High triglycerides on 0 carb carnivore diet

#1

My bloods since starting keto are not good.

Please see below. I’ve been on keto for over 4 months (0 carb carnivore for around 2 months)

I’m in UK in mmol/L (edit use a conversion calculator to put the US mg/dL system - let me know if they’re incorrect!)

triglycerides (should be 0-1.7)
Before keto: 1.7mmol/L (just OK) 150.58mg/dL
After 4 months keto: 2.03mmol/L (too high) 179.81mg/dL

HDL (should be over 1.0)
Before keto: 1.4 (OK) 54.14mg/dL
After 4 months keto: 0.85 (too low) 32.87mg/dL

LDL (should be 0-2)
Before keto: 3.12 (high) 120.65mg/dL
After 4 months keto: 6.43 (way too high) 248.65mg/dL

Serum cholesterol/HDL ratio (should be below 5)
Before keto: 3.79 (OK)
After 4 months keto: 9.65 (too high)

Height: 176cm & male

Weight:
76kg before keto
74kg 4 months into keto

As a result of these blood results, I’m starting to wonder if keto / carnivore is as good as everyone is claiming. It has resulted in my blood lipids going haywire. I understand that LDL can be ignored under carnivore diet as long as triglycerides & HDL are good- but mine aren’t good since doing keto. I also experience fatigue after eating (often have to fall asleep) and fatigue throughout the day. I have no other health problems.all other blood tests normal.

(You've tried everything else; why not try bacon?) #2

Well, one thing you need to know is that it takes about six months for lipid numbers to settle. Since you’ve only started eating carnivore a couple of months ago, give it at least another four months before testing again. If those numbers are still bad, then you can start to worry a little.

Also, for the sake of good data, be sure to fast only between 12 and 14 hours before the blood draw, and make sure you are decently hydrated. No caffeine before the blood draw, however.

The only lipid number that really reflects cardiovascular risk is the ratio of triglycerides to HDL, which you want to be 0.9 or less. Since the triglyceride number is highly variable throughout the day, it is important to get the fasting number.

We could go into all the reasons for refusing to believe that cholesterol causes cardiovascular disease, but I’ll spare you my usual rant. Just be aware that there is a lot of scientific evidence to associate higher cholesterol with a lower disease risk, and precious little to show that cholesterol has a causal link to cardiovascular disease. At best, as with the triglyceride/HDL ratio, lipid numbers may serve as markers for disease risk.

Do you have any other blood work you might share? What is your HbA1C, for example? And what are your inflammatory markers like? That would give us a better picture.

#3

Thanks PaulL for your reply. I’ll post the HbA1C & other results below. I’ll also edit the above cholesterol results to convert to the US system of mg/dL - correct me if I’m wrong with those!) just incase anyone from US is reading.

True that I’ve only been on carnivore for 2 months but I have been on keto for at least 4 (probably longer- perhaps closer to 6 but I said 4 to be safe). The rest of my bad results are below. The figures in brackets are the normal range for healthy people.

Mean cell volume: 99.9 fL [83.5 - 99.5] - HIGH
Mean cell haemoglobin concentration: 313 g/L [315.0 - 350.0] - LOW

There are hundreds of results so it’d take hours to type them all but the rest seem to be normal range. They forgot to do the iron test- I have to keep reminding them to do anything. We can’t seem to rely on any doctors here to be pro-active - according to other patients, staff often don’t call patients even if blood test results are life threatening. You have to do everything yourself. The doctors aren’t keto / carnivore friendly either.

My blood test so far would be taken by carnivore critics as evidence toward their cause and is making me question things. I noticed that when someone has results that support whatever narrative is in the room, they get more replies but when results go against any narrative, they receive less replies.

(Bob M) #4

Please STOP denigrating us. You gave us no information.

  • if you weigh 150 pounds, why are you on keto/carnivore? You’re 5 feet 9 inches, I’m about 1 inch less but weighed 100+ pounds more than you do at one time. What are you trying to achieve?
  • do you fast? If so, when did you fast prior to getting your test done?
  • do you drink coffee?
  • how many meals a day do you eat?
  • for your test, how long did you fast?
  • do you exercise? If so what and how much?
  • when do you get fatigue? (I know you say “throughout the day”, but after meals, all the time, etc.)
  • have you had a complete thyroid workup (not just TSH)?
  • since you are thin, your LDL is much more likely to rise dramatically, as you have low fat reserves. I’m not sure why HDL is going down, nor do I know why trigs are going up (could be coffee for trigs). But fasting affects all these numbers.
  • why did you go carnivore instead of staying on keto?
#5

I’m not sure whether to reply to the latest comment as I don’t want to give attention to trolling comments but here are my answers:

I’m not denigrating you & sorry you feel that way. I gave you information. Please see my blood test results.

I weighed 76Kg which is 167 pounds, not 150. I’m on keto because I would like to do the proper human diet. I’m trying to achieve improved health & to know what effect this diet has on me (energy levels, cholesterol etc.). If you weighed 100 pounds more than me (267 lbs is 150kg at 5’8), that is mordibly obese. Here is a height weight chart:

As you can see, 76Kg (12 stone), at 5’9 is overweight. Just because someone isn’t as obese as another person does not mean they’re healthy. Height / weight also doesn’t tell the whole picture. It is possible for someone to be classified as healthy under a height weight chart but still be fat because they have low low muscle mass or too much internal (also known as ‘visceral’ fat). It’s also possible to be of high fat & low muscle mass at the same time.

I do. I fasted immediately before getting the test done.

No.

1 - 2 meals per day.

between 14 - 20 hours

Yes. I rollerblade, run, swim, and lift weights. Not much.

90% of the time. It’s more pronounced after meals- sometimes I can’t stay awake after a meal. My sleep has increased unhealthily since carnivore.
Before carnivore/keto: I used to sleep 7-8 hours.
Since carnivore: I sleep 10 - 16 hours. It actually interferes with my work.

My doctor said he was ‘testing everything’. I asked if there was anything else to do, he said no. I posted all abnormal results. Could you give me the name of the thyroid test so I can see if I have it?

I’ll also post my entire test results in separate post below.

I’m not thin. I’m have around 23% body fat. I have pronounced body fat, manboobs & a double chin. If you see this illustration, I’m between 20 - 25%:

My muscle mass is likely low-ish.

To see if it improved my energy levels / health. I’ve heard many good things about it. I also watch Dr. Ken Berry on youtube.

(MC) #6

What sort of foods are you eating on carnivore?

#7

Ribeye steak, eggs, pork belly or bacon, bone broth, short ribs, fresh salmon.

The only seasoning I use is redmond real salt & a pepper grinder.

(I eat until full so dont count calories)

Example day:
Ribeye steak
Egg & pork belly broth with real salt

Another example day:
Eggs & bacon
short ribs with bone broth

#8

As promised, for those who’ve expressed interest, my full recent labwork is below. The numbers in brackets are ‘healthy’ range. Triglycerides & HDL are heading in the wrong direction since keto/carnivore & messed up, as are others. I’ll highlight the bad readings in bold:

Full blood count (424…)

Total white blood count (XaIdY)
5.1 10*9/L [4.2 - 10.6]

Red blood cell count (426…)
4.63 10*12/L [4.23 - 5.46]

Haemoglobin concentration (Xa96v)
145 g/L [130.0 - 168.0]

Haematocrit (X76tb)
0.463 L/L [0.39 - 0.5]

Mean cell volume (42A…)
Above range
99.9 fL [83.5 - 99.5]
Above high reference limit
In an otherwise normal FBC and reticulocyte count, an isolated MCV up
to 104fL can be tolerated without further clinical investigation or
follow up blood film. When macrocytosis is unexpected or unexplained
suggest a repeat FBC after 3 months. If MCV continues to rise, or a
new FBC abnormality is identified, consider a referral to haematology.
For NWLP clinical guidance on raised MCV please refer to:
https://www.nwlondonccg.nhs.uk/professionals/referral-guidelines-and-c
linical-documents/haematology.

Mean cell haemoglobin level (XE2pb)
31.3 pg [27.5 - 33.1]

Mean cell haemoglobin concentration (429…)
Below range
313 g/L [315.0 - 350.0]
Below low reference limit

Red blood cell distribution width (XE2mO)
13.1 % [10.0 - 16.0]

Platelet count - observation (42P…)
186 10*9/L [130.0 - 370.0]

Mean platelet volume (42Z5.)
9.2 fL [8.0 - 12.0]

Nucleated red blood cell count (4266.)
0.0 10*9/L [0.0 - 0.1]

Neutrophil count (42J…)
2.5 10*9/L [2.0 - 7.1]

Lymphocyte count (42M…)
1.9 10*9/L [1.1 - 3.6]

Monocyte count - observation (42N…)
0.4 10*9/L [0.3 - 0.9]

Eosinophil count - observation (42K…)
0.1 10*9/L [0.0 - 0.5]

Basophil count (42L…)
0.0 10*9/L [0.0 - 0.2]

Haemoglobin A1c level - IFCC standardised (XaPbt)

Specimen: BLOOD

Haemoglobin A1c level - IFCC standardised (XaPbt)
36 mmol/mol [20.0 - 41.0]

(NOTE)
HbA1c >=48 mmol/mol: possible diabetes. If patient symptomatic,
diagnosis is confirmed. Consider re-testing HbA1c within 4 weeks if
patient not symptomatic.
HbA1c 42-47 mmol/mol: considered at high risk of developing diabetes.
Consider implementing lifestyle measures.
Comment: HbA1c is accepted for the diagnosis of type 2 diabetes in
the UK, but should not be used to diagnose type 1 diabetes or in the
following contexts: childhood, pregnancy, renal failure,
haemoglobinopathy trait, anaemia, HIV, abnormal red-cell turnover,
or any recent treatment likely to affect glycaemia or red-cell
turnover.
In cases of confirmed Type 2 diabetes mellitus, NICE CG66 treatment
target HbA1c is 48-59 mmol/mol

Liver function tests (X77WP)
Specimen: BLOOD

Liver function tests (X77WP)

Serum alanine aminotransferase level (XaLJx)
23 U/L [0.0 - 45.0]

Serum bilirubin level (44E…)
11 umol/L [0.0 - 21.0]

Serum alkaline phosphatase level (XE2px)
73 U/L [30.0 - 130.0]

Serum albumin level (XE2eA)
41 g/L [35.0 - 50.0]

Serum lipid levels (XE2q7)

Specimen: BLOOD

Serum cholesterol level (XE2eD)
8.2 mmol/L

(NOTE)
In primary prevention, lipid results should be assessed in tandem
with other risk factors to estimate cardiovascular disease (CVD)
risk. NICE recommend using the QRISK2 calculator In primary
prevention, lipid results should be assessed in tandem with other
risk factors to estimate cardiovascular disease (CVD) risk. NICE
recommend using the QRISK2 calculator
https://www.qrisk.org/2017/
When considering treatment for primary prevention of CVD in
individuals with ?10% risk, share the option to have treatment or
not before prescribing. Patient decision aids include:
http://www.jbs3risk.com/JBS3Risk.swf
https://www.nice.org.uk/guidance/cg181/resources/patient-decision-aid-
pdf-243780159
Non-HDL cholesterol (total chol minus HDL chol) is recommended for
CVD risk prediction; fasting samples are not required for this.
Non-HDL cholesterol targets for patients treated for CVD risk
reduction are:

  • 40 % reduction from baseline (NICE CG181, 2014) or
  • < 2.5 mmol/L (JBS3. Heart 2014:100:ii1)
    Once a patient has reached their target level of cholesterol, there
    is no need to keep measuring it.
    Significant dyslipidaemia, seek specialist advice.

Serum triglyceride levels (XE2q9)
Above range
2.03 mmol/L [< 1.7]
Above high reference limit

Serum HDL cholesterol level (44P5.)
Below range
0.85 mmol/L [> 1.0]
Below low reference limit

Serum LDL cholesterol level (44P6.)
above range
6.43 mmol/L
Consider familial hypercholesterolaemia, exclude other causes and seek specialist advice if necessary

Serum cholesterol/HDL ratio (XaEUq)
Above range
9.65 [< 5.0]
Above high reference limit

Serum non high density lipoprotein cholesterol level (XabE1)
7.4 mmol/L

Renal function tests (451…)
Specimen: BLOOD

Serum sodium level (XE2q0)
135 mmol/L [133.0 - 146.0]

Serum potassium level (XE2pz)
4.0 mmol/L [3.5 - 5.3]

Serum creatinine level (XE2q5)
85 umol/L [60.0 - 125.0]

eGFR using creatinine (CKD-EPI) per 1.73 square metres (XacUK)
over 90 mL/min/1.73m2 [> 89.0]

Serum vitamin B12 level (XE2pf)
Specimen: BLOOD

Serum vitamin B12 level (XE2pf)
414 ng/L [160.0 - 800.0]

Serum folate level (42U5.)
Specimen: BLOOD

Serum folate level (42U5.)
4.4 ug/L [> 2.7]

Serum TSH level (XaELV)
Specimen: BLOOD

Serum TSH level (XaELV)
1.37 mU/L [0.3 - 4.2]

Serum total 25-hydroxy vitamin D level (Xabo0)
Specimen: BLOOD

Serum total 25-hydroxy vitamin D level (Xabo0)
73.9 nmol/L [50.0 - 150.0]

(NOTE)
Recommendations for Bone Health
Deficient = < 25
Insufficient = 25-50
Replete = 50-150
This method underestimates vitamin D2.
If patient is taking D2 or unknown vitamin D replacement, please
request D2/D3 assay.

#9

Is it this simple?..

If you eat fat and little carbs, it makes perfect sense that more fats will be in the blood as they are the main fuel for the body.
The fat is in the blood because it is going to be used.

#10

Bob, that is a hell of a lot of sleep. 10-16 hours, is that without waking? Or are you waking up and falling back to sleep? Or is this including a nap?

A friend of mine has cronic fatigue syndrome and this sounds similar. Have you ruled that out?

To add.
If you are sleeping for up to 16 hours a day, your bmr could potentially be half what you might think.
So you may be well over eating. But instead of storing the fat, it is floating around in your bloodstream.
It might be worth getting an app and seriously counting your macros for a few weeks to get an idea of what you are really taking in.

(Joey) #11

I’ve refrained from jumping into this thread as I have no useful insights to share with @Bobsmith to help him get to the bottom of what’s going on in his situation. I do hope he gets some meaningful answers to resolve the way he is currently feeling and begins to get the benefits of his serious efforts to improve his health. :vulcan_salute:

But I do have to reply to @Rusty above… Are you serious?

Perhaps you were being humorous, in which case :slight_smile:

But if you’re serious, this would be an erroneous line of thinking. When carbs are restricted, eating fat does not make fat circulate through your blood for energy.

#12

I’m sorry. How does fat get from your stomach to your muscles?

(You've tried everything else; why not try bacon?) #13

VLDL. Triglycerides convey the carbohydrate that has been converted in the liver to the adipose tissue for storage.

(Michael) #14

I am posting despite having no good news for you, based on what I see.

There is no doubt that for the majority of people, the elimination of carbs raises HDL and lower trigs while LDL normally goes up a little to a lot depending on adiposity. The fact that your HDL and trigs are going in the wrong direction is baffling. I have never heard of this happening before, so congratulations on being unique! Based on what I see from your blood results, it makes no sense really. As such I have no meaningful advice. I will note that measuring for inflammation might be worthwhile, as that can mess things up. Otherwise, you may be a unicorn, or (hopefully not), you having something serious happening which has yet to be determined. Since I was not helpful, I will simply say good luck! Let us know if you figure it out.

Lastly, I switched to carnivore and went from 7 hours of sleep to about 5 per night. You are sleeping way more than you should be, something is definitely not working well for you (and had you not noted length of time, I would have assumed not fat adapted, but you should be by now).

(You've tried everything else; why not try bacon?) #15

Forgot to mention the Web site, http://www.cholesterolcode.com. It is run by Dave Feldman, a citizen-scientist who got interested in lipidology. There is a lot of useful information on that site, well worth knowing, even if you don’t find help with your current situation.

(Joey) #16

@Rusty High serum triglycerides are typically due to: (a) diet rich in refined carbohydrates/sugars, (b) eating artificial trans-fats as opposed to healthy saturated/MUFA dietary fats, (c ) lack of exercise, and (d) excess alcohol consumption.

If you’re not engaging in any of this, and most especially if you’re restricting dietary carbs, your serum triglycerides will typically drop, not increase. And your HDL will typically increase.

The single most meaningful lipid test result is the ratio of Trigs to HDL. In a keto context, eating dietary fats does not elevate trigs (fat) in the blood.

Hope this helps clarify a bit. And of course, if my understanding is flawed, I welcome correction.

(You've tried everything else; why not try bacon?) #17

That’s an accurate description. On a carnivore diet, (a) should not apply, though I suppose (b) would be possible. I have a bias against exercise (whenever I get the urge, I just lie down, till it passes), so I’m going to ignore ©. I suppose (d) could be a possibility for the OP to consider.

There is such a thing as familial hypertriglyceridaemia, and it is apparently a serious condition, though very rare. However, the neurobiologist David Diamond, who lectures about lipids and statins, says he reversed his FT by going keto. So it’s mystifying that the OP is seeing an increase instead of a decrease in triglycerides.

(Joey) #18

… the only thing that gives me pause with respect to the OP is that there are many reports of elevated trigs when some folks go keto in the early months (search this forum for ample evidence). But, as was noted above, while one can draw blood at any time, it may simply be too soon to draw conclusions :wink:

(You've tried everything else; why not try bacon?) #19

Yeah, there is that, at least. I hope we get to see how things progress.

#20

thank you. That actually does help a lot.
i guess this next point is irrelevant if the op fasted for 20hours before the blood test, but would dietary fat show up in the test if he did eat fat just before? and what would it show up as?

So to clarify… the fat you eat, does not show up in blood tests, even if it is on its way from your stomach to the liver?