Cholesterol - yikes!

[susanm]

I finished my first whole 30 on Oct. 10, and have continued eating compliant excepting some wine and occasional dairy. Previously I ate a "Standard American" type diet with plenty of sweets and occasional fast food, however I have never been overweight.

I had my yearly physical last week and just got the lipid panel - my cholesterol, which had been borderline high in years past, is now rather drastically increased. My doctor is recommending I see a nutritionist, and go on a "strict diet" (as yet unspecified), and then get retested. This is interesting as my diet has been (in my mind) so much better. I have been eating no added sugars (which was a vice), no pre-processed foods (aside from items like coconut oil), and only grass fed/organic/wild caught meats, fish, and veggies. I don't eat especially much carb wise - I don't like sweet potatoes, my go to veggies are spinach (at least once a day), cauliflower, broccoli, lettuces, peppers. Fruits are are apples and bananas - 1 per day at most. I may eat on the higher side of healthy fats - I eat 1/2-1 avocado per day, and every meal is cooked with ghee or olive oil.

Interestingly my blood test shows ketones as +2 so I guess I'm burning fat.

I'm going to ask for a VAP test to better define the LDL (which is almost double), but curious if anyone has other thoughts. Thanks in advance.

Here are the current and last year results. The rations of total/hdl and trig/hdl are good based on what I've read, however the numbers are high - I'm not sure how to interperet overall.

Triglycerides Cholesterol LDL HDL

6/8/11 86 254 140 97

10/24/12 123 378 266 87

[Tom Denham]

378 is high enough that I would go on medication to get it down. My cholesterol and triglycerides went down substantially when I started eating the Whole30 way, but yours have gone up. Something is wrong. Actually, my LDL went up a little, but everything else improved so much that my doctor was happy.

Are you losing weight? I hear that active weight loss tends to increase cholesterol readings, although I do not know for sure this is true.

Do you get any exercise? Are you sleeping 8 to 9 hours per night?

[Flynn]

I am sure you will get lots of other good feedback, but anecdotally when I went paleo/whole30 my LDL increased significantly and my HDL went way down. I'd had normal numbers my whole life and I got scared because people in my family have died from heart disease. My doctor wanted to put me on meds but first suggested I cut out eggs, red meat (I never ate this) and dairy fat (I'm allergic, so this wasn't an issue) and eat nuts and fish instead. I cut out my 3 a day egg habit and my numbers went back to normal fairly quickly and I didn't have to go on meds. I do whole 30 style eating within my own limits and my numbers are all good....yay for sardines We're all different, keep up with your doctor visits, be safe and good luck!

[Johnny M]

There is pretty debatable info regarding statins and their effectiveness and there are some pretty awful side effects from them. I would seek out a paleo focused doctor (http://paleophysiciansnetwork.com/) to get their take and recommendations before anything else. Chris Masterjohn is a great resource for (progressive) cholesterol information as is Chris Kresser. I'd check their blogs for relevant info too.

Tom is correct in that weight loss can effect cholesterol readings. I was suffering from fatty liver disease before my whole30. My cholesterol went up during my whole30 which my doctor explained is often a result of fats from your liver breaking down. Cholesterol readings can also widely vary due to a number of factors. It might be worth getting at least one more reading to make sure it's consistent. Chris Kresser and others advise that the readings can almost be irrelevant unless you've been at a stable weight and health for 6 months or so and have had multiple readings that are showing consistent numbers.

[Renee Lee]

Another thing to consider is that statins have shown to be ineffective for women in the literature, so you get minimal if any benefit with all of the nasty side effects. Not a great cost/benefit if you ask me.

It's high enough to be concerned, but I think that too much time has lapsed between tests to determine if the W30 really was the cayuse, or if there is something else going on. Root cause is important here. Your tris are also a little higher than I'd expect, but definitely not bad.

In addition to the resources that Johnny mentioned, Peter Attia also has some really good cholesterol stuff floating around out there. Check all this stuff out and decide next steps.

again, if you have lost weight/fat DO NOT PANIC until your bw has normalized.

[susanm]

Thanks very much for all your input. I am not interested in taking statins, and I was thinking my body was "normalizing" after years of bad diet. I'm going to continue on with what I'm doing and do another blood test in a month or so.