1

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Celiac --> low cholesterol. Giving up gluten --> higher cholesterol?

Answered on March 14, 2015
Created August 17, 2013 at 7:00 PM

I'm currently reading Celiac Disease: A Hidden Epidemic by Dr. Peter Green. In it he states: "Patients with active celiac disease tend to have low cholesterol levels because they are not properly absorbing cholesterol in the intestine."

That made a light bulb go off in my head. A small but substantial subset of people (I'm one) have their total and LDL cholesterol skyrocket when they transition to a paleo diet. Could this be a result of gut health improving when people stop eating gluten? The large majority of celiacs are undiagnosed, plus a lot of people have health issues before going paleo, which could be caused by undiagnosed celiac.

So here's my theory:

  1. Undiagnosed or poorly-controlled celiacs have malabsorption in the gut due to villous atrophy.

  2. This leads to low serum cholesterol levels (http://www.ncbi.nlm.nih.gov/pubmed/19660152).

  3. Upon going paleo and giving up gluten, the villi heal and absorption improves.

  4. Cholesterol levels go up.

I've never heard this theory floated as a reason for cholesterol levels to rise after transitioning to a paleo diet. What say ye, Paleohackers? Plausible or dubious?

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on August 18, 2013
at 05:10 PM

When you say your thyroid is fine, how low is your FT3? And exactly how high are your TC and LDL. And the question regarding your reading of ApoE3/3, is did you get that tested recently? I've been realizing that 2/3 of people who get their results read them incorrectly.

F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 18, 2013
at 02:14 PM

Oh, I see. But you cannot test gluten intolerance through stool anyway. I am just trying to say that somehow celiac and altered gut flora are connected. Not sure how to tie it to cholesterol.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 12:21 PM

I haven't eaten enough wheat for 4 years to test positive for celiac even if I had it (and now I'm eating none), and I'm not willing to do a gluten challenge. I have very few symptoms that could be attributable to celiac anyway. My question was mostly theoretical.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 12:04 PM

I was under the impression it was due to malabsorption of fat.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 12:03 PM

No need to be snarky. Obviously he thinks it matters, otherwise he wouldn't have written a whole book about it.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 11:57 AM

I was under the impression it was due to malabsorption of fat. However, I dug into the study cited above and found this: "Intestinal malabsorption, reduced cholesterogenesis, increased biliary secretion and/or high faecal elimination of cholesterol have all been proposed as mechanisms which might lower total cholesterol in people newly diagnosed with coeliac disease in comparison to the general population(18–20). However, the lack of increase in total cholesterol with treatment of coeliac disease suggests that any mechanism based on intestinal malabsorption is less likely." On the other hand,

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 11:24 AM

Good point, but it leaves my mystery unsolved. My cholesterol is in the ranges you described (high TC & LFL, high apoB, high HDL, very low TG). My thyroid checks out fine, I have no major inflammation or autoimmune issues, and I'm ApoE 3/3 (I did 23andme to find out my ApoE status because of my high LDL). I think there are plenty of people in my situation who can't find a nice neat reason why their LDL went up.

72cf727474b8bf815fdc505e58cadfea

on August 18, 2013
at 01:57 AM

Don't we typically argue that dietary cholesterol is relatively unimportant to serum cholesterol levels? So why would cholesterol malabsorption lead to hypocholesterolemia?

F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 17, 2013
at 08:20 PM

It is not that expensive to get your stool tested. But I would highly recommend you doing so if you have any indication you might be gluten intolerant.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 17, 2013
at 08:18 PM

Actually, I don't have celiac, at least I don't think I do. So many people are undiagnosed, so it's hard to be sure without testing. But I recently found out through 23andme that I carry both "celiac genes", so I have cut out the very small amount of wheat that I was still eating.

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8 Answers

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0
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on August 18, 2013
at 03:37 AM

I can understand such peoples' lipids going back up to normal levels gradually as their villus atrophy heals and you get your villi back but why would they skyrocket to FH levels? The reason for that usually has to do with FT3 getting low or ApoE4 genes acting up or some unknown micronutrient deficiency. We're talking about going way above 250-300 TC and 150-200 LDL upon doing HFLC Paleo. If they were Celiacs, they wouldn't all of a sudden react to saturated fat. There are enough plausible theories out there now to account for high cholesterol when doing high fat Paleo.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on August 18, 2013
at 05:10 PM

When you say your thyroid is fine, how low is your FT3? And exactly how high are your TC and LDL. And the question regarding your reading of ApoE3/3, is did you get that tested recently? I've been realizing that 2/3 of people who get their results read them incorrectly.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 11:24 AM

Good point, but it leaves my mystery unsolved. My cholesterol is in the ranges you described (high TC & LFL, high apoB, high HDL, very low TG). My thyroid checks out fine, I have no major inflammation or autoimmune issues, and I'm ApoE 3/3 (I did 23andme to find out my ApoE status because of my high LDL). I think there are plenty of people in my situation who can't find a nice neat reason why their LDL went up.

1
14b8422e9b449a21e06fa3349953d4f7

on August 17, 2013
at 07:13 PM

That sounds logical but not only is it meaningless because it will eventually go back down to normal after your body adjusts the amount of cholesterol it produces, but even if it stayed high, you have a greater chance of heart problems being caused by inflammation than because of high cholesterol

0
170cff022d5124696273dfc4109c0596

on March 14, 2015
at 03:39 PM

Annika, I was searching for the connection between low cholesterol and gluten intolerance. I found your question and created an account just to respond to it.

I gave up gluten two years ago -- I don't know if I'm celiac or not, but I'm also unwilling to eat gluten again in order to be tested. I gave it up to clear up brain fog. What happened was my anxiety went down notably. (Still have anxiety, of course, but no longer bad mental panic attacks.) Also some digestive problems lessened.

I have also given up dairy and greatly reduced my grain and sugar intake. (Not fully Paleo, but I eat a lot of Paleo meals. Still need to work on the sugar part, too, but it's better.)

I just got bloodwork back and found my cholesterol went up, too, by 34 points. It's now in the middle of normal range. Three years ago when I was last tested my cholesterol was bordering on low (1 point in range). And it had always been on the low end of normal. It has never, ever been in mid-range. All my cholesterol levels (hdl, triglicerides) are better, too.

I was just looking up low cholesterol and saw a link between low cholesterol and celiac disease -- as well as anxiety and depression! Of course then I saw a lot of stuff linking high cholesterol and celiac disease. I'm guessing it's one of those things that can go one way or the other. But I'm fully believing that my giving up gluten (and maybe some other dietary changes) has made my cholesterol higher -- higher as in a healthy way.

So I'm no doctor or health expert but based on my own health, my beliefs on this sync up with yours.

0
Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 12:18 PM

Okay, I think I leaped into this theory without doing my homework.

I dug into the study I cited above and found this:

Intestinal malabsorption, reduced cholesterogenesis, increased biliary secretion and/or high faecal elimination of cholesterol have all been proposed as mechanisms which might lower total cholesterol in people newly diagnosed with coeliac disease in comparison to the general population(18–20). However, the lack of increase in total cholesterol with treatment of coeliac disease suggests that any mechanism based on intestinal malabsorption is less likely.

On the other hand, the authors go on to suggest that the rise in HDL seen after 12 months on a gluten-free diet was due to reduction in intestinal or systemic inflammation. Also, TC didn't change (LDL was not reported, but if HDL went up, LDL must have gone down).

Another study showed:

a gluten-free diet results in a TC increase that is primarily the result of a substantial increase in HDL-C in both men and women and, to a lesser extent, the result of an increase in LDL-C in men but not in women.

So, my theory seems to be poorly supported by available data! Oh well.

0
197651282ddd8d675b974ee811d2269e

on August 18, 2013
at 05:05 AM

Interesting theory but this was not the case for me. My TC was 290 (very high) before Paleo when I had a severe gluten allergy and many digestive issues and stayed there after about a year of Paleo. The lipid profile changed, though.

Before/ after 1 yr of Paleo (except for trig, all other numbers were high) TC 290/290 HDL 69/90 LDL 188/150 Trig 207/130

But then my whole family has high cholesterol so it could be a genetic disposition.

0
04a4f204bc2e589fa30fd31b92944549

(975)

on August 18, 2013
at 12:06 AM

This makes a lot of sense to me. I have celiac disease but I'm too young for them to want to check my cholesterol so I don't know. I did have fat malabsorption, which is cured now.

0
F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 17, 2013
at 07:58 PM

It makes sense to me, but I am not a scientist.

However, since you are celiac, I highly highly highly recommend getting a stool test for gut flora/dysbiosis, preferably the genetic one. My personal theory is that celiac develops when our gut flora deteriorates.

I recommend Genova GI effects. If you see that your flora is out of whack, that's the first thing you need to work on.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 17, 2013
at 08:18 PM

Actually, I don't have celiac, at least I don't think I do. So many people are undiagnosed, so it's hard to be sure without testing. But I recently found out through 23andme that I carry both "celiac genes", so I have cut out the very small amount of wheat that I was still eating.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 12:21 PM

I haven't eaten enough wheat for 4 years to test positive for celiac even if I had it (and now I'm eating none), and I'm not willing to do a gluten challenge. I have very few symptoms that could be attributable to celiac anyway. My question was mostly theoretical.

F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 17, 2013
at 08:20 PM

It is not that expensive to get your stool tested. But I would highly recommend you doing so if you have any indication you might be gluten intolerant.

F5a0ddffcf9ef5beca864050f090a790

(15515)

on August 18, 2013
at 02:14 PM

Oh, I see. But you cannot test gluten intolerance through stool anyway. I am just trying to say that somehow celiac and altered gut flora are connected. Not sure how to tie it to cholesterol.

-2
Dba4686e589eb5ce6bb2d69a9a0036c7

on August 18, 2013
at 12:39 AM

Jimmy Moore says cholesterol doesn't matter. Case closed.

Bcb2f5436d11467e89123680c046b858

(1356)

on August 18, 2013
at 12:03 PM

No need to be snarky. Obviously he thinks it matters, otherwise he wouldn't have written a whole book about it.

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