Carnivore Diet N=1 and High Triglycerides Riddle

(Samuel Ashford) #1

First of all, sorry for the long post.

Starting June 11, I shifted from a well formulated keto diet (50g total carbs, 70g protein, the rest fat - about 160g) to a carnivore diet. I did not track macros. I ate morning and evening only (same eating pattern as past two years), frequently fasting all day (no breakfast). I allowed coffee, sparse carbs (1/2 pickle here and there), diet soda (my weakness, which I’m working on kicking - and which by the very mention of it I’m sure will generate a flood of comments, which will deserve another post altogether), and moderate alcohol. I consumed copius amounts of all types of animal foods (bacon, eggs, cheese, steak, salmon, shrimp, roast, sausages, beef liver, pork neck bones, and ground beef) to the tune of around 1.5 pounds a day. Essentially, I wanted to see what would happen if I went practically zero carb, and shifted from measuring out macros with a scale to my plate, to just eating intuitively on a haunch of meat like a hunter after the kill.

The execution wasn’t perfect, which can be expected trying to live like a Paleolithic hunter in modern times, but I made every effort to keep everything the same except for the type A measuring bit, and the shift from low carb/moderate protein to pull out the stops eating meat to satiety.

It’s also worth noting that I began a weaning off supplements, and now at the end of 30 days all that’s in the cabinet is a few capsules of alpha lipoic acid and vitamin D3.

My aim was to see how my body responded, and to see how I felt, how I enjoyed it, and if I needed more experiments.

After the first month on the carnivore diet, I had labs run. Here are the results:

Glucose Control.
HBA1C. 5.0 (previously 5.1)
Fasting Glucose: 98

4.9 (previously 3)

350 (previously 200, 157, and 126 over months)

56 (previously 83, 90, 92)

C-Reactive Protein
.35 (previously .18, .31, .30)

33/26 (previously about the same)

BUN/Creatinine Ratio
High, as expected with a high protein diet (previously within the normal range).

Anyway, it’s clear that

  1. Glucose control improved slightly
  2. Inflammation and liver function stayed about the same
  3. Triglycerides got worse
  4. HDL was within reference range but decreased (not good)
  5. Insulin increased (not good). This one can be influenced dramatically by many factors, not just glucose, as is apparently the case with this test.

As to how I felt. Well, one observation that stands out is GI improvement. The BM is much less frequent (gross factor out of the way). I find with a lot of leafy carbs and cruciferous vegetables there are also issues of discomfort for me. That has resolved.

Sleep is about the same. I so no great improvement or decline in time or quality.

Overall feeling physically and mentally is slightly better, but being a huge fan of ketosis anyway and used to its benefits, there is no surprise nor substantial change here.

As to enjoying the diet. I find that I personally am content with it, and find that it could easily be a sustainable long term solution for me. There’s no washing of vegetables. There’s no hand wringing over supplements (and added dent to the budget). The kitchen is far simpler. Shopping is effortless. Taste is fabulous - there’s nothing better I can imagine in the eating world than the smell of bacon cooking in the pan.

Now I love the whole cooking experience, and have had years of joy in the kitchen. And I know that most people can’t do such a simple eating life. I respect that and completely understand.

Going forward for now, my thoughts are that I am inclined to determine what might happen if I did a four day elimination diet with only ribeye steaks, water, and coffee. And then run a CMP to look at glucose, liver function, and lipids. I may run insulin again as well.

I feel I would learn a lot from ruling out all foods but protein, particularly red meat, and one rich in nutrients like the ribeye.

I am not giving up on the carnivore diet, but I want to solve the triglycerides riddle. The insulin is troublesome but it’s not the glucose. It’s possible that IGF1 is at play and raising insulin slightly. Not sure.

I am concerned about the drop in HDL.

It’s worthy of note that I consumed quite a lot of fat over the past month. Much of it was the “drippings” of the meats, which were eaten along with the flesh parts. So though I didn’t test ketones, I feel confident that I was still in ketosis, considering the energy I had and the work load I was under every day.

It’s also worth considering that it may take a longer period of adaptation. And, the other confounding variables over the past month, like alcohol and a lot of aspartame in the diet sodas, might have an effect. That’s why a short elimination diet is appealing. With a short window of time, an accurate reflection of lipids and insulin can be shown. I could eat nothing but coffee and donuts for four days and in theory run a lipid panel that would accurately reflect serum lipids. And that’s just it - serum lipids, not cellular. Same goes for glucose and insulin. It’s what is floating around in the blood while in a fasted state.

As for the riddle, this is a question I have: could it be that my body isn’t very efficient at storage of fat, and so the triglycerides, no matter how much fat consumed, aren’t getting stored but rather used - and whatever isn’t used is also not recycled but just hangs out in the blood awaiting use? This is the riddle. Ive been chasing it for two years. There must be some accounting for the high triglycerides. And the consistency of low HBA1C and insulin results over many months - on a super low carb diet - leads me to rule out glucose or fructose altogether. Considering also that I am not the only anomaly - Brenda Zorn, for instance, who, after the 30-day steak challenge had readings of triglycerides approaching 1000 mg/dl - it therefore seems that the dogma that “serum triglycerides reflects dietary carbohydrates” is simplistic at best and deserves a lot more attention. I don’t mean to be contentious, but I feel that there’s still so much we have yet to learn. Sarah Hallberg’s research outliers with high lipids while faithfully on a ketogenic diet are another example of anomaly not sufficiently explained.

Anyway, this is one of many experiments I will conduct and hopefully post over the coming months. I look forward to any and all suggestions, and to fine tuning, and even solving the riddle. After two years and no answers, I’m ready to try nearly anything to understand my lipids.

Is there anyone else out there with this issue? Please chime in! I hope discussions like this will help you too. Cheers!

Keto and HIGH triglycerides and HIGH cholesterol
(Omar) #2

Very interesting

(Karen) #3

Yes I think the trigs hang out in the blood. You could try the Feldman protocol and retest.


(Samuel Ashford) #4

Remind me about Dave’s protocol. Isn’t it gorging on fat and then testing to see if excess = lower lipids? Then assuming I’m a hyper responder if the results are favorable?

(Samuel Ashford) #5

This is a link to a spreadsheet in my Google Drive. More insight.

(PrimalRhino) #6

Following. Reading up and heading towards a carnivore diet.

(Kimble M Lemen) #7

I had a blood test adter 2 months cv. My Hba1c went down to 4.4 from 5.2 on 45 gr carb/day. Previously, it had been 6.2 on plant diet.

Glucose - 77

Triglycerides up from 105 to 169. I was suprised. Will get another test in four months to see if I am using the fat more efficiently. I am 63.

Lost 10 lbs in the right places. Increased muscle mass. Much less cellulite. I natually fast 20 hours/day.

(Samuel Ashford) #8

Kim, thanks for posting. Yeah, the more I do a search in the forums for “high triglycerides” the more it seems that an uptick is not as uncommon as we previously believed.

It seems to me the science is not absolutely clear about all the physiological mechanisms and causes for high triglyceride levels in the blood. I am no expert, as I am learning something new every day. Just yesterday I read a study offered by someone on the forum regarding alcohol and triglycerides. It seems from that study that alcohol has an acute inhibitory effect on lipase, the enzyme responsible for breaking down the trigs into free fatty acids so they can be shuttled into cells for use as fuel.

Furthermore, it seems clear that people produce triglycerides differently, even when on the same diet. I recall that when Brenda Zorn did the thirty day steak challenge (eating only steak and water, and I think, coffee) that her triglycerides went sky high (whereas they are normally within the acceptable range below 150) and the other lady (I forget her name) had extremely low TG. Same diet. Two different individuals. So the usual answers for high triglycerides, namely that “there must be some hidden carbs in your diet” did not apply.

As I recently heard Elon Musk say, “I’d rather be optimistic and wrong than pessimistic and right.” I am hopeful that the constant chatter and lack of complete answers about high triglycerides on a low carb high fat diet will stimulate more conversation and lead to better research and answers. I believe the time is now and that we need it. It seems the consensus is that high TG is a bad marker (no matter the nutritional stripe) because it seems to be a powerful mover towards arterial plaque and heart attacks. I’d say it’s a serious concern.

Most people going low carb experience rapid physiological changes that are amazing and favorable: lower insulin, stabilized serum glucose, fat loss, more energy, decreased TG, increased HDL, lower BP, and so on. And this happens almost without fail. But that’s almost.

I am grateful for this forum and all the inquisitive and thoughtful people contributing on a daily basis. There’s truly nothing else out there like it. Let’s put our heads together and figure this out. Surely there’s a way to help all of us who are following the lifestyle faithfully, but our results are not aligning with the majority. As for me, I will keep plugging away until I find a solution.


(G. Andrew Duthie) #9

On the topic of insulin, one thing of note is that insulin is pulsatile.

So depending on when your blood is drawn, you could be at a high or low point of the range within which it cycles. Which makes it basically impossible to meaningfully compare from one blood test to another, unless the change is huge.

In your case, 3 is already quite low, and a bump to 4.9 could easily be a product of the 3 being a low ebb, and the 4.9 a high mark, within your normal range. Both, if the units are what I’m thinking they are, are way below the threshold that should allow the body to freely access stored fat.

Which is a long-winded way of saying I definitely wouldn’t worry about the change in insulin here. :grin:

(Samuel Ashford) #10

Just a quick update to the N=1.

Doing a lot of ready of studies of alcohol when consumed with a high fat meal. Scary stuff. Here’s an example: (Journal of Lipid Research).

Since July 22, zero alcohol, artificial sweeteners, or incidental carbs. Only meat, a little dairy, water, and coffee.

I plan to retest in a week. Will have a blood draw for Complete Metabolic Panel (including lipid panel), Fasting Insulin, HBA1C, and CRP. I wish I had the money for another calcium score, but that will have to wait.

The retest, I hope, will reveal something. It may be too soon, but we shall see.:thinking:

(Thurston ) #11

Been on Keto 5 months.

Before Keto with alcohol

A1C. 6.7

Total C 184
HDL 40
LDL 90
TRI 270

After 5 months Keto no alcohol

A1C 5.5

Total C 152
HDL 50
LDL 91
TRI 55

Calcium Score ZERO

I guess it’s working.

(Samuel Ashford) #12

Awesome, and very encouraging! Congratulations.

(Mike W.) #13

What the purpose of the pickles?

(Samuel Ashford) #14

Nothing to it. No real purpose. My teenage kids were in the kitchen prepping up their burgers (they get why I’m doing what I do but aren’t carnivore), and I snagged a couple of slices. Barely what I’d call side items. Just impulse.

(Samuel Ashford) #15

At the two month mark on Monday. Carnivore diet, no alcohol, no sweeteners. Beef, some pork and dairy. Coffee, water, and some tea or sparkling water.

Blood work at LabCorp Monday. Fasted 12 hours.

Insulin: 4.8
Glucose: 117 (increasing, not decreasing)
AST/ALT: 35/44 (elevated)
Triglycerides: 330 (still sky high)
HDL: 57 (still lower than normal for me)
HOMA-IR: 1.4 (borderline)
HBA1C: 5.6 (borderline)
CRP: .69 (increasing since last test)
BUN: 28 (increasing)
Creatinine: .79
Creatinine Clearance Value: 95 (finally in normal range)
eGFR (mL/min/1.73): 105
eGFR AfricanAm (mL/min/1.73): 121
Bilirubin, Total (mg/dL): .2 (normal)

Weight is stable. Waistline stable.

But blood markers are not favorable.

Either the carnivore diet isn’t for me, or there are things going on above my paygrade. I love Dr. William Davis and his “undoctored” recommendation, but as I’ve been going undoctored for many years, I believe I’m heading into the territory of needing the big guns. Seriously considering contacting Dr. Ken Berry, since he’s close to my locale. I need a hands on keto friendly expert.

I appreciate everyone on this forum who’ve contributed to help solving my health issues. But I still haven’t found answers to my high triglyceride levels. Since attempting carnivore, in hopes that removing all plants and eating only fatty animal products might turn the tide, it’s clear that even removing every conceivable carbohydrate bearing food is not working. Or, at least not yet. And I’d like to find an answer before there’s an event I can’t recover from.

(Omar) #16

If I may ask

how is your intestine regarding leaky gut IBS or SIBO

Any of these conditions?

(Samuel Ashford) #17

Interesting that you bring this up. This is actually one of the more favorable points of carnivorous eating for me. The GI is actually okay. Stools are very normal, even though Transit time is slower, as would be expected on a carnivorous diet.

(Eric - The patient needs to be patient!) #18

Good labs. Nice! I’ve given up alcohol right after my last labs a few weeks ago. Next labs in Feb.

(Samuel Ashford) #19

Three updates.

  1. After last Labs decided to try two interventions: first to return to the model of nutrition I did when I started low carb 15 years ago: the Drs Eades’ protein power lifeplan. Back then it cut triglycerides from 178 to 47. Second, to try the coffee WITH the filter hack.

  2. After going protein power for a week, these we’re the results:

Glucose: 109 (decrease)
Insulin: 2.4 (down 100%)
Triglycerides: 215 (30% decrease)
AST: 28 (decrease)
ALT: 28 (decrease)

Those we’re the tough ones I was mostly concerned with.

  1. Ken Berry is now my doc. He’s kinda right up road from me here in Tennessee. First visit he was so helpful and encouraging. He basically told me to chill. He’s not seriously worried about the labs, and had his staff draw blood for a full work up of his own labs. About the diet? His take is that carnivore isn’t for everyone, and the Eades model might be best for me after all. Eager to see these next labs and his analysis.

So for now I’m keeping it low carb and mildly keto.


I’m in your camp I think Kairos. I posted a reply in a similar thread which I’ll replicate below, but before I do that, what exactly have you concluded so far? your switch to protein power from carnivore presumably means that you’re now eating less protein? have you noticed a pattern regarding saturated fat intake? apparently this is a big deal for some of us (we respond better to monounsaturated fats) and if you were eating a lot of meat fat and dairy on carnivore I presume sat fat has now reduced on protein power.

Just had my recent labs back and basically my numbers have gotten ‘worse’ again. I’m now 8 months into my keto diet, have dropped a lot of weight but my cholesterol refuses to move in the right direction. Over three or four tests in the last 8 months, my LDL is usually around 200, HDL between 40 and 50, trigs 130-200. In fact, my numbers are exactly the same as when I was eating a whole load of carbage, apart from the fact that my LDL is now even higher.

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On the plus side, my Hba1c was 5.2 before keto when I was 50lbs heavier (topped out at about 240 lbs)…and is still 5.2 after 8 months of keto (no change, what to conclude from that I’m not sure). I also have some pretty big guys in my family (aged in their 50s and 60s) and none of them are diabetic or even pre-diabetic, despite basically eating a standard western diet.

As an experiment, for the last couple of months I’ve started doing a lot more exercise, have been doing resistance training and gaining muscle, I’ve done two 5 day fasts as well as multiple 24 hour and IF most days…and it’s had absolutely no impact on the numbers.

The high trigs and complete lack of HDL improvement since I started keto are both confusing to me too, given what we know about quality fat intake etc.

A couple of possible factors at play for me is that I am heterozygous for ApoE4 (alzheimer’s gene) and homozygous for MTHFR C677T which messes with my bodies methylation cycle and is fairly famous on ‘the internet’. Both of these may somehow influence the way the body uses cholesterol so I’ve just this week started a supplementation experiment that I’ll stick to for a few months to see what, if any difference, it makes to my general wellbeing/lab numbers. For anyone interested I’ll be taking

  • A fancy multivitamin
  • Creatine
  • Glycine
  • Choline (Sunflower Lecithin)
  • Curcumin
  • Magnesium/Potassium (which I was taking anyway)

Running out of ideas after that…I am still losing weight so perhaps that’s all it is…maybe I need to wait until I reach a stable, healthy body fat for 6 months or so then run the numbers.