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Jun 29

Questions

This thread is dedicated to questions for CholesterolCode.com. Again, we are not doctors or medical professionals and nothing we say here constitutes medical advice.

If you have a question that doesn’t involve your specific cholesterol numbers, feel free to comment to this thread below.

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Garnetta
Guest
Garnetta

These are my hubby’s recent lab results, w/o statin. Dr. Wants him on statin because his TC is high. This all looks great to me! 61 y/o Black male, down 30 lbs.
==== CholesterolCode.com/Report v0.9.2 ====–
…7.5 months on LCHF (20g to 120g carbs) ::: …
Total Cholesterol: 283 mg/dL 7.32 mmol/L
LDL Cholesterol: 187 mg/dL 4.84 mmol/L
HDL Cholesterol: 85 mg/dL 2.2 mmol/L
Triglycerides: 56 mg/dL 0.63 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.13 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.543 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 187 | Iranian LDL-C: 152
Total/HDL Ratio: 3.33
TG/HDL Ratio in mg/dL: 0.66 | in mmol/L: 0.29

Bill+G
Guest

A person with type 1 diabetes has an inability to effectively metabolize glucose (carbs are broken down into glucose but need insulin to shuttle the resulting glucose into the cells to be used for energy).

Is there a similar metabolic dysfunction in some people that fats/FFA (due to a hormone or enzyme deficiency) cannot be shuttled effectively into the cells and be used for energy?

Patrick Slaughter
Guest
Patrick Slaughter

How would you classify someone that sees a meaningful jump in their cholesterol when switching from SAD to LCHF, but doesn’t hit your LMHR limits? I am a lean, tall guy (6’4” & 183 lbs plateaued for 18 months now). I am 31, and my CIMT, CT Calcium, & Echocaridogram were all flawless taken after 18 months of LCHF lifestyle (>325 Total Cholesterol). Full disclosure, I do 5 days LCHF & 2 days higher carb on the weekends since my goal is just fitness maintenance. I did 8 weeks straight keto with weekly blood work (weight held at 183) and my lipids didn’t improve further, so that’s why I settled on the 5-2 schedule as a lifestyle that maintains my weight targets. I don’t eat sugar during my 2 days of higher carb since my TRIGs showed crazy response (350-400 on Monday’s after weekend cheats eating sugar) to sugar early on. I am trying to look to the scans of plaque as the hard endpoints to monitor for changes, but I’m curious if you have other markers to follow. My glucose, insulin, homocysteine are all normal.

SAD: Total Chol = 180-240 mg/dL
SAD: LDL = 118-176
SAD HDL = 37-47
SAD TRIG = 100-124

LCHF Total Chol = 325-375
LCHF LDL = 200-300
LCHF HDL = 45-60
LCHF TRIG = 100-150
LCHF hsCRP = 0.3 mg/L

Sheelagh Littlewood
Guest
Sheelagh Littlewood

Hi Dave.
Would you be worried by the following after 3 years LCHF. I’m female, 65, 5 ft10 and 62 kg. Work out 5 or 6 days a week
Cholesterol-360
TGs-71
HDL104
LDL-239
Just referred to lipid clinc after GP horrified

Sandra
Guest
Sandra

Wow, Sheelagh, my profile nearly mirrors yours! (My TGs are 72 and LDL 271; HDL same as yours. I am a 60-year-old woman;5’6” and 125 pounds.My GP was puzzled as last year’s test was much more “doctor friendly” and he only has me scheduled for another test in 6 months. (He said to try reducing animal fats, but I am ZC so that’s not happening.) Good health to you! Thanks for sharing – glad to see Dave’s reply.

Beth
Guest
Beth

Hello,
I did the 3-day protocol before this one. The numbers improved significantly.
March 29, 2018
–==== CholesterolCode.com/Report v0.9.2 ====–
…13 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 272 mg/dL 7.03 mmol/L
LDL Cholesterol: 213 mg/dL 5.51 mmol/L
HDL Cholesterol: 57 mg/dL 1.47 mmol/L
Triglycerides: 82 mg/dL 0.93 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 2 mg/dL 0.05 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.04 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.199 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 199 | Iranian LDL-C: 182
Total/HDL Ratio: 4.77
TG/HDL Ratio in mg/dL: 1.44 | in mmol/L: 0.63

Here are the previous numbers from December 2017.

–==== CholesterolCode.com/Report v0.9.2 ====–
…8 months on LCHF (20g to 120g carbs) ::: 2 hours water fasted…
Total Cholesterol: 369 mg/dL 9.54 mmol/L
LDL Cholesterol: 245 mg/dL 6.34 mmol/L
HDL Cholesterol: 43 mg/dL 1.11 mmol/L
Triglycerides: 508 mg/dL 5.74 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 81 mg/dL 2.09 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.88 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.714 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 224 | Iranian LDL-C: 500
Total/HDL Ratio: 8.58
TG/HDL Ratio in mg/dL: 11.81 | in mmol/L: 5.17

Od-curious
Guest
Od-curious

Hi Dave,
I’m puzzled about my results and need some guidance on what I may have done wrong that caused my Triglycerides to increase. I consistently ate around 3700 calories with fats ranging in the low 300s, throughout the three days prior to having my blood drawn.
*** Previous results, Dec. 2017
–==== CholesterolCode.com/Report v0.9.2 ====–
…7 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 335 mg/dL 8.66 mmol/L
LDL Cholesterol: 250 mg/dL 6.46 mmol/L
HDL Cholesterol: 70 mg/dL 1.81 mmol/L
Triglycerides: 77 mg/dL 0.87 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 15 mg/dL 0.39 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.21 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.318 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 250 | Iranian LDL-C: 220
Total/HDL Ratio: 4.79
TG/HDL Ratio in mg/dL: 1.1 | in mmol/L: 0.48

*** Current results, Jun.2018, after doing the 3 days cholesterol code protocol
–==== CholesterolCode.com/Report v0.9.2 ====–
…6 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 313 mg/dL 8.09 mmol/L
LDL Cholesterol: 214 mg/dL 5.53 mmol/L
HDL Cholesterol: 72 mg/dL 1.86 mmol/L
Triglycerides: 135 mg/dL 1.52 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 27 mg/dL 0.7 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.38 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.088 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 214 | Iranian LDL-C: 231
Total/HDL Ratio: 4.35
TG/HDL Ratio in mg/dL: 1.88 | in mmol/L: 0.82

Any idea, suggestions where I may improve for the next round of lab work?
Thank you for all your great work helping us all understand this cholesterol issue and getting closer to clarifying the cholesterol myth.

Jennifer Douglas
Guest
Jennifer Douglas

I know the “Feldman protocol” is to increase calories to 5000 calories a day for 3 days, but is there a sliding scale for smaller women. I am 5″2″ and 130. I am sure I CAN eat 5000 calories in a day, but without carbs, it is going to be hard. How low can I go and still see the inversion pattern?

Liv
Guest
Liv

Hi. I am wondering if “the cholesterol drop protocol” will work for someone (me ) that have been eating “wrong” (good LCHF meals but also to much ice-cream, liquorice and chocolate) for about 6 months? I also have autoimmune reactions in my body. The doctor want to put me on statins, and even if I am confident in my decision not to take them- I would like it if I did not have to defend my choice. I am eating better now (vLCHF/Keto might change to carnivore). I am 50, woman, tall, almost 20kg (=BMI26 )above desired weight, I am not fit and do not have the energy to exercise(just small walks and light gardening). Do I risk making my numbers “worse” after eating vLCHF for four weeks with the “three day protocol “before my next bloodtest?

Lisa
Guest
Lisa

–==== CholesterolCode.com/Report v0.9.2 ====–
…1 months on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 290 mg/dL 7.49 mmol/L
LDL Cholesterol: 208 mg/dL 5.38 mmol/L
HDL Cholesterol: 68 mg/dL 1.76 mmol/L
Triglycerides: 68 mg/dL 0.77 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 14 mg/dL 0.36 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.21 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.359 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 208 | Iranian LDL-C: 180
Total/HDL Ratio: 4.26
TG/HDL Ratio in mg/dL: 1 | in mmol/L: 0.44

Also: Lpa 191 mg/L (was 484 mg/L when diagnosed with FH), hsCRP: 0.74

Hi Dave,

I’m a 33 year old female who was diagnosed with FH when I was 22 based on my lipids and family history (father died of MI at age 56, sister had similar lipids to mine). My cardiologist put me on statins despite my extreme reluctance (I did some research and was not comfortable with the lack of studies using statins in such a young population). I had to stop my statin 4 years ago when trying to conceive and have not restarted as we want to have another child. After a month on a low-carb diet, my lipids were as shown above (better than they ever were on a stain, with the exception of LDL, which is basically the same).

I’ve been a pharmacist for 6 years now, and I have become very educated on the fallacies of the lipid hypothesis and controversy with statins. I’ve been following various experts on the issue (including yourself) and have started to wonder if I even have FH! I’m trying to get the genetic test covered for me but it’s proving to be very difficult. The cardiologist had tested for clotting abnormalities and I had none.

Have you come across anyone with FH who has #’s like this?
Could it just be that cholesterol “runs high” in my family but we do not have FH?

Doctors keep saying to me “who cares if you confirm the genetic mutation or not, that LDL level still needs to be treated”! I, of course, know that is untrue. But maybe their question has some meaning, i.e. does it really matter if I have FH given my current results? If a genetic test confirms my FH but my lipids are fine (and actually resemble those of a LMHR) then what does that change?

I know the research on FH is very confusing and hard to draw conclusions from and so you may not have firm answers to these questions, but I am very interested to hear your any thoughts you may have on this.

Thank you so much for the very important work you do and for the crucial information you are providing!

Lisa

Jim
Guest
Jim

Hi Dave,
I believe you mentioned the home testing kit you use in a video but I can’t find it. I would like to do my own testing. Can you reply with a name or link?
thanks!

Rob Smith
Guest
Rob Smith

Hi, Seeing my LDL numbers, Dr is asking me to take statins. I am bit hesitant to take it. My CRP is 0.36 mg/dl, HOMA-IR is 0.43 A1C 5.6. I am diabetic but just taking Metformin once a day.. I am 5″11 at 136 lbs with body fat of 17%

–==== CholesterolCode.com/Report v0.9.2 ====–
…4 months on Keto (less than 20g carbs) ::: 12 hours water fasted…
Total Cholesterol: 336 mg/dL 8.69 mmol/L
LDL Cholesterol: 243 mg/dL 6.28 mmol/L
HDL Cholesterol: 75 mg/dL 1.94 mmol/L
Triglycerides: 118 mg/dL 1.33 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 18 mg/dL 0.47 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.24 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.164 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 237 | Iranian LDL-C: 238
Total/HDL Ratio: 4.48
TG/HDL Ratio in mg/dL: 1.57 | in mmol/L: 0.69

Alex Chang
Guest
Alex Chang

I read the inverse pattern you proposed. I wonder what’s the FAT good to lower LDL you mean. Is it one or some or all of Saturated fatty acid, Monounsaturated fatty acid or Polyunsaturated fatty acid?

Richard
Guest
Richard

Hi

What are your thoughts and recommendations on my numbers below. I am still around 30kg overweight.

1st Test on SAD. 12 Hours fasted
HbA1c 8,0 TC 8,5 Trig 3,6 HDL 0,8 LDL 5,5 RC 2,2
2nd Test 3 months on <30g Carbs. 13 Hours fasted
HbA1c 6,4 TC 9 Trig 1,4 HDL 0,9 LDL 7,2 RC 0,9

Missy Em
Guest
Missy Em

I’ve just been ripped a new backside by my doctor for my cholesterol results after two months on Keto and I’m spooked: results are total cholesterol 10.6, HDL 2.7, LDL 7.5 and Triglycerides 0.9. Tests say I’m indicated for familial Hypercholesterolemia????

Devlin
Guest
Devlin

50 y/o male – fit/athletic – 11% body fat (DEXA). MD wants a f/u blood panel in 3 months with advice to go on statins to get LDL down to 100…

–==== CholesterolCode.com/Report v0.9.2 ====–
…40 months on Keto (less than 20g carbs) ::: 12 hours water fasted…
Total Cholesterol: 337 mg/dL 8.71 mmol/L
LDL Cholesterol: 187 mg/dL 4.84 mmol/L
HDL Cholesterol: 136 mg/dL 3.52 mmol/L
Triglycerides: 71 mg/dL 0.8 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 14 mg/dL 0.36 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.1 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.643 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 187 | Iranian LDL-C: 159
Total/HDL Ratio: 2.48
TG/HDL Ratio in mg/dL: 0.52 | in mmol/L: 0.23

Charles Hiller
Guest

These are my recent results…

..3 months on Carnivore/Zero Carb/Meat Only ::: 24 hours water fasted…
WARNING: fasting for multiple days can risk confounded lipid numbers. See http://cholesterolcode.com/the-fasting-disaster/
Total Cholesterol: 226 mg/dL 5.84 mmol/L
LDL Cholesterol: 167 mg/dL 4.32 mmol/L
HDL Cholesterol: 36 mg/dL 0.93 mmol/L
Triglycerides: 113 mg/dL 1.28 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 23 mg/dL 0.59 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.64 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.139 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 167 | Iranian LDL-C: 179
Total/HDL Ratio: 6.28
TG/HDL Ratio in mg/dL: 3.14 | in mmol/L: 1.38

These are the results from last Dec…

…1 years on Keto (less than 20g carbs) ::: 24 hours water fasted…
WARNING: fasting for multiple days can risk confounded lipid numbers. See http://cholesterolcode.com/the-fasting-disaster/
Total Cholesterol: 282 mg/dL 7.29 mmol/L
LDL Cholesterol: 212 mg/dL 5.48 mmol/L
HDL Cholesterol: 46 mg/dL 1.19 mmol/L
Triglycerides: 122 mg/dL 1.38 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 24 mg/dL 0.62 mmol/L >>> Medium Risk Quintile
Remnant Chol to HDL: 0.52 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.064 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 212 | Iranian LDL-C: 221
Total/HDL Ratio: 6.13
TG/HDL Ratio in mg/dL: 2.65 | in mmol/L: 1.16

I am concerend that my HDL dropped so much in 6 months. Is this normal with carnivore or do I need to address something else? I also had a CAC done in January with a score of 0.

Jennifer Douglas
Guest
Jennifer Douglas

My 72-year-old dad has been eating keto for about 6 months. I do think he was following the rules and doing a good keto diet. He has been on a statin for 20+ years. Because I kept complaining, he got off the stain for 3 months and then took another blood test. His follow-up test last week was the day after mine where I confirmed I am a LMHR (my numbers are Total 387 LDL 270, HDL 100, TRI 66). His LDL went up from 135 on the statin to 225 in 3 months without. I don’t know if you want all his numbers, but I calculated his remnant cholesterol at 16 for BOTH labs (1 point better than mine). So I say he is doing great and should stay off the drugs (he didn’t care what I thought). My bigger question is about his HDL. It was 46 on Statins and only increased to 51 drug-free. He says his HDL has always been low. Is that a genetic thing? Not trusting me and my advice and being freaked out by the 90 point increase in LDL, he immediately went back on the statin. He claims that his joints in his hands and wrists started hurting more the statin. Could that even be true? Are their benefits of a statin?
thanks for allowing questions

Colleen
Guest
Colleen

Possibly, the mechanism of statin may be anti-inflammatory (not the LDL lowering effect) but this is one theory as to why statin may benefit that is not related to LDL lowering.

Kelly
Guest
Kelly

Hi Dave, I take it from these numbers that I am at high risk? How do I fix this. This was at 5 months Keto, I am now at 9 months. I am due for repeat bloodwork. My doctor wants me on a statin. I have opted not to take it. I do have a high family history of cardiac events resulting in death at early age for my grandfather 48yrs, uncle 55yrs. My mom 42 yrs and brother 58 yrs survived their attacks. I am worried. On a positive note, all inflammatory markers are within normal for the first time in decades. If you could provide some input, I would appreciate it. I have lost 99 lbs, I am 57.My blood pressure did go up on Keto, it is now down with Coversyl.

–==== CholesterolCode.com/Report v0.9.2 ====–
…5 months on Keto (less than 20g carbs) ::: 15 hours water fasted…
Total Cholesterol: 485 mg/dL 12.53 mmol/L
LDL Cholesterol: 408 mg/dL 10.55 mmol/L
HDL Cholesterol: 48 mg/dL 1.24 mmol/L
Triglycerides: 144 mg/dL 1.63 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 29 mg/dL 0.75 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.6 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.119 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 408 | Iranian LDL-C: 402
Total/HDL Ratio: 10.1
TG/HDL Ratio in mg/dL: 3 | in mmol/L: 1.31

Greg
Guest
Greg

Thanks for all your work on lipids. It has been very helpful to me given my high LDL. Below are my latest lipid numbers with a few extra details. I was drinking coconut oil and cream in my coffee but stopped in May 2018 after seeing triglycerides at 200 even with BHB Ketones well above .5. I have had a number of NMR tests and my hsCRP has ranged from .9 to 2.7. LDL-P is over 3,000 (30% or less small dense) – Pattern A. Since LCHF, my triglycerides have ranged from 72 to 200. 200 was an anomaly. TG’s have mostly been under 100 during LCHF. I had a thyroid test in May 2018. My reverse T3 was high at 30 and my Free T3 was 2.2. (TSH 1.6; T4 7.1; Free T4 1.41). I will have a second thyroid test in July or August. I don’t have a specific question but your thoughts/comments would be interesting to know. LCHF has been great but my LDL-C and P are crazy. Of course, I fit right in on this site.

–==== CholesterolCode.com/Report v0.9.2 ====– 7/2/2018
Age: 53
Weight: 169
Height: 68″
CABG x 4 on 10/7/2016 (heart functioning is normal (no MI))
LCHF since May 2017; Keto since 12/15/2017
No Statin since 6/2017 – it caused stiffness in my thigh muscles.
HDL was always low and was 29 on 3/22/2017
LDL was 70 on 3/22/2017.

12 hours water fasted…
Total Cholesterol: 412 mg/dL 10.65 mmol/L
LDL Cholesterol (Direct): 344 mg/dL 8.9 mmol/L
HDL Cholesterol: 48 mg/dL 1.24 mmol/L
Triglycerides: 99 mg/dL 1.12 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 20 mg/dL 0.52 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.42 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.044 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 344 | Iranian LDL-C: 317
Total/HDL Ratio: 8.58
TG/HDL Ratio in mg/dL: 2.06 | in mmol/L: 0.9

chris c
Guest
chris c

Thyroid may have something to do with it also.

When mine went high (don’t have the actual numbers to hand right now) my LDL dropped by exactly the same amount as the statin I no longer take. When overtreated (ie. low) the LDL shot up again.

Anecdotally elderly/retired doctors from back in the days before metabolic syndrome (and statins) would suspect thyroid as the cause when they saw high cholesterol/LDL.

vernon
Guest
vernon

Hi Dave, no cholesterol question as i am not a LMHR. My wife appears to be, however. Your work has been helpful in easing our worries.

My question is regarding fasting blood glucose. Mine is consistently higher than I would prefer based on the “normal” numbers floating around. It’s funny because my wife’s cholesterol is high and sugar low and my cholesterol is “normal” and sugar “high”.

Are you gathering FBG data from folks as well? My wife and I have been strict keto for a year and myself low carb for 20years at least. My FBG is usually above 100. It does not really decrease much during the day as well. My fasting insulin is around 2.2 to 2.6 though. This is a puzzler to me. My A1C is 5.2 which I think is consistent with the FBG. Once you and Siobahn get the cholesterol bogeyman destroyed, this would probably be the next big thing to understand.

Thanks for your work

Vernon

Francesc
Guest
Francesc

Hi,
If you have FH its important to look at the level of HDL and TG, but even so, CVD cases are observed in people with optimal levels. What biomarkers do you think you also have to check periodically if you suspect a possible FH?
I also wanted to ask you if you know any scientific evidence of the impact of Lchf on FH?

Many thanks for your work. Greetings from Barcelona

My recent numbers:
I’m a male, 39 years, thin and I do intermittent fasting every day
-==== CholesterolCode.com/Report v0.9.2 ====–
…7 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 275 mg/dL 7.11 mmol/L
LDL Cholesterol: 200 mg/dL 5.17 mmol/L
HDL Cholesterol: 60 mg/dL 1.55 mmol/L
Triglycerides: 77 mg/dL 0.87 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 15 mg/dL 0.39 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.25 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.251 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 200 | Iranian LDL-C: 179
Total/HDL Ratio: 4.58
TG/HDL Ratio in mg/dL: 1.28 | in mmol/L: 0.56

Jim
Guest
Jim

Here are my results after 6 months for a very fit 55 year old white male 17% BF, very high TC, Should I be concern?

–==== CholesterolCode.com/Report v0.9.2 ====–
…6 months on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 547 mg/dL 14.15 mmol/L
LDL Cholesterol: 451 mg/dL 11.66 mmol/L
HDL Cholesterol: 75 mg/dL 1.94 mmol/L
Triglycerides: 104 mg/dL 1.17 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 21 mg/dL 0.54 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.28 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.22 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 451 | Iranian LDL-C: 408
Total/HDL Ratio: 7.29
TG/HDL Ratio in mg/dL: 1.39 | in mmol/L: 0.6

Colleen
Guest
Colleen

Hi Dave: First, great work here!! Questions:

(1) Have you done any more looking at ferritin? I wondered if you have noticed any patterns. Mine was “higher” (156) while on Day 4 of a fasting mimicking diet then at 75 a few weeks later, while “normal” LCHF.

(2) Have you listened to Peter Attia’s podcast with Ron Krauss? Any thoughts? Overall a great discussion, but they glossed over the situation with High LDL, High HDL, low trigs, just a very oblique reference that in some instances LDL did not need to be lowered. I understand they are treating patients with bad markers or active disease, but how can one understand heart disease risk if one does not understand the various permutations of the healthy human?

(3) Re LMHR, from my understanding of your theory (and I am in the LMHR group) this is a subtype, and there are some lean folks where the TC and LDL do not get that high but stay more at about 200 or less? Have you looked for/noticed any common genetic component? (i.e. APOE4?) Is there a downside to be LMHR? For example, in the Attia/Krauss discussion one of them might simply argue that being exposed to more LDL over decades will not be as good as a person who is not so exposed.

Philippa
Guest
Philippa

Hi Dave,
Was thinking about your protocol and the concept of lower LDL production during high fat intake as less energy to be delivered to cells…….raised the question in my mind as to whether a greater cholesterol drop would be achieved with a deliberately high meal frequency as well as high fat for the 3 days……my idea being that with a food fat bolus say every hour, the blood would be permanently full of chylomicron fat energy and so even less VLDL would be produced to traffic fat to tissues? Wondering if you have experimented with this and what your thoughts are?
Thanks for all your great work!

Matt Giovinetti
Guest
Matt Giovinetti

Hi Dave,

I dropped my total cholesterol from 269 to 185. I upped my fat intake and stopped drinking coffee three weeks before my second test. I thought I heard you mention there might be a link between coffee and higher numbers. Did I hear this from you or Robb Wolf? Im interested in your thoughts. I’ve switched to decaf coffee this month to see if the results are similar next test.

Rock
Guest
Rock

I wondered the same about decaf. enjoyed my coffee. Post up when u get results

Siobhan Huggins
Admin

Nice drop! Yes, in some people it appears as though coffee may be a confounder when attempting the protocol, in addition to possibly raising triglycerides in some.

Mary
Guest
Mary

Hi, do you ever work with people on their health? I just don’t know where to turn. Thanks

Rock
Guest
Rock

Here is test still drinking coffee

==== CholesterolCode.com/Report v0.9.2 ====– 
…3 months on Carnivore/Zero Carb/Meat Only ::: 12 hours water fasted… 
Total Cholesterol:368 mg/dL9.52 mmol/LLDL Cholesterol:NaN mg/dLNaN mmol/LHDL Cholesterol:35 mg/dL0.91 mmol/LTriglycerides:696 mg/dL7.86 mmol/L

–CHOLESTEROL REMNANTS–

Remnant Cholesterol:NaN mg/dLNaN mmol/L >>> High Risk QuintileRemnant Chol to HDL:NaN >>> High Risk Quintile

Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–

AIP: 0.936 >>> Highest Risk Third

Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–

Friedewald LDL-C: 194 | Iranian LDL-C: 606 
Total/HDL Ratio: 10.51 
TG/HDL Ratio in mg/dL: 19.89 | in mmol/L: 8.64

Here is 10 days later no coffee

CholesterolCode.com/Report v0.9.2 ====– 
…3 months on Carnivore/Zero Carb/Meat Only ::: 12 hours water fasted… 
Total Cholesterol:403 mg/dL10.42 mmol/LLDL Cholesterol:300 mg/dL7.76 mmol/LHDL Cholesterol:45 mg/dL1.16 mmol/LTriglycerides:292 mg/dL3.3 mmol/L

–CHOLESTEROL REMNANTS–

Remnant Cholesterol:58 mg/dL1.5 mmol/L >>> High Risk QuintileRemnant Chol to HDL:1.29 >>> High Risk Quintile

Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–

AIP: 0.454 >>> Highest Risk Third

Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–

Friedewald LDL-C: 300 | Iranian LDL-C: 413 
Total/HDL Ratio: 8.96 
TG/HDL Ratio in mg/dL: 6.49 | in mmol/L: 2.

Still a long way to go. But haven’t had a triglyceride that low in years.
54 yo. 6’3″ heaviest. Was 249lb
Now 215. On my way to 205 goal.

Siobhan Huggins
Admin

Wow! Still high, as you said, but what a big drop from just taking out coffee! You may want to check out the other items on this list and see if there’s anything else on there that could be impacting, just in case – if you haven’t already.

Ketomike
Guest
Ketomike

How are all of the cholesterols actually measured? Do they seperatre the ldl from the Hal and then measured the cholesterol they contain. Same question for trigs. Is it trigs in Iipoprotein only. Do they include free fatty acids in albumin. I hope my question is clear

chris c
Guest
chris c

To a degree I suspect it depends on the lab and the equipment they have. In the past my LDL was always calculated. Originally my current doctor used a lab that actually measured LDL – the result came out about halfway between the standard Friedwald and newer Iranian equation, which was interesting.

Now she has to use a different lab and the LDL is again calculated rather than measured. Our nurses, and an increasing number of doctors elsewhere, now only provide total cholesterol and a “ratio”. Obviously trigs must be measured to do this but the result is unavailable. I suspect someone brought out a cut price analyser which only provides the result the doctor/nurse needs to determine your statin dose.

Here (UK) useful things like NMR are generally unavailable.

Mary
Guest

I am a 61 year old woman.5’9″ 145lbs –CONVENTIONAL MARKERS AND RATIOS—-==== CholesterolCode.com/Report v0.9.2 ====–
…2 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 337 mg/dL 8.71 mmol/L
LDL Cholesterol: 261 mg/dL 6.75 mmol/L
HDL Cholesterol: 65 mg/dL 1.68 mmol/L
Triglycerides: 55 mg/dL 0.62 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.17 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.433 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 261 | Iranian LDL-C: 215
Total/HDL Ratio: 5.18
TG/HDL Ratio in mg/dL: 0.85 | in mmol/L: 0.37

My Dr. freaked insisting on statins. I procrastinated for 4 months until she refused to refill my thyroid meds until I had another test.(I don’t have a thyroid). I panicked and with only 2 days before blood test I went off keto hoping to lower LDL. BTW I will never do that again Ive struggle all week to feel well and get back to where I was. Just got my results and I lowered LDL by 78. I also had a A1-C of 5.60 without metformin for the last 4 months. She only saw the TC of 260. LDL183 HDL 63 Trigs 69. I have a statin prescription in front of me that I don’t intend to take. WTF I have an appt on the 9th of August so she can make sure I’m complying!! Seriously thats not going to happen!

Mike
Guest
Mike

=== CholesterolCode.com/Report v0.9.2 ====–
…6 months on Standard American ::: 11 hours water fasted…
WARNING: fasting for less than 12 hours can risk confounded lipid numbers. See https://www.youtube.com/watch?v=ZQHztlN1Yls
Total Cholesterol: 252 mg/dL 6.52 mmol/L
LDL Cholesterol: 177 mg/dL 4.57 mmol/L
HDL Cholesterol: 79 mg/dL 2.04 mmol/L
Triglycerides: 68 mg/dL 0.77 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: -4 >> High Risk Quintile
Remnant Chol to HDL: NaN >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.423 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 159 | Iranian LDL-C: 138
Total/HDL Ratio: 3.19
TG/HDL Ratio in mg/dL: 0.86 | in mmol/L: 0.38

Hi Dave, these are my latest blood check results.
I’ m man, 59y old, BMI=26,7, I follow IF ( 16:8) for the last 6 months with an adherence of ~80%. Hypertension, regulated with medication.
My doctor wants me to start taking statines. Note that eight months ago the baseline was: TC: 6.11, TG: 0.82, HDL: 1.85, LDL: 4.02

I want to start an LCHF diet in // with IF.
Could you comment p’ease on my lipid profile as I don’t want to start statines?
Thanks a lot for the superbe job on the blog.
Mike

Emily
Guest
Emily

Thanks for the remnant cholesterol calculator! These are my results. I’m a bit concerned that it’s coming up medium-high risk. Any thoughts on this or what my plan of action would be to improve my numbers? Note: my LDL was a calculated LDL if that makes a difference. Thanks!

–==== CholesterolCode.com/Report v0.9.2 ====–
…15 months on Keto (less than 20g carbs) ::: 12 hours water fasted…
Total Cholesterol: 291 mg/dL 7.53 mmol/L
LDL Cholesterol: 150 mg/dL 3.88 mmol/L
HDL Cholesterol: 114 mg/dL 2.95 mmol/L
Triglycerides: 136 mg/dL 1.54 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 27 mg/dL 0.7 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.24 >>> Medium-Low Risk Quintile

Chris
Guest
Chris

Hi Dave, Thanks for all of your great work. Wondering if you have any thoughts about my numbers… I have always had great lipid panels, but also have been an outlier with low triglycerides. When I was eating SAD my trigs were around 70. Since going LCHF with bouts of keto and zero-carb, they’ve been down around 30. Also my fasting glucose has always tended high, around 100, which did not change with diet. My A1C was around 5.4 on SAD and has been around 4.6 recently.

Most of what I’ve found about low trigs involves chronic inflamation, thyroid issues, starvation, malnourishment, fat malabsorbtion. But none of those seem to apply to me.

Any thought s on whether it’s anything to worry about?

Thanks!

–==== CholesterolCode.com/Report v0.9.2 ====–
…5 years on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 165 mg/dL 4.27 mmol/L
LDL Cholesterol: 87 mg/dL 2.25 mmol/L
HDL Cholesterol: 69 mg/dL 1.78 mmol/L
Triglycerides: 30 mg/dL 0.34 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 9 mg/dL 0.23 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.13 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.719 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 90 | Iranian LDL-C: 54
Total/HDL Ratio: 2.39
TG/HDL Ratio in mg/dL: 0.43 | in mmol/L: 0.19

Jen
Guest
Jen

–==== CholesterolCode.com/Report v0.9.2 ====–
…6 months on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 260 mg/dL 6.72 mmol/L
LDL Cholesterol: 153 mg/dL 3.96 mmol/L
HDL Cholesterol: 92 mg/dL 2.38 mmol/L
Triglycerides: 62 mg/dL 0.7 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 15 mg/dL 0.39 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.16 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.531 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 156 | Iranian LDL-C: 129
Total/HDL Ratio: 2.83
TG/HDL Ratio in mg/dL: 0.67 | in mmol/L: 0.29

Should I be concerned with these numbers…. I had my DNA tested and it said that I am genetically prone to high LDL but I have never had it this high before. I had my blood taken after 3 months of strict LCHF and lost 15 pounds in the 3 months.

Marcelo
Guest
Marcelo

Hi Dave,
I’m writing because I got a bit worried with my last blood test. My previous one was in nov-2015. I’ve been most of the time in a low carb diet since 2013. I was probably around 80kg, and I’m 5’10”, regularly weight training. The results were:

–==== CholesterolCode.com/Report v0.9.2 ====–
…2 years on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 194 mg/dL 5.02 mmol/L
LDL Cholesterol: 128 mg/dL 3.31 mmol/L
HDL Cholesterol: 55 mg/dL 1.42 mmol/L
Triglycerides: 56 mg/dL 0.63 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.2 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.353 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 128 | Iranian LDL-C: 104
Total/HDL Ratio: 3.53
TG/HDL Ratio in mg/dL: 1.02 | in mmol/L: 0.44

After gaining a bit of weight I’ve been following a strict LCHF for two months (maybe even keto, but I don’t track exactly the amount of carbs, they are mainly from leafs and vegetables, some eventual lower carb fruit), and increased the amount of fats. I also restrict my feeding window between 12-20pm. My weight dropped from 83kg to 79kg and I’m feelin great. The last results were:

–==== CholesterolCode.com/Report v0.9.2 ====–
…2 months on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 273 mg/dL 7.06 mmol/L
LDL Cholesterol: 203 mg/dL 5.25 mmol/L
HDL Cholesterol: 51 mg/dL 1.32 mmol/L
Triglycerides: 86 mg/dL 0.97 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 19 mg/dL 0.49 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.37 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.134 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 205 | Iranian LDL-C: 190
Total/HDL Ratio: 5.35
TG/HDL Ratio in mg/dL: 1.69 | in mmol/L: 0.73

I was worried about the increase in LDL, with hello staying the same. What’s your opinion? I appreciate your help.

Sebastjan Dimnik
Guest
Sebastjan Dimnik

Hi Dave,

these are my lab results:

…15 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted… 

Total Cholesterol: 247 mg/dL 6.4 mmol/L
LDL Cholesterol: 166 mg/dL 4.3 mmol/L
HDL Cholesterol: 70 mg/dL 1.8 mmol/L
Triglycerides: 44 mg/dL 0.5 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.16 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.556 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

On my lab results TG were marked as too low… are there any possible consequences to low TG, or is it just a lab range i should ignore?

Thanks in advance…

amy
Guest
amy

I am 33 year old Women 5’4″ 110lbs. My doctor wants me to take drugs to lower my LDL through natural means like B3 and others foods because I told them I wont take drugs. What do you think? My small LDL-P 326 but the large VLDL-p couldn’t be determined not sure why.
HDL-P: 40.4 nmol/L
Large HDL-p: 11.4
LDL size : 21.7
HDL size: 9.6
VLDL size: 44.2
HA1C : 4.9
Before going on the diet the LDLC was only 100 the triglycrides were 52.
Have a family of history of heart diseases. In my mind I thought it was due to the type of diet they consumed.

–==== CholesterolCode.com/Report v0.9.2 ====–
…6 months on LCHF (20g to 120g carbs) ::: 16 hours water fasted…
Total Cholesterol:
275 mg/dL
7.11 mmol/L
LDL Cholesterol:
185 mg/dL
4.78 mmol/L
HDL Cholesterol:
79 mg/dL
2.04 mmol/L
Triglycerides:
57 mg/dL
0.64 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol:
11 mg/dL
0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL:

0.14 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.503 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 185 | Iranian LDL-C: 151
Total/HDL Ratio: 3.48
TG/HDL Ratio in mg/dL: 0.72 | in mmol/L: 0.31

James
Guest
James

Loved the podcast with Bret Scher

–==== CholesterolCode.com/Report v0.9.2 ====–
…10 months on LCHF (20g to 120g carbs) ::: 16 hours water fasted…
Total Cholesterol: 328 mg/dL 8.48 mmol/L
LDL Cholesterol: 239 mg/dL 6.19 mmol/L
HDL Cholesterol: 74 mg/dL 1.92 mmol/L
Triglycerides: 70 mg/dL 0.79 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 15 mg/dL 0.39 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.2 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.386 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 240 | Iranian LDL-C: 207
Total/HDL Ratio: 4.43
TG/HDL Ratio in mg/dL: 0.95 | in mmol/L: 0.41

Leti
Guest
Leti

Hello Dave, me and my boyfriend are doing keto since October. For me everything was great lab work great lost 57 pounds and no longer insulin resistance. But my boyfriend had a blood test today and everything was perfect but this.. Fasting for 11-12 hours
Triglycerides: 308.
Total cholesterol: 420.
HDL:45.
LDL:313.
VLDL:61
Tg/hdl: 6.8
All higher risk I use you calculator.
He has been eating a lot of heavy whipping cream and coffee. He’s also taking omega 3 supplements. He’s really lean now. Her weight is 62kg not a lot of muscle but he was obese and lost 58 pounds. I’m really concerned before keto he had high cholesterol and triglycerides but nos as high as now. He feel really well on keto and don’t want to stop it. What we can do? (sorry for my english). Thanks!

Tom M
Guest
Tom M

Hey Dave,
In addition to this report, see below:

–==== CholesterolCode.com/Report v0.9.2 ====–
…5 years on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 387 mg/dL 10.01 mmol/L
LDL Cholesterol: 307 mg/dL 7.94 mmol/L
HDL Cholesterol: 64 mg/dL 1.66 mmol/L
Triglycerides: 81 mg/dL 0.91 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 16 mg/dL 0.41 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.25 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.261 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 307 | Iranian LDL-C: 272
Total/HDL Ratio: 6.05
TG/HDL Ratio in mg/dL: 1.27 | in mmol/L: 0.55

Doc is still concerned about high oxLDL-p because of:
HDL-p (29)
LDL-p (2869)
hsCRP (2.43)
ApoB (200) .
CAC has gone from 15 to 41 over a 2 year perilod (I’m 65YO male)

My argument was that small LDL-P was 222, ApoA1 was 178, LDL-particle size was 22.3, large HDL-p number was 11.9, large vLDL-p was <0.8. I had the ClevelandHeartLab test 3 years ago and oxLDL was 95 so was "high" at that time. Lp-PLA2 was 197 and MPO was 164, both supposedly "low risk". Thoughts?

Ove
Guest
Ove

Hi Dave,
Thank you big time for all your work on lipids on keto.
Question: From your experience, does excercise (esp. resistance training) have any effect on the results of the Cholesterol Drop Protocol?
Would it be advisable to pause excercising during these few days? – It should be hard on the low calorie days anyway.
Ove

Siobhan Huggins
Admin

Hi Ove – in my experience it can, in fact, interfere. I’ve seen a few people who’ve tried the protocol and didn’t experience a drop, and retried without exercise during that week and the protocol worked as expected. This would make some sense as LDL is taken up by cells to be used for repair, so it may limit how much change you can see. I would say go ahead and limit intensive exercise during the protocol period – walks are okay, but nothing intensive just to make sure it doesn’t confound results.

Ove
Guest
Ove

Hi Siobhan, thanks for the advice.

Hachim Hamidi
Guest
Hachim Hamidi

–==== CholesterolCode.com/Report v0.9.2 ====–
…18 months on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 295 mg/dL 7.63 mmol/L
LDL Cholesterol: 214 mg/dL 5.53 mmol/L
HDL Cholesterol: 64 mg/dL 1.66 mmol/L
Triglycerides: 60 mg/dL 0.68 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.27 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.388 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 219 | Iranian LDL-C: 183
Total/HDL Ratio: 4.61
TG/HDL Ratio in mg/dL: 0.94 | in mmol/L: 0.41

Hachim
Guest
Hachim

Dave – These are my lab test done on June 23rd 2018. I would like your help to lower my ldl for next test to shut my doctor up. Please let me know how I can proceed for my next lab test. I love being on Keto diet I had similar journey to yours going to HFLC and I am also a software engineer so I do understand your methods.
Thanks,

–==== CholesterolCode.com/Report v0.9.2 ====–
…18 months on LCHF (20g to 120g carbs) ::: 16 hours water fasted…
Total Cholesterol: 295 mg/dL 7.63 mmol/L
LDL Cholesterol: 214 mg/dL 5.53 mmol/L
HDL Cholesterol: 64 mg/dL 1.66 mmol/L
Triglycerides: 60 mg/dL 0.68 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.27 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.388 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 219 | Iranian LDL-C: 183
Total/HDL Ratio: 4.61
TG/HDL Ratio in mg/dL: 0.94 | in mmol/L: 0.41

Debbie mackey
Guest
Debbie mackey

Hello, I just listened to your podcast with Chris Kresser. I have the profile you talked about. I have high LDL-180, HDL-74 and triglycerides-74. I have been exercising, paleo and gluten free. The dr. wants me to take a statin but I also have two copies of APO4 gene. I am concerned because my Father had two heart attacks but he smoked but I don’t want to take the statin. I weigh 118. Thanks for any advice.

Karen Carleton
Guest
Karen Carleton

Have you ever checked your cholesterol numbers after eating salmon every day?
Many years ago I ate salmon twice daily for a month (sometimes with egg whites) with either mustard or sugar free ketchup. Occasionally I ate a vegetable. At that time my cholesterol numbers decreased significantly. I’m currently on keto and IF and have lost over 30 lbs in 3.5 months (190 to 157 lbs., 5’4”, 67 yo- healthy). I quit Zetia 3 months ago and my cholesterol was 242 (LDL 170) two weeks ago. Because I Need Low cholesterol numbers for a job overseas, I started Zetia and quit coconut oil at that time. . I will have my cholesterol checked in 2 weeks and then again in August. Any advice/comments?

Marian
Guest
Marian

Tried a modified Feldman Protocol for my latest blood draw: keto diet (>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.25 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.268 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 224 | Iranian LDL-C: 200
Total/HDL Ratio: 4.81
TG/HDL Ratio in mg/dL: 1.24 | in mmol/L: 0.54

Marian
Guest
Marian

Don’t know why my comment above got messed up – pasting the full report
–==== CholesterolCode.com/Report v0.9.2 ====–
…3 years on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 303 mg/dL 7.84 mmol/L
LDL Cholesterol: 224 mg/dL 5.79 mmol/L
HDL Cholesterol: 63 mg/dL 1.63 mmol/L
Triglycerides: 78 mg/dL 0.88 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 16 mg/dL 0.41 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.25 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.268 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 224 | Iranian LDL-C: 200
Total/HDL Ratio: 4.81
TG/HDL Ratio in mg/dL: 1.24 | in mmol/L: 0.54

I am not a lean mass hyper responder but tried a modified Feldman Protocol for three days prior to my latest blood draw: ate a keto diet (< 20g carbs/day), upped my caloric intake 40-50%, and avoided all caffeinated drinks.
Results show my total cholesterol is slightly lower (303 here, 312 & 315 last two tests) so no appreciable drop. What pleasantly surprised me was my HDL hit a high (63 here, 56 and 53 last two tests) and triglycerides hit a low (78 here, 127 and 111 prior two tests).
Not sure if it was the keto or no caffeine or both that affected HDL and Triglycerides.

Donald Allen
Guest
Donald Allen

–==== CholesterolCode.com/Report v0.9.2 ====–
…3 months on Carnivore/Zero Carb/Meat Only ::: 16 hours water fasted…
Total Cholesterol: 286 mg/dL 7.4 mmol/L
LDL Cholesterol: 217 mg/dL 5.61 mmol/L
HDL Cholesterol: 58 mg/dL 1.5 mmol/L
Triglycerides: 57 mg/dL 0.64 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.19 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.37 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 217 | Iranian LDL-C: 180
Total/HDL Ratio: 4.93
TG/HDL Ratio in mg/dL: 0.98 | in mmol/L: 0.43

Hi Dave et al, I’m happy with what I received above, but am curious about the fairly significant drop in HDL from my last panel taken in January (when I was between a dirty low carb and a low-quality SAD). The January results were TC:212 LDL:122 HDL:76 TG:94. I expected my HDL to remain stable or increase from Jan, but today’s HDL:58 is the lowest I remember. 62/M/5’10/185, have lost 15 lbs on carnivore, maybe 20 to go. Any thoughts on the drop in HDL? Thanks much..

Siobhan Huggins
Admin

Hi Donald,
In my experience, that drop could very well be normal fluctuation.

HDL does tend to be a bit slower to move but in my own results I’ve seen it fluctuate back and forth by about 15 points, and Dave has likewise seen his HDL fluctuate quite a bit as well in response to fat intake, and exercise.

One thing is that I’d want to make sure is that it is not continuing to drop and just to keep an eye on it. But other than that, it still looks to be in a pretty normal range, and adjusting to a diet may have just tweaked it a bit.

Donald Allen
Guest
Donald Allen

Will do, thanks much Siobhan!

Lee Sandwith
Guest

Hi Dave,

Hope you’re well. Just ran my latest numbers through your report and got a negative score on Cholesterol Remnants – what do you make of that?

Cheers, Lee

–==== CholesterolCode.com/Report v0.9.2 ====–
…36 months on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 327 mg/dL 8.46 mmol/L
LDL Cholesterol: 262 mg/dL 6.78 mmol/L
HDL Cholesterol: 74 mg/dL 1.91 mmol/L
Triglycerides: 59 mg/dL 0.67 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: -9 >> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 241 | Iranian LDL-C: 201
Total/HDL Ratio: 4.42
TG/HDL Ratio in mg/dL: 0.8 | in mmol/L: 0.35

Siobhan Huggins
Admin

This can be due to calculating the LDL improperly or via a different way than the calculator is expecting.
If you use the LDL from the friedewald LDL-c at the bottom of the report instead you get RC of 12 – which is pretty low, but not below 0 low 😉
The negative result can also happen when they *do* use friedewald, but the triglycerides (used in the calculation) are so low it messes with the equation (generally like <30).

Lee Sandwith
Guest

Ok great, thanks for taking the time to respond 🙂

Lili
Guest
Lili

Just curious, will the calculator be adjusted to account for the new Martin-Hopkins method? Quest Labs uses this method exclusively now. Thanks!

Siobhan Huggins
Admin

I’d assume not, as the research on remnant cholesterol uses friedewald so it wouldn’t be equivalent as far as calculating risk. If you input your numbers into the calculator it says friedewald calculated LDL at the bottom that you can put in though. 🙂

David
Guest
David

Hey Dave, My lipid results:
Total Cholesterol 336
HDL 92
LDL 228
Triglycerides 78
I think I may be a Lean Mass Hyper Responder. Doc mentioned the word statin because of LDL. I want to lower my trigs. I think they’re a bit high because I’ve been overindulging on summertime fruits which are in season. Would like to lower my LDL too. I don’t eat any dairy so I can’t fatten up on heavy whipping cream prior to a retest. What do you think? Am I a LMHR? Also, genetic testing from twenty three and me revealed I’m a APOE3/4 carrier. I think the APOE4 half means I’m more prone to heart disease and Alzheimer’s. I don’t want a sudden unexpected heart attack like that Bob Barker commercial. Nor do I want Alzheimer’s. If I eat lots of veggies, that tends to destroy my gut – I don’t want to do that. It took me years to get my gut functioning well. What should I eat? What say you? Thanks for exposing the potential non-harm from high LDLers who might be LMHR. Cheers.

Siobhan Huggins
Admin

I certainly wouldn’t consider those triglycerides high! Under 80 mg/dL is pretty typical, and I’d be happy with those results!
Also, yes you do seem to be a hyper-responder. If you want to try the Feldman Protocol sans dairy to temporarily lower LDL that should be doable, just opt for very fatty meats for the protocol, like pork belly, pork shoulder, lamb breast, and so on.

APOE4 carriers do seem to be at a higher risk of alzheimers/heart disease, but as far as I’ve seen it addressed this still seems to relate to insulin resistance, as mentioned by Ivor Cummins and Amy Berger. “More vulnerable to modern disease” is how I’ve heard it discussed, meaning making sure to avoid modern risk factors (insulin resistance, dietary factors, etc) *may* be key. Amy discusses this in her book “The Alzheimer’s Antidote”.

As far as I’m aware eating lots of vegetables doesn’t lower risk of alzheimers or heart disease in and of themselves, so if they hurt your stomach perhaps it is best to limit them to match your tolerance? That is certainly not my area of expertise though.

David
Guest
David

Siobhan, thank you! I may have a few clarification questions but want to review the protocol again – my answers might be there. BTW, great presentation.

Siobhan Huggins
Admin

Any questions and let us know of course! And thank you! 🙂

David
Guest
David

Ok, I reviewed the protocol, a few questions. I’ll do 3 days (or 5 days if I’m measuring LDL-P too). Gonna quit coffee for two weeks prior, quit MCT and coconut oil, fast for 12-14 hrs before the test.
1) Is a shorter 12 hour fast better than a longer 14?
2) Should I also avoid exercise during the 3 days leading up to the test? (Seems like exercise might increase LDLs)
3) If my normal baseline calories are ~2000, should I increase them ~50% to 3000 during the protocol or should I eat more? (I’m afraid I’ll have a hard time eating so much especially if I aim for 80% fat 15% protein)
4) If in addition to a standard lipid panel I want to test Lp(a), should I wait and have that test done when I’m back on my “normal” baseline diet?

Siobhan Huggins
Admin

1) Anywhere within the 12-14 hour range is fine, I’ve not really noticed a huge difference going more towards 12 hours or more towards 14. I usually try to hit 13 just for consistency.
2) Avoid strenuous exercise, yes some walking is ok if it’s a part of your normal routine
3) Just eat as much as you can comfortably without making yourself feel unwell with as much of the extra calories coming from fat as possible. High fat cheese, heavy cream, bacon, etc. Try to keep ketogenic ratios. The higher the fat, the bigger the drop will be.
4) I would wait for a normal baseline, I’m not sure what the feldman protocol does to it, so it’s better to make sure you don’t confound it on accident.

David
Guest
David

Is the elimination of coffee primarily to lower triglycerides or is it also geared towards lowering LDL? I don’t want to give up coffee if I don’t HAVE to.

Siobhan Huggins
Admin

Sometimes people doing the protocol will not experience a drop if they have coffee during, so it’s definitely a possibility. You don’t necessarily have to, but I’d much rather give it up the first go around rather than not experience a drop and have to redo it (I know from experience the high calorie portion of the protocol is not easy, nor is it particularly fun!). But, of course, the decision is left in your hands 🙂

David
Guest
David

Thanks for your guidance. My retest was a success. I’d say I’m a LMHR.
–==== CholesterolCode.com/Report v0.9.2 ====–
…2 years on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 249 mg/dL 6.44 mmol/L
LDL Cholesterol: 134 mg/dL 3.47 mmol/L
HDL Cholesterol: 102 mg/dL 2.64 mmol/L
Triglycerides: 42 mg/dL 0.47 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 13 mg/dL 0.34 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.13 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.75 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 139 | Iranian LDL-C: 101
Total/HDL Ratio: 2.44
TG/HDL Ratio in mg/dL: 0.41 | in mmol/L: 0.18

Siobhan Huggins
Admin

Wow! I think I also saw you mention this on twitter as well – I’ll reiterate it’s definitely a success of the protocol (and your hard work put into it, of course 😉 ) congrats on such a huge drop!

David
Guest
David

What would be the top 5 or more tests for a LMHR to request from their doctor to put them at ease regarding heart disease risk? Is there a post anywhere? I’m thinking 1) CAC, 2) CIMT, 3) Lp(a), 4) NMR or something that tests for LDL particle size (small dense vs large fluffy), 5) any others?

Siobhan Huggins
Admin

standard lipid panel (for redundancy), insulin, and hs-CRP
I’d agree with the ones already listed

David
Guest
David

Which CardioChek at home device do you or Dave use for at home lipid testing? It looks like there’s an expensive one and also a relative cheap one (~$80). Would love your or Dave’s thoughts on which to get and also how accurate it is.

Siobhan Huggins
Admin

Dave has the CardioChek Plus. I don’t have one yet (trying to work it into my budget for the Plus as well).
As far as I understand, the main difference is that the CardioChek Plus can do simultaneous readings of a full lipid panel (Total, HDL, trigs, and calculated LDL) plus glucose from 2 test strips. The CardioChek home device (the cheaper one) only does separate tests one at a time (HDL, total, trigs, glucose all separate).

As far as I’m aware the Plus is pretty accurate (or else there’d be no point in using it), and he has done cardiochek vs lab readings and they are comparable (although not exactly the same due to rate of error, a few minutes between tests, etc). That’s just off the top of my head so I’ll double check with Dave too. Especially as he has experience using it fairly frequently.

Patrick
Guest
Patrick

Dave/Siobhan,

I’m at my whits end trying to improve my numbers. I’ve lost 50lbs and kept it off over the last 4yrs (low carb). In 2016 I got some blood work done as I was tightening up my diet and losing the last bit of that 50lbs. My ratios came back poor. I researched and read and listened to Ivor and Dave and tightened up my diet even more, added much more exercise. I currently exercise 5 mornings a week in the fasted state (30min jump rope in Zone 2, Pull-ups 13, Push-ups, pistol squats). I eat one meal a day mostly meat with very little veg (sauerkraut, cruciferos veg). No sauces, no liquid dairy, no BPC or other liquid fats or bombs. I do drink a fair bit of coffee and will now have to quit as I understand because for no other apparent reason my Trigs are still stubbornly high. The morning of my last blood work I didn’t exercise as It conflicted with the time I needed to have the blood drawn. Is it possible that the trigs parked in my blood were there in preparation for my usual workout? What else can I do to collapse my risk? I’ve applied each and every one of Ivor’s levers to minimize my risk. Please any insight you could provide would be greatly appreciated.

******************************************************************************
June 2016 (LCHF, actively losing some weight at the time)
-==== CholesterolCode.com/Report v0.9.2 ====–
…5 months on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 381 mg/dL 9.84 mmol/L
LDL Cholesterol: 277 mg/dL 7.16 mmol/L
HDL Cholesterol: 39 mg/dL 1 mmol/L
Triglycerides: 334 mg/dL 3.77 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 65 mg/dL 1.68 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.67 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.576 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 275 | Iranian LDL-C: 423
Total/HDL Ratio: 9.77
TG/HDL Ratio in mg/dL: 8.56 | in mmol/L: 3.77
*****************************************************************************
July 2018 (One Meal a Day, Nutritional Ketosis full time, previous 3 months Carnivore, did not exercise morning or bloodwork, did not drink coffee morning or bloodwork)
–==== CholesterolCode.com/Report v0.9.2 ====–
…2 years on Keto (less than 20g carbs) ::: 12 hours water fasted…
Total Cholesterol: 662 mg/dL 17.12 mmol/L
LDL Cholesterol: 572 mg/dL 14.78 mmol/L
HDL Cholesterol: 51 mg/dL 1.33 mmol/L
Triglycerides: 202 mg/dL 2.28 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 39 mg/dL 1.01 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.76 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.234 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 571 | Iranian LDL-C: 578
Total/HDL Ratio: 12.98
TG/HDL Ratio in mg/dL: 3.96 | in mmol/L: 1.71

Siobhan Huggins
Admin

If you don’t think it’s anything else, coffee is definitely a possibility. Could you try and cut it out for 2 or so weeks and see if you get better results?

Patrick
Guest
Patrick

Thank you for your response Siobhan, I cut the coffee out today and will try to test again soon…which where I live means scheduling a Dr appointment so they can give you a blood req 🙁

Siobhan Huggins
Admin

That is rather inconvenient, but not a huge deal in this case as you’ll need around 2 weeks of no-coffee to see if it’s influencing anyway.

Anthony
Guest
Anthony

Hi Dave,
Thank you for everything you do regarding lipidology. As an emergency physician, I can honestly say that your writings and research are a breath of objective fresh air in a medical world that seems to be focused on number thresholds and selling drugs without truly understanding all of the issues at play regarding lipids. I am 36 years old and started Keto/LCHF about a year and half ago after realizing I had metabolic syndrome. I had dramatic results, losing about 36 pounds in 3 months and now have never felt better in my life. I had some questions about my numbers. I have had significant improvement with much lower TGs and remnants, but TG still not in super low range. HDL has improved a bit but still low. I have always had low HDL-C and have never been out of the 30s. My NMR results show up trending LDL-P while on Keto? Small LDL-P is high? Would you expect to see any more improvements on LCHF? Thank you so much for your time.

Pre Keto:
on Standard American ::: 14 hours water fasted…
Total Cholesterol: 345 mg/dL 8.92 mmol/L
LDL Cholesterol: 156 mg/dL 4.03 mmol/L
HDL Cholesterol: 31 mg/dL 0.8 mmol/L
Triglycerides: 290 mg/dL 3.27 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 158 mg/dL 4.09 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 5.1 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.611 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 256 | Iranian LDL-C: 376
Total/HDL Ratio: 11.13
TG/HDL Ratio in mg/dL: 9.35 | in mmol/L: 4.09

After 5 months Keto:

..5 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 212 mg/dL 5.48 mmol/L
LDL Cholesterol: 153 mg/dL 3.96 mmol/L
HDL Cholesterol: 33 mg/dL 0.85 mmol/L
Triglycerides: 132 mg/dL 1.49 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 26 mg/dL 0.67 mmol/L >>> Medium Risk Quintile
Remnant Chol to HDL: 0.79 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.244 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 153 | Iranian LDL-C: 180
Total/HDL Ratio: 6.42
TG/HDL Ratio in mg/dL: 4 | in mmol/L: 1.75

After 15 months Keto, 11% body fat, athletic:

..15 months on LCHF (20g to 120g carbs) ::: 15 hours water fasted…
Total Cholesterol: 217 mg/dL 5.61 mmol/L
LDL Cholesterol: 159 mg/dL 4.11 mmol/L
HDL Cholesterol: 36 mg/dL 0.93 mmol/L
Triglycerides: 112 mg/dL 1.26 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 22 mg/dL 0.57 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.61 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.132 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 159 | Iranian LDL-C: 171
Total/HDL Ratio: 6.03
TG/HDL Ratio in mg/dL: 3.11 | in mmol/L: 1.35

NMR RESULTS
5 Months Keto
LDL-P 1672
HDL-P 23.7
Small LDL- P 1026
LDL size 20.4

15 Months Keto
LDL-P 2049
HDL-P 24.7
Small LDL-P 1152
LDL size 20.4

Anthony
Guest
Anthony

Ooops. Made a typo on total cholesterol for pre keto numbers
on Standard American ::: 14 hrs fasted…
Total Cholesterol: 245 mg/dL 6.34 mmol/L
LDL Cholesterol: 156 mg/dL 4.03 mmol/L
HDL Cholesterol: 31 mg/dL 0.8 mmol/L
Triglycerides: 290 mg/dL 3.27 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 58 mg/dL 1.5 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.87 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.611 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 156 | Iranian LDL-C: 292
Total/HDL Ratio: 7.9
TG/HDL Ratio in mg/dL: 9.35 | in mmol/L: 4.09

Siobhan Huggins
Admin

Hi Anthony, the low HDL could very well be genetic if its been consistently low through your history. Mine likewise stays pretty well within the same range. Or it could just be slower going up…
The LDL-P is around where I’d expect for your LDL, but the small LDL is interesting. It’s interesting to note that the percentage of small LDL has gone down (roughly same small LDL, but higher particle count)…
Do you have other results you can pair with this info like hs-CRP and fasting insulin in order to see the bigger picture?

Anthony
Guest
Anthony

Hi Siobhan,

Thank you for your reply! I actually have hs-CRP as well as LP(a) and LP-PLA2 pending after reading your very excellent posts on LP(a). I also just found out through 23andme genotyping followed by a promeathease analysis that I have risk alleles for LDLR (rs764550980 A,G) which causes FH and LPA (rs3798220 C,T) which is associated with high levels of LP(a). Uggh! Maybe that’s why my particle count went up? Impaired uptake/removal of particles?

Siobhan Huggins
Admin

Possibly… you could always check to see if you have impaired clearing by doing the feldman protocol. If you rapidly drop LDL-C and LDL-P within a few days, then perhaps even if you have the gene it isn’t expressed, or it’s only a slightly impaired function. But generally those with FH have a lifelong issue, not only after switching diets.