I had a ischemic stoke last Friday, I got blasted by all of the Dr.s for being KETO and my cholesterol being the culprit. I went KETO in 2018 and it has relieved me of most of my arthritic pain, which was very bad. The floor Dr in the hospital told me “I had to quit KETO and live with a little pain or die”. The neurologist said “high LDL causes stokes”. I regained most motor skills back within 24 hours, I was released and followed up with my PC. He is aware of my past with not tolerating statins or praulent. He know that I am a LMHR and my cholesterol is always high. In the hospital my LDL was 270. That was relatively low for me.
The MRI showed this was my second stroke, not my first. My CT scan said " Atherosclerotic changes with mild (<50%) narrowing " in most of my brain vessels. My PC said I need to go back on the praulent (it brought my LDL to 187 and he said I need to go back on that. (on that I lost 50% mobility in my right shoulder) I went to PT for 3 months because my Cardiologist swore that was not caused by the praulent. It was gone a week after I stopped the praulent. My shoulder still pains me because of that. I am being sent to my new cardiologist for him to decide what to do. I just saw him 3 weeks ago and got a “see you in a year” On the good side He was impressed as to my CAC scan with him. I reduced my plaque around my heart from 310 to 92. I will attach my chart of my CAC scans. I am looking for suggestions going forward.
I had a stroke last Friday
I’m terribly sorry to hear what you’ve been going through this past week. Strokes can produce all kinds of effects - totally dependent on where the blockage occurs. Based on your post, at least it sounds like you’ve got a lot to be thankful for - notwithstanding that any stroke is a setback.
I couldn’t disagree more with the thesis that keto is what caused (or even contributed) to your having an ischemic stroke. The fact that you’ve been able to reduce (echolucent) plaque and reverse pain speaks volumes about who is right and who is wrong in the clinical sense.
Your avoidance of carbs has no doubt significantly reduced inflammation - which is what prompts soft plaque to form. Calcification of soft plaques is the “scabbing” … soft plaques otherwise can dislodge, which is what causes an ischemic stroke (as contrasted with a hemorrhagic stroke).
There are various reasons that one’s body might produce soft plaque (typically found in arterial pathways near the heart). But avoiding carbohydrates is not one of them.
LDL has been shown repeatedly to have no bearing (= no correlation) with CVD. HDL/Trig ratio, on the other hand, does. Taking a statin - even aside from unpleasant side effects - is effective at lowering ALL cholesterol components. Why would anyone want to lower HDL?!
Lower LDL in seniors (60+) has also been shown repeatedly to be correlated with higher all-cause mortality rates - not lower mortality. Not a good bargain.
Again, I’m sorry to hear what you’ve been experiencing. Continue to do your research and keep us posted on developments.
I’m just asking questions. I have no advice and know very little about this, but I do know that strokes can be caused by blood clots as well as atherosclerotic plaques. Do they know which is the cause of your ischemic stroke? Is it even possible to know?
Gosh, it seems to me if the plague around you heart is actually reducing, how can your LDL be the cause? You must be doing something right.
That’s a bummer, though I’m unsure “high” LDL has anything to do with this.
The first problem with strokes is that there are two types, but I’m assuming we’re talking about the atherosclerosis type (not the bleeding type). Given that, these could be caused by non-calcified plaque getting into the brain or moving from another part of the brain, or by coagulation (or both?). For FH (familial hypercholesterolemia), where people have high LDL for their entire lives, one theory is that it’s not the LDL that’s dangerous, but instead their coagulation/clotting factors. I’m similarly concerned, because I have “high” homocysteine and Lp(a) (another type of LDL, really), both of which are associated with clotting.
I would suggest some daily aspirin or something else that limits clotting.
Hello Bob, they put me on 2 blood thinners and want me to lower my cholesterol a lot.
Thanks Germaine
Thanks for the info, I responded to that from my email not in the forum. Germaine
Hello Bob, my LPa is 26, which is quite low, good to know its effect on clots. Germaine
High homocysteine levels are often related to folate deficiency. The MTHFR gene can make one prone to that. But I guess it could be a matter of not enough folate in the diet or too much niacin.
Understood, thanks for editing out the links in the post - I’ve deleted my comment above, too. 
I’m wondering … Was the plaque around your heart the hardened type that shows up on a CAC scan? If so … What happens to that if it decreases. Does it soften / release itself into the bloodstream? Just theorizing maybe the decrease in your score is somehow related to the stroke.
@Gms Depending on what units that is, that is low or very low. Mine is in the top few percent of people, depending on the study.
@betsy2 I am “part” (1/4?) MTHFR, but homocysteine is weird. Many people say too high of a level (where “too high” varies) is bad. Mine has varied from 10.2 to 17.9 umol/l, though the 17.9 appears to be a single instance much higher than normal; most are closer to 11-13. The problem is that lowering might not help:
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/226081
So, I take some unique B vitamins to try to lower it, but not knowing what benefit that has.
@kib1 You’ve asked a million dollar question. What you’ve proposed is one possibility. But others think that lowering the plaque burden is good. (And still others say that statins, which RAISE CAC scores, are “good” because they make the plaque more dense – supposedly – making it less likely to release – again, supposedly.)
First go to a lab that the public can use like Ultalabs, and get an oxLDL test.
With that CAC first immediately start on at least 200 mcg of vitamin K2/day. Also, if you are not supplementing or getting sunlight, probably supp about 250 mcg or 10,000 IUs of vitamin D daily. Next, take a good quality methylated multi-vitamin. I also supp with a decent magnesium on a daily basis. Restrict red meat to grass fed lamb, rabbit or wild deer. Eat cold-water fish or sardines, shrimp, crab, squid. Avoid grain fed pork or poultry…Eat organic berries with goat or sheep dairy. Eat cruciferous vegetables with your dinner entre. Count fiber against your total carb intake to stay below 50 net carbs/day.
Eliminate all refined sugars and refined seed oils if you haven’t already.
After at least 2 mo get another oxLDL… If not below 60 reevaluate.
Another thing you can do is supplement CoQ10 or Ubiquinol(a more expensive, but targeted derivative). If you have been or if they want you to use a statin, these will suppress the body’s own production of CoQ10, as well as cholesterol. You need CoQ10 or Ubiquinol to act as an antioxidant within the LDL. Lacking one of those, you can supplement astaxanthin instead.
I was just thinking about the experiment Nick Norwitz did with oreo cookies. He is a lean mass hyper responder. That means his cholesterol goes way up when he eats low carb. It looks like you are in the same boat.
Early last year he published a paper about his legit, n=1 experiment testing his cholesterol values using a statin versus eating oreo cookies. Eating the oreo cookies lowered his LDL more than the statins did. His paper is linked below.
Now… I’m not saying you should eat oreo cookies, but…
How many carbs a day are you eating? If you are being very strict keto, as in < 20g a day, maybe if you up your carbs to 50 - 70 g/day, you could still reap the benefits of low carb, but your cholesterol would drop to low enough numbers to prevent your doctors from putting you on a statin or the Leqvio?
Just a thought?
I don’t have any advice - just wanted to express my sympathy with what you are going through.
What strikes me most is that your CAC began to rise and tripled after five years while on keto, but then it returned to below your baseline and relatively quickly. Did you change anything about your lifestyle/diet over the past 12-16 months? I see you (like me) eventually regained the initial weight lost – if BMI is accurately reflecting your weight.
I’m so sorry you’re going through this.
Hello Wendy, the weight came on this year after I had a hysterectomy. I started the CX8 after the 2/9/2021 CAC, I was so bummed that it increased after that , so then I started taking berberine, nattokinase, K2 along with the CX8 after the 8/2/2021
(CAC on the same machine) That is where the drop started.