Help needed please

(Liam) #1

Hi first post…
Been on low carb four ish weeks, gradually moved towards keto, carnivore at times, now decided on 2 meals a day.
I’m a confused about all the different opinions about cholesterol levels and plaque. I’m a 55 yo male. Do I definitely need a test or tests for something to be safe?
Have any of you not tested and had strokes, heart attacks, or heart problems?
Many thanks

(Bob M) #2

I wouldn’t get tested for a while, because LDL (the so-called “bad” “cholesterol”) can go up initially.

There are plenty of markers you can get: HS-CRP; ferritin; GGT; fasting insulin and glucose; sedimentation rate; trigs/HDL; etc. Many of those are looking for inflammation, though some are markers for “insulin resistance”.

The cheapest real test you can get is a coronary arterial calcification scan.

(B Creighton) #3

Your confusion reflects the sad state of our knowledge concerning cholesterol and heart disease. IMHO suffice it to say that all the general advice we have been getting in the last 50 years has been mostly wrong or far off the mark. Around 50% of the people who end up on the operating table have cholesterol levels within “normal” limits. Again IMHO, the main tests I would be concerned with are the LDL/HDL ratio, omega 6 - omega 3 ratio and oxLDL(which can be had at Ulta labs), which you want below 80 - Also your fasted blood sugar and insulin. Focus on optimizing these numbers, and I think you will do fine.

(Liam) #4

I appreciate your replies. Does everyone get tests and how many get heart disease though not testing. So it seems you can’t just change your diet safely you need money to be able to afford tests? Not for a lot of money and my wife wouldn’t be happy spending money on tests as she already thinks I’m doing something silly.

(KM) #5

I have never been tested for anything in the 12 years I’ve been eating a keto diet. I mean that literally, other than a recent abdominal surgery, I haven’t been to a doctor in 13 years. IMO there is nothing I’ve seen that precludes a ketogenic diet (especially one that reduces processed foods) being helpful to nearly anyone. Edit: that’s fancy talk for “keto is a good idea”.

Of course this doesn’t mean I’m not wrecking myself, but if so it’s taking a godawfully long time to show itself, I’m 63 and after losing 25% of body weight in the first 3 years have maintained a healthy weight and basic good health since.

If you respect modern medicine or just have a fascination with your numbers, or you have a specific health issue you want to see progress with, testing is useful. Otherwise I personally see no reason for it, especially not for a change in diet, which most doctors have no idea about anyway.That’s my non- medical opinion.

My experience through my husband’s doctor, you go to them and ask permission, with tests, they say “oooh, booga booga, fad diet, don’t do it”. You go do it anyway. You come back fixed or better, at least, they say “huh, one off concidence, nothing to do with that voodoo diet”. IMO, why bother unless you enjoy arguing.

(Liam) #6

Thanks for your reply. It’s obviously what I want to hear. I just hope your right. If I had the money for tests I might do them but we all have to live within our means.
I’ll probably post another post asking it in a different way to try and get some kind of consensus.
I’m really glad you’ve done well on keto. Are you keto, carnivore, or something else? Thanks

(KM) #7

I cycle between low carb, keto and occasional 100% carnivore. My idea is seasonal eating (doesn’t always happen). Definitely try to stay as close to meals home made from single low-un processed ingredients as I can.

(Liam) #8

Great thanks. I’m much the same. Thanks

#9

Since you’ve already started, your cholesterol numbers will be useless for a few months. Past that, you can do an NMR to see what kind of shape you’re in. While you’re adapting, and especially if you’re losing a lot of fat, your cholesterol will spike up for a while.

Standard panels are useless either way, but even more so for a keto’r. The bad guess equation they use doesn’t scale when you’re low carb / keto. So you need direct measurements.

With the exception of sdLDL (which a standard panel doesn’t give you) not much on a cholesterol panel tells you anything as far as heart attack / stroke risk. There are other markers you can check that have a much larger impact, but those aren’t on most cholesterol panels.

(KM) #10

There are some new guidelines out there.