1

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Blood work results: High LDL-P and TSH trending upward

Answered on September 07, 2014
Created June 05, 2013 at 11:31 PM

This is an update to a previous question: http://paleohacks.com/questions/191813/my-blood-panel-results-update-to-high-ldl#axzz2VMYbmKlO

I recently got more blood work done. Here are the results:

NMR LIPOPROFILE

Large VLDL Particle Number: <0.7 nmol/L
LDL Particle Number: 1955 nmol/L
Total Cholesterol: 275 mg/dL
LDL Particle Size: 22.2 nm
HDL Particle Number: 27.0 umol/L
Large HDL Particle Number: 13.2 umol/L
LP Insulin Resistance Score: 6
VLDL Size: 13.2 nm
HDL Cholesterol: 75 mg/dL
Small LDL Particle Number: 129 nmol/L
Triglycerides: 60 mg/dL
HDL Size: >10.0 nm
LDL Cholesterol: 188 mg/dL

TESTOSTERONE

Total Testosterone: 569.26 ng/dL
Sex Hormone Binding Globulin (SHBG): 35.4 nmol/L
Free Testosterone, Percent: 2.01%
Free Testosterone (calculation): 114 pg/mL
Testosterone Bioavailable: 280 ng/dL

HbA1C: 5.0 %
Estimated Average Glucose: 97 mg/dL

TSH 4.79 mU/L

Although it is good news to see LDL-C and total cholesterol gradually going down (compared to the labs from the previous question), it is a bit concerning to see LDL particle number that high as well as the gradual increase in TSH from previous labs. Any thoughts or suggestions?

048dd52752c45129c1212bfffb37ca72

(3150)

on June 06, 2013
at 01:50 PM

I see. I went to your previous topics to search for more context. This is sure a complex topic, hope you can get good advice from your doc or someone else. Your previous liver indicators seem to be in the normal range, do you have updates? Watch carefully liver/thyroid/adrenals trio as it seems that issues in any of these areas impact a lot the other. Being high LDL, low fT3 and low fTest is what I'm researching right now as it hits me also. Please report back whatever you find out as I'm pretty interested. Now I'm trying some adaptogens, Vit D3+K2, less exercise and more relax... we'll see!

8f2d9842fdfec224a425c0f77c4ee34d

(1241)

on June 06, 2013
at 12:31 PM

Thanks for the detailed response. Unfortunately, I'm definitely not low carb, so there's got to be some other explanation.

048dd52752c45129c1212bfffb37ca72

(3150)

on June 06, 2013
at 05:38 AM

Don't worry! :) Also, take it with a grain of salt and do your research. This is my understanding on the issue as a plain layperson but, honestly, there still some things that I have to tie together for a full understanding of the picture.

00cd3b6f51530a6832fcda1712edbec3

(2411)

on June 06, 2013
at 05:33 AM

Albert, I tried to upvote your answer twice, but the system wouldn't let me. Great synopsys of the current thinking on this issue.

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3 Answers

1
048dd52752c45129c1212bfffb37ca72

on June 06, 2013
at 05:20 AM

You're into a similar scenario as me. I've rockstarish HDL (108) and Triglycerides (77) but also high (185) LDL. My TSH is in range but slightly off from being optimal at 3.28 and total T4 is in range with 8.07 ug/mL and total T3 also in range with 1.14 ng/mL. BUT free T3 is slightly low with 2.27 pg/mL and I suspected this because I felt pretty cold this recently and monitored my temp and sometimes I even hit 35.6 C.

There are a lot of possible causes for thyroid problems but when you have pretty much normal TSH and T4 levels but bad conversion ratio to T3 it seems that it's not a thyroid problem per se but an inability from to body to convert enough T4 to its active form.

And, as T3 seems to regulate LDL receptors, it has been shown a direct correlation between low T3 levels and high circulating LDL.

It could be related to several things but most likely two of them: too much low carb intake and/or high cortisol. It would be called glucose deficiency. So that's why athletes might be susceptible of over-training if too much stress is generated to us and we are dieting hard or living in a low carb style. Have you gone very low carb this recently? Seems that less than 30 to 40% of carbs from your diet might have triggered this.

Take a look at this amazing link from Dr Jaminet, you'll learn a lot about the thyroid/carb relation and how it works. http://perfecthealthdiet.com/category/disease/hypothyroidism/

As recommended, you should check all thyroid markers because as you see a misdiagnose is very easy here. But an easy way you can track your status is taking body temperature as regularly as you can (awakening, midday and before bed) and see how responds. You can also monitor your heart rate. As an experiment, you can try to up carbs to a 150 to 200 gr per day or even more to see if it makes any difference to you. If your body temp and HR rises, that's a signal that you might be in a kind of "hibernation" mode and this would explain pretty well your numbers. Then as your thyroid ramps up you should start seeing your LDL lower.

With all this being said, I'm still not sure if this low thyroid function is even harmful or not. The likes of Ron Rosedale and Kruse think that a downregulated thyroid when carb presence is low is a normal thing and that in fact is desirable and promotes longevity. But, if you're feeling cold, or seeking for performance/youthfulness/fertility, it seems that carb restriction should be avoided... it could be related with the fact that we are meant to be eating carbs in warmth months with long light cycles and not so much when it's cold. If we go low carb that it's like we're always on winter so we favour cortisol + reverse T3 and if you do not get out of this you're stuck in it.

00cd3b6f51530a6832fcda1712edbec3

(2411)

on June 06, 2013
at 05:33 AM

Albert, I tried to upvote your answer twice, but the system wouldn't let me. Great synopsys of the current thinking on this issue.

048dd52752c45129c1212bfffb37ca72

(3150)

on June 06, 2013
at 05:38 AM

Don't worry! :) Also, take it with a grain of salt and do your research. This is my understanding on the issue as a plain layperson but, honestly, there still some things that I have to tie together for a full understanding of the picture.

048dd52752c45129c1212bfffb37ca72

(3150)

on June 06, 2013
at 01:50 PM

I see. I went to your previous topics to search for more context. This is sure a complex topic, hope you can get good advice from your doc or someone else. Your previous liver indicators seem to be in the normal range, do you have updates? Watch carefully liver/thyroid/adrenals trio as it seems that issues in any of these areas impact a lot the other. Being high LDL, low fT3 and low fTest is what I'm researching right now as it hits me also. Please report back whatever you find out as I'm pretty interested. Now I'm trying some adaptogens, Vit D3+K2, less exercise and more relax... we'll see!

8f2d9842fdfec224a425c0f77c4ee34d

(1241)

on June 06, 2013
at 12:31 PM

Thanks for the detailed response. Unfortunately, I'm definitely not low carb, so there's got to be some other explanation.

0
Cbe1731034411e1ce373cdc62e7d4eef

on September 07, 2014
at 01:20 PM

I had same thing happen. My TSH went from 3 to 6 to now 10 after 2 years of fairly low-carb.  I saw amazing things early on with weight loss, etc but after 6 months - al things stalled and started going in opposite direction.  I think low-carb for bit of time is fine but not long term.  I am visiting an endo next week and will be interesting to see what is going on. 

0
75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 06, 2013
at 12:10 AM

Definitely get your free T3 and free T4 levels checked. If they are low then get reverse T3 and anti-thyroid antibodies checked.

_Lazza

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