2

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LDL cholesterol doubled from pre-paleo

Answered on September 12, 2014
Created April 02, 2012 at 6:03 PM

alt text

Male 40 years old, 188cm, 76kg (6feet 2 inch, 168 pounds), 15% body fat, bodyweight training and swimming.

Fairly strict paleo since one year ago (gluten and diary free), not limiting carbs (150 - 250 grams/day from rice, potatoes and fruits).Cured mild psoriasis and leaky gut with the diet, very good flu record compared to previous seasons, sucseeded to gain weight since the rediscovery of butter and coconut oil. Never felt better. All of that makes me never want to go back.

Great success story apart from the LDL cholesterol number. Almost double from pre-paleo. Are there some studies showing that LDL of this size is not an issue? If I restrict all the eggs (30+/week) and fat (0.4 kg of butter or coconut oil/week ) I will have nothing to eat and will start loosing weight. I do eat sufficient amounts of liver and chocollate(copper) and iodine to support proper thyroid function

Do I need to do something about it? I need your help

please vote int the poll on how many eggs you eat http://www.marksdailyapple.com/forum/thread52386.html


Update after 6 months of diet change: After 6 months of restricting butter and coconut oil (not eliminating) and eliminating eggs my cholesterol numbers are down to reference level (I believe the eggs had minimal effect, I am noting that just to list all the dietary changes) Thanks for the advice from Travis Culp. File closed

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:40 AM

How many eggs have you been eating by the way?

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:39 AM

Oh, and I dont know if its relevant, but my dropped LDL has occured after going from eating 85% pasta, to eating five eggs a day, one slice of bacon and everything cooked in coconut oil, or butter, 80grams of cheese most days and some kinda fatty meat every dinner. Mine could be genetics, or simply a massive body readjustment, but so far the 35 odd eggs (lol) I eat every week is treating me fine. I really must get into some other breakfasts though, as tasty as eggs are.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:34 AM

exactly where that sweet spot is.......We can only guess that absurding high is probably bad, and that absurdly low is probably bad...

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:34 AM

"it does indicate some aberrant metabolism." - In order to know whats abberant, wed need to know whats natural. Hard to do when everyones eating unnatural diets. "No matter what it is we are measuring, I think assuming a U-shaped mortality-risk curve is prudent." - That makes total sense. It may not be an issue, but for most things you need a certain amount, and you can also get too much. Trouble is to know what is in the centre point of the U curve, we need some idea of an optimal LDL level. We know so little about its lipids roles in the body, due to the lipid hyp nonsense, its hard to know

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:33 AM

"it does indicate some aberrant metabolism." - In order to know whats abberant, wed need to know whats natural. Hard to do when everyones eating unnatural diets. "No matter what it is we are measuring, I think assuming a U-shaped mortality-risk curve is prudent." - That makes total sense. It may not be an issue, but for most things you need a certain amount, and you can also get too much. Trouble is to know what is in the centre point of the U curve, we need some idea of an optimal LDL level. We know so little about its role in the body, due to the lipid hyp nonsense, its hard to know.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:24 AM

Fascinating. My LDL dropped from out of the reference range, to inside it, on a low carb high fat paleo diet. Admitidly not nearly as much time has passed. As to whether that LDL score means anything, I think ill leave the speculation up to others more informed. I do beleive particle size is supposed to be more important than LDL though, if thats any comfort. And supporting that your trigs are very low and HDL high enough, both good markers, from what I have read.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:22 AM

Fascinating. My LDL dropped from out of the reference range, to inside it, on a low carb high fat paleo diet. Admitidly not as much time has passed. As to whether that means anything, I think ill leave the speculation up to others more informed. I do beleive particle size is supposed to be more important than LDL though, if thats any comfort. And supporthing that your trigs are very low and HDL decently high, both good markers, from what I have read..

5437163ddf70d4532f196bfb4333753e

(3614)

on April 03, 2012
at 05:54 PM

True true. I was thinking more for justification in case some physician down the road gets in a tizzy over the numbers :-)

Medium avatar

(39821)

on April 03, 2012
at 04:05 PM

The acetyl-coa used to manufacture cholesterol could come from fats or protein. Additionally, the cholesterol itself could come from fatty-meaty cholesterol-rich foods. Not sure where you got this idea.

C8586fa2188272d5474d22aa8a500619

(358)

on April 03, 2012
at 02:49 PM

I have TSH of 3 with reference range of 0.25 - 4.5. That should be considered normal thyroid

Acc38052c1efe7fc4338dc55f2428bfe

(242)

on April 03, 2012
at 01:37 PM

Thank you! I'm surprised that there are still so many people that just try to brush abnormal biomarkers under the rug with tired explanations such as "they're large and fluffy so 500 ldl is good!" While I think there's more to the story than the conventional view with regard to lipids, the approach of "the biomarkers can't be bad if they're eating 'paleo'" is unproductive nonsense. That isn't to say that I think these numbers are crazy but they at least warrant investigation.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on April 03, 2012
at 01:14 PM

Good point. High cholesterol may or may not be predictive for CVD, but it does indicate some aberrant metabolism.

D8c04730b5d016a839b3c5b932bf59dd

(823)

on April 03, 2012
at 04:43 AM

Have you had your thyroid tested? Just because you eat enough whatever doesn't mean it couldn't go off.

100fd85230060e754fc13394eee6d6f1

(18706)

on April 03, 2012
at 01:01 AM

You don't even really need to check particle size, because it is so well predicted by trigs: low trigs = predominantly large sized LDL.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on April 02, 2012
at 08:43 PM

Check. No matter what it is we are measuring, I think assuming a U-shaped mortality-risk curve is prudent. More of everything is not automatically better.

6120c989fd5b69f42a0834b69b87955b

(24553)

on April 02, 2012
at 08:33 PM

The LDL/HDL ratio is pretty close to what it was, so it could be a non-issue. But if you are nervous do a particle size test.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on April 02, 2012
at 06:22 PM

My numbers have not changed in the year I've followed this lifestyle and I eat lots of fatty beef plus fatty dairy. So, you are reacting to something that may or may not include dietary changes.

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9 Answers

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10
Medium avatar

on April 02, 2012
at 08:25 PM

I hit a total cholesterol of 393 with a lot of butter/cream, which dropped to 215 or so when I replaced it with standard animal fat. (HDL stayed around 60). I'd wager that you're having a similar issue. At the very least, you could try replacing the butter with coconut oil, since butter's known to be approx twice as hypercholesterolemic as coconut oil. They both increase LDL more than tallow/suet.

Nobody can say with any real certainty if such large pools of LDL can be maintained without oxidation. I suspect that having substantially more LDL than our ancestors as a result of novel fats plus substantially more oxidative stress due to pollution is a recipe for an increased risk of heart disease.

It's possible for me (and apparently you) to simulate heterozygous familial hypercholesterolemia via diet. We know that those individuals are at a greatly increased risk of CHD. I think we ought not to assume that because conventional wisdom wrongly puts people on health-damaging drugs at a cholesterol level of 230 that 430 is also OK. I've seen people post here an elsewhere with levels up to 500-something. I think we ought to draw the line around 250 just in case.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on April 03, 2012
at 01:14 PM

Good point. High cholesterol may or may not be predictive for CVD, but it does indicate some aberrant metabolism.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on April 02, 2012
at 08:43 PM

Check. No matter what it is we are measuring, I think assuming a U-shaped mortality-risk curve is prudent. More of everything is not automatically better.

Acc38052c1efe7fc4338dc55f2428bfe

(242)

on April 03, 2012
at 01:37 PM

Thank you! I'm surprised that there are still so many people that just try to brush abnormal biomarkers under the rug with tired explanations such as "they're large and fluffy so 500 ldl is good!" While I think there's more to the story than the conventional view with regard to lipids, the approach of "the biomarkers can't be bad if they're eating 'paleo'" is unproductive nonsense. That isn't to say that I think these numbers are crazy but they at least warrant investigation.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:33 AM

"it does indicate some aberrant metabolism." - In order to know whats abberant, wed need to know whats natural. Hard to do when everyones eating unnatural diets. "No matter what it is we are measuring, I think assuming a U-shaped mortality-risk curve is prudent." - That makes total sense. It may not be an issue, but for most things you need a certain amount, and you can also get too much. Trouble is to know what is in the centre point of the U curve, we need some idea of an optimal LDL level. We know so little about its role in the body, due to the lipid hyp nonsense, its hard to know.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:34 AM

"it does indicate some aberrant metabolism." - In order to know whats abberant, wed need to know whats natural. Hard to do when everyones eating unnatural diets. "No matter what it is we are measuring, I think assuming a U-shaped mortality-risk curve is prudent." - That makes total sense. It may not be an issue, but for most things you need a certain amount, and you can also get too much. Trouble is to know what is in the centre point of the U curve, we need some idea of an optimal LDL level. We know so little about its lipids roles in the body, due to the lipid hyp nonsense, its hard to know

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 27, 2012
at 11:34 AM

exactly where that sweet spot is.......We can only guess that absurding high is probably bad, and that absurdly low is probably bad...

4
5437163ddf70d4532f196bfb4333753e

(3614)

on April 02, 2012
at 07:52 PM

NICE work on the triglycerides! High TGs are not only indicative of heart disease, but insulin resistance and inflammation. The LDL count is a red herring. I would check on the LDL particle size, though. If your LDL is the big and fluffy kind, you are doing great!

100fd85230060e754fc13394eee6d6f1

(18706)

on April 03, 2012
at 01:01 AM

You don't even really need to check particle size, because it is so well predicted by trigs: low trigs = predominantly large sized LDL.

5437163ddf70d4532f196bfb4333753e

(3614)

on April 03, 2012
at 05:54 PM

True true. I was thinking more for justification in case some physician down the road gets in a tizzy over the numbers :-)

3
32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on April 03, 2012
at 01:13 PM

Chris Kresser's recent Paleo Summit talked about the variability in cholestrol numbers on a day-to-day basis... You need a few more data points to know if what you're seeing here is real or not. The error bars on these are so large that it is possible you've had zero change in your blood lipid numbers.

In all likelihood, your numbers did change a bit, but it might not be as bad as it seems.

1
0ead271762198cb1344fdc104b42bbbd

on April 03, 2012
at 06:30 AM

Here's a post from the Jaminets that might help:

Answer Day: What Causes High LDL on Low-Carb Paleo?

Short answer is that micronutrient deficiencies can cause underlying pathologies that result in higher LDL. Paul recommends that unless you're very confident that you're hitting your micronutrient needs (particularly minerals) then most poeple could benefit from supplements. Wouldn't cost much to test.

1
7d5faecbdf9bb7987013008c6bf6b307

(130)

on April 02, 2012
at 08:17 PM

This is almost exactly what happened with my levels: HDL went up from 40 to 72, Trigs went down from 110 to 60, and LDL went up from 130 to 181. A VAP cholesterol test shows my LDL to be Pattern A (large and fluffy rather than small and dense). So, although my doctor is concerned about the LDL (while ignoring the other values, which are markedly improved), I'm inclined to think these are good results.

1
782d92f4127823bdfb2ddfcbcf961d0e

on April 02, 2012
at 07:24 PM

Your LDL's may need further evaluation but your HDL's and trigycerides have improved significantly. Congratulations!

1
A3ff262a2686d79789e09a26013901b3

on April 02, 2012
at 06:22 PM

LDL particle size from small to large may be what happened. This is a good thing.

0
50fa7068b8446cc9a5ebe7d30d861427

on July 27, 2012
at 09:47 AM

I have the almost exact same situation. I am 33 y old, 11% body fat, 72kg for 188cm and eat almost perfect paleo (90% chicken or fish, vitually no beef/pork), all carbs from vegetables and fruits with zero refined carbs (my only treats are the occasional oats on sports days). For fat, I supplement with 2g fish oils per day, and eat 30g of walnut/flax/sunflower/sesame mix per day for poly-U intake, eat avocado and olives everyday for mono.

Despite all this, my LDL is >5mmol/dl which is very high. I have sort of stopped worrying about it as my diet is fairly tight already, but would indeed be curious to get a scientific explanation.

-2
D8943072358128638901aa8faa6ba99e

(56)

on April 03, 2012
at 10:59 AM

Cholesterol in your blood is ONLY synthesized from dietary carbohydrates and NOT from any dietary protein or fats. I would restrict your carbs to less than 25-30 grams a day, then re-test after 3 weeks. If the numbers come down, then slowly re-introduce low glycemic carbs. Any meats, eggs, cheese, milk, etc that you eat MUST be grass fed. It is critical to maintain a ratio of 4:1 or less of Omega-6s to Omega-3's. Eat lots of fish. Exercise daily, low intensity aerobic such as walking, so you burn any excess carbs you do not store in glycogen in your liver or muscles. What you dont burn you either store in fat or convert to cholesterol.

Medium avatar

(39821)

on April 03, 2012
at 04:05 PM

The acetyl-coa used to manufacture cholesterol could come from fats or protein. Additionally, the cholesterol itself could come from fatty-meaty cholesterol-rich foods. Not sure where you got this idea.

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