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why is my cholesterol going up?

Answered on September 12, 2014
Created October 26, 2012 at 2:22 PM

i have been strict paleo for over a year, i am 64 and have a family history of heart disease. in january i had a blood test, the results were... triglycerides 210, overall 237, HDL 76, LDL 119, VLDL 42, ratio 3.1

i was just retested,the results are... triglycerides 58, overall 250, HDL 83, LDL 155, VLDL 12, ratio 1.9

i am worried, i know everyone says cholesterol doesn't matter but with my family history, i wonder if i am doing the right thing...

F694fc245d03b64d6936ddb29f4c9306

(2613)

on October 26, 2012
at 08:11 PM

Quick addendum: you should choose EITHER the Apo B or LDL-P. You don't need both. LDL-P is a better test for particle count, but it tends to be expensive and hard to find.

2bcee6f44420a8525b489ba1eef6128d

(257)

on October 26, 2012
at 07:07 PM

i feel so much better!

B3de48c5f099ec6d7c3435a16efaaaa5

(138)

on October 26, 2012
at 05:00 PM

See references on this link for scientific explanation http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on October 26, 2012
at 04:42 PM

Tyler, do you have literature supporting that calculator? I'd love to see it's accuracy. Thanks!

B3de48c5f099ec6d7c3435a16efaaaa5

(138)

on October 26, 2012
at 03:54 PM

Love the calculator!

276a5e631b62f8e0793987c0496364bb

(1644)

on October 26, 2012
at 02:59 PM

Your LDL is more accurately calculated as 127. https://dl.dropbox.com/u/10789757/Calculator.html

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5 Answers

3
F694fc245d03b64d6936ddb29f4c9306

(2613)

on October 26, 2012
at 02:41 PM

Your trig improvement is nothing to shrug at. It's phenomenal! Your old trigs were off the chart. You were probably very insulin-resistant, as trigs over 100 can indicate insulin resistance. You might have just saved yourself from diabetes, among other things.

As the others have said, your HDL/total ratio is improving. I wouldn't worry about the increase in LDL. High triglycerides can actually mask high LDL, because the lipoproteins that normally carry LDL become inundated with trigs. With this improvement to trigs, you cannot compare your old LDL concentration to your new one.

Some people with perfect cholesterol panels have heart attacks because of the effect of trigs. Cholesterol panels are not a great predictor of atherosclerosis. The best predictor of atherosclerosis are Apolipoprotein particle counts. If you're really concerned, get Apo A-1, Apo B, and LDL-P tests. Without that, you're poking around in the dark.

In the end, remember that blood cholesterol doesn't cause heart attacks. Oxidized plaques do. By reducing inflammation with Paleo, you're improving those.

F694fc245d03b64d6936ddb29f4c9306

(2613)

on October 26, 2012
at 08:11 PM

Quick addendum: you should choose EITHER the Apo B or LDL-P. You don't need both. LDL-P is a better test for particle count, but it tends to be expensive and hard to find.

2
63f2e1f026317464d8553801ea5fe495

(314)

on October 26, 2012
at 02:35 PM

Your trigs are so much better, as are your HDL/LDL and Trig/HDL ratios. Nice work!

1
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on October 26, 2012
at 03:29 PM

I have some news for you. Your doctor (or rather the labs) used algebraic formulas to calculate your LDL and VLDL. For the LDL they used the Friedewald formula which was designed in 1972 and validated (with p=.1) for trigs between 100 and 300 mg/DL (not very good statistical precision and your trigs are outside it's valid range).

The Friedewald formula is LDL = TC - HDL - TG/5.0 mg/dL. In 1972 when it was prohibitively expensive to do a direct measure of LDL, the Friedewald formula was a HUGE breakthrough. It is ridiculous that an additional $50 test (difference from standard panel ($150) to VAP panel ($200) under most insurances) is almost never required. And they put people on Statins without doing a VAP panel.

For VLDL they did something that I believe is downright unethical. They used a simple formula, VLDL=TG/5 mg/dL (note this is the last component of the Friedewald formula). This formula has been shown to be statistically inaccurate and should not be used period.

What does this mean? Well your LDL went up because your trigs went down. It's a straightforward linear equation, you reduce one variable and you have to increase another, so they go with the unknown -- the LDL.

I would demand that your doctor perform a VAP panel. Check out this post ( http://paleohacks.com/questions/147801/how-does-my-first-paleo-blood-work-look/147822#147822 ) there is a 40 mg/dL difference between his measured LDL and the Friedewald formula!

0
76211ec5301087de2588cfe3d6bccba9

(1178)

on October 26, 2012
at 02:27 PM

your trigs are way down and your HDL is up! plus your total:HDL ratio is about 3.0, down from about 3.1 previously. it sounds like your markers are getting better.

-1
D7854f42e1c1d92f22b3903cd5d4a438

on October 26, 2012
at 02:41 PM

The problem could be that your LDL is being calculated instead of being directly measured. By default they usually calculate it.

When Triglycerides are below 100 though the calculation for LDL can be off by a bit. Maybe ask your doctor to measure your LDL directly next time.

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