Paleo Diet and Paleolithic Diet Questions & Answers

Question

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October 2011 (about 2 weeks into Paleo):

HDL cholesterol: 106 mg/dL
LDL cholesterol: 153 mg/dL
Triglycerides: 58 mg/dL
Total cholesterol: 271 mg/dL

April 2012:

HDL cholesterol: 108 mg/dL
LDL cholesterol: 253 mg/dL (!!!!!!)
Triglycerides: 57 mg/dL
Total cholesterol: 372 mg/dL (!!!!!!)
Apolipoprotein B: 169 mg/dL (!!!!!!)

Okay, my HDL went up a little and my trigs went down a little but oh my good golly gosh look how much my LDL and total went up. And my apoB levels are kinda scaring me too. I eat very strict Paleo but with dairy (full-fat Greek yogurt and grass-fed butter/ghee). I'm not low carb at all.

flag	asked May 8 2012 at 21:06 April S.♦ 11.9k●1●13●47

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FWIW, my LDL shot up also after going Paleo, with a slight increase in HDL and decrease in triglycerides. A year later, the LDL went down by about 40, with the overall ratios the same. So the upshoot in total cholesterol here may be temporary, and could be a function of your body "needing" the extra cholesterol to repair damage. As your body "fixes" itself, the cholesterol level drops again. At least, that's my understanding. – WyldKard May 8 2012 at 21:39

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What exactly are you eating? Just curious :). Also, I think you might know this already, but there is quite a few posts on paleohacks regarding dairy's ability to raise cholesterol to really high levels in some susceptible individuals. – ROB May 8 2012 at 22:12

Who are you asking, ROB? – WyldKard May 8 2012 at 22:56

Robb, wow, I hadn't heard that about dairy before. Interesting. – MeepsIsWellfed May 8 2012 at 23:05

@ROB Lots of meat and veggies (including starchy tubers), coconut oil, some nuts and dairy, rarely eat fruit. @Meeps, Travis Culp has mentioned butter increasing cholesterol levels. – April S.♦ May 8 2012 at 23:31

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Andrea Reina · Answer 1 · 2012-05-09 06:31:15Z UTC

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Cholesterol ratios may be a better predictor for CVD, but her results are still WAAAY outside normal range, and we do not have the evidence to say that her results are not problematic!

We have data that suggest that long-lived, healthy populations tend to have total cholesterol in the range of 200-240 mg/dl. I am not aware of any data that says the same thing about 300+.

April, I would recommend talking to someone with more experience in the field, not a bunch of people on the internet. Kurt Harris doesn't give medical advice over the internet, but he may know someone in your area, or make suggestions about how to find someone in your area. Chris Kresser does do consultations. Stephan Guyenet, Chris Masterjohn, Paul Jaminet: I would be much, much more confident about their advice than a random paleohacker.

answered May 9 2012 at 6:31

Andrea Reina
259●1●2

	Chris Kresser would say the same thing. chriskresser.com/… Kurt Harris said "the Lipid Hypothesis is BS". Stephen Guyenet said "the commonly measured lipoprotein pattern that associates most tightly with heart attack risk in typical Western populations is high LDL (particularly LDL particle number [i.e., direct measurement]), low HDL and high triglycerides" Her HDL is high and her trigs are low. April - If you're concerned, get tested directly for atherosclerosis, and have them check your inflammatory markers at the same time. – Tyler F May 9 2012 at 16:26
	The lipid hypothesis states that heart disease is caused by the accumulation of lipids in the arteries. Not what I'm claiming at all. Cholesterol does not cause heart disease, but it is associated. Maybe it's reverse causation (heart disease causes high cholesterol). Maybe it's another factor that causes both, like inflammation. I won't comment on what it could be, that's why I recommend she ask someone qualified. – Andrea Reina May 11 2012 at 13:21
	With respect to the Guyenet quote: please explain to me when a cholesterol level of 300mg/dl is found in the "typical Western population". Usually, when a biomarker is way outside the range we typically see in healthy populations, there is cause for concern. Usually. Not always, which is why, again, I recommend she ask someone qualified. Anyway, who says it has to be heart-related? Cholesterol has many functions in the body, only few of which we really understand. What remains is that abnormal results usually mean that something is not normal. It's a tautology, but sometimes that's necessary. – Andrea Reina May 11 2012 at 13:30

eric · Answer 2 · 2012-05-09 07:25:10Z UTC

The only thing I can write is that it appears that some people experience a rise in TC after going Paleo. I personally have experienced a decrease in LDL and a rise in HDL.

As well, I have yet to read a satisfactory explanation as to why this occurs except for the fact that people are different and have different reactions to how they handle specific foods. Maybe you could begin to slowly remove certain foods from your diet and see the practical results in a lipid test.

Tyler F · Answer 3 · 2012-05-08 22:09:22Z UTC

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Cholesterol ratios are better predictors of CVD, and yours are perfect. (Calculator here.)
And make sure they're doing a direct measurement of your LDL. 253 is incorrect.

answered May 8 2012 at 22:09

Tyler F
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	Isn't it only incorrect according to the Iranian formula? – April S.♦ May 8 2012 at 23:33
	The Iranian formula is a significantly better estimator of LDL when triglycerides are low, but neither is exactly correct. – Tyler F May 8 2012 at 23:45
	Cholesterol ratio correlations with risk are based on population estimates. Whereas these estimates might have validity in the center of the curve, out at the edges (very high HDL), n is relatively small and the statistic is basically an extrapolation and subject to greater uncerta inty. The underlying biochemistry could be totally different! Also, re the Iranian formula, people here are fooling themselves. More significant than the LDL::HDL ratio is the non-HDL::HDL ratio. Forget LDL numbers; IDLs are problematical too. – Dan H. May 14 2012 at 0:16

Kinda freaking out about my cholesterol

3 Answers