Familial Hypercholesterolemia? Probably, what now?

Answered on June 06, 2014
Created June 05, 2014 at 3:35 PM

My story, my numbers....(this is a bit long, but any advice/resources are appreciated. This is all very confusing and frustrating. Every time I try to improve my health it gets worse!)

My dad has FH. Triple bypass surgery at 30. Numerous procedures since and drugs, of course. His cousin had one (bypass) at 18. His dad died of heart attack in his 50's, his uncle at 32, while bending over to tie his shoe.

Four years ago I was vegetarian (gasp, I know) and had been for 14 years since I was 20. Ate lots of whole grains, veggies, little dairy (sometimes vegan), never any eggs. After three pregnancies and nursing three children, I felt depleted. I got cholesterol tested, numbers normal enough. (See them below)

After third pregnancy got turned on to WAPF. Consumed meat, eggs, raw dairy, organs, gelatin. Switched to only coconut and olive oil and lard/animal fat from pastured animals. Took FCLO (cod oil), probiotics, fermented foods, eliminated dairy and drastically reduced grains. Felt better, but not great. Suffered many digestive issues, started taking Hydrochloric Acid.

Last summer I went close to full Paleo. No dairy, no grains, no sugar, no beans, a few nuts. Also did HIIT workouts 2x week, sprints 1x week, walking and farming. After 2.5 months, I was gaining weight (already about 25lbs over, especially thighs,belly, hips, bum). I figured something was not right. Tried to be more ketogenic, high fat, less carb....did not feel well.

I employed the help of a WAPF/Paleo friend who is a nutritionist/metabolic typing expert. She had me do blood work. My LDL jumped 100 points in the four years since leaving vegetarianism! She had me do a modified GAPS. Suspected leaky gut/inflammation. Two months later we retested to see if the LDL was a lab error. Also did a NMR. Here are all the numbers. First vegetarian, second 4 years later, experimenting with different variations of Paleo/WAPF and third after 4 Weeks modified GAPS (mostly stew, well cooked veggies/bone broth, very little dairy, less animal fat,)

Total cholesterol 199 to 294 to 312

Triglycerides. 74 to 65 to 45

HDL 45 to 43 to 42

LDL. 139 to 238 to 261

Total to HDL ratio 4.4 to 6.8 to 7.4

Then the NMR only taken once, most recently.

VLDL. 13

LDL-P 2541

Small LDL-P. 564

Large VLDL <.8

Large LDL P. 4.2

LDL size. 21.1

HDL size 8.6

VLDL. Too low to measure

LP-IR score. 38

I know I have to get thyroid tests done, before completely assuming FH, but I am looking all all possible protocols. Thanks!

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2 Answers



on June 06, 2014
at 10:15 AM

I really hate to say this, but if FH has been confirmed, and nothing else works, this condition is likely the only place where statins should be used. :( If you go this route, lots of Co-Q10 is required, the doctors won't normally tell you that part.


on June 05, 2014
at 04:55 PM

I don't have much to suggest but following a few trends i've seen in other people - being high on fat, perhaps mainly animal fat, can make LDL jump up quite high, a few people say this is irrelevant to CVD, more people say it is relevant. So high fat may not be ideal, but increasing your carbs, going more 'veggie' may drop your LDL/LDL-P down but could mean more small LDL-P.

I need to bring down LDL myself drastically, but i'm quite intolerant of carbs so it's a difficult position to be in. At the moment i'm slowly adding in more carbs, mostly veggies, some starch, and switching to plant fats but finding it hard to give up butter/ghee which seems to be the worst for raising LDL in those prone to high cholesterol.

I love how I feel eating ketogenic, but it appears some people can go too high on fat and need to strike a balance.

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