Paleo Diet and Paleolithic Diet Questions & Answers

Question

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I've done a fair amount of research in advance of my annual physical expecting that my lipid panel in terms of total cholesterol might be an issue for my doctor. This site, Kresser, Robb Wolf, Mark Sisson, FTA, all have numerous articles on the matter.

That being said I'm freaked out because I think I have to do something fast or else in 6 weeks when I test again if things aren't better my doctor will pressure me to go on statins and I won't do it. I have listed these results exactly as they are on the report. My results are fasted (16 hours).

Cholesterol (Total): 315 mg/dL Triglycerides: 70 mg/dL HDL-Cholesterol (Direct): 50 mg/dL LDL-Cholesterol (Direct): 228 mg/dL

Per my research I understand that ratios are important so here they are: Total/HDL: 6.3 (high) (ideal = 5 or below) Trig/HDL: 1.4 (ok) (ideal = 2 or below) LDL/HDL: 4.56 (ok) (ideal = 5 or below) I do not know LDL particle size.

Supplementation: 5,000 IU daily of D3 Diet: Mostly pastured animals and eggs. Grass-fed beef. Carbs under 100 per day except for my binge into Halloween candy days prior to the blood work. Only dairy is heavy cream in my coffee daily and ice cream splurges maybe on average once every other month. I average a piece of fruit every other day...not a lot...and usually then just berries. My highest carb diet staple is probably butternut squash. Negligible potato. No rice. No legumes except green beans. No grains. No processed foods (probably obvious but thought I'd mention.). Limited nuts and dark chocolate...those are treats. Exercise: Not sure what to call it...three sessions per week at 38 minutes each of weights with intervals to tax my cardiovascular system.

When I lost weight in the past and was non-paleo I ate chicken and fish and very little beef, eggs, etc and my total cholesterol was 115. I have no idea what my other values were. While I understand that total cholesterol isn't the full picture, I feel like that kind of a diet over the next few weeks may get my numbers to where my doctor likes to see them so that he won't pressure me into taking statins.

What do you conclude about my lipid panel? Is the direct (NOT measured) LDL of 228 a real problem? Perhaps inconclusive without knowing the size, but is there anything you can suggest? How might I change my diet in the short term to test better in 6 weeks? It looks like my HDL would ideally be higher and my trigs lower based on other paleo panels I've reviewed.

I will ask for a VAP next time. I don't know if they'll do it or not but I'd really like to know what kind of LDL I have. I'll pay for it if I have to.

I also have other values that I can share from CMP (comprehensive metabolic panel) if more information is needed.

Thank you in advance for any suggestions.

flag	asked Nov 13 2011 at 21:58 Cheryl 31●1

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Let your doctor pressure you to go on statins you don't have to comply. Your body - your choice. – Sue Nov 14 2011 at 0:10

Thank you for your reply. I will fight the good fight if I need to, but I guess bottom line is that I'm concerned that something is awry and needs to be addressed. For my next blood workup I want to make sure that my LDL particle size and number is optimal and have my thyroid and inflammation checked. Prior to the next workup I want to see if I can optimize my LDL, HDL, and trigs so that even if I'm not under 200 like they want, I'm under 250 and my total:HDL ratio is good. – Cheryl Nov 14 2011 at 13:04

Phoenix · Answer 1 · 2011-11-13 23:40:49Z UTC

Those numbers really don't look too bad. Low trigs, pretty good HDL. The high LDL may or may not be a problem, and I think that depends on inflammation levels in your body and thyroid function. High cholesterol with poor turnover that exists in a high-inflammation environment is where problems arise, in my opinion. Your diet looks pretty good to me, so I wouldn't be too worried. Make sure you're getting lots of low-intensity activity (walking) and not snacking to keep those trigs down.

That all being said, if I were in your position I would aim to get my LDL down as that kind of level is probably not part of the evolutionary norm. The easiest thing to try is to greatly reduce (or eliminate) dairy fat, as some people's cholesterol seems to be greatly influenced by the particular ratios of fatty acids in cream, butter, etc. Another potential reason for a high LDL could be micronutrient deficiency (eat your liver!)

Namby Pamby · Answer 2 · 2011-11-14 00:12:22Z UTC

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I would look at some possibilities before sounding alarm bells: (1) are you in the midst of losing weight rapidly; (2) were you overweight/insulin resistant and previously had high liver enzymes; and (3) are you perhaps hypothyroid?

If none of the above and if your TC was only 115 and now it's skyrocketed to 315, then join the club. It's called the Apo E4 club, which is presumed to be 25% of the population. In a significant minority of dieters, TC and LDL can go bonkers when they start eating high fat.

Your HDL is NOT high enough, when your TC is over 300. So at 50, it's not quite protective. Are you not exercising?

This is all assuming that your TC of 115 is true. It is extremely low for even those doing vegan/vegetarian diets.

answered Nov 14 2011 at 0:12

Namby Pamby
5,907●11●42

	Thank you. I wanted to clarify that the 115 TC was a 10+ year old data point and perhaps not relevant. Was just very surprising that the two diets produced such drastically different TCs at the completion of the weight loss. So to the answer to your questions 1) I just completed a weight loss of 60 lbs 2) I was overweight and presumably insulin-resistant. I don't know about the liver enzymes. 3) I don't know although I have had previous thyroid tests which have all been fine. Any suggestions for increasing HDL? I do circuit training with weights 3 x week at 38 mins each. – Cheryl Nov 14 2011 at 12:47
	I'm wondering if your thyroid function is low because of too low intake of carbs. I would look at the perfect health diet and maybe add in some carbs in line with their thinking. I know I feel better when I eat more in line with PHD and I much higher cholesterol when my thyroid numbers are only a bit off. – Terry Nov 14 2011 at 15:57
	Then u should give yourself the benefit of the doubt. Wait til your weight has stabilized. Get a grip of your IR through HbA1c. If you have hypothyroid symptoms, get your antibodies tested. Fish oil + dry red wine + avocadoes + coconut oil + exercise (30 min HIT + 30 min cardio) 3x per week is my formula for increasing HDL. Beware, if you're Apo E4, fish oil could increase your LDL still. But I would look at other possibilities for now before concluding this. – Namby Pamby Nov 14 2011 at 18:49

Please…I think I’m messed up…Hack my lipid panel and don’t want statins

2 Answers