Prediction: Mikhaila Peterson’s Cholesterol Will Climb

Who is Mikhaila Peterson?

If you’re a regular reader of this blog there’s a pretty strong chance you already know who Mikhaila Peterson is. Certainly, her recently famous father may have contributed to her renown. But in my opinion, she should be most recognized most for her extraordinary health journey, which can’t be understated.

If you’ve spent any time with people who suffer from chronic pain and illness since childhood, you get a real respect for how intense and unimaginable their lives are. I’ve now met quite a few since beginning my research and connecting with so many at conferences. But I can’t think of anyone that really comes close to Mikhaila. She had it rough from the very start in a multitude of ways we can’t even begin to grasp.

From her blog:

I was a really sick person since I was 2. I was prone to getting bacterial infections (strep throat, pneumonia, etc.), yeast infections, colds, etc. I was diagnosed with severe rheumatoid arthritis when I was 7 and ended up with multiple joints replaced at age 17. I started antidepressants for severe depression/anxiety in grade 5. I suffered from “idiopathic hypersomnia” – aka I couldn’t wake up. I spent approximately 17 hours a day sleeping and the rest in a half daze. I had itchy skin starting at age 14 that I just ignored. Then my skin problems started at about age 19. Cystic acne, painful bumps, blistering…

Then she discovered dietary influence and eventually ended up on carnivore:

I’m in remission from everything. I don’t take any medications, I don’t take any vitamins. The hardest thing to get rid of was the depression, but that’s gone too!

To be sure, like any other personal story, this is an “N=1” — an anecdote. But of course, there are many other now famous cases of people going carnivore to reduce terrible health issues, which includes even a few notable vegans.

It’s much too early to say what the long term outcomes of the carnivore diet will be, positive or negative. But for Mikhaila, it’s hard not to appreciate how much of an impact it has had on her life.

Lipid Numbers from August 2018

In august of this year, she posted her blood work, which included lipid markers. They are as follows:

Total Cholesterol: 3.42 mmol/L (132 mg/dL)

LDL Cholesterol: 1.75 mmol/L (68 mg/dL)

HDL Cholesterol: 1.37 mmol/L (53 mg/dL)

Triglycerides: 0.66 mmol/L (58 mg/dL)

Needless to say, this is a conventional doctor’s dream lipid panel. HDL is high, triglycerides are low — and of course, the most important of them all: LDL cholesterol is very low at just 68 mg/dL. Many would call that “heart attack proof”.

I Predict Mikhaila’s Total and LDL Cholesterol will Climb as She Gets Healthier

Assuming (1) she continues to stay very low carb and high fat, (2) continues to stay lean, and (3) continues to regain her health — I’m going to go out on a limb and hypothesize her total and LDL cholesterol will rise.

Why in the world would I make this prediction?

Certainly, if you’ve been a long time follower of my work, you know about the Lipid Energy Model. If not, I have a nice, layperson’s version from Low Carb Breckinridge of this year. I’ll also have some more posts on it again soon as well. Thus, given this model, I full expect many lean and/or fit low carbers to have higher total and LDL cholesterol. Yet, Mikhaila’s TC and LDL are low… why?

The Backlog Hypothesis

There’s also another hypothesis I’ve had for a long time that I’ve shared privately with many, but not so much publicly until I have more data. But the overly simplified version is that LDL particles can actually be much lower for many who are recovering from either a metabolically deranged state, a substantial illness (depending on type), repairing existing tissues, or any combination of the three. The deeper details I won’t go into here, but I suspect this may be the case with Mikhaila. The timeframe is harder to guess on as to when this change in levels would happen, but it wouldn’t surprise me if it were within the next couple years.

If True, Does This Mean the Mikhaila Made a Mistake?

Whenever I express any cautious optimism with regard to there being such a thing “healthy lipid metabolism that could include high LDL,” I’m roundly criticized (even when I provide data and studies suggesting this very real possibility). But yes, the Lipid Energy Model (see right) suggests why it might not only be metabolically likely, but even appropriate.

While I make no claim as to whether the Lipid Hypothesis is true or not, I do have a very large, public challenge that is nearing a year without answer yet. (See #LCCholesterolChallenge and #LDLBounty) In other words, is there any evidence — even a single study — where high LDL cholesterol or particle count leads to high CVD in a population of high HDL cholesterol and low triglycerides? To date, I haven’t been able to find one.

This isn’t just a public prediction, it’s a hypothesis made in advance of resulting, ongoing data. Yes, I’ve had a good record of predicting things that come true (like my first presentation experiment, or my resistance training experiment, or my tandem drop experiment, etc) — the truth is that I I do this to keep myself honest. It’s easy to look at data after it is in and retrofit it.

So I guess I have two hypotheses. The first is the rise of cholesterol. The second is that it’s highly unlikely Mikhaila will be considering this a mistake.