2

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I geeked. 18 monts Post Paleo, first Blood-test Results

Answered on September 12, 2014
Created February 22, 2011 at 3:19 PM

cross post from Rob Wolff's forums*

Hey All,

Been eating PALEO since Sept '09. I was about 250lbs, I am down to 195 @ 6'1 as of this month. Weight loss has stabilized, and I am still losing body fat and increasing muscle mass. Started Crossfit back in August of '10. My box leans towards heavier oly lifts, and I goto the box 3 times a week. Cardio is long walks, slow rowing, hiking.

I didn't want to go this route but I went ahead and geeked out a bit and had some blood work done. I am a 27 year old male, 6'1, 195, no previous medical issues other than right knee ACL/meniscus reconstruction 10 years ago. Lots of family history of cancer, and one grand parent who had heart disease.

I've been eating, what most would categorize, as a cyclical ketogenic paleo diet. I eat probably 70% store bought meat/30% grass-fed meat. I take a tablespoon fish oil when I eat the standard meat (works out to be 3-4grams of EPA/DHA). Other fat sources come from pastured butter, coconut, avocado, some olive oil (only as dressing).

With all that said, here is the blood work that came back (24 hour fast before results taken):

Fasted Blood Glucose - 93mg/dL
Cholesterol, Total - 377
Triglycerides - 86 mg/dL
HDL Cholesterol - 72 mg/dL
vLDL Calc - 17 mg/dL
LDL Calc - 288 mg/dL
25-Hydroxy - 62.8 ng/mL
A1C - 5.5
CRP - 0.75 mg/L
TSH - 2.150 uIU/mL
T4,Free(direct) - 1.2 ng/Dl
T3 - 69 ng/DL

Everything seemed within paleo norms, except the obvious: LDL @ 288.

I was hoping my fasted blood sugar would have been in the mid 80s, and that my A1C would have been closer to 5. T3 was just outside the spectrum by one 1ng/DL.

I was happy with the HDL count, and the Trigs overall.

Thoughts on the LDL?

1340fe0b7e7b01683ea33042092e05d6

(1693)

on February 23, 2011
at 11:42 AM

I did not get insulin/cortisol/dhea measured unforunately

2b8c327d1296a96ad64cdadc7dffa72d

on February 23, 2011
at 01:40 AM

what was your fasting insulin? were cortisol & DHEA measured?

47a42b6be94caf700fce9509e38bb6a4

(9647)

on February 22, 2011
at 08:59 PM

@LiveForIt: see Peter on "physiological insulin resistance" for the FBG. Here is one place among many this has come up on PH: http://paleohacks.com/questions/4647/does-a-sugar-bolus-hit-you-like-the-flu/4667#4667 But 93 is not really all *that* high.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 08:29 PM

that's basically what i'm asking- but i'm asking that not just about ldl but across the board. i would imagine that seeing a pattern of outside the normal range markers in sick individuals isn't the same as seeing occasional outside the range markers in asymptomatic and otherwise healthy individuals. does the "if it ain't broke don't fix it" principle apply?

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on February 22, 2011
at 08:20 PM

my question is how do we REALLY know what 'high LDL' is? I haven't yet seen a properly done study that confirms that when a person eats healthy foods, has otherwise healthy markers, and has large ldl dominance, that they are still at risk for heart disease if their LDL is 200+.Everyone responds differently.I know for sure that I've seen many many people comment on several different Paleo forums that their LDL went up significantly after going Paleo. This leads me to strongly suspect that the LDL theory is faulty, if people eating the right foods put themselves at 'perceived' risk by doing so.

1340fe0b7e7b01683ea33042092e05d6

(1693)

on February 22, 2011
at 07:45 PM

Interesting trend I am seeing. I am seeing more and more recommendations to go a bit higher carb.. I am Irish, and always down for some more Tubers!

1340fe0b7e7b01683ea33042092e05d6

(1693)

on February 22, 2011
at 07:44 PM

@ Travis: I dont go out of my way to get iodine (aka supplements) but i do have shrimp several times through out the month, on top of seafood. Albeit, bigger game fish (mahi, salmon) The salt in our cupboard that we use is Idonized if that counts.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:49 PM

idiosyncracies when it comes to markers are handled.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:48 PM

fine living with before testing that worry them afterwards. no symptoms of anything, just staring at numbers. as someone not in the scientific field, it seems to me that people are always looking to fit a person, who seems to be feeling fine by all accounts, into a range. i'm just questioning the ranges and that maybe those ranges are good touchpoints for 95% of people but others could fall outside of those ranges of any given marker and be just fine given their biological make-up. Again, i'm not scientist. Just a paleo guy who's done well on this but has some questions as to how individual

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:44 PM

@travis what would the symptoms of those historical imbalances be? just because historically it is imbalanced, does that mean that it's a net negative as far as longevity or overall health is concerned? have there been scientific studies stating that we should be within a certain range or x happens or doesn't happen? i have no scientific background, i'm just curious because after following the basic paleo model(no wheat, very limited grains, real food) i've noticed that the basic deal is beneficial to pretty much everyone. beyond that, i see some individual numbers and such that people were

Medium avatar

(39821)

on February 22, 2011
at 06:36 PM

Lucky: We all have much higher exposure to perchlorates than occurred historically and our diets are lower in selenium. These exacerbate a deficiency.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:13 PM

@melissa being that historically, many cultures may have not had access to seafood or kelp, if someone is eating a proper diet from a paleo perspective that is appropriate their region(say the plains of africa) would they have had thyroid problems from lack of seafood? i'm asking because absent other symptoms, and LivForIt doesn't mention anything else that would suggest a faulty thyroid, couldn't the situation be that LDL numbers have a much greater range than the medical establishment currently believes?

Medium avatar

(39821)

on February 22, 2011
at 06:07 PM

TSH seemed a little high to me; how do you get your iodine? The Jaminets claim that under 1 is ideal and reflects a proper iodine intake.

9d43f6873107e17ca4d1a5055aa7a2ad

on February 22, 2011
at 06:05 PM

TSH is a little high. Remember "normal" is based on a population where hypo is probably rampant.

Medium avatar

(39821)

on February 22, 2011
at 06:04 PM

TSH seemed high to me; how do you get your iodine?

1340fe0b7e7b01683ea33042092e05d6

(1693)

on February 22, 2011
at 05:21 PM

Hey Melissa, interesting stuff. From your research do my TSH/T4,T3 levels lead you to believe something may need to be explored w/my thyroid?

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5 Answers

4
F38ece2204c6ab63fef7887e9f4e30d2

(100)

on February 22, 2011
at 04:00 PM

I have similar blood counts after eating basically low carb since 2009. While my HDL and Triglycerides went up, so did my total cholesterol. HDL up from 62 to 87, Triglycerides from 158 down to 67, but total C up from 258 to 371. One explanation I have found is that some people have an Apo E4 allele that means they don't process fat well. Here is a comment from Joe D. Goldstrich, MD, January 23, 2011 at on the proteinpower blog (http://www.proteinpower.com/drmike/lipid-hypothesis/the-big-lie/#comments):

"I believe the low carb, higher fat diet is the best diet for around 75% of the population. However, about 25% of the population carry the Apo E4 allele. These individuals will increase their LDL-C, LDL-P and sdLDL as they increase their fat intake. I am Apo E3/4 and have been eating low carb for the past 5 years and at the same time struggling with LDL issues. I recently began limiting fat (especially saturated fat) as well as carbs and lost approximately 15 pounds over a 10 week period while concomitantly cutting my LDL-P and sdLDL in half with little change in my LDL-C. My LDL particles got bigger and hopefully less atherogenic. My weight has now stabilized. One diet apparently doesn???t fit all."

Also, there is a different calculation for LDL when your triglycerides go below 100. Here is a link to the study: http://www.ams.ac.ir/AIM/08113/0014.pdf and here is a link to the calculator: http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

2
9d43f6873107e17ca4d1a5055aa7a2ad

on February 22, 2011
at 05:00 PM

I think the LDL is too high. I probably shouldn't speak for my boyfriend Chris Masterjohn and I am prodding him to post on this, but high LDL is possibly a sign of poor thyroid function, which unfortunately has many causes.

I would definitely eat more real seafood or use kelp as a seasoning. Fish oil doesn't contain the rich variety of minerals that seafood does. I might also look towards replacing some coconut with tallow and lard. It's possible you are genetically sensitive.

There are plenty of high-fat dieters with target LDL levels, myself and Chris included.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:13 PM

@melissa being that historically, many cultures may have not had access to seafood or kelp, if someone is eating a proper diet from a paleo perspective that is appropriate their region(say the plains of africa) would they have had thyroid problems from lack of seafood? i'm asking because absent other symptoms, and LivForIt doesn't mention anything else that would suggest a faulty thyroid, couldn't the situation be that LDL numbers have a much greater range than the medical establishment currently believes?

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:44 PM

@travis what would the symptoms of those historical imbalances be? just because historically it is imbalanced, does that mean that it's a net negative as far as longevity or overall health is concerned? have there been scientific studies stating that we should be within a certain range or x happens or doesn't happen? i have no scientific background, i'm just curious because after following the basic paleo model(no wheat, very limited grains, real food) i've noticed that the basic deal is beneficial to pretty much everyone. beyond that, i see some individual numbers and such that people were

Medium avatar

(39821)

on February 22, 2011
at 06:04 PM

TSH seemed high to me; how do you get your iodine?

1340fe0b7e7b01683ea33042092e05d6

(1693)

on February 22, 2011
at 07:44 PM

@ Travis: I dont go out of my way to get iodine (aka supplements) but i do have shrimp several times through out the month, on top of seafood. Albeit, bigger game fish (mahi, salmon) The salt in our cupboard that we use is Idonized if that counts.

Medium avatar

(39821)

on February 22, 2011
at 06:36 PM

Lucky: We all have much higher exposure to perchlorates than occurred historically and our diets are lower in selenium. These exacerbate a deficiency.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:49 PM

idiosyncracies when it comes to markers are handled.

Medium avatar

(39821)

on February 22, 2011
at 06:07 PM

TSH seemed a little high to me; how do you get your iodine? The Jaminets claim that under 1 is ideal and reflects a proper iodine intake.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on February 22, 2011
at 08:20 PM

my question is how do we REALLY know what 'high LDL' is? I haven't yet seen a properly done study that confirms that when a person eats healthy foods, has otherwise healthy markers, and has large ldl dominance, that they are still at risk for heart disease if their LDL is 200+.Everyone responds differently.I know for sure that I've seen many many people comment on several different Paleo forums that their LDL went up significantly after going Paleo. This leads me to strongly suspect that the LDL theory is faulty, if people eating the right foods put themselves at 'perceived' risk by doing so.

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 06:48 PM

fine living with before testing that worry them afterwards. no symptoms of anything, just staring at numbers. as someone not in the scientific field, it seems to me that people are always looking to fit a person, who seems to be feeling fine by all accounts, into a range. i'm just questioning the ranges and that maybe those ranges are good touchpoints for 95% of people but others could fall outside of those ranges of any given marker and be just fine given their biological make-up. Again, i'm not scientist. Just a paleo guy who's done well on this but has some questions as to how individual

9d43f6873107e17ca4d1a5055aa7a2ad

on February 22, 2011
at 06:05 PM

TSH is a little high. Remember "normal" is based on a population where hypo is probably rampant.

1340fe0b7e7b01683ea33042092e05d6

(1693)

on February 22, 2011
at 05:21 PM

Hey Melissa, interesting stuff. From your research do my TSH/T4,T3 levels lead you to believe something may need to be explored w/my thyroid?

66e6b190e62fb3bcf42d4c60801c7bf6

(12407)

on February 22, 2011
at 08:29 PM

that's basically what i'm asking- but i'm asking that not just about ldl but across the board. i would imagine that seeing a pattern of outside the normal range markers in sick individuals isn't the same as seeing occasional outside the range markers in asymptomatic and otherwise healthy individuals. does the "if it ain't broke don't fix it" principle apply?

1
Ef4c5b09fdccf73be575d3a0c267fdd9

(2539)

on February 22, 2011
at 06:53 PM

I would say add in maybe a bit of iodine from kelp supplements or eating kelp and then add in some starch. I had some thyroid symptoms until I added more carbs in the mix.

Also note - iodine can cause a rise in TSH initially, not sure why, but it goes back down again. Make sure you are eating enough and you should take breaks from any caloric restriction. DO not fast so much either.

1340fe0b7e7b01683ea33042092e05d6

(1693)

on February 22, 2011
at 07:45 PM

Interesting trend I am seeing. I am seeing more and more recommendations to go a bit higher carb.. I am Irish, and always down for some more Tubers!

1
13c5a9f1678d75b93f269cdcf69f14d5

(2339)

on February 22, 2011
at 05:53 PM

I don't know that the a1c is unreasonable, but I would have expected, from your description of diet and lifestyle, that the FBG would be lower, espc. Since you have done this for 18 months.

A full thyroid panel, including the rt3, would give you more info. But I am pretty sure Doc Harris would say that you're just looking for trouble. I'd wait, check the a1c again in a year a log with a vap or NMR which counts cholesterol rather than calculates.

More seafood this year wouldn't hurt, and less fish oil!

47a42b6be94caf700fce9509e38bb6a4

(9647)

on February 22, 2011
at 08:59 PM

@LiveForIt: see Peter on "physiological insulin resistance" for the FBG. Here is one place among many this has come up on PH: http://paleohacks.com/questions/4647/does-a-sugar-bolus-hit-you-like-the-flu/4667#4667 But 93 is not really all *that* high.

1
Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on February 22, 2011
at 03:45 PM

A high LDL like that is typical for Paleo. Mine is 211. But your trigs are low and HDL is a healthy 72. Also, your vLDL is fairly low at 17. I think the best way to really know if your LDL might be troublesome for you in the future is to get a lipoprotein analysis/VAP test to determine your LDL particle type. If you've been on Paleo for a year and a half, then you've got to know by now that if your LDL is dominated by large, bouyant particles, that's regarded as a good sign. If that be the case, I don't think you have anything to worry about.

Remember, the only reason why we even stress over the LDL count is because of the faulty theory that got us into so much trouble int he first place. Imagine if they took CVD and heart attack statistics from a large group of Paleo only eaters. I'd wager a fair sum that the 'high' LDL count and 'high' total cholesterol would confound the so called experts. Just because high LDL and high TC has been associated with heart disease in group studies doesn't mean it's true for all, as I doubt very much the people studied had the same 'kind' of LDl and TC. It is highly likely that their diets were nowhere near appropriate, making these 'target numbers' to shoot for completely unreliable in my opinion.

What I am really saying is that I believe that if someone were testing cholesterol numbers from the cave man days, we'd likely see numbers similar to yours and many other Paleo peoples. A slightly elevated LDL (only known as "elevated" based on today's conventional standards") would probably have been the norm.

Cheers,

Jack Kronk

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