I hit 393 with heavy butter/cream consumption. I would wager that simply removing that will cause it to plummet, as it did for me. Paleo has created a Healthy Fat monolith that doesn't account for the differential response to various ratios of specific fatty acids. Butter and cream are twice as hypercholesterlemic as coconut oil, which is itself considerably more hypercholesterolemic than tallow.

That we've been sold a bill of goods with regard to saturated fat from healthy animals doesn't then mean that one can't create potentially dangerous aberrations with evolutionarily novel fats in large amounts.

Hey Bryan--

Keep in mind that cholesterol isn't a disease but rather an indication that something is going on in your body for which cholesterol is needed. There are many things which commonly elevate cholesterol, which may include things like: depressed thyroid function, excess dietary carbohydrate (unlikely due to your healthy HDL number and triglycerides), chronic infection (viral, bacterial or parasitic), chronic stress, lipopolysaccharides (due to dysbiosis) and (drumroll) a possible inflammatory process. As you indicated, you have psoriatic arthritis--an autoimmune disease (always inflammation-prone). One thing is certain: you do not have a carbohydrate deficiency. In fact, you would be more prone to inflammation with increased insulin production. The Paleo diet is perfect for you. As someone with autoimmune you WILL be prone to flare-ups and cytokine storms from time to time with antigenic exposure and stimulation of immune polarity. There's no question this can and will imact your cholesterol numbers from time to time. It happens. It also happens a lot less frequently on a Paleo Diet than a carbohydrate-based one. This is periodically likely regardless of the far healthier diet you have been on and you will find these numbers go up and down accordingly. That said, there is a ton you an do to modulate your immune response and help mitigate these flare-ups so this happens far less frequently and less tissue destruction occurs over time.

The very good news here is that there has never been more that is understood regarding the basic mechanisms behind autoimmune illness and how to modulate it naturally. There's a ton you can do. I don't see your cholesterol as the biggest issue here, and I would typically be more inclined to look at a broad array of other markers to better determine where the imbalances are and what might need to be prioritized. Cholesterol information alone is far from enough to really tell you very much. If I were you I'd get some Cyrex testing (Arrays 2, 3 and 4) ASAP to figure out at least some of what might be triggering this. You can contact Cyrex at www.cyrexlabs.com) to find out more. I'll be writing about all this more in the future.

I hope this bit of info is helpful to you.

Best of luck!

Warmly,

~Nora Gedgaudas (author of Primal Body, Primal Mind)

There are some good Apo E and cholesterol discussions here

http://paleohacks.com/questions/55153/hack-my-ignorance-re-apo-e4#axzz1nyb4nqVQ

http://paleohacks.com/questions/36855/i-think-i-may-have-figured-out-why-some-of-us-have-really-high-ldl#axzz1nyb4nqVQ

http://paleohacks.com/questions/80505/potential-hacks-resolve-heart-brain-dilemma-for-apoe4/98807#98807

I'd ditch the cream.....thats about all I'd change and then I'd test again.

Are you LC/VLC? I was reading some articles yesterday on PubMed that LCHF diets will increase LDL.

http://www.ncbi.nlm.nih.gov/pubmed/16712573

http://www.ncbi.nlm.nih.gov/pubmed/20107198

http://www.ncbi.nlm.nih.gov/pubmed/9805219

I would also chillax on the cream a little.

I love hearing improvements thus far!!! Congratulations!! The labs may be suggestive of E4 allele(s) presence and/or FHC allele(s).

New studies show psoriasis is highly associated to peptides of gut flora breaching the intestinal lining and triggering autoimmunity leading to skin, collagen and jOint attacks where the tissue peptides resemble the breaching gut flora

In my experience what ive observed helps psoriasis is

-- thyroid replacement if refractory to diet, nutraceuticals and cleaning up the gut first

-- improving thyroid (NOW Thyroid Energy contain nearly 99% of what thyroid glands need to optimally function besides adrenal support; the adrenals are synced with thyroid and both need to usually by addressed) [as noted earlier by Korion, look at thyroid -- poor thyroid/adrenal function reduces LDL clearance at the receptor level; read: Chris Masterjohn. I shoot for upper 1/4 of normal lab ranges for both FT4 and FT3 and TSH ~ 0.5-2.0 and lowest quartile of rT3 ranges]

-- when thyroid/adrenals improve then this improves body temps improve and we evolved normal 98.6 f temps to fight pathogens and parasites; our immunity and protein enzyme work horses function better and optimally when our vitals (temp, pH, O2 sat, etc) are within normal range, no?

--Conventional medicine UV Lamp therapy (vitamin D)

--fat soluble hormonal messengers and nutrients omega3 and ADEK2 particularly Retinol and D [which all aid the gut healing/sealing in clinical trials]

--probiotics and fermented foods to alter gut flora

http://www.jrheum.org/content/33/10/2099.2.long

it's the cream. i did the same thing. i used to go through about 3 pints per week. I haven't had a drop of cream in months. now I put half and half (trader joes) in my coffee instead, and use milk in places where I previously used heavy cream (although I don't consume much milk anyway). also, I cut my butter consumption by probably 70-80%. Also also, we used to fry a lot of stuff in ghee. Now... I've made one 16oz jar of ghee in the last 4 months, and most of that got used when we threw a party and cooked a bunch of platanos.

what I am really saying is that I second Travis' answer. just because butter and cream are good whole foods that are nutrient dense and pure does not mean we should use them as diesel fuel and eat as much as we can stomach.

Supplement with d3 and remove dairy as a test.

I am totally confused about cholesterol.

The only cholesterol testing that I have had in the last year and a half is the total cholesterol test I get every two months when I give blood. I always fast for 10-12 hours prior and always give in the morning between about 9 and 10 AM, so that I'm consistent on that. I suppose the assumption on my part is that there is hopefully some sort of meaning to be gleaned from the total cholesterol number and being fasted in the same way each time will help with some sort of consistency. Or something.

Having written all of that, I have to say that the numbers I get are all over the place. I fluctuate from as high as 311 to as low as 240. I'll jump 40 or more from test to test.

Perhaps this speaks to the blood people's testing or perhaps it speaks to fluctuations in cholesterol (or a little of each). At any rate, I'm confused about what any single cholesterol test means.

So your arthritic condition has improved, you have more energy, lost weight, Gerd and hypertension dissipated, and you have a problem? WIsh I could have more problems like you.

P.S. you're probably heterozygous for FH (familial hypercholesterolemia)

Just going over the astounding amount of unsubstantiated information given out here on cholesterol and this caught my eye:

"Keep in mind that cholesterol isn't a disease but rather an indication that something is going on in your body for which cholesterol is needed. "

It would be nice to know upon what exactly this statement is based other than wishful thinking.