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  #31   ^
Old Thu, Nov-19-09, 15:24
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,189
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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HDL is included in the Total cholesterol calculation. But having such low triglycerides will also increase the calculated LDL. You have nothing to worry about!

Also, different labs use different D3 testing methods so that can account for some difference too.

Your D3 levels should be 50 ng/ml at a minimum!
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  #32   ^
Old Tue, Dec-15-09, 12:10
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,189
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
Default The Dirty Little Secret of the Diet-Heart Hypothesis

Excellent posting!

Quote:
The fact is, the vast majority of high-quality observational studies have found no connection whatsoever between saturated fat consumption and heart attack risk. The scientific literature contains dozens of these studies, so let's narrow the field to prospective studies only, because they are considered the most reliable. In this study design, investigators find a group of initially healthy people, record information about them (in this case what they eat), and watch who gets sick over the years.

Learn to love your sat. fat, folks.
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  #33   ^
Old Sat, Dec-19-09, 11:04
melibsmile's Avatar
melibsmile melibsmile is offline
Absurdtive
Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
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Hi Nancy and all other LCarbers out in Cholesterol land. My LDL is 260 right now, which is really high. That was the only bad thing in the blood work though. My Tris are down to 113 from 187 a year ago, and my HDL is maintaining at 66, which is up since before starting LC. My blood glucose was 89 after 6 months off metformin, so that was really good to see. I am guessing that the tri's will continue moving steadily downward and will get under 100 sometime next year.

I am not as concerned about the LDL as the doctor is, but I feel somewhat weird. I should be really happy about the Tri's/HDL/BG, but I'm not. I am a little concerned about the LDL. A year ago the LDL was 153 on LC. Everything that I've read indicates that it's not a significant finding and intellectually that's what makes sense, but there's some part of me that is doubting everything right now--there's some part of me that gets paranoid when it sees a total cholesterol of 349 and an LDL of 260. My official ICD-9 diagnosis has changed from "impaired fasting glucose" to "hypercholesterolemia", which is a bit unsettling. The name scares me a bit, even though there may actually be nothing going on. I wish I was one of those people whose LDL went down on Atkins, or at least stayed the same. Then my doctor would be pleased as punch. I am feeling like I need some reassurance right now. I don't like seeing my doctor make that face, but I also have no plans to abandon LC when it's helped me come so far.

I convinced the doc to do follow-up testing on LDL so we'll have more information on whether it's worrisome or not--have another lab invoice for a lipoprotein fractionation test, not sure if that's the one that I really need but hopefully will show that my LDL is all the large fluffy kind. He also included new tests for Vitamin D and B12. I am praying that the test comes back with good news, but it will be weeks before I hear the results because the health center is shutting down for the holidays. So I could get the bloodwork done next week but I won't hear about the results until mid January probably.

Do any of you have thoughts on an LDL of 260? I've never seen a number that high.

--Melissa
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  #34   ^
Old Sat, Dec-19-09, 11:31
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,189
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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Apparently thyroid dysfunction can do that. Also, your triglycerides are still kind of high. I'd expect a good low carber to have them down well under 100. Like 60ish.

Do you have diabetes and/or pre-diabetes? I think that can be one cause of highish triglycerides too. Oh you must be, you were on metformin.

You might want to look into some of the postings Awriter has been making about her thyroid and how taking some thyroid meds has decreased her cholesterol levels, like 100 points in one month.

When delving into thyroid issues keep this in mind: The lab range is pretty wide and what is represented as normal may not be optimal. So it is important to get your lab test results. Also, it seems that some people create a lot of RT3 and this isn't normally measured. That can mess up things because RT3 and T3 bind to the same receptors but only T3 is active.

Anyway, these are some ideas for you.

How are your D3 levels and do you take fish oil? Both help a lot with the heart, not necessarily cholesterol.

Read up Dr. Davis's blog, he's really good. http://heartscanblog.blogspot.com

If you're concerned enough about this, I'd join Dr. Davis' Track your plaque program and follow his recommendations. But his program is directed towards people with actual arterial plaque, not just high cholesterol numbers. But if you don't want to do that, read his blog and follow his recommendations for supplements for Vit D3, getting your thyroid in optimal order, fish oil, possibly niacin (use slo-niacin, not no-flush) and his dietary recommendations -- low carb diet, no wheat, no corn starch, etc. He gives an overview of all this in his blog but you'd probably get a better idea, faster by joining the program. Ralph, one poster here, is pretty happy to be on that program. But he actually had a heart scan and it showed he had plaque and stuff developing.

Last edited by Nancy LC : Sat, Dec-19-09 at 11:41.
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  #35   ^
Old Sat, Dec-19-09, 11:55
melibsmile's Avatar
melibsmile melibsmile is offline
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Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
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Progress: 91%
Location: SF Bay Area
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Nancy, I was pre-diabetic with impaired fasting glucose. My D3 levels will be tested in this next round of labwork. My last D3 level was 43. I have been taking 5000 IU of D3 daily before and since then. I take two capsules of fish oil each day. I haven't tried the niacin but I would consider it. Is there evidence that the no-flush niacin is effective.

My doc is going to do some thyroid testing in the next round, but he refused to order Free T3 and RT3 tests. He said that they are unreliable; I think that is what he understands from the endos. I will take a look at awriter's posts.

--Melissa
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  #36   ^
Old Sat, Dec-19-09, 12:02
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,189
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
Default

43 isn't bad for D3. Depends on the lab, some lab numbers are highish due to the way they're measured. You might want to look into the D3 testing issues at http://vitamindcouncil.org.

It's unfortunate your doctor won't order those tests, however you probably can get them still if you want, you might just have to pay for them out of pocket. There are a number of places you can self-order tests.

Here's what I go by for establishing what was a good level for myself: http://www.grassrootshealth.org/_do...hart_101608.pdf
I tested 60 ng/ml using the ZRT test, which uses the most accurate testing available. I had been on 50,000 iu a week for quite some time.

Here's info about the testing: http://preventdisease.com/news/08/090308_vit_d.shtml Some of the labs use a method that inflates the numbers by 25% or more!
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  #37   ^
Old Sat, Dec-19-09, 12:39
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awriter awriter is offline
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Plan: Kwasniewski Ratios
Stats: 225/158/145 Female 65
BF:53%/24%/20%
Progress: 84%
Default Yes, it's your thyroid hormones

Quote:
Originally Posted by melibsmile
My LDL is 260 right now, which is really high. That was the only bad thing in the blood work though. There's some part of me that gets paranoid when it sees a total cholesterol of 349 and an LDL of 260. Do any of you have thoughts on an LDL of 260? I've never seen a number that high.

Melissa,

My TC and LDL were each higher than yours -- way higher -- before I began T3 therapy. As Nancy has already noted, a month after starting the meds my TC and LDL each dropped nearly 100 points. I expect my next test to show another 100 point drop, which will put my numbers into the 'normal' level. No statins or change in High Saturated Fat diet required, thank you.

Please read some of my other posts on the subject to see what other hypo symptoms fit you, and instructions for how to take your '3-hr' tests, because given your other numbers there's more than a good chance you've got a thyroid hormone (not glandular!) problem called thyroid resistance. Only doing your temps for a week and getting Ferritin Level, Cortisol Saliva test, as well as FREE T4, FREE T3 and REVERSE T3 will give you an accurate diagnosis.

Quote:
My doc is going to do some thyroid testing in the next round, but he refused to order Free T3 and RT3 tests. He said that they are unreliable; I think that is what he understands from the endos.

Gee, another idiot doctor taking advice from major idiot doctors. Talk about the blind leading the blind!

Sure, the TSH is the so-called gold standard for thyroid tests -- IF what you're testing for is a problem with the thyroid GLAND. If on the other hand you need to find out not what hormones you're making, or how much -- but how much (if any) is actually getting into your cells, then the TSH is utterly useless and unreliable, and only the hormone tests mentioned above will show anything. Of course, you'd need to understand what peripheral thyroid hormones are and what they do in order to know that, and most PCP's don't -- and neither do endos!

As for your BG and TG numbers, I'm suspecting you are also leptin resistant, as am I (just learned once I finally demanded my doc order the test), which would explain both issues for someone on a low carb diet. I plan on writing a long post on leptin resistance -- what it is, what it does, and how to deal with it -- sometime over the weekend, if the impending blizzard allows.

If your doctor won't order the tests you need in order to properly treat your lipids and diabetes because of his or her ignorance, and if he or she refuses to get educated -- find another doctor.

Lisa
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  #38   ^
Old Sun, Dec-20-09, 23:00
melibsmile's Avatar
melibsmile melibsmile is offline
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Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
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Thank you for the info Lisa. I am going to do this round of testing with the doctor. He is ordering a Lipoprotein Subfractionation Profile aka VAP, which is:

Quote:
The VAPô cholesterol test is a comprehensive lipoprotein analysis. It provides a direct measurement of total cholesterol, LDL-C, HDL-C, VLDL-C, Lp(a), and triglycerides. Additional reported information includes the qualitative assessment of LDL particle size, HDL subfractions (HDL2-C and HDL3-C), and VLDL subfractions (VLDL 1+2-C, VLDL3-C, and IDL-C).

Test Includes: Apo B100 calculation; HDL subfraction cholesterol (HDL2 and HDL3); LDL cholesterol; LDL subclass pattern (pattern A, B, A/B); LDL-R(real)-C; lipid and metabolic syndrome assessment; Lp(a) cholesterol; quantitative measurement of total HDL cholesterol, total LDL cholesterol, total VLDL cholesterol, total cholesterol, and triglycerides (indirect measurement); VLDL subfraction cholesterol (VLDL 1+2 and VLDL3)


So I am hoping that this will show that I am not in danger of a heart attack at 30 years old after having lost 80 pounds and feeling healthier than I have in years Then maybe my doctor will stop worrying about it and we can attack the thyroid testing itself.

Do you have a sense of how expensive these tests are if you pay for them out of pocket? I'd have to do some research to find another doctor around here who is willing to find out the whole story if he is unwilling to consider it. I live in a major metro area--there must be a good thyroid doctor around here somewhere...

--Melissa

Last edited by melibsmile : Sun, Dec-20-09 at 23:05.
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  #39   ^
Old Mon, Dec-21-09, 08:54
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awriter awriter is offline
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Posts: 1,096
 
Plan: Kwasniewski Ratios
Stats: 225/158/145 Female 65
BF:53%/24%/20%
Progress: 84%
Exclamation Don't waste time on useless tests; get the tests you need

Quote:
Originally Posted by melibsmile
I am going to do this round of testing with the doctor. He is ordering a VAP.... I am hoping that this will show that I am not in danger of a heart attack at 30 years old after having lost 80 pounds and feeling healthier than I have in years. Then maybe my doctor will stop worrying about it and we can attack the thyroid testing itself
.
Melissa,

This is sort of missing the point. You don't need to placate your doctor. Your doctor works for you, not the other way around. The point is not to waste time on useless tests (you already know what the VAP will show: your risk for heart disease is exceedingly low) -- but to insist on getting the tests you need NOW.

You may feel healthy, but your high TC shows that your metabolism, which controls almost every process in your body, is ill. It needs to be diagnosed and fixed. Every day you wait your metabolism is getting worse. And there's no guarantee that your doctor will ever see the connection between the high TC and thyroid no matter what the VAP results are. Then you'll be right back where you are today, having to find another doctor, and having wasted a lot of time in the process.

Do some research on high TC and thyroid hormone problems. There's a slew out there. Print the pages out, hand them to your doctor, and INSIST on his ordering the tests you need to be done. Those tests -- not the VAP -- will PROVE what is causing the high TC, and you can then get a prescription for the drug that will FIX the problem!

Quote:
I live in a major metro area--there must be a good thyroid doctor around here somewhere.

Either Google for that -- it's how I found my Endo, or go to http://wilsonssyndrome.com and go to the doctor's list page to see if there's someone especially trained in handling these issues.

Lisa
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  #40   ^
Old Mon, Dec-21-09, 09:50
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,189
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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VAP isn't useless. Medium and small particle LDL are bad and you can have low triglycerides and still have a lot of small LDL. So it's a good idea to get it checked. What you're hoping for is Pattern A. Pattern B is bad. It usually goes along with low HDL too.

Definitely get the thyroid tests done as well. I haven't heard anything about how/if the thyroid affects the production of small LDL so it could perhaps do so.
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  #41   ^
Old Mon, Dec-21-09, 09:52
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,189
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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I wanted to be sure to post this. It's a really, really good article at Men's Health about cholesterol. It explains why having a higher than advised LDL might be perfectly fine, or might be worrisome. Please be sure to read it before resorting to statins.

Before you swallow what your doctor prescribes, we suggest you read this article
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  #42   ^
Old Tue, Dec-22-09, 17:21
melibsmile's Avatar
melibsmile melibsmile is offline
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Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
Default

Thanks for the link Nancy, it's a great article except for their equivocating on saturated fat. I have absolutely zero desire or willingness to take statins since they have never been shown to reduce the risk of heart attack or mortality in women. I don't mind my LDL going up a little if it meant that HDL and triglycerides were moving in the right direction..I just don't like seeing LDL double itself in a year. I am hoping that the next round of testing will show that it's benign, as I suspect. I will let you and Lisa know when I have results.

--Melissa
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  #43   ^
Old Sun, Jan-03-10, 09:46
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,189
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
Default

Here's an interesting posting about why insulin resistance makes triglylcerides worse, thus why so many people with Type 2 seem to have high trigs.

http://heartscanblog.blogspot.com/2...experiment.html

Quote:
The one potentially confusing aspect of all this is Gretchen's late rise in triglycerides on the low-fat diet. This phenomenon is due to something called de novo lipogenesis, or the liver's conversion of carbohydrates to triglycerides that occurs when an excessive carbohydrate load comes through diet. Because the human body cannot store anything beyond a minor quantity of carbohydrates (as glucose and glycogen), carbohydrates are converted to fats.

Another factor causing the late triglyceride increase is insulin resistance, given the high blood sugar response. When insulin resistance is present, the activity of the enzyme, lipoprotein lipase, is reduced. Less lipoprotein lipase activity allows slower VLDL degradation, allowing VLDL (and thereby triglycerides contained in VLDL) to "stack up" in the blood. Thus, the higher triglycerides late after eating and into the next morning.
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  #44   ^
Old Mon, Jan-04-10, 11:11
Elizabell Elizabell is offline
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Plan: Atkins
Stats: 145/135/132 Female 5 feet 6 inches
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I don't mean to junk up this thread with somewhat unrelated posts, but I wanted to say thank you for making this a sticky. I've been a lurker on these boards for a while now and was panicked when my LDL went up. Reading through this thread, including the various articles posted, and doing research on my own, has made me realize that what happened to me was typical for low-carbers. I also now realize that cholesterol is far more complicated and less settled than many people (including me until recently!) realize.

Thank you to all who contributed to this thread, and particularly to those who posted links to articles.
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  #45   ^
Old Sat, Jan-16-10, 17:44
melibsmile's Avatar
melibsmile melibsmile is offline
Absurdtive
Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
Default

Hi Lisa and Nancy. I got the full results of my VAP test today. The results are as follows, with the listed reference ranges if the results were out of range:

LDL 299 (<130)
HDL 71
VLDL 24
TC 394
Tris 132
Non HDL Cholesterol 323 (<160)
apoB100-calc 195 (<109)
LDL-R (Real) -C 257 (<100)
Lp(a) 12.0 (<10)
IDL 30 (<20)
Remnant Lipo (IDL+VLDL3) 45 (<30)
HDL-2 19
HDL-3 52
VLDL-3 (small remnant) 15 (<10)
LDL Density Pattern A

So I was pattern A as expected, which was nice to see. I was about a third of the over into pattern A from pattern A/B, so there is probably still room for improvement. Do you know what any of these other numbers mean? I'm not sure what to make of the Lp(a), VLDL-3, etc. Not sure if the apoB100 number is useful or not since it seems to be calculated.

A few other tests were run. My Free T4 was 1.16, with a range of 0.82-1.77. My TSH was 2.41, Total T3 was 107 (range 83-200). Vitamin D3 was 58, which has definitely improved thanks to my 5000 IU daily. My Vitamin B12 was 712.

I feel like there is definitely something else going on here. My LC diet does not explain why my LDL has doubled in the last year, even as all of my other indicators have improved. I think I need to find a doctor who is willing to do all of the testing that I need. Any thoughts or interpretations are appreciated.

--Melissa
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