Lipid analysis


(Maj) #1


I started ketogenic diet since 2017 for 3 years but I switched to low carb for the last 3 years. However I kept the types of food I eat within the scope of ketogenic diet, keeping my carbs below 100g daily.

A couple of months ago, I did my health check up as I stepped in to my big five o age and as usual I got a different lipid counts than average 50 years bloke on western diet. Prior to this check up, if my doctor would’ve takes about my high cholesterol and would’ve gone down the road of statin and what not, I’d communicated my diet and gently moved myself into science safety zone and based on my health status they seem to not mind.

However this time again the same conversation happened but to my surprise they offered me a proper lipid analysis option rather than just penalising my lipid counts which I thought is nice of them and is good opportunity to learn more about my health as I am sure there many good doctors out there wanting only good health to the public.

That means I will be talking to an specialist on my blood tests results and wanting to speak with his with respect to his speciality and therefore am looking for some up to date materials than my average diet knowledge so that I am asking the right questions and answering scientifically backed reasoning should he chooses to stick to the good cholesterol bad cholesterol model disregarding reasonable studies out there.
I have been pondering on this matter so I am reaching out for your inputs. Please keep in mind that I’ll have a limited time speaking with him so I have to deliver my responses short and sharp so that I won’t lose him thinking I am on dr Google mode.
If you’ve read this far, thank you. I know it is not always possible to wrap a topic in a short paragraph but if you could stick to I’d love to hear your short sharp and to the point responses please.

(Peter - Don't Fear the Fat ) #2

I would ask if he’s/she’s familiar with the work of Dr X or Study Y … if he’s not aware of recent findings it might prompt him/her to go look.

Views from another doctor or group may be more persuasive. I’m not saying your not good at getting a point across but, you know what I’m saying.

(Joey) #3

Short & sharp: You’ve been at this for 6 years. You know what to say. :vulcan_salute:

(Maj) #4

Nicely said. You are right I do know but the only problem is articulating it in a way that hits the right note. This is where I fall short hence I created this post.

On a different note, i just happened to see this from Dave Feldman. I think it is a good one to have in hand.

(Joey) #5

I would suggest that, since both you and your doctor are individuals (with unique personalities), there’s no telling which notes are the right ones until the conversation unfolds.

Keto facts are what they are. If it’s “emotional intelligence” tips you need, we may not be the right crowd to ask :wink:

(p.s. - FWIW, respectful & curious often work best with our family docs.)

(KM) #6 you could try this website for some good “layperson” reasoning regarding cholesterol on a low carb diet. And if you do get grief about it, ask for either a particle analysis or a CAC scan, both of which would give much more info - what is the size of your LDL (small is bad, large and buoyant basically not a problem), and do you have any arterial calcification. The blank eyed zombie approach (arterycloggingsaturatedfat highcholesteroltakeastatin uuuhhhhh) just isn’t good enough any more.

(Bacon enough and time) #7

Something you can check from the existing test: I imagine it has numbers for triglycerides and HDL. Take the triglyceride number and divide it by the HDL number. If the result is 0.9 or less (2.0 or less in U.S. measurements), you are going to show the healthy Pattern A in the NMR lipid test.

Also, if the trend of triglycerides is downward, and the trend in HDL, upward, then you are good. And point out your HbA1C, which I assume is probably decent, and also your inflammatory markers (white blood cells, C-reactive protein, ferritin, and creatine). Though inflammatory markers will still be high if you have an injury or an acute infection. If they are all good, your doctor should really have nothing to worry about.

Also, the side effects of statins include impotence, onset of diabetes in the non-diabetic, muscle damage, and mental fog. These all are documented to occur in non-trivial numbers of patients.

And, for your own information, while Professor Sir Rory Collins, director of the statin trialists’ group at Oxford, claims that the number of patients with statin side effects is minuscule, he nevertheless did develop a genetic test to determine if a patient is at risk for a side effect of taking a statin, and the company he formed to market it claims that at least 25% of patients on statins suffer one or more of these side effects.

(Maj) #8

Thank you Paul. Really good info. Jam packed and you’ve communicated it really well.
P.S. have you changed your avatar pic😁it is nice

(Bacon enough and time) #9

Glad you like it. It is the silhouette of my beautiful sweet Anne, who was one of my very first pet rats.

BTW, if your doctor is a man, when you talk about statins, be sure to stress that impotence is a possible side effect (or maybe use the prissy newer term, “erectile dysfunction”). That will be sure to explain why you don’t want to risk taking the drug, lol!

(It’s definitely a “guy thing;” don’t know how well it would work on a woman.)

(Maj) #10

Is cooking (scrambling) eggs with more than usual amount of butter, effectively to emulsify them, unnecessary or good way of increasing fat intake for satiety? For last six years I have had my 4-5 large eggs with a good amount of butter (30-50 grams), mostly in the morning. But now moving into age of 50, it occurred to me that I might need to adjust this ratio. Any thoughts on this please?


I am in my 70s and pay no mind to it. Love butter, and heavy cream, and have plenty of it, to satiety.

(Bacon enough and time) #12

It’s a good question. How do you feel, eating that way? Go with what works.

For what it’s worth, I scramble my eggs with heavy cream, and cook them in the bacon grease. But butter works just as well as bacon grease, if you’re not indulging in bacon that morning.

(Maj) #13

Long live @velvet.
Same here. I only eat to satiety. The beauty of this method is that it is difficult to over.

(Maj) #14

Thank you Paul. This way has been my tool and it is actually difficult to overdo and I feel peckish if I have less butter.
I love animal fat but to keep the house aroma free (otherwise I’ll be hearing some grumbling :grin:) I resort to butter. I should try adding some double cream tomorrow. I often add cream and cheese when I make omelette.
In early days I used to mix and match some different ingredients with my scrambled eggs but after a few times that my wife cooked my breakfast i realised that I like simple flavours such as eggs, butter and salt.

(Alec) #15

If you are going to speak to an “expert” lipidologist, my suggested question is: can you please provide the RCTs not conducted by the pharmaceutical industry that prove that high LDL causes CVD.

Simple as that. I think he might find there aren’t any.

(Jane) #16

I knew there was another reason I didn’t want my hubby taking statins!!! :rofl:

(Maj) #17

Hi @PaulL I have my results. Would you happen to know an online tool that I can use (that is not as per statin-minded knowledge) to key in my data to have a workable scale in hand? Thanks

(Maj) #18

Take the triglyceride number and divide it by the HDL
1.2/1.9= 0.63
Off the hook? :grin:

(Bacon enough and time) #19

That is a lovely ratio, congratulations.

And sorry, I don’t know any good Web sites for lipid numbers. The ones I know of tend to automatically assume that, regardless of their lipid numbers, people over 55 should be on a statin. I haven’t yet see a site with an algorithm that actually takes the actual lipid numbers into account.

(Maj) #20

Thanks @paul. I know Dave Feldman have been working on this field over the past five years (maybe more) but don’t know if he has got one.