3

votes

High LDL, Tryglicerides and Uric Acid

Answered on September 12, 2014
Created December 16, 2011 at 10:55 AM

Hi folks!

This is my first question here. I've recently received my blood test. I've been following pretty much a paleo diet (with a few cheats now and then) and I'm a little bit alarmed regarding my lipid profile. The names are in Spanish but I think they are pretty similar to English.

Here it is:

alt text

CGT stands for Gamma-glutamyl Transpeptidase (I think)

My tryglicerides seems to be a little bit high, as well as my LDL and Uric Acid. I'm not particularly worried about total cholestelerol level, but the ratio seems to me not so good.

I do not eat grains (almost) and I eat dairy (cheese) quite often.

One day before the testing I fasted for 18 hours more or less.

What are your thoughts about them? How can I improve the ratios?

EDIT AFTER SOME RESEARCH

I've been resesarching this a little bit further. It seems to me that it could be related to a genetic intolerance to saturated fat. ApoE gene could be a explanation as posed by Dr. Davis.

In my analisys ketone bodies were 50 and my glucose is 60 so I assume that I'm on ketosis and somehow my cells are not able to handle all this lipids. For those of you interested here are two articles that explains this:

Low Carb Paleo, and LDL is Soaring ??? Help! http://perfecthealthdiet.com/?p=2536 High LDL on Paleo Revisited: Low Carb & the Thyroid http://perfecthealthdiet.com/?p=4457

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 26, 2011
at 09:36 AM

Thank you Ambimorph! :) I'll keep this thread alive!

100fd85230060e754fc13394eee6d6f1

(18696)

on December 21, 2011
at 01:52 AM

I don't know. I guess it's worth looking into. Let us know how it goes. Congratulations on your baby!

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 19, 2011
at 07:06 PM

I read about your levels just after my comment. In my case, dealing with stress could help not only to deal with my lipids. One question. Does anyone have answered your question about 25% of the population having ApoE genome? If true, that would be a problem for many paleo folks, dont you think? I'll keep posting?

De267f213b375efca5da07890e5efc25

(3747)

on December 19, 2011
at 03:10 PM

Cordain preaches a wide and varied diet. His claim is that animals of Paleo times were lean so we should eat similar protein today. The claim has also been made that Paleo man couldn't get eggs in the quantities that we get them today. In any case, we know today that virtually all foods have an inflection point, where increasing quantities start to have diminishing improvement to health. I don't know if it's 6, as it will vary by person and diet, but there probably exists some nominal number there.

Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on December 19, 2011
at 03:06 PM

nirgal - people wondered if my cortisol and/or T was jacked, but when I got tested it was middle of the road. As for VitC, yah I am supping 500mg daily from acerola cherry concentrate. I know some people take much more than that, but I like to take small amounts of supps because they are supposed to be just that... supplements, right?! Keep us posted on your progress.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 19, 2011
at 09:04 AM

BTW, reading this post (http://paleohacks.com/questions/22439/high-uric-acid-levels-doctor-told-me-to-cut-out-red-meat#axzz1gy8vCK4s) it seems to me clear that my Vit C levels could be lower than optimal, since my fruit intake has always been realatively low.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 19, 2011
at 08:47 AM

"especially with respect to putting butter on everything and frying lots of things in coconut oil and ghee" I may have indulge in this situation as well. Adding cheese to the equation. Definitely, fats from dairy seems to be a plausible cause for me. What do you think about stress and high levels of cortisol? I think that your walks have worked partly bc of they reduced your stress. My approach is going to be supplement with vit C, cooper, seleniumm, and iodine, reduce dairy dramatically, management of stress (less coffee, more walks) and increase safe carbs (fruits)

77877f762c40637911396daa19b53094

(78467)

on December 18, 2011
at 10:52 PM

Jack, we missed you for Travis's "Defending the LFHC Alamo" thread this week. He could have used you against" Santa Anna's HFLC" forces.Also, did you see my SD paleo -friendly doctor answer.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 18, 2011
at 06:20 PM

Thanks so Much Ambimorph for your help! As you say what it's worring for me are my triglycerides :( I was consuming way more carbs (sugar bread) three years ago and my blood panel was better. Anyway, I'll look carefully the carbs I eat. According to this post (http://perfecthealthdiet.com/?p=4457) it seems to me that a low T3 level could be the cause. Maybe a combination of poor sleep (elevated cortisol) bc I've been father quite recently (2nd time), nutrient deficency (low Vit C, copper, selenium and iodine). Do you think that this could be the cause and a way to handle the problem?

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:40 PM

Anyway, it is certainly possible that your genetics make your response to a LC diet less positive than others. I'm just confused, because your triglyceride levels don't look like those of someone eating LC. So concrete measurements of what you are eating would be helpful.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:25 PM

Also, your HDL is too low. That's what's making your ratios total/HDl and LDL/HDL so bad. If your LDL stayed the same, and your HDL went up to even 60, those ratios would be great. If in addition your triglycerides went down to 100, your risk profile would be excellent.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:17 PM

If you are really concerned about LDL (and let me reiterate that what I think you should be worrying about is triglycerides) you might try lowering your butter intake, thought that doesn't effect everyone and take a look at these other threads here: http://paleohacks.com/questions/67905/skyrocketing-ldl-at-313-concerns http://paleohacks.com/questions/68043/does-anyone-here-that-eats-dairy-not-have-a-high-ldl http://paleohacks.com/questions/50789/why-does-ldl-skyrocket-when-doing-paleo-it-could-be-apoe among others you can find through search.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:06 PM

You keep mentioning that you were in ketosis at your lab, but that isn't a persistent indicator. That could have been the only day you were in ketosis. It can change on a daily basis.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:04 PM

Well, I don't know anything about whether that gene variant affects triglycerides. He's talking about LDL. Your LDL does seem high, but I don't know that it is particularly a worry. Others here have reported higher. The LDL values for people he refers to elsewhere in his blog with that problem have LDL at the *2000* level. What stands out to me is you triglycerides. For one thing, they are correlated with small LDL particle size, which is much more a risk factor than high LDL itself. What were your previous levels that were normal?

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 18, 2011
at 10:31 AM

I don't understand. I'm consuming far less carbs than my wife or coworkers, more nutrients (or at least that what I thought), my previous blood levels were normal. I'm missing something here. What if I have ApoE4 gene as suggested by Dr. Davis in this post: http://www.trackyourplaque.com/blog/2011/07/the-exception-to-low-carb.html? In that case replacing carbs with more fat would make thing even worse. Really, my carb intake is very limited. As I said before, my ketone levels for this analysis were 50, how can I have ketone bodies with a high carb intake? It does not reconcile well?

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 17, 2011
at 08:42 PM

Scrambled eggs with salmon for breakfast, salad with chicken, fishes (tunna, cod) for lunch, avocado salad for dinner, broccoli, chorizo (good quality), cheese. That's for the weekdays, during the weekend I binge a little bit with pizza (soocer day) but not always. Really, not to much carbs, and the carbs I eat are ala Dr. Kurt Harris (white potatoes, rice, tubers...)

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 17, 2011
at 08:37 PM

I've just edit my question with more information. I cannot say precisely how low carb I was before this analisys. But what I can say is that my saturated fat intake has been higher during this last year. I've started to use coconut butter, lard and butter in several dished, something that I never did before. I've never used PUFA oils and my wheat intake is rare.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on December 17, 2011
at 04:44 AM

That's what Cordain preaches.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 17, 2011
at 12:34 AM

Below you say low carb, here you say moderate. Can you be more specific?

Fb67dc30cead043d1d13ea503a3044dc

(3280)

on December 17, 2011
at 12:16 AM

Why the egg cap? Curious.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 16, 2011
at 11:34 PM

What else do you eat? Triglycerides are closely tied to carbohydrate level. Can you give a typical full day's menu?

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 16, 2011
at 06:50 PM

I weitghed arround 83, I've been following a moderate carb (reduced processed sugars) for two years. No smoking, drinking coffee (2/3 cups), beer and alcohol now and then (not daily), coke zero. The odd question is that my wife is following more or less the same diet, ever with more carbs and wheat and her total cholesterol levels are below 200! I'll try to reduce dramatically my dairy intake. Any other thoughts? BTW my ketone levels for these analisys were 50.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 16, 2011
at 06:46 PM

I'll try that! Thanks! I'll miss the butter though :(

3c6b4eed18dc57f746755b698426e7c8

(5147)

on December 16, 2011
at 04:35 PM

Actually, that would be a bit speculative, since other explanations exist. But were you a heavy soda / sweetened juice drinker before Paleo? That's usually the most common expalnation for high TG and UA.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on December 16, 2011
at 03:36 PM

High liver enzymes, high trigs, high uric acid. Points to possible prior indulgence in sugar/fructose & processed carbs. How long u been Paleoing and how much weight have you lost? This may be just the state of becoming Paleo: it takes time to shed your prior bad markers -- considerable inflammation exists in your system. At your level of UA, I would be a gout sufferer if it weren't for my ablity to control my pH.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 16, 2011
at 01:08 PM

yes, I'm from Spain. I thought I already eat a low carb diet. I eat plenty of salmon, eggs, fish, and pate. A common breakfast is scrambled eggs with salmon. Apart from that I eat cheese, yogur and butter quite often. I forgot to mention that my weight is 75Kg and 177cm height. Pretty active (kettlebell, running now and then and playing soccer once a week). I've been reading through various post and I cannot find a plausible explanation.

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4 Answers

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1
Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on December 18, 2011
at 08:00 PM

Nirgal -

As you mention in my original VAP post, our situations are similar. I think we will find that many people fall into this category and must eat a specific Paleo diet coupled with regular exercise.

You should take a look at my latest entry from a few weeks ago:

Hack Jack Kronk???s Latest Lab Results: Part 3 - Nov 19, 2011

Lots of factors have helped me so far, but key among them I believe to be the following:

  • Heavily reduced dairy (butter, ghee, cream, cheese)
  • Elimination of coconut oil
  • Fasted "cardio" style exercise (brisk paced walking and/or jogging) for 20-25 min 3-4 times per week. For me, this is in addition to weight lifting 3x per week.

It should be noted that I still eat a fair amount of carbs, including bananas, dark chocolate, rice, and have added back in potatoes and I feel fine. When I cook potatoes now, I cook them in mac nut oil or avocado oil and use very little (just enough to coat the bottom of the pan.)

I have been feeling much better lately with regard to the uneasy feeling in my chest. I think I may have successfully brought down my levels of blood lipids to a point that, so long as I continue to maintain my new exercise routine, I would be ok to eat some C/O and some more dairy, but I will never return to my previous consumption levels, especially with respect to putting butter on everything and frying lots of things in coconut oil and ghee. Also, I don't even buy cream anymore. I used to eat a bowl of fruit with heavy cream all the time. Now I never do that, and I use only a dollop of pure half and half for my coffee and don't even finish a pint every 2 weeks. But I think coconut oil should be fine in moderation. Travis has made an interesting case for MCTs to possibly play a role and it may be true, but I am more suspect of the heavy amount of palmitic acid in the full fat dairy. This is why I think Chris Kresser and Kurt Harris might wanna consider rethinking the whole "diesel fuel" recommendation for dairy. Kresser says in part 3 of his perfect health series to "eat as much as you like" of LCSFA. Well... I question that as a blanket recommendation now. I am pretty certain that it cannot apply to everyone. However, I still respect both Kresser and Harris and definitely value their tremendous input to this community.

Anyway, you'll just need to tweak and re-test until you find what your body responds best to. I'm kinda still in the middle of that.

Best,

JK

77877f762c40637911396daa19b53094

(78467)

on December 18, 2011
at 10:52 PM

Jack, we missed you for Travis's "Defending the LFHC Alamo" thread this week. He could have used you against" Santa Anna's HFLC" forces.Also, did you see my SD paleo -friendly doctor answer.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 19, 2011
at 07:06 PM

I read about your levels just after my comment. In my case, dealing with stress could help not only to deal with my lipids. One question. Does anyone have answered your question about 25% of the population having ApoE genome? If true, that would be a problem for many paleo folks, dont you think? I'll keep posting?

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 19, 2011
at 08:47 AM

"especially with respect to putting butter on everything and frying lots of things in coconut oil and ghee" I may have indulge in this situation as well. Adding cheese to the equation. Definitely, fats from dairy seems to be a plausible cause for me. What do you think about stress and high levels of cortisol? I think that your walks have worked partly bc of they reduced your stress. My approach is going to be supplement with vit C, cooper, seleniumm, and iodine, reduce dairy dramatically, management of stress (less coffee, more walks) and increase safe carbs (fruits)

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 19, 2011
at 09:04 AM

BTW, reading this post (http://paleohacks.com/questions/22439/high-uric-acid-levels-doctor-told-me-to-cut-out-red-meat#axzz1gy8vCK4s) it seems to me clear that my Vit C levels could be lower than optimal, since my fruit intake has always been realatively low.

Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on December 19, 2011
at 03:06 PM

nirgal - people wondered if my cortisol and/or T was jacked, but when I got tested it was middle of the road. As for VitC, yah I am supping 500mg daily from acerola cherry concentrate. I know some people take much more than that, but I like to take small amounts of supps because they are supposed to be just that... supplements, right?! Keep us posted on your progress.

3
100fd85230060e754fc13394eee6d6f1

(18696)

on December 17, 2011
at 11:21 PM

I'm not getting a very clear picture here. In the comments to Syrio's question you lay out a typical day as quite low carb with very occasional pizza. And on the day that your labs were taken you were in ketosis. But then you say you do eat Paleo starches: rice, tubers, potatoes.

Saturated fat can raise your LDL and total cholesterol, but it doesn't raise triglycerides. Triglycerides that are as high as yours are almost certainly from a high carbohydrate intake, and it doesn't matter if they are Paleo approved sources. Since this is the most likely culprit, if you really want to be sure, you should track your carbohydrate intake for a couple of weeks and see where you really stand.

Your triglyceride/HDL ratio, which is over 4.5, strongly suggests metabolic syndrome, so serious carb restriction (under about 30g/day) is likely to benefit you.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:40 PM

Anyway, it is certainly possible that your genetics make your response to a LC diet less positive than others. I'm just confused, because your triglyceride levels don't look like those of someone eating LC. So concrete measurements of what you are eating would be helpful.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:25 PM

Also, your HDL is too low. That's what's making your ratios total/HDl and LDL/HDL so bad. If your LDL stayed the same, and your HDL went up to even 60, those ratios would be great. If in addition your triglycerides went down to 100, your risk profile would be excellent.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:04 PM

Well, I don't know anything about whether that gene variant affects triglycerides. He's talking about LDL. Your LDL does seem high, but I don't know that it is particularly a worry. Others here have reported higher. The LDL values for people he refers to elsewhere in his blog with that problem have LDL at the *2000* level. What stands out to me is you triglycerides. For one thing, they are correlated with small LDL particle size, which is much more a risk factor than high LDL itself. What were your previous levels that were normal?

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 18, 2011
at 10:31 AM

I don't understand. I'm consuming far less carbs than my wife or coworkers, more nutrients (or at least that what I thought), my previous blood levels were normal. I'm missing something here. What if I have ApoE4 gene as suggested by Dr. Davis in this post: http://www.trackyourplaque.com/blog/2011/07/the-exception-to-low-carb.html? In that case replacing carbs with more fat would make thing even worse. Really, my carb intake is very limited. As I said before, my ketone levels for this analysis were 50, how can I have ketone bodies with a high carb intake? It does not reconcile well?

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:06 PM

You keep mentioning that you were in ketosis at your lab, but that isn't a persistent indicator. That could have been the only day you were in ketosis. It can change on a daily basis.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 18, 2011
at 06:20 PM

Thanks so Much Ambimorph for your help! As you say what it's worring for me are my triglycerides :( I was consuming way more carbs (sugar bread) three years ago and my blood panel was better. Anyway, I'll look carefully the carbs I eat. According to this post (http://perfecthealthdiet.com/?p=4457) it seems to me that a low T3 level could be the cause. Maybe a combination of poor sleep (elevated cortisol) bc I've been father quite recently (2nd time), nutrient deficency (low Vit C, copper, selenium and iodine). Do you think that this could be the cause and a way to handle the problem?

100fd85230060e754fc13394eee6d6f1

(18696)

on December 18, 2011
at 05:17 PM

If you are really concerned about LDL (and let me reiterate that what I think you should be worrying about is triglycerides) you might try lowering your butter intake, thought that doesn't effect everyone and take a look at these other threads here: http://paleohacks.com/questions/67905/skyrocketing-ldl-at-313-concerns http://paleohacks.com/questions/68043/does-anyone-here-that-eats-dairy-not-have-a-high-ldl http://paleohacks.com/questions/50789/why-does-ldl-skyrocket-when-doing-paleo-it-could-be-apoe among others you can find through search.

100fd85230060e754fc13394eee6d6f1

(18696)

on December 21, 2011
at 01:52 AM

I don't know. I guess it's worth looking into. Let us know how it goes. Congratulations on your baby!

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 26, 2011
at 09:36 AM

Thank you Ambimorph! :) I'll keep this thread alive!

2
C8ab93904862544555c148f5720089e7

(40)

on December 16, 2011
at 12:32 PM

Take a look at this thread:

Griff's tutorial on cholesterol

You need to lower tryglicerides to begin with: eat very low carbohydrates, omega-3 and niacin until triglycerides <100.

Are you from Spain?

100fd85230060e754fc13394eee6d6f1

(18696)

on December 16, 2011
at 11:34 PM

What else do you eat? Triglycerides are closely tied to carbohydrate level. Can you give a typical full day's menu?

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 16, 2011
at 01:08 PM

yes, I'm from Spain. I thought I already eat a low carb diet. I eat plenty of salmon, eggs, fish, and pate. A common breakfast is scrambled eggs with salmon. Apart from that I eat cheese, yogur and butter quite often. I forgot to mention that my weight is 75Kg and 177cm height. Pretty active (kettlebell, running now and then and playing soccer once a week). I've been reading through various post and I cannot find a plausible explanation.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 17, 2011
at 08:42 PM

Scrambled eggs with salmon for breakfast, salad with chicken, fishes (tunna, cod) for lunch, avocado salad for dinner, broccoli, chorizo (good quality), cheese. That's for the weekdays, during the weekend I binge a little bit with pizza (soocer day) but not always. Really, not to much carbs, and the carbs I eat are ala Dr. Kurt Harris (white potatoes, rice, tubers...)

1
De267f213b375efca5da07890e5efc25

(3747)

on December 16, 2011
at 04:32 PM

Switch to the Cordain / Wolff version of the diet: * Eliminate the dairy * Cap eggs at 6 per week * Limit organ meats like pate to 1-2 times per week * Replace lost volume with more fruits and veggies

You should be good.

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 16, 2011
at 06:46 PM

I'll try that! Thanks! I'll miss the butter though :(

Fb67dc30cead043d1d13ea503a3044dc

(3280)

on December 17, 2011
at 12:16 AM

Why the egg cap? Curious.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on December 17, 2011
at 04:44 AM

That's what Cordain preaches.

De267f213b375efca5da07890e5efc25

(3747)

on December 19, 2011
at 03:10 PM

Cordain preaches a wide and varied diet. His claim is that animals of Paleo times were lean so we should eat similar protein today. The claim has also been made that Paleo man couldn't get eggs in the quantities that we get them today. In any case, we know today that virtually all foods have an inflection point, where increasing quantities start to have diminishing improvement to health. I don't know if it's 6, as it will vary by person and diet, but there probably exists some nominal number there.

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