Cholesterol

[Snownsunlover]

I finished my first Whole30 a couple weeks ago, prior to that I was eating Primally with a dessert or glass of wine on occasion.

I went for my annual physical and lab work was ordered. I was actually looking forward to the results, but instead I am totally freaked out.

FBS - 87

Total Cholesterol - 413

TRIG - 60

HDL - 99

VLDL - 12

LDL - 302

Last time I had the values checked, about 3 years ago, they were normal, HDL was about 60, TRIG 40, LDL 101 and TC about 160 (estimated from what I remember).

I have to get these rechecked next week. I'm also going to request TSH, LDL particle size testing, and Vitamin D. My parents have been taking statins for as long as I remember, but they eat standard American diet. Any advice? Should I continue with the Paleo diet?

[Andrea D.]

I am no expert in this area so I'm sure other that know way more than me will chime in... IMHO, I believe wholeheartedly that a paleo/primal diet is the healthiest way to go so I would definitely stick with it.

I'm sure it was but...was it fasting blood work? I've heard that a heavily fatted meal prior (even the night before) to lipid tests can cause really high readings like yours...I don't blame you at all for being freaked out, I would have reacted the same way! I definitely would have the blood work repeated...but I'm anxious to hear what the more educated on the subject have to say... Good Luck!

[Johnny M]

I am not a doctor so to be responsible people we need to say to listen to yours above anything we say...but I'm pretty sure statins aren't known to actually help women and lot of people think the only reason they work at all is because they reduce inflammation not because they lower cholesterol. They also have some nasty side effects. Chriss Kresser and Chris Masterjohn are my go-to sources for all things cholesterol. Might wanna give these a listen:

part 1

http://chriskresser.com/the-healthy-skeptic-podcast-episode-11

part 2

http://chriskresser.com/episode-16-chris-masterjohn-on-cholesterol-heart-disease-part-2

part 3

http://chriskresser.com/chris-masterjohn-on-cholesterol-and-heart-disease-part-3

[Snownsunlover]

@Andrea - I was fasting over 12 hours and all other labs looked normal. No big fatty meals either. I'm going to continue with the Paleo/Primal eating because I, like you, think it is the healthiest way to eat.

@Johnny, thanks for the info as well! Statins scare me and I have no desire to take them. I'm going to continue to educate myself on this topic. I have a feeling I'm going to end up battling the doctor with this one! Ugh.

[Renee Lee]

Have you lost a lot of weight recently? It takes about 3-6months after you STOP losing weight/fat for your LDL numbers to normalize.

I'd also recommend getting your T4 and T3 checked along with your TSH. Those can give a more complete/accurate picture of what's going on.

But definitely read up on the Chrises' websites AND work with your doc to come to a mutual agreement about how to proceed. I wouldn't give up paleo just yet

[Johnny M]

Renee is right. 1 in 3 people have a fatty liver and probably just don't know it. I was lucky enough to have mine diagnosed. I learned that as you change your diet to a paleo one, your liver will quickly start releasing stored fat and lipo proteins which can skew lab results. This is just 1 skewing factor - there are many. I simultaneously cured my liver, dropped 25 lbs, lowered my blood pressure and my cholesterol went up. My doctor said "great news! You've made so much progress! But I need you to cut back on fat". Sigh. Fat saved me. I plan to get tested again in a couple months as my weight is starting to stabalize. But remember the jury is largely out on what our cholesterol numbers really mean.

[Snownsunlover]

I'm 29 years old, 5'2 - 129 pounds, my goal is to lose a little more fat and add some muscle. This is the most I've weighed since college, boo, but a change in employment from a standing job to a sitting job plus a knee injury made maintaining weight a challenge.

Since doing the Whole30, I've lost about 3 pounds. I walk 30-60 minutes a minimum of 4 times a week and strength train 1-2 times a week for 30 minutes, and I try to do easy yoga once a week. Prior to the knee injury, I was running 3 miles a couple days a week, running half marathons, and doing HIT. My trainer at the gym told me that running for years can really mess up your metabolism, so I'm wondering if that has anything to do with this....

[Snownsunlover]

Oh and Johnny, how did you get diagnosed with fatty liver?

[Johnny M]

Oh and Johnny, how did you get diagnosed with fatty liver?

I had some routine blood tests done for a physical that revealed some higher than normal liver enzymes in my blood; AST 63 and ALT 164. I understand these to be enzymes that are naturally in everyone's liver but only get released to the bloodstream when your liver is injured. I liken it to, you only see blood streaming from your arm if you have a cut in your arm. That said, I don't fully understand what they mean and I do know that there are a number of factors that can cause these enzymes to appear at high levels when in fact your liver is not injured so alone they're not indicative of a liver problem. But my results were consistently high, I was overweight, and I was having dull nagging pain in my lower right abdomen.

My doctor ordered more tests including for things like hepatitis but those came back negative. She ordered an ultrasound for me as the numbers were not budging and that test revealed my liver was enlarged and covered in fat deposits. They had NO ADVICE or explanation other than try losing 5-10 lbs. They also didn't tell me that having a fatty liver means that you're 5x more likely to have heart disease and that some things like high fructose corn syrup have proven to rapidly fatten a liver and that some recent research has shown removing carbs like those from wheat and sugar have shown to rapidly reverse fatty liver.

Regardless I found whole30 and that did the trick. I have not had another ultrasound but my liver enzymes at my last test were AST 22 and ALT 49 (which is totally back to normal) and the pain I had is now gone.

[Snownsunlover]

Hmm... my liver enzymes are normal, so I'm not sure that's the problem. I'm going back next week to repeat the labs, I'll be sure to update when I get the results!

[Melissa Urban]

Snowsunlover, don't panic just yet.

Your triglyceride:HDL ratio looks fantastic, and that's the biggest predictor of risk - way ahead of total cholesterol. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664115/ Yours is under 2.0 - a really fantastic, low-risk place to be.

Your LDL could be "high" for a number of reasons. There is a 3-6 month transitionary period with cholesterol when you first switch your diet - I don't know how long you've been eating Primal/Paleo, but that could be factoring in. In addition, if your diet is very high in animal products (lots of red meat, shrimp, eggs, etc.) then that could be pushing your LDL up - but that's not necessarily problematic. Your body's own endogenous production of cholesterol is the real risk factor, and that gets kicked into high gear with systemic inflammation.

So, it's possible that you've got some issues going on - you said you recently had a knee injury? If you're recovering from that (and have other stressors, like lack of sleep), your body could be kicking out lots of cholesterol as a result of inflammatory processes, and a high-fat diet on top of that could be skewing the numbers (and your risk factors) in a negaive direction. Or, you could just be eating lots of animal products, and your body's own production is low, and your VAP will come back with lots of big, puffy LDL-C molecules and very few small, dense ones and you're all good.

Point is, get the additional lab work, because those numbers DO look high... but don't worry just yet. Continue with your healthy Whole30, and see what the results show on your next tests.

Best,

Melissa

[Karen]

Jumping in with my experience...

I'd also recommend getting your T4 and T3 checked along with your TSH. Those can give a more complete/accurate picture of what's going on.

I echo that! I've had high cholesterol since docs started testing it, and also had thyroid symptoms for years but had a very normal TSH. Fast forward to a year and a half ago, I finally had a doctor test more. My free T4 and free T3 were low, and finding the correct thyroid supplementation (cytomel) dropped my cholesterol by a whopping 50 points within months (snythroid and dessicated did nothing but shut my body down). I've read that defore statins were around, docs used to treat high cholesterol with thyroid supplementation! I'm not at all implying that's what's going on with you, but it may at least be something to rule out.

[Snownsunlover]

Still eating Paleo, cut down on some of the animal fat and the labs are still high.... but TSH is a little high too...

TC: 363

TG: 45

HDL: 86

LDL: 260

TSH: 3.04

Could a low carb diet be causing the elevated TSH, which is causing elevated lipids??

A few years ago when I was eating paleo plus beans, oatmeal, and regular treats, my lipid profile was perfect, TC: 167, HDL: 68, TG: 38.

I know that everyone says not to worry about cholesterol, but I have a family history of heart disease. I think most people probably don't have to worry, but there is a small population of us that probably do.

I am going to a naturopath tonight, so I'll post what she says after the appointment.

[Renee Lee]

The thyroid rules over LDL receptor sites (where LDL particles go to get absorbed back into the body). If thyroid hormone isn't signalling the receptor sites, then you'll have a lot of LDL particles that just keep circulating.

Low carb diets can absolutely mess with thyroid function, but you don't have T3 and T4 values in your labs to really suggest what or where things are going wrong. If you're very low carb (which you typically wouldn't be following a W30), this is obviously something to keep in mind.

From a diet perspective, the spice turmeric also will stimulate LDL receptor activity, so make some indian food and put some carbs on your plate.

Let us know what the naturopath says!

[Snownsunlover]

I have a lab order for all of the thyroid tests, hopefully this gives an answer. In the mean time, I've got a mega dose of B vitamins, Red Rice Yeast (yes a statin), and a mega dose of fish oil. She says something is going on, but she wants to start working to lower the numbers while we wait for the thyroid labs to come back. Stay tuned....

Hopefully this will help people who are in the same situation!

[crobert]

Below are my results from recent blood work. I'm finishing up my second Whole30 for 2013 and was excited to see how healthy I am. Well, the doc says some of my numbers could be better, specifically HDL and LDL. I eat 3-4 eggs per day which could be the cause. I also have heart disease in my family, which is my primary reason for living and eating the way I do. I feel better than ever and am in the best physical shape of my life (Crossfit 4-5 days per week). Please give me some feedback that might help in my decision to continue living this way. Thanks

CHOL: 196

TG: 55

HDL: 43

LDL: 142

non-HDL: 153

Are there any other categories that I could obtain from blood test to gain a better understanding of my health?

[Renee Lee]

Is your LDL calculated or measured?

[crobert]

measured

[Robin Strathdee]

crobert -

There is SO much information out there about cholesterol, how it affects your body, and when to worry. I'd suggest starting with the section on cholesterol in It Starts With Food, and then checking out the websites of both Chris Masterjohn and Chris Kresser. I think that information will help you put your numbers in context. Long story short: We don't see a reason to worry. And the eggs are not causing any problems.

PS: We're not doctors, guys, nor do we play them on tv. We can point you in the direction of some awesome resources, but we won't analyze your bloodwork for you or try to help you determine why one number went up, one went down, and another played knick knack on your shoe. We're here to help you rock your Whole30 and solve those problems.