Very high AST / ALT / Cholesterol (LDL) after 6 weeks on a ketogenic diet

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(Eric - The patient needs to be patient!) #21

I meet with my cardiologist in a week+ and am going to tell him no statins. I expect a fight as I had a 4-bypass when I was 48. But I have a nuclear stress test 6 months ago with no detected blockage and pumped 10mets (I’m 65yo) on the treadmill with no pain, normal EKG. My AST and ALT are in the “normal” range but I don’t want to suffer cognitive impairment and think I may have a little.

Also there is increased risk of cancer and her never told me about the risk of T2D of which I went pre and the pulled back with Keto.

(Janelle) #22

Part I

Four or so months into keto and my ALT was elevated as well (54). Both my PCP and obesity medicine guy chalked it up to “dietary changes” and told me we’d test in 3 months again.

Part II

However, while getting a heart scan for calcium scoring last Friday, they saw what they think is a benign cyst on the liver. To be suresies that it’s truly nothing to worry about, I’m having a liver ultrasound this Friday. Without the higher value, I wouldn’t have worried. Without the scan results, I wouldn’t have worried. With both, this $190 test will hopefully put my mind at ease.

(Central Florida Bob ) #23

Those are pretty common. My wife has two that showed up over 20 years ago. She had cancer and they were looking for any places it might have spread to. They were just little cysts. Nothing. She beat the cancer and has never had problems with the cysts.

Here’s hoping yours are just benign little nothings, too.

(Central Florida Bob ) #24

To be honest, secondary prevention (of second heart attack) is the only place where statins have been proven to be useful. I think nobody actually knows the reality going on, but I lean to believing if they do anything positive, it’s from the anti-inflammatory effects the drugs have. They help the epithelial layers in the various arteries.

Cholesterol reduction is a side effect. I mean, it’s their intended use, but cholesterol reduction has nothing to do with how they work.

Just my crackpot ideas.

(Bob M) #25

Yikes, that was an impressive drop.

(Bob M) #26

I think you’re spot-on CFLBob. Have you been reading Malcolm Kendrick’s blog?

(Charlotte) #27

I was on 30mg adderall for the last 8 years. I stopped taking it 8 weeks on keto because I just didn’t need it anymore. My focus, attention, and energy has steadily improved a ton.

(Txdr) #28

Awesome! So glad to hear this! I too have noticed that I might not need it anymore when being in ketosis (my anxiety becomes almost non-existent and my focus levels are out of this world sometimes plus I can also handle coffee way better than before w/o worrying that I’m going to get a panic attack) but am honestly anxious to start experimenting w/ my current medicine routine… And I keep waiting for the optimal moment to do so… I think that I should start playing w/ dosing now or very soon once my body gets more used to being in ketosis (testing slow weaning off of both of my medications and seeing whether it affects positively or negatively my basal anxiety levels). So glad to hear about other people experiencing the same events.

(Txdr) #29

No worries. Sorry if I came out defensive. As you can imagine these drugs carry a ton of stigma (and mental health issues in general). I really wish I didn’t have to take anything…

(Charlotte) #30

When I went off the meds I did it gradually. I started with weekends and then only used it when I knew I had some project I had to do. Then I would just forget to take it and not even notice. Thats when I went off it altogether. 10mg is a pretty low dose which will make it easier. I’d give yourself more time honestly. Don’t rush it.

(You've tried everything else; why not try bacon?) #31

Not at all, but given my own history, I am sensitive to that kind of stuff and didn’t want an inadvertent impression to stand. I just wanted to be sure I hadn’t given offense.

(Central Florida Bob ) #32

Yes, I’ve read several of his posts. Haven’t tried to go back to his first posts and read everything, but the doctor who was my GP while searching for a statin that didn’t damage my AST/ALT levels said the same thing. If I recall correctly, it was over 10 years ago. He said he had talked to cardiologists he worked with and they were speculating that the primary action of statins was anti-inflammatory.

(Agelos Chatzopoulos) #33

After 1 month in keto diet with ketosis level from 1.2 - 3.7 but mostly around 2 and a lot of intense workout 5 times per week (always my workout was like this) I make today my first blood exams and the resutls was not good at all.

LDL going to 251 from 194
HDL 40 from 53
triglygerides 319 from 79

Mostly worries me the triglygerides, my doctor said that is not the important aspect because of how variable is this number however the ratio of all statistic is very bad.

What do you suggest ?
I’m planning to avoid the coconut oil, my consumptio before the test was around 30 grams per day.

(You've tried everything else; why not try bacon?) #34

Numbers often rise like this when people first start eating a ketogenic diet. Wait till you’ve been eating this way for at least six months, then get re-tested. If the numbers still look bad at that point, you can worry; right now, you’re fine.

#35

My LDL is freaking nuts at 279, BUT my HDL is improving for the first time in my life to 40. My PCP was absolutely freaking out and wanting to get me on the PCSK9 inhibitor or whatever all those initials are. I have flat out refused statins. and my doctor has refused to test my APOB etc, so I switched PCPs and then I refused to have my lipids tested LOL.
I am just past a year on Keto and am scheduled for a retest here in a month or so. I have lost 49 pounds. When I started keto my liver enzymes were high but they have steadily decreased and now are just a point above normal despite taking methotrexate which is why I get them tested every 90 days. So I have seriously switched my meats out and am barely eating red meat at all, upping my fiber, laying off the coconut oil,I am keeping my cheese and butter although trying to decrease my amounts, in preparation for this test. If no changes I am going to demand genetic testing. But I have been encouraged by my liver enzymes. (I had fatty liver). My trig have been stubborn despite my a1c being 5.5, last test was 179 and that bothers me more than the LDL. So we will see. I think we are all different and what is going on with us genetically should impact our dietary choices.But at over a year in my weight loss has been stubborn (female) and I hope the changes in my lipids are just that as well, slow.

(Bob M) #36

Little to none of that will help your lab results. Do the 6 and on-half day version here:

Note that trigs are highly variable (as are all the cholesterol lipids). If you fast more, you’ll raise trigs.

Please eat red meat. It’s really the healthiest meat there is.

(Janelle) #37

Yeah - why this? I’ve read the protocol and didn’t think it said anything about the type of meat - just lots of it (technically).

#38

I haven’t read all responses, but I feel that you are consuming fat more then you are burning. Fat is good but overdoing is also not very beneficial. But It’s just my opinion.

(Todd Allen) #39

How long did you fast before the blood draw? And how recently had you exercised?

#40

From what Im reading so far if I have apoe4, which my lipids are suggesting I might, I would need to decrease my saturated fats, and I eat a lot of red meat. https://www.fatforweightloss.com.au/genetic-makeup/
I love keto so much and I have quite frankly been afraid something will come along that would make me have to change. This is the perfect diet! So I am researching and trying to figure it out.