Cholesterol results after 6 months on keto

(Colin) #1

Hi all. Great forum you have here!

I’ve just got my blood results back after six months on keto. I’m a type 1 diabetic, and I’ve finally managed to step off the blood glucose rollercoaster. Historically, my HbA1c has always been mid- to low-60s. Best ever was 57. Now 51 mmol/mol.

I was slightly alarmed at my lipid profile, though:
cholesterol 21.5 mmol/l (831 mg/dl)
HDL 3.1 mmol/l (120 mg/dl)
LDL 16.8 mmol/l (650 mg/dl)
triglycerides 3.5 mmol/l (310 mg/dl)

I’ve read a few other posts on here and it looks like I may be a low mass hyper-responder. From what I can tell, the ratios are okay, but the trigs are still on the high side. The test was done after a 15-hour fast, although I did have two mugs of black coffee beforehand (I didn’t know at the time that that can affect the trig level). And alas, I don’t have a pre-keto test to compare (again, I didn’t know better at the time).

Any thoughts welcome!

#2

Those are some high numbers & I would definitely be asking the Doctor for a repeat blood test. You may well be a lean mass hyper responder but unless you’ve fasted properly you can’t really get a proper read on things. If the numbers come back similarly high then it’s worth seeking the opinion of a lipid specialist.

EDIT: Might be worth running this by Dave Feldman https://www.facebook.com/DaveFeldmanLC/

(You've tried everything else; why not try bacon?) #3

I wouldn’t worry about the cholesterol levels as such, but your ratio of trigs to HDL could be lower. In millimoles, you want it under 0.9; in mg/dL, you want it under 2.0.

One thing that increases HDL is saturated fat. Butter and lard are both just under 50% saturated fat; you might consider cooking with them, and using butter as a sauce. And don’t forget the ribeye!

Welcome to the forums, and keep on ketoing on. :bacon:

P.S.—If you have reason to worry about your cardiovascular risk, would your doctor be willing to authorize a CAC scan? If it’s low, then you won’t need to worrry about your cholesterol numbers.

(Colin) #4

I already eat quite a bit of butter, lard and tallow, thanks.

I also forgot to mention that, historically, my total cholesterol has never been higher than 4.8 mmol/l (186 mg/dl). That was on a carb-based diet, though. So I don’t think I’ve got cause for concern really. My wife who is also keto’ing has researched things a bit more than me, and she says that inflammation can raise these levels too. That would make sense, as I have probably a fair bit of inflammation going on.

(You've tried everything else; why not try bacon?) #5

All of which a ketogenic diet should eventually help. Good luck to you, and keep us posted.

(Colin) #6

Hey guys. So I just got my results back, five weeks after the first lot were done. These included an apolipoprotein A & B test.

Cholesterol 22.1 mmol/l (854 mg/dl)
triglycerides 2.3 mmol/l (204 mg/dl)
HDL 3.2 mmol/l (124 mg/dl)
LDL 17.9 mmol/l (692 mg/dl)
Apolipoprotein A1 1.31
Apolipoprotein B > 4.00
(I don’t know what units the apoA and apoB are in, nor how to convert these to US equivalents.)

So the triglycerides are down quite a lot, while everything else remains in the same ball park.

I avoided caffeine for a full two weeks before the test this time. So the good news is, I can drink tea and coffee with impunity!

I’m interested to hear what anyone has to say…

(kmg555) #7

My friends cholesterol recently shot way up. Turned out she has liver cancer. You should see a Dr. Asap. Good luck.

#8

Do you know what the numbers were? What tests did they perform to determine the liver cancer?

I’m just wondering, because most doctor’s initial response to high cholesterol numbers is a statin, not to test the liver for cancer.

(Bob M) #9

Your total cholesterol went from 4.8 to 21.5? That seems incredible, even if you are a lean mass hyper-responder. Have you been tested for familial hypercholesterolemia?

(You've tried everything else; why not try bacon?) #10

On the other hand, your ratio of triglycerides to HDL is 0.72, which is fantastic, so I wouldn’t start worrying just yet, even though your LDL is very high. That your triglycerides are down is a good sign.

As for familial hypercholesterolemia, be aware that fully half of the people who have this condition are perfectly fine, never develop heart disease, and die at perfectly respectable ages of other conditions than cardiovascular disease. So it’s not the cholesterol level itself that is the problem. The people with FH who develop heart trouble, it turns out, have genetic variations that make their blood clot more readily, affecting in particular their fibrinogen and their Factor VIII. So despite the urgings of the statin manufacturers, it seems that lowering cholesterol is not the be-all and end-all of reducing the risk of heart disease.

#11

Very encouraging, Paul. Thank you for your valuable insight!

(Colin) #12

Thanks for your replies, guys. I’m aware the TG:HDL ratio is much better, and I’m very happy about that, especially since my HDL was historically quite low.

I’m no expert, but I’m sure it’s not FH, as the jump in total cholesterol coincides with the switch to keto, and there’s no family history of high cholesterol.

I next need to read up on the apo B count, to work out what that means. It’s a little frustrating that they only measure up to 4, and that all they can tell me is that it’s ‘> 4’, but it’s a starting point.

I’m also wondering whether my livef isn’t working quite right. Besides the cholesterol figures, another clue I have is that I often feel cold when others around me are fine, and I seem to get hot quite easily when physically active (doing the vacuuming, for example). I know the liver is involved in regulation of body temperature, so maybe it needs more investigation?

(bulkbiker) #13

Is it possible though for someone to have TC of 4.8 then suddenly develop FH almost overnight… or does it simply show that some people get inconveniently high cholesterol reading?

(Colin) #14

That’s exactly what I think, and why I’m disinclined to believe it’s FH.

(Diane) #15

I worked in a research clinic where we saw many families with FH (genotyped) for 15 years. My understanding and experience is that babies even a few days old who have FH (as long as they have ingested/digested food) will already have the typical very high LDL levels. Since this is a genetic disorder, it seems unlikely to me that someone who has this would suddenly go from more normal lipid levels to those that would suggest FH.

(bulkbiker) #16

That makes so much more sense than just saying “oh no really high cholesterol it must by familial hypercholesterolemia” which seems to be the response of most doctors.

(Diane) #17

We worked with many families who had family members who had been genotyped and diagnosed with FH. Once you knew how closely a family member was related to the genotyped individual and that person’s lipid levels, we could tell them whether it was likely that they were also affected and offer them genetic testing as well.

(kmg555) #19

Her numbers went from normal, like 185, up to 350. For no apparent reason. This was confirmed on a retest. So they did an ultrasound and saw the mass.

(kmg555) #20

Hi. After 4 months on Keto, my A1c went from 6.0 to 5.6. Triglycerides dropped from 81 to 75. HDL from 51 to 43. Total cholesterol from 157 down to 148. I also lost about 14 pounds. So…I’m cutting my Lipitor in half…from 20 mg to 10 mg. I’ll get new labs in 3 months.