. Magnesium and cholesterol top the list.0
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I look forward to reading wabmester's links! So much to learn!
Might I say though, Dan, that your attitude of "possibly needing to adjust a few things" is a good one! I can't see your diary, but it seems to me that keto and weight loss alone might not be enough for optimal fat profile/health. I'm thinking it is so easy to possibly get into an unhealthy omega 6 balance for example due to low quality meats, over consumption of certain nuts, etc. So, keto itself might not be the villain if you do in fact have some issues - perhaps just some healthy tweaking is needed, ie, more grassfed meats, more green stuff, more omega 3's, more exercise, etc. - again, I don't know because I can't see your diary. Just a thought to balance things here...let us know how it goes!0 -
Total cholesterol and LDL-calc are usually the things doctors freak out about. Neither of them really matter. In fact, the total cholesterol range of 200-240 (which doctors consider high) has the observed overall lowest statistical mortality rate. LDL-calc is wrong if your trigs are lower than 100.
The only numbers I, personally, care about are trigs, hdl, and their ratio (trigs/hdl). As long as the ratio is under 4, you're fine. Between 4-6 is an increased risk. Over 6 is high risk. Anything under 2 is superb. My ratio is nearly 1. The fact that my total cholesterol was 250 doesn't concern me at all.
As for their story about not printing the results, that would be new to me. I asked for a printed copy (over the phone) and they had it waiting at the desk for me that afternoon.0 -
I think LDL-C can be measured directly, but most labs estimate it. They use the Friedewald equation, which assumes a "normal" and constant ratio between TG and total cholesterol. It can be off when TG is either low or high (it's usually high for metabolic syndrome).0
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I think LDL-C can be measured directly, but most labs estimate it. They use the Friedewald equation, which assumes a "normal" and constant ratio between TG and total cholesterol. It can be off when TG is either low or high (it's usually high for metabolic syndrome).
LDL can be measured directly. But, LDL on a standard lipid test is almost always the calculated version. You'll know for sure because it will say "calc" next to it.
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Wabmester and Fit_Goat have covered most of the bases. You may wish to google Ivor Cummins who has some really good stuff, having analysed countless research papers. He comes from an engineering background and his hard headed and practical approach should appeal to you.0
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Phinney and Volek in The Art and Science of Low Carbohydrate Living say that when you are losing weight your blood cholesterol may go up because your fat cells store some cholesterol, and when you lose weight the cholesterol from those cells enter your bloodstream. The amount entering the blood is less than the amount that can be cleared from the blood (it is secreted in bile) and it can take several months after weight loss is over before the levels come back down. In addition, low carb diets can increase the amount of large LDL particles, which are at worst benign. So if your doctor freaks about about an increase in LDL levels and it was direct-measured (not calculated) you then need to ask for a particle size test. Blood cholesterol frankly is overall pretty meaningless, but it is unfortunate that the health care system is set up to have it be one of the main areas of concern, as it is something big pharma can make money from with statins, which are terrible drugs for the vast majority of people.0
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I just noticed this thread and wonder if you can clarify my recent blood work results. Everything was ok except for DHDL ......that was 104 / status high. The note states that 40 to >/= 60 normal. Huh? OK, I did not fast before this lab work but the clinician said it would not matter.
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HDL high is a good thing. The epidemiology uses Total chol / HDL ratio as a predictive of risk so higher HDL usually means lower ratio and lower risk.
Most people on LCHF end up with better lipid profiles, some get sky high LDL which may be due to thier resposne to saturated fat - this can be solved by using other fats.0 -
Related to your question but with a different approach, I watched a fascinating podcast with a Doctor Mark Gordon. The main focus of the podcast was how he has "discovered" that you can treat most cases of PTSD and some head trauma with testosterone. He says he basically just studies the data and is willing to follow it, uninfluenced by big pharma.
Anyway, here is a transcript of a section relating to cholesterol. He has a very different approach. I will also provide the link to the podcast at the bottom if you want to hear more or get his contact and info about his book (likely at the end of the podcast). The transcription I'm provinding starts at appros. 53minutes in (it is a 3hr podcast).
53:40
" cholesteral shuts off CoQ10 & vitamin D.... [a man taking drugs for cholesteral was found that ] all his hormones were down because cholesterol is the pre-cursor to all our hormones, our androgens and our oestrogens. So cortisol, cholestoral, [a big list] were all reduced. All we did was stop his statin drug and his levels all came up. I didn't have to do anything." (He mentioned that he references this guy as the first study in his new book)
Joe: And what do you do to reduce cholesteral other than diet for a guy like that?
Dr Mark Gordon: That opens up a box of worms. The question is, is cholesterol really the issue? When you look at the statistics, 50% of all heart attacks happen in people with low or normal levels of cholesterol. So the question that any intelligent person has to ask is what's causing it? How do these peole get heart attacks if their cholesterol is normal or low? Why don’t I have a heart attack with my cholesterol between 275 & 349 and my ultra fast ct scan that looked at my coronary arteries were perfectly clear. How is it that one of my best buddies who’s an ex fighter pilot has a cholesterol of 140 to 150 and he ended up having open heart surgery because his calcium count was greater than 2000. Mine was zero, his was greater than 2000. Less than 100 is great. Greater than 400 is dangerous. He was greater than 2000. He had 95% acculsion of the main artery, the left anterior descending, ends up having open heart surgery and an artery replaced from his leg.
How do you account for it? Well we went back and we did a series of tests …(mentions where who paid for them)…. The Lp6 which looks at the inflammatory markers that lead to heart disease. So something called PLAC, small density LDL, homosistine, C reactive protein, there’s a whole group of chemistry that causes inflammation to lead to the hardening of the arteries and the body responds by putting calcium down. That’s the artherocloris lesions to try and work like a bandaid. What spun off that, you’ve heard of chelation therapy. Well chelation therapy for many years has been poo-pooed by the medical community and 3 years ago the federal government did a study and what did they say? Chelation therapy works.
Joe: What is chelation therapy exactly?
He goes on to explain what it is and how he uses it to “fix” people at risk of heart disease. And a bit more on the purpose of cholesterol in our bodies. But I’m sure you get the idea.
From Joe Rogan's interview with Dr. Mark Gorden, Matthew Gosney and Jason Hall
https://www.youtube.com/watch?v=tbxPxFiOIKc
Hope something there is useful. After all we are people who don't take everything at face value.
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whoa! I don't know how to just post a link. It keeps putting the video in there! Sorry guys.0
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Just as an aside, do you suspect that maybe your doctor is so willing to go along with you whether it be keto or bariatrics because A- he doesn't have to think about it, you're offering a reasonable solution that is B-just as good as any solution he has, because he has no solution? If we use this reasoning, any moderately well prepared and coherent amo should see you in good stead because it will likely exceed his area of expertise.
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Related to your question but with a different approach, I watched a fascinating podcast with a Doctor Mark Gordon. The main focus of the podcast was how he has "discovered" that you can treat most cases of PTSD and some head trauma with testosterone. He says he basically just studies the data and is willing to follow it, uninfluenced by big pharma.
<snip>
Hope something there is useful. After all we are people who don't take everything at face value.
WOW you are AWESOME gsp! Thank you for typing/linking!
I listened to it (where you said and beyond a few minutes). That guy was interesting. I now am NOT going to worry too much. Its interesting that he links Vitamin D/ Calcium and lo-T with the statin drugs. (shhhh ...I am Lo-T also!) But I voluntarily stopped taking Statins (after taking them for 10 years) last September-ish when I started Keto. And I stopped taking Vitamin D at the same time. I want to see if my body will adjust naturally.
One bad thing here in Michigan is that it is cloudy all winter and Vitamin D deficiency is rampant. I even checked out if sun tanning booths (UV light) would help produce Vit-D, but its the wrong wavelength.
Dan the Man from Michigan
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