High cholesterol (LDL) on keto need advice

#1

Three months on keto. Started out 150/100 blood pressure and 174 pounds (I’m 5’6") and now down to 158 pounds with a blood pressure of 128/80. My endocrinologist scoffed at me when I told him I’m doing keto to regulate my blood pressure instead of taking meds and discouraged me, telling me once I plateau my blood pressure will raise back up. I took a bunch of blood tests on his recommendation and my LDL came back high. He referred me to my primary care physician for further investigation. Is this OK/expected since I’m doing keto or should I be freaking out? Here are the numbers:

Non-HDL Cholesterol 184 MG/DL (High)
Cholesterol Total 237MG/DL (High)
Triglycerides 76MG/DL
HDL Cholesterol 53MG/DL
LDL-Cholesterol 166MG/DL (High)
CHOL/HDLC Ratio 4.5

(Eric - The patient needs to be patient!) #2

I’ll let others that are more informed about LDL comment on that. Please keep us posted on your BP over the coming months. Mine is very resistant to meds and diet but is starting to improve with fasting. I’m always interested in other people’s experiences lowing BP.

(Bruce) #3

My understanding is that if you are actively losing weight then this will throw your lipid profile right off due to the body shoving stored fat into the bloodstream to be used (I hope I got the science right!). Wait until your weight stable before you get more bloods or simply up your intake for a week prior to bloods so you’re in caloric balance. I gather this will fix matters.
I’m sure I’ll be corrected if I’ve got this wrong, apologies if I have!

(Carl Keller) #4

There’s a ton of literature and studies about the cholesterol myth. Most of them suggest that our current focus is and has been on the wrong factors and much of this is due to companies that make statins support and fund studies that make their drugs appear essential for good heart health. Many doctors will tell you the most important risk factors for heart disease are high HDL and good HD/trig ratio. I encourage you to do some research on this.

Here’s one article:

https://drjockers.com/cholesterol/

(Sheri Knauer) #5

Since you are using fat as a fuel source now instead of glucose, you will naturally have more fat being moved around in your blood to be used and available as an energy source. I suggest reading Dave Feldmans work at https://cholesterolcode.com and look him up as well as Ivor Cummings and Dr David Diamond on YouTube. They have some very informative talks regarding cholesterol.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #6

You have a similar profile to me. High HDL, low Triglycerides, High LDL. Dave Feldman of the Cholesterol Code has challenged the lipid community to show a single study, not for drugs or genes, that shows increased risk with this profile. No one has cashed that challenge yet. Maybe because the focus is always on the LDL, so researchers don’t segment their data to show this pattern and maybe researchers don’t segment the data this way because it shows less risk and complicated the whole “LDL Bad” theory.

I’ve had an endocrinologist and my GP chirp concern over my high LDL, despite no other risk factor being high anymore. I fired the endocrinologist, because she was focused on lipids when I was seeing her about her thyroid research. I had a conversation with my doctor about when I would be open to statin and why I’m not (no all cause mortality benefit for people like me… folks who haven’t had a heart attack), and we agreed not to do more lipid panels or discuss cholesterol until I have a stroke or a heart attack. I’m not expecting either event, as the only folks in my family who’ve had such things were smokers, diabetics or much older. So, while my doc notes that I have like a 3% chance in the next ten years, I think she pegs me at 95% odds in the next year (she’s a vegetarian and is highly skeptical of my near carnivorous diet), so we’ll see. But it’s very liberating to not be going back to the doctor for a blood draw every three months because she wants to see where my lipids are today. I highly recommend discussing the real risks of treatment and of cardiac events with your doctor, after arming yourself with some Dave Feldman and Ivor Cummins.

(Bob M) #7

While I like both of these gentlemen, I think the person who has the real answer to what causes heart disease is Dr. Malcolm Kendrick:

I suggest you read his entire series on heart disease.

The cholesterol hypothesis is so full of holes, that it’s amazing that it keeps going. They just keep changing it. It’s now down to LDL and maybe LDL-p as the bad guys.

Anyway, here’s just one hole, a drug (well, a set of druges) that raised HDL AND lowered LDL, yet caused more heart attacks and strokes than a placebo:

If lowering LDL is good, why did this drug not work?

One could rightly say that the drug had some effect other than lowering LDL, which is correct. However, lowering LDL was not beneficial and why don’t statins have some other effect other than lowering LDL? After all, the main reason they give statins to you is to lower your LDL…but lowering LDL did not have a benefit in the studies for this other drug. So maybe statins work (to the extent they do) for reasons OTHER than lowering LDL? Hmm…

This is just one of the many holes in this theory that get ignored, explained away,…

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #8

Statins lower LDL through action in the liver. My understanding is that they show a mild protective effect for men who have already had a heart attack, and are under 65. They don’t show any ACM improvement for anyone else. Men over 65, women of any age, men under 65 who haven’t already had a heart attack. They also increase your liklihood of developing T2DM, which will worsen your odds of premature death, and oddly enough, increase your odds for a cardiac event. The side effects of statins have been massively understated by the pro-statin camp, to the point where Sir Rory Collins published a study to show that incidence was low, after developing (and marketing) a genetic test to see who was likely to have side effects, and then excluding them from his study.

https://twitter.com/ozparadoxdotcom/status/906015000849858560

So, when we say that statins work… they lower LDL. That is their purpose. But do they really save lives? Is high LDL really more destructive than low LDL? LDL-p is the latest tool to market statins.

I’m not taking a drug that increases my likelihood of developing T2DM to treat something that isn’t proven to be worse than T2DM. I think that’s rational and reasonably well informed.

That is all.

(Bob M) #9

I agree with everything you say, except:

“Statins stimulate nitric oxide synthesis in endothelial cells, thus they are effective anticoagulants, and help to protect the glycocalyx”

This is from Dr. Kendrick.

Let’s just agree that to the extent statins work, they work not because they lower LDL but because they do something else. Unfortunately, there is only one test – LDL – they use to determine whether to give you statins.

Also, once you get into this area, you realize how things keep changing. What’s the current spin? For instance, did you know that statins are associated with higher plaque build up in the arteries? That’s bad, right? No, of course not! (The spin is that) The plaque caused by statins is “more stable” than normal plaque. Yes, that’s right the current spin is that bad is good.

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

Your LDL is not high, what are they talking about? Three hundred is high (maybe); 166 is fine, except in the eyes of statin manufacturers looking to move product.

Look at your ratio of triglycerides to HDL: 76 / 53 = 1.44 = amazing! There are people who would kill for a ratio that good. Anything under 2.0 is considered very low risk for heart disease. The ratio you have virtually guarantees that your LDL is Pattern A, which is excellent in terms of cardiovascular risk. If your doctor gives you any grief, or so much as thinks the word “statin,” ask for a CAC scan to determine what your actual risk of heart disease is. That should shut him up.

You should know that the researchers David Diamond and Uffe Ravnskov have come to the conclusion that high LDL levels, if they have anything at all to do with cardiovascular risk, are actually protective, especially as we get older. They have advanced the hypothesis that the real risk is glycated hemoglobin in people who already have variants of fibrinogen and clotting factor VIII that make their blood noticeably more likely to clot, especially in the context of inflamed arteries from chronic high insulin levels.

(Tyler Watkins) #11

I have been on the keto diet for almost a year. Love it. Lost 50lbs (215lbs to 165lbs). My cholesterol numbers are the following:
Total cholesterol (mg/dl): 353
Triglycerides (mg/dl): 77
HDL (mg/dl): 46
LDL (mg/dl): 292
HDL/Trig: 1.7

I’m 25 years old and my doctor is super concerned and is trying to make me go to a specialist. But I have never felt fitter. Any advice?

(Karim Wassef) #12

New doctor?

(Tyler Watkins) #13

Yes

(Karim Wassef) #14

No. I mean find a new doctor, one who is more aware of the recent research.

(Khara) #15

:point_up:This. Or at least challenge your current doctor or new specialist on the topic. Also spend some time reading on this forum about this. You’ll see a ton of resources… books, videos, websites, that you can check out. It’s a lot and will require some time. Being as informed as possible will give you more confidence in being able to talk with your doctors.

(You've tried everything else; why not try bacon?) #16

The ratio of your triglycerides to HDL is well under 2.0, which is excellent. If your doctor were to order an NMR analysis of your LDL, it would turn out to be Pattern A, the good type. (This assumes that cholesterol levels actually have anything to do with cardiovascular risk in the first place, which is looking more and more unlikely.) But if your doctor is really concerned, and not just making noises, have him/her order a CAC (coronary artery calcium) scan to assess the actual damage and your 5-10 year risk of a cardiac event.

I understand that, in the U.S. at least, you could obtain a CAC scan without a prescription, which I urge you to do if you have any concerns, but you should put the question to your doctor, just to see what the response is, and possibly shut him or her up.

There is a documentary, available on Netflix, about the CAC scan, called “The Widowmaker.” You might encourage your doctor to watch it.

(Karim Wassef) #17

I got a CAC from Groupon for $50

Didn’t even tell my doctor

(You've tried everything else; why not try bacon?) #18

What was the result?

(Karim Wassef) #19

It was 3.6… I used a calculator that translates to 3.3% risk.

(You've tried everything else; why not try bacon?) #20

Yeah, healing plaque takes a while, especially to get the calcium out of there. Vitamin D is supposed to help get calcium from other parts of the body and into the bone, where it belongs. You might try supplementing? (I don’t know, just guessing, here.)