So after three months on pretty strict paleo, my LDL went up from 87 to 111. I know these tests don't break down large and small particles, but I'm impressed with how quickly it went up. I have more than my fair share of bulletproof coffee. I'll own up to that. My doctor wants it at 70. I'm 32 5'5" and 145 lbs. She also says I need to exercise more to lower it. I don't really have a question, but does anyone have anything to add to the general doctors v/s cholesterol discussion?
Old: Chol: 162, HDL 55, Triglycerides 99, LDL 87 (not 86, sorry)
New: Chol: 190, HDL 64, Triglycerides 79, LDL 11
If I read everything correctly:
1) Your HDL:LDL ratio improved (it's actually stellar per the AMA standards)
2) Your tridlycerides went down (again stellar per conventional standards)
3) Your LDL value is average for your age
4) Your HDL falls above the threshold for 'protective'
By conventional metrics your levels are perfectly fine and your doctor is not satisfied? I say fire your doctor it it's an option.
A paleo diet (high in saturated fat) will increase both your HDL and LDL particles, but really it's the ratio between the two that is important and saturated fats should not throw the ratio out of whack. The key difference should be that your LDL becomes large and fluffy. Like you mentioned, a normal lipid profile will not show that. How is your triglyceride:HDL ratio? - Dr. Lustig recommends using that as a proxy for LDL particle size. <1 is very good. If it is >1 try eating more foods that raise HDL, and of course eat fewer carbohydrates since they are known to increase LDL and reduce LDL particle size (very bad).
I'm sure you knew all that, but just beware since a lot of doctors don't stay current with advances in nutrition science. Your LDL count really isn't that high, so I would be wary if your doctor wanted you on statins to reduce to 70.
Molly, we really need more information about your diet and cholesterol history. When I started paleo, my cholesterol was 150 LDL 180 HDL. After four months of semi-strick, often cheating, my count is 122 LDL 200 HDL.
Cholesterol is produced by the body to protect the arteries from the damaging affects of sugar in the blood. My question is, why does your doc want it THAT low?
My doctor keeps pushing for statins and feels there is very little chance that the numbers will budge enough from diet/exercise alone.
So far I've been able to fend this off by citing concerns about the ongoing longitudinal trends demonstrating the dangerous (and sometimes, irreversible) side effects of these drugs. When you take these into account the cost/benefit ratio becomes much less convincing.
If I don't continue to "win" this argument I'll look for another doctor!
Here's a link to my post a few weeks ago on my diet. Before I switched to Paleo, my weight was 150, and I ate an 80/20 whole foods diet (whole grains, lentils, fat free dairy, whole grain bread, hard cheeses, homemade semolina pasta, veggies, fish, and lean red meat followed .by more wine than I needed) My 20% was occasional takeout and sweets. My exercise has stayed about the same.
There's also a big question about where that LDL number comes from. Forget 3 months of radical diet changes (how long would you expect it take for an impact anyhow, your body is practically rebuilt after 3 months), you could get a change in that LDL figure in a few hours just by going to a different doctor. Certainly doesn't sound like you need to start worrying yet. Still, if the worst that could happen is that you do a bit more exercise to keep the doctor happy then I wouldn't worry either way.
From what is currently understood, you have very healthy ratios. In my opinion, you cannot gather anything from your numbers that should cause you to worry.
In fact, I think your numbers may have improved, with HDL rising to 64, trigs lowering to 79, and LDL settling in at 111.
Remember that your body will produce cholesterol as needed. That includes LDL particles. And it appears as if that is exactly what is happening based on your changes in diet. Nothing to worry about. Also, being female, these figures are probably even less important for you than for men.
Listen to the following podcasts from Chris Kresser. He is discussing the subject of cholesterol with Chris Masterjohn. Part 2 specifically addresses your concern about total cholesterol and LDL going the "wrong" way while HDL and triglycerides are improving.
Episode 11, Part 1, 6/7/2011 Episode 16, Part 2, 9/8/2011 Episode 25, Part 3, 2/8/2012
The same thing recently happened to me with my lipid profile. If you're losing weight on the paleo diet then your lipid profile is not going to be static because fat is being released into your blood. Take a listen. It is quite educational.
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