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hypolipidemia ... what to do?

Commented on June 05, 2014
Created June 03, 2014 at 7:56 PM

Hi. I am a 57 y.o. healthy male. I've been eating dairy free/gluten free for five years, autoimmune protocol Paleo for several months (to manage my psoriasis). Since my mid-30s my total cholesterol has ranged from 120 - 143. Below 120 is considered hypolipidemia, although the lab report indicates that only below 100 is considered abnormal. My recent lab report shows total cholesterol as 111. I think a reason for the drop is that I am no longer eating 2 eggs/day; eliminating eggs did wonders for my gut and my psoriasis. As for fat/oil consumption I do cook with coconut oil and ghee.

Unsurprisingly, my primary care physician thinks there isn't such a thing as "low cholesterol". But hypolipidemia is real. Are there any suggestions for elevating my cholesterol while still adhering to the autoimmune Paleo diet?

Since my cholesterol has always been low-ish, even when my diet was awful, I suspect I was born this way. Still, it would be nice to bump my total cholesterol to 150.

For completeness my triglycerides is 41, HDL 45, VLDL 8 and LDL 53 (..an LDL of below 50 is also a sign of hypolipidemia).

Thanks!

_Lazza

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 05, 2014
at 11:57 AM

Thanks. Yeah, next time I get a blood work done I will ask for a full thyroid workup. I've had free T4 tested before (low normal) but never T3.

I have had TSH tested annually for the past 3 years. My TSH used to be in the 5.x range. Somehow the autoimmune Paleo diet has had a positive impact in lower my TSH value, but nothing to help with raising my cholesterol production. Still, you are right: I need more data wrt my thyroid. Oh, I also know that I don't have any anti-thyroid antibodies ... so no Hashimoto's disease.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 04, 2014
at 04:12 PM

thhq, no I am not underweight (my BMI is 25).

paleot, I didn't know of apoE2. At first glance there might be a match. But assuming there is a match, I suspect there is little I can do wrt diet/supplements to counteract being apoE2. I found this chart to be helpful:

http://www.atherotech.com/images/vapliterature/pdfs/testingfactsapoe.pdf

Medium avatar

(10611)

on June 04, 2014
at 03:54 PM

Most paleo dieters have the opposite problem. Are you underweight or do you undereat?

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 04, 2014
at 12:57 PM

Oh, gut malabsorption is an interesting possibility. Any ideas on what tests can prove this out?

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 04, 2014
at 12:54 PM

Not sure if any of this applies to me really. I eat fruit daily, albeit not that much. My starch intake is far, far less now than in my pre-Paleo days. My liver enzymes are absolutely fine. I also don't suffer from hyperthyroidism, in fact I might be a touch hypothyroid (TSH 3.32, which is the lowest its been in a long time).

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 04, 2014
at 12:49 PM

I don't know why dairy affects my psoriasis but it does, or at least it did. I haven't had dairy in five years. But now that my IBS has cleared (through dieting) it might be worthwhile giving dairy a try. Having said this, eating more dairy probably isn't the solution. Before I went dairy free I ate a lot of dairy, perhaps 25% of my caloric intake. Despite this my total cholesterol was on about 130 - 135.

Thanks for the tip on trying other animal fats. It's certainly worth giving them a chance.

Cf08ad26759fdd206a2c9f9385080a57

(995)

on June 04, 2014
at 09:15 AM

I wonder if you're an apoE2. Might be worth looking into.

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3 Answers

0
5f2b8e0a671b7eaae8a6bd97f0ded166

(120)

on June 05, 2014
at 12:29 AM

TSH 3.2 is normal in conventional medicine, but it definitely indicates hypothyroidism.

People can have major hypothyroid symptoms with this level of TSH.

A really healthy person should have TSH close to zero. As far as i understand,

Liver enzyme tests do not reflect liver's ability of make cholesterol. Lack of active thyroid hormone T3 plays a major role in liver function. People can have good TSH but low

T3, that is why a full panel of TSH, total T3, total T4 , reverse T3 are needed.

If you are following low carb and low fructose diet then amount of fructose may not be enough to compensate for liver's inability. Low manganese can also lower cholesterol.

You can find a lot of good studies on "hypocholesterolemia" on google.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 05, 2014
at 11:57 AM

Thanks. Yeah, next time I get a blood work done I will ask for a full thyroid workup. I've had free T4 tested before (low normal) but never T3.

I have had TSH tested annually for the past 3 years. My TSH used to be in the 5.x range. Somehow the autoimmune Paleo diet has had a positive impact in lower my TSH value, but nothing to help with raising my cholesterol production. Still, you are right: I need more data wrt my thyroid. Oh, I also know that I don't have any anti-thyroid antibodies ... so no Hashimoto's disease.

0
5f2b8e0a671b7eaae8a6bd97f0ded166

(120)

on June 03, 2014
at 09:31 PM

Here is a quote from wikipedia "According to the American Heart Association in 1994, only total cholesterol levels below 160 mg/dL or 4.1 mmol/l are to be classified as "hypocholesterolemia".[1] However, this is not agreed on universally and some put the level lower." There is speculation that

pharma industry lowered the limit to boost sale of cholesterol lowering drugs. They used to believe

that upper limit of cholesterol is 200+age. That means 200+57=257 is your upper limit.

Hormone researcher Ray Peat PhD thinks excessive consumption of starch is a common cause of

low cholesterol. Fructose containing foods are the best to way to increase cholesterol.

Damaged liver can inhibit cholesterol production and hypothyroidism causes liver to be

inefficient. Low cholesterol lowers production of all the protective hormones like progesterone,

pregnenolone, DHEA . One possible cause of low cholesterol is hyperthyroidism,

where excess thyroid hormone increases the conversion

of cholesterol to protective hormones. This is not so bad as having low cholesterol and low

thyroid function. You still need good amount of cholesterol to be healthy. Some studies

have found higher cholesterol level in older people, 50+ increases longevity.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 04, 2014
at 12:54 PM

Not sure if any of this applies to me really. I eat fruit daily, albeit not that much. My starch intake is far, far less now than in my pre-Paleo days. My liver enzymes are absolutely fine. I also don't suffer from hyperthyroidism, in fact I might be a touch hypothyroid (TSH 3.32, which is the lowest its been in a long time).

0
Medium avatar

on June 03, 2014
at 08:08 PM

Is the dairy an allergy, fear of MAP, or just lactose intolerance? Because drinking heavy cream with essence flavored soda water is easy as pie and has no lactose. Just beware of the additives in some heavy creams like mono/di-glycerides, and various gums. Whole foods (of course) often has plain heavy cream without additives if you can't find one in a grocery store that is tolerable. It may even be from a grass fed cow.

Otherwise, rendering various fats from duck or beef trimmings is also not difficult. Different fats have different effects so you might want to run those tests again after a couple of weeks trying a new fat. But as for the illness you're experiencing, looks like your doctor or other health pro is going to have to deal with that one (checking thyroid, looking for gut malabsorption, etc..).

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 04, 2014
at 12:49 PM

I don't know why dairy affects my psoriasis but it does, or at least it did. I haven't had dairy in five years. But now that my IBS has cleared (through dieting) it might be worthwhile giving dairy a try. Having said this, eating more dairy probably isn't the solution. Before I went dairy free I ate a lot of dairy, perhaps 25% of my caloric intake. Despite this my total cholesterol was on about 130 - 135.

Thanks for the tip on trying other animal fats. It's certainly worth giving them a chance.

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