Yes . . . another Cholesterol post, but this one 22 months in


(David Deutsch) #1

So . . . I’ve been on Keto since June 2017, when I weighed 208 (I am a male 5’4", just turned 59). I have been extremely disciplined in compliance with the WOE since then, and by about 10 months ago I reached 148 or so. My goal had been 129, and despite continued close observance of the rules, I’ve kept bouncing back and forth between 155 and 145. no matter how hard I try since then (I integrated intermittent fasting, too, but the best that does is bring me closer to 145, before I rise back up into the lower 150’s).

I am focused on my accomplishments and on the facts I have sustained my weightloss. I am happy I went from a nearly size 40 to a size 30 (size 29 on a good day). But my BMI still isn’t where I need to be, I still have weight my body refuses to lose, and it seems I am very slowly starting to regain weight (it’s now getting harder and harder to drop down into those 140’s from the low 150s), despite the fact my carb consumption is very low, my fats and protein are in decent proportion, and the keto sticks all show deepest purple.

Anyhow, this post is actually not about my personal discouragement with my current progress, but rather with my Cholesterol and sugar readings. I know there is a LOT posted in this forum, which I will take time to read and absorb (there is so much stuff about it, in fact, that it will take time, and I hope the membership doesn’t mind, in the meantime, that I post this, and get feedback).

When I first started with the WOE, my Lipid panel was:

HDL: 38
Overall Chol: 199
Triglycerides: 130
LDL: 135

Chol/HDL ratio: 5.2

My sugar was around 99

About 4 months into the WOE, here were my results:

HDL: 39
Overall Chol: 173
Triglycerides: 93
LDL: 115

Chol/HDL ratio: 4.4

My glucose was 95

A year later, the results were:

HDL: 48
Overall Chol: 232
Triglycerides: 134
LDL: 157

Chol/HDL ratio: 4.8

My glucose was 76

Yesterday, my results were:

HDL: 61
Overall Chol: 245
Triglycerides: 114
LDL: 161

Chol/HDL ratio: 4.0

My glucose was 98

I know that part of the vibe of people responding to cholesterol threads is “cholesterol is meaningless” and I am absorbing that into my analysis. I do find it quite telling that cholesterol’s smoking gun remains unfound, by many accounts, and that holds a lot of weight with me. But cholesterol also remains an important tool/predictor for coronary heart disease among a significant percentage of the medical community, and for that reason, I am interested in and curious to understanding the odd trajectory of my readings during my WOE.

Did you guys see how, 4 months in, my cholesterol actually dropped dramatically? Why would it first drop, THEN rise? If adding fat and removing carbs would push my body to go into one direction, what would cause it to go in another direction when the diet did not change?

One possibility: I was put on Allopurinol some time after my first lipid panel. Does allopurinol raise cholesterol levels?

Also, considering my consumption of carbs is so very very low, how can my glucose levels still be so borderline high?

As you all might imagine, I am keeping these results to myself and not sharing them with my family. If they were to learn of them, I would be under a lot of pressure to abandon this WOE, which would result in my regaining all my lost weight.

Thanks,

David


(Omar) #2

are you consistent in the fast time before the blood work?
if you are fat adopted which I am confident you are, the triglycerides among other factors can be sensitive to how much exercise you are doing in the vicinity of the test?

do you drink coffee?


(David Deutsch) #3

I have the blood work done generally around 8-10 a.m. in the morning on an empty stomach with a glass of water beforehand so I am not dehydrated during venipuncture (dehydration makes venipuncture more difficult).

I do drink coffee generally (is that what you were asking? Or were you asking if I drink coffee before the bloodwork?). I am unfamiliar with coffee consumption as an issue one way or another, and have always consumed coffee, both during the period when my cholesterol went down, and when it went up. I do not consume coffee before bloodwork, as it would prevent me from compliance with the fast.


(Omar) #4

if the time span between one test and the blood withdrawal is 10 hours.

while the time span for another test is 12 hours then the two tests are not treated equally.

for the effect of coffee I refer you to David Fieldman protocol. search the net or the forum for David Fieldman.


(Omar) #5

the reading at the bottom is pre keto

The 2 readings at the top after quitting coffee

pre test fast span is 11 hours +/- 15 minutes


#6

Your HDL is getting better, that at least is something to be happy about. The triglycerids are still high, and that is likely what you should try targeting. Quitting coffee, or dairy, or mct oil are things worth trying.

Blood sugar isn’t borderline high, it’s more likely at your body’s preferred level. Gluconeogenesis is a natural process which doesn’t require carbohydrate, and below 100 is normal. When you see a dip in blood sugar, this may actually be because your body was expecting a meal. Blood sugar has a tendency to drop before meals, if you eat at the same time every day.


(David Deutsch) #7

I only recently (last few days) began adding MCT oil because I had heard this is beneficial.

Is this not the case?

OK. I need to figure out how to get rid of coffee, which really is a huge part of my life, without getting big headaches and so forth.

Question: Is it the COFFEE per se? Or is it the caffeine? So that a switch to decaf would do the trick?

This question also relates to the question of hidden caffeine in other areas of consumption, like teas, for instance.

Also, I need to know whether I am one of those 1-in10,000 who get increased cholesterol from allopurinol . . .


#8

MCT oil is beneficial for most, but there are no absolute guidelines on this. Just like some people can drink as much coffee as they want, while others can’t. You could just start with eliminating coffee, and I think it has to to with other things than the caffeine. Coffee is full of usually beneficial things, but humans are not created equal in this regard either.

Cholesterol can be rather changeable in tests, so I recommend this not too long informative video about how tobread test results. At the end, he talks about factors that can make huge changes to your LDL levels when testing: https://youtu.be/DXKJaQeteE0


(Brian) #9

I didn’t see anything in those numbers that looked that bad to me at all. The fact that the HDL was up 13, awesome!

The thought that came to mind is that these numbers aren’t nearly as static as people like to think they are. They move up and down, significantly, and sometimes quickly, for many reasons. But that was just my own thought.

I suspect there would be some who would kill (just a figure of speech, at least I hope) to have the numbers you have.


(Eric - The patient needs to be patient!) #10

factors that can affect your lipid panel

  • Coffee while fasting for lipid panel blood draw or maybe even the day before can raise triglycerides.
  • How much fat you ate the 3 days before the blood draw. Better lipid panel results from more good fat.
  • The length of time you are fasted before the blood draw. 12 to 14 hrs is ideal.

Research the dave feldman protocol at https://cholesterolcode.com/

I have persistently higher Blood Glucose as a phenotype. It is coming down but still 99 to 103 mg/dL fasted. Even 18 hours fasted. Stress can raise BG. Did you have a bad night sleep the night before the blood draw? Was traffic bad? Work? Other?

We have implicitly been led to believe that BG and Lipid Panel results are long term trends in our metabolic biomarkers. However there is more viability in these values due to environment and diet 3 days pre test than most doctors would believe.

The good news is that you can measure your own BG and for that matter ketones and track how your values change with diet, stress and fasting (among other factors).

Your BG levels might even be indicators of Adaptive Glucose Sparing https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher


(Bacon is a many-splendoured thing) #11

Congratulations! Your ratio of triglycerides to HDL is excellent, being under 2.0, which indicates low cardiovascular risk. Your LDL and total cholesterol are at what used to be considered healthy levels, before the invention of statins.

Dave Feldman’s site, mentioned upthread, has lots of useful information about how the body handles its lipids. Ivor Cummins’s site, thefatemperor.com, also contains a lot of very useful information. Dave Feldman and Ivor Cummins are citizen-scientists who have become cholesterol experts.

If you would like a real assessment of how bady damaged your arteries are and what your risk of a cardiac event would be over the next five to ten years, as your physician to authorize a coronary artery calcium (CAC) scan.

If you would like an assessment of what we actually know about cholesterol, LDL, and cardiovascular risk, go on PubMed and look up the recent papers by Uffe Ravnskov and David Diamond.

Given that cholesterol is actually part of the body’s healing mechanisms, I agree with David Phinney that “Blaming cholesterol for heart disease is a lot like blaming fire trucks for fires.”


(KCKO, KCFO) #12

Go to Dave’s site https://cholesterolcode.com/extreme-cholesterol-drop-experiment/

For some people coffee, both regular and decaf can confound the results. Best to skip both types for a few days before a draw. Also make sure you have water only for 12-14 hrs. before a draw.

If you are not losing fat, you might want to skip the MCT oil and let your body burn its own fat.

Are you having issues with uric acid? That drug is used for reducing uric acid. The fact that your pee sticks are deep purple should indicate you are not hydrating enough. Trust me you do not want to get dehydrated, that really sucks.

Good luck sorting it all out.


(Alec) #13

David
You might consider this data from the World Health Organisation. Cholesterol is protective.

image


(Dawn O Miller) #14

After being almost 1 year Keto and 3 months Carnivore I had a significant jump in my cholesterol as well and a slight rise in my A1c.

I am 5’4 and 120lbs, I lost 16lbs shaved 7" off my waist. I suspect the rise in cholesterol was related to me becoming a lean mass hyper-responder.

Dave Feldman relates that this can happen to people on a LCHF if they are lean, active or both. I don’t know how active you are but maybe your cholesterol results are a sign that you are on your way to become a lean mass hyper-responder.


#15

BOTH of those reading are in constant fluctuation, especially the sugar. It’s all over the place all day, food, exercise, stress etc. You haven’t posted a single bad sugar number so scratch that. On the Cholesterol, same deal, it’s always floating around especially the trigs, you’re only looking at what your numbers WERE at the time of the blood draw, 1hr from them it wouldn’t have been the same. It does seem you’re very slowly trending up, but higher total is pretty normal for us and the trigs going up could be a lot of things. Have you been tracking what your eating / doing so you can back track and maybe find a change?

BMI is beyond a useless measurement, forget it exists. It’s incapable of taking body composition into the equation so it’s completely pointless. Also a little weird your still turning urine strips, some people can but as a whole they stop working after fat adaptation, may or may not be a sign of something not optimal in your diet. Are you exercising / working out?


(David Deutsch) #16

I really got an education from all the replies that were posted in response to my own post. Thanks to everyone!!!

Wow, I really had no clue how to interpret my cholesterol results.

I hope my PCP doesn’t give me a hard time about ordering an arterial calcification scan…


(Eric - The patient needs to be patient!) #17

The price of these are coming down so if you have to maybe consider paying fo it out of pocket if your doctors does not cooperate.

Good luck.


(Jane- Old Inky Crone) #18

I had the scan a couple weeks ago and the cost out of pocket (without insurance) was $150 in Charlottesville, VA. Not too bad in my opinion. BTW, my results were not good. My doc recommended that I get back on Keto and stick to it strictly.


(Eric - The patient needs to be patient!) #19

Jane
Sorry to hear the results were not good. Sounds like a supportive doctor however.


#20

I’m sorry about the results. But you doc seems rather sensible. I hope you’ll manage to keep it stable.