3

votes

Cutting carbs but lipids surging. Is this

Answered on August 19, 2014
Created May 19, 2011 at 8:38 AM

Hi all,

Blood tests during my recent month of low carbing is instilling a bit of lipiphobia. I wonder if anyone can help sort this out:

I cut carbs late last year after a very disturbing triglyceride number: 520! I went down to about 80g carb per day, and the triglycerides dropped down to the low hundred level, sometimes rising to the mid 100. My HDL was a low 35 and had been for years. But my total cholesterol and LDL were around 200 and 130 respectively.

After a few months on 80g per day carbs I noticed my cholesterol soaring. LDL started a gradual climb: 144, 166, 176, etc. I decided to bite the bullet and eliminate grain and fruit breakfasts, and cut carbs down to 30g per day, following Eades's 'intervention' stage in Protein Power.

Before starting the 30g per day carbs, on 25th April, my lipids were as follows:

FBS 109.00 HDL 47.00 - (yes, they jumped up from 35 for the time in about six or seven years!) Trig 110.00 LDL 186.00 (calculated) total chol 250.00

Trig/HDL was a comfortable 2.3.

The next week, fasting blood sugar was down, HDL stable, but the other values were up:

FBS 94.00 HDL 46.00 Trig 148.00 LDL 190.00 calculated total chol 260.00

I was surprised by the Trig increase. Previously, trig correlated nicely with carbs. But this time I cut carbs significantly and the trig number increased!

The next week, FBS was down to 83, the lowest I can recall. But other numbers remained much the same.

The next week, I tested again:

FBS 88.00 HDL 47.00 Trig 181.00 LDL 212.00 (calculated) total chol 289.00

Trig up a whopping 20%, LDL up 10% (yes, I know calculated is unreliable, but the trend is clear). In just one week!

There are some good trends here: i. Fasting blood sugar is way down. ii. HDL is up for the first time in years. iii. Weight is down about 10% (it was never a major issue) iv. blood pressure down from 140/90 to 120/80 v. CRP - less than 0.02

But there are two disturbing trends:

i. Triglycerides are not correlating with carbs and glucose: they usually do.

ii. The cholesterol just keeps going up: I've noticed many people complain about this when starting low carb.

It's difficult to avoid the common charge that I'm eating too much saturated fat, as my doctor claims. (I live in Thailand, where my doctor laughed and said that "insulin resistance" is "a load of crap".)

I like the diet. I have introduced coconut oil, plenty of meat, fish, shellfish, chicken, leafy greens, steamed veggies, a few nuts. But lipidphobia - saturated fat phobia in particular - is deeply ingrained. It's difficult to fly in the face of established 'science'.

If anyone can offer any insight into the two disturbing trends, I would be grateful.

gregory b

Medium avatar

(39831)

on September 07, 2013
at 01:28 AM

Calcification and lipoprotein peroxidation are two different things. Calcification isn't necessary for plaque formation, though it can exacerbate it.

Cf4576cbcc44fc7f2294135609bce9e5

(3125)

on December 20, 2011
at 05:09 PM

i just figured out whats up with the comments, the quilt is a Medical Doctor, im a former Medical Microbiologist. Doctors try to keep things alive and wind up killing them, i try to kill things and wind up keeping others alive. LOL

9de28a80b0dea81e50495aa5bf28184b

(180)

on December 18, 2011
at 10:34 AM

I'm exactly in the same situation, please visit my question here: http://paleohacks.com/questions/83913/high-ldl-tryglicerides-and-uric-acid#axzz1ggZ4xUqa Do you have any clue now?

03fa485bfd54734522755f47a5e6597e

(3944)

on December 13, 2011
at 01:27 PM

You may be right that total and LDL correlate with thyroid function. My own tests were somewhat that way: plenty of one thyroid hormone but low on another, suggesting poor signalling/conversion, and "high" LDL, though my trigs and HDL/LDL ratios were excellent and my total was 190, right in the sweet spot of the cholesterol/mortality correlation curve. But I suspect enough other things affect total and LDL levels that thyroid is only one factor among many, if an important one.

03fa485bfd54734522755f47a5e6597e

(3944)

on December 13, 2011
at 01:21 PM

I was addressing the 10% and 20% changes that you saw in a single week. If you started taking a thyroid supplement that week, then naturally that could have had something to do with it. But you didn't mention anything like that, so I assumed you hadn't changed anything, in which case a 20% change in trigs is pretty huge, and suggests that people shouldn't take the results of a single test (what most people would get) too seriously. 20% is a large enough swing to make the difference between a doctor giving you a clean bill of health or trying to scare you into a statin.

499f188c87c6980742b9ba98caa6f563

(683)

on December 13, 2011
at 09:34 AM

no, spelling is too good.

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on December 13, 2011
at 07:33 AM

See my comment below.

24df4e0d0e7ce98963d4641fae1a60e5

on December 09, 2011
at 04:31 PM

"You seem to be proving how unreliable and irrelevant cholesterol numbers are. Your trigs -- the one thing pretty much everyone agrees matters -- increased 20% in one week, and we can probably assume your health didn't change much in one week, or that you became significantly more likely to have a heart attack than you had been a week earlier." AMEN. Further, context is also everything. I am wondering about the "everyone agrees matters" on the trigs. I used to be in that camp, but not so much after learning all that goes into fasting trigs. High fasting trigs not always bad.

7d64d3988de1b0e493aacf37843c5596

(2861)

on December 09, 2011
at 01:59 PM

I think Jimmy is only about 40 years old. His calcium score should be zero unless he has really major problems.

03fa485bfd54734522755f47a5e6597e

(3944)

on December 09, 2011
at 01:34 PM

You seem to be proving how unreliable and irrelevant cholesterol numbers are. Your trigs -- the one thing pretty much everyone agrees matters -- increased 20% in one week, and we can probably assume your health didn't change much in one week, or that you became 20% more likely to have a heart attack than you had been a week earlier. Maybe someday cholesterol tests will get cheap enough that everyone can take them every week, and we'll discover that they're about as reliable as "testing" for disease by swinging a crystal back and forth over your body.

Medium avatar

(19469)

on December 09, 2011
at 01:29 PM

My total cholesterol jumped from a lifetime average of ~180 to 280 when I first went low-carb "primal". Since then, it has gradually gone back down and is now around 230. There might be something to Chris Masterjohn's idea that cholesterol "clears" from the liver when carbs are reduced for the first time.

Medium avatar

(19469)

on December 09, 2011
at 01:08 PM

I thought this was The Quilt for a second :)

Medium avatar

(39831)

on December 09, 2011
at 07:38 AM

Dude, cutting carbs in Thailand? Are you crazy, man? Just exercise, lift weights etc. and remove coconut oil, fructose and ethanol. You don't need to cut starch.

5e36f73c3f95eb4ea13a009f4936449f

(8280)

on June 16, 2011
at 02:33 PM

My recollection is that the overall idea is that small low density cholesterol deposits in the arteries and causes plaque/inflamation. Those deposits are high in calcium. So if you do a CT scan, you'll see large amounts of calcium in your arteries, indicating a problem. No calcium, no deposits, no problem.

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on May 21, 2011
at 08:10 AM

Right. Normal by no means indicates optimal. But in my case, it is the trend and negative correlation that are of concern.

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on May 21, 2011
at 08:02 AM

Thanks. Deficiency is an interesting concept. Better than killing of the ambulance men.

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on May 21, 2011
at 08:01 AM

Yes, good question.

50637dfd7dc7a7e811d82283f4f5fd10

(5838)

on May 19, 2011
at 04:49 PM

What does a zero calcium score reflect?

E6c790e285048d9d09a554e65879693a

(435)

on May 19, 2011
at 10:17 AM

Sounds like you're getting blood work every week...how does that work??

  • Dc0227d5b1a277fd641d878c1516b2ca

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8 Answers

3
Cf4576cbcc44fc7f2294135609bce9e5

on December 09, 2011
at 04:38 AM

cholesterol is an acute phase reactant and is a zero predictor of impending cardiac death. the measurement of cholesterol was a test in need of a disease. the cholesterol story is one of clever marketing rather than science. cholesterol will wildly fluctuate irrespective of diet because thats what all acute phase reactants do. In the rat aspirin will increase cholesterol by 30 percent, i cant tell you what aspirin will do in man because no such research exist. you can imagine why no research was done cant you? stop testing your blood take some Vitamine C and enjoy your heathly life. if you have adopted a paleo diet you are already doing everthing you need to increase your lifespan while at the same time reduce the ageing process.

Medium avatar

(19469)

on December 09, 2011
at 01:08 PM

I thought this was The Quilt for a second :)

499f188c87c6980742b9ba98caa6f563

(683)

on December 13, 2011
at 09:34 AM

no, spelling is too good.

Cf4576cbcc44fc7f2294135609bce9e5

(3125)

on December 20, 2011
at 05:09 PM

i just figured out whats up with the comments, the quilt is a Medical Doctor, im a former Medical Microbiologist. Doctors try to keep things alive and wind up killing them, i try to kill things and wind up keeping others alive. LOL

2
03fa485bfd54734522755f47a5e6597e

(3944)

on December 09, 2011
at 03:39 PM

You seem to be proving how unreliable and irrelevant cholesterol numbers are. Your trigs -- the one thing pretty much everyone agrees matters -- increased 20% in one week, and we can probably assume your health didn't change much in one week, or that you became significantly more likely to have a heart attack than you had been a week earlier. Maybe someday cholesterol tests will get cheap enough that everyone can take them every week, and we'll discover that they're about as reliable as swinging a crystal back and forth over your body.

24df4e0d0e7ce98963d4641fae1a60e5

on December 09, 2011
at 04:31 PM

"You seem to be proving how unreliable and irrelevant cholesterol numbers are. Your trigs -- the one thing pretty much everyone agrees matters -- increased 20% in one week, and we can probably assume your health didn't change much in one week, or that you became significantly more likely to have a heart attack than you had been a week earlier." AMEN. Further, context is also everything. I am wondering about the "everyone agrees matters" on the trigs. I used to be in that camp, but not so much after learning all that goes into fasting trigs. High fasting trigs not always bad.

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on December 13, 2011
at 07:33 AM

See my comment below.

2
E5c7f14800c5992831f5c70fa746dc5c

(12857)

on December 09, 2011
at 01:03 PM

Could be a hypothyroid issue. Do a body temp test, you want it 97.6 upon waking and 98.6 after eating. If its lower than this that's a good indicator you are hypothyroid.

1
Dc0227d5b1a277fd641d878c1516b2ca

on December 13, 2011
at 07:30 AM

"You seem to be proving how unreliable and irrelevant cholesterol numbers are."

I disagree. Since posting this question in May I started taking T3 supplement. Then, after a few months, I weaned myself to a much lower dose to see the effects on cholesterol. Total cholesterol (and LDL) correlated with the dosage of T3, falling from 350 to 150 as I worked my way up to a dose of 75mcg and rising back above 300 as I weaned to a lower dose of 25mcg. The relationship between thyroid and cholesterol seems clear. Cholesterol levels would seem to be a good indicator of thyroid function.

Triglycerides also fell with T3. But they did not rebound materially on dropping the T3 dosage, suggesting correlation without causation.

03fa485bfd54734522755f47a5e6597e

(3944)

on December 13, 2011
at 01:21 PM

I was addressing the 10% and 20% changes that you saw in a single week. If you started taking a thyroid supplement that week, then naturally that could have had something to do with it. But you didn't mention anything like that, so I assumed you hadn't changed anything, in which case a 20% change in trigs is pretty huge, and suggests that people shouldn't take the results of a single test (what most people would get) too seriously. 20% is a large enough swing to make the difference between a doctor giving you a clean bill of health or trying to scare you into a statin.

03fa485bfd54734522755f47a5e6597e

(3944)

on December 13, 2011
at 01:27 PM

You may be right that total and LDL correlate with thyroid function. My own tests were somewhat that way: plenty of one thyroid hormone but low on another, suggesting poor signalling/conversion, and "high" LDL, though my trigs and HDL/LDL ratios were excellent and my total was 190, right in the sweet spot of the cholesterol/mortality correlation curve. But I suspect enough other things affect total and LDL levels that thyroid is only one factor among many, if an important one.

1
Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on May 19, 2011
at 12:58 PM

This is an interesting discussion of the high LDL on Paleo phenom: http://perfecthealthdiet.com/?cat=92

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on May 21, 2011
at 08:02 AM

Thanks. Deficiency is an interesting concept. Better than killing of the ambulance men.

1
E3267155f6962f293583fc6a0b98793e

(1085)

on May 19, 2011
at 11:48 AM

Chris Kresser has a blog post regarding this. You might be interested in reading his blog post.

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on May 21, 2011
at 08:10 AM

Right. Normal by no means indicates optimal. But in my case, it is the trend and negative correlation that are of concern.

0
B2157bdf4a217ac943c41125d1a67845

(258)

on May 19, 2011
at 10:41 AM

Triglycerides will change rapidly, usually over a 24 hour period. I am not a doctor, but your cholesterol looks fine to me. Jimmy Moore has a cholesterol level over 300, but his calcium score is zero. Cholesterol numbers may not mean very much.

50637dfd7dc7a7e811d82283f4f5fd10

(5838)

on May 19, 2011
at 04:49 PM

What does a zero calcium score reflect?

Dc0227d5b1a277fd641d878c1516b2ca

(25)

on May 21, 2011
at 08:01 AM

Yes, good question.

5e36f73c3f95eb4ea13a009f4936449f

(8280)

on June 16, 2011
at 02:33 PM

My recollection is that the overall idea is that small low density cholesterol deposits in the arteries and causes plaque/inflamation. Those deposits are high in calcium. So if you do a CT scan, you'll see large amounts of calcium in your arteries, indicating a problem. No calcium, no deposits, no problem.

7d64d3988de1b0e493aacf37843c5596

(2861)

on December 09, 2011
at 01:59 PM

I think Jimmy is only about 40 years old. His calcium score should be zero unless he has really major problems.

Medium avatar

(39831)

on September 07, 2013
at 01:28 AM

Calcification and lipoprotein peroxidation are two different things. Calcification isn't necessary for plaque formation, though it can exacerbate it.

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