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Jan 20

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Please consider supporting my Patreon. All funding for my research and this site come solely from individuals like you. Thank you!

  • If you know little to nothing about cholesterol->
    • And you want to learn the basics->
      • You can check out my Simple Guide to Cholesterol series. It’s full of illustrations and is written for laypeople. Enjoy!
      • Likewise, I have this video that goes over the basic markers for cholesterol while on a low carb diet. (Pictured to the right)
    • You can enter your cholesterol numbers into our popular Report tool to check them against many risk calculations at the same time.
  • If you’re wanting to know about my research->
    • You want an overview->
    • You want the most recent breakthroughs->
      • 1/2/2018: In this latest video, I demonstrate massive changes to my LDL Cholesterol over 5 stages in a matter of days. LDL 207 to 103 mg/dL in seven days with high carb, up again to 146 on mixed, down again to 113 on high fat. (Pictured to the right)
  • If you have seen your cholesterol rise considerably on a low-carb high-fat diet (like myself):
    • You may want to first visit the FAQ.
    • I would strongly encourage you to read through this blog and my own journey revealing the Inversion Pattern. Key moments were the Identical Diet experiment and the Extreme Cholesterol Drop experiment that I wrapped around the first presentation of my data for the Ketogains Seminar.

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Elizabeth
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Elizabeth

Hello! I would love to share your presentation with my father, but he is deaf. Do you have a transcript we can access or is it possible to add CC to the you tube video? Thank you!

Chris
Guest
Chris

Hi Dave, thanks for your work. I’ve enjoyed your twitter feed and will be perusing your site here. I tweeted you about a patient of mine who has familial hypergyceridemia with Trg in the thousands. Currently Crestor and Tricor for this. he is motivated and now has a recent dx of DMT2 with a hgb A1C of 6.7. He is seeking dietary intervention. I’ve been a proponent of low carb high fat diets for many of my DMT2 patients and am having success coaching this, but had some pause in this gentleman given his Trg. He is reticent to start metformin and anxious to intervene w diet. I already started talking to him about LCHF. I am new to LCHF and as a intervention. While high Trg has not been implicated in mortality, non-alcoholic pancreatitis can be a serious complication and high saturated fat diet can be concerning for this. I’ve seen anecdotes about LCHF lowering Trg but would like to see some data on this. Thanks. Chris PA-C

Kaiden
Guest
Kaiden

I have two sets of test results. I did the protocol backwards (5000 calories first, then 500 calories). They weren’t NMR. They do contain some other numbers I found interesting. The high-day test did come back with elevated BUN. Is this common (i.e. because of the high amount of protein)? Either way, I’ll ask my doctor to rerun the test after a week of fasting.

Andrew
Guest
Andrew

Hi Dave,

I was recently turned-on to your Biohackers podcast interview & on one hand, am excited to tap into a LCHF / Keto community however am now slightly in panic mode after my first NMR, which is the second cholesterol test since going LCHF. Your thoughts would be wonderful. Below are my NMR results from Monday, June 5 2017:

– Total Cholesterol: 233, down from 254 on 10/6/16 (first test on LCHF) up from 202 from my last test before going LCHF
– HDL-C: 67, down from 71 on 10/6/16 (first test on LCHF) up from 55 from my last test before going LCHF
– LDL-C: 154, down from 166 on 10/6/16 (first test on LCHF) up from 130 from my last test before going LCHF
– Triglycerides: 60, down from 86 on 10/6/16 (first test on LCHF) & even with my last test before going LCHF
– LDL-P: 1,724 (no previous record)
– HDL-P: 28.9 (no previous record)
– Small LDL-P: 634 (no previous record)
– LDL Size 20.9
– LP-IR Score: <25

A little background: The Saturday & Sunday leading up to Monday, June 5 2017 were very active where I burned probably close to 1,000 calories each day mountain biking in fairly warm weather. I'm wondering (hoping) the high LDL-P is my liver releasing cholesterol for repair / maintenance? Also, this weekend was a little more carby than usual. Finally, high blood pressure is prevalent on my Mom's side of the family with her dad suffering from both stroke & heart attack. I think both parents are taking cholesterol lowering medications. In terms of next steps, I think another NMR is in order, perhaps not after exerting as much energy in the days leading up? At least to rule it out. What are your thoughts?

Lars Behme
Guest
Lars Behme

Dave, I am going to schedule my next blood test, I find the calorie intake for your protocol challenging :). I am T2D, off meds, but am keeping my carbs below 10g a day – any hint/ suggestion on how to beef it all up while keeping the carbs at that level (if it “has” to be 3%) ?
thanks for your time.
\Lars; Ireland

Lars Behme
Guest
Lars Behme

True, I did a test run, and managed around 1780 cals… natural carbs, even the mascarpone was made from farm made double cream which raw milk was used for – where I actually know the cow it came from… I was truly sick munching away – Let’s see how I will manage that huge amount :), and if the blood sugar is a wee higher (didn’t rise over 5 today) so be it. Factory based oils don’t usually hit my table (The blessings of living in rural Ireland and knowing the farmers, I guess).- Thanks Dave, good words.
\Lars

Latife
Guest
Latife

In relating your calling ‘Lean-Mass-Hyper responders’ and exercise part, I am bit confused and want to ask some questions. Let say I am a lean person and have lower glycogen stores. I regularly do exercises after low carb high fat dinner (about 2 hours after dinner). Also during day I am quite active physically doing kitchen, garden, shopping works etc. (or playing with kids). in this case my body uses fat or glucose? How long takes my body to use glucose or glycogen? If I have lower glycogen stores and think my body uses it during HIIT exercise and after about 12-14 hours fast isn’t it possible my body mobilising energy from triglycerides that increases my LDL? What is the reason my LDL or cholesterol decrease after exercises?
Thanks in advance!

Ian
Guest
Ian

Hi Dave
Thanks you for your blog and the video of your latest research.

Just a question about the lipid response to fat intake. In your studies (fasting, 5000 calories, etc) were you able to test the ldl subfractions (1 to 6)? Reason for asking is – maybe the LDL overall drops on high fat intake but the profile becomes more atherogenic (or vice versa). Hope that makes some kind of sense.

regards
IanA

b. holiday
Guest
b. holiday

Hi Dave. I want to report my results. I ate 4000 calories on Monday, 400 grams of fat. 5000 calories on Tuesday, 500 grams of fat. 5000 calories on Wednesday 500 grams of fat. 5000 calories on Thursday, 500 grams of fat. Tested blood glucose and ketones every night around 8PM. Blood sugar in 70-80’s. Ketones from 4-7.8.

Last meal around 4pm on Thursday. Blood test 8:15 am Friday.

LDL-P >3500 High.
LDL-C >429 High.
HDL-C 74
Triglycerides 147
Cholesterol, Total 532 High.
HDL-P (Total) 34.3.
Small LDL-P 219
LDL Size 22.3
LP-IR Score: 51 High.

Do these numbers look good, or very bad? I am getting very mixed messages.

Gina
Guest
Gina

First, thank you for the blog and all of the information you have been providing to us. I am also a hyper responder. When I started a ketogenic diet, my total cholesterol steadily rose to the 500+ range. After three years of being on the diet and improving all of my health markers, including a 100+ weight loss, my total cholesterol has slowly been going down and it’s currently at 345. I am not concerned over my cholesterol as I don’t believe in the lipid hypothesis but I am very interested in lipids, especially how LDL works.

Excuse my ignorance but since this subject really is fascinating to me, I want to make sure that I am not missing anything important. I am just not understanding what this protocol is for or what it is showing about cholesterol that we didn’t already know and why the results are meaninful. I have read through the blog and I also have a basic understanding of how lipids work. I am just not understanding what your research is showing.

If you eat a whole lot of calories, a few days before your blood test and it makes your cholesterol go down, what does that mean? Why would that be of any importance? You normally wouldn’t eat 5000 calories or more a day, so the fact that doing that causes your cholesterol to drop, is almost a fluke result. In other words, it’s not a true, everyday, result that you would get otherwise. I don’t see why anyone would do that unless they are trying to manipulate results for insurance purposes or to get their doctors off their back.

Most importantly though, I want to know what it means and why it’s meaningful? “Cholesterol” is so dynamic that basically anything can change it. I think that lipidologists know this and it hasn’t changed the country’s obsession on cholesterol so showing this effect on multiple people wouldn’t cause them to think cholesterol is any more harmful.

Craig
Admin

Gina,

Unfortunately, most doctors aren’t as informed about TC/LDL as they should be regarding both it’s predictive power as a risk factor and its dynamic variability. Instead of educating them, it’s often easiest just to give them a ‘good’ number and move on. If you have a LCHF-friendly doctor who is more interested in measuring insulin resistance, inflammation, and atherosclerosis, you don’t need the protocol.

The research so far has shown that the lipid system is highly dynamic, and more is going on than the conventional wisdom suggests. There is still a lot more to figure out, and we don’t know for sure if having high LDL-p is causal for disease in-and-of itself. So if you’re interested in learning more, you’re in the right place. 🙂

Craig.

Gina
Guest
Gina

Thank you Craig.

Joe
Guest
Joe

Hi Dave,

Your research is really fascinating- I as well had higher LDL numbers when I started the low-carb/Keto diet. The only thing is when my doctor tests my cholesterol he absolutely insists that I take the test non-fasting. When I look at the numbers with a layman’s eye, the numbers are always outside of the normal reference ranges- I.e: Either the ldl to high or the hdl is too low or both. He never seems concerned an always tells me everything is OK

Do you take your tests on a full or empty stomach? Do you think there is any clinical value to doing the test on a full stomach?

Thanks,

Joe

Jan Bardot
Guest
Jan Bardot

Hi Dave,
I just met you at San Diego LCHF. My name is, Jan an empath, the retired professional athlete, massage therapist and you read my NMR. I loved your presentation and your passion for getting the true data out about what cholesterol numbers really mean. Thank you very much.

Please let me know the dates in advanced so I can plan. As I said to you yesterday I am now single with no children which gives me the freedom to travel.

Looking forward to hearing from you.

Jan

RS Weir
Guest
RS Weir

Hi Dave:
Not sure if this is the right place to ask this question…but here goes.
I’ve been on a keto program for the last five years. Virtually no carbs other than leafy greens, cauliflower etc.. Yet fasting glucose is 96. However, fasting insulin is 2 which gives a very favorable HOMA_IR of .47.
I am curious as to why the glucose remains in the 90s. I would think that with no carbs I could get it lower.
Does the low carb, high fat, moderate protein diet produce such low insulin that consequently glucose cannot be driven down below 90 without long periods of fasting?
Thank you.

Craig
Admin

Check out Dave’s comment from today at 11:32 in The Game of Glucose. Your muscles learn to ignore the glucose so that its only used by tissues that require it.

Matt Allington
Guest

Hi Dave.

Matt here (twitter @exceleratorbi). I would love to work with you to help visualise your data. I am a professional data consultant and made keto guy.

Mary
Guest
Mary

Former Reliability Engineer here.
This stuff is fascinating.
Would love to see someone decompose dietary “risk factors” and associations into a ranked list of 1st order, 2nd order, 3rd order effects. Does anyone think that’s possible?
After the 1st order effects, genetics, microbes, frank poisons, (known and unknown exposures), accidents, available calories ( non starvation), exercise levels, even background radiation, a lot of medical science “risks analysis” especially from nutrition, looks pretty specious to me. Presumably the goals are to not die sooner or more painfully than needful and to function well. The first goal is more clear than the last goal
Many biological deaths are marked by (could be modeled as) cascading failures from the disruption of homeostatic processes ( don’t screw around with electrolytes and oxygen uptake). A. Be careful with your experiments B. We don’t know squat about proteomics, or the microbiome for that matter , and C., the whole science of endocrinology appears to be a bit thin on the subject of nutrition.
There are differences in phenotypes that affect metabolic efficiency for some compounds. (12 phenotypes for alcohol metabolism) Homeostasis will mask a good bit of variation. Everyone has some organ reserve. You might not realize damage until you’ve lost a good bit of cellular machinery. Then your numbers are going to go seriously south without a good way back. So be careful.

Kathy Kennedy
Guest
Kathy Kennedy

Hi Dave,

Glad to have found your blog. I had suffered for well over 15 years with horrendous digestive problems. After much trial and error, I tried a no starch diet and the results were incredible. It was the first thing that actually helped me. I eventually discovered that eating as close to zero carb as possible has given me the best symptom control to date. I am probably not in ketosis because I eat a fair amount of protein. I do what works for me.

I read that the body handles saturated fat differently on low carb or keto diets, so I didn’t worry about it, although I have had high cholesterol in the past. But at my physical in June, I got these results:

Total Cholesterol: 561 mg/dl
Trigycleride: 97 mg/dl
HDL: 109 mg/dl

I retooled my diet to lean meat, 2 eggs per day on average, fish,a little cheese, and monounsaturated fat and fish oil. And that is seriously about it, diet-wise, plus a piece or two of dark chocolate. I can tolerate beer because no fiber. No fruit, no vegetables of any kind, because I can’t digest them and any supposed health gains are canceled out by poor quality of life. I might be one of your lean mass hyper responders because I am 5’5″ and 107 pounds or so. Pretty physically active–lift weights and lots of walking. (15,000-20,000 steps/day)

Anyway, I don’t really know if it pays to be tested again. I will not take statins under any circumstances, and I simply can’t eat carbs. I figure I am doing the best that I can under the circumstances, but you seem to have studied this way more, so if you have any thoughts, I would be interested in hearing them.

Thanks,
Kathy

Ted
Guest
Ted

I’m curious if you have considered Dr. Thomas Cowan’s theory on the causes of heart attack. His explanation, while not an explanation of how dietary cholesterol or blood lipids work, it shows that the root cause of heart attacks is not blocked arteries, it’s capillary dysfunction, stress and poor para sympathetic response.

https://cdn.shopify.com/s/files/1/1021/7291/files/What-Causes-Heart-Attacks-Cowan-reprint.pdf?10079655763935097707

Ann
Guest
Ann

Hi Dave.
I’ve been on lchf keto for around 18 months, I’m 55 and recently passed menopause (still getting hot flashes, so not settled and my weight hasn’t really budged (bmi 28.5)) but feeling good and fit and healthy. However, got cholesterol reults today – first since being keto and they are:

TRIGLYCERIDES 1.4 mmol/L
CHOLESTEROL 10.8 mmol/L
HDL CHOLESTEROL 2.6 mmol/L
LDL CHOLESTEROL 7.6 mmol/L
Non-HDL Cholesterol 8.2 mmol/l
HLD as % of total – 24

My hsCRP was nice and low at 0.5 mg/l

So, trigs and inflammation not bad, but rest much higher than expected (and comparable to last reading prior to lchf when total cholesterol was about 5.)

I had fasted for 11 hrs prior to test.

I guess I’m a hyperresponder. Would backing off from keto be likely to lower the total and non-HDL?

Although not too worried about being out of “normal” range, I would like to be lower than this and any suggestions from your experience would be welcome.
Thanks
Ann

Antonia Montoya
Guest
Antonia Montoya

Dear Dave,

First of all I want to thank you for dedicating your time to research and for sharing it openly, it has been really helpful and a big insight for me in my current situation.

My name is Antonia Montoya and I am from Colombia, South America. I am a women, 32-years old, 5’6” and my current weight is 147 lbs. I have been on a low carb diet for the past 5 months and I have lost around 19 lbs.

Last week I had my blood work done and I was really shocked with my cholesterol levels. I have always had an elevated LDL (maximum 162), but never to these levels.

I would mean a lot to me if you could take a look at my charts and give me your insight. (Please take a look at the reference values used here, they might be different from the USA ones). By all means understand that you are not a medical doctor, but your insight is very valuable to me.

FREE T3:
Now: 2.3
Jan/17: 3.23
Ref Values: 1.71-3.71 pg/ml
Technique: CMIA

FREE T4:
Now: 1.02
Jan/17: 0.94
Ref Values: 0.70-1.48 ng/dl
Technique: CMIA

TSH:
Now: 2.9827
Jan/17: 3.5859
Ref Values: 0.3500-4.9400
Technique: CMIA

TRIGLYCERIDES:
Now: 65
Jan/17: 143
Ref Values: Accepable under 200 mg/dl

TOTAL COLESTEROL:
Now: 377
Jan/17: 252
Ref Values: Accepable under 200 mg/dl

HDL:
Now: 103.2
Jan/17: 77.7
Ref Values: Accepable over 40 mg/dl

LDL:
Now: 269.8
Jan/17: 145.7
Ref Values: Accepable under 130 mg/dl

FASTING GLUCOSE:
Now: 80
Jan/17: 77
Ref Values: 70-110 mg/dl

CREATININA:
Now: 0.84
Jan/17: 0.82
Ref Values: 0.51-0.95 mg/dl

RATIO HDL/T Ch:
Now: 0.27
Jan/17: 0.31

RATIO TRIG/HDL:
Now: 0.63
Jan/17: 1.84

On behalf of the Low Carb-High LDL community, thank you again! I’ve donated a small amount in sign of my appreciation.

Best wishes,

Antonia

Dean
Guest
Dean

Hi Dave,

I’ve been diving into your research and trying to fully understand it. I am a 49 yr old male who has been diagnosed with high cholesterol most of my adult life. I have been on 10 mg of statin for years. I am also on LCHF and continue to get high cholesterol numbers.

I feel silly asking this, but I seem to be missing a simple point of your research. The event that led you to this was being on LCHF and getting high cholesterol numbers. However, your inversion experiment shows that the more fat you eat, the lower your cholesterol number are. If that is the case, then why is cholesterol rising on the LCHF?

Thanks.

-Dean

Helena
Guest

Hi Dave,

One of the factors that’s mentioned as a possible cause of elevated cholesterol numbers is weight loss. Is there any information available on how long after weight stabilization that persists?

Since Jan. 18, 2017, I have been on a ketogenic LCHF diet, and have lost 20kg, which was close to 30% of my body weight when I started (No, I’m not anorexic, just short & small-boned!). Currently I’m within two kilo of my target weight and am beginning to work on stabilizing my weight.

I had blood work done on Nov. 4. Below, I’ve compared the results from my last previous test, which was on Jan 5, 2016 to those of Nov 4, 2017:

Total cholesterol 6.76 / 9.49 mmol
Triglyceride 1.15/1.14 mmol
HDL cholesterol 2.14/2.26 mmol
LDL cholesterol Calc 4.09/6.71 mmol
Non-HDL cholesterol Calc 4.6/7.23 mmol
Total cholesterol HDL-C ratio 3.2/4.2
Hb A1c 0.058/0.052

The dramatic rise in my cholesterol numbers freaked me out slightly, and I’ve been researching what I can find on the web. There’s a huge amount of info, and it ranges all over the place. Predictably, it’s left me confused! As well as the question of elevated cholesterol due to dieting, there’s also the apparent protective effect of high cholesterol for old women – I’m 73.

But before I make any decision on diet & lifestyle, I’d like to have a reasonably accurate picture of my cholesterol status. An NMR would be a good next step, but it’s expensive, so I’d like to wait until it’s likely that the post-diet cholesterol spike has settled down.

Thanks for your great work on this vexatious question!
Helena

Vik
Guest
Vik

Hi Dave
I just came across your blog and it has been very helpful. This is very informative and thank you for all the knowledge you are sharing. I need your help and some advice on my cholesterol situation if you dont mind. I am 40 yr old male and mostly been diagnosed to border level cholesterol from past 5 years. I have been working very hard at the gym and lifestyle to improve my cholesterol levels. But unfortunately this does not help me much and I bumped into the Keto diet.

I have been on Vegetarian Keto Diet (eat eggs) from 60 days now.
My macros has been like 75-25-5 and around 1800-2000 calories per day. My Ketones are at avg of 1.5 and Blood sugar avg at 92.

Before 60 days non-keto : HDL – 35, LDL-153, Tri-112, Total-210
After 60 days of keto: HDL – 35, LDL-196, Tri-140, Total-259

Some of my concerns are:
– My HDL never increased? (this was my main reason to start keto)
– Should I increase my ketones?
– I am also pre-diabetic before Keto and getting my blood sugar normal is my other goal.
– Cholesterol numbers are concerning and What changes would you suggest me to do on the above data I provided?

Big Thank you for everything you are doing and looking forward to your reply! Appreciate your response!Thanks!

EvgeniaBB
Guest
EvgeniaBB

How can you be sure that cholesterol drops due to a huge amount of calories and not due to the fact that excessive protein and part of the fat you consume on the days before the test? It seems that the protein you eat on usual days is largely sufficient for the body and all the extra will be converted to glucose?
The fact that only 95g of glucose is needed to drop cholesterol also seems to support this hypothesis.

Helena
Guest

Hi Dave,

Thanks for clearing up my conversion confusion – if I’ve calculated correctly, my TG/HDL ratio is 1.15539, which is a number to be pleased about!

Last January, I expected that, if I lost the extra weight I was carrying, my doctor would be happy with the results. Now, even though I have, talking with her is probably going to get “interesting”.

Though I wasn’t pre-diabetic, and not suffering from insulin resistance, I was worried about my weight and blood pressure. After ten years of battling a slow but inexorable weight gain, and developing borderline hypertension, I went on an LCHF diet. With great success. I won’t bore you with the details – if you’re interested, there’s an entry on my blog:

http://redefininglittleoldlady.com/little-old-lady-on-ketones-or-seven-months-on-an-upside-down-diet/

So far, I haven’t found a physician who’s willing to work with me on LCHF, so, when I was close to my target weight of 50 kilos, I made an appointment with a nurse practitioner at a local clinic. She was willing to prescribe a bunch of blood tests for me. When the result came in, she was very much alarmed and phoned me immediately, with the advice to go see my doctor as soon as possible

I wasn’t best pleased myself. I had been merrily expecting wonderful results – and most of them were excellent! Blood pressure down from ~ 130/90 to 100/80, Hemoglobin A1c of 0.052, all the other values bright & shiny.

But, as you said is typical for hyper-responders, the cholesterol figures were in what is routinely perceived as the prescribe-a-statin-immediately zone. For many reasons, I’m unwilling to even try statins.

Aside from the physical improvements, I’ve never felt better. My energy is way up, and for the first time, I’ve managed to keep up a regular exercise program (two vigorous one-hour aquafit sessions a week, plus an average of half an hour’s walk daily the other five days) for more than a month or two.

But the biggest improvement is that the low-grade depression that’s been dragging me down for years is finally lifting. So, even if I weren’t deeply concerned about the side effects of statins, it would take an awful lot of solid evidence to persuade me to change my diet significantly.

Which is going to make for a lively conversation when I finally do go see my family practitioner! I’ll give her the link and see what happens…

Thank you again!

Dr D Taylor
Guest
Dr D Taylor

Hi Dave

I am a UK based zero energy architect/renewable energy engineer who has been LCHF for about 14 years and have been time limited feeding (usually 16:8) and also occasional intermittent fasting.

As I had a blood test recently I fasted for about 2.5 days prior to the blood test as my focus was on keeping blood glucose levels low. I was somewhat surprised to find that my cholesterol came back high as did my trigs.

I was perplexed for a while then I remembered your presentation at Low Carb Breckinridge and I think that you mentioned that when you fasted your cholesterol shot up – was that also true of your Trigs?

I am due to see my doctor this evening so I am trying to pull some thoughts together.

I was very impressed with your research into the topic and it does seem as if you have nailed it and the thinking about LDL being an energy transporter – especially if one is LCHF/keto – seems to make sense.

Good luck with your experiments and research.

Regards

DT

Corey
Guest

Dave,

I just tried your protocol twice after being prescribed cholesterol lowering medication. After the second try my Lipid panel came back within normal levels.

Total Cholesterol:
11/11 – 395

11/17 – 242

11/22 – 186

I would be honored to share more my blood test and food journal if it would be of benefit.

Thank you for sharing this information.

Craig
Admin

Awesome, Corey. We are certainly interested in gathering citizen scientist data!

First, what were the TC/TG/HDL-C/LDL-C numbers? That would let us plot you on the Blood Pool visualizations.

So 11/11 was a low-calorie phase and 11/17 and 11/22 both high calorie phases?

P. H.
Guest
P. H.

Wow! You managed to drop total cholesterol over 200 points in 10 days. Can I ask what dietary changes you made on the second try?

Ron
Guest
Ron

Hello Dave,

I hope you can give me some advice on my Lipid numbers. I have been keeping my blood work numbers from my late 30s. I didn’t have blood work done any more often than what was required by an insurance company or as part of a normal checkup. My family history seems to show that we have higher Triglycerides than most people, and I tried to lower them by staying in good shape and eating healthy. My game plan had been to eat low fat and if I did eat fat, it would be the “healthier” fats (EVO, etc.). The most I have ever weighed is 200 lbs and I am 6 feet tall. In an effort to improve my Triglycerides, I worked to lose fat and get leaner. I would eat small portions of healthy meals and finally got my weight down to about 175. I wasn’t counting calories, and I didn’t track carbs, but I did target an approximate amount of protein. Occasionally i would get close to breaking the 170 mark, but it was like a wall. I started reading a lot about nutritional Ketosis in August/2017 and got a game plan ready and started eating a Keto diet. So I have been in nutritional Ketosis a little over 3 months. The amazing thing is how fast I have dropped pure fat from my body. I have tracked everything I eat and rarely went over 20 net carbs on any day. I have been eating 70-80% fats, 15-20% protein, 3-5% carbs. I currently weight 153 and I feel great. I had blood work done about 2 weeks after starting Ketosis, it just happened to be my annual checkup and I have to check my TSH numbers for my Hypothyroidism (that was diagnosed about 5 years ago and I take Levothyroxine 75mcg each day). I will give you some results from a few of my past blood draws going back long before I started Ketosis and hopefully you might have some thoughts about what I should be doing.

2/9/2013
Total Cholesterol 254
Triglycerides 538
HDL 35

6/29/2013
Total Cholesterol 276
Triglycerides 1380
HDL 32

12/2/2013
Total Cholesterol 194
Triglycerides 312
HDL 34
VLDL 62
LDL calc. 98

8/18/2014
Total Cholesterol 167
Triglycerides 222
HDL 36
VLDL 44
LDL calc. 87
(These numbers are after I started eating very small healthy meals as I described above and dropped my weight down in the mid 170s. This is also the lowest Triglycerides I have ever seen with my blood draws)

2/1/2016
Total Cholesterol 224
Triglycerides 662
HDL 28
VLDL 132
LDL calc. unable to be calculated
(Because I was in a routine of eating basically the same things and working out the same, these numbers surprised me and my Doctor. As I tried to figure out what I did to make these numbers change, I knew that the only material change in my diet, was that I had cut back almost entirely from eating Tuna (after reading an article in Consumer Reports about Mercury poisoning) and had stopped using fish oil supplements, thinking that I was getting plenty of fat from the EVOs and Flax. So I told the Doctor to give me a few weeks to put fish (Salmon, not the same risk of Mercury poisoning) and fish oil back in my diet and lets see if everything goes back to the 8/2014 numbers. They did, surprising myself and the Doctor (see the 5/16/2016 results below).

5/16/2016
Total Cholesterol 165
Triglycerides 222
HDL 34
VLDL 44.4
LDL 87

9/13/2017
Total Cholesterol 468
Triglycerides 1251
(These numbers are after I have been in Ketosis for approx. two weeks, and I have never seen my Cholesterol numbers ever go this high).

12/06/2017
Total Cholesterol 487
Triglycerides 1115
HDL 35
(The only thing I changed between the 9/13 test and the 12/06 test, was that I stopped using butter cooking my eggs and I reduced my cheese intake to one slice in the morning with my eggs. In that first two weeks of Ketosis, I had been eating lots of cheese all through the day.)

I am curious about your thoughts looking at my history and how it might relate to my short experience with being in Ketosis. Do you think that having Hypothyroidism (even though control with Hormones) having any effect on my results in Ketosis?

Thanks

Ron
Guest
Ron

Hello Dave,

I don’t think there was any specific markers that led my Doctor to suggest the Thyroid test. He is a really good guy that is more open to correcting health issues naturally if possible and he suggested we should do a Thyroid test since I had never had one before. After looking at potential causes of Hypothyroidism, one cause can be lack of Iodine, and I actually supplemented that for six months without positive results before going on the hormone.

As far as your thoughts that I could be in a “energy surplus”, I will tell you that i do consume a few protein drinks (but not everyday), specifically Muscle Milk and Advant EDGE. I only drink one of these if I want to add some protein to my numbers for the day, and I chose these because of the low carbs they have. I do consume one tablespoon of MCT oil (three teaspoons throughout the day). Sometimes I eat a snack/protein bar and I have a few different brands, all with low carbs, but I do notice that they show a high carb count and then after subtracting the fiber and then the “sugar alcohols” that brings the total down to 1 to 3 net carbs. Could those “sugar alcohols” be creating this energy surplus? I have read if you consume alcohol and you are in Ketosis, your liver will burn the alcohol first and basically put your fat burning state on hold, until the alcohol is burned. If that is true, that shouldn’t be a very long time, because the total calorie count in these protein/snack bars is approx. 150 to 250 calories. I do occasionally have an alcoholic drink and when I do, I mix one ounce of Rum with diet Pepsi and hardly ever have more than two (which is just a little more than “one shot”). As I think about these sugar alcohols and or alcohol consumed, I didn’t think there would be much impact, because I burn approximately 450 to 650 calories at the gym everyday (according to my Apple watch), depending on if I’m just weight lifting or doing cardio. Like I said earlier, I was weighting in the mid 170s three months ago and now I’m 153 after being in Ketosis. I’m sure I have a small amount of fat stores on my body, but most have been burned off.

I guess what is confusing me, I can go back to eating the way I was prior to being in Ketosis and get my Lipid numbers back down, to at least where they were (Cholesterol 165, Triglycerides 222), but how can being in Ketosis not be good for me after losing so much fat, not to mention feeling very good. After reading on your web site that I can order my own blood work and they have a location about 10 miles from me, I am wanting to experiment tweaking different things in my diet to see how much it will affect lipid numbers, so your suggestions will be appreciated. Do you have any thoughts of what I should try first and for how many days, before I schedule another blood draw?

Thanks Dave.

Chris Kunselman
Guest
Chris Kunselman

Hi Dave. Thanks for your resources and research. I’ve been traditionally high in cholesterol all my life. I went LCHF about 2 yrs ago. I am fat adapted and typically in mild ketosis. Just got my numbers again and I’m confused. I think I’m a hyper responder. Will get tested for FH. In general my TG to HDL ration is less than 2 which I think means good. But the other numbers worry me. I am active and in shape but not exactly lean. I would like to lose another 20-25 lbs. What are your thoughts? Total: 353 HDL: 67 LDCL:261 TG: 112.

I had the quest diagnostics lipo profile earlier this year and it turned up with pattern size A. My holistic doc has not been worried. But these LDL numbers are trending up. I see him again in a month.

Thanks,
Chris

Tim
Guest
Tim

Hi Dave.

Haven’t looked at the site for awhile, but I see you have been busy.

You may be aware of the following paper by, among others Volek and Phinney, apologies if so.
It looks analytically at stepwise increments of carbs and decrements of fat in a controlled feeding experiment.
Although the emphasis is on the disconnect between dietary and plasma fat, there is an interesting sidebar on plasma cholesterol versus dietary fat that supports your main thesis.

Enjoy.

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113605#pone.0113605-Aarsland1

Diane
Guest
Diane

Hello. I’m not a Keto dieter and my carb ingestion is probably a bit more than a true low carb diet, maybe more in the daily 80-150 grams or fewer range. My weight is on the low side for my height/age (BMI just touch over 20). My cholesterol numbers have been trending upward the last decade or so, even when I ate true low carb for a while. Lately they’ve gone up quite a bit, with LDL going up enough to get my primary doctor’s attention, from 177 to 219. She retested it 5 weeks later and it went up an additional 15 points, to 234.

I’ve been on a couple different statins years ago, both of which eventually caused muscle soreness, so can’t and won’t go on a statin again. I’ve read Cholesterol Myth, Good Calories/Bad Calories, and other books, so don’t buy into the “cholesterol causes heart disease” camp anyway. But I have started monitoring my particle counts, etc. even though my doctor is only focused on the traditional numbers (LDL, HDL, trigs).

Anyway, I stumbled onto your inversion-pattern video a couple months ago so decided to try the 3-day protocol before my next test. I ate my usual diet but tried to really increase the fat. Each day I ate two avocados, a lot more nuts, more EVOO, etc. I just got my test results and thought that you’d be interested. The protocol definitely worked in my case:

My results (from 11/2017 test to 1/2018 test):
LDL: from 200 to 167
HDL: from 68 to 63 (minor decrease likely from less exercise)
Total Cholesterol: from 281 to 238
Triglycerides: from 63 to 39

I’m pretty pleased with the results–I’m pretty sure that the doctor will get off my back now, even though she thinks the LDL is still way too high (but it’s been around that number for at least 5 years). I thought I’d share with you though the dramatic results. I’ve never had a trig number so low either.

Scott Belanger
Guest
Scott Belanger

Hi Dave
I appreciate all of your information and hard work behind the scenes you bring to we lay people. I’m due for a lipid panel in 2 weeks. I’d like to know if for the 3 days prior to the blood draw if I eat mainly copious amounts of raw macadamia nuts ,avocados and bacon trying for around 5000 calories each day should I see favorable lipid panel results compared to my last one I did 3 months ago while eating a low carb diet ( but not the very high fat like I plan on doing this go around) I certainly appreciate your comments on my question
Sincerely
Scott Belanger
Newcastle Maine

Maia Jensen
Guest
Maia Jensen

Hi Dave, I’m just wondering if you have done any cholesterol testing with regards to eating keto and being dehydrated vs not being dehydrated? I recently had blood work done and my numbers are as follows (I have been pretty strict keto for nearly 2 years):

Tryg: 94 (up from 83 six months prior)
HDL: 56 (down from 64)
LDL: 196 (down from 240)

I’m a tad confused as to why my tryglycerides would have gone up and HDL gone down, but given the ratio I’m not highly concerned (although my doctor is slightly panicked and wants to put me on statins).

BUT, my tests always show that I am dehydrated. I have a very hard time getting in adequate water and am horrible at adding extra salt. Oddly enough I still feel terrific.

I did a quick online search and discovered, “Drinking water can actually thin the blood, making in a natural way to help the blood pump more smoothly. When the body is dehydrated, the blood becomes acidic which can lead to a build-up in LDL levels of cholesterol. Drinking plenty of water will keep your blood ways clean and eliminate excess buildup of cholesterol waste from the body.”

I’ll be going in for more blood work soon. I’m curious to see if I do a simple change like drinking over 2 litres of water a day and getting 3 to 5 grams of salt, if my ldl levels would drop considerably. Perhaps chronic mild dehydration can be another reason so many people on keto may have higher levels of ldl?

Matthew
Guest
Matthew

LI’m so confused. I’m trying to understand all this info and it’s frustrating. I am on 40mg a day of Atorvastatin and I hate this medicine. I’m using keto and love it. I have managed to lower my blood pressure enough to come off 1 of my meds. My goal is to be medicine free and I’m using keto to do this. Can you please help me better understand my LDL/HDL numbers and what I can do to improve them? I was told to focus on “cleaning” my arteries and that would help improve cholesterol. But I’ve also been told cholesterol isn’t the issue it is the triglycerides. I weight train 6 days a week. Do cardio at least 4 days a week and eat HFLC diet (keto). Thank you.

Total:213
LDL: 136
HDL: 26.6
TRIGLYCERIDES: 252

Linda Hunkele
Guest
Linda Hunkele

Greeting! I have been strictly keto for 5-months. My most recent cholesterol test show a rise across the board including my triglycerides (before keto 102; 30-days keto 133; 5-mos keto 150). Not sure what to make of this, any info you can point me to?

Bahram
Guest
Bahram

Hi Dave, i got to know about from the 2 Keto dudes and went over yours interviews and presentations. You make a very compelling case for the correlation of lipoproteins and TG/Cholesterol transport in the blood with keto diets and fasting states.
As a biologist, I think your model seems very good and you data clearly support it well. What I am missing is the role of HDL in this model. If the LDL (U and V variantes specially) are the long range transport vesicles, and the local distribution from the fat tissue to the local TG consumers is done by NEFA, what is HDL doing and why is it associated with better healthier outcomes? Any insights? or maybe could someone point me to a reference where this is discussed?
Many thanks and keep up the great work!

Ruth
Guest
Ruth

Hi Dave,

Here are my numbers, this really freaks out all the wellness workers every time. The one time they checked it twice thinking something was wrong with their equipment. They see the other good numbers for blood pressure and blood sugar and are beside themselves.

I am 51 and have been low carb many years, after I lost weight my cholesterol shot up. I feel great. Thanks for all your info, I feel at times I am a lone duck with this, but after following this site I realize I am not alone.

Tc 359
LDL 273
Hdl 76
Tg 50

Jarrod Payne
Guest
Jarrod Payne

Hi Dave.

I have recently found your experiments and it has been really interesting and helpful in helping make sense of my own numbers. I am a researcher by trade so i was wondering if a) I can help in any way with your experiments or analysis, b) whether adding my data to the pool would be useful

For context i have always had high cholesterol as does my whole family. Genetic testing shows that i have increased ldl, decreased hdl and high trigs due to CELSR2, APOC1, PSRC1, APOE, CR1L mutations. I have been keto since 2014 and this has been great, my BF is about 14% and my cholesterol numbers are super fun. See my reports below. I don’t have my tests from pre-keto but they were similar. Particle size shows high levels of small and large particles and an average mean size because of this.

Are you going to be rolling the cheap blood tests out to Australia at all? Would love to do the Feldman protocol.

Total Cholesterol: 406 mg/dL 10.5 mmol/L
LDL Cholesterol: 340 mg/dL 8.8 mmol/L
HDL Cholesterol: 50 mg/dL 1.3 mmol/L
Triglycerides: 89 mg/dL 1 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 16 mg/dL 0.41 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.32 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.114 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 338 | Iranian LDL-C: 305
Total/HDL Ratio: 8.12
TG/HDL Ratio in mg/dL: 1.78 | in mmol/L: 0.77

Jim Wheeler
Guest
Jim Wheeler

Hi Dave! Love your blog. Love your videos. I just discovered yesterday that I am apparently a hyper responder. He’s my story: I’m 49 years old, not very active. I started Keto a couple years ago and have lost 40 lbs over the two years. Initially I was taking a statin. While on a Statin, my total Cholesterol was about 180. My LDL was about 115. My HDL was about 50. My Triglycerides were about 95. Then about four months ago, I decided to stop taking my statin to see what the effect would be on my lipids. So after four months of not taking statins and also being strict on keto (85%, 20%, 5% macros), I decided to get my lipids tested yesterday. The doctor called me back a few hours later with the results: He informed me that my total cholesterol is 330! My LDL is 255. My HDL is 60. My Triglycerides are 73. I was STUNNED! I really expected my numbers to be excellent. He is insisting I go on Lipitor immediately. I’m resistant. Any thoughts?

Norman
Guest
Norman

Hi Dave – I thought these figures may be of interest – I am a 62 yr old LADA diabetic on LCHF since 2013 – my LDL score started out in 2014 on 4 mmol/l moved to 9 and the latest test is 8.5 My HDL was 1.8 mmol/l at best and Trigs 1 mmol/l at best, now 2. but was as high as 2.3 mmol/l
My doctor being worried suggested a CAC scan but it came out 0 and showed a strong heartbeat. I am grateful indeed, but as you can see from my lipid profile it indicates a high risk of CVD but for me it is not the case. My Lipo (a) is >> Medium-High Risk Quintile
Remnant Chol to HDL: 0.54 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.187 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 321 | Iranian LDL-C: 351
Total/HDL Ratio: 8.12
TG/HDL Ratio in mg/dL: 3.54 | in mmol/L: 1.54

Kim M
Guest
Kim M

I have been Keto since AUG 2017 (pre-keto numbers were Total: 231/LDL138/HDL 80/Trig-64 taken April 2017) as you can see, after 6 months of Keto…BIG increase. Hard to wrap my head around it. But TG/HDL ratio looks okay….

–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 688 mg/dL 17.79 mmol/L
LDL Cholesterol: 586 mg/dL 15.15 mmol/L
HDL Cholesterol: 72 mg/dL 1.86 mmol/L
Triglycerides: 150 mg/dL 1.69 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 30 mg/dL 0.78 mmol/L >>> Medium-High 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: -0.042 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 586 | Iranian LDL-C: 554
Total/HDL Ratio: 9.56
TG/HDL Ratio in mg/dL: 2.08 | in mmol/L: 0.91

Norman
Guest
Norman

Hi Dave – sorry about the gremlins – below is the full picture – My confusion is because of my 0 CAC score and no problem with liver – kidneys – blood pressure – hba1c – 6.3 and test reveal large particle size – Regards

-==== CholesterolCode.com/Report v0.9.2 ====–
…5 years on LCHF (20g to 120g carbs) ::: 12 hours water fasted…
Total Cholesterol: 406 mg/dL 10.5 mmol/L
LDL Cholesterol: 329 mg/dL 8.5 mmol/L
HDL Cholesterol: 50 mg/dL 1.3 mmol/L
Triglycerides: 204 mg/dL 2.3 mmol/L

–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 27 mg/dL 0.7 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.54 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.248 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 315 | Iranian LDL-C: 365
Total/HDL Ratio: 8.12
TG/HDL Ratio in mg/dL: 4.08 | in mmol/L: 1.77

Kevin
Guest
Kevin

Your blog is amazing, thank you for sharing all the information!

I would really, really, really love to read about these variables and how they might impact results:
1. Apoe-4 and, in particular, Apoe 4/4 vs. other genotypes (I’m not sure if you know your genotype but this might be possible if a community of people with different genotypes does similar experiments)
2. Holding total calories, total carbs (let’s say medium), and total fat constant, drill down into effects of MUFA vs SUFA and even better MUFA vs specific types of SUFA, e.g. a week of getting 90% of fat from olive oil (mostly MUFA) vs a week of coconut oil (SUFA, mostly lauric acid) vs a week of dairy/animal fat (SUFA but different fatty acids).

Bernd Biermann
Guest
Bernd Biermann

Hi Dave, I just saw your Youtube Video about high fat diet on Cholesterol. Very impressive. I’m going to start Keto, but i’m also afraid about the high fat intake to my Body, I have a triglyceride-anemia. My highest result was Trigs: 1148, Cholesterol 598, LDL not measurable and HDL 33. I’m on Statines and Ezetimibe which keep my values in order. My Question: Do you see a Chance to start LCHF to get rid of the tablets or do you see the Chance of LCHF is working for me even with the medicine. i’m also having Diabetes 2 (15,2), but brought it down to 10 within a few days on Keto diet. 111 kg on 1,86m (far to much). looking forward to your answer.
I know your are not a doctor, but maybe you have an opinion based on your experience.
Cheers Bernd

Sylvia
Guest
Sylvia

Hi Dave! Have been fascinated with your presentations thus far and can’t wait for what’s to come especially on remnant cholesterol. The following are my latest lab test but I will be doing your protocol soon hopefully the 10+ day protocol but for now here’s the latest also I’ve been doing LCHF/Keto since August of 2017 but not strict my fault when I travel I tend to go off here and there but not too crazy 🙂

Total CH-202
HDL-67
LDL-118
TRIG-75
Chol/HDLC Ratio-3.0
LDL/HDL Ratio-1.8
Non-HDL Chol-135
Lipoprotein-10
HS CRP-0.7
T3 uptake-31. (Normal)
T4 Total-5.7 (normal)
Free T4 index-1.8 (normal)
TSH-9.90 (High)***

My stats: Female
Age: 41
Height: 5′
Current weight: 154.3lbs (and still losing)
Highest weight: 297lbs

Lee
Guest
Lee

Hi Dave!
Thank you for all the work you are doing, this is all very fascinating! I have been carnivore since Jan 1st, and I recently got my blood work done. Last time I had it done was July of 2017. But, I’m just not sure how to read it. Is there anyone you would recommend or any resources to refer to in regards to reading everything? Here are my results:
Total Cholesterol 226 (High) (was 181 in 7/17)
HDL Cholesterol 45 (was 58 in 7/17)
Triglycerides 46 (was 58 in 7/17)
LDL Cholesterol 167 (High)(was 111 in 7/17)
CHOL/HDLC Ratio 5.0 (High)(was 3.1 in 7/17)
Non HDL Cholesterol 181 (High)(was 123 in 7/17)
Glucose is 95 (was 86 in 7/17)
Insulin 5.7 (was 2.9 in 7/17)
Everything else is within their ranges, except for:
BUN 31 (High)(was 26(High) in 7/17)
BUN/Creatinine Ratio 26 (High)(was 21 in 7/17)
ALT 56 (High)(was 28 in 7/17)
Also interesting is that my testosterone levels were all almost cut in half, but I don’t feel any different in that regard. Dr. Baker (his testosterone levels were considered on the low end) mentioned that it could be that his body is just very efficient and processing and absorbing testosterone.
I used your reporting tool, but have no idea what the results mean 🙂
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 14 mg/dL 0.36 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.31 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants

–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.348 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma

–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 172 | Iranian LDL-C: 135
Total/HDL Ratio: 5.02
TG/HDL Ratio in mg/dL: 1.02 | in mmol/L: 0.45

Any help, feedback or direction would be greatly appreciated!
Cheers,
Lee

George
Guest
George

Dear Dave,

I came across your videos in youtube and this website only yesterday. Thank you! I am extremely glad to see what you do, which is so relevant to me being (very likely) a hyper-responder myself, who had to quit LCHF (see ‘My LCHF history’ below, after my questions for you listed next)!

Now by seeing all the amazing information that you have been putting forth, I am eager to restart the LCHF diet. To that end, I would like a few clarifications from you on some of the things to have mentioned in your blog:
– When you say ‘the fasting disaster’ makes LDL go over the roof, does that also indicate that a hyper-responder should better avoid intermittent fasting to keep LDL low? (I like to doing intermittent fasting, as it feels good and because the weight loss is faster when I want it).
– Again, when you emphasize, in the Feldman Protocol, on avoiding coconut oil and coffee (two of my favorite things) as they have resulted in discrepancies in the cholestrol lowering experiment, does that also indicate that these are things a hyper-responder should better avoid in daily diet?
– In short, should a hyper-responder be keeping the LDL from shooting-up, on an LCHF diet, by always eating more calories, not fasting, and avoiding coconut oil and and coffee?

My LCHF history:

I had to quit the LCHF diet two years ago, which I blissfully enjoyed for a span of 7 months—seemingly with all its benefits except for the dramatic lipid profile—until the day I got my blood work which returned the following:
TC – 422 mg/dL
HDL – 76 mg/dL
TG – 133 mg/dL
LDL-C (Friedewald) – 319 mg/dL
To contrast, the numbers (from an year before the foregoing test) when I was eating a not-so-healthy high-carb-moderate-fat diet—and thereby was overweight—were:
TC – 279 mg/dL
HDL – 47.4 mg/dL
TG – 176 mg/dL
LDL (Friedewald) – 196.4 mg/dL
(Thanks to your calculation tool, I’ve noted that with LCHF I could improve my remnant cholesterol only to:
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 27 mg/dL 0.7 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.36 >>> Medium Risk Quintile
from the worse situation before:
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 37 mg/dL 0.96 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.8 >>> High Risk Quintile.
I have not been physically active enough, and I have a family history of heat disease.)
Obviously, my general physician and endocrinologist freaked out and asked me to stop the high-fat diet immediately. Moreover, as per the advice from Dr. Andreas Eenfeldt of dietdoctor.com, which he has given in his blog:http://www.dietdoctor.com/low-carb/side-effects#cholesterol, I decided to stop doing LCHF. In addition to cutting down on saturated fats while avoiding sugar and excess carbs, I started doing intermittent fasting by skipping breakfast (which used to be ‘coffee with butter/coconut oil/heavy cream’ during my LCHF days) and in two months, I got the following numbers:
TC – 251 mg/dL
HDL – 59 mg/dL
TG – 100 mg/dL
LDL (Friedewald) – 172 mg/dL
(which put into your tool gives:
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 20 mg/dL 0.52 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.34 >>> Medium Risk Quintile)
I have been following roughly the same type of diet ever since…

Maryann+D
Guest
Maryann+D

I wanted to get back to you on the Feldman protocol I followed for my blood work. I ate an average over the 3 days of 251 grams of fat daily, 27 grams of carbs daily, 93 grams of protein daily and 2190 calories daily. I am a 72 year old woman with moderate activity level. My CAC score was 200. My previous blood work in Nov. ’17 was TC (288), after the protocol (March 2018) (313); Triglycerides Nov. ’17 (156), after the protocol (155); HDL Nov.’17( 63), after the protocol (66); LDL Nov. ’17 (194), after the protocol 213. My remnant cholesterol Nov.’17 was 31, and after the protocol 31. My only ratio that stayed under the suggested level (3.5) was LDL/HDL = 3.32 (up from Nov. ’17 of 3.08) However, my A1C went from 5.7 in Nov.’17 to 5.2 in March 2018. So my takeaway is I’m a hyper-responder.

Mike
Guest
Mike

I had blood drawn for an NMR test through Requestatest.com baseline on Friday, March 30, after fasting for 13 hours. I ate 4,900-5,000 calories, 80% of them from fat and under 4% from cards, each day staring Monday, April 2 through Wednesday, April 4. I had no coconut oil, MCT or coffee any of those three days. I had blood drawn again for a second NMR test on the morning of Thursday, April 5, after fasting for 13 hours. While I used no coconut oil, it dawned on me the second day of the second run-through that I was drinking unsweetened coconut milk and I switched, half-way through, to unsweetened almond milk. It is unclear to me whether unsweetened coconut milk would contain enough coconut oil to be problematic.

03/30/18 04/05/18
LDL-P 2423 1825

LDL-C 194 144

HDL-C 52 47

Triglycerides 114 116

Cholesterol 269 214
Total

HDL-P 25.3 30.2

Small LDL-P 864 941

LDL Size 20.9 20.4

LP-IR 26 97

I would call these mixed results. If I am reading the lab report correctly, my LDL Size dropping from 20.9 to 20.4 means that I went from from being a smidge into Pattern A to being a smidge into Pattern B. Total cholesterol, LDL-P and LDL-C did drop. HDL-C dropped, although not into a “Low” result.

So long as a doctor runs an “old school” test just for Total Cholesterol, LDL-C, HDL-C and triglycerides, at least my numbers look more borderline. On a personal level, I am most disturbed by the swing in LP-IR. I went from literally off the chart for optimal to being in the highest end of the range for diabetes risk.

I had two previous tests done in a similar scenario except that I drank coffee and the results were actually worse. I will post those separately when I have time, but that was a first-run of the protocol for me, with the baseline test taken by my doctor and processed by Quest Diagnostics.

Mike
Guest
Mike

I apologize. I typed the numbers in as a nicely spaced table, but the [spaces] apparently do not hold up when posted.