Blood test numbers - unexplained elevated triglycerides and sub-optimal cholesterol

by 0 · October 28, 2013 at 07:54 PM

Been Paleo for about 2 years now, but this is my first post on here. I've dug and dug and can't find any solutions to what I'm experiencing so I'm hoping this awesome community can help.

I consider myself a good paleo follower, practicing 80/90% most weeks in terms of food, and lifting primal while incorporating plenty of play (sports, like Basketball and Ultimate). I feel great, but have been troubled by the numbers that I've consistently gotten when I do my annual blood panels. I accidentally left the sheet in my car but I recall the numbers and they look like this:

Trigs: 151 / HDL: 47 / LDL (calculated): 131 / TSH/T4: I don't recall the numbers but they fell within the "normal" reference range

Any thoughts on what could cause this? My wife and I food prep together and her numbers were the typical rockstar profile you would expect of a paleo (trigs in the mid-40s, etc). I know my body tends to run cool (one morning I woke up at 95.7!?!?, but my TSH and T4 came back normal so not sure if there's anything there). I'm 5'8, 184 and generally lean though I carry some adipose fat around my stomach, which I literally cannot lose even when I go whole30 for extended periods of time.

Thanks in advance for your input!

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9 Replies

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15 · October 25, 2013 at 05:50 PM

5 grams of salt/day? That is pretty low, if you say paleo diets need more salt. Paleo or not you can safely eat up to 15 grams/day. Or forget all that damaging salt phobia alltogether and just salt to taste. Also there's no evidence behind all that potassium loading.

0 · October 25, 2013 at 05:35 PM


I'm new here and still learning but based on my studies here's some info that could be useful in guiding you. Borrowing from Gary Taubes book "Good Calories Bad calories" :-

1. On the diet prescribed by him with fat at 70%, proteins at 20% to 25 % and the balance from complex carbs such as green salads etc your Lipid profile will over time change as follows:-

a. Your overall cholesterol will rise, but that is not necessarily bad as you will understand below.

b. Your good cholesterol which is HDL, will rise too which is good.

c. Your so called bad cholesterol will also rise but change in character from small dense particles (which burrows into artery walls ) to fluffier large particles which are relatively harmless.

d Your VLDL which is the really bad cholesterol should reduce significantly

e. Your trigycerides should come down to well within a healthy range but since this has not happened I assume your more sensitive to carbs than others and are therefore not eliminating enough carbs. I would advise you to :-

1.Look at trying replace more carbs with fat as given above.

2. Read Dave Asprey's Bulletproof Executive website and while I wouldn't advocate you go the whole hog with the entirety of what he prescribes ( as I do not have the relevant personal experience with his complete protocol yet) one area which seems to work and may be of use to help u cut past your inability to use your triglycerides as fuel and thereby reduce them is his INTERMITTENT FASTING method. (his other method of Rapid fat loss fasting protocol sounds too dangerous and is not advocated by even him so do not go in that direction ).

Otherwise, fr your information and in my humble opinion ( again borrowed from a lot of studies but primarily from Gary Taubes ) saturated fat is good for you and fatty meat (not lean meat, in fact the more fat the better) will help your lipid profile. I know this sounds strange and even I have to keep telling myself to look at the science and not go by what I have been conditioned to hear by the media and public health authorities but that is the truth as I understand and believe it.

In your quest fr information dig a little more and validate what I say by using the following resources:-

1. Get a copy of Gary Taubes simpler (not so technical and with more practical tips ) book - "Why we get fat and what to do about it ". Just fr your info, Taubes is an investigative journalist who has done a stellar job of explaining the history and science of low carb dieting, obesity, heart disease and to an extent the cholesterol enigma.

2. Visit Dave Asprey's website "the Bulletproof Executive".

Good Luck !!

2318 · October 25, 2013 at 04:47 PM

Lowering carbs to less than 50g/day is likely to put you in a state of dietary ketosis, where you're burning dietary and body fat for fuel. This isn't bad, but you need to take some precautions, namely increasing your electrolyte intake, esp. salt. At this level of carbs, Dr. Steve Phinney says you can safely eat up to 5 *grams* of salt/day, since the kidneys rely on insulin signaling to retain water (salt's water-soluble), and you won't be creating much insulin. Also, eat more potassium-containing veggies, such as swiss chard (960 mg/cup (raw) or 960 mg/cup (cooked)), or low-sodium V8 (800 mg/cup) (but 10g of carbs). If you tolerate dairy, eat some cheese, yogurt, or raw milk (not just organic) for calcium. Supplement with chelated Mg., too.

I sympathize about having to work extra hard to get a normal lipid profile; I'm on the tail end of some genetic distribution curve, too.

Medium avatar
15 · October 25, 2013 at 02:57 PM

Paleo dieting causes unfavourable blood lipids, there are dozens of reports here and on other paleo boards. What you NOT want to do is restrict carbs even more and exercise even more, that is the opposite direction to go.

Hypothyroidism is a major cause of elevated LDL. An impaired liver due to excessive exercise and lack of glucose will lead to reduced T3 production, elevating your lipids.

7944 · October 25, 2013 at 03:28 AM

Trigs are directly related to dietary carbs. If you want to get that number down, reduce the carbs. To get HDL up, more omega 3's--fish and pastured eggs.

2318 · October 24, 2013 at 08:30 PM

Yes, your triglycerides are high, cholesterol concentrations don't typically matter, unless you have familial hypercholesterolimia, TSH is irrelevant, and your need *free* T4 and free T3 tests performed before you claim something's wrong with your thyroid.

Also, get an LDL-P test to see if it confirms the LDL-C test, and get a carotid calcium scan as a confirmation before you start freaking out.

10 · October 24, 2013 at 07:59 PM

I am hypothyroid (apparently Hashimoto's) with elevated TSH, which is usually controlled with meds. I've been taking Levothyroxine for about 5 years. However, my triglycerides have always been good; as is my LDL and HDL. Last labs I had an HDL of 68 and that was BEFORE going paleo. So I'm not sure there's a connection, necessarily, between thyroid and cholesterol. If you had thyroid disease, you would likely have unpleasant symptoms, like fatigue, alternating with feeling wired, weight gain, lethargy, irritability and exercise intolerance. I had all those things when I was diagnosed . . .now I have them occasionally.

0 · October 24, 2013 at 06:25 PM

Won't let me reply to you @samc so having to reply in an answer...

Re: test accuracy, this test confirmed a previous test &I'm finally distraught enough about the #s to seriously dig into it. I used to chaulk it up to "I feel great, so disregard" but I just don't think something adds up. Interesting idea about lean meats and easing up on sat fats, but won't the lean meats tend to turn into glucose in the blood? Guess everyone reacts differently though.

Looking at possible diseases or illnesses is the thing I think is the culprit, but frankly, I'm clueless as to what it could be if not hypothyroid. Also my blood pressure tends to be a touch high~135/70

Medium avatar
190 · October 24, 2013 at 05:47 PM

If it was me, I'd try going to lean meats and easing up on saturated fats. This would be an experiment for a few months and then retest. But are we then just chasing numbers? I'd also investigate the possible diseases or illness that can cause the elevated numbers. I'd also want to make sure the lab numbers were correct. Often times the results show that they went back and retested do to out of range results. I had that issue with a urine test and the doc had me scared for no reason, reran the test and it was fine.

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