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

MommyJill2005 · 2019-04-01 15:09:38 UTC

I will be on keto about 9 months by the time I have to get my cholesterol checked again. I am bracing myself for it to be high, but not terribly worried because losing multiple inches off my waist I know will be overall more healthy for me than a lower cholesterol number.

Alecmcq · 2019-04-04 20:53:19 UTC

Jane
Please ignore this if you do not want to share, but do you mind telling us what your score was? We (both the keto community and the general public) have a lot to learn about CAC scans and what to do with the results. Also, what is your plan to deal with this?

Best wishes, it’s good that you have found out and can do something about it.
Cheers
Alec

JaneyMae · 2019-04-04 22:54:05 UTC

@Alecmcq
I don’t mind at all. Here is the email from my doc. BTW, this arrived before I got home from having the scan

Hi Jane, your CIMT study is abnormal and high risk. It shows evidence of “mixed” plaque (both soft, “high risk” and calcified plaque) in both carotid arteries. This is associated with an increase risk of cardiac event (heart attack, stroke, death from heart disease). We can talk about how to proceed at your follow up. In the interim please start a low dose aspirin 81mg if you are not taking this already.

Aggressive preventative measures for atheroslerosis prevention/regression recommended and include: Low carb diet, high quality Omega 3 1,000mg two tabs daily, Co-enzyme Q10 100-200mg daily, Vitamind D with K2, aged garlic, and antioxidants (Vitamin C, E), Consideration of Arterosil for arterial protection and regression of plaque (see www.arterosil.com, discount code:blueridgeheart).

She also mentioned a statin, but my cholesterol always goes down when I lose weight so I’m waiting to get more bloodwork before deciding. I will have been on the supplements for 6 weeks by then, and I started Keto the day after my first visit with this doc on 3/5/19. Unfortunately, I was sort of Keto (at least that’s what I thought I was doing) for almost a year before going on my last BIG BINGE for a year. Now I’m definitely in ketosis, but not losing any more after the first 6-10 lbs of water weight.

Alecmcq · 2019-04-04 22:59:57 UTC

I am incredibly impressed by the fact the Dr’s first recommendation to drive “atheroslerosis prevention/regression” is a low carb diet. That to me is a major step forward in mainstream health advice. I wonder whether this is just this Dr, or has that now become standard advice? If so, I have not heard this before.

Thank you so much for sharing. I think a lot of us at some time in our lives will go through something like this, and learning about it beforehand is really helpful. Quick question: I note there was not a numerical scan score, did they ever give you one? Or was this not a standard CAC scan? I am not very knnowledgeable here, trying to learn…

JaneyMae · 2019-04-04 23:06:00 UTC

I will add that I am a 59-year-old woman, for him most of my life at least, I’ve had a pretty healthy diet. I used to always eat a lot of fruits and vegetables, and stuck with the “recommendations“ to keep my fat and protein low. I have, however, avoided those nasty trans-fats, preferring real butter, coconut oil, olive oil, and ghee. Years ago I lost a bit of weight on Atkins, then gained a whole lot which I lost by doing calorie restriction (CRON). I was miserably hungry the whole time I was doing that, but maintained my weight at 125, having lost 60 lbs, for a few years. Then the weight gradually started creeping back, and I found I couldn’t stand being hungry anymore. I had some success with the Keto last time, but now I’m sure I was just doing low carb/high fat. I have also done intermittent fasting for a couple years, and now am pretty much OMAD all the time. This time on Keto, with the guidance of these boards, I’m doing a very strict Keto, but alas, not losing yet. It’s only been about a month though, and I have Hope’s that it will start coming off when I get the courage to fast for longer periods.

JaneyMae · 2019-04-04 23:08:10 UTC

The doctor practices Keto and IF herself, in fact, she also recommended that I do longer fasts when we discussed the fact that I do OMAD.

JaneyMae · 2019-04-04 23:15:42 UTC

Yes, I received the scores, but can’t make heads or tails out of them and the program won’t let me copy and paste. The test was called a CIMT, basically it was an ultrasound of both my carotid arteries.

Audibe · 2019-04-22 05:38:43 UTC

In regards to coffee - are you drinking Instant or some other form?

Alpha · 2019-04-22 06:52:27 UTC

Starbucks and the like when I am out.

but most times Nescafe (brand ) at home. both regular and decaf. both are the worst for my symptoms. which is bloating and problem with digestions.

I am not pointing at Starbucks or Nescafe as both are very good coffee. It is just me as David Fieldman and others have pointed out that some people get affected with coffee.

Also the net is full of article relating coffee to cortisol secretion and digestive issues.

Audibe · 2019-04-22 07:19:24 UTC

I suspect the subtypes of coffee and their degree of roasting are in play here.

Thank you for the insight

BuckRimfire · 2019-04-26 05:28:50 UTC

As Paul said above, you should be glad that your trig/HDL is now below 2. The literature is rich with papers showing that high trigs and high trig/HDL are the strongest correlates with cardiovascular disease. OTOH, the correlation of high LDL with CVD is pretty weak.

For example:
“Triglycerides and ratio of triglycerides to HDL cholesterol were the most powerful, independent variables related to precocity of CAD.”

ncbi.nlm.nih.gov

Comparison of serum lipid values in patients with coronary artery disease at <50, 50 to 59, 60 to 69, and >70 years of age.

PL da Luz, FH Cesena, D Favarato and ES Cerqueira, The American journal of cardiology, Dec 2005 15

We evaluated the relation between lipids and precocity of coronary artery disease (CAD) in the real world as characterized by increasing statin use. The highest mean values of total cholesterol, low-density lipoprotein cholesterol, triglycerides, non-high-density lipoprotein (HDL) cholesterol, and ratio of triglycerides to HDL cholesterol were found when CAD was detected in patients who were <50 years of age (p <0.01 for all); the opposite occurred for HDL cholesterol (p <0.01). Triglycerides and ratio of triglycerides to HDL cholesterol were the most powerful, independent variables related to precocity of CAD.

If you follow that link then enter “triglyceride hdl cardiovascular” in the search bar near the top, you can while away many hours reading the related results. A couple of months ago, I did such a search and found studies in several different countries that all found the same result: the most powerful predictor of bad cardiovascular health was a high trig/HDL. I should have saved the results because I don’t have the search history or the time to look them up again now!

Is your high LDL a cause for concern? Maybe a little:
“Adults with both high TG and low HDL-C, particularly those with diabetes, have increased risks of incident CHD and stroke. In particular, those with an LDL-C level ≥130 mg/dL may have an increased risk of incident stroke.”

ncbi.nlm.nih.gov

Triglyceride and HDL-C Dyslipidemia and Risks of Coronary Heart Disease and Ischemic Stroke by Glycemic Dysregulation Status: The Strong Heart Study.

JS Lee, PY Chang, Y Zhang, JR Kizer, LG Best and BV Howard, Diabetes care, Apr 2017

High triglyceride (TG) levels and low HDL cholesterol (HDL-C) levels are risk factors for cardiovascular disease. It is unclear whether this relationship depends on glycemic dysregulation, sex, or LDL cholesterol (LDL-C) level.We studied 3,216 participants (40% men, 41% with diabetes) who were free of cardiovascular disease at baseline in a community-based, prospective cohort of American Indians (median follow-up 17.7 years). Cox models estimated hazard ratios (HRs) and 95% CIs for incident ischemic stroke and coronary heart disease (CHD) in relation to combined TG and HDL-C status, where a fasting TG level ≥150 mg/dL was "high" and a fasting HDL-C level <40 mg/dL for men (<50 mg/dL for women) was "low." Models included age, sex, BMI, smoking, diabetes, fasting LDL-C level, antihypertensive medications, physical activity, estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio.Participants with high TG and low HDL levels had a 1.32-fold greater HR (95% CI 1.06-1.64) for CHD than those with normal TG and normal HDL levels. It was observed in participants with diabetes, but not in those without diabetes, that high TG plus low HDL levels were associated with a 1.54-fold greater HR (95% CI 1.15-2.06) for CHD (P value for interaction = 0.003) and a 2.13-fold greater HR (95% CI 1.06-4.29) for stroke (P value for interaction = 0.060). High TG and low HDL level was associated with CHD risk in participants with an LDL-C level of ≥130 mg/dL, but this was not observed in those participants with lower LDL-C levels. Sex did not appear to modify these associations.Adults with both high TG and low HDL-C, particularly those with diabetes, have increased risks of incident CHD and stroke. In particular, those with an LDL-C level ≥130 mg/dL may have an increased risk of incident stroke.

But that specifically studies Native Americans. Does that generalize to other populations? Hard to say. But again that is a correlation of high LDL with high trig/HDL, so I would not chase a lower LDL at the expense of higher trigs and lower HDL if I were you!

My LDL is 138 (still kinda high), and I’m not worried since all my other, more reliable, markers are good.

Alecmcq · 2019-04-26 05:39:34 UTC

Jane
How are things going? Have you researched holding and reducing CAC scores? Ivor Cummins has some good thinking in this area… hope you are ok?

JaneyMae · 2019-04-26 10:46:10 UTC

Thanks for asking @Alecmcq. I’m sticking pretty strictly to Keto. My doc has me on a handful of supplements and one she recommended is called “arterosil”, a supplement designed to reverse arteriosclerosis. (https://drjoelkahn.com/product/arterosil/). I’m hopeful that the diet, combined with the supplements and IF/EF, will take care of the issue. I was also diagnosed recently with osteoporosis, something I knew I had, but really didn’t want to know. I’m now on some good hormone replacement SQ pellets, a much more effective thyroid protocol for the Hashimoto’s, and along with the dietary improvements these things can be reversed or at least arrested. I’m due to have bloodwork next week and hope it will show improvements.

Nearly2Years · 2019-04-26 12:06:31 UTC

Jane, you mention Hashimotos. Have you read this?

https://www.lowdosenaltrexone.org/index.htm#What_diseases_has_it_been_useful_for

Also, my MD put me on full dose Naltrexone to help me fight my weight loss set point.

This is a useful drug.

JaneyMae · 2019-04-26 12:58:39 UTC

Thanks, sounds interesting, particularly since I’m 30 years clean and sober, with an extensive background working in mental health and substance abuse treatment.
I’m going to stick with my doc’s protocol for now and see how I do after getting fully adapted. She is very amenable to my desire to avoid pharmaceuticals when possible. I have had many bizarre and severe reactions to pharmaceutical medications and prefer not to cloud the issues as I try to get adapted to this WOE and the new interventions.