Should I quit keto?

#21

I would take the last 3 criteria as the most important. They look good.

Conclusions— These results indicated that estimated cholesterol levels in the large LDL subfraction were not associated with an increased risk of IHD in men and that the cardiovascular risk attributable to variations in the LDL size phenotype was largely related to markers of a preferential accumulation of small dense LDL particles. https://www.ahajournals.org/doi/10.1161/01.ATV.0000154144.73236.f4

Sorry, if you’re not a man… I can’t really tell from your name.

#22

I only have a few numbers from before keto, but in 2016 my TC was 152, LDL was 99, and HDL was 53. So my LDL more than quadrupled! This last round was from mid-April.

#23

No, I’m not a man but I appreciate this anyway! I’m Veronica :slight_smile:

(Cancer Fighting Ketovore :)) #24

I would re-run the labs at about 3 months from the prior set. If you can have it covered by insurance, run them every 3 months or so to watch for trends.

#25

Good idea. I’ll see if the doctors will cooperate. If not I’ll pay for them myself as often as possible.

#26

Here’s a podcast by Peter Attia you might want to give a listen. There’s a nice summary of the content included on this page…

(Bob M) #27

I assume you’re also not an APOE4?

I have a difficult time with modifying what you eat to get different cholesterol results. Let’s say that saturated fat raises your LDL (though not sure how that’s true: https://drmalcolmkendrick.org/2018/07/03/why-saturated-fat-cannot-raise-cholesterol-levels-ldl-levels/).

Does this increase your risk of heart disease? That’s the real issue. No one really knows, though I would say it does not.

The other thing is I’m sure you could modify your LDL by gobbling polyunsaturated fats like soybean oil. (I have a study bookmarked at work for this, but I’m at home now.) But that would be a very bad thing to do for many reasons. True, your LDL would look great, but you would be much less healthy.

That’s the problem with looking at markers, including LDL and BHB (blood ketones), without looking at the whole person. If you feel great and can exercise well, I personally find it hard to believe your body is killing you. (And did you know there’s a relationship between high LDL and reduced cancer and sickness? That’s hidden in the “we must reduce LDL at all costs!”)

#28

Nope, E3/E3. I do have a variant that means I respond badly to saturated fat, another reason for my change.
I try to avoid PUFAs.
I understand your point, but you’re right, no one really knows and if my LDL were just “high” I would be OK but I’m so far above that that I just want it lower. If LDL can become stuck in arterial walls then it would make sense to want less of it. I’ve talked to a few other LMHR’s who have successfully brought their LDL down by lowering saturated fat. And like I said, I don’t really feel great and can’t exercise like I used to, but hopefully that’s just because I’m still adapting.

#29

The big fluffy ones aren’t going to do that, just the small dense ones.

#30

How can you say that for sure? And if I bring down my total LDL won’t I bring down the small ones necessarily?

(Bunny) #31

Are you drinking coffee three days before your test?

If so that may be why?

Or your taking or eating something similar?

The things your being tested for fluctuate so much and your only three months in, things like coffee will enhance the test results.

(Edith) #32

Check out this podcast with Dr. Brett Sher. He is a cardiologist that promotes low carb and keto.

#33

Well, I drink coffee ever day but these tests were all at least twelve hours water fasted.

(Bunny) #34

Ah ha! That’s why?

#35

The coffee thing was related to high triglycerides in sensitive people.

(Michael - When reality fails to meet expectations, the problem is not reality.) #36




#37

It is the ratio between them that’s indicative of a problem.

Also, there’s a carotid intima-media thickness test (CIMT) that looks at arterial conditions which is different from the CAC, which looks at calcification.

I also agree with continued testing to see a trend, especially on the particle size.

(Siobhan) #38

Regarding whether you should quit keto - I think you are the only one who can feasibly answer this.
If the high LDL is legitimately freaking you out, and you feel the research doesn’t support even being cautiously optimistic regarding high LDL in isolation, it is entirely warranted to say you are not comfortable with it, and want to lower it. If that is what will make you most comfortable long term, it is a legitimate option.
The strategy that most consistently seems to work for people is to increase carbs a bit, and lower fat proportionally so you are running more on glucose for fuel. So, essentially, yes this would be moving away from keto. From what I’ve seen some people see results from going up to just 75-100g per day, so more low carb instead of keto.
I’ve seen others in the LMHR group opt for medication, of various types. I’m sure you could ask more details on that if you wished, in the group.

If you just want to keep an eye on things over time, you could opt to measure risk via something like a CAC (something I see a lot of LMHRs getting), CIMT (measures thickness in the carotid artery), carotid doppler (visually looks for soft plaque in carotid), further bloodwork (inflammation markers, insulin, etc).

Regardless of what you pick, it should be the one you think is right for you. And know that no choice you make has to be permanent. You can always try something, decide you dislike it, and move on to something else.

You are correct that we do not know, regarding risk. I am cautiously optimistic, but not certain it doesn’t carry some risk. Some choose to intentionally move away from the profile, some choose to stick with it because they feel the evidence is strong enough for them to feel comfortable. Imo, both are legitimate reactions.
Dave recently did a presentation on the topic of risk - but as he said, it is the beginning of a conversation. As such, whatever people decide to do is going vary because the research on this profile is still in its infancy.

(Bunny) #39

Depends what kind of coffee and the terpene oils found in the coffee? (will make LDL appear to sky rocket and sometimes HDL if it is unfiltered, but who wants to play with fire?)

Curious as to how many hyper-responders that do not drink coffee at all? When your in ketosis it’s a whole different chemistry? (a non-coffee drinker, hence no bio-accumulation of a fat soluble substance i.e. terpene oils?)

Or if it’s just an APOE4 or other genetic mutation to saturated fats? (…they need to consume more polyunsaturated and monounsaturated fats along with or less than saturated fats?)

(Bacon is a many-splendoured thing) #40

With a ratio of trigs to HDL under 1.0, and pattern A LDL, how much do you really need to worry about your lipid numbers? The people who are telling us to worry about it are the same ones who brought us the SAD, after all. Have you read any of the papers by Ravnskov and Diamond on the actual relationship between cholesterol and cardiovascular disease? There is so solid a lack of correlation between cholesterol and heart disease that it amounts to proof of non-causation. One wonders how the statin manufacturers can claim with a straight face that their products do us any good whatever.