That is odd. My father eats about 50 grams of carbohydrate per day (the past couple of months he has been below 20). He just went to the doctors maybe, 3 days ago. The doctor was amazed with his cholesterol levels - he said they were better than his. Now my dad is 60 years old and 350 pounds, how often do you think 40 year old doctor sees someone like my father come in with better cholesterol levels than his?

He currently eats what I eat (you eat). Bacon, HWC, Pork, beef, bacon, eggs, etc.

So anyway I am not really qualified to make this assessment but I am definitely leaning towards agreement with the others in this thread that think you need other tests done. So far as I know, have researched and personally seen a high-fat high-cholesterol (low carb) diet does not adversely affect cholesterol and triglycerides.

Some people have amazing results with their cholesterol on low carb. Their LDL will drop along with triglycerides. Other people will see their LDL shoot up. While some of that can be explained with how the LDL calculation fails when triglycerides are very low, it doesn't explain every case.

As we've seen a few times, this also seems to go hand-in-hand with people who produce a lot of RT3 on low carb.

So, it isn't everyone, but it isn't all that infrequent either.

So, I went back to the doc to ask for the additional thyroid tests and he refused, saying that the TSH test was the "gold standard" of thyroid tests and mine was fine. When I pressed, he interrupted, saying that all the other tests I had asked for beyond the standard lipid and metabolic panels were pointless as well. He then asked me to find another doctor and showed me the door. Clearly, it was his way or the highway and he simply didn't want someone like me as a client. At least he didn't charge for the visit.

Anyway, on to plan B. I'll give the changes to my diet and supplimentation a couple months to work and then go back to my old doctor to get my lipids checked again. Maybe he'll order the thyroid tests for me too, but I doubt it. If my LDL hasn't dropped much by then, a statin may be my only option.

As for thyroid......I've increased my carb intake to between 50 and 80 carbs a day on the chance that my T3 levels are low. Yes, it took me out of ketosis, but I've seen studies where T3 levels in low carbers rose when they added as little as 50 carbs to their diet, and not knowing whether I'm low on T3 or not, I'm just trying to cover all the bases. Can simply eating 50-100 carbs/day correct for low T3?

Since you are here for advice, I have to say that strikes me as a bad plan. You are going to go back to the doctor who threw you out of his office? I don't think he's cooperative.

Here's a symptom test you could fill out and bring to the next doctor; might get you more of a hearing.

And please, that LDL could be the "fluffy" type which isn't dangerous at all. If your triglycerides are low enough, you need a different calculation, as described here, to get the right numbers. For instance, this calculator gives both results.

But whatever happens, I would urge you to never consider statins. They have a rate of serious complications of at least 33%; and I'm talking the risk of ruining your muscles, your memory, or even getting Lou Gehrig's disease if you have a particular genetic profile. The "lipid theory" which is the basis for cholesterol number hysteria has been discredited; the original scientist has been shown to have rigged his data.

Don't trade a nonexistent problem for a real one.

No. I don't think I could see him again if I wanted to. By "old doctor" I meant one I used to see about 15 years ago. Sorry I wasn't clear.


Thanks. I only ticked 6 or 7 from the hypo list. I understand that classic symptoms include feeling cold and/or trouble losing weight, neither of which I've experienced. Still, I won't know for sure until tested, so this is worth a try.


The NMR results show my LDL as pattern A. But it also shows that I have a huge number of them, both large and small. See my first post for the numbers. Personally, I believe pattern A LDL to be relatively harmless as long as there aren't a huge number of them. I'm just not comfortable with an LDL-P of 3200 nmol/L.


I asked for and received a direct LDL test. The results corresponded closely with the calculated LDL. Besides, the LDL-P number is my biggest concern.


Based on what you and others have posted to this board over the years, I'd rather not take statins. I'll do what I can on my own to lower the LDL numbers and check in a couple of months. If there's reasonable improvement, I'll just continue with whatever I'm doing. If not, then I've got a decision to make. Meantime, I'll keep reading.

Thanks for the input.

Hawaiinei, if you have been following Dr. Peter Attia's long series about cholesterol, http://eatingacademy.com/ , his latest posts indicate that the particle number, not the size of the particles, are the most important predictive value and has some interesting correlations of LDL-P with LDL-C.
Like you, I am trying to just raise my carbs back up closer to 100g while still following a primal diet, mostly more veg. Beside the higher LDL numbers, some of the other concerns about zero-carb expressed at the PerfectHealthDiet rang true for me, so first trying a modest increase in carbs seems a good plan.

Btw, recently I ordered those thyroid tests directly myself through DirectLabs. The entire experience was excellent and professional, the blood was drawn at a nearby LabCorp office and tested at the same facility any doctor would have used. They offer the NMR Lipo Profile for $127 which is what my doctor prefers over VAP. Even with my insurance discount, some of the tests are cheaper to order myself than using the hospital lab. You can then share your results with any doctor you wish...or not. There are a few other online labs, there was a list of them under a thyroid thread, but my first experience with DirectLabs was flawless.

AddEdit: DirectLabs' June special is the Comprehensive Wellness Profile plus Vit D for $87, if you just wanted to re-check the non-NMR cholesterol profile and some basic thyroid, plus many others.

Well, here's an update.

I saw another doctor last week for a general checkup and he had the usual labs done. Here are the old and new results.

5/12..........12/12

337............255..........Total Cholesteral
243............151..........LDL (calculated)
63..............89............HDL
74..............73............Triglycerides
5.35...........2.87..........Chol/HDL ratio

Suffice it to say I'm pleased with the results. I knew the numbers would improve some, but I'm a little surprised by the amounts. These are the changes that I've made in the last 7 months.

a) Reduced coconut oil consumption from 3T to 1T a day (used in cooking only)
b) Cut out use of MCT oil completely
c) Switched from HWC to Half and Half for coffee and whole milk for yogurt
d) Take 2g Slo-Niacin daily
e) Suppliment with Mag, Zinc, Copper and Ubiquinol
f) Increase carb consumption to between 50 and 80 carbs/day

Like before, I continue to suppliment with 2g fish oil, eat lots of red meat, eat a 3-4 egg & cheese omelette and 3-4 slices of bacon every morning, drown my veggies in butter and snack on things like macadamia nuts and cheese. I also have not started any kind of regular exercise.

I brought in my old numbers so the doc could make a comparison and he too was impressed with the improvement. However, he still wants total cholesterol down to 200 and didn't think I could lower much further without the help of a statin, so he wrote a prescription for the lowest dose Lipitor and wants to see me in 3 months. I'm not going to fill it, though. I think with exercise and further tweaking of diet I might be able to get my cholesterol down to a number I am comfortable with.

On a side note, I do have a couple of concerns.

My glucose reading was 95. It was 80 back in May. I'm not sure why its elevated, but I don't think I'll worry about until its tested again.

He tested TSH and total T4 and they were both on the lower end of the scale.

TSH = 1.36 (range 0.34 - 5.60)
Total T4 = 6.1 (range 5.8 - 14.1)

I know free T3 and free T4 are the tests that should be done, but this doc won't do them. Basically my question is, should I have further thyroid testing done based on these results, or are the TSH and Total T4 tests completely useless?

Thanks for the update. These are terrific numbers and You should be very comfortable with them right now. Without the NMR, the best ratio to read on a regular lipid test is Triglycerides to HDL, good being under 2. With your high HDL and low trigs, yours is only .82! Also as WearBear wrote above, with trigs that low the regular formula should be recalculated with the Iranian formula.
Even Dr. Oz is changing his cholesterol/statin recs. Had the authors of The Great Choleserol Myth on his show. Links on this thread, read the article on post #5.
http://forum.lowcarber.org/showthread.php?t=448357
I have continued to follow a low carb plan but with a higher amount of non-starchy vegetables, and take a kelp tablet for iodine. I feel great and decided I don't need any thyroid or lipid tests to tell me that. I use coconut oil and butter for cooking and olive oil for salads in generous amounts, but no pushing fats beyond what is needed to make food tasty.
It sounds like you too have found an extremely healthy diet for the long term and those tests prove it. Glucose and thyroid seem fine, no reason to retest those. Enjoy your good health! all the best,

Well, without thyroid symptoms, I wouldn't sweat it, but if your FT3 is low it could cause the higher LDL cholesterol reading.

I suspect your cholesterol reduction is due to the niacin rather than any eating changes. Be sure to have your liver values checked periodically, niacin can mess up your liver.

Thanks Janet. Seeing those new numbers makes me feel MUCH better about this WOE compared to how I felt about it coming out of the docs office 7 months ago.



Yeah, I don't really have any of the classic thyroid symtoms. My concerns are based on these new results, but I guess I'm just being concerned over nothing.

Funny anecdote about the Niacin. When I went to the doc, my labs had yet to arrive. So as we waited for them to be faxed over, I told him that I had forgot to tell him on my initial visit that I had been taking Slo-Niacin for the past 7 months. He quickly said that he wanted me to stop taking "slow" Niacin because it lingers in the body too long and causes liver problems. He would rather I take regular Niacin twice a day (he prescribes himself Niaspan).

Anyway, just then the nurse hands him my labs and after looking it over for a moment he says, "well, I guess it isn't a problem". My liver enzymes were not only in the normal range, but the numbers were better than they were before I started taking Slo-Niacin. He quickly moved on to the subject of cholesterol and I felt like asking him again about the Slo-Niacin, but thought better of it. I think he's got his Niacins confused and I'll just keep taking mine.

Thanks for the input Nancy.

No, I don't think he got his niacins mixed up. When I went to Costco looking into any of the niacins for my husband, the pharmacist told me he should take the straight niacin and not Slo-Niacin because of the possible links to kidney problems. Ask a pharmacist, they know the science.

Also, your Total T4 is near the bottom of the range. If the Total is down there, the Free T4 is probably low too (needs to be around mid-range). You can get the tests done or not, but if you do, get both Free T4 and Free T3 together. You can sign up with healthcheckusa (online and go to a LabCorp near you) and get the Thyroid Panel II (TSH, FT4, FT3) for about $76.50 in December, normally $85.00. They're running a sale this month. Yes, thyroid can affect cholesterol numbers.

Your thyroid is connected to every part of your body. I'm hypothyroid, and there have been times when my total cholesterol was 30-40 pts. higher than normal for me, when my thyroid hormone replacement needed adjusting.

All niacin has a risk of liver damage:



And while it lowers your cholesterol, just like statins, it doesn't seem to make a difference for heart disease.

http://www.nytimes.com/2011/05/27/h...heart.html?_r=0

Maybe someone will finally put 2+2 together... lowering cholesterol doesn't prevent heart disease and they'll start looking for the real cause.

Based on what Dr Davis says, slow-release niacin (12 to 24 release) is the dangerous version that you want to avoid, and that Niaspan (what my Dr takes) and Slo-Niacin are both considered extended-release (~6 hours) niacin and are "far less liver toxic than slow-release niacin". That's why I question why he told me to stop the Slo-Niacin while handing me a brochure for Niaspan.

http://blog.trackyourplaque.com/201...s-are-safe.html

That said, both my doc and Dr Davis recommend straight niacin as the safest and most effective form of niacin to take. But they both say you need to take it twice a day and that the flush is quite strong. Since my liver panel looked great after 6 months on Slo-Niacin, I think I'll stick with it for now.


Wish I could, but the nearest LabCorp is a couple thousand miles away.

OP, I think your numbers look great. Stop worrying and enjoy your food and increasing health!

OP here. It's been 3 years since I last had lab work done so I thought I'd get updated readings. Since 2012 I've increased my fat intake somewhat, though not to full keto levels due to concerns with lipid levels. I also decided to start taking red yeast rice and to continue with the niacin.


Date...................5/2012........12/2012........1/2016

LDL......................243...............151................45
HDL.......................77.................89...............114
TG.........................84.................73................89
Total Chol..............337...............255..............177
TG/HDL ratio..........1.1...............0.82.............0.78

Not sure what to make of the low LDL or the HDL/LDL ratio. Plan now is to switch to full keto WOE, then retest in a few months with NMR. If LDL remains very low, may drop the RYR to see what happens.