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Can someone please help me understand cholesterol numbers!!

Answered on August 19, 2014
Created February 03, 2013 at 3:30 AM

I am so confused about cholesterol numbers!! I just got a call today from my doctor's office with lab results that really shocked me. I expected a raise in Cholesterol numbers after going paleo but this scared me!

My total is a whopping 330 (up over 100 from last time 1.5 yrs ago) LDH:256 HDL:86 Tryglicerides (sp?): 67

How concerned should I be???

I am a 50 yr old female with family history of heart disease. I have been fairly strict paleo for 10 months. I eat no grains or dairy, eat mostly grassfed meats, low carb diet with fruits and veggies. Coconut oil/ghee used daily. Dropped almost 20 lbs to a perfect weight for me of 135lbs at 5'7". Feel mostly pretty good.

I realize there are many posts on cholesterol and numbers. Sorry for the redundancy of my question but should I be concerned? Doc wants me to go on a statin asap, I said no. I have been reading may posts on this site and others to try to make some sense of cholesterol numbers. Any thoughts on this will be appreciated.

My plan right now is to get exercising more (got fairly sedentary this winter)and have the test again in 3 months.

Thank you

Ea1bb0c24b59345463ef96880b6b27fc

(300)

on February 04, 2013
at 06:19 PM

Based on tests, my LDL rose from 7/10 through at least 2/11 after which I added more carbs. It peaked in 6/11 after which it began to fall as measured on 2/12 and continuing through 10/12. As I have said, it is not possible to know if was the additional carbs, the time elapsed, or some combination of both. I have also left a response to your original question from November.

D8612a7c536e74f9855b70d8e97919b5

(1042)

on February 04, 2013
at 03:06 PM

John: How long did it take your LDL to go down? I changed my diet to be somewhat lower in fat and higher in carbs over the past 6-7 months and in that time my LDL has gone from 220 to 180. LDL-P was very high (over 2000) when LDL-C was 220, so I'm hoping that LDL-P has gone down as well, but it wasn't checked last time.

Ea1bb0c24b59345463ef96880b6b27fc

(300)

on February 04, 2013
at 02:09 PM

As far as magnesium, you should be aware that these claims are based mainly on the work of a single individual who once wrote a pop science book on the subject. Almost every vitamin and mineral has at one time been touted as the "cure" for heart disease so beware.

Ea1bb0c24b59345463ef96880b6b27fc

(300)

on February 04, 2013
at 02:07 PM

I edited my answer to you in line with the new information. See above.

Medium avatar

(40)

on February 04, 2013
at 03:39 AM

oh very sorry!! I incorrectly stated my bp. it is 118/60

Medium avatar

(40)

on February 04, 2013
at 03:39 AM

Very sorry, I wrote the wrong BP number!! it is 118/60. never been a problem

Medium avatar

(40)

on February 04, 2013
at 03:28 AM

also, want to add, the calculator put me in a 1% risk factor. But as you said, this doesn't take family history into the equation.

Medium avatar

(40)

on February 04, 2013
at 03:25 AM

oh oops...sorry Jeff, meant to write 120 systolic

7fc82eebafd44badc73c520f44660150

(3275)

on February 04, 2013
at 01:05 AM

Great calculator! Thanks

D7cc4049bef85d1979efbd853dc07c8e

(4029)

on February 03, 2013
at 08:47 PM

I dont mean that iodine is toxic, but rather something the Perfect Health diet mentioned that if you ramp up iodine to fast there are cases of trouble. Iodine in fact appears to be very nontoxic and safe, something more than 80% of Americans are deficient in. One side effect of iodine supplementation is acne as iodine will begin competing with bromides in the body which the body will purge through sweat (you don't want bromides in the body it seems), so you may need to up your hydration and exercise if you start seeing any signs of the temporary acne.

D7cc4049bef85d1979efbd853dc07c8e

(4029)

on February 03, 2013
at 08:42 PM

Jeff's right about Brazil Nuts. Don't take more than two or three per day though, that's enough for your entire RDA of selenium. Iodine can be tricky, start supplementing low, like about 225 micrograms/day but work up to about 1 milligram/day.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on February 03, 2013
at 06:31 PM

Brazil nuts are high in selenium... You may also want to use some kelp granules as a seasoning for the iodine.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on February 03, 2013
at 06:29 PM

Suzanne that's pretty high... systolic BP over 130 is one of the criteria for metabolic syndrome

Medium avatar

(40)

on February 03, 2013
at 05:26 PM

Thank you for your definitions of the terms. Your response however doesn't sound like paleo eating to me.

Medium avatar

(40)

on February 03, 2013
at 05:25 PM

hmmm...I eat sea salt, thus not fortified with iodine. What are high selenium foods?

Medium avatar

(40)

on February 03, 2013
at 05:23 PM

thank you, I will try that

Medium avatar

(40)

on February 03, 2013
at 05:22 PM

Thank you for the magnesium link. That is very interesting. My blood pressure is 180/60 so no worries there.

Medium avatar

(40)

on February 03, 2013
at 05:21 PM

I will see about getting a thyroid done. I don't tend towards cold extremities. My meat sources include: Beef, pork, fish, chicken, lamb and shellfish, pretty much in that order.

Medium avatar

(10611)

on February 03, 2013
at 04:41 AM

The exercise should help drive systolic blood pressure down, if that's a problem.

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 03, 2013
at 04:15 AM

Interesting paper, Jeff.

4bd4e2fe6a095663f80c69656936e487

(744)

on February 03, 2013
at 03:54 AM

Also, what are the sources of your meats? Beef, lamb, chicken, pork?

4bd4e2fe6a095663f80c69656936e487

(744)

on February 03, 2013
at 03:53 AM

Did you also get a thyroid lab, including TSH numbers? Do you feel cold in the extremities sometimes (a symptom of hypothyroidism). According to Ray Peat, high cholesterol is almost always caused by hypothyroidism.

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5 Answers

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0
Ea1bb0c24b59345463ef96880b6b27fc

(300)

on February 03, 2013
at 08:34 PM

Welcome to the wonderful world of those eating Paleo diets and ending up with sky-high LDL! You are not alone and there are a myriad reports of this phenomenon on this forum alone. A common piece of advice which you have already received is that with high HDL and low Trigs, you have nothing to worry about. Yes, it is true that your Framingham Risk Score is very, very low but remember that these scores were not developed with a population with the levels of LDL being discussed here. To get an idea of where your LDL level puts you in the general public, see this:

http://www.wolframalpha.com/input/?i=ldl

You also don't know if this increase in cholesterol will continue as some have seen continuing increases with levels as high as an LDL of 463. The increased HDL and lowered TG's are part of a pattern that almost everybody with greatly increased LDL is reporting. Saying that there is nothing to worry about because of HDL/TG's is basically saying nobody has anything to worry about with this pattern.

However, the reality is that nobody knows what these levels of LDL mean in the context of a pale/lowcarb diet. The question you have to ask yourself is if you are willing to conduct this experiment on yourself, especially given that there is heart disease in your family? My opinion is that given the lack of understanding, it is prudent to make an attempt to bring down LDL from these levels to something more in line with what is better understood.

So, the question becomes what to do? You are already getting some of the standard answers often given. For example, there is the idea that if your LDL is high, then likely there is something wrong with your thyroid. However, since you are not reporting any symptoms of hypothyroidism, it would have to be subclinical (SHT) and research that looked at SHT and cholesterol:

http://www.ncbi.nlm.nih.gov/pubmed/16789979 (paywall)

found only "slightly elevated TC and LDL-C levels in subjects with SHT." Therefore, it is highly unlikely that an LDL increase of 100+ has anything to do wit SHT even if it exists.

That said, there may be something to the idea that very lowcarb diets (VLC) may in some people depress T3 (Triiodothyronine) without any thyroid dysfunction per se. Emily Dean, an MD, had this to say:

"Starvation, fasting, or a very low carb diet can tend to lead to low TSH, normal or slightly elevated free T4, and low T3. There is nothing wrong with the thyroid and this is not "hypothyroidism" per se, but a normal physiologic response to perceived starvation, and it should resolve without other intervention once someone stops fasting or increases carbohydrate intake."

You should realize that one of the phenomenon common to starvation (and anorexia) is elevated LDL cholesterol. Given that, I wonder why you are continuing to eat a low carb diet although you haven't said how low that is. While temporary lowcarb may have some therapeutic value in situations like Metabolic Syndrome, there is no evidence to suggest that it is of value over the long term or for those without any health issues to address. You might think about starting to add potatoes, bananas, and other such food or even, horrors, grains if you are not truly intolerant or have Celiac.

The other issue to address is fat intake, both the level and kinds. Some people are "hyper-responders" to certain saturated fats so you might think about substituting more mono=saturated fats for cooking such as olive oil (forget the nonsense about it oxidating when heated). If you are adding large amounts of fat to meals (Bulletproof Coffee for example), you should likely stop that as there is no reason to be adding large amounts of additional fats to your diet.

The bottom line is that there is no real mystery here. You changed your diet and your cholesterol shot up. It doesn't happen to everybody but it happens to some. You can certainly choose to do nothing and it maybe that the situation will resolve itself over time. However, in the meantime, you will not be hurting yourself and likely helping by modifying your diet along the lines I have outlined. This doesn't mean you have to abandon what you are doing. Rather, you would only be modifying things given the situation you are in and the lack of knowledge about what it means.

Following these principles, I saw my LDL go from 330 to 180 at last count with probably an LDL-P of even lower although I need to confirm that. This was without the use of any supplements or thyroid medications.

Medium avatar

(40)

on February 04, 2013
at 03:39 AM

oh very sorry!! I incorrectly stated my bp. it is 118/60

Ea1bb0c24b59345463ef96880b6b27fc

(300)

on February 04, 2013
at 06:19 PM

Based on tests, my LDL rose from 7/10 through at least 2/11 after which I added more carbs. It peaked in 6/11 after which it began to fall as measured on 2/12 and continuing through 10/12. As I have said, it is not possible to know if was the additional carbs, the time elapsed, or some combination of both. I have also left a response to your original question from November.

D8612a7c536e74f9855b70d8e97919b5

(1042)

on February 04, 2013
at 03:06 PM

John: How long did it take your LDL to go down? I changed my diet to be somewhat lower in fat and higher in carbs over the past 6-7 months and in that time my LDL has gone from 220 to 180. LDL-P was very high (over 2000) when LDL-C was 220, so I'm hoping that LDL-P has gone down as well, but it wasn't checked last time.

Ea1bb0c24b59345463ef96880b6b27fc

(300)

on February 04, 2013
at 02:07 PM

I edited my answer to you in line with the new information. See above.

6
64433a05384cd9717c1aa6bf7e98b661

(15236)

on February 03, 2013
at 03:55 AM

I wouldn't freak out (because of your high HDL and low trigs), but I'd certainly exercise, as well as get a full thyroid panel done, and talk to your doc about supplementing with magnesium.

If they ask why you can send them this paper discussing how magnesium can do what statins do.

http://www.ncbi.nlm.nih.gov/pubmed/15466951

and another broad overview

http://nutritionalmagnesium.org/research/heart-health/409-magnesium-deficiency-linked-to-heart-disease.html

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on February 03, 2013
at 04:15 AM

Interesting paper, Jeff.

Medium avatar

(40)

on February 03, 2013
at 05:22 PM

Thank you for the magnesium link. That is very interesting. My blood pressure is 180/60 so no worries there.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on February 03, 2013
at 06:29 PM

Suzanne that's pretty high... systolic BP over 130 is one of the criteria for metabolic syndrome

Ea1bb0c24b59345463ef96880b6b27fc

(300)

on February 04, 2013
at 02:09 PM

As far as magnesium, you should be aware that these claims are based mainly on the work of a single individual who once wrote a pop science book on the subject. Almost every vitamin and mineral has at one time been touted as the "cure" for heart disease so beware.

Medium avatar

(40)

on February 04, 2013
at 03:39 AM

Very sorry, I wrote the wrong BP number!! it is 118/60. never been a problem

Medium avatar

(40)

on February 04, 2013
at 03:28 AM

also, want to add, the calculator put me in a 1% risk factor. But as you said, this doesn't take family history into the equation.

Medium avatar

(10611)

on February 03, 2013
at 04:41 AM

The exercise should help drive systolic blood pressure down, if that's a problem.

Medium avatar

(40)

on February 04, 2013
at 03:25 AM

oh oops...sorry Jeff, meant to write 120 systolic

4
Medium avatar

(10611)

on February 03, 2013
at 04:36 AM

Run your numbers through this. Use 320 for your total, since that's as high as it goes. http://hp2010.nhlbihin.net/atpiii/calculator.asp

The Framingham study is the best predictor I know of for CV risk. It gives a lot of weight to having low systolic blood pressure and high HDL. And being female. It doesn't factor in familial tendency though.

Medium avatar

(40)

on February 03, 2013
at 05:23 PM

thank you, I will try that

7fc82eebafd44badc73c520f44660150

(3275)

on February 04, 2013
at 01:05 AM

Great calculator! Thanks

0
D7cc4049bef85d1979efbd853dc07c8e

(4029)

on February 03, 2013
at 05:06 AM

I'd suggest getting your thyroid levels checked. Thyroid hormone is used to activate LDL uptake with cells. Poor thyroid hormone could mean poor recycling of LDL leading to an abundance of LDL in your blood. You could try supplementing iodine and eating high-selenium foods.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on February 03, 2013
at 06:31 PM

Brazil nuts are high in selenium... You may also want to use some kelp granules as a seasoning for the iodine.

D7cc4049bef85d1979efbd853dc07c8e

(4029)

on February 03, 2013
at 08:42 PM

Jeff's right about Brazil Nuts. Don't take more than two or three per day though, that's enough for your entire RDA of selenium. Iodine can be tricky, start supplementing low, like about 225 micrograms/day but work up to about 1 milligram/day.

D7cc4049bef85d1979efbd853dc07c8e

(4029)

on February 03, 2013
at 08:47 PM

I dont mean that iodine is toxic, but rather something the Perfect Health diet mentioned that if you ramp up iodine to fast there are cases of trouble. Iodine in fact appears to be very nontoxic and safe, something more than 80% of Americans are deficient in. One side effect of iodine supplementation is acne as iodine will begin competing with bromides in the body which the body will purge through sweat (you don't want bromides in the body it seems), so you may need to up your hydration and exercise if you start seeing any signs of the temporary acne.

Medium avatar

(40)

on February 03, 2013
at 05:25 PM

hmmm...I eat sea salt, thus not fortified with iodine. What are high selenium foods?

-3
23f701386ac9e4ccc6767b627c5e3abf

on February 03, 2013
at 10:04 AM

Firstly, to explain the terms, LDL stands for Low Density Lipoprotein and HDL for High Density Lipoprotein. In simpler terms, bad cholesterol and good cholesterol respectively. Ideally, your LDL should be less than 120 and you HDL should be more than 50. Triglycerides are the chemical form of fat in the body and should normally be less than 150. While your HDL and triglyceride levels are ideal, your LDL level is a cause for concern. So it is time for you to start working out rigorously, avoid saturated fats, and eat more foods rich in fiber.

Medium avatar

(40)

on February 03, 2013
at 05:26 PM

Thank you for your definitions of the terms. Your response however doesn't sound like paleo eating to me.

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