High triglycerides on 0 carb carnivore diet

(Joey) #21

There’s a lot to unpack here… and context is everything (LFHC vs LCHF diet, extent of metabolic adaption, pre-existing conditions like metabolic syndrome/T2D/liver health, insulin resistance vs sensitivity, exercise levels, etc.)…

But my understanding is that dietary fat doesn’t simply go directly from one’s digestive tract to one’s bloodstream, and certainly not in its original form as “fat.”

It gets broken down (digested) into other components and then absorbed and ultimately stored based on one’s individual metabolic context. I’ll leave the finer details to others who’ve spent more time researching the chain of events (like @PaulL) - my organic chemistry books are rather dusty at this point in life.

(You've tried everything else; why not try bacon?) #22

I’m not entirely clear on the details, either. I’ll bet Dave Feldman could tell us, however. :grin:

But as I understand it—and please do not take this as Gospel—it is dietary carbohydrate that clouds the blood serum with fat. (It gets converted in the liver.) The liver packages the carbohydrates into triglycerides and puts them into very large lipoproteins called chylomicrons. This is the source of the triglycerides lipid measurent, if I’ve got it right.

Fatty acids are hydrophobic, so cannot travel through the blood as is. My understanding is that the fats in our food need to be formed into triglycerides for transport. And I believe the liver puts them in very low-density lipoproteins (VLDL) and sends them to the adipose tissue for temporary storage. They are then released between meals, to keep the cells fed.

As I understand it, it is the triglycerides that are the real passengers in the lipoprotein boats (to borrow a metaphor from Dave Feldman); the cholesterol in the lipoproteins is there only for cases where it is needed. And the difference between VLDL, LDL, IDL, and sdLDL is merely in the amount of triglycerides being transported.

Now, if anyone can do better than this, please do so. I’d like to get it straight, myself.

(Michael) #23

Still getting this down pat myself, but your explanation looks pretty solid. I will add however, that if I understand correctly the cholesterol is in the particles to help maintain shape as well (not really to deliver if needed since all cells can create their own if it is needed, but they CAN deliver cholesterol). The particles deliver trigs AND vitamins AND apoproteins as needed. The remodeling takes place with both a smaller cargo and a loss of apoproteins. Like you though Paul, I am happy to have someone further clarify.

(You've tried everything else; why not try bacon?) #24

Ah, I see. Thanks for that bit of illumination.

I think there is probably more that I haven’t quite got right, however, so let’s hope for further explanations and amplifications.

Oh, and I should probably add that I have this impression that chylomicrons, LDL, and HDL are formed from different lipoproteins. Do I have that right? Anyone feel free to jump in here, please.

#25

Your numbers take a while to normalize, but either way it’s a result of your diet. You didn’t show LDL breakdowns so I assume you got a standard lipid panel, those are pointless when eating low carb and keto, aside from not having the numbers that matter, the equation (the Friedewald equation) that’s used to calculate them doesn’t work on a fat based metabolism. You need to get NMR’s to have numbers you can go by.

Do you track what you eat? Mine went really bad for a while, and simply changing what I was eating drastically changed it. Fat isn’t unlimited, keto / carni doesn’t change that contrary to belief. So can get away with things that others don’t. But what you eat matters.

This is a post where I put up my NMR which shows my original and a follow up, I had to force this one quick, but it shows how much you can change it in 3mo, pretty drastic!

https://www.ketogenicforums.com/t/fix-your-cholesterol-including-sdldl-fast/109381

(Michael) #26

LDL and HDL ARE different lipoproteins. I think you meant different apoproteins, which yes they are. ApoA1 (HDL), ApoB100 (LDL), ApoB48 (chylomicrons) ect. apoB48 is so named because is has 48% of the content of apoB100 (ie 100% as the baseline)

#27

ok this is very early to panic in any way :slight_smile:

yes MANY carnivores have increased cholestrol results from very very early testing…so key is like Paul said, 6 mos to a year on carnivore then take a new test and ALL YOUR numbers will be probably dramatically diff. as it has gone down for many zc people.

you need this info and join these groups for the best of the best chol. information regarding your numbers and also to ‘search the files’.

facebook. don’t care if ya hate it, join the darn thing to HIT THE MAIN groups who are totally zero carb and HAVE ALL the info on the issues you are checking about…the real deal info is here:

ZIOH (Zeroing in on Health) join it
ZCH (Zero Carb Health) who has a wonderful Zero Carb Health website also with tons of info you need being carnivore.
Strict Carnivore (another great one with LONG TERM people who have your answers…in fact all the above have your answers you seek.
Zero Carb Carnivore UK!! They are wonderful with the info you require.

in fact ALL the above are 2 yr, 5 yrs, `10 yrs, 20 plus years on this plan, they got the info you need point blank :wink: don’t get info from Keto forums for real issues you have ‘kinda now being carnivore’ expecting what it is to ‘be on the carnivore’ plan ya know.

wishing you the best way forward…you are fine, you got alot of time to correct that testing and I have info to type out for ya but it SO much easier for you to go to the direct answers ya need from above…best way forward. Many ZC people have experienced and chatted and we got real deal science and experiences to back up all the chol. stuff :slight_smile:

hang in there, all good!!

(Joey) #28

@Fangs Now this is what community is all about. Great info.

(Bill) #30

Hi Bob and welcome from a fellow UKer.
The conversion for cholesterol from mmol/l to mg/dl isn’t multiply by 18 thats blood glucose levels only so far as I’m aware so any US persons looking at your numbers won’t have the right info.

e.g. your trigs of 2.03 translate to 179.81mg/dl

I would however probably go with the others that your numbers at the moment are a bit haywire and need to stabilise before you can draw any conclusions.
Also the small fact that LDL is “calculated” not measured isn’t helpful.

My guess would be that your trigs are elevated due to the period you fasted. 12-14 hours water fasted is recommended for a “clean” reading so you may have gone a bit too long.

What many people also don’t realise is that like blood sugar, cholesterol levels are very dynamic and change all the time … there are a few studies out there that point this out. I’ll wager 99% of doctors don’t know this simple fact.

My advice would be carry on as you are.
Try and get another test in 6 months time and fast for 12-14 hours beforehand.

Oddly this popped up on my timeline this morning…

https://twitter.com/ElieJarrougeMD/status/1556752731964166144

Also well done on the HbA1c.

#31

Thanks everyone for your helpful replies and to skeptic888 who linked to the converter - I’ve corrected the mg/dL numbers for US readers.

Thanks to Fangs for recommending the facebook groups- I signed up to the strict carnivore group but was told to seek help in the UK groups. Most require a month wait before you can post, but I want to get this sorted asap.

To summarise, this is what I’ve gathered:

  • I might have a slower BMR (basal metabolic rate) due to being sedentary & need to exercise more.
  • Sleeping too much might be a sign of CFS (chronic fatigue syndrome) - there is no known test or cure for this but perhaps exercise & better lifestyle might fix it.
  • I might not be fat adapted yet & need to wait longer (e.g. 6 months)
  • While there is disagreement on this, many people say it’s normal for cholesterol to go haywire during the first 6 months & I need to wait for 6 - 12 months for it to settle down.
  • The LDL test I had isn’t an accurate measurement because it doesn’t include all types of LDL. Unfortunately, even having a conversation with an NHS doctor about this would get you kicked out so I’m not sure how to get an accurate LDL test.
  • I might be eating too much fat & not exercising enough. There is some disagreement over whether it’s possible to eat too much fat on keto or carnivore.

I should add:

  • I’m struggling to make friends because I work from home alone, and this causes depression- I’ve had this for years.
  • I have no colleagues, and the lack of human contact has an effect on me. This could contribute to tiredness, but doesn’t explain the sudden change since starting keto/carnivore.

Things I’m changing moving forwards:

  • Exercise more
  • Eat less fat (at least until my bodyfat reduces from 24%)
  • Wait until 6 months (total) before getting another blood test
  • Keep posting online to find a keto aware NHS doctor
  • If anyone has any more suggestions, please let me know.

I’ll leave all these posts intact for anyone going through the same in future.

I will be going to visit my family soon but carnivore would cause huge rifts in the family so I’m going to revert to KETO diet for the week I’m with them. I’ll use this as an opportunity to reduce fat for now.

Thanks everyone for the help. My worry is that when everyone says ‘wait 6-12 months’ - with these bloods heading in the wrong direction what if I’m dead by then! I wonder if there’s a more gradual way to do this.

Thanks again everyone

It’s a shame there aren’t studies or research looking into all this & so few decent doctors out there.

(Michael) #32

I want to second the comment @skeptic888 that you Should fast the same length of time. I try and do exactly 12 hours for every measurement now so that I am comparing apples to apples. I had some funny lipid readings recently when I intentionally fasted for 15 hours in a throw away panel (not the tests I wanted from a doctor I fired immediately after getting the requisition order). I ignored those results due to difference in fasting time.

(Bill) #33

I also had a recent blood test after a 36 hour fast Trigs were very elevated (as I expected) led to the usual statin call from the surgery pharmacist…

(Joey) #34

@Bobsmith You’ve gotten solid dietary/exercise guidance above, so I’ll pick up on a slightly different thought to address the social/human interaction issue you’ve shared…

You sound like a very thoughtful, diligent person. This suggests you have a great deal of insight and empathy to share.

The best way I’ve found in life to lift my spirits and create joy in my life has been to volunteer with causes that move me. I don’t know what those might be in your case – but it’s hard to imagine there aren’t things going on in the world, especially your local community, that don’t tug at your heart strings.

Identify a cause that moves you, and begin to invest some time and energy into moving it along for the better. I appreciate it’s hard to dig into your reserves of energy when fatigued and depressed … but it is precisely doing so that will energize your spirit and give you strength you need to also then address your own most immediate concerns.

Easier said than done. But once you start, you will be amazed at how it transforms your life.

You will meet like-minded people. And they will enrich your life as much as you enrich theirs. :vulcan_salute:

#35

A solid suggestion there.

I used to volunteer part time at a local cat rescue and it really helped lift me out of my depressive isolation.

(You've tried everything else; why not try bacon?) #36

You don’t need a nuclear magnetic resonance test (NMR) to know that your LDL will fall into the “unhealthy” Pattern B, because your ratio of triglycerides to HDL is too high (a very strong association). And even people who believe that cholesterol actually causes cardiovascular disease (despite all the available evidence that it does not) have to admit that a low ratio associates with minimal cardiovascular risk.

A couple of other tests, which you might be able to persuade your physician to order, are a CIMT (coronary intima media thickness) test and a CAC (coronary arterial calcium) test, which are better measures of the actual state of your arteries and your risk of a coronary event.

The assumption, a carryover from the current conventional wisdom, is that fat in the diet results in fat gain. There is evidence to suggest that (a) this is not true on keto, because insulin is low, and (b) fatty-acid metabolism increases to handle both dietary fat and the release of excess stored fat. We know that the metabolism adjusts up and down to match the resources we give our body. Of course, this is within a broad range, only. The lower end of the range is death from starvation, and the upper end of the rang is energy (fat) storage. But the upper part of the range is wider than the conventional wisdom assumes.

Given that fat yields over twice the calories per gram than carbohydrate yields, it is much easier to be satisfied when eating fat. So the key is to listen to one’s body, and to stop eating when hunger is satisfied. Granted, at the beginning, doing this means eating a lot of food, and that scares people. But many of us have found our appetites suddenly dropping, several weeks into this way of eating.

There is actually a growing body of evidence showing the effects of a well-formulated ketogenic diet. There is actually surprisingly little equivalent evidence showing the effects of the recommended diet. This was known at the time, when the dietary guidelines were first promulgated, and a number of large, well-funded studies have actually shown that a low-fat, high-carbohydrate diet actually increases the risk of cardiovascular disease, but we never talk about that.

#37

Very likely, all you can do is track your intake and make an educated guess on whether what your metabolism can get away with is right or not, or just go and have it measured. I play with my numbers forever, not realizing how slow mine was. I had a more physical job at the time and worked out 5-6x a week and it was measured at 1700! Horrible! Had to reverse diet to get it back up, took a while, not fun.

That’s because CFS technically isn’t a real thing, it’s a catch all term. This is where optimization Doc’s excel at figuring out what’s going on. DO’s are usually better there than MD’s because DO’s treat / diagnose the body from the systemic mindset, where MD’s (usually) start with symptoms and treat them directly. ND’s are actually really good at weird stuff like that, problem with them is, there’s not as many of them in circulation, and ND’s run obscene amounts of labs on you, which is good, but when you’re paying out of pocket it hurts.

Being stuck with a Gov’t healthcare systems means you have to go private to get what you need. In the US the NMR has more or less become the standard, my doc won’t even consider a standard lipid panel, my wifes doc does the same. They’re slowly learning.

Not really, only those who make excuses. The mindset of you can’t eat too much is a braindead idea, I don’t care what type of WOE you follow, whether you want to track macros or not, clearly over eating is real, there’s no reality in thinking you can eat a certain way and it doesn’t matter anymore.

I regularly speak to a lot of UK people on my lifting forums who routinely get all their own labs done, there’s definitely options for you doing it on your own. Just search for direct consumer labs in your area, or optimization / anti-aging docs. TRT clinics may also be a good path since most of them do that stuff as well.

(MC) #38

Sorry to hear about the depression and lack of social side. That could have a definite effect on you. My suggestion would be to get out and walk every day. If you have somewhere nice to walk, a park, a river, even fields, it’s uplifting to get out in nature and say morning to other people. It’s also excellent exercise. Alternatively you could join a gym and meet people there.

With the CFS, I wonder if you’re missing something on carnivore. I don’t know a huge amount about that WOE, but we need electrolytes to function; sodium, potassium and magnesium. You need to make sure you’re getting 4700mg of potassium daily and take a magnesium supplement. You might also want to add some animal organ meat in that, bone broth is great but you might need more retinol.

Also make sure you’re getting sunlight, not easy if you’re working from home I know. Morning/afternoon light provides melatonin for mitochondria, you want to keep those little guys happy for energy production.

Good luck and I hope things improve soon : )

(You've tried everything else; why not try bacon?) #39

I wouldn’t think so. I have a type of chronic fatigue, but it is not Chronic Fatigue Syndrome, because I tested negative for Epstein-Barr infection. Going keto actually increased my stamina and energy levels.
You might think that more glucose would give me more ready energy, but actually, I find that when I go over my carb limit, I am more fatigued, not less. My hypothesis is that cutting out plants entirely would therefore give me even more energy, but alas, going carnivore is not feasible for me at the moment. I have hopes for the future, however.

(Edith) #40

My son went through this exact same thing. For the past seven years, ever since he graduated from college, he has been working from home except for business trips. On his business trips he had colleagues and was in an office and would feel alive and engaged. At home, he would have lack of motivation and similar to you, more need for sleep.

We refer to him as the introverted extrovert. He likes to be around people, but he needs it to fall into his lap. Being in an office environment is perfect for that. He, too, started suffering from depression. I think a big part of that depression was just from loneliness. For years we were telling him he needs to find a new job, one where that has coworkers and an office that is not his bedroom. I think young people, especially right out of college, really should be in an office-type setting (if that’s the kind of career they have chosen.)

Anyway, he FINALLY found a new job and starts next month. He is VERY excited to finally be in an office and NOT be working from home. If finding a new job is not an option, you really should try to find a way to get out there and be around people.

You did mention that the sleep change happened since changing to carnivore. I tried a carnivore trial for a while. When I first went full carnivore, there were times when I could just not keep my eyes opened after eating, particularly lunch. It was especially bad after I ate fatty beef.
Maybe try cutting back meal size a bit or try leaner cuts of meat until you are carnivore adapted. I have to admit, I don’t remember how long it took for that to go away.