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How can we ascertain whether or not our Super High HDL is a good thing?

Answered on August 19, 2014
Created April 15, 2011 at 4:50 PM

Gary Wu has posted a couple questions about high HDL, and Elaine shares how she had 127 and usually floats at around 110. HDL is not talked about nearly as much as LDL, because it seems to be highly agreed upon, both within the Paleo community, and even outside the Paleo community (miraculous, i know) that high HDL is good. So what's there to talk about, right?

That's why I am delighted to see Paul Jaminet of Perfect Health Diet dive into the topic of high HDL. He wrote 2 articles on HDL, back to back, and I believe there's a 3rd article coming soon.

HDL and Immunity

HDL: Higher is Good, But is Highest Best?

At the root, he defines what HDL is/does.

  1. HDL gathers anti-pathogenic immune molecules and acts as a ???Trojan horse??? to attach those molecules to pathogens, helping white blood cells find and kill them.

  2. Toxin clearance. The primary lipoprotein in HDL, apolipoprotein A-I, not only binds to immune proteins, it also can pick up an assortment of toxins, including oxidized LDL.

These articles contain a bevy of seemingly fresh thought on the subject and address some critical questions and ideas.

A standout among these:

"In concrete terms: Is Richard Nikoley???s coconut oil-induced HDL of 133 mg/dl too high? It???s a fair question!"

Basically, Paul ends with a pretty open assessment that striving for a high HDL like Richard Nikoley is great. Some heavyweights chime in on the comments, including Emily Dean with her razor sharp wit, and Chris Kresser.

My question: If we are to strive for high HDL, because of the host of protective benefits it brings, while simultaneously knowing that actually HAVING a high HDL could imply warning signs of inflammation and/or infection, how can we carefully balance determining when we see a high HDL on our VAP tests that everything is all good in the hood.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 08, 2011
at 08:15 PM

This is how you down regulate the LDL receptor.....and using T3 as well. There are some others but these are the way we work.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on April 16, 2011
at 01:07 AM

lots of assumption in their articles? you have a lot more to offer on this but you're holding back. fine then.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 16, 2011
at 12:53 AM

WBC can be low in a bad infection.....context!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 16, 2011
at 12:52 AM

Correct stabby......I am faced daily with these issues and the answer is never the same for most patients. I think clinicians with a canned answer you must be wary of.....medicine is a science whose mistress is an art. Never forget this.

Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on April 16, 2011
at 12:34 AM

That was a good Dr. K answer, just a little brief. Basically if il 6 and crp are high and so is HDL it's more likely indicative of something like perhaps an infection, but if not and you're just exercising smart, getting good nutrition and eating a lot of fat then there is nothing to worry about.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on April 15, 2011
at 06:11 PM

Dr K. Post an answer! I was hoping to hear specifically from you on this.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 15, 2011
at 05:58 PM

Context of the HDL number is most critical......if the il 6 and us crp are low it's all good.....many times it's not

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4 Answers

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on April 16, 2011
at 12:03 AM

Super high HDL tends to be the result of the high myristic acid content in coconut/palm oil and butter. So, we have to wonder if our bodies strongly desire any and all myristic acid and rejoice when we supply these massive doses and thus create a highly optimal HDL level or if the supplying of unrealistically high doses simply potentiates a pathway that historically never really needed negative feedback controls.

The context of the epidemiology studies is also important and similar to the perceived benefits of omega-3. If a person is eating the SAD, then more omega-3 results in better health because it works to cancel out an imbalance. If a person is eating paleo-ish, then more omega-3 is unnecessary and potentially harmful to health because there is no imbalance being addressed. Perhaps more HDL for one eating the SAD results in decreased mortality due to the inherent increase in LDL oxidation, toxin load etc. present in the SAD but is useless or potentially harmful to someone eating a paleo-ish diet. Difficult to say.

Because the dietary factors that increase HDL the most tend to have not been encountered by a substantial number of the ancestors of the vast majority of people, I'm personally leaning toward it being disadvantageous to set a triple-digit HDL number goal and eating whatever amount of coconut oil it takes to get there. It's consistent with western medicine's tendency toward extracting a useful compound into a supraphysiological dose and trying to massively overwhelm all receptors in an attempt to produce some effect. There's no precedent for an 80% fat diet comprised mostly of coconut oil, so I'd be hesitant to say that it's ideal. I suppose it's possible. On the other hand, if most of the fat you eat is attached to ruminant flesh, you exercise regularly and the result is a highly elevated HDL number, then that seems to be appropriate.

I suppose a good approach to this question might be to find those individuals like the aforementioned Beijing resident with the 270+mg/dl reading and ascertain whether they are of unusually good health and live to strikingly old age or whether there is some detriment present.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 08, 2011
at 08:15 PM

This is how you down regulate the LDL receptor.....and using T3 as well. There are some others but these are the way we work.

0
8b4d1ba636ee4ec909b1f17ea41d6be1

on September 08, 2011
at 07:36 PM

I recently found some evidence that candida species feed on HDL, which in turn makes me wonder if inversely, candidiasis might cause HDL levels to spike:

http://www.ncbi.nlm.nih.gov/pubmed/10452650

Hard to say, but in a recent talk I attended on lipids, I found it disturbing that not once did the lecturer mention the link between infection and cholesterol, when many believe that HDL is part of the innate immune system and it's known that LDL rises in the presence of infection...

Diet is only part of the equation... Infection is another piece of the puzzle. Of course, paleo may play a role in infection prevention and control due to its low sugar content, but I'm told that even fruit can feed candida, so it probably depends on how stringent one is with one's intake of sugars in all forms.

0
Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 16, 2011
at 12:55 AM

Lots of assumption in here.....but hdl is raised best by resistance exercise not just MCT........and the excess you speak of is easily surmised by true and calculate lipid profile numbers....much we can infer.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on April 16, 2011
at 01:07 AM

lots of assumption in their articles? you have a lot more to offer on this but you're holding back. fine then.

0
4781cf8ae1bfcb558dfb056af17bea94

(4359)

on April 15, 2011
at 06:21 PM

It's a good question. I'm no doctor but there are other measures for inflammation and infection -- like white blood count, erythrocyte sedimentation rate, and C-reactive protein. Also, if you know your historic HDL, you should be able to gain a feel for how much of it is due to dietary changes (like high coconut, low omega 6, moderate fish intake , optimal vit D, A, K, adequate copper from foods like chocolate or liver or potatoes, etc).

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 16, 2011
at 12:53 AM

WBC can be low in a bad infection.....context!

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