As CholesterolCode continues to grow, our ability to handle all the comments coming in has been a concern, but we didn’t want to miss the opportunity to answer the awesome questions you guys have either. Luckily, not too long ago, Low Carb San Diego happened…
At Low Carb San Diego, I met Debbie – she used to be an engineer in silicon valley for 33 years, but is currently retired. She also happened to mention that she was interested in helping out Dave and I, and had the time to offer. She is passionate about learning as much as possible, and helping to get people accurate information so they can make informed decisions, and I felt that this attitude was a good fit, and her help might be a possible solution to our dilemma.
A Warm Welcome
If you haven’t guessed already, all of this is leading to introducing Debbie to the CholesterolCode readerbase! Debbie will be helping out by answering some of the comments that come in starting this week. I’ll still be replying to many of the comments that come in, as per usual, but don’t be surprised if you see Debbie around as well. This will hopefully mean, over time, even faster responses to comments especially during conferences as we continue to grow.
Welcome, Debbie–glad you’re here!
Good afternoon, I just had my annual physical with my doc who as always orders labs for my cholesterol. I am 58 year old female on the downside of menopause. I have had high cholesterol my entire adult life and have never taken meds. I have been physically active my whole life but once I hit 53-54 I gained a lot of weight that I could not “run or walk” off. So I started Keto/LC last November 2018. Prior to that, in March 2018, I had bloodwork done: Total Cholesterol was 279, HDL 65, LDL 200 and Trigs 71. The doctor wanted to start me on statins so I did what every patient tends to do, I avoided her for 18 months. Now, on August 27, 2019, after 9 months of keto/low carb, I go back for a check up and my numbers are: Total 337, HDL 65, LDL 260 and Trigs 60. Of course she feels I need statins and was not shy about pressing the prescription into my hand. I did hand it back and said, let me do some reading and I will get another blood test in 6 weeks. I had already come across literature from Dr. Nadir Ali and Dr. Paul Mason that LDL was not necessarily the “evil” that it has been made out to be so I wanted to gather more evidence to show my doctor when I came across your Breckenridge lecture and the protocol. So guess what? I’m gonna do it. I haven’t schedule the lab test, but I told my doc it would be around mid to late October 2019 which is 6-8 weeks away. 3 days before I go, I’m going to eat all the good fat and see what happens. 🙂 I typically fast for 20 hours/3 days a week and had just done that when I had this last test done so that really compounded the rise in LDL. I also usually do not count anything except net carbs and have been extremely happy losing weight (31lbs) and feeling amazing. I am 5’6″ and 145 lbs. I will let you know how it goes after my visit for a lab test in October. Thank you for sharing this information!
Just a note that neither Dave nor I like the idea of using the protocol to mislead your doctor – as their job is to use your bloodwork and other health signs to help advise you on how to reach your health goals. However, I’ve personally used it as a conversation starter with my doctor with success.
Some helpful tips: avoid liquid/refined forms of fat, water fast for 12-14 hours prior to the blood draw, and if you ever feel unwell err on the side of caution and stop. 🙂
Welcome Debbie! I am so intrigued by all the questions, answers and threads on this site. Can’t wait to see/hear what you add! Thank you!!
Welcome to Debbie and thanks to all of you!!
Have been monitoring my blood pressure and noticed a significant drop after being in outside swimming. Did some internet searches and found this was indeed a thing related to uv exposure and nitrous oxide production by skin. Nitrous oxide causes vasodialation.
In a YouTube video Dr. Ignarro, who won a Nobel prize for this discovery, mentioned that nitrous oxide lowers LDL cholesterol. I could find no other reference or article on this.
Anyway, had not seen nitric oxide mentioned in any of the low carb sites I follow, and uv (sun exposure) seems to be complementary to the effects we are trying to achieve with a low carb lifestyle. I’d really like to know if there are any studies that show a cause and effect relation between sun exposure (nitric oxide production) and LDL levels.
Hello Debbie, Siobhan and Dave,
I have followed a low card diet for about 13 years. I’m 71 and weight 130 pounds, 5’8″ in height. My recent Lipid Profie is (mg/dL):
Not on lipid lowering drugs.
I am near to several walk in Quest Diagnostics locations. I’d like to get my LDL particle count measured and, once measured, determine where I fall in the large and fluffy versus small diameter debate.
I’m sure that the type of testing required to measure the LDL particle size is linked to somewhere on this website along with some discussions about particle size.
I’d hoping that you can link me to that information.
Thanks for all you do!
Butler, PA USA
Hi Philip – The test can be listed under different names – for example “NMR LipoProfile” (at RequestATest.com) and “Cardio IQ Lipoprotein Fractionation, Ion Mobility” (at Ulta Lab Tests). Costs vary – sometimes you can find a special deal. Here’s a direct link to the test at Ulta Lab Tests and Request A Test .
I’ll contact the testing labs that you linked too. I was also hoping that you could link me to a discussion about LDL particle size.
If I find anything about Quest Diagnostics relative to LDL particle size testing I’ll post that information here.
There isn’t a posting specifically on particle size in this forum – consider joining the Cholesterol Code facebook group as there may be someone there who has recommendations on reading material.
Quest does the “Cardio IQ Lipoprotein Fractionation, Ion Mobility” test Debbie mentioned below. I needed my doctor to order it. Not sure what your situation would be. Good luck!
I’m 36 and got my bloodwork done for the first time almost a year ago. Had slightly elevated ALT (even though I don’t drink and never have), triglycerides, cholesterol, etc. I changed nothing as a result and probably gained another 10 pounds over the next few months. I reached my highest ever weight at 79# over what is considered the top end of the normal weight range for my height based on BMI. Likely 100# over where I really should be?
I drifted back down maybe 3-5# after that until about 3 weeks ago when I started studying all things keto. I’ve been on a pretty strict keto diet for 2 weeks and based on how it’s going so far I feel like it’s sustainable for me.
I’ve accurately documented weight as well as waist and hip size while I’ve been on keto but I’d like to have some more in depth documentation of this journey towards health. I’m considering getting a calcium scan and another blood test. I don’t know if there are better cholesterol tests I should order rather than the standard? Are there varying qualities of calcium scans? When I ask for a calcium scan do I need to ask a certain way so that I get the right thing done?
I live in a rural area but if I need to I can drive 3.5 hours to Denver once or twice a year and pay out of pocket to get what is best to tell me what I want to know.
Any suggestions on how to more completely document how my health changes as I move forward would be appreciated.
Hi – we have a list of our favorite tests here that may be of use to you. CACs are also called “Cardiac CT w/o contrast” so it may help to specify that and mention you want the coronary artery calcium score.
Another test some get to document their baseline is a CIMT (Carotid Intima-Media Thickness) test. This looks at the thickness of the arteries in the neck (the carotid), and gives a number that you can track over time. The only thing is to make sure you get follow-ups with the same technician, for consistency.
I’m also not sure if you are aware, but if you’re near Denver you may want to check into Dr. Jeffry Gerber – who hosts Low Carb Denver and practices as a GP in the area.
Thanks for reading this. Being new to taking charge of my health, thank you for being there. I’ll get to it. Last year , oct 2018, I had a heart attack. Im 68 . I’m on heart meds. Metaprolol, losartan,Lipitor and atorvastin. About a month ago I started the lchf diet. Have lost a few pounds, went from 205 to199. Just wanted to get to190. Anyway my lipid panel went pretty well as of July 2019. Cholesterol-154, chol/hdl ratio-3.76, hdl chol-41, ldl-98, ldl/hdl ratio-2.39 and trigs-77. Just had a Lp(a) test. According to the lab was 75.0 nmol/l. I got this done on my own, sent it to my cardiologist, he responded by telling me to double my statin. I’ve read enough about statins to know i don’t want to take his advice. Any studies on statins lowering Lp(a)? Any help would be greatly appreciated . Thank you, Chris J
Hi – I can’t comment on whether or not you should take medication, but as far as I’m aware from what I’ve seen from lipidologists in the field, the increase in statin is not to decrease lp(a) (as they don’t do this, and sometimes increase lp(a)) but rather to further decrease LDL on the basis that the person is higher risk, so a lower LDL is preferred.
As always, ultimately it is up to you to decide if you think this is something that helps you reach your health goals/something you are comfortable with, based on the available research.
Hi Chris, just another reader who has also taken charge of my own health. Just a couple things to think about for your journey. It’s really a whole lifestyle approach to better health and reducing heart attack risk. You may want to be thinking about (not necessarily in order) adequate sleep; stress management; adequate sunlight; movement and exercise (particularly strength), not being sedentary, and having strong social ties. Check out the work (on many podcasts, etc.) of Dr. Nadir Ali, a Houston cardiologist. Other labs to consider: HsCrp, fasting insulin, HbA1c. Could be okay now but was poor earlier on prior diet. Alcohol status? Think about your visceral fat mass (check out the Root Causing Health podcast episode with Dr. Sean O’Mara). There are a lot of things to think about/work on before doubling the meds but sadly hard to get many docs engaged on these topics.
And intermittent fasting.
I am very interested in the subject. I am a nurse and I like to have information with as much scientific evidence as possible. Have you done any systematic review / meta-analysis that could be published in a scientific journal? If so, please I would love to read it. If not, I encourage you to do it, since I think you have the qualities to be able to do it and its conclusions (whatever they may be) will be of great help to the world’s health professionals. Thank you very much for your work. Regards.
Hi – we don’t have any published research – but thanks for your interest! If we do publish in the future there would be an announcement on the website – so keep an eye out! 🙂
I have been LCHF for over a year. Am 67, lost 30 lbs down to 175 and many good things happening, BUT my latest lipid test showed my Tri way up, my HDL down and LDL also up. Previous 3 tests after being keto showed all lipids improving. THe only thing I consciously changed since last blood test was to stop my Crestor 10mg daily. Could this change have caused the lipid change?? FIrst 9 months LCHF my HDL was running 44-46, Tri running about 100 and LDL about 100. Latest reading HDL 34, Tri 222 and LDL 196. Latest number about the same as they ran prior to LCHF. I have decided to re start the statin, but any other suggestions or steps you think I should explore?
Hi, I don’t really have experience with how medication impacts HDL/TG but you may want to check out this post and see if any apply. For example, were you 12-14 hours water only fasted for the blood draw?
Hi Scot, just another reader who has also taken charge of my own health. Just a couple things to think about for your journey. It’s really a whole lifestyle approach to better health. You may want to be thinking about (not necessarily in order) adequate sleep; stress management; adequate sunlight; movement and exercise (particularly strength), not being sedentary, having strong social ties, and intermittent fasting. Check out the work (on many podcasts, etc.) of Dr. Nadir Ali, a Houston cardiologist. Other labs to consider: HsCrp, fasting insulin, HbA1c. Could be okay now but was poor earlier on prior diet. Alcohol status? Think about your visceral fat mass (check out the Root Causing Health podcast episode with Dr. Sean O’Mara). There are a lot of things to think about/work on while figuring out if/how to get off the meds. Check out the Low Carb MD podcast, they do talk routinely on taking people off meds.
My name is Therese and I’m from Sweden. I recently got my blood markers checked and it turns out that my blood lipid profile might not be the best. I have been strict keto for the past 4 months and LCHF for 4 years. I have gotten amazing results lately with losing weight and I have so much more energy!
Now what I’m hoping to get some clarification about and what is the is the missing piece in the puzzle for me is something called “remnant cholesterol”. To give you the full picture I will post my values here for you to have a look at:
Cholesterol: 7.8 mmol/L
HDL: 2.1 mmol/L
LDL: 4.6 mmol/L
ApoB/Apo A1 quote: 0.7
Triglycerides: 0.84 mmol/L
Glucose: 4.4 mmol/L
B-HbA1c: 23 mmol/mol
CRP: 0.32 mg/L
Remnant cholesterol: 1.1 (translates to 42.537)
So, as you can see my glucose values are very low and my inflammation marker is very low so that all looks good. But my LDL value is fairly high and the quote points towards me having a bit too high of a number of the “bad” LDL particles and if you check the quote for “remnant cholesterol” I sit on a very high number.
From what I’ve been reading on this website I am a “Lean-mass hyper responder” stating the following; ”Cholesterol scores can be higher for those who are lean and/or athletic on a low-carb diet.”. Now in my case this is true, I am a lean/athletic type of person.
But my question is; should I worry about my high remnant cholesterol in the context of my values? Or is this only concerning when on a high-carb diet with too much insulin in the blood?
Wonderful to see the team growing.
Just need some feedback on recent lab/CT results. Age 72. Poor nutrition for years although highest weight was about 160 age 20. Struggled with weight all my life by starving. Started Keto/low carb August 2018 (after trying all carb diet no salt, sugar, or fat for the prior year) which only made me hungry all the time and very fatigued and worse IBS. Also got more serious about exercise. (The lowest my cholesterol had been was 200 even then.) Have had IBS since my late 30s. Lactose intolerant. Started adding liquid fat with the Keto plan and 1 month later ALL lipid values increased 60% with Cholesterol 321. Kept watching everything available on YouTube. Due to IBS I started carnivore plan April 1, 2019. Found I had a very poor relationship with food. Lost weight from 122 to 112. 5’5”. Gradually increased protein to about 130G or more in 2 meals. Usually around 1200-1500 calories. % of protein to fat ratios about the same. Fasting 8PM to noon or 2PM. Exercising in mornings. Eating beef, salmon, egg yolks or eggs, sardines, chicken. I like beef and eggs the best. Was eating bacon and pepperoni but cut those hoping to lose body fat. Having hard time building significant muscle. Stopped all supplements except omega 3 capsules. Taking one prescription eye drop only. Due to recent low D of 26 started D3 even though I am brown from walking this summer (Louisiana). Since on carnivore noticed changes at about 4-6 weeks. Big improvement in IBS. More “present” in mind. Physically improved.
10/4/19. US Labs.. water/salt fasted 15 hours did exercise morning of blood draw
Fasting glucose of 89.
BUN 30 with 25 being cutoff . creatinine and GFR ok
Extra tests I got my doc to order
HgA1c. 5.8. (5.7 is cutoff)
Sed rate. 2
CT calcium score 0!
My body has too much fat to be a lean mass hyper responder. Waist at belly button 28. Hips 37. Most of my fat loss has been chest/rib area. Have lots of fat from thighs to knees.
I am very confused. Any insights? And many thanks for all the content you have provided.
Hi Sally – I’m helping out Dave and Siobhan by responding to some questions. Great to hear that you’ve seen a big improvement with the IBS, mind and physically. You do fit the description of a LMHR. Check out the LMHR characteristics which state that LMHRs are “often lean, with low body fat (<= 23% for women)”. There is no exact body fat % – the general trend is that LMHRs aren’t overweight which you certainly are not at 5’5” and 112 pounds. Consider joining the LMHR facebook group for people who want to share resources and experiences.
Is there information and research on genetic/high Lpa lipoprotein on the cholesterol code website?
Yes, indeed! There is this post in particular, and I also recently did a presentation at Low Carb Houston entirely on Lipoprotein(a) that is a bit more updated. It hasn’t been put out on youtube yet, but there will be a post on it when it is. 🙂