3

votes

High cholesterol from blood results - advice/analysis?

Answered on September 12, 2014
Created July 25, 2012 at 10:26 AM

Hi there, first time posting here.

I've had my first post-primal diet blood results back and the nurse was quite concerned about the massive jump in my cholesterol. To be honest, I kind of expected this and I'm not in panic mode but I'd like to see what other people make of my results.

Based on my own research, I think there is room for improvement but overall my results aren't something to worry about.

When speaking to the nurse, after asking her what she made of my results in terms of heart disease risk (this is in the UK, so based on NHS guidelines), she said initially that it would be deemed high risk but taking a holistic view of my overall health, recent weight loss and activity level, she said that I probably have nothing to worry about.

So, before I post the results, a little bit of background...I started eating a primal diet back in January, at a calorie deficit and very low carb (< 50g/day) in order to lose weight. This has put me in a state of ketosis for much of the last 6 months. I also intended to make the diet change a permanent one if it worked for me and so far I'd say it has.

Since January, I've lost 38lbs, dropping from 213lbs to 174lbs at a height of 5'11", a change on the BMI scale from 31+ to 24. I feel healthier and I'm happy with my weight loss. This was all achieved through my diet changes. I started lifting weights a month ago and started running again last week.

The bulk of my diet is meat, eggs and vegetables with a small amount of nuts and fruit and starches like sweet potato. I eat lots of greens. I don't get hung up about saturated fat and enjoy small amounts of full fat milk in my tea, double cream with my fruit, some cheese and full fat yogurt and I like to cook in a mixture of butter, ghee, coconut oil and olive oil depending on what I'm cooking.

I've cut grains out of my diet completely (I did eat the occasional bowl of oats in the first few months), most sugars (I still enjoy the occasional glass of red wine and some 85% cocoa dark chocolate) and all vegetable oils for the most part (I may occasional consume small amounts in the small amount of convenience food I eat, but generally I'm very careful about what I eat).

On to those results...(results in mmol/L, converted to mg/dl in parens)

Total cholesterol:   6.2 (240)
Serum triglycerides: 0.97 (86)
Serum HDL:           0.99 (38)
Serum LDL:           4.8 (185)
Total/HDL ratio:     6.26
HTL/LDL ratio:       0.2
Trigs/HDL ratio:     2.05

As you can guess, the nurse was concerned about the total and LDL levels. The LDL does seem high and I'm sure my HDL could do with being a bit higher but the trig levels look good.

For comparison, here is the results of my blood test from December 2011, a month before changing my diet (no trigs or LDL as it was not a fasted test):

Total cholesterol:   4.3 (166)
Serum triglycerides: N/A
Serum HDL:           0.78 (30)
Serum LDL:           N/A
Total/HDL ratio:     5.5

What do you think? Am I on the right course with my diet? Could I do with cutting back the saturated fat a little? I intend to move my carbs closer to the 100g/day mark once I hit my weight loss goals and scale back some of the fat to accomodate but I'll still be eating a largely high fat/moderate protein/low carb diet.

Looking forward to hearing people's opinions.

A968087cc1dd66d480749c02e4619ef4

(20436)

on July 26, 2012
at 04:35 PM

Oh, I think I understand you now, I will take back my down vote. I stand by cute, though.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 05:41 PM

DePaw: that's what confuses me. I eat no processed carbs and little in the way of sugars which probably explains my decent tri numbers. But I do consume a healthy amount of saturated fats, from meat, dairy and things like coconuts/avocados. Shouldn't my HDL be higher as a result?

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 05:39 PM

I'm unlikely to get a more detailed analysis at this stage. I can't even find companies offering a VAP test privately here in the UK. I continue to wonder if my rapid weight loss and ketogenic state s skewing the results. I'm due to have another test in 3 months. By that point I should have lost most of the fat I need to lose and would have been exercising regularly by then. I think my combination of lifting weights and running will have a positive effect. What do you think?

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 05:37 PM

I didn't actually see my Doctor, just a nurse. She didn't really know much TBH, beyond her NHS guidelines. She seemed pretty astonished I'd manage to lose weight at all on my high fat diet! I see that my tri/HDL ratio isn't far off from being good which is why I thought my HDL could do with going up a bit. I guess it would be good to get the LDL down a little, although I think my numbers indicate type A particle size.

F0119aaf2bbf794bdc0bd05136b8d604

(50)

on July 25, 2012
at 02:36 PM

This is why we can't always trust the internet (and our vegan friends, I guess). I happen to quite enjoy meat and am definitely not, nor will I ever become vegan.

A968087cc1dd66d480749c02e4619ef4

(20436)

on July 25, 2012
at 02:32 PM

Oh Betsy, Betsy, Betsy. You are way too cute to be such a troll! I will add that eating cholesterol essentially no effect on serum cholesterol levels. Besides, cholesterol is good for you. It is part of every cell membrane, a precursor to all steroid hormones, required in the skin for vitamin D manufacture from solar rays, and also made into bile for the digestion of fats. Our bodies need plenty of cholesterol. And it's implication in CHD/CVD is very weak. (Also saturated fat has been exonerated from causing CHD/CVD.) Google Uffe Ravskonov, Dr. Mike Eades, Chris Masterjohn or Anthony Colpo.

B8592e62f9804ddabae73c1103d6bcb9

(1956)

on July 25, 2012
at 02:00 PM

The most important ratio is tri/HDL, with ideal being under 2, which he almost is. Tri's are increased by sugars and processed carbs, and HDL is raised by saturated fats.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 01:15 PM

your trigs are ok. your TC is a bit high especially because your HDL is not. Your ratios (which I think is a better measure than magnitude measures) are not great. You need to work with your doctor to figure out what's going on and fix it. But before you do you need to get direct measures so you know what your true measures are.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 01:13 PM

The cholesterol we eat is NOT the same as the cholesterol our bodies produce. Cholesterol is required by all cell membranes and to produce steroid hormones and bile acids. Only about 20% of the cholesterol in our bodies is produced by the liver -- Most of the cholesterol we eat is esterified and cannot be unesterified released by the liver. That means that our diet can only effect about 5% of our TC numbers. Vegan/Vegetarian diets raise Trigs which (because it's a linear equation) make it appear LDL goes down. No direct measure study has EVER linked diet to a change in LDL.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 12:29 PM

I'm quite happy with my trig levels and I've read that low trigs/high LDL is an indication of pattern A LDL (the good kind). I am concerned about my HDL level though, I think it could do with being higher.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 12:27 PM

Yes, I am, but at a much slower rate after 7 months of loss.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 11:50 AM

it's scary. My friend was put on statins because his LDL was high, but his trigs were low. I told him he needed to get a direct measure -- yeah no statins his numbers are normal. Doctors are using a formula that they do not understand and making medical decisions by applying it where it is not appropriate.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 11:48 AM

LDL = TC - HDL - TG/2.17 (mmol/L) = 6.2-.99-.97/2.17=4.763

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 11:47 AM

Friedewald (for mg/dL) LDL = TC - HDL - TG/5.0 = 240-38-86/5= 184.8 . it's always rounded to a integer

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 11:46 AM

Actually, you are right. I just ran the numbers again and they were fairly close. I was mistakenly putting my mmol numbers through the formula.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 11:44 AM

Hi CD - how can you be sure that it is calculated rather than measured? I tried to apply the Friedewald formula to my numbers and they didn't match up.

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5 Answers

3
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 11:39 AM

luke, your results for LDL is based upon the Friedewald formula and is an estimate of the serum LDL. The Friedewald formula has been shown to be fairly accurate (and cheap since it's just a linear equation) for people with trigs between 110 and 350. Your Trigs are outside of the accepted bounds for the Friedewald formula.

In comparison, the Iranian formula (which is designed for trigs in 50-100 or 350-450) would suggest that your LDL is 174 (sorry I work in mg/dL you can convert back). That would put you on the low end of "high".

The first thing I would do is demand a direct measure of your LDL and VLDL levels. Once you know what your actual results are (i.e. not what a formula tells you) then you can discuss potential next steps with your doctor.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 11:46 AM

Actually, you are right. I just ran the numbers again and they were fairly close. I was mistakenly putting my mmol numbers through the formula.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 12:29 PM

I'm quite happy with my trig levels and I've read that low trigs/high LDL is an indication of pattern A LDL (the good kind). I am concerned about my HDL level though, I think it could do with being higher.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 11:47 AM

Friedewald (for mg/dL) LDL = TC - HDL - TG/5.0 = 240-38-86/5= 184.8 . it's always rounded to a integer

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 05:41 PM

DePaw: that's what confuses me. I eat no processed carbs and little in the way of sugars which probably explains my decent tri numbers. But I do consume a healthy amount of saturated fats, from meat, dairy and things like coconuts/avocados. Shouldn't my HDL be higher as a result?

B8592e62f9804ddabae73c1103d6bcb9

(1956)

on July 25, 2012
at 02:00 PM

The most important ratio is tri/HDL, with ideal being under 2, which he almost is. Tri's are increased by sugars and processed carbs, and HDL is raised by saturated fats.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 05:37 PM

I didn't actually see my Doctor, just a nurse. She didn't really know much TBH, beyond her NHS guidelines. She seemed pretty astonished I'd manage to lose weight at all on my high fat diet! I see that my tri/HDL ratio isn't far off from being good which is why I thought my HDL could do with going up a bit. I guess it would be good to get the LDL down a little, although I think my numbers indicate type A particle size.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 11:50 AM

it's scary. My friend was put on statins because his LDL was high, but his trigs were low. I told him he needed to get a direct measure -- yeah no statins his numbers are normal. Doctors are using a formula that they do not understand and making medical decisions by applying it where it is not appropriate.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 01:15 PM

your trigs are ok. your TC is a bit high especially because your HDL is not. Your ratios (which I think is a better measure than magnitude measures) are not great. You need to work with your doctor to figure out what's going on and fix it. But before you do you need to get direct measures so you know what your true measures are.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 11:44 AM

Hi CD - how can you be sure that it is calculated rather than measured? I tried to apply the Friedewald formula to my numbers and they didn't match up.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 11:48 AM

LDL = TC - HDL - TG/2.17 (mmol/L) = 6.2-.99-.97/2.17=4.763

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 05:39 PM

I'm unlikely to get a more detailed analysis at this stage. I can't even find companies offering a VAP test privately here in the UK. I continue to wonder if my rapid weight loss and ketogenic state s skewing the results. I'm due to have another test in 3 months. By that point I should have lost most of the fat I need to lose and would have been exercising regularly by then. I think my combination of lifting weights and running will have a positive effect. What do you think?

1
B8592e62f9804ddabae73c1103d6bcb9

(1956)

on July 25, 2012
at 01:56 PM

Your total blood cholesterol is not high, the doctor is wrong. Lowest all-cause mortality risk in between 200 and 240mg/dl total cholesterol: http://3.bp.blogspot.com/-pttFtp8eZx0/T3IFYTDzEwI/AAAAAAAAAQ8/Grmm-gHD1yI/s1600/CholesterolMortality.jpg

0
3cda0068be135e20d6328960fc403d49

on July 26, 2012
at 06:26 AM

Good day! Interesting article, if you're interested, here's another article on this topic http://www.howtolowercholesterol2.com/lower-cholesterol-through-diet.html.

0
Fc25b41326b954c4e5b8ce0dabb889a6

on July 25, 2012
at 12:06 PM

Also,

are you still losing weight on Primal/Paleo?

Blood lipids are going to be high when you're breaking down adipose tissue or using fat for energy.

Bdd4d23d1a822b2d68b53e7c51d69a39

on July 25, 2012
at 12:27 PM

Yes, I am, but at a much slower rate after 7 months of loss.

-4
F0119aaf2bbf794bdc0bd05136b8d604

on July 25, 2012
at 12:19 PM

Meats contain high levels of cholesterol. When I considered being vegan before switching to a mainly paleo diet, I read a lot about the negative aspect of meat, mainly that it has high amounts of cholesterol that your body does not need.

F0119aaf2bbf794bdc0bd05136b8d604

(50)

on July 25, 2012
at 02:36 PM

This is why we can't always trust the internet (and our vegan friends, I guess). I happen to quite enjoy meat and am definitely not, nor will I ever become vegan.

A968087cc1dd66d480749c02e4619ef4

(20436)

on July 25, 2012
at 02:32 PM

Oh Betsy, Betsy, Betsy. You are way too cute to be such a troll! I will add that eating cholesterol essentially no effect on serum cholesterol levels. Besides, cholesterol is good for you. It is part of every cell membrane, a precursor to all steroid hormones, required in the skin for vitamin D manufacture from solar rays, and also made into bile for the digestion of fats. Our bodies need plenty of cholesterol. And it's implication in CHD/CVD is very weak. (Also saturated fat has been exonerated from causing CHD/CVD.) Google Uffe Ravskonov, Dr. Mike Eades, Chris Masterjohn or Anthony Colpo.

A968087cc1dd66d480749c02e4619ef4

(20436)

on July 26, 2012
at 04:35 PM

Oh, I think I understand you now, I will take back my down vote. I stand by cute, though.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 25, 2012
at 01:13 PM

The cholesterol we eat is NOT the same as the cholesterol our bodies produce. Cholesterol is required by all cell membranes and to produce steroid hormones and bile acids. Only about 20% of the cholesterol in our bodies is produced by the liver -- Most of the cholesterol we eat is esterified and cannot be unesterified released by the liver. That means that our diet can only effect about 5% of our TC numbers. Vegan/Vegetarian diets raise Trigs which (because it's a linear equation) make it appear LDL goes down. No direct measure study has EVER linked diet to a change in LDL.

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