I had my appointment with Dr. Mark Cucuzzella yesterday, and as I anticipated, it was extremely beneficial. I brought my last two NMR Lipid panel results, as the last one that I had done in February indicated a higher TC and higher LDL than the previous one a year earlier when I had eliminated dairy for 30 days prior to the blood draw. I had called his office earlier to see if there were forms for me to fill out with my medical history (most places strictly require these), and there was nothing for me to do in advance other than show up on time.
There is a reason for this, as I discovered that Mark takes the time in the first visit to talk with his patients to learn exactly what is going on and what my health situation is, my objectives, and how I want to work with a physician. He is very thorough, and was enthusiastic when I told him I followed a keto WOE. He looked at my NMR Lipid panels and indicated that with my triglycerides so low, a reasonably high HDL, an IR score indicating no IR, an hs-CRP of 0.4, and an HbA1c of 4.9, that anything else (TC, LDL-C, etc.) was unimportant. He agreed that those on LC or keto have a very different lipid profile than those on SAD or any other WOE, and that much is still being learned about identifying valid health markers for low carbers (and I'll add, anyone else). I asked if further lipid tests were necessary, answer: "No, not necessary, as you are consistent with your dietary practices."
He spent over an hour discussing lifestyle and research. Note that his practice focuses on diabetes and metabolic health, and that is exactly what I'm looking for in a physician. We discussed physical fitness and workouts to enhance one's overall health, and he's a wealth of knowledge in the area of running fitness as well.
Next steps: I'm now making an appointment with my PCP, as he's requested a follow up from last February when he suggested I should consider statins to manage my TC. He'll likely request another lipid test, which I will refuse, as I believe these are no longer necessary for me unless there's a change in my health or diet. My approach is to be clear how I eat and why my lipid profile should be different. I respect my PCP and will find a way to work with him and Dr. Cucuzzella.