With the total being above 200 they will recommend a statin. My recommendation is to see if they will allow you to try adjusting with diet, for now. Then, continue your LCHF woe. I don't know how long you've been eating this way, but I agree with @GaleHawkins, the numbers aren't a true reading until about a year of this woe. Personally I don't think your numbers are super high, so I wouldn't worry about them, for now. If they increase after a year of LCHF, then I might back up and reevaluate the where majority of the fat sources are that you've been consuming.

Btw: it's always your right to choose not to take any medication that a physician may prescribe!

neohdiver wrote: »

Deena_Bean wrote: »

Here's what my numbers are:
Total: 229
HDL: 48
Triglycerides: 192
LDL: 143

Ask your doctor to run an NMR test. That test distinguishes between the small very dense particles and the larger, less dense ones. That may ease some of the concerns about the numbers.

And, as others have said, give it time to settle out. I get to have a conversation with my doctor in a couple of months. Whatever the results, I won't let him put me on statins at least until I've reached my target weight and have stabilized there. (And he has ordered the NMR test.)

This.

I just had blood work done and it was perfect. The previous 12 months on LCHF, it's been high. However, my particles are fluffy (good) and they kept getting bigger (good). So, my docs said that if they're still high 1 year *after* I've reached my goal weight, then he'd consider putting me on meds. As of 2 weeks ago eating enough animal products to freak out 3 planets worth of vegetarians, my numbers are perfect. Give it time. While you're losing and adjusting, they'll be wonky.

If you're worried about thyroid issues, you're going to want to see an endocrinologist not a gynecologist. Just fyi. I suggest you talk to you PC about getting a referral to one. No sense in butting heads with an unhelpful doctor (your gyno). Have you thought about getting a different gyno since it sounds like you are having such trouble with your current one?

High Triglycerides can indicate hypothyroidism.

Deena I finally got my Vitamin D level out of the 20's into the 90's (used K2 as well) and my all of my numbers are improving but the connection is questioned by some. The link below makes a connection per the author between Vitamin D levels, risk of heart disease and blood lipid values. The material is kind of a dry read but the charts and graphs on pages 52-58 may be of interest to you if you know your Vitamin D level. Other literature on Vit D levels indicate levels 70-90 can even protect from death by cancer, heart disease, etc. Levels <30 is inviting to death causes.

lib.dr.iastate.edu/cgi/viewcontent.cgi?article=4424&context=etd

Check out this podcast. Around 31:30 she talks about how thyroid tests often come back ok when the issue is autoimmune. Just another idea to maybe look into.
https://www.ketovangelist.com/episode-30-dr-kelly-austin-discusses-hormones-and-keto/

Deena_Bean wrote: »

I don't think I have thyroid problems - it's been tested before and come back ok. It's more that the cholesterol thing is off and that can be a sign of it. The gyno ran the blood tests because I requested them - and then whatever looks sketchy they tell you to see your doc. When I talk to my GP in a couple of weeks I'm going to see what she has to say and possibly request a referral if needed. I think the GP can request all of the blood tests, but the endo would probably be better to analyze. That gyno is history. She doesn't know it yet, but she's seen the last of me. What a ridiculous appointment that was.

What test did they run? If the only thing they ran was TSH, then that's meaningless. TSH isn't even a thyroid hormone, but a pituitary one. It's thyroid stimulating hormone -- the one that tells the thyroid to do its job. It's the T3/T4 ones that actually matter. I highly recommend checking out http://www.stopthethyroidmadness.com/tsh-why-its-useless/ for more information on that front.

Deena_Bean wrote: »

She wouldn't approve hormone tests either (I have PCOS) because the results won't change the fact that I have PCOS.

Cyster to cyster -- drop that doctor like a sack of bricks.

No, tests don't change the fact that you have and will always have PCOS, but they will tell you whether your actions are moving in the right direction toward overall hormone balance, which will, in turn, very likely correct your cholesterol issues.

PCOS alone is probably the prime reason your cholesterol is wonky. It comes with the territory, as part and parcel with the metabolic disorder that usually comes with PCOS, too. However, you can correct it (and, in my opinion, LCHF is hands down the best way to do that).

Keep in mind, too, that having PCOS may mean that you're extremely sensitive to carbs. Going lower on your carbs may actually give improvement to your cholesterol, as backward as that sounds, but when you understand that triglycerides are the result of the body turning sugar into fat for storage, it begins to make more sense.

One of the gotchas with PCOS -- at least for some of us -- is that the body miscommunicates with itself. It basically simultaneously tells the body to store all energy as though it's excess (by keeping insulin high), while also telling it it's starving/hungry (by decreasing leptin and/or increasing ghrelin). This can be corrected (and can be done through diet and exercise), but requires something like LCHF, which keeps dietary prompts of insulin release (particularly for the purpose of dealing with glucose) to a minimum.

Sunny_Bunny_ wrote: »

Check out this podcast. Around 31:30 she talks about how thyroid tests often come back ok when the issue is autoimmune. Just another idea to maybe look into.
https://www.ketovangelist.com/episode-30-dr-kelly-austin-discusses-hormones-and-keto/

This is actually a good point, too. It's not uncommon to find co-morbids of autoimmune issues like Celiac or Hashi's with PCOS. I know @KnitOrMiss can attest to "normal" thyroid tests while still having thyroid issues, too. Hopefully she'll chime in on that front.

@wabmester you live!!

Dragonwolf wrote: »

Deena_Bean wrote: »

That gyno that refused the hormone testing was basically talking to me like I'm some idiot that knows nothing about PCOS. Seriously, I'm the one living with this crap and have been for 20 years. I've read legions of material on it, and it did nothing but infuriate me that she was talking to me like a toddler and telling me the hormone tests don't change anything. I left that appointment both defeated and angry beyond measure.

Been there, done that, got the t-shirt. I had a GP like that once. I ended up leaving that appointment nearly suicidal (seriously, the only thing keeping me from driving off a bridge was the fact that I had martial arts right after and it was something I was really enjoying and I just focused on getting there and doing that above all else), because I felt so defeated and was made to feel about an inch tall. Suffice it to say, I quickly found a new GP. That experience is why I'm very vocal about self-advocacy among women with PCOS. It's astounding how many times I hear stories like ours.

Been there, done that - although not with PCOS.

Nearly bleeding to death for most of a year (1 quart every 5 days), misdiagnosed by 2 (male) gynos (all of whom informed me I was grossly exaggerating my blood loss) & one (male) PCP & one hematologist (to whom I was sent because my anemia was so severe it did not look as if I was producing any new red blood cells; turns out I was just losing them faster than I could make them. Go figure.

Then, once proven wrong, the PCP and the male gynos just wanted to yank the uterus. After all I was done having kids so it was just a useless body part. I still have that "useless" body part hanging around 15 years later, causing no trouble at all (and a female gyno - who not only doesn't declare body parts useless, but she respects the fact that I know my body and am a very strong advocate for patient involvement in medical care)

neohdiver wrote: »

Dragonwolf wrote: »

Deena_Bean wrote: »

That gyno that refused the hormone testing was basically talking to me like I'm some idiot that knows nothing about PCOS. Seriously, I'm the one living with this crap and have been for 20 years. I've read legions of material on it, and it did nothing but infuriate me that she was talking to me like a toddler and telling me the hormone tests don't change anything. I left that appointment both defeated and angry beyond measure.

Been there, done that, got the t-shirt. I had a GP like that once. I ended up leaving that appointment nearly suicidal (seriously, the only thing keeping me from driving off a bridge was the fact that I had martial arts right after and it was something I was really enjoying and I just focused on getting there and doing that above all else), because I felt so defeated and was made to feel about an inch tall. Suffice it to say, I quickly found a new GP. That experience is why I'm very vocal about self-advocacy among women with PCOS. It's astounding how many times I hear stories like ours.

Been there, done that - although not with PCOS.

Nearly bleeding to death for most of a year (1 quart every 5 days), misdiagnosed by 2 (male) gynos (all of whom informed me I was grossly exaggerating my blood loss) & one (male) PCP & one hematologist (to whom I was sent because my anemia was so severe it did not look as if I was producing any new red blood cells; turns out I was just losing them faster than I could make them. Go figure.

Then, once proven wrong, the PCP and the male gynos just wanted to yank the uterus. After all I was done having kids so it was just a useless body part. I still have that "useless" body part hanging around 15 years later, causing no trouble at all (and a female gyno - who not only doesn't declare body parts useless, but she respects the fact that I know my body and am a very strong advocate for patient involvement in medical care)

Ouch, that sucks! That's a lot like what I've seen them do with PCOS women, too. It's astounding that people like that manage to go into practice!

Karlottap wrote: »

I love hearing stories where patients advocate for themselves! Whenever you feel a doctor isn't listening and doesn't have your best interests at heart (meaning they are treating you from their experience with the last patient, instead of looking at YOU) it's time to fire them and move on!

Op, I'm so glad you aren't going tothe incompetent gyno anymore! I have found that doctors don't like to order labs that they know nothing about! She wouldn't be able to explain the results! So she gave the generic response that comes with that of convincing you it's not needed. Is a definite red flag to tell you to do that moving on!

We must have physicians who LISTEN TO US! Not spend the visit plugging symptoms into a computer that gives them "diagnoses" either! This is not practicing medicine, imo!

Spend this time educating yourself (yes, there are times that we know more than they do, even though their supposed to be "educated"), and make a list to take with you, including your rationales for the requests (doctors do like this). I hope the next doctor is receptive to your reasonable requests, and understand why you are requesting them!

@neohdiver, congratulations on standing up for yourself during your ordeal with physicians! I'm glad you stuck with it and resolved the situation without the need for surgery! More people need to do the same!

Exactly! All of this!

Both of you might be interested in Dr. Eric Topol's The Patient Will See You Now, and following Dr. Topol in general. He's a huge advocate for a more collaborative doctor-patient relationship, and is an avid follower of technological advancements in the medical field (like continuous glucose monitoring, and various monitoring tools that can attach to mobile devices so all information goes directly into the digital systems).