Hi,
I am a new member here, so Hi!!
I have listened to the first 40 episodes the 2KD podcast and am fully in. I know that in about 6months I am going to have to argue with my doctor. Is there a list on the forum or somewhere for a reading list of counter arguments about high LDL.
I have already made progress after 3 weeks but I am certain my LDL is going to be an issue for the doc.
Cheers
Welcome to the forum. I find it very informative!
When it comes to dealing with your PCP, I would suggest that you remind yourself that that person is your consultant and you may or may not agree on everything. However you are at liberty to consider the advice and take it or not. You can also agree to disagree.
Years ago when I was in the learning stages of keto I attempted to âschoolâ my doc and quickly came to the conclusion if was going to be fruitless and really not my job. I lost weight, came off BP meds, have kept the weight off, avoided type 2 diabetes and probably many more things. Discussing my eating came off the table in terms of discussion.
Your LDL may not go up. Itâs a complex relationship as to what causes LDL to go up, but I have eaten insane amounts of saturated fat, and my LDL went down. LDL depends on a lot of factors. For instance, if you fast, your LDL (typically) goes up. Why? Because it comes from VLDL/Triglyderides, which go up because they are energy distributors. If youâre using fat as the source of fuel, your LDL can go up because VLDL is going up.
If you already have âhighâ LDL, then itâll be a discussion.
@WishIKnewYearsAgo Welcome!
As noted above, weâre all individuals (and our chemistry changes over time) and your doctor(s) are consultants and practitioners, but as an adult you remain in charge of your body and your choices.
There are many excellent books and NIH studies to read and bring along to your appointments if you wish. And this forum is a great place to search for them⌠too many to list!
Best wishes and please keep us posted. 
Thanks all for your responses.
Unfortunately as I am an airline pilot, my aviation overlords will have a problem with my LDL at 7.0. Will need my aviation medical doctor to go into bat for me.
I am not horribly out of shape. Started keto at 94kg. I am 187cm tall so not horrendous. I do actually think I was pre pre diabetes as my fasting glucose has been very slowing going up over time. I am lucky that I have an annual medical and consistent blood tests annually for the last 35 years.
Anyway, I am down to 87kg and waist down from 110cm to 104. I am targeting to get waist to hip and waist to height ratios back to where they should be.
But, I will absolutely need to argue my case with mr doctor.
I understand from the podcast there are issues with the Framingham study. Any pointers on where to look for understanding these issues?
Cheers
Most of us can ignore our doctorâs advice and refuse to take their meds, but you are in a different situation.
There are some hacks to lower your LDL before a blood test but I donât remember what they are because I never had to worry about it. Maybe someone else can chime in.
To me, the most damning statistic is half the patients who show up in the ER with a Coronary Artery Event have normal LDL. 50% are normal, 50% are high - I am no statistician but to me that says âno correlationâ. I donât have a link to that data, but maybe someone else can provide.
I wish you the best!
Look up Dave Feldman. I think heâs probably the one of the most knowlegeable people regarding Keto and Cholesterol. He has also experimented with his own cholesterol levels and has found he can raise or lower them for short periods fairly easily (eg before a doctors visit hint hint) âŚif I am remembering correctly.
If you do get a high level for LDL, you could request a full lipid panel (I think thats what its called) which shows actual particle size. Most Keto results should show high LDL A, the big fluffy type and low LDL C, the small dense type. A short search with google or AI I think would turn up a medical journal article or two demonstrating that a high level of LDL A is actually protective, especially in people over 60. Low LDL C is what is required because if any cholestrol is âdangerousâ, then it is this one (although it is disputed if even this type is dangerous). Doctors know medical journal articles and its probably just easier to print it out and give it to them to read rather than entering into a discussion. Make it even easier for them and highight the relevant parts!
You may even want to find some evidence to print out showing that HDL/Triglicerides ratio is a far better measure of cholesterol âhealthâ than LDL. As a Ketoer your ratio should be great.
Good luck.
PS If I remember rightly, Ancel Keys who started this whole cholesterol & heart disease mess in the first place actually conducted a study later on which refuted his original thesis, but it was never published. I think someone interviewed his secretary a few years ago and got a copy of the paper.
Just Googled it, hereâs the paper:
https://www.bmj.com/content/353/bmj.i1246.abstract
Ask AI to explain it you if necessary, I just put in the phrase âancel keys unpublished paperâ.
Amazing. Thanks for the effort in your reply.
I will look into all of your points.
Cheers
One of my favorite stories is that Ancel Keysâ paper that seems to have started the cholesterol issue, the Seven Countries Study, was actually on 23 countries, but the data he presented was from picking the seven countries that verified his idea. Thatâs commonly referred to as âcherry-pickingâ the data and any statistics class, and pretty much any science class will warn you not to do that.
I used to design commercial aviation radios and other electronics. If I cherry picked results out of tests to prove a box I worked on worked properly, Iâd be in jail. It worked on about a third of the things it was supposed to do and thatâs good?
Youre very welcome. Hope it helps.
I actually had a visit with a GP because she was concerned that my LDL was a little high. I said to her that we couldnt be sure if it was a concern as the test didnt involve particle size so we couldnt know if it was the LDL A or C that was high. She gave me blank look, so I tentatively asked if she knew what I was talking about and she bravely enough said she didnt. Our conversation didnt progress any further as I dont think either of us wanted me explaining cholesterol to a medical professional, and we politely said our goodbyes. I was however absolutely dumbfounded as this isnt controversial niche info, this is Cholesterol 101 and since cholesterol levels are one our UK GPs major concerns, I did at least expect them to be knoweledgable about the subject. It was an important lesson though - I will never blindly trust a medical professional again and will always do my own research.
For a really good discussion of all things heart/cholesterol related, check out Dr. Anthony Jayâs book âSugar Beatsâ - thereâs more than just LDL particle size that your GP isnât aware of. Also find Dave Feldmanâs movie (itâs on Amazon Prime) The Cholesterol Code - brilliant piece of work. Good luck with the medical profession . . . .
Correction, your doc will have an argument with you! Thatâs his problem. Thereâs way beyond counterarguments, thereâs literally studies showing thereâs no connection between LDL and coronary events, thatâs literally why the FDA removed cholesterol as a ânutrient of concernâ back in 2015.
If your doc doesnât know that, heâs very out of touch. Which most are!
Your cholesterol as a whole will go up, especially LDL at first, but it will smooth out. If your doc is still doing outdated old school lipid profiles instead of fractionated panels showing ALL the LDLâs, again, thatâs his problem for being a dinosaur. Also keep in mind that while youâre losing fat, that by itself will raise LDL, and thatâs for everybody, not just Ketoârs.
My LDL normally stays in the 100s when I do keto. I attribute that to eating a good amount of soluble fiber even while doing keto. I also do not do a âhigh fatâ diet. My keto is protein based, and when I do eat a fat bomb, I usually make it with coconut oil, which doesnât seem to spike my cholesterol too much.
Mine, too. It has been in the range of about 125 to 200 for every measurement I have records of. I was on Statins until about 2012 and that was the only time LDL was below 100 (of the records I have). The issue with that was the my HDL has always been lower than Iâd like and the statins lowered that, too. The main reason I got off the statins was I asked the doc if statins lower the âgoodâ cholesterol and the âevil LDLâ was never that bad, why am I on statins? The doc said, âexcellent question! Do you want to get off the statins and see what it does?â
Hopefully your ldl does not go up too much.
You may be able to keep your ldl normal with diet using oilve oil, eating lots of low carb vegetables, and psyllium husk.
I actually remember a study in which coconut oil lowered LDL levelsâŚJFYI. I plan never to go on statins. I believe I have no CVD. Sonograms of carotids and descending aorta were negative. Why go on statins, when I believe my cardio system is healthier than 6 yrs ago?
Same if you fast. Why? Because VLDL is an energy transport mechanism, and you have higher VLDL, which is the precursor to LDL, so youâll have higher LDL. By the way, VLDL = triglycerides. Not sure why they needed to invent another word.
One thing I need to figure out is why there is discordance between trigs and LDL for LMHRs. I havenât figured that out.
There is also ILDL or intermediate LDL⌠LDL, ILDL and VLDL are really all the same particle at different stages. Hopefully, it is VLDL when it leaves the liver. I think the different terminology comes from years ago when they just saw these different sizes in the blood stream, and didnât realize they were all the same particles in different stages of fat and cholesterol off-loading.
Thank you for confirming my experience. 2 years ago when I got tested my VLDL was high and my cholesterol was high for me. My triglycerides were flagged as being high⌠I believed it was because I was burning fat as my ketones were 1. Sure enough last year when I tested, my ketones were trace, and everything else was markedly lower. It just goes to show depending on one number like LDL or triglycerides, can be very off the mark⌠it depends on context.