5

votes

My doctor is still concerned about my cholesterol. How bad is it?

Answered on September 12, 2014
Created May 18, 2013 at 1:02 AM

It's been a year since I saw my doctor and I've had another cholesterol test. She is very concerned about the results, which show elevated levels. According to a "risk assessment", I have a 15% chance of cardiovascular event in the next five years.

I personally don't feel like cholesterol is a big deal (as most here don't), but my LDL is pretty high. I know when I go back for a follow up she will want to put me on medication, which I'm not interested in at all.

I'm a 35yo Male (73kg, 180cm tall blood pressure 120/70) with a family history of Heart Disease. I have been "mostly" paleo for a couple of years, and the day I got my blood test was the last day of a Whole30 challenge, which I adhered to pretty strictly. My levels are: Total 336, Triglyceride 221, HDL 45, LDL 247.

I should have added that. I'm walking an hour, 3 times a week. do body weight exercises 2-3 times a week (push up, pull up, planks, kettlebell squats and kettlebell swings). I'm fairly active in my job, with a lot of walking as part of the work. I'm just (re)starting out with the workouts so my numbers aren't great yet, but I feel I'm getting a good balance between pushing my self and allowing recovery time.

A typical day of eating may look like this: Breakfast - 3 x fried eggs (coconut oil, duck fat or occasionally butter), with spinach, and sauerkraut, black coffee. Lunch - (last night's leftovers!) slow cooked beef brisket with broccoli and broth. Dinner - Baked Chicken Tenders (crumbed with almond), (occasional) sweet potato and stir fried cabbage. Add another coffee or 2 in the morning somewhere.

Sleep - bed by 9.30pm, sleep by 10pm. I get up at 6am for work at 7.30am.

What are the opinions out there regarding my levels? What else can I be doing to lower my LDL, assuming I continue to eat a clean paleo diet? I have been doing my homework and I'm not a total noob, so I'm pretty confused by the poor result. I've read several paleo books, I subscribe to podcasts and have frequently lurked on paleohacks before this, my first question.

** Update May 24 **

Thanks everyone for the input, again, great community! I'm making some dietary changes: Cutting back on eggs from ~3 per day to 1-2 eggs every other day (20-25 per week to 7 per week). I'm actively seeking out fresh salmon and introducing more sardines into the mix. Fried lamb's liver with spinach is pretty damn decent too! Beyond that, More veges, more olive oil, starchy carbs - sweet potato, potatoes and occasional white rice. It's winter here so I'm taking vitamin D supplements, and I'm making a point to keep my workouts consistent, walk every day, and even try some yoga on my non workout days (I used to practice a little and always feel better when yoga is in the mix.

My doctor is supporting my desire to try fixing things with diet, we agreed to retest in 6 months - November. If nothing is better then, I will investigate the possibility of thyroid issues.

F5a8a14fc6a4d33c2563d0dd3066698a

(714)

on August 21, 2013
at 09:14 PM

I would back off that dietary cholesterol suggestion. We aren't even sure if there is a relationship between dietary cholesterol and serum cholesterol.

7a6529ea25b655132fe58d793f95547a

(2030)

on May 24, 2013
at 12:14 AM

@CD, I got the info from the book I posted below but here is the study linked to in the book: http://circ.ahajournals.org/content/96/8/2520.full http://www.medscape.org/viewarticle/588474

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 23, 2013
at 10:35 PM

James, thanks for your concern. Since you have taken the time to contribute, could you take a little longer and offer specific suggestions (beyond saturated fats) , instead of "you're going to die?" Thanks.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 23, 2013
at 10:32 PM

No, haven't had the full blood panel. I will push my doctor for this if I don't see improvement. Fow now I'm actively working on lowering these numbers.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 22, 2013
at 05:12 PM

Hey stephen, you should do some research on starchy vegetable carbs like potatoes and sweet potatoes. I hear those are really good for you.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 21, 2013
at 04:13 PM

Colin, where has that been proven?

5dd50f78f47b8848d93724d6eb38d4c1

(907)

on May 20, 2013
at 07:39 AM

Mike. Particle size is useless with a LDL that high. LDL-p is what's important and it usually follows LDL if that goes up. I guarantee you're LDL particle count is extremely high as well. probably jimmy moore type levels. It's crazy for you to be eating this way with a family history of heart disease. Cut your saturated fat and adopt a diet that's less likely to kill you prematurely

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 19, 2013
at 08:00 PM

What carbs should he add though.

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 19, 2013
at 07:56 PM

Yea I'm like 99% sure it's soluble fiber that binds bike salts: http://skeptics.stackexchange.com/questions/4762/is-soluble-fiber-a-miracle-dietary-component .

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 19, 2013
at 07:53 PM

I don't think so, maybe it does to a lesser degree though? A quich google turned this up as the first result for me: http://www.foods-healing-power.com/soluble-and-insoluble-fiber.html .

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 02:53 PM

True, but I think crowdsourcing his problem is likely a more efficient use of funds. The holistic doc is going to say, 'try this and check back in 6-8 weeks.' He can do that without the holistic doc too, plenty of ideas the answers to his question.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 02:49 PM

Isn't it insoluble fiber that reduces LDL levels via absorption of bile salts in the GI tract?

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 12:18 PM

FH is often mentioned, but the rate is low: 1 in 500. Unlikely that even a few high cholesterol folks have FH.

Medium avatar

(10611)

on May 19, 2013
at 12:17 PM

The OP already eats duck fat. It doesn't get much better than that.

Medium avatar

(10611)

on May 19, 2013
at 12:16 PM

I've had size done for the last 2 years. It's not the be-all-and-end-all, but it does give you more information than you have now.

Medium avatar

(10611)

on May 19, 2013
at 12:14 PM

Not necessarily. My carbs are much higher than this and my TG's are below 50. Heredity?

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 12:12 PM

Not everybody has stellar serum lipids eating low carb, the standard dietary intervention (dropping fat, increasing carbs) does work.

72cf727474b8bf815fdc505e58cadfea

on May 18, 2013
at 10:49 PM

How does "it's the wrong types of fats" lead to "up the carbs"?

3491e51730101b18724dc57c86601173

(8395)

on May 18, 2013
at 08:38 PM

Hmmm, scratching head. Most low carb/paleo experts agree with this: http://www.proteinpower.com/drmike/cardiovascular-disease/elevated-triglycerides-are-driven-by-carbohydrate-consumption/ See also: http://perfecthealthdiet.com/2012/11/more-evidence-for-low-carb-diets/ How's your thyroid? That can cause elevated lipids.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 18, 2013
at 03:23 PM

Will add that high cholesterol is a symptom of a larger health issue. Artificially lowering serum lipids may not change your risk of a CV event.

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 18, 2013
at 02:43 PM

Yes, the assumption being that you're not. Phil Campbell did a trial at KDMC in Mississippi where a HIT protocol resulted in changes in people's cholesterol and triglycerides levels that were comparable to taking statins. Lots of studies show the benefits of exercise on heart health. It sounds like you're already doing this. The only other piece of advice I'd give you is to include adequate soluble fiber, possibly from certain legumes in an attempt to help bind more cholesterol in your gut. But I'm no expert in that field so take that as a loose recommendation.

7a6529ea25b655132fe58d793f95547a

(2030)

on May 18, 2013
at 01:51 PM

Ya cholesterol isn't really a good marker anyways, the particle size can just give you a bit of an insight. Kudos on the asthma meds that's great man.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 18, 2013
at 11:44 AM

And I assume you've had a full blood panel? Thyroid levels? Copper levels? Magnesium? Vitamin D?

048dd52752c45129c1212bfffb37ca72

(3150)

on May 18, 2013
at 06:55 AM

Everything seems pretty consistent. I'd try to get the thyroid, sex hormone, cortisol and vitamin D levels checked. An imbalance in these seems to hit HDL/LDL ratios pretty badly. In the meanwhile, maybe I'd cut to just one egg aday and change some animal fat for monounsaturated and try to keep always fat and carbs in separated meals but always with some protein added, maybe a leaner source. I don't see any seafood commented, do you have any? I think this point is critical, I'd switch 50% of the animal flesh for 10% offal and 40% seafood instead and see how it works.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:18 AM

Thanks, I've updated the OP for a more detailed picture of where I'm at.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:16 AM

I'm from New Zealand, before the test I asked my doctor about the particle size test and she said it was something they don't offer as funding is limited for these. Our health care system is quite different (to say the least), but my doctor's appointment was $35, the blood test was free, and asthma medication for the next 6 months will be about $6. This is all without insurance. BTW, I'm nearly off my asthma meds and this time i'm trialling a child's dose of the preventative steroid, largely due to my lifestyle changes.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:05 AM

The assumption being that I'm not I guess?:) I should have added that. I'm walking an hour, 3 times a week. do body weight exercises 2-3 times a week (push up, pull up, planks, kettlebell squats and kettlebell swings). I'm fairly active in my job, with a lot of walking as part of the work. I'm just (re)starting out with the workouts so my numbers aren't great yet, but I feel I'm getting a good balance between pushing my self and allowing recovery time.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:02 AM

We have been low carb for quite a while. I'll read up on this too, thanks!

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:00 AM

We've been eating low carb for a long time now, mainly meat and vege diet. I do have room for improvement in my omega 3 and fish intake.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 05:59 AM

It's worrying me too. I've been no sugar or dairy for the last 30 days, but before that, I would occasionally eat too much chocolate. When I'm being good an couple of squares on 85%, but sometimes I would destroy a family block of milk chocolate - weekly. Dairy is generally pretty light.

7a6529ea25b655132fe58d793f95547a

(2030)

on May 18, 2013
at 04:26 AM

@Roth- It's the trig to hdl ratio that's concerning, and that has proven to be a much better marker for heart disease risk.

7a6529ea25b655132fe58d793f95547a

(2030)

on May 18, 2013
at 04:22 AM

For some folks the higher levels of palmitic and myristic acid in coconut and dairy fat will negatively impact lipid profiles. http://atvb.ahajournals.org/content/14/4/567.short

3327924660b1e2f8f8fc4ca27fedf2b2

(2919)

on May 18, 2013
at 02:57 AM

Replace some of your fat intake with coconut and do more cardio if you're genuinely concerned.

3327924660b1e2f8f8fc4ca27fedf2b2

(2919)

on May 18, 2013
at 02:56 AM

High cholesterol requires a doctor. High cholesterol = symptomless health "issue."

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14 Answers

best answer

7
72cf727474b8bf815fdc505e58cadfea

on May 18, 2013
at 01:21 AM

Your doctor's chief recommendation will probably be to reduce saturated fat in your diet. Most paleo eaters have some room to do that. e.g., eat leaner meat, don't use quite as much butter, stop eating coconut butter straight out of the jar. You can replace the calories with protein, appropriate carbohydrates to a reasonable extent, and monounsaturated fats or omega-3 PUFAs. The research I've seen suggests that this is likely to lower your LDL and increase HDL.

best answer

0
048dd52752c45129c1212bfffb37ca72

on September 07, 2013
at 12:44 AM

I think it would be very useful if you post how exactly a full day of your life looks like or has been looking until recently, regarding:

  • Diet: How many meals a day, what kind of foods exactly, amounts, macro ratios, total daily calorie intake..
  • Activity level: whether you exercise or not, your job is active or you lay 10h a day in the desktop, and so on...
  • Well-being: How many hours do you sleep per day, what time you get up / go to sleep, are you phisically or mentally stressed? How do you feel at the morning and at night? How's your libido? other issues? etc..

Then I think we will be able to figure a plan for you, trying to give advice with no context other than your actual cholesterol numbers and family history of CVD -which is really helpful to know BTW- isn't enough for a solid advice IMHO.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:18 AM

Thanks, I've updated the OP for a more detailed picture of where I'm at.

048dd52752c45129c1212bfffb37ca72

(3150)

on May 18, 2013
at 06:55 AM

Everything seems pretty consistent. I'd try to get the thyroid, sex hormone, cortisol and vitamin D levels checked. An imbalance in these seems to hit HDL/LDL ratios pretty badly. In the meanwhile, maybe I'd cut to just one egg aday and change some animal fat for monounsaturated and try to keep always fat and carbs in separated meals but always with some protein added, maybe a leaner source. I don't see any seafood commented, do you have any? I think this point is critical, I'd switch 50% of the animal flesh for 10% offal and 40% seafood instead and see how it works.

7
32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 18, 2013
at 01:47 PM

Ok, you're low carb and you've got crappy serum lipids, what to do? Obviously something very different than you're doing now! High fat, low carb isn't doing the trick. It's the wrong types of fats. Dietary cholesterol might be problematic as well.

The solution? Up the carbs, decrease the saturated fat, decrease dietary cholesterol. Ditch the chicken, replaces with fatty fish. Ditch the coconut oil, use olive oil. Reduce the serving sizes of eggs and beef. 2-3 times as much vegetable matter.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 18, 2013
at 03:23 PM

Will add that high cholesterol is a symptom of a larger health issue. Artificially lowering serum lipids may not change your risk of a CV event.

72cf727474b8bf815fdc505e58cadfea

on May 18, 2013
at 10:49 PM

How does "it's the wrong types of fats" lead to "up the carbs"?

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 12:12 PM

Not everybody has stellar serum lipids eating low carb, the standard dietary intervention (dropping fat, increasing carbs) does work.

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 19, 2013
at 08:00 PM

What carbs should he add though.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 22, 2013
at 05:12 PM

Hey stephen, you should do some research on starchy vegetable carbs like potatoes and sweet potatoes. I hear those are really good for you.

F5a8a14fc6a4d33c2563d0dd3066698a

(714)

on August 21, 2013
at 09:14 PM

I would back off that dietary cholesterol suggestion. We aren't even sure if there is a relationship between dietary cholesterol and serum cholesterol.

7
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 18, 2013
at 03:33 AM

Your numbers are concerning, especially with your family history. To be honest, your Trigs are almost three times higher than any measure I have heard from someone following a Paleo diet.

How much sugar and dairy are we talking about here?

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on May 18, 2013
at 11:44 AM

And I assume you've had a full blood panel? Thyroid levels? Copper levels? Magnesium? Vitamin D?

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 05:59 AM

It's worrying me too. I've been no sugar or dairy for the last 30 days, but before that, I would occasionally eat too much chocolate. When I'm being good an couple of squares on 85%, but sometimes I would destroy a family block of milk chocolate - weekly. Dairy is generally pretty light.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 23, 2013
at 10:32 PM

No, haven't had the full blood panel. I will push my doctor for this if I don't see improvement. Fow now I'm actively working on lowering these numbers.

4
Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 18, 2013
at 02:18 AM

You could exercise.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 02:49 PM

Isn't it insoluble fiber that reduces LDL levels via absorption of bile salts in the GI tract?

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 19, 2013
at 07:56 PM

Yea I'm like 99% sure it's soluble fiber that binds bike salts: http://skeptics.stackexchange.com/questions/4762/is-soluble-fiber-a-miracle-dietary-component .

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 18, 2013
at 02:43 PM

Yes, the assumption being that you're not. Phil Campbell did a trial at KDMC in Mississippi where a HIT protocol resulted in changes in people's cholesterol and triglycerides levels that were comparable to taking statins. Lots of studies show the benefits of exercise on heart health. It sounds like you're already doing this. The only other piece of advice I'd give you is to include adequate soluble fiber, possibly from certain legumes in an attempt to help bind more cholesterol in your gut. But I'm no expert in that field so take that as a loose recommendation.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:05 AM

The assumption being that I'm not I guess?:) I should have added that. I'm walking an hour, 3 times a week. do body weight exercises 2-3 times a week (push up, pull up, planks, kettlebell squats and kettlebell swings). I'm fairly active in my job, with a lot of walking as part of the work. I'm just (re)starting out with the workouts so my numbers aren't great yet, but I feel I'm getting a good balance between pushing my self and allowing recovery time.

Cb9a270955e2c277a02c4a4b5dad10b5

(10989)

on May 19, 2013
at 07:53 PM

I don't think so, maybe it does to a lesser degree though? A quich google turned this up as the first result for me: http://www.foods-healing-power.com/soluble-and-insoluble-fiber.html .

3
543a65b3004bf5a51974fbdd60d666bb

(4493)

on May 18, 2013
at 05:52 AM

According to Jaminet, your sort of 'numbers' could be related to 'low thyroid' function &/or 'low carb' (if you are low-carbing).

Jaminet has a few articles on the topic, worth taking a look,
Low Carb Paleo, and LDL is Soaring ??? Help!
What Causes High LDL on Low-Carb Paleo?
High LDL on Paleo Revisited: Low Carb & the Thyroid

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:02 AM

We have been low carb for quite a while. I'll read up on this too, thanks!

2
44348571d9bc70c02ac2975cc500f154

(5853)

on May 19, 2013
at 11:07 AM

Last year when i had up to 3 pounds of wild fish per week my trigs where so low that they had never been, 30. Then i scaled back a little bit :) I ate almost no meat for a month. Just fish and eggs.

1
5dbc84fc8a8e78e4db7293b58efdde32

(120)

on May 19, 2013
at 02:38 PM

Try taking slo-niacin every day. Also make sure you get at least 2 grams of omega 3s every day. I would also cut down on total cholesterol in your case.

0
B41cdb2253976ba9b429dd608d02c21f

(1495)

on May 19, 2013
at 12:06 PM

Why don't you consult with a holistic med practitioner? Everyone here can throw opinions and ideas at you (all of which are educated and great ideas), but to get to the real cause you should work with someone in the specialty. If you can't find one locally, I'm sure you can find one in a major city who will work with you from afar.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 02:53 PM

True, but I think crowdsourcing his problem is likely a more efficient use of funds. The holistic doc is going to say, 'try this and check back in 6-8 weeks.' He can do that without the holistic doc too, plenty of ideas the answers to his question.

0
32652cb696b75182cb121009ee4edea3

(5802)

on May 19, 2013
at 11:29 AM

I would track down some of Chris Masterjohn's thoughts on the issue. Here is one blurb where he talks about familial hypercholesterolemia and how it relates to eating PUFA's, etc. Seems to also dovetail with Jaminet's thoughts on thyroid issues (posted by daz above):

http://www.cholesterol-and-health.com/Does-Cholesterol-Cause-Heart-Disease-Myth.html#conclusion

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 19, 2013
at 12:18 PM

FH is often mentioned, but the rate is low: 1 in 500. Unlikely that even a few high cholesterol folks have FH.

0
1c67bc28f4e44bbb8770b86df0463df3

on May 18, 2013
at 05:26 PM

Your Trigs are high because your body is burning stored bodyfat which shows up in your blood test as Triglycerides. Your LDL is HIGH from those eggs. Eliminate the eggs and it will drop substantially.

If you are excersising or have 'brain fog' eat more carbs as this will cause hormone levels to change negatively and impact your hdl/ldl levels negatively.

0
3491e51730101b18724dc57c86601173

(8395)

on May 18, 2013
at 04:29 AM

High trigs mean your carbs are too high. Bring your carbs down and trigs will follow. To get HDL up, saturated fats and omega 3's. eat lots of fatty fish or supplement it.

3491e51730101b18724dc57c86601173

(8395)

on May 18, 2013
at 08:38 PM

Hmmm, scratching head. Most low carb/paleo experts agree with this: http://www.proteinpower.com/drmike/cardiovascular-disease/elevated-triglycerides-are-driven-by-carbohydrate-consumption/ See also: http://perfecthealthdiet.com/2012/11/more-evidence-for-low-carb-diets/ How's your thyroid? That can cause elevated lipids.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:00 AM

We've been eating low carb for a long time now, mainly meat and vege diet. I do have room for improvement in my omega 3 and fish intake.

Medium avatar

(10611)

on May 19, 2013
at 12:14 PM

Not necessarily. My carbs are much higher than this and my TG's are below 50. Heredity?

0
4c16ecea710e77553ee8b778e002cb25

on May 18, 2013
at 03:24 AM

Ironically, healthy fats like grass-fed butter and coconut oil combat this:

Start reading www.BulletProofExecutive.com

Medium avatar

(10611)

on May 19, 2013
at 12:17 PM

The OP already eats duck fat. It doesn't get much better than that.

7a6529ea25b655132fe58d793f95547a

(2030)

on May 18, 2013
at 04:22 AM

For some folks the higher levels of palmitic and myristic acid in coconut and dairy fat will negatively impact lipid profiles. http://atvb.ahajournals.org/content/14/4/567.short

0
7a6529ea25b655132fe58d793f95547a

(2030)

on May 18, 2013
at 02:46 AM

Hard to say if the cholesterol is problematic, you'd need a ldl particle size test to check like a VAP test. I would say though that your trig to hdl ratio is a little high and I'd want to work to get that down. I don't know what to suggest but you are at risk so I'd recommend reading "The Great Cholesterol Myth" a really good up to date book on heart disease and at least you'll have some talking points when you go back to see your doc.

Medium avatar

(10611)

on May 19, 2013
at 12:16 PM

I've had size done for the last 2 years. It's not the be-all-and-end-all, but it does give you more information than you have now.

7a6529ea25b655132fe58d793f95547a

(2030)

on May 18, 2013
at 01:51 PM

Ya cholesterol isn't really a good marker anyways, the particle size can just give you a bit of an insight. Kudos on the asthma meds that's great man.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 18, 2013
at 06:16 AM

I'm from New Zealand, before the test I asked my doctor about the particle size test and she said it was something they don't offer as funding is limited for these. Our health care system is quite different (to say the least), but my doctor's appointment was $35, the blood test was free, and asthma medication for the next 6 months will be about $6. This is all without insurance. BTW, I'm nearly off my asthma meds and this time i'm trialling a child's dose of the preventative steroid, largely due to my lifestyle changes.

8a0d2a746eaf669b6fadb26793d2ff62

(25)

on May 23, 2013
at 10:35 PM

James, thanks for your concern. Since you have taken the time to contribute, could you take a little longer and offer specific suggestions (beyond saturated fats) , instead of "you're going to die?" Thanks.

5dd50f78f47b8848d93724d6eb38d4c1

(907)

on May 20, 2013
at 07:39 AM

Mike. Particle size is useless with a LDL that high. LDL-p is what's important and it usually follows LDL if that goes up. I guarantee you're LDL particle count is extremely high as well. probably jimmy moore type levels. It's crazy for you to be eating this way with a family history of heart disease. Cut your saturated fat and adopt a diet that's less likely to kill you prematurely

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