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My total level is 286, unfasted as of a couple weeks ago. That total was the only number I got, annoyingly. I'll go back for the fasted pane in January. Last June when I ate a WAPF style diet my bloodwork revealed a fasted 263 but my ratios were right on target—HDL 85, LDL 169 and my triglycerides were 44.

I'm 42, 5'5", 123 pounds. Non-smoker, non-drinker, active, happier and healthier than I've ever been in my life.

I've been fully Primal for five months. I read Chris Masterjohn's page about cholesterol-rich foods raising blood levels of cholesterol being a myth.

I'm not worried about the number after doing so much reading on the subject. But it niggles at me—why, if my food choices don't affect the amount of cholesterol in my blood, is my number so high?

Is it because my LDL particles have grown in size and the test measures the weight of cholesterol in my bloodstream?

Thank you for any insight!

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 Just because dietary cholesterol doesn't affect serum cholesterol that much doesn't mean that diet itself doesn't affect serum cholesterol. In the past people did claim that dietary cholesterol was a significant factor, but I believe now even mainstream medicine has rejected this (mainstream medicine tends to blame saturated fat). – Paleo2.0 Dec 2 2011 at 14:11
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 SAturated fat, not cholesterol, does raise cholesterol in some people. By the way, your fasted numbers are very good. – Jay Dec 2 2011 at 14:31

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If you look at the Mevalonate pathway (http://en.wikipedia.org/wiki/Mevalonate_pathway), one of the feedback loops for upregulation and downregulation is dietary cholesterol levels. Since the Paleo approach has a higher intake of dietary cholesterol, it's plausible that HMG-CoA levels (rate-limiting enzyme in Cholesterol synthesis in the Mevalonate pathway) will be pretty low and the whole pathway itself will be pretty suppressed. This would be the expected result in most.

When one also has altered inflammatory levels this invariably leads to changes in the distal hormones after LDL cholesterol is converted with T3 and Vitamin A as co factors. The body will protect the synthesis of the neuro-humoral response to make these steroids it needs over down regulation of hepatic LDL. The most interesting part of this situation is that changing over to a paleo template actually puts us at risk of Ubiquinol deficiency because of the Mevalonate pathway's biochemistry. So when you see your LDL and HDL rise you should not worry too bad but you might want to consider taking 400 mgs of CoEnz Q10 or the better choice, Ubiquinol.

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 Can you write this in layman's terms? It seems this is good information but I can't understand it... – JakeA Dec 2 2011 at 13:35
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 The problem is not cholesterol.......its a lack of optimal hormones and backround inflammation as to why most paleo folks have a raised cholesterol when they jump to a paleo template. Without testing you never know why. My explanation is the reason why. – The Quilt Dec 2 2011 at 14:36
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 Most physicians seem unaware that dietary cholesterol has zero to do with serum levels......or that LDL cholesterol rises in response to low hormone levels or when one is actively trying to dump some weight. Lipid level should never be relied upon while a dietary a change is being made. Most people do not realize it can take weeks to months before the liver begins to normalize to the new dietary epigenetics signaling. This is why I tell most of my patients I could care less about their LDL numbers.......I care most about their TG and HDL and not their LDL or particle size until a yr in. – The Quilt Dec 2 2011 at 14:39
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 could a pregnenolone steal/high cortisol cause this? I'd imagine that could be a common cause of high serum cholesterol. If the body isn't making the testosterone/estradiol, etc. that it needs due to high cortisol, the liver will keep making cholesterol. Periphery cells that do not make hormones will have an oversupply of cholesterol and inhibit their synthesis of LDL receptors and HMG CoA reductase? – Jeff Dec 2 2011 at 14:59
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 Quilt, there is a simpler explanation for all this. About 1/4 of us are ApoE4. Most of us are ApoE3: high fat will reduce TC and LDL. In some, the opposite is true. Granted, I would give it some more time, after weight stabilization, and a full 1Y after starting the diet, before concluding this. – Namby Pamby Dec 2 2011 at 16:10
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Why pay any attention at all (or even submit to) an UNFASTED test?

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Hi Elise,

  1. Your question criminalizes dietary cholesterol as the culprit, yet we do not how how/why you are wondering this? Are you eating loads of eggs and dairy or something?

  2. Even if dietary cholesterol did raise your numbers, it seems that it raised them in a very good way. 85 HDL on WAP diet? 44 trigs?

  3. I would not call 263 TC high when you consider that your TC/HDL ratio is only 3.09.

  4. "Non-smoker, non-drinker, active, happier and healthier than I've ever been in my life." This says it all. Does it not?

Feel free to test them again fully fasted if you want to make sure you're still on track, but you probably have NOTHING to worry about.

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I had high cholesterol when I was on a high carb, low fat diet. Part of this I account for as obesity and overeating, but mostly I think my liver is good at making cholesterol.

Your before and after TC's aren't much different. Is your HDL higher? I've seen diet and exercise shift my VLDL/LDL towards HDL without changing the total.

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Travis Culp has mentioned on this board a few times that dairy fat seems particularly good at raising cholesterol. You mentioned that you are "fully Primal", so this might be an area where you can do some self-experimentation. Eliminate dairy for a month and re-test.

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I donate blood about every 3 months and here at the San Diego Blood bank they take all of your vitals (and post them online in your account for you to view) iron levels, blood pressure, pulse and cholesterol. My Cholesterol was 199 before I started eating primal. Three months later my levels turned out to be 186. Three months after that (last week) my levels are now at 165.

I would say to give it time, it wasn't an over night situation for me. On a side note my co-workers couldn't believe it when they see me eating steak and eggs plus bacon nearly every morning.

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From all the examples I've seen, total cholesterol doesn't seem to drop necessarily, which is fine since there's nothing wrong with it. It's the other indicators that matter, tryglycerides, apo-B, particle size etc. which CW (and in fairness it's true enough with SAD) correlates with total cholesterol.

The question is, have you significantly increased your intake of cholesterol-rich food, and has your total cholesterol actually increased? From the info you gave, we simply don't know.

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I have increased my cholesterol-rich foods between test 1 and test 2, and I eliminated grains and sugar in that time. the total went from 263 to 289 but maybe those numbers are meaningless since test 1 was fasted and test 2 was not. – elise a. miller Dec 4 2011 at 2:37

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