Ketogenic diet and high LDL
thecommoncold40299
Posts: 12 Member
Ive been doing the Ketogenic diet for a few weeks now. I had my yearly physical and figured since I've lost 40 pounds I would hear nothing but good news. I was wrong. My LDL was 165! Now my doc has me on Lipitor! What foods can I eat to stay keto but also lower my LDL? All my other levels were great including my BP but that's never been an issue.
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Did you ask your doctor about your diet? What did he or she think?0
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Congratulations on the weight loss.
I couldn't tell if you are male or female. Statin drugs, like lipitor, have been linked to new onset of diabetes and breast cancer in women and no change in mortality. If you are female, these are things you might want to discuss with your doctor. As you continue to lose weight, keep an eye on the lipids, and they may improve. Or, they may not. Plenty of thin people have hyperlipidemia -- it is largely genetic.0 -
queenliz99 wrote: »Did you ask your doctor about your diet? What did he or she think?
This.0 -
Here are links to studies that looked at your question: what is the best diet for a person with elevated LDL/success with a ketogenic diet. I think they would be a good starting point.
http://www.biomedcentral.com/content/pdf/1476-511X-9-54.pdf
http://annals.org/mobile/article.aspx?articleid=717451
http://annals.org/mobile/article.aspx?articleid=19006940 -
Ask your doctor to run an NMR test to determine particle size. LDL has (at least) 2 particle sizes, and it is the small dense ones that are bad for heart disease. A ketogenic diet tends to increase overall LDL, but you need to know the composition of the particles to know whether the high number is something you need to worry about. http://www.ncbi.nlm.nih.gov/pubmed/26277632thecommoncold40299 wrote: »Ive been doing the Ketogenic diet for a few weeks now. I had my yearly physical and figured since I've lost 40 pounds I would hear nothing but good news. I was wrong. My LDL was 165! Now my doc has me on Lipitor! What foods can I eat to stay keto but also lower my LDL? All my other levels were great including my BP but that's never been an issue.0 -
Thank you!! I'm definitely going to discuss this with him.0
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Thank you all. I'm going to talk to my doc. Going back through my food logs I am only averaging about 25 grams of saturated fat a day. Both my cholesterol and sodium levels are either at normal levels or below. I've lost 40 pounds. I feel so much better and I would hate to have to stop this diet. Of course if I have no choice I will, but I'm going to discuss this with him. I'm also wondering if the fact that he told me I didn't need to fast before the lipid panel was taken would affect the results. I had eaten about 4 hours prior to the test.0
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thecommoncold40299 wrote: »T I'm also wondering if the fact that he told me I didn't need to fast before the lipid panel was taken would affect the results. I had eaten about 4 hours prior to the test.
I'm surprised they didn't do it fasting. My very first cholesterol test, they told me to fast, but never mentioned coffee. One cup put me into the 200s! I had to re-do the test.
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Yeah I am surprised also. Maybe I can request a retest and fast before just to see. I just can't believe it's so terrible and I'm not taking Lipitor!0
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thecommoncold40299 wrote: »Thank you all. I'm going to talk to my doc. Going back through my food logs I am only averaging about 25 grams of saturated fat a day. Both my cholesterol and sodium levels are either at normal levels or below. I've lost 40 pounds. I feel so much better and I would hate to have to stop this diet. Of course if I have no choice I will, but I'm going to discuss this with him. I'm also wondering if the fact that he told me I didn't need to fast before the lipid panel was taken would affect the results. I had eaten about 4 hours prior to the test.
Disclaimer: I am not following a low carb diet, never did, so not commenting on this part.
Not everyone responds the same to high fat and especially saturated fats. Some people might not be affected, others might be far more sensitive. For example, 25 grams of saturated fat which you consider low, is for me crazy high, even if it is low for someone else.
To give you some perspective, the American Heart Association recommendation for people who need to lower their LDL is saturated fat below 5% of total daily calories, and virtually zero trans fat.
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Saturated-Fats_UCM_301110_Article.jsp#.VnEkVEp95D8
http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Know-Your-Fats_UCM_305628_Article.jsp#
and mayo clinic guidelines are similar:
http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fat/art-20045550?pg=2
For a woman with e.g. a 1700 kcal goal, 5% of calories from saturated fat means a limit of just 85 kcal from saturated fat, or just 9-10 grams per day.
Thus is a tough goal unless you eat a mainly plant and fish based diet. But it might be worth discussing with your dr since you have already been prescribed medication.0 -
Dump the Lipitor! You are fine! Large fluffy LDL particles have increased - not a problem. Lipitor however will create lots of problems!!
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I thought that if you are actively losing weight that blood work can show not normal results that settle down when weight stabilizes? I don't have a source, but have seen this said over and over. Maybe research a bit on results during active weight lose?0
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Even people on the keto reddit are concerned that higher LDL for some just gets hand waved away by the true believers.queenliz99 wrote: »
My understanding is that not fasting can skew and that, regardless, you probably want more than one test before jumping to conclusions, anyway.
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http://www.lecturepad.org/dayspring/lipidaholics/pdf/LipidaholicsCase291.pdf
I've not read the study but it was quoted in a thread I was following. For some people, not all, keto can cause elevated hdl. It can be reversed with a modified diet.0 -
I thought that if you are actively losing weight that blood work can show not normal results that settle down when weight stabilizes? I don't have a source, but have seen this said over and over. Maybe research a bit on results during active weight lose?
I don't know about that. Here is a study that used a low-fat diet to help treat subjects with metabolic syndrome, and their LDL decreased http://care.diabetesjournals.org/content/30/11/2945.full
I know there are tons of other diets that show a decrease in LDL, so I wouldn't say weight loss in general leads to an increase in LDL. There is a lot of evidence for the opposite.
Unfortunately, it seems that most of my search on the intarwebz shows that the discussion of keto increasing LDL is mostly blog and keto sites using the rationalization you suggested. I can't easily find a study to confirm it though.0 -
A couple years ago my LDL was 201 and total cholesterol was 287 when I was eating a low carb, high fat diet with plenty of meat, cheese, eggs and added oils. My weight was about 140-145 lbs at the time. My dr told me if I don't get it under control, I'd have to go on meds.
I've now changed my diet to low fat, whole foods plant-based diet starting a few months ago and my total cholesterol is now 168, LDL is 105, HDL is 46 and Triglycerides 71, tested in September. My macros are now roughly 75/15/10% - C/P/F. My weight is down to 125 lbs. The weight difference is only 15-20 lbs so the key for me was the diet. I had to cut back on fat.
So if you want to improve your lipid panel, you may have to rethink the ketogenic diet. The only people I know who need it are people with seizures/epilepsy. It's completely unnecessary for weight loss, and it's obviously having a direct negative effect on your cholesterol.0 -
Whether your LDL/diet is a cause for concern or not I honestly don't know but an otherwise healthy 35 year old women being prescribed a statin on the basis on one test? That's outrageous and cause for concern, IMO.
Please get a second opinion if you can afford it.0 -
Expatmommy79 wrote: »http://www.lecturepad.org/dayspring/lipidaholics/pdf/LipidaholicsCase291.pdf
I've not read the study but it was quoted in a thread I was following. For some people, not all, keto can cause elevated hdl. It can be reversed with a modified diet.
Thanks - need to sit down at a quiet moment and read that, just skimmed it and was confused on the example patient used vs the analysis.
The sample case was a not-so-extreme low carb dieter who later tested to be a hyper-responder to dietary cholesterol.
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queenliz99 wrote: »
That is what I said, isn't it?0 -
Pertinent info -
-OP is actively losing weight and has lost 40lbs
-OP has been on ketogenic diet a 'few' weeks
-OP has bloodwork with numbers that prompt a Lipitor Rx
40lbs lost - a few weeks of keto - then Lipitor Rx.0 -
Traveler120 wrote: »A couple years ago my LDL was 201 and total cholesterol was 287 when I was eating a low carb, high fat diet with plenty of meat, cheese, eggs and added oils. My weight was about 140-145 lbs at the time. My dr told me if I don't get it under control, I'd have to go on meds.
I've now changed my diet to low fat, whole foods plant-based diet starting a few months ago and my total cholesterol is now 168, LDL is 105, HDL is 46 and Triglycerides 71, tested in September. My macros are now roughly 75/15/10% - C/P/F. My weight is down to 125 lbs. The weight difference is only 15-20 lbs so the key for me was the diet. I had to cut back on fat.
So if you want to improve your lipid panel, you may have to rethink the ketogenic diet. The only people I know who need it are people with seizures/epilepsy. It's completely unnecessary for weight loss, and it's obviously having a direct negative effect on your cholesterol.
Your results may very well be because of your change of diet, but I'll just point out that a 20lb loss on a 145lb person is a significant loss and can easily change the results of your blood panel.0 -
I was just arguing about keto with someone elsewhere. There's a study on pub med showing healthy weight men on ketogenic and healthy weight men in control. LDL went up slightly on the keto group. They did not control for type of fat consumed. Not sure if that would have an effect or not.
You definitely need to be fasting to get an accurate LDL though. The keto group saw their HDL go up as well, did you see that as well?0 -
when i lost weight all my levels went up,was told that a lot of times that when you lose weight the cholesterol can be released into the blood stream and read higher. . they went down when I went lower carb,then I started eating more carbs and it went up. I was on all kinds of meds for my cholesterol and only one helped but my insurance wont cover it. I refuse to take lipitor because of all the side effects and some of the other meds caused me other issues. I had to stop taking my meds. I dont recommend it unless you talk to a dr. my high cholesterol is hereditary and even on meds it didnt make a big difference. definitely retest and fast for 24-48 hrs before.(get better results that way or so Ive been told).then go from there.you may have to change your diet but that may not make a difference either. my cholesterol issues started before I became overweight as well so.good luck though.0
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The study that I showed my doctor for my weightloss plan featuring keto was about overweight individuals with high cholesterol and insulin concerns, which is my target health issues. In the study, it was mostly unsaturated fats, but no mention of exercise for all numbers to improve. So maybe more eggs, less animal fat. "Good oils" will help. Exercise is pretty good to add, too.0
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queenliz99 wrote: »
I don't have a study, but I have heard this, too. It does make sense biologically - when you're losing weight, you're going to be mobilizing fat, and both HDL and LDL's main function in the body is moving fatty acids through the bloodstream. It does make sense that when you need to move a lot of fatty acids, you will have more lipoprotein.0 -
rankinsect wrote: »queenliz99 wrote: »
I don't have a study, but I have heard this, too. It does make sense biologically - when you're losing weight, you're going to be mobilizing fat, and both HDL and LDL's main function in the body is moving fatty acids through the bloodstream. It does make sense that when you need to move a lot of fatty acids, you will have more lipoprotein.
@rankinsect Thank you0 -
Here's my n=1...
I've always had middle-of-normal cholesterol levels, although my particles were on the small side (bad kind). When I went low carb (100-150g) 3 years ago, nothing changed. When I went low carb (under 100g) 1.5 years ago, my particles started getting bigger, but the numbers were steady. When I went keto (under 35g) and started losing weight 11 months ago, my LDL went up. After the first 20lbs of loss, my LDL was just above the normal range, but the particles were big and fluffy (good kind).
My doctors cared when the particles were small. When they showed up as big and fluffy, the three of them took a joint sigh of relief and said they were happy. My LDL still flirts with the high edge of normal and they're happy. My nit-picky, panty-twisted, pain in the *kitten* doctors are happy with my blood work, high LDL and all... because the particles are big and fluffy and I'm still losing weight.
They did say that once my weight is stabilized for 2 years, they'd like to see my LDL back into a normal range. Again, they expect a higher LDL while I lose and stabilize, then they'd like it to drop, but they're ok if it doesn't.
If I were you, I wouldn't take that statin and I'd insist on another full panel fasted, because an un-fasted cholesterol panel is worth exactly diddly squat. I'm not a doctor, but that's my 2 cents having dealt with this for 3 years.0 -
Here's my n=1...
I've always had middle-of-normal cholesterol levels, although my particles were on the small side (bad kind). When I went low carb (100-150g) 3 years ago, nothing changed. When I went low carb (under 100g) 1.5 years ago, my particles started getting bigger, but the numbers were steady. When I went keto (under 35g) and started losing weight 11 months ago, my LDL went up. After the first 20lbs of loss, my LDL was just above the normal range, but the particles were big and fluffy (good kind).
My doctors cared when the particles were small. When they showed up as big and fluffy, the three of them took a joint sigh of relief and said they were happy. My LDL still flirts with the high edge of normal and they're happy. My nit-picky, panty-twisted, pain in the *kitten* doctors are happy with my blood work, high LDL and all... because the particles are big and fluffy and I'm still losing weight.
They did say that once my weight is stabilized for 2 years, they'd like to see my LDL back into a normal range. Again, they expect a higher LDL while I lose and stabilize, then they'd like it to drop, but they're ok if it doesn't.
If I were you, I wouldn't take that statin and I'd insist on another full panel fasted, because an un-fasted cholesterol panel is worth exactly diddly squat. I'm not a doctor, but that's my 2 cents having dealt with this for 3 years.
This is what I have heard and read too.
As a woman, I tend not to put too much stock in cholesterol numbers. IMO, the link to CAD is tenuous at best.0 -
Thank you! Yeah I didn't get the script filled. I'm too young to be on that! Lol seriously if I had to I would take it but I agree. I want another test first. When I went in that day I had no idea he was going to do a panel and I told him I had eaten and he said it didn't matter. I've never taken a test without fasting first. It was the first time I've gone to him so I'm a little iffy about him anyway:) thank you for the advice. Since posting I've lost another two pounds. How can that be bad lol? Btw, I did tell him I had a recent 40 pound weight loss and I guess that didn't register with him when he read my LDL. I'm watching my saturated fats and sodium but I'm still doing my keto diet. It's just more difficult now lol. My Actual cholesterol intake has been great actually, But I've been getting about 25 mg of saturated fats per day so I'm trying to chill out on that. If it doesn't contain saturated fats then it's full of carbs!!!!! Ugh! But I am not giving up. Somehow I'm going to find a happy medium in this mess! I've got another 40 to lose and I'm not quitting.0
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