Long term effects of high LDL without any other health issues

cholesterol
evidence
ldl
(Stefana) #1

Trying to rock this low-carb/keto lifestyle but my labs just came back:
LDL cholesterol went up from 170 to 220
HDL went up from 46 to 70
Trigs went down from 70 to 49

No health issues otherwise and not taking any meds. Now doc wants additional testing like Calcium score and LDL particle test. Hopefully it’s going to look good since I’m 36 and should be in the clear. I’m doing this for about 4 months and have encountered several benefits since drastically reduced carbs.

My question is, who of you here has similar labs and has lived without any issues for longer than 5 years? No issues meaning no heart related disease for 5+ years on this WOE? I’m female so hopefully I’m not the only one here with this type of dilemma.

I’m familiar with LMHR and believe I might be one of them, but as you know all that is very new and there’s not much data to support that high LDL is harmless in low carb eating individuals (which by the way I do believe to be true since there is lack of inflammatory foods etc).

I do not want to take statins and never will. But I’m also wondering if this is truly fine :sweat_smile:

Thank you all for reading.

(Geoffrey) #2

My markers have been similar to yours for over 30 years. I’m 67 and have never had any issues. My last blood test my LDL was the same as yours. I will not take a statin because they are worthless and there is plenty of evidence to show that higher cholesterol is not a factor in cardiovascular disease or all cause mortality.

(Stefana) #3

Thank you! I really appreciate your comment. I’m feeling great and don’t want to pop pills that I don’t need.

(Bob M) #4

My BELIEF, based on all of the evidence I’ve seen, is that you’re not only fine, you’re great. Your trigs/HDL is less than one, which is fantastic.

The trigs/HDL is really a marker for metabolism really. Your numbers are great.

LDL can go up because it’s the end result of VLDL. VLDL acts as an energy shuttle for many on a low carb diet – you’re shuttling energy (fat, via trigs) because you’re eating fat (or possibly living on fat stores). Once VLDL delivers its fat payload, it becomes LDL. This provides an overview, though calls both of them “bad”:

You could get a calcium score. That would give you a baseline. (Hint: it will be/should be low; you’re only 36, and I see little evidence that there’s a relationship between LDL and score; Seen a study where many people with familial hypercholesterolemia, who have very high LDL their entire lives, still have zero scores.)

You can get an LPIR score (Labcorp only, have to get an NMR lipoprofile); HS-CRP (c-reactive protein, a measure of inflammation); fasting insulin (along with fasting blood sugar); HbA1c (a measure of blood sugar over about 90 days); ferritin (can indicate inflammation, although is really a measure of your access to iron); c-peptide (similar to insulin); GGT (a measure of liver function).

These will provide a better indication of your health than LDL.

(Stefana) #5

Thank you so much for the very informative comment! I am so glad I found this group.

(Joey) #6

@Stefana Welcome to the forum! Loved your very first post…

Yes, indeed. You ARE rocking this! :+1:

I’m another long term keto’er with similar labs as you’ve shared (for past 5 yrs). I’m well into my 60s and doing fabulous as a LMHR.

And three internists later (they moved/retired), each one loved my labwork just as it is. My wife, same, same. They even took her off statins and high blood pressure meds she had been on previously … as they agreed she doesn’t need either any more.

Keep us posted on how you’re feeling! :vulcan_salute:

#7

Science and medicine can, at times, be very slow to change. The risk of CVD is only looked at from a 10-year window in the mainstream (western world). This means that your risk might be zero now and only slightly increased in 10 years, but what does it look like in 30 years? I would be proactive and get an ApoB test. If your doctor refuses, then offer to pay for it. (about $25). Ask your doctor, “What is my 20- and 30-year risk?” Most will not know this answer. Have them look at Dr. Allan D. Sniderman’s research. The ApoB test is far more predictive of CVD than simply LDL-C. At worst, look at it as another tool to stack with others to get a better lipid profile picture. Studies in the last few 2-3 years have shown ApoB is a better proxy for lipid profile than the LDL-C. Family history is also important. What do your relatives die from? How many were obese and had high blood pressure?

(Stefana) #8

That’s amazing. I’m so glad both you and your wife are doing so great! I appreciate all your words of support 🩷

(Stefana) #9

Thank you for the informative comment. My father died young at 56 years old, of heart failure and CAD. My sister is obese & diabetic. My mother has elevated blood pressure.
I asked my doc for the LDL particle size test and I’m scheduled to go give blood for that lab.

I’m physically active and with a normal BMI, never had any health problems except some weight issues after pregnancy and always preferred preventing health issues than trying to fix them. I tried many different ways of eating in my life including vegan and vegetarian and during that time is when my cholesterol started going up. But only after I started low-carb did my HDL go up and Trigs go down.

Both my husband and I are in the medical field so I’m very aware of medication side effects and would prefer not ever to be on any medication.

#10

These two numbers are important. ApoB and Lp(a) tell you the most when predicting the risk of ASCVD. ApoB not only tells the concentration of LDL particles but also captures the concentration of VLDL particles, which, as members of the apoB family, can also contribute to atherosclerosis. Furthermore, even someone whose apoB is low can still have a dangerously elevated Lp(a). Lp(a) still has an outsize ability to cause damage, even in relatively small numbers.

(Bob M) #11

Again, don’t get too excited about Lp(a) (or ApoB for that matter). My last two Lp(a) tests:

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Those levels are somewhere around the top something % of people (the “something” changes depending on study). And I have around that value for the last 10 years, since I got the value tested.

After 5.5 years, my CAC scan score was zero. At least from a “hardened” atherosclerosis as measured by CAC scan, Lp(a) doesn’t seem to be causing this.

Moreover, there’s not much you can do about high Lp(a). Statins increase Lp(a), at least in some studies. You can take a PSCK9i, but even these only lower it so much, maybe 27% or so:

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.037184

But take a look at this figure from the supplementary material:

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If Lp(a) was the deadly killer it’s supposed to be, this shouldn’t be a flat line, which is basically what it is. Ref is the lowest decile, and only two lines are above that.

As for ApoB, I know one can find studies where ApoB is a terrible marker. I was following someone on Twitter who had a ton of studies showin ApoB was not a great marker. Unfortunately, I don’t remember who this was and can’t find his information.

#12
#13

https://www.sciencedirect.com/science/article/pii/S1043661823002293#:~:text=From%20this%20perspective%2C%20apoB%20is,%2C%20metabolic%20syndrome%2C%20insulin%20resistance%2C

(Denise) #14

I’m kind of laughing, but at myself, believe me :sweat_smile: I have/had super high, and I mean high cholesterol since before I ever got on Keto. I remember one time it was 300, and I went on this Oatmeal and niacin thing, it went down very little. Got on Keto, January will be 4 years, and my last Lipid Panel, total cholesterol was 500 something.

I’ve been told so many times if my Trigs/HDL are good, mine are still good at 1.5, not to even worry about the high LDL. So I pretty much forgot about it altogether. My MD, and Cardio NEVER forget about it but I won’t take their 'statins so they probably just write me off :wink: They’re stupid in my opinion because they just ignore the tests that come back “clean” but still want to pump me full of Big Pharma’s drugs. No way.

I’m 71 and the only real dangerous health issue has been T2 Diabetes I was diagnosed with, which helped me to find Keto, and haven’t had any A1c’s over 6.0. I also don’t have any other issues, but had to have a pacemaker put in '97. I’ve had every test pretty much, no clogged arteries, not heart issues except what they call a 3rd degree AV node block. That’s the electrical part of my heart.

I think I still have my last copy of Lipid Panel I’ll put at the bottom. But I’m honestly a very active senior lady at 71. I workout at least 5 days a week with Resistance bands, and when weather is better I walk at about 4 miles an hour. I am 5’2", 112 lbs, building muscle.

I suppose time will tell for me personally, everyone is different, but people like Dr. Ben Bikman, Dr. Ken Berry, are my go to’s about cholesterol, also I like Diet Doctors on Youtube. For now, I just don’t see my ridiculously high cholesterol as being any problem for me.

Glad you found the site, welcome, and doing Keto I believe, has given me a ton of quality of life :wink: Denise PS Just might leave my body to Science, I’d probably end up at Area 51 so no one could know the truth.

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#15

Did you read the conclusion of the study you quoted?
For reference here it is:

"Conclusions:
Higher levels of Lp(a) are associated with an increased risk of cardiovascular events in patients with established cardiovascular disease irrespective of low-density lipoprotein cholesterol. Evolocumab significantly reduced Lp(a) levels, and patients with higher baseline Lp(a) levels experienced greater absolute reductions in Lp(a) and tended to derive greater coronary benefit from PCSK9 inhibition."

(Joey) #16

@Stefana If you haven’t already seen this video (recently posted again by @Goldengirl52) have a look as it addresses your initial concern expressed in this thread…

(Bacon is a many-splendoured thing) #17

Congratulations! Those are excellent results. Your ratio of triglycerides to HDL is 0.7, which is fantastic. No risk of cardiovascular disease. With such a great ratio, your LDL number is irrelevant, and if you had an NMR done of the particle sizes, they would most definitely fall into the healthy Pattern A.

I don’t know what my LDL is currently. It was 148 last time it was checked. My current doctor refuses to order a lipid panel, I suspect because he doesn’t want to have to go through the charade of trying to prescribe a statin, and my having to refuse it. (He knows I’m keto and supports it.)

In 2018, the limit for LDL was 150 (and it used to be much higher before that), but I understand that the statin manufacturers now recommend treating patients with LDL over 90. It’s pretty clear that LDL level does not cause cardiovascular disease, so I refuse to worry. In fact, several large, well-funded studies have shown an inverse correlation between LDL level and cardiovascular disease, or between LDL level and all-cause mortality, so it certainly appears that high LDL may very well have a protective effect, especially in women over the age of 50.

Studies of people with familial hypercholesterolaemia have shown that it isn’t the high LDL that is the problem, it’s whether people also have genetic variants of fibrinogen and clotting factor VIII that make their blood readier to clot. These genes tend to associate with the gene for FH, but only half of the FH population has them. The people with FH who don’t have those variants live long lives and die of causes other than cardiovascular disease. In fact, one study showed that people with FH who live into their 70’s have a higher life-expectancy than the general population.

Dave Feldman and his team are currently running a study designed to test the hypothesis of whether LDL in lean patients is a cardiovascular risk or not. The early data look promising. Their LMHR’s all have very high LDL levels, yet their CAC scores are very close to 0, if not actually 0. And even the most die-hard statin advocate is forced to admit that a CAC score under 100 is a contra-indication for taking a statin.

Personally, I value my brain function and my muscles too much to want to put them at risk by taking a statin. I would prefer to be cognizant and functional right up till the fatal heart attack (if any), than to live a longer life of dementia and physical incapacity. I have also reversed my pre-diabetes and don’t want to put myself at risk of diabetes again.

(Stefana) #18

Thanks will do!!

(Stefana) #19

Thank you for your comment :heartbeat::heartbeat::heartbeat:

(Stefana) #20

Thank you for your response :heartbeat::heartbeat::heartbeat::heartbeat: