What about triglycerides? With your exceptional HDL and presumably low TGs, you have a strong inverse correlation with mortality. If you're concerned about your LDL, get a VAP test and you'll almost certainly have mostly large, buoyant LDL predominating.

What do your triglycerides look like? I think they are a better indicator of problems than just HDL/LDL.

I don't think any of this is really a concern until you get more info.

In addition to triglycerides which are the most useful, you might want to get a look at LDL particle size. Paleo--and meat eating in general--can increase LDL. But in absence of massice amounts of carbohydrate all the LDL will be a big fluffy type which is similar to HDL in terms of being good for you.

If you have low Triglycerides and get a LDL size breakdown and you have very few 'small' LDL, you are probably in great shape.

The science of cholesterol has changed so much that HDL,LDL and total are somewhat useless numbers at this point for determining health.

I wouldn't be alarmed in the least bit. My doctor is an idiot as well. I decreased TC by 17%, TGs by 31%, LDL by 23% and increased HDL by 22% in two months and she still wants to put me on medication. I don't even return her calls. Our medical establishment is a bad joke, my friend. I'm not sure if these doctors even take a nutrition class in school. I bet they take plenty of "how to capitalize on pharmaceutical dispensing" courses though. LDL taken out of context is probably the poorest indicator of health of anything on the panel.

Post a typical day's worth of food between your last two cholesterol tests.

My guess is that your myristic/palmitic acid intake is still fairly high. Try shifting your fat intake to ruminant tallow.

To address the catabolism/cortisol issue, I would increase carbohydrates to 150g per day minimum. That would then likely increase testosterone assuming you don't have a marginal Zn, Cu or Se status and that you continue to eat a fair amount of quality saturated fat.

Edit: So how much butter did you eat per day in the last few months? When you eat a potato or sweet potato do you put tons of butter in it like I did? How many grams of carbs per day would you say? If you didn't really eat that much butter or coconut oil, I'd say that it might be a lack of starch as Jaminet was suggesting. Maybe that's what caused the big change for me.

To be clear, I'm not certain in the least bit that really high LDL matters, but assuming that you'd like to play it safe and have it around 200-something, you could just eat a tuber with every meal like I do and cut out all butter and see how it goes. I would estimate that I'll be back within that range in 3-6 months.

As a whole, your diet looks excellent and will produce far better overall health and longevity than anything your doctor would have you eat, if they even mentioned diet. Shouldn't have to worry about missing out on any micros.

Any cause for concern?

Let's not elevate it to CONCERN, but let's be real here: you might have something that, as you get older, bears watching. Continue to seek and don't panic by any means. You're 28, which means that you're at a ridiculously low risk for any cardiac issue.

Keep looking and seeking. You have shown that you're not afraid to tinker and test with your diet, so keep doing that.

Best wishes.

I'm getting very suspicious of supplementation with fish oil and Vit D. I know this runs counter to what the big names in the paleo community say, but my LDL cholesterol jumped from 114 to 240, and the major changes were 5:

• High fat
• Low carb
• Vit D supplementation
• Fish oil supplementation
• Age

Of course there might be other reasons for the rise in my LDL cholesterol, but I decided to stop taking fish oil supplements (and get O3 from real fish), to ditch the Vit D, and to take another test soon.

I'd keep a cautious watch and see how things proceed. SOme doctors have noted initial higher cholesterol readings after beginning paleo, but then those numbers later go back down. Also, there can be quite a bit of natural variation in cholesterol readings between one day and the next and also quite a bit of variation between lab testings. I too am still not sold on fish oil pill supplements, but occasional modest use probably is not a big deal either way.

THis one is tricky. There have been other weird symptoms and by the description of the situation, I am not sure if they were present before paleo or only came to pass after paleo. So it's hard for me to say much in that regard. However, if triglycerides are not high, and/or if there is correlation in the timing of the probs with paleo, one option might be to try a bit more healthy carb, especially if the person is not overweight and/or is a heavy exerciser. Paleo is often lower carb than SAD but it is not a requirement for it to be very low carb. SOme paleo eaters find that regular consumption of healthy starches and a moderate amount of fruit help them feel at their best.

Cholesterol Is not a parameter that is significantly worth worrying about. Scientific evidence does not support C as the cause of anything to have angst over. It is right there in the 'over blown - hyped' column.

Hey, don't worry at all! Maybe you have a hidden inflammation. Did you check your c-reactive protein? Anyway, check this out: http://www.youtube.com/watch?v=uv2Z3UWYJKk&feature=related

Many have asked about the VAP Cholesterol Test and its value in this forum. I encourage you to see patient cases and sample VAP Test lab reports on Dr. Michael Cobble's lipid discussion at http://www.cobblescorner.com. The post "Marathon Man" might be of interest to those with the paleo lifestyle.

Hate to make this belated observation but your Lp(a) is high. It's a genetic factor that cannot be addressed by diet or medication, unfortunately. But you should still do something about it. Google Dr. Sinatra and see if his steps for lowering LP(a) makes sense. People claim to have lowered Lp(a) using his method. You should lower that to under 8, if possible. Do you have a family history of CVD on either side of the family tree? Your rise in TC also could be that you're ApoEE.

Now the other possible issue is your kidneys. Your BUN and Creatinine are high for a 28 year old guy. I dont think that's because you're overding protein; you seem to be eating enough carbs. Were u tested for Lupus, Lupus Nephritis? Did your rheumy check for ANA and antibody tests for various connective tissue related diseases? If you're positive for RA, then it's best to avoid dairy, even raw dairy, and all nighshades.