11

votes

I Think My Cholesterol Level Caused a Heart Attack (For My Doctor)

Answered on September 18, 2015
Created March 01, 2011 at 11:11 PM

Edit 4: Since this just got bumped, I should say that the TC/LDL-C was definitely the result of butter intake and the low testosterone was definitely the result of a zinc deficiency that arose as a result of not eating animal products for 8 years + a bunch of phytate from wheat and soy. Whoops.

Got my first batch of labs in today from yesterday's draw:

Glucose: 101 (seems high, but apparently being low in carbs in the days leading up to the test can influence that)

Cholesterol: 391 (120-200) TGs: 54 (30-199) HDL: 55 (27-68) LDL: 325 (Friedewald; an online calculator using the Iranian equation is 268.99) HDL Risk Factor 7.1 (0-7 ref range) hsCRP: .4 (0-3.0) TSH: .86 (.35-5.50)

I'm still waiting on vitamin D, HbA1c, testosterone and I asked for a VAP test and she said she would do it, so I'm kind of wondering why I even got these results back unless she didn't do the VAP or did both for some reason. Naturally, there's a note that says the cholesterol is "quite high and really needs to be treated." Sure, let's treat it with the SAD and statins.

I've only been doing what most would consider to be high fat diet for a short while. Before that I'd say it was moderate fat but still low carb, both compared to the SAD. I think LDL jumps up pretty rapidly in response to dietary shifts, but HDL lags a bit. I'll have to dig up my previous results, but total cholesterol was something like 168, with HDL a bit lower and TGs a bit higher. I'd like to work toward a higher HDL and lower TGs, but I'm pretty happy with TSH and CRP.

I'm kind of wondering if our diets might skew the cholesterol results in a way that hasn't been accounted for. This was a 12 hour fast, but the last things I ate before I started the fast were two fatty lamb steaks cooked in butter. I'd be pretty surprised if that didn't have an effect on the levels 12 hours later. Anyone have any thoughts on this?

For what it's worth, I typically eat 2-4 pastured eggs for breakfast, and grass-fed lamb for lunch and/or dinner. I eat mashed potatoes in whatever amounts I feel will fill up my glycogen stores most of the way on that particular day. There's some fish and crustaceans here and there and occasionally some chicken. I eat close to a half a pound of steamed spinach a day. Everything is cooked in or covered in pasture butter. I am leaner, stronger, get sick far less frequently and just feel all around better than I ever have in my life, so I'm not worried about the test results, but it is curious that some of us are only slightly out of range for cholesterol while others go off the charts. Even though TC or LDL of our type don't really correlate to mortality, I think it would be interesting if we pinned down why some of us can set records for these values.

Edit: I should also say that I had a low fat vegan diet for 8 years, followed by about 2 years or so on a low fat, whole grain yuppie diet. I wonder if going so long with so little fat in my diet has caused me to be ultra-sensitive to it with regard to LDL? Maybe someone else who is similarly off the charts might see if they had a similar pre-paleo situation.

Edit 2: 3 years ago cholesterol was 168, TGs were 65, HDL was 48 and LDL was 107.

Edit 3: 25(OH)D: 85ng/mL; free testosterone 1.8 (1.6-2.9); total testosterone 374 (300-1080) Clearly vitamin D is quite high and right where I wanted it. Testosterone on the other hand is quite low and far less than I expected. I realize that it is highly variable based on time of day etc. but this is fairly striking, especially considering how aggressive I am and my level of libido. I can only assume that if it is fairly low that it is the result of a nutrient deficiency, such as selenium. I wonder if the high LDL may be related to the low testosterone? Perhaps it's not being properly used to create sex hormones and as a result it just sitting around idle. In any case, I think liver consumption will be advantageous for correcting both situations.

As always, any input is appreciated.

Medium avatar

(19479)

on September 21, 2011
at 08:34 PM

Yerba Mate is a cultural tradition in many South American countries (particularly Argentina). It does contain caffeine, but also has other substances that seem to have a stimulatory (but not excessively so) effect. I tend to cycle between coffee, green tea, and yerba mate.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 06:30 PM

I checked out what he was talking about, but he is basing that on the most popular (but I believe deeply flawed study about Apo E4). The researchers were a) working with the "cholesterol hypothesis" paradigm, so they could not imagine a reason why higher cholesterol could be beneficial, b)it presumes that a gene that has survived with us longer than the other 2 Apo E alleles is somehow "flawed", which I find terribly hard to believe, and c)Apo E4 is "the" gene of the of the ice age hunter gatherer, they weren't skimping on the animal fat.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on September 21, 2011
at 05:06 PM

what the heck? HDL at 58? uh nope. Jeez I wish. I don't know why I put that. I think it was just an honest mistake of confusing numbers. My HDL on that particular test for 42, not 58. I still mostly support my comments here about LDL. I am not that concerned about LDL if other factors are in healthy range like Trigs, HDL, VLDL, which I oddly mention nothing about here. Anyway.. pretty neat to see historical comments and then rethink them with what we've learned since that time. :)

Da8e709acde269e8b8bfbc09d1737841

(1906)

on September 21, 2011
at 01:57 PM

@PortlandAllan - Suddenly being a doctor is an appeal to authority, when the community as a whole disregards medical advice from most doctors? Come on.

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 11:45 AM

Definitely still unknown. I was referring to this post: goo.gl/EiZQX

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 11:40 AM

Definitely still unknown. I was suffering to this post: http://goo.gl/EiZQX

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 11:18 AM

Some groovy theories about why these folks actually require more cholesterol: http://drbganimalpharm.blogspot.com/2011/06/ancestral-allele-apoe4-super-brain.html

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 11:10 AM

The increase in endogenous cholesterol in these people seems to be in response to lack of dietary saturated fat, and their numbers will remain relatively high regardless of the source, but will go higher if the nutritional fat needs aren't being met, it won't spiral endlessly out of control, it will settle at the proper amount for that individual.

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 10:52 AM

BTW, Trevis, how come your D level is so high ? Do you supplement ?

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 10:49 AM

Yes, but if you produce more cholesterol then regular people then you need less dietary one. Right ? 2-4 eggs a day he eats provide non-trivial amounts. Dr Davis has provided lot of info on this.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 10:45 AM

From what I've found in my research lately, no one is genetically incompatible with a high fat diet, some genetic types (like Apo E4) simply produce more cholesterol for their particular metabolic needs, like synthesizing more D from dietary sources.

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 09:53 AM

I would start Vitamin C megadose ASAP. You are probably deficient so your cholesterol is adjusted by the liver accordingly. You don't eat liver, eyes, brainz. You are paleo. Try to find your bowel tolerance.

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 09:47 AM

I would start Vitamin C megadose ASAP!

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 21, 2011
at 02:56 AM

I hear two sides to this: some for psyllium, some against. Some say that the fiber in psyllium will rake your intestine lining. Some claim to have solved constipation with it. Were you taking psyllium specifically to lower your LDL or was it for your constipation?

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 21, 2011
at 01:37 AM

To what????????

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 21, 2011
at 12:42 AM

1500 cals of macadamias! I would switch to pork rinds.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 21, 2011
at 12:41 AM

I take 3 out of 4. Yerma Mate tea, I've never heard of. But I'll investigate.

Medium avatar

(39821)

on September 20, 2011
at 11:54 PM

Heh, this thread takes me back...

5672b2d190891342389e764cc4056ca9

(1304)

on March 24, 2011
at 09:54 AM

Travis, take a look at this article that connects vitamin deficiencies and cholesterol production: http://www.familyhealthnews.com/alternative-health-information/heart/heart-disease-halted.html. Paul Jaminet also talks about his experience with scurvy, which may be related to low fruit consumption combined with some infection. I find this link between vitamins and cholesterol more compelling than the one between copper and cholesterol.

D05e94d3fa7fbf32eb56445ad932f654

(773)

on March 06, 2011
at 10:16 AM

Up until my blood test, I had been taking cod liver oil daily. Since then, I have been having liverwurst about every other day.

Medium avatar

(39821)

on March 05, 2011
at 10:24 PM

Do you ever eat liver?

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 05, 2011
at 08:06 AM

yes indeed Bob. see my earlier answer above (starts with "fascinating article"...) thx!

D05e94d3fa7fbf32eb56445ad932f654

(773)

on March 05, 2011
at 12:32 AM

Yes, I use coconut oil for cooking and sometimes eat it by the spoonful. (Since my test, I've been sort of replacing it with butter..I'll see how that goes). I also eat MANY eggs. I average around 6 whole eggs a day. Lots of bacon and red meat. Almost no white meat. I'd say I'm VLC. for a while I had tubers after workouts, but have since cut them out because I have found that I feel better without them, even PWO. Oh, also, I eat a ton of macadamias. Sometimes 1500 calories worth in one sitting. Not exactly proud of that, but not feeling guilty either.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 04, 2011
at 07:48 PM

I have been considering supplementing copper too. There is a very informative article on the importance of copper on WAPF site. Similar to their Magnificent Magnesium article, it throws everything on earth at you like Copper is connected to every single function of the body. So it's gotta be hugely important. Plus Dr Kurt Harris says he supps Magnesium. I just started taking iodine in the form of kelp tablets and I may add copper and magnesium.

Medium avatar

(39821)

on March 04, 2011
at 06:44 PM

I was just reading that and it's really interesting. I actually do have the PHD and eat in a way that happens to be pretty consistent with it, but I just couldn't bring myself to eating much liver. I eat kelp, at least two eggs and a lot of spinach every day, so I figured that I'd hit all of the bases, but it appears that this may be a copper deficiency. I get the feeling that most people on the SAD are similarly deficient, but because their fat intakes aren't high enough, they can't produce the requisite cholesterol that is attempting to repair the damage.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 04, 2011
at 03:23 PM

sorry, not buyin it. do not take psyllium husks. it's just harsh fiber and you don't need that for any reason. some fiber in natural foods = ok. but too much fiber can jack you up real bad.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 04, 2011
at 03:19 PM

i still agree with Ignacio and Ikco here. we are all grown adults, yes? we all can determine for ourselves if following Dr K's advice is smart or not. But this is a question/answer website. He answered the question. Whether he is right or not, regardless of what screenname he chose, he didn't say anything derogatory. it's one thing to intelligently question his advice and put it through skeptical thinking, like Kamal is doing with the Olympic lifts, but it's another to attack him for answering a question. Doc or not, he didn't break any rules in his post.

Medium avatar

(39821)

on March 04, 2011
at 01:16 AM

Pretty much same results but with a really solid HDL. What do you eat typically? Lots of coconut?

4e40d2b9e1a762949a25b958762aa10d

(762)

on March 03, 2011
at 06:24 PM

@PortlandAllan: You make my point! Why else would Dr. K chose to call himself that? When someone uses the title 'doctor' they must be careful what they say because people may give it more weight. A doctor saying you should get this test is usually treated different than your friend giving the same advice.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 03, 2011
at 05:43 AM

Throwing more fuel on the proverbial fire, I still can't understand why someone would prescribe low rep olympic lifts to increase HDL. If there's a study or a biological mechanism in there, compared to non-olympic lifts, I'd love to see it. But without knowing Travis, why would someone tell him to do olympic lifts? In other words, the lifts that require the most exacting technique, with the highest risk of injury, that you can't do at home?

5740abb0fa033403978dd988b0609dfd

(2633)

on March 03, 2011
at 05:10 AM

I agree with both Ignacio and Kamal. I think what puts me off is the choice to have "Dr" in one's handle is an obvious "appeal to authority". Do we even know K is a Dr? No. Therefore, I assume K is not. And treat the posts with the same skepticism I would if they were from "Anonymous K"

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 03, 2011
at 04:42 AM

And the reason I sort of agree with mac is that the general townsfolk of paleohacks are seen as regular townsfolk. When a doctor posts, people actually have been asking "Doctor, what do you think about this?" and seem much more amenable to making important decisions based on the answer. That's why so few doctor bloggers give specified advice to individuals. Kurt Harris doesn't do it, Dr. Eades doesn't do it, etc etc.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 03, 2011
at 04:40 AM

I still don't understand where some of this advice is coming from. It's nice to have Dr. K giving insight into things, but a few times he (or she?) has "diagnosed" a condition and prescribed treatments rather than suggesting possible avenues. The other one or two doctors on here never do that, which I think is wise considering that you can't examine people over the internet.

50637dfd7dc7a7e811d82283f4f5fd10

(5838)

on March 03, 2011
at 01:02 AM

Also never heard of this. Thank you Kaz, for the quality input.

Medium avatar

(39821)

on March 03, 2011
at 12:49 AM

That's really interesting info about something I was previously unaware, but I don't really eat anything that is dense in plant sterols, and when I did, my LDL was less than half of what it is now. I think something else is at play here.

100fd85230060e754fc13394eee6d6f1

(18706)

on March 02, 2011
at 10:59 PM

Good question. I was supposed to see him when the results came in, but haven't yet.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 02, 2011
at 09:45 PM

I agree with Ignacio and Ikco here.

5edbf85deaf83e13b176df023abb154d

(1293)

on March 02, 2011
at 09:18 PM

GREAT profile! What does your doc say about it?

84666a86108dee8d11cbbc85b6382083

(2399)

on March 02, 2011
at 05:44 PM

I'm with Ignacio. PaleoHacks is a question platform. Answers are provided. Medical advice is something else and I'm sure Trav knows there are other path to pursue that. If wanted.

Ac1e55cf06c2180f4008ff01953d10dd

(3524)

on March 02, 2011
at 05:30 PM

mac I do not think it is serious that you blame DrK for "giving halthcare advice". He is a member of paleohacks and answers in that condition, or do you think that doctors have less freedom of expression than other citizens do? Besides he is giving Travis the kind of advice that other members may offer: If someone is going to forbid people from advising about vitamins or other supplements I do not think that doctors should be the first "victims" of your ruling!

Ac1e55cf06c2180f4008ff01953d10dd

(3524)

on March 02, 2011
at 05:29 PM

mac I do not think it is sreious that you blame DrK for "giving halthcare advice". He is a member of paleohacks and answers in that condition, or do you think that doctors have less freedom of expression than other citizens do? Besides he is giving Travis the kind of advice that other members may offer: If someone is going to forbid people from advising about vitamins or other supplements I do not think that doctors should be the first "victims" of your ruling!

4e40d2b9e1a762949a25b958762aa10d

(762)

on March 02, 2011
at 02:55 PM

@Dr. K: It's seriously irresponsible of you as a practicing physician to give healthcare advice to someone who isn't your patient-they aren't your guinea pig. Either that or you are flagrantly violating HIPAA rules. Also, your advice is costly and, to my knowledge, not supported by data. Please send me the information that informs these clinical decisions.

100fd85230060e754fc13394eee6d6f1

(18706)

on March 02, 2011
at 12:41 PM

Thanks! I actually do supplement with K2. Maybe I should also supplement D? Then again, that was January, so it's probably at its lowest for the year.

Medium avatar

(39821)

on March 02, 2011
at 06:51 AM

I've been giving all of this a lot of thought today, and I know there are many things I could do to manipulate my LDL downward, but I'm not convinced that that's even desirable. That I would have an actual deficiency in any of these things seems unlikely. I've given my body all of the raw materials and it has decided that it wants high LDL right now (to purge fat from the liver or for whatever reason) so why interfere? I think I'll retest in 6 months and see how it looks.

5740abb0fa033403978dd988b0609dfd

(2633)

on March 02, 2011
at 06:41 AM

Hilarious title! Excuses that it's not a question.

Medium avatar

(39821)

on March 02, 2011
at 05:53 AM

That's interesting; I had a high fructose, low choline diet for a very long time.

Medium avatar

(39821)

on March 02, 2011
at 05:47 AM

Yeah, that's really interesting. I bet I had some serious fatty liver from a high fructose, no choline diet.

3a833804187fe8926214e6c0bd8a0766

(1023)

on March 02, 2011
at 05:39 AM

Oops, I read that as "high LDL after shifting..."

Ac1e55cf06c2180f4008ff01953d10dd

(3524)

on March 02, 2011
at 04:03 AM

Travis I think the ratio of Tot. Chol to HDL is too low. I would not speculate about why is that but if I were you I would see how to improve it. Your CRP is excellent, on the other hand! – Ignacio 59 mins ago

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 02, 2011
at 03:53 AM

A couple things I don't get: I understand niacin, but why fish oil for HDL when it increases HDL by only the tiniest bit? (several studies, such as pubmed ID 20041810 show this). Also, what is the rationale for low rep olympic lifts? This would be different then powerlifting or other movements only because of the speed and injury risk involved, I would think, not some cardiovascular factor.

Medium avatar

(39821)

on March 02, 2011
at 03:21 AM

I'm allergic to tree nuts, so no coconut for me. What myristic acid I get now is largely from butter. I'll consider upping my salmon intake.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 03:13 AM

micronized Niacin.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 03:12 AM

The large NIH VITAL Trial will provide more definitive data on both Vitamin D and Omega-3 links to heart disease when it is completed sometime in 2014.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 03:07 AM

Vitamin D does increase the cholesterol......but its the total that rises......not the HDL. The real benefit is that it also lowers the cardiac CRP and calcium score too.

Ac1e55cf06c2180f4008ff01953d10dd

(3524)

on March 02, 2011
at 03:03 AM

Travis I think the ratio of Tot. Chol to HDL is too low. I would not speculate about why is that but if I were you I would see how to improve it. Your CRP is excellent, on the other hand!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 02:33 AM

This is a great profile. My last HDL was 94. And Cardiac Crp was .02 and a zero calcium index score. Your D is too low. shoot for 60-80. TO raise it you need vit K2 supplement daily as it carboxylates osteocalcin to very quickly double your 25 D OH levels.

Medium avatar

(39821)

on March 02, 2011
at 02:16 AM

Very interesting theory indeed. I wouldn't be surprised if my vitamin D comes back as out of range upward. I'll have to do some research into this. Seems though that low D should cause increased cholesterol levels so that you could manufacture more. I stopped taking fish oil months ago btw.

Medium avatar

(39821)

on March 02, 2011
at 02:13 AM

Very interesting theory indeed. I wouldn't be surprised if my vitamin D comes back as out of range upward. I'll have to do some research into this.

5edbf85deaf83e13b176df023abb154d

(1293)

on March 02, 2011
at 01:20 AM

Here is the article in question: http://www.westonaprice.org/blogs/why-is-my-cholesterol-so-high-on-this-diet.html With respect, I do think it was to do with high cholesterol.

3a833804187fe8926214e6c0bd8a0766

(1023)

on March 02, 2011
at 12:36 AM

I think that was high triglycerides.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 01, 2011
at 11:18 PM

Love your tags!

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21 Answers

7
9dd74d3941535d0aaa2c8d3cf454fb7e

on March 03, 2011
at 12:41 AM

With cholesterol levels in excess of 350 ng/dL I would suggest getting tested for sitosterolemia. Standard cholesterol tests do not differentiate from, and include in the totals, beta sitosterol, camposterol, etc. This occurs when the body can't break down and excrete plant sterols. The condition is believed to be under diagnosed.

Sources with high levels of beta-sitosterols are the ubiquitous vegetable and seed oils in the SAD, as well as in many nuts (pistachios are quite high, as are the skins of almonds). Canola oil, expeller pressed, is the worst. Animal fats generally contain little if any beta sitosterol or other plant sterols.

http://en.wikipedia.org/wiki/Sitosterolemia

The test runs about 150 USD if not covered by your health insurer.

50637dfd7dc7a7e811d82283f4f5fd10

(5838)

on March 03, 2011
at 01:02 AM

Also never heard of this. Thank you Kaz, for the quality input.

Medium avatar

(39821)

on March 03, 2011
at 12:49 AM

That's really interesting info about something I was previously unaware, but I don't really eat anything that is dense in plant sterols, and when I did, my LDL was less than half of what it is now. I think something else is at play here.

7
Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 02:30 AM

Well everyone here is praising you. I wont. You HDL is way too low for these labs, especially the ratio of LDL to HDL. And if your eating coconut oil and still got a 55 I would be even more concerned. I also would want your Cardiac CRP to be on the ground considering your TG levels, but its not at 0.4. Anyone north of 330 I want Cardiac CRP's real low......like .02 low. It has to do with arterial wall thickness and PAD risk. And if youre inflamamtion goes above .5 you can still hurt yourself. It may not kill you but it could lead to issues. I think you need to fine tune it a bit. Overall compared to a Standard American Diet youre way ahead. But I do not like your HDL at all. With the labs you posted I would be OK with your HDL north of 70. To get there you need to supplement In some areas......and using low rep olympic lifts a few times a week to get there. Dont settle for good or OK......settle for optimal. And eat more myrstic sat fats and more stearic fat. It will also help your fat profiles and push your HDL over 70. Low TG and high HDL with real low cardiac crps are the key to long healthy doctor free life. If your labs stayed this way for several yrs I would be sending you for biannual calcium index scores. So the news for you is not totally rosy............its good in context to the kids eating Taco Bell......but you would not be the head of my paleo pupils.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 03, 2011
at 04:40 AM

I still don't understand where some of this advice is coming from. It's nice to have Dr. K giving insight into things, but a few times he (or she?) has "diagnosed" a condition and prescribed treatments rather than suggesting possible avenues. The other one or two doctors on here never do that, which I think is wise considering that you can't examine people over the internet.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 02, 2011
at 03:53 AM

A couple things I don't get: I understand niacin, but why fish oil for HDL when it increases HDL by only the tiniest bit? (several studies, such as pubmed ID 20041810 show this). Also, what is the rationale for low rep olympic lifts? This would be different then powerlifting or other movements only because of the speed and injury risk involved, I would think, not some cardiovascular factor.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 03, 2011
at 05:43 AM

Throwing more fuel on the proverbial fire, I still can't understand why someone would prescribe low rep olympic lifts to increase HDL. If there's a study or a biological mechanism in there, compared to non-olympic lifts, I'd love to see it. But without knowing Travis, why would someone tell him to do olympic lifts? In other words, the lifts that require the most exacting technique, with the highest risk of injury, that you can't do at home?

4e40d2b9e1a762949a25b958762aa10d

(762)

on March 02, 2011
at 02:55 PM

@Dr. K: It's seriously irresponsible of you as a practicing physician to give healthcare advice to someone who isn't your patient-they aren't your guinea pig. Either that or you are flagrantly violating HIPAA rules. Also, your advice is costly and, to my knowledge, not supported by data. Please send me the information that informs these clinical decisions.

Medium avatar

(39821)

on March 02, 2011
at 06:51 AM

I've been giving all of this a lot of thought today, and I know there are many things I could do to manipulate my LDL downward, but I'm not convinced that that's even desirable. That I would have an actual deficiency in any of these things seems unlikely. I've given my body all of the raw materials and it has decided that it wants high LDL right now (to purge fat from the liver or for whatever reason) so why interfere? I think I'll retest in 6 months and see how it looks.

84666a86108dee8d11cbbc85b6382083

(2399)

on March 02, 2011
at 05:44 PM

I'm with Ignacio. PaleoHacks is a question platform. Answers are provided. Medical advice is something else and I'm sure Trav knows there are other path to pursue that. If wanted.

Medium avatar

(39821)

on March 02, 2011
at 03:21 AM

I'm allergic to tree nuts, so no coconut for me. What myristic acid I get now is largely from butter. I'll consider upping my salmon intake.

Ac1e55cf06c2180f4008ff01953d10dd

(3524)

on March 02, 2011
at 05:30 PM

mac I do not think it is serious that you blame DrK for "giving halthcare advice". He is a member of paleohacks and answers in that condition, or do you think that doctors have less freedom of expression than other citizens do? Besides he is giving Travis the kind of advice that other members may offer: If someone is going to forbid people from advising about vitamins or other supplements I do not think that doctors should be the first "victims" of your ruling!

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 02, 2011
at 09:45 PM

I agree with Ignacio and Ikco here.

Ac1e55cf06c2180f4008ff01953d10dd

(3524)

on March 02, 2011
at 05:29 PM

mac I do not think it is sreious that you blame DrK for "giving halthcare advice". He is a member of paleohacks and answers in that condition, or do you think that doctors have less freedom of expression than other citizens do? Besides he is giving Travis the kind of advice that other members may offer: If someone is going to forbid people from advising about vitamins or other supplements I do not think that doctors should be the first "victims" of your ruling!

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 04, 2011
at 03:19 PM

i still agree with Ignacio and Ikco here. we are all grown adults, yes? we all can determine for ourselves if following Dr K's advice is smart or not. But this is a question/answer website. He answered the question. Whether he is right or not, regardless of what screenname he chose, he didn't say anything derogatory. it's one thing to intelligently question his advice and put it through skeptical thinking, like Kamal is doing with the Olympic lifts, but it's another to attack him for answering a question. Doc or not, he didn't break any rules in his post.

5740abb0fa033403978dd988b0609dfd

(2633)

on March 03, 2011
at 05:10 AM

I agree with both Ignacio and Kamal. I think what puts me off is the choice to have "Dr" in one's handle is an obvious "appeal to authority". Do we even know K is a Dr? No. Therefore, I assume K is not. And treat the posts with the same skepticism I would if they were from "Anonymous K"

4e40d2b9e1a762949a25b958762aa10d

(762)

on March 03, 2011
at 06:24 PM

@PortlandAllan: You make my point! Why else would Dr. K chose to call himself that? When someone uses the title 'doctor' they must be careful what they say because people may give it more weight. A doctor saying you should get this test is usually treated different than your friend giving the same advice.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on March 03, 2011
at 04:42 AM

And the reason I sort of agree with mac is that the general townsfolk of paleohacks are seen as regular townsfolk. When a doctor posts, people actually have been asking "Doctor, what do you think about this?" and seem much more amenable to making important decisions based on the answer. That's why so few doctor bloggers give specified advice to individuals. Kurt Harris doesn't do it, Dr. Eades doesn't do it, etc etc.

Da8e709acde269e8b8bfbc09d1737841

(1906)

on September 21, 2011
at 01:57 PM

@PortlandAllan - Suddenly being a doctor is an appeal to authority, when the community as a whole disregards medical advice from most doctors? Come on.

4
Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 04, 2011
at 06:34 PM

Fascinating article with subsequent comments conversation going on over on Perfect Health Diet regarding high LDL. BE SURE to read the comments too, not just the article. Masterjohn weighs in. Paul Jaminet replies frequently. It's very interesting.

Paul poses question about Paleo, high LDL:

http://perfecthealthdiet.com/?p=2536

Paul answers question about Paleo, high LDL:

http://perfecthealthdiet.com/?p=2547

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 04, 2011
at 07:48 PM

I have been considering supplementing copper too. There is a very informative article on the importance of copper on WAPF site. Similar to their Magnificent Magnesium article, it throws everything on earth at you like Copper is connected to every single function of the body. So it's gotta be hugely important. Plus Dr Kurt Harris says he supps Magnesium. I just started taking iodine in the form of kelp tablets and I may add copper and magnesium.

Medium avatar

(39821)

on March 04, 2011
at 06:44 PM

I was just reading that and it's really interesting. I actually do have the PHD and eat in a way that happens to be pretty consistent with it, but I just couldn't bring myself to eating much liver. I eat kelp, at least two eggs and a lot of spinach every day, so I figured that I'd hit all of the bases, but it appears that this may be a copper deficiency. I get the feeling that most people on the SAD are similarly deficient, but because their fat intakes aren't high enough, they can't produce the requisite cholesterol that is attempting to repair the damage.

4
D05e94d3fa7fbf32eb56445ad932f654

(773)

on March 02, 2011
at 01:40 AM

Hi Travis,

I had my levels tested a few weeks ago. They also shocked my doctor.

Total Cholesterol (mg/dL): 419

Cholesterol, HDL (mg/dL): 114

Cholesterol, LDL (mg/dL): 277

Triglycerides (mg/dL): 51

Glucose: (mg/dL): 101

This was done after about a 14 hour fast. I'm male, 26 years old, paleo for 9 months. I'm 5'11", 160 lbs and quite active. Honestly, I'm not too worried about my results, but they seem to scare some people (like my parents).

D05e94d3fa7fbf32eb56445ad932f654

(773)

on March 05, 2011
at 12:32 AM

Yes, I use coconut oil for cooking and sometimes eat it by the spoonful. (Since my test, I've been sort of replacing it with butter..I'll see how that goes). I also eat MANY eggs. I average around 6 whole eggs a day. Lots of bacon and red meat. Almost no white meat. I'd say I'm VLC. for a while I had tubers after workouts, but have since cut them out because I have found that I feel better without them, even PWO. Oh, also, I eat a ton of macadamias. Sometimes 1500 calories worth in one sitting. Not exactly proud of that, but not feeling guilty either.

Medium avatar

(39821)

on March 05, 2011
at 10:24 PM

Do you ever eat liver?

Medium avatar

(39821)

on March 04, 2011
at 01:16 AM

Pretty much same results but with a really solid HDL. What do you eat typically? Lots of coconut?

D05e94d3fa7fbf32eb56445ad932f654

(773)

on March 06, 2011
at 10:16 AM

Up until my blood test, I had been taking cod liver oil daily. Since then, I have been having liverwurst about every other day.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 21, 2011
at 12:42 AM

1500 cals of macadamias! I would switch to pork rinds.

3
244dca88091fa349a77379b1629d0b25

(255)

on March 04, 2011
at 03:29 PM

There was an interesting article posted on Perfect Health Diet blog about high LDL levels on low-carb Paleo and the possible causes. http://perfecthealthdiet.com/?p=2547

3
Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 02, 2011
at 05:27 PM

I'm with Travis on this one. I think the numbers that we all have come believe are 'normal' do not provide an accurate picture of health. It doesn't make any sense to say that if Travis is eating the right things in his daily diet, is fit, and feels healthy that he has to adjust some stupid LDL number that people rely on as a health marker when it's unfounded.

LDL numbers taken from sample groups of people on the SAD is a VERY different scenario than LDL numbers and cardiac arrest percentages taken from folks on a pure foods or 'paleo' style diet. Until I see a well run study that shows people who eat a high quality fat diet with whole, nutrient dense foods, essentially avoiding the agents of disease, who are fit and healthy, then I just don't buy into the LDL figure being a 'trump all' for all the other indicators that Travis has going for him. These are some pretty intricate numbers folks, and I know that we can deduce 'some' important factors from them, but I strongly believe that it's much better to rely on Travis's (or anyone else) personal eating/activity habits. I know being 'fit' or not obese does not necessarily equal health, but at least it's a great plus on his side.

I have nearly the same story. "high" LDL at 211, low trigs at 82 and decent HDL at 58. CRP is healthy. Vit D is in range. Liver functioning perfectly. I am fit and muscular and have plenty of energy. And I bet my HDL has climbed in the last 4 months since gettint tested. But Doc wants to put me on statins for my LDL. So ignore all other factors that my body is functioning very well and focus on some silly LDL number that we don't even know is really detrimental? I say... hogwash. I only live once, and I'm not about to screw up my health with some stupid manmade drug that NOBODY on earth had access to 100 years ago.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on September 21, 2011
at 05:06 PM

what the heck? HDL at 58? uh nope. Jeez I wish. I don't know why I put that. I think it was just an honest mistake of confusing numbers. My HDL on that particular test for 42, not 58. I still mostly support my comments here about LDL. I am not that concerned about LDL if other factors are in healthy range like Trigs, HDL, VLDL, which I oddly mention nothing about here. Anyway.. pretty neat to see historical comments and then rethink them with what we've learned since that time. :)

3
F9a0b72f38860d7601afd5a45bb53394

(3618)

on March 01, 2011
at 11:25 PM

Your TGs are so awesome. She needs to do direct count and make sure the LDL particles are fluffy before she starts yelling at you. CRP's really good too, look Ma, no inflammation!

2
100fd85230060e754fc13394eee6d6f1

(18706)

on March 02, 2011
at 02:23 AM

That's pretty interesting, Travis. I'm glad you are not letting it phase you. I had mine done in January. I don't know what I ate the night before, but as I eat only meat and fat, you can bet it was fatty meat. Here were the results (I'm female, and was 37 at the time):

Lipids: (mg/dL)

  • chol 246 (140-200) high
  • trig 38 (35-135)
  • HDL 94 (40-80) high
  • LDL calculated 145 (70-100) high
  • VLDL 7 (8-25) low

glucose 71 (70-100 mg/dL)

25-OH vit D 33.3 (25-80 ng/mL)

I had forgotten to ask for direct LDL measurements, but since low TG/Total predicts low particle size, I'm not concerned. Also my ratios are stellar.

I was really surprised at the glucose though. Most carnivores report about 100.

I do have vegetarianism in my past (in fact I was raised ovo-lacto), but it was never low-fat, and the vegan experiment in my case was for less than a year (I think), and I haven't been vegetarian for over a decade, so if there is an effect, it might have passed.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 02:33 AM

This is a great profile. My last HDL was 94. And Cardiac Crp was .02 and a zero calcium index score. Your D is too low. shoot for 60-80. TO raise it you need vit K2 supplement daily as it carboxylates osteocalcin to very quickly double your 25 D OH levels.

100fd85230060e754fc13394eee6d6f1

(18706)

on March 02, 2011
at 12:41 PM

Thanks! I actually do supplement with K2. Maybe I should also supplement D? Then again, that was January, so it's probably at its lowest for the year.

5edbf85deaf83e13b176df023abb154d

(1293)

on March 02, 2011
at 09:18 PM

GREAT profile! What does your doc say about it?

100fd85230060e754fc13394eee6d6f1

(18706)

on March 02, 2011
at 10:59 PM

Good question. I was supposed to see him when the results came in, but haven't yet.

2
5672b2d190891342389e764cc4056ca9

(1304)

on March 02, 2011
at 01:40 AM

Travis, we already had a little discussion about Vit D, sun tan, and fooling the body...

I also have very high LDL cholesterol after a period eating what I believe to be healthful and natural food. I don't think that high cholesterol causes CVD, but suspect that there might be something wrong when is too high; at the same time, as I refuse to believe that what I eat is not good (sounds vegan?), I started looking at supplementation as the possible cause of the problem.

I actually suspect that the relationship between cholesterol, Vit D, and fish oil is not completely understood and might be cause for concern.

Ok, the causation is: cholesterol+sunshine >> Vit D.

However, is it possible that when we get a lot of Vit D and fish oil through supplements, our body is fooled into thinking that it's summer, that we are going to get a lot of sushine, and thus ups cholesterol production? Should supplementation be seasonal?

It would be interesting to see if those who supplement with Vit D (+fish oil) have seen a sharp increase in cholesterol levels.

Medium avatar

(39821)

on March 02, 2011
at 02:16 AM

Very interesting theory indeed. I wouldn't be surprised if my vitamin D comes back as out of range upward. I'll have to do some research into this. Seems though that low D should cause increased cholesterol levels so that you could manufacture more. I stopped taking fish oil months ago btw.

Medium avatar

(39821)

on March 02, 2011
at 02:13 AM

Very interesting theory indeed. I wouldn't be surprised if my vitamin D comes back as out of range upward. I'll have to do some research into this.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 03:12 AM

The large NIH VITAL Trial will provide more definitive data on both Vitamin D and Omega-3 links to heart disease when it is completed sometime in 2014.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 03:07 AM

Vitamin D does increase the cholesterol......but its the total that rises......not the HDL. The real benefit is that it also lowers the cardiac CRP and calcium score too.

1
11232a01233944f959ce9ff3eb99a07a

on March 03, 2011
at 04:21 AM

Just in case anyone wants to lower LDL and Total Cholesterol, I have found psyllium to do a very good job. I reduced my total cholesterol and LDL by about 25% in only 3 weeks, taking about 20 grams of psyllium per day (10 grams in am, 10 grams in pm). I also recommended the same to a friend and he reported similar results.

My total cholesterol normally runs about 265, and I wanted to get into a study that required "normal" cholesterol of below 200. I hit 197 after only 3 weeks of taking the psyllium 2x/day.

Just make sure you take the psyllium with plenty of water. I put mine in 16 oz of water morning and night.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 04, 2011
at 03:23 PM

sorry, not buyin it. do not take psyllium husks. it's just harsh fiber and you don't need that for any reason. some fiber in natural foods = ok. but too much fiber can jack you up real bad.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 21, 2011
at 02:56 AM

I hear two sides to this: some for psyllium, some against. Some say that the fiber in psyllium will rake your intestine lining. Some claim to have solved constipation with it. Were you taking psyllium specifically to lower your LDL or was it for your constipation?

1
D0578c3826123f66a80b034cd3e78816

(565)

on March 02, 2011
at 12:47 AM

I've heard that the Iranian equation is more accurate in these situations but, in any case, as long as your triglycerides and HbA1c look good, I wouldn't worry about it. It is my understanding that high fat diets can increase cholesterol because the liver is now no longer afraid that all your cholesterol is going to oxidize from the toxic environment of high PUFAs and high glucose. Saturated fat cholesterol is stable.

1
89a3eb9e05b04102f0a584e438a7da3e

(1136)

on March 02, 2011
at 12:23 AM

I think it was Chris Masterjohn who speculated the high cholesterol after shifting to a high fat diet resulted from clearing stuck fat out of the liver.

3a833804187fe8926214e6c0bd8a0766

(1023)

on March 02, 2011
at 05:39 AM

Oops, I read that as "high LDL after shifting..."

Medium avatar

(39821)

on March 02, 2011
at 05:53 AM

That's interesting; I had a high fructose, low choline diet for a very long time.

5edbf85deaf83e13b176df023abb154d

(1293)

on March 02, 2011
at 01:20 AM

Here is the article in question: http://www.westonaprice.org/blogs/why-is-my-cholesterol-so-high-on-this-diet.html With respect, I do think it was to do with high cholesterol.

3a833804187fe8926214e6c0bd8a0766

(1023)

on March 02, 2011
at 12:36 AM

I think that was high triglycerides.

Medium avatar

(39821)

on March 02, 2011
at 05:47 AM

Yeah, that's really interesting. I bet I had some serious fatty liver from a high fructose, no choline diet.

1
A2fe5bbd09c7804fd321e9e9a9f9d199

on March 01, 2011
at 11:49 PM

I wonder about that too. I got some blood work done a month ago... did about a 14 or 15 hour fast ahead of time, and come to think of it I'm pretty sure my last meal was also some fatty lamb meat ; ) (uncommon at the time but that's a staple meal much more frequently now).

My results were something like TG 28, HDL 84, and LDL 101. Total cholesterol around 191. I had no clue how accurate these numbers were and didn't know what to think of them. Like you I'm not sure how much what I eat or not eat prior to the test skews the results.

0
Dd2057f54f34dddd0012801c3eb4fd25

on September 18, 2015
at 03:38 PM

I totally agree with the all questions you raised. Has anyone ever wondered how to fill out forms online? I have, and found a simple service. Filling out forms is super easy with PDFfiller. Try it on your own here My Life Planning Workbook and you'll make sure how it's simple.

0
77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 09:56 AM

I would start Vitamin C megadose ASAP. You probably have subclinical hipoascorbemia so your liver makes cholesterol to repair the damage. You don't eat liver, eyes, brain. Fruit doesn't contain much of it and blocks it. I would use tbsp every 4 hours for few months then retest. It can't harm, and cholesterol will probably go down, if nothing else, at least a little bit. You may also want to reduce a bit on spinach. Its high in iron and that is last thing man needs (unless you donate blood). Talking about iron, don't supplement C after high iron meals. Chronic infections may rise LDL. You could check that tho.

If you want to speed things up, buy LET or buy ultrasonic cleaner & Lechitin and make your own one.

50mg Cinc-Gluconate is good idea too. 1 good multi.

If that doesn't help, I would check the genes. Maybe you are one of those unlucky bastards not compatible with high fat diets.

"I should also say that I had a low fat vegan diet for 8 years, followed by about 2 years or so on a low fat, whole grain yuppie diet. I wonder if going so long with so little fat in my diet has caused me to be ultra-sensitive to it with regard to LDL? Maybe someone else who is similarly off the charts might see if they had a similar pre-paleo situation"situation"

Its possible. Liver perhaps overproduce now given that it was starving for cholesterol for pretty long time.

I wonder if the high LDL may be related to the low testosterone?

Its possible. Low testosterone may prime liver for production of more cholesterol as it is precursor. See this paper. Its not very likely tho.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 11:18 AM

Some groovy theories about why these folks actually require more cholesterol: http://drbganimalpharm.blogspot.com/2011/06/ancestral-allele-apoe4-super-brain.html

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 11:40 AM

Definitely still unknown. I was suffering to this post: http://goo.gl/EiZQX

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 10:45 AM

From what I've found in my research lately, no one is genetically incompatible with a high fat diet, some genetic types (like Apo E4) simply produce more cholesterol for their particular metabolic needs, like synthesizing more D from dietary sources.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 11:10 AM

The increase in endogenous cholesterol in these people seems to be in response to lack of dietary saturated fat, and their numbers will remain relatively high regardless of the source, but will go higher if the nutritional fat needs aren't being met, it won't spiral endlessly out of control, it will settle at the proper amount for that individual.

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 10:49 AM

Yes, but if you produce more cholesterol then regular people then you need less dietary one. Right ? 2-4 eggs a day he eats provide non-trivial amounts. Dr Davis has provided lot of info on this.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 21, 2011
at 06:30 PM

I checked out what he was talking about, but he is basing that on the most popular (but I believe deeply flawed study about Apo E4). The researchers were a) working with the "cholesterol hypothesis" paradigm, so they could not imagine a reason why higher cholesterol could be beneficial, b)it presumes that a gene that has survived with us longer than the other 2 Apo E alleles is somehow "flawed", which I find terribly hard to believe, and c)Apo E4 is "the" gene of the of the ice age hunter gatherer, they weren't skimping on the animal fat.

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 10:52 AM

BTW, Trevis, how come your D level is so high ? Do you supplement ?

77877f762c40637911396daa19b53094

(78467)

on September 21, 2011
at 11:45 AM

Definitely still unknown. I was referring to this post: goo.gl/EiZQX

0
F1b82cc7e6d90384ad30007dd6c1b9e3

(1187)

on September 20, 2011
at 11:48 PM

you've only been Paleo for a short time you say? give it 6 months and retest. Doctors freak out when improvement isn't seen in 30 days which is unrealistic. Supplementing helps the body, too. your cells are confused with the vegan lifestyle.

Medium avatar

(39821)

on September 20, 2011
at 11:54 PM

Heh, this thread takes me back...

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on September 21, 2011
at 01:37 AM

To what????????

0
60199d3a580a4e17969059609e48e678

on March 08, 2011
at 03:16 AM

this makes me want to get my cholesterol levels checked! I am very curious now!

0
Fa6e406ab332eb3a229fa58181ad21d0

on March 05, 2011
at 02:56 AM

The Perfect Health Diet guy seems to have some good info for you, Jack. I've seen your comments on his blog so I know you're over there as well.

Af1d286f0fd5c3949f59b4edf4d892f5

(18472)

on March 05, 2011
at 08:06 AM

yes indeed Bob. see my earlier answer above (starts with "fascinating article"...) thx!

0
Ac1e55cf06c2180f4008ff01953d10dd

on March 02, 2011
at 01:19 AM

Travis, in case you wish to reduce LDL and/or increase HDL I will share with you several natural substances that I normally use (because I like them, and I would use them anyway whether or not they had any effect on blood lipids). BTW my cholesterol numbers are normally quite good.

Green tea, yerba mate tea, ginger, cinammon if you google any of them +cholesterol you will find papers supporting what I am saying.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 02, 2011
at 03:13 AM

micronized Niacin.

Medium avatar

(19479)

on September 21, 2011
at 08:34 PM

Yerba Mate is a cultural tradition in many South American countries (particularly Argentina). It does contain caffeine, but also has other substances that seem to have a stimulatory (but not excessively so) effect. I tend to cycle between coffee, green tea, and yerba mate.

3c6b4eed18dc57f746755b698426e7c8

(5152)

on September 21, 2011
at 12:41 AM

I take 3 out of 4. Yerma Mate tea, I've never heard of. But I'll investigate.

0
3a833804187fe8926214e6c0bd8a0766

(1023)

on March 02, 2011
at 12:34 AM

A doctor did the same thing to a friend; said she'd order the VAP then gave him the results from a standard lipid panel. My numbers look pretty similar to yours and I thought increasing vitamin D would lower LDL but it didn't do much. Went from a 31 to 75 and my LDL only dropped a couple points (from 240 to 230)

0
0adda19045a3641edac0008364b91110

(1146)

on March 02, 2011
at 12:16 AM

My diet is almost exactly like yours. I often wonder how high my cholesterol might be, sadly I have no health insurance.

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