1

votes

Disappointing test results. What to do?

Answered on August 19, 2014
Created November 19, 2012 at 2:56 PM

Just ran my 1st NMR test after 18+ months on Paleo and it is disappointing to say the least.

Total Cholesterol - 297 mg/dL
HDL-C - 51 mg/dL
LDL-C - 231 mg/dL
Triglycerides - 77 mg/dL

HDL-P - 31.8 (LOW)
LDL-P - 2565 (VERY HIGH)
Small LDL-P  - 883 (HIGH)

CRP-hs - 0.55 mg/L
Vitamin D, 25-hydroxy  41.2 ng/mL

So only two good measurements - Trigs and CRP. The rest makes me worry. Also disappointed in Vitamin D measurements - last year it was 57ng/dL with Now Foods 5000IU/d gelcaps, this year I tried to follow Rob Wolf's advice with liquid D drops by Carlson (8000IU/d) and it dropped. I thought they drops were better, guess not.

Also ran a thyroid panel, seems okay. TSH 2.07 T4, Free 1.59 ng/dL T3, Free 3.1pg/mL RT3 17.1ng/dL RT3 Ratio 18.1.

So far I've lost ~30 pounds in 18 months (252). Doing 1-2 weight lifting sessions every week, bicycle ~20-30 miles/week in last 2 months. Diet is strict Paleo with ocasional fruits (1 apple/pear/grapefruit a day), no grains, no legumes. But I eat heavy cream with coffee, greek yogurt, grass-fed butter, kefir.

So I wonder, what's the cause of this sky high LDL and what do do about it?

244dca88091fa349a77379b1629d0b25

(255)

on February 21, 2013
at 08:24 PM

D.K., that cholesterol support formula you recommended is not good. It contains unbound phystosterols which simply replace the regular cholesterol. Yes, your cholesterol lab test numbers go down, simply because phytosterols are not detected or counted by regular lab tests, but the risk stays the same as they contribute to the artery plaque formation just as the regular cholesterol does.

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 24, 2012
at 06:44 PM

I am Apo E 3/4.

7b20db75b09540914bd0c852e868a9d6

(454)

on December 13, 2012
at 11:40 AM

Flourishing, I agree that nuts probably weren't in the cavemen's diet by the roasted, salted, handful. but the only thing that concerns me is nixing another food group- a lot of us have already cut out so many: dairy, grain, legumes, etc. Eventually we're going to be avoiding everything but broccoli.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on December 13, 2012
at 04:08 AM

Do you know what they are? E3E4 or E2E4?

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 12, 2012
at 07:31 AM

I'd drop the dairy, and retest in a few months. Some of us are really sensitive to it.

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 12, 2012
at 07:29 AM

I dunno, the ApoE4 thing is tricky. It is certainly worth playing around with to see if he can tweak it, but I have one copy of it, and my LDL goes down on a higher fat diet.

77877f762c40637911396daa19b53094

(78467)

on December 12, 2012
at 07:19 AM

The biggest thing we all do wrong is that we eat nuts. First of all, humans weren't really inteded to eat nuts even if caveman did, second of all the majority of nuts are roasted in today's environment to prevent salmonella. Roasting destabalizes fat, and that will certainly ruin your cholesterol results.

7b20db75b09540914bd0c852e868a9d6

(454)

on November 19, 2012
at 10:12 PM

@Britt & D.K., I agree, they certainly wouldn't be slathering everything in coconut oil.

2e777bbcd49262eb31a24f821abec6bc

(1974)

on November 19, 2012
at 07:33 PM

I've been wondering if we get a bit carried away with the fat. I mean they wouldn't be loading their foods with coconut oil and butter. They would be eating lots of raw fruits and veggies and meat right? That wouldn't be the high fat diet more paleo people tend towards.

531b053b68e92ac509fc1544f88dc103

(1205)

on November 19, 2012
at 05:16 PM

I agree. When you consider that primitive human tribes have an average of 105mg/dl to 130mg/dl total cholesterol, it makes me wonder what people are doing wrong in this paleo diet.

244dca88091fa349a77379b1629d0b25

(255)

on November 19, 2012
at 04:33 PM

Grass-fed beef, fish (wild sardines, wild of farmed salmon), eggs and plenty of veggies. About 5-10% carb, 20-25% protein, 65-75% fat.

244dca88091fa349a77379b1629d0b25

(255)

on November 19, 2012
at 04:30 PM

Taking 2 caps of LEF Mega DHA. I did some calorie counting and the n3:n6 ratios are about 1:3-1:4, less than 10g of PUFAs a day. Tried 500mg slo-niacin for ~6 month without any result.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on November 19, 2012
at 04:14 PM

WHy do you think it's hard to get enough omega 3s without supplementing? How many do we need in the context of a low n-6 diet?

531b053b68e92ac509fc1544f88dc103

(1205)

on November 19, 2012
at 03:07 PM

http://www.swansonvitamins.com/lee-swanson-signature-line-healthy-cholesterol-support-formula-120-sgels

531b053b68e92ac509fc1544f88dc103

(1205)

on November 19, 2012
at 03:06 PM

I have very low, stubborn HDL and high LDL cholesterol too so I take Swanson's cholesterol lowering supplement. It keeps my total cholesterol down to around 130 isntead of 200+ while my HDL stays exactly the same. This way, I can improve my HDL/LDL ratios. I also take 100mcg of vitamin K2 MK7 to prevent plaque build up in my arteries. Sometimes food can't fix everything - paleo or not.

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8 Answers

2
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on November 20, 2012
at 05:41 AM

3 letters: SNP = single nucleotide polymorphism. TC and LDL skyrocket on a high fat diet for ApoE4. I would cut down on dairy, butter, eggs and introduce some tubers, white rice, if you prefer, then retest. I've seen this so often now that it's really no surprise. 25% of the population is E4 either homo or heterozygously. Decrease your fat by increasing carbs and see where that gets you. If you respond, I'm 90% sure you will, then it's your genes.

Your issue is your high LDL-P. At that level, it could be atherogenic and trump the particle size caveat. The large LDL particles are atherogenic as well if they're aplenty. HDL not high enought to be really protective given TC ~ 300. Also, you haven't been losing weight rapidly enough to have those numbers go up significantly. Your thyroid #s are generally ok but it depends on your symptoms. Ft3 just a bit low and so is Ft3/Rt3. I wouldn't worry if no symptoms.

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 12, 2012
at 07:29 AM

I dunno, the ApoE4 thing is tricky. It is certainly worth playing around with to see if he can tweak it, but I have one copy of it, and my LDL goes down on a higher fat diet.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on December 13, 2012
at 04:08 AM

Do you know what they are? E3E4 or E2E4?

6120c989fd5b69f42a0834b69b87955b

(24553)

on December 24, 2012
at 06:44 PM

I am Apo E 3/4.

2
3b0b95dfc6dc5c18e535945f4aab0866

on November 19, 2012
at 04:09 PM

Your CRP is very low. Your trigs are low. Your HDL is getting close to the recommended number of >60 Your small LDL particles are 25% of the overall LDL particles, meaning most of them are large LDL which is good.

Even your VitaD is good.

Even your total cholesterol is not really bad - only statin companies and doctors confused or paid by them would have a problem with that number. Total cholesterol is factually not relevant, only hdl/trig ratio and crp, and you have better than most there.

2
64433a05384cd9717c1aa6bf7e98b661

(15236)

on November 19, 2012
at 03:52 PM

Dairy can really drive up cholesterol levels in some people. Try getting rid of it (substitute coconut and olive oils perhaps), and see what the numbers do.

From Paleohacks' greatest hits collection....

http://paleohacks.com/questions/36855/i-think-i-may-have-figured-out-why-some-of-us-have-really-high-ldl#axzz2CgZmZOh3

1
F1e6b44b47498c0c40e7311f8f882787

(10)

on November 20, 2012
at 01:30 AM

If you are still losing weight your lipids will not be accurate. Wait until weight is stable for 90 days and retest.

1
7b20db75b09540914bd0c852e868a9d6

(454)

on November 19, 2012
at 05:00 PM

seeing those numbers (and other's posts) after such a long time on Paleo kinda makes you think, what if we're wrong, too?

7b20db75b09540914bd0c852e868a9d6

(454)

on November 19, 2012
at 10:12 PM

@Britt & D.K., I agree, they certainly wouldn't be slathering everything in coconut oil.

531b053b68e92ac509fc1544f88dc103

(1205)

on November 19, 2012
at 05:16 PM

I agree. When you consider that primitive human tribes have an average of 105mg/dl to 130mg/dl total cholesterol, it makes me wonder what people are doing wrong in this paleo diet.

2e777bbcd49262eb31a24f821abec6bc

(1974)

on November 19, 2012
at 07:33 PM

I've been wondering if we get a bit carried away with the fat. I mean they wouldn't be loading their foods with coconut oil and butter. They would be eating lots of raw fruits and veggies and meat right? That wouldn't be the high fat diet more paleo people tend towards.

77877f762c40637911396daa19b53094

(78467)

on December 12, 2012
at 07:19 AM

The biggest thing we all do wrong is that we eat nuts. First of all, humans weren't really inteded to eat nuts even if caveman did, second of all the majority of nuts are roasted in today's environment to prevent salmonella. Roasting destabalizes fat, and that will certainly ruin your cholesterol results.

7b20db75b09540914bd0c852e868a9d6

(454)

on December 13, 2012
at 11:40 AM

Flourishing, I agree that nuts probably weren't in the cavemen's diet by the roasted, salted, handful. but the only thing that concerns me is nixing another food group- a lot of us have already cut out so many: dairy, grain, legumes, etc. Eventually we're going to be avoiding everything but broccoli.

0
6c75689340db7a8e128af148465f5205

on December 12, 2012
at 04:33 AM

Coming from a guy with outrageous numbers (way worse than yours) I am also looking for answers. Someone sent me this article that makes a very convincing argument that the LDL Particle count is the number you should be the most concerned with.

http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-i

It's a really long article and some of it's pretty technical, but I think it's worth the read. Also, you might want to listen to this Livin La Vida Low Carb show with Dr. Thomas Dayspring

http://www.askthelowcarbexperts.com/2012/10/29-dr-thomas-dayspring-cholesterol-testing-what-matters-most/.

0
2e777bbcd49262eb31a24f821abec6bc

(1974)

on November 19, 2012
at 04:05 PM

Do you eat mostly meat or mostly veggies? Usually high veggie diets drive cholesterol down. I try to eat a huge salad a day to load myself with raw veggies. I of course include meat too but think that a healthy ratio of the two should be kept.

244dca88091fa349a77379b1629d0b25

(255)

on November 19, 2012
at 04:33 PM

Grass-fed beef, fish (wild sardines, wild of farmed salmon), eggs and plenty of veggies. About 5-10% carb, 20-25% protein, 65-75% fat.

0
D112d09497fca43ce4e68b2300942eca

on November 19, 2012
at 03:52 PM

Do you watch your Omega 3:6 ratio? Its really hard to get enough Omega 3's without supplementing. I would suggest trying a good Krill Oil supplement and taking Niacin (the flushing kind). My theory is we use to get most of the goodness of Krill Oil from eating insects, so unless you're willing to eat a few handfuls of insects each day I think supplementing is probably necessary.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on November 19, 2012
at 04:14 PM

WHy do you think it's hard to get enough omega 3s without supplementing? How many do we need in the context of a low n-6 diet?

244dca88091fa349a77379b1629d0b25

(255)

on November 19, 2012
at 04:30 PM

Taking 2 caps of LEF Mega DHA. I did some calorie counting and the n3:n6 ratios are about 1:3-1:4, less than 10g of PUFAs a day. Tried 500mg slo-niacin for ~6 month without any result.

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