Paleo Diet and Paleolithic Diet Questions & Answers

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Got a couple blood panels, and here are the results. Doctor wants me to followup with a VAP because she's concerned with my cholesterol results (go figure). I actually wanted them to do the VAP right away, but they wanted me to take the metabolic panel first. The practice is low-carb friendly, but I get the impression that they're not too well versed with paleo despite this.

Any thoughts from the paleo crowd? Age 31 male, ~160lb, 6'2".

Testosterone, Free-tot, LC-MS-MS

Testosterone, Total, LCMSMS     598
Testosterone, Free              87.9

TSH* W/Free T4 RFX

TSH             1.72

CBC (includes DIFF-PLT)

White Blood Cell Count      6.4
Red Blood Cell Count        5.18
Hemoglobin                  15.6
Hematocrit                  46.6
MCV                         90
MCH                         30.0
MCHC                        33.3
Platelet Count              170
RDW                         13.6
MPV                         10.3
Absolute Neutrophils        3834
Absolute Lymphocytes        2150
Absolute Monocytes          314
Absolute Eosinophils        83
Absolute Basophils          19
Neutrophils                 59.9
Lymphocytes                 33.6
Reactive Lymphocytes        0.0
Monocytes                   4.9
Eosinophils                 1.3
Basophils                   0.3

Hemoglobin A1C

Hemoglobin A1C              5.3

C-Reactive Protein

C-Reactive Protein          <1

Vitamin D, 25-hydroxy, LC-MS-MS

Vitamin D, 25-OH Total      55
Vitamin D 25-OH, D3         55
Vitamin D, 25-OH D2         <4

Comp Metabolic Panel W-eGFR

Sodium                      140
Potassium                   5.1
Chloride                    103
Carbon Dioxide              26
Glucose                     88
Urea Nitrogen               16
Creatinine                  1.19

Calcium                     10.2
Protein, Total              7.3
Albumin                     5.1
Globulin, Calculated        2.2
A/G Ratio                   2.3
Bilirubin, Total            1.0
AST                         17
ALT                         21
Alkaline Phosphatase        38
Non-African American eGFR   81
African Amerucab eGFR       94

Lipid Panel

Cholesterol                 320
Triglycerides               69
HDL Cholesterol             87
LDL Cholesterol, Calculated     219
Cholesterol/HDL Ratio           3.7

Update (06/07/2011):

VAP Cholesterol Test

Total LDL           207
Total HDL           78
Total VLDL          17
Sum Total           301
Triglycerides       55

Total Non-HDL       223
LP(a)               8.0
LDL                 14
Sum Total LDL-C     207
Real-LDL Size       Pattern A

Remnant Lipoproteins    24
No constellation of lipid risk.
HDL-2                   27
HDL-3                   51
VLDL-3                  10
Total APOB100 Calc      135

edited Jun 7 2011 at 17:20

asked May 19 2011 at 22:22

WyldKard
2,302●1●10●27

	Updated with VAP results. Doctor indicated that everything is likely fine, but suggested a CIMT test to verify that the cholesterol levels are indeed benign. Thoughts? – WyldKard Jun 7 2011 at 17:23
	For those interested, my CIMT results came back and there is no evidence of atherosclerosis. In fact, my "arterial age" is 21, and the doctor stated that my scores were the lowest she's ever seen, on par with the "control" group which is some sort of hunter-gatherer group (she believed it was native Inuit). – WyldKard Aug 19 2011 at 13:49

Dexter · Answer 1 · 2011-05-19 22:43:07Z UTC

I think you should be happy, very happy. Everything looks good and your VAP more than likely will show you are mostly Pattern A, large bouyant particles.

Your HDL/LDL 87/219 = .39 is excellent. Anything above .3 is great and preferable over .4

More paleo eating will keep you and your lipid panel happy. If your VAP show a distribution of 50/50, just keep on trucking with paleo as you have practiced.

Vit D3 level is fine. The Quilt wants his clients to be 70-100ng/ml. You could be a little higher here by a little more sun during the day or a bit more supplementation.

Namby Pamby · Answer 2 · 2011-05-20 05:00:59Z UTC

For a 31 year old guy, your creatinine seems a bit high and, as a result, your GFR is low. Have you have kidney-related problems? Your calcium is also high normal. Based on just your GFR only, you could be taken for someone at Stage 2 of Chronic Kidney Disease, CKD (unless you're African American) ... not to worry, very mild. I would get your Parathyroid Hormone (PTH) tested with calcium and redo the GFR, as they all could have been faulty.

The Quilt · Answer 3 · 2011-05-20 11:01:30Z UTC

The labs on absolute numbers are fine. But to point out some finer points.....Your Testosterone for a 31 yr old male is not optimal. Your free T is also not optimal. Neither is your Vitamin D. My bet is you have a very mild case of Pregnenlone steal likely from higher levels of cortisol.....I would suggest you get salivary cortisol checked to see what that is doing. Clinically tracking your sleep will tell you if the cortisol is a problem. If I am correct then fixing that will autocorrect the T and D issues. The reason is cortisol T and D are made from the same precursor and evolution dictates that we make cortisol first before T and D because its more important to be able to run away from a Tiger than have sex or protect you bone or immune system.

Your kidney function is low and that is likely secondary to volume depletion and dehydration. So I suggest you drink more water too. If you are supplementing creatine I would back off a bit

grace · Answer 4 · 2011-05-20 20:59:54Z UTC

How long have you been paleo?

I'd agree the SCr (kidney) test is mildly high which could be temporarily high from dehydration or if you have more muscle mass compared to the average person. You seem skinny from your stats but are you a hard gainer or is your BF (body fat) < 10%? High muscle mass translates to higher SCr which is innocuous.

Not enough sleep!!! Sleep makes people bionic -- and grows GH and T (growth hormone and T) and lowers cortisol as others have mentioned above.

Don't worry about the LDL --- as Dexter mentioned likely the $99 VAP will just verify how great the labs otherwise are. FH (famililar hypercholesterolemia) is common among northern Chinese and northern European descendants. It indicates apo E status, that is all. Your body may absorb more cholesterol from the GI than normal (and toxic chemicals and toxic metals). Avoid heavy metals, contaminated tuna/seafood, scented products, petroleum products etc (which increase estrogenic effects anyway). These are all neolethal and best to avoid but specifically in those apoE4/E4 (aluminum is associated with Alzheimers in these folks studies show).

I think the liver tests are mildly high -- > 15 for guys (> 12 for women) is sometimes suggestive of mild NASH/fatty liver. How much fructose and carbs do you consume? consider < 100 grams daily if you are eating a ton. I think there is some mild insulin resistance and possibly estrogen dominance from the T, lack of sleep and ALT/AST status.

Have you ever read Ori Hofmekler? Read him. He's the author of the warrior diet -- he has good info on how to up the T and lower the estrogens...

Would love to hear about the improvements later!

What do you thnk about these blood results?

4 Answers