Hi all,

I've been doing low carb for something over a year. Just for heck I asked my nurse practitioner to check my cholesterol levels. The nurse just called me & wants me to come in to talk to the practitioner because the results were really high:

Total: 460 (should be less than 200, she said)
Triglycerides: 48 (should be less than 150)
HDL: 110 (should be more than 40)
LDL: 340 (should be less than 130)

The last time it was checked (maybe 2 years ago) the values were in the normal/good range.

Has anyone had anything like this happen? Any thoughts?

Thanks, Beth

I'm about to have mine checked this week so I'll find out! In the meantime I would at least think about having the test redone in case of possible lab errors. Otherwise I don't have any ideas.

Why your cholesterol levels went up on low carb

The value for LDL cholesterol is calculated and the calculation breaks when triglycerides are < 100. Also, your TC goes up when your good cholesterol goes up too. Be assured that with such low triglycerides your LDL is large and bouyant and not going to be a problem. Not something most doctors know about so you might want to dig up the info for her and educate her on it.

Unless they actually measured particle size (and did not calculate), the only significant number you posted is Triglycerides. And since that number looks FANTASTIC, don't stress the rest. If your doctor is stressed out over the other numbers and being a pain, make doc give you the test where the particle size is actually measured (lipoprotein subfraction testing).

Beth, RUN -- don't walk -- to look up all the information you can on Hypothyroidism. I imagine you're going to see that you have many of the symptoms.

One little well known symptom that has been written about extensively in medical journals though not in mass media, is that very high TC and LDL levels, absent other markers of heart disease (like high Triglyercides and low HDL) is a classic indication of hypothyroidism.

You have very low TGs and very high HDL, so markers of heart disease ARE absent, making your TC and your LDL a huge indicator of hypo.

Medical Journal articles all say that if this turns out to be the case there's only one treatment to bring down your TC/LDL: thyroid medication. With it, your TC/LDL should drop like a stone.

If you do have many other symptoms of hypo or even if you don't, get to an endo and have him or her order the following tests. They must ALL be done without exception or a true diagnosis of sub-clinical hypothyroidism won't be possible. Don't be foisted off to a simple TSH -- that alone will tell you nothing.

You need:

TSH
T4
Free T4
T3
Free T3
MOST Important: REVERSE T3

Plus:

B12
Ferritin
Fasting Insulin (not just fasting glucose)
Cortisol

Get these done and post the results here, and don't forget to do your hypo research. Don't worry, all will be well -- these are classic symptoms.

Lisa

Actually, I have close to none of them. My hair is a bit thin :-( and I get muscle cramps, but low carb produces the muscle cramps & sadly, hair loss happens to some people. I don't have any of the rest of them.

Thanks, Beth

Awesome -- you & Wifezilla have given me what I need. I had found a post that talks about the particle size, but knowing that they are calculated is the trick. :-)

Thanks, Beth

I can ask for the tests anyway, just for heck -- but if I don't have any symptoms, I don't think there is a problem. The web page I found says that the symptoms can get worse with time, but if there aren't any then I doubt it matters.

Thanks, Beth

The most common symptoms of hypothyroid is fatigue often extreme, sleeping a whole lot and still feeling tired, feel cold when everyone else is warm, and the I hate most: inability to lose weight when even very low calorie.

Beth, you have one of the biggest symptoms of all -- extremely high TC for no reason at all.

And guess what? That was my only symptom too (outside of not being able to lose weight after a while, and low body temp) -- and the tests showed that I was in fact, hypothyroid. I have a major reverse T3 problem, which means that although my TSH is normal and happily making T4, all my T4 is converting into RT3 instead of T3, which is what the thyroid actually needs to function well.

I've been on meds for about 3 months now, slowly ramping up the dose, and the changes have been remarkable. Weight loss has restarted (especially fat loss), my energy level has reverted to what it was two decades ago, and my body temp, which could never get over 97 at its highest (95.5 - 96.5 was the norm) is now 98.4

And oh, yeah -- my LDL dropped from 283 to 180 in the first month. I go back for a full blood panel in December.

Lisa

was this test done after fasting?....nearly anything can raise chloesterol levels.

I am losing weight, so that isn't a symptom. It is happening slowly, but I am also running a very small calorie deficit. I figure that if I eat only a little less than I burn, I won't be hungry to speak of. So far, it is working.

I have a low temp, but I have read (and it makes sense to me) that this is associated with longevity, so I would not want to mess with it. Also, my temp has been low for years & the last time my cholesterol was checked (before low carb) it was normal, so I am inclined to think it is diet.

My theory right now is that I have very large LDL particles, which would raise the total weight of that fraction of the blood. I am inclined to ask for a fractional LDL measure, to look at the LDLs in more detail.

I'll ask the doctor to run the hypothyroid panel, though, what the heck.

Thanks, Beth

A priori, total cholesterol, and even individual subsets like LDL, are a bad predictor of disease. See here:
http://high-fat-nutrition.blogspot....een%20countries

Then print and keep this in mind when you do go see that "practitioner":
http://www.proteinpower.com/drmike/...et-your-doctor/

And here's a site where all kinds of trouble are being brewed by people who are probably, certainly, several times more knowledgeable than the practitioner you're about to go see on the subject. But don't tell him that.:
http://www.thincs.org/

And finally, this is for your own personal peace of mind since it says you eat "Just no carbs". I presume that you eat mostly meat and probably cheese.:
http://www.jbc.org/content/87/3/651.full.pdf+html
(At the end of the document, page 17)


From my personal experience, my lipids went through the roof when I cut out all carbs. LDL and total cholesterol was especially high. HDL used to be double what it is now during the time I supplemented with vitamin D.

Finally, really, here's a post explaining it all:
http://forum.lowcarber.org/showthread.php?t=54255

First, I'm not a medical doctor.

That said, a few thoughts:
1. I'd have a second cholesterol test. The values are rather unusual, and the possibility of a screw up somewhere in the testing process is nontrivial, particularly given your previous normal test.

2. The goal of under 200 is weird, given that that level does not minimize all cause mortality. Yes, it's "standard," but that doesn't make it good.

3. Focusing on total cholesterol isn't helpful in any event. The two big numbers for predictive purposes are HDL and tryglycerides, and LDL is supposed to be unpredictive of much of anything. You're doing great on HDL and triglycerides. However, the LDL of 340 is enough of an outlier that I wouldn't trust the result that it's not predictive to hold that far out. Any lipid experts out there?

I wish low carbing would shoot up my cholesterol levels. I'm around 130 total typically, and there are health risks (cancer and stroke) that low :-( Up for a blood swap? Half of mine for half of yours? ;-)

joe

I went back & read the chapter on lipids in Good Calories, Bad Calories last night & I think I know what might be going on (besides a bum test, which is possible). When I went low carb, I decided that I'm not afraid of no saturated fat & started eating it. I'll bet that bumped up the LDL.



Taubes agrees that it's weird, but in politely damming tones.



This is the relevant summary of what I got from reading Taubes:

• total cholesterol isn't a predictor of risk
• HDL & triglycerides are predictive. These move together in an inverse relationship -- if HDL is high, triglycerides will be low. The high HDL/low TG pattern is protective against heart disease.
• LDL isn't measured directly, fwiw, but inferred from the other numbers (as was pointed out here)
• Eating saturated fat raises LDL & so total cholesterol

However, there is one more interesting point. LDL itself is not a single entity, but comes in "good" LDL & "bad" LDL. The good stuff are the light, fluffy LDL and the bad are the small dense LDL. These also don't vary independently of the HDL/TG pattern -- the high HDL/low TG pattern is associated with the large fluffy LDL, the low HDL/high TG with the small dense LDL. It's the kind and not the amount of LDL that matters for heart disease risk.

When looking at LDL, it appears that it is the number of particles (which can be measured by looking at something called ApoB) that is revealing. Lots of particles implies small LDL. Wikipedia says



Thus, I think I shall ask for an apo B test, but for the most part, I think my numbers are fine, except for the part about freaking out my nurse practitioner. I just got her too, I wouldn't mind too much easing her into understanding what a maverick I really am.



Eat meat, eggs, cheese and heavy cream and almost no carbs. It seems to have worked for me. :-) BTW, Eades, in his latest book, is all over how good saturated fat really is for health.

Thanks, Beth