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  • Cholesterol sky high

    image_17332.jpg
    Worried about my blood work
    male 59
    5'11
    76kg or 167 lbs
    paleo 2006-2015
    keto 2015-present
    The attachment shows columns of results dating from 2014 - to the present March 2017.
    I have listed the Triglyceride/HDL ratio on the right.
    WOuld anyone care to comment, the DR wants to prescribe statins !
    My Testosterone level is also massive?
    I'm following a Keto protocol 80 F/15P/5C macro
    Thanks !
    Attached Files
    Last edited by Paneristi; 03-16-2017, 02:13 AM.

  • #2
    Trigs really seam relatively high and HDL lower than expected for a keto dieter.

    I don't see a great deal of evidence to support the cholesterol hypothesis, but if you want to make numbers look pretty for labs.....

    I'd employ some alternate day fasting. Studies show that fasting significantly lowers cholesterol, and being ketogenic already it should be a real breeze for you!

    https://intensivedietarymanagement.c...ol-fasting-16/
    Last edited by Neckhammer; 03-16-2017, 06:28 AM.

    Comment


    • #3
      I would be worried too. Since you changed your diet to 80% fat, your LDL has skyrocketed. That's quite an increase and it's pretty clear that you aren't tolerating the keto diet well. Additionally, your lowish HDL in the presence of a high fat diet, elevated triglycerides, elevated uric acid, and high-normal glucose suggest that you have worsened insulin resistance, another consequence of a high sat fat diets and very low carb diets. Have you considered modifying your diet? Your doctor should probably screen you for diabetes with an A1C or a glucose tolerance test, too.

      If it were me, I would reintroduce healthy carbs, reduce saturated fat by a lot, and get most of my fat calories from olive oil, nuts, avocados, fish, etc.. If that doesn't work and you could afford to drop a little more weight from your already skinny frame you could try to improve your insulin resistance with a few weeks on the Newcastle diet.

      You need a thyroid screen. Hypothyroidism will cause elevated LDL, but usually not the other abnormalities. There are some aditional, more rare causes that your doctor might want to consider too, especially if better diet doesn't improve the situation for somebody with your weight. Thin peoplw with new onset diabetes may have autoimmune type disease which is treated differently.

      The testosterone is probably just a red herring as it's a very volatile number (sex the night before the test will raise the result) and a repeat test may be lower.
      Last edited by JBean; 03-16-2017, 07:37 AM.

      Comment


      • #4
        Some people get really scared about high cholesterol regardless the science:

        "A review of research involving nearly 70,000 people found there was no link between what has traditionally been considered “bad” cholesterol and the premature deaths of over 60-year-olds from cardiovascular disease.

        Co-author of the study Dr Malcolm Kendrick, an intermediate care GP, acknowledged the findings would cause controversy but defended them as “robust” and “thoroughly reviewed”.

        “What we found in our detailed systematic review was that older people with high LDL (low-density lipoprotein) levels, the so-called “bad” cholesterol, lived longer and had less heart disease.”

        Vascular and endovascular surgery expert Professor Sherif Sultan from the University of Ireland, who also worked on the study, said cholesterol is one of the “most vital” molecules in the body and prevents infection, cancer, muscle pain and other conditions in elderly people.

        “Lowering cholesterol with medications for primary cardiovascular prevention in those aged over 60 is a total waste of time and resources, whereas altering your lifestyle is the single most important way to achieve a good quality of life,” he said."

        That said, you could and should still consider integrating a fasting program into your regimen. There are just too many good reasons to do it to ignore.
        Last edited by Neckhammer; 03-16-2017, 08:17 AM.

        Comment


        • #5
          Could you link to that chart somewhere? Straining my eyes to read it, not sure if I'm reading the numbers correctly.

          See the thread just a few below this on high cholesterol. You might pick up some good thoughts, heck I KNOW you will. The best lesson is that we all don't react the same to diet, lifestyle, and meds. Some people thrive on paleo and keto, some don't. There are people who have blood glucose levels over 700 without any parallel problem.

          The easiest thing to do is undo you most recent diet. Depending on your funds and/or insurance, you might consider a heart scan, a C-Reactive Protein inflammation test, and Apo A and B's. Lipid panels are more like fingers point to statistical somethings, but they are not the end result, what matters.

          And, could you please send me some to that T? Holy manhood..........

          Comment


          • #6
            Originally posted by Neckhammer View Post
            Co-author of the study Dr Malcolm Kendrick, an intermediate care GP, acknowledged the findings would cause controversy but defended them as “robust” and “thoroughly reviewed”.

            What we found in our detailed systematic review was that older people with high LDL (low-density lipoprotein) levels, the so-called “bad” cholesterol, lived longer and had less heart disease.”

            Vascular and endovascular surgery expert Professor Sherif Sultan from the University of Ireland, who also worked on the study, said cholesterol is one of the “most vital” molecules in the body and prevents infection, cancer, muscle pain and other conditions in elderly people.

            “Lowering cholesterol with medications for primary cardiovascular prevention in those aged over 60 is a total waste of time and resources, whereas altering your lifestyle is the single most important way to achieve a good quality of life,” he said."

            Just the facts.
            In other words, a few people who make their livings as contrarians, but don't do any direct research, disagree with 50-60 years of research and disregard the data that doesn't support their preferred narrative.

            Comment


            • #7
              I'm having trouble reading the charts, I can't seem to expand them. Is something marked in red bad? Why is it flagging higher Testosterone as bad? You need cholesterol to produce Testosterone, and you have high cholesterol and high testosterone so it seems things are working as intended. What does puzzle me though is the uric acid. If it's going up, that would tell me a possible liver issue like fatty liver.

              Your actual glucose number isn't necessarily good to go by, that can rise and fall given how much or how little sleep you got, the A1C test is better.

              I'd stay away from statins, they are linked to muscle wasting, but if you are worried about CVD (which isn't even linked to high cholesterol anyway, that's calcification, that can be linked to lack of K2), see if your doctor has access to a full in depth cardio blood profile style test. You may have to pay for it.

              On a side note, as others have said, implementing some fasting can always be a good idea. Either daily fasting like a 16:8, or alternate day fasting. Numbers should fall across the board, and it should be simple to implement considering you've been doing keto for a while.

              Comment


              • #8
                Originally posted by JBean View Post

                In other words, a few people who make their livings as contrarians, but don't do any direct research, disagree with 50-60 years of research and disregard the data that doesn't support their preferred narrative.
                Sweet....I love the smell of ad hominem in the morning!

                A strange one though considering this is published research data.

                Meh, you can believe what you wish. This is but one of many studies that find such a correlations in regard to cholesterol.
                Last edited by Neckhammer; 03-16-2017, 01:17 PM.

                Comment


                • #9
                  Originally posted by Neckhammer View Post

                  Sweet....I love the smell of ad hominem in the morning!

                  A strange one though considering this is published research data.

                  Meh, you can believe what you wish. This is but one of many studies that find such a correlations in regard to cholesterol.
                  Hardly "ad hominem". It is quite valid to look at the quality of opinions and to consider the experience of the author.

                  Since you don't post a link to the "study", I believe that you are refering to a meta-analysis performed by a group of anti-cholesterol consensus authors, rather than any primary study. Of course, a meta-analysis is only as good as the studies that are selected for re-analysis. Here's a critique of the MA:

                  https://www.ncbi.nlm.nih.gov/pubmedh...heart-disease/

                  Comment


                  • #10
                    Originally posted by JBean View Post

                    Hardly "ad hominem".
                    Of course it was!

                    But that's fine. At least you found your way to a more proper way to debate with your followup post actually containing a rebuttal. This doesn't seem to be published though? And I can't find authors? Seems more of a "put out the fires!" news release. Meh, its a step up for you vs your previous post though so there is that at least.

                    Comment


                    • #11
                      If we want to argue about a causal relationship, we should look at controlled experiments, rather than meaningless observational studies.

                      http://www.bmj.com/content/353/bmj.i1246
                      The intervention group had significant reduction in serum cholesterol compared with controls...these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease (1.13, 0.83 to 1.54) or all cause mortality (1.07, 0.90 to 1.27).
                      My opinions and some justification

                      Comment


                      • #12
                        Originally posted by Elliot View Post
                        If we want to argue about a causal relationship, we should look at controlled experiments, rather than meaningless observational studies.

                        http://www.bmj.com/content/353/bmj.i1246
                        My oh my...I wonder why such data was not reported previously...

                        "Unpublished data" does seem to run rampant in the cholesterol industry.
                        Last edited by Neckhammer; 03-16-2017, 04:07 PM.

                        Comment


                        • #13
                          Thank you everyone for your brilliant feedback: Here is the link to the data :

                          https://www.dropbox.com/s/5z57inndyj...esult.jpg?dl=0

                          The period 2014-Oct 2015 results I was eating a Primal Blue print diet ( from the book what grok would eat)

                          Thank you everyone for your brilliant feedback:
                          I most certainly will get some more detailed tests done as you've suggested.

                          I'm listing below the diet I was doing from Oct 2015-Dec 2016 -I followed this to the tee...religiously. The weight dropped from 78-76.5 kgs and i got a bit leaner but stalled.

                          I dont drink alcohol and havent since 2000.
                          I do smoke one cigar a day at night.
                          My job isnt stressful.

                          So then in Dec 2016 - March 2017 after watching Jason Wittrock and Stephanie Business person on Youtube and the 250g fat thing and in an attempt to break the stall and get really lean I dropped the breakfast items and switched to bulletproof coffee every morning for 3 months 1 tbs Kerrygold butter, MCT Oil 1 Tbs and Coconut oil 1 tbs and two tbs liquid double cream.

                          I also introduced three eggs and cheese for lunch as an omelette and three strips of bacon dropped the veg, Dinner was fatty lamb chops, butter and brussles sprouts with more butter. Exercise stayed unchanged three - four days a week Benchpress 50kg, deadlifts 50kg and squats 50 kg, 60 pullups, 40 pushups, reverse rows 60, tricep dips 15 ...100 ad crunches and rowing in the form of high intensty tabata sprints for 9 mins or 1600 meters I'm strong for 59 !


                          The reason for starting KETO and this diet was paid for from a 'consultant' at PrimalEdgeHealth.com was to drop BF. I still have about 10 lbs to go and it hasn't really made much difference if I'm honest the fat is still around the rear flank ( love handles).

                          Mentally I feel terrific burning Ketones and have been fat adapted with high levels of Beta Hydroxybuterate 1.1 in the blood.
                          My Blood fasting glucose i take a pin prick daily three times is usually around 5.8-6.2 when I wake then after a couple of hours eating it will drop to 4-5.
                          I exercise - weights and rowing 3-4 days a weekfor an hour but don't move around much as I'm fairly desk bound.

                          Meal Plan
                          Oct 2015
                          Jan -
                          2017



                          DAY 1 Monday

                          Meal 1 Breakfast ( send with GM night before )

                          150 grams Salmon, raw sashimi
                          50 grams Oysters, canned or fresh
                          200 grams Kale and Sea Kelp Greens, sauté greens in 20 grams coconut oil -
                          1x avocado

                          Meal 2 Lunch
                          6oz Ground Grass Fed Beef pattie, weigh raw meat by finely chopping finely minced kale, 1 small onion, 2 garlic cloves, 1 bunch cilantro, 1 hot pepper, 1 tsp cumin, ½ tsp paprika, ½ tsp cayenne pepper, 1 tsp turmeric, ½ tsp salt and ¼ tsp black pepper.
                          Serve with 100 g sauerkraut and Fresh spinach and one raw Avocado

                          Meal 3 Dinner
                          100 grams salmon baked with 1 x tbsp Coconut oil, juice of one lemon and fresh dill sprigs.
                          200 grams local, kale with sea kelp and sauté with 1 tbsp coconut oil sauté one small onion until translucent


                          DAY 2
                          Meal 1
                          150 grams Salmon with 1x tbsp Coconut Oil lightly, sprinkle in 1 tsp turmeric, ¼ ground black pepper, ½ tsp salt. 150 grams broccoli or kale steamed + 50 g sauerkraut

                          Meal 2
                          100 g Beef Tenderloin, 1 avocado, 1 garlic clove minced and liberal amounts of fresh herbs together to achieve a thick paste. Spread the beef slices, top with fresh salad greens
                          150 g RAW sauerkraut

                          Meal 3
                          100 Salmon bake in 50 grams olive oil with a handful of garlic cloves, chili pepper flakes, turmeric, oregano, salt and black pepper. 300gm Spinach

                          DAY 3
                          Meal 1
                          5 oz Salmon, raw sashimi -
                          1/4 cup macadamia nuts -
                          1-2 cups mixed salad greens or baby lettuces and sauerkraut, mix ingredients nicely for a salad. (with minced garlic, salt, pepper)

                          Meal 2
                          Roast Beef
                          6 oz Beef Tenderloin with hollandaise sauce (weigh raw meat)
                          Fresh salad greens, rosemary and cilantro mixed together.
                          Serve with two servings of hollandaise sauce using - 3 egg yolks and coconut oil

                          Meal 3
                          Coconut Beef Curry – 6 oz served along side 1.5 cup (steamed blended cauliflower)

                          Physically I feel strong, have loads of energy, no mood swings, very sharp mentally and certainly less forgetful.I feel terrific :-)
                          Thoughts >?

                          Last edited by Paneristi; 03-17-2017, 01:53 AM.

                          Comment


                          • #14
                            http://ajcn.nutrition.org/content/79/4/564.full
                            Seems MCT oil can raise LDL I've taken 12 capsules a day in the past three months
                            Last edited by Paneristi; 03-17-2017, 03:21 AM.

                            Comment


                            • #15
                              I'm not surprised that you feel better and more alert with less weight and more exercise, but that's a lot of saturated fat and it does explains your LDL. You have to decide who you believe; the cholesterol deniers or the cholesterol researchers. If you believe the cholesterol deniers, that cholesterol doesn't matter, then don't test your cholesterol.

                              If I were you, though, I wouldn't combine pre-diabetes or diabetes, high sat fat intake with consequent LDL, and smoking. Individually, those all raise your risk of cardiovascular disease, but together they are a pretty potent combination for disaster. From all the available data (not just a carefully selected subset of the available!), you are at substantially elevated risk -- that's "risk", not "absolute certainty", but still, I can understand why your doctor wants to stabilize the situation with a statin.

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