35 Years old, male, Paleo for 1 year+, no health problems. 185 LBS at 5'9", aprox 10-11% bodyfat.
Had Gall Bladder removed in 2005.
Current medications: Ambien5-10mg
Other Medical Issues: Seborrheic Dermatitis (controlled with Selson Blue). Low Vit D test/Calcium in Feb 2011 (taking supplemental Vit D and Calcium usually).
Diet:Low salt, low carb - Coffee w heavy cream daily. Green Salads w olive\vinegar most days, Eggs 6\day(local farm fresh), Beef and Chicken most days(grain fed), Whey\Casein protein most days, bacon every other day, coconut milk some days, carrots\peas\ zucchini\peppers\sweet potatoes\onions\garlic\broccoli most days. Honey 1/week if that. Blueberries/Strawberry/Black Berries very occasionally. Almond butter sometimes, mixed nuts sometimes (neither around the test).
Activity: Low, Strength Training 3x week (Squats,Deadlifts,Bench,weighted Pullups).
Supplements: MultiVit, Vit D 2000iu/day, Fish Oil most days, Creatine Monohydrate.
Most likely in Keto state during test and previous week. Fasted aprox 20 hrs(nothing but water) and then this:
This is a bit extreme no?
Full Results below:
ALANINE AMINOTRANSFERASE 38 U/L 0-40
ALBUMIN 4.7 g/dL 3.5-5.0 ALKALINE PHOSPHATASE 41 U/L 0-125
ASPARTATE AMINOTRANSFERASE 21 U/L 0-45
BILIRUBIN 0.6 mg/dL 0.0-1.3 CALCIUM 9.4 mg/dL 8.4-10.5
CARBON DIOXIDE 30 mmol/L 23-32
CHLORIDE 98 mmol/L 98-108
CHOLESTEROL 506 High mg/dL 0-199
CHOLESTEROL.IN HDL 30 Low mg/dL >40 CHOLESTEROL.IN LDL 450 High mg/dL <129 CREATININE 1.1 mg/dL 0.5-1.2 GLOMERULAR FILTRATION RATE.PREDICTED 81 mL/min
GLUCOSE 91 mg/dL 65-99
POTASSIUM 4.4 mmol/L 3.5-5.0 PROTEIN 7.6 g/dL 6.0-8.2 SODIUM 136 mmol/L 135-145 HYROTROPIN 1.070 uIU/mL 0.27-4.2
TRIGLYCERIDE 131 mg/dL 0-149
UREA NITROGEN 19 mg/dL 9-20
is the rest of it.
BASOPHILS 0.04 k/cmm 0.0-0.2 Details
BASOPHILS/100 LEUKOCYTES 0.7 % 0-2 Details
EOSINOPHILS 0.24 k/cmm 0.0-0.3 Details
EOSINOPHILS/100 LEUKOCYTES 4.0 High % 0-3 Details
ERYTHROCYTE DISTRIBUTION WIDTH 47.4 fL 39.0-52.2 Details
ERYTHROCYTE DISTRIBUTION WIDTH 14.3 % 11.5-14.5 Details
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 31.9 pg 27-33.3 Details
ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.2 g/dL 31.8-37.1 Details
ERYTHROCYTES 5.18 M/cmm 4.44-6.1 Details
GRANULOCYTES.IMMATURE/100 LEUKOCYTES 0.00 % 0.00-2.00 Details
HEMATOCRIT 46.9 % 41-52 Details
HEMOGLOBIN 16.5 g/dL 13.9-18 Details
IMMATURE GRANULOCYTE # 0.00 k/cmm 0.00-0.2 Details
LEUKOCYTES 5.97 k/cmm 4.6-10.8 Details
LYMPHOCYTES 2.90 k/cmm 1.2-3.6 Details
LYMPHOCYTES/100 LEUKOCYTES 48.6 High % 25-33 Details
MEAN CORPUSCULAR VOLUME 90.5 um3 80-98 Details
MONOCYTES 0.48 k/cmm 0.14-0.76 Details
MONOCYTES/100 LEUKOCYTES 8.0 High % 3-7 Details
NEUTROPHILS 2.31 k/cmm 1.8-7.8 Details
NEUTROPHILS/100 LEUKOCYTES 38.7 Low % 54-65 Details
PLATELET MEAN VOLUME 11.4 High um3 7.4-10.5 Details
PLATELETS 222 k/cmm 130-440
**OTHER BLOOD WORK BELOW****
ALANINE AMINOTRANSFERASE 18 U/L 7.0-52 Details ALKALINE PHOSPHATASE 65 U/L 40-150 ASPARTATE AMINOTRANSFERASE 17 U/L 5-34 BILIRUBIN 0.73 mg/dL 0.2-1.2 BILIRUBIN.GLUCURONIDATED+BILIRUBIN.ALBUMIN BOUND 0.32 mg/dL 0-0.5 CARBON DIOXIDE 30 mmol/L 20-30 CHLORIDE 105 mmol/L 100-110 CREATININE 1.3 mg/dL 0.5-1.5 GLOMERULAR FILTRATION RATE.PREDICTED 68.4 mL/min GLUCOSE 56 mg/dL <199 POTASSIUM 3.5 mmol/L 3.5-5.0 SODIUM 142 mmol/L 135-145 THYROTROPIN 1.01 uIU/mL 0.35-5.5 THYROXINE.FREE 1.15 ng/dL 0.6-1.6 UREA NITROGEN 17 mg/dL 7-25
BASOPHILS/100 LEUKOCYTES 0.6 % 0-2 Details
EOSINOPHILS/100 LEUKOCYTES 4.1 % 0-7 Details ERYTHROCYTE DISTRIBUTION WIDTH 13.9 % 11.5-14.5 Details ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 32.4 pg 27-34 Details ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 34.9 g/dL 32-37 Details ERYTHROCYTES 5.34 M/cmm 4.7-6.1 Details HEMATOCRIT 49.6 % 40-52 Details HEMOGLOBIN 17.3 g/dL 14-18 Details LEUKOCYTES 6.7 K/cmm 4.5-11.0 Details LYMPHOCYTES 1.9 K/cmm 1-4 Details LYMPHOCYTES/100 LEUKOCYTES 27.9 % 10-55 Details MEAN CORPUSCULAR VOLUME 92.9 fL 80-98 Details MONOCYTES/100 LEUKOCYTES 8.1 % 2-12 Details NEUTROPHILS 4.0 K/cmm 1.8-6.5 Details NEUTROPHILS/100 LEUKOCYTES 59.3 % 40-75 Details PLATELET MEAN VOLUME 9.6 fL 7.4-10.4 Details PLATELETS 226 K/cmm 130-450
ALANINE AMINOTRANSFERASE 91 High U/L 7.0-52 Details
ALBUMIN 4.0 g/dL 3.2-5.0 ALKALINE PHOSPHATASE 59 U/L 40-150 ASPARTATE AMINOTRANSFERASE 41 High U/L 5-40 BILIRUBIN 0.31 mg/dL 0.2-1.2 BILIRUBIN.GLUCURONIDATED+BILIRUBIN.ALBUMIN BOUND 0.14 mg/dL 0-0.5 CALCIUM 9.6 mg/dL 8.5-10.5 CARBON DIOXIDE 26 mmol/L 20-30 CHLORIDE 108 mmol/L 100-110 CHOLESTEROL 186 mg/dL 0-199 CHOLESTEROL.IN HDL 31 Low mg/dL >40 CHOLESTEROL.IN LDL 116.6 mg/dL <130 CREATININE 1.3 mg/dL 0.5-1.5 GLOMERULAR FILTRATION RATE.PREDICTED 68.4 mL/min GLUCOSE 86 mg/dL <199 MAGNESIUM 2.5 High mg/dL 1.8-2.4 PHOSPHATE 4.0 mg/dL 2.5-5.0 POTASSIUM 4.0 mmol/L 3.5-5.0 PROTEIN 7.0 g/dL 6.0-8.5 SODIUM 144 mmol/L 135-145 THYROTROPIN 1.53 uIU/mL 0.35-5.5 TRIGLYCERIDE 192 mg/dL 0-199 UREA NITROGEN 14 mg/dL 7-25
BASOPHILS/100 LEUKOCYTES 0.4 % 0-2 Details
EOSINOPHILS/100 LEUKOCYTES 6.2 % 0-7 ERYTHROCYTE DISTRIBUTION WIDTH 13.6 % 11.5-14.5 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 33.1 pg 27-34 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.1 g/dL 32-37 ERYTHROCYTES 4.97 M/cmm 4.7-6.1 HEMATOCRIT 46.9 % 40-52 HEMOGLOBIN 16.5 g/dL 14-18 LEUKOCYTES 8.6 K/cmm 4.5-11.0 LYMPHOCYTES 3.0 K/cmm 1-4 LYMPHOCYTES/100 LEUKOCYTES 34.5 % 10-55 MEAN CORPUSCULAR VOLUME 94.4 fL 80-98 MONOCYTES/100 LEUKOCYTES 8.2 % 2-12 NEUTROPHILS 4.4 K/cmm 1.8-6.5 NEUTROPHILS/100 LEUKOCYTES 50.7 % 40-75 PLATELET MEAN VOLUME 9.2 fL 7.4-10.4 PLATELETS 282 K/cmm 130-450
THYROTROPIN 0.937 uIU/mL 0.27-4.2 HEMOGLOBIN A1C/HEMOGLOBIN.TOTAL 5.4 %
BASOPHILS 0.05 k/cmm 0.0-0.2 Details
BASOPHILS/100 LEUKOCYTES 0.7 % 0-2 EOSINOPHILS 0.42 High k/cmm 0.0-0.3 EOSINOPHILS/100 LEUKOCYTES 6.3 High % 0-3 ERYTHROCYTE DISTRIBUTION WIDTH 41.9 fL 39.0-52.2 ERYTHROCYTE DISTRIBUTION WIDTH 13.4 % 11.5-14.5 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 32.2 pg 27-33.3 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.7 g/dL 31.8-37.1 ERYTHROCYTES 5.18 M/cmm 4.44-6.1 HEMATOCRIT 46.8 % 41-52 HEMOGLOBIN 16.7 g/dL 13.9-18 LEUKOCYTES 6.68 k/cmm 4.6-10.8 LYMPHOCYTES 1.86 k/cmm 1.2-3.6 LYMPHOCYTES/100 LEUKOCYTES 27.8 % 25-33 MEAN CORPUSCULAR VOLUME 90.3 um3 80-98 MONOCYTES 0.45 k/cmm 0.14-0.76 MONOCYTES/100 LEUKOCYTES 6.7 % 3-7 NEUTROPHILS 3.90 k/cmm 1.8-7.8 NEUTROPHILS/100 LEUKOCYTES 58.5 % 54-65 PLATELET MEAN VOLUME 12.1 High um3 7.4-10.5 PLATELETS 174 k/cmm 130-440
ALANINE AMINOTRANSFERASE 53 High U/L 7.0-52 Details
ALKALINE PHOSPHATASE 54 U/L 40-150 ASPARTATE AMINOTRANSFERASE 25 U/L 5-40 BILIRUBIN 0.54 mg/dL 0.2-1.2 BILIRUBIN.GLUCURONIDATED+BILIRUBIN.ALBUMIN BOUND 0.23 mg/dL 0-0.5 CARBON DIOXIDE 27 mmol/L 20-30 CHLORIDE 103 mmol/L 100-110 CREATININE 1.2 mg/dL 0.5-1.5 GLOMERULAR FILTRATION RATE.PREDICTED 74.1 mL/min GLUCOSE 61 mg/dL <199 POTASSIUM 4.3 mmol/L 3.5-5.0 SODIUM 142 mmol/L 135-145 THYROTROPIN 1.36 uIU/mL 0.35-5.5 UREA NITROGEN 16 mg/dL 7-25
BASOPHILS/100 LEUKOCYTES 0.4 % 0-2 Details
EOSINOPHILS/100 LEUKOCYTES 5.3 % 0-7 ERYTHROCYTE DISTRIBUTION WIDTH 13.0 % 11.5-14.5 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 31.2 pg 27-34 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 34.1 g/dL 32-37 ERYTHROCYTES 5.25 M/cmm 4.7-6.1 HEMATOCRIT 48.2 % 40-52 HEMOGLOBIN 16.4 g/dL 14-18 LEUKOCYTES 5.8 K/cmm 4.5-11.0 LYMPHOCYTES 1.6 K/cmm 1-4 LYMPHOCYTES/100 LEUKOCYTES 28.0 % 10-55 MEAN CORPUSCULAR VOLUME 91.7 fL 80-98 MONOCYTES/100 LEUKOCYTES 6.9 % 2-12 NEUTROPHILS 3.4 K/cmm 1.8-6.5 NEUTROPHILS/100 LEUKOCYTES 59.4 % 40-75 PLATELET MEAN VOLUME 10.2 fL 7.4-10.4 PLATELETS 207 K/cmm 130-450
BASOPHILS 0.06 k/cmm 0.0-0.2 Details
BASOPHILS/100 LEUKOCYTES 0.7 % 0-2 EOSINOPHILS 0.65 High k/cmm 0.0-0.3 EOSINOPHILS/100 LEUKOCYTES 7.1 High % 0-3 ERYTHROCYTE DISTRIBUTION WIDTH 13.1 % 11.5-14.5 ERYTHROCYTE DISTRIBUTION WIDTH 41.9 fL 39.0-52.2 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 31.0 pg 27-33.3 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.3 g/dL 31.8-37.1 ERYTHROCYTES 5.39 M/cmm 4.44-6.1 GRANULOCYTES.IMMATURE/100 LEUKOCYTES 0.10 % 0.00-2.00 HEMATOCRIT 47.3 % 41-52 HEMOGLOBIN 16.7 g/dL 13.9-18 IMMATURE GRANULOCYTE # 0.01 k/cmm 0.00-0.2 LEUKOCYTES 9.11 k/cmm 4.6-10.8 LYMPHOCYTES 2.44 k/cmm 1.2-3.6 LYMPHOCYTES/100 LEUKOCYTES 26.8 % 25-33 MEAN CORPUSCULAR VOLUME 87.8 um3 80-98 MONOCYTES 0.45 k/cmm 0.14-0.76 MONOCYTES/100 LEUKOCYTES 4.9 % 3-7 NEUTROPHILS 5.50 k/cmm 1.8-7.8 NEUTROPHILS/100 LEUKOCYTES 60.4 % 54-65 PLATELET MEAN VOLUME 12.0 High um3 7.4-10.5 PLATELETS 237 k/cmm 130-440
ALANINE AMINOTRANSFERASE 86 High U/L 0-40 Details
ALBUMIN 4.3 g/dL 3.5-5.0 ALKALINE PHOSPHATASE 70 U/L 0-125 ASPARTATE AMINOTRANSFERASE 35 U/L 0-45 BILIRUBIN 0.5 mg/dL 0.0-1.3 CALCIUM 9.1 mg/dL 8.4-10.5 CARBON DIOXIDE 24 mmol/L 23-32 CHLORIDE 104 mmol/L 98-108 CHOLESTEROL 202 High mg/dL 0-199 CHOLESTEROL.IN HDL 22 Low mg/dL >40 CHOLESTEROL.IN LDL 116 mg/dL <129 CREATININE 1.0 mg/dL 0.5-1.2 GLOMERULAR FILTRATION RATE.PREDICTED 91 mL/min GLUCOSE 94 mg/dL 65-99 POTASSIUM 4.2 mmol/L 3.5-5.0 PROSTATE SPECIFIC AG 0.822 ng/mL 0-4 PROTEIN 7.2 g/dL 6.0-8.2 SODIUM 139 mmol/L 135-145 TRIGLYCERIDE 321 High mg/dL 0-149 UREA NITROGEN 15 mg/dL 9-20
BASOPHILS 0.05 k/cmm 0.0-0.2 Details
BASOPHILS/100 LEUKOCYTES 0.5 % 0-2 EOSINOPHILS 0.22 k/cmm 0.0-0.3 EOSINOPHILS/100 LEUKOCYTES 2.3 % 0-3 ERYTHROCYTE DISTRIBUTION WIDTH 44.0 fL 39.0-52.2 ERYTHROCYTE DISTRIBUTION WIDTH 13.4 % 11.5-14.5 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN 31.3 pg 27-33.3 ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 34.5 g/dL 31.8-37.1 ERYTHROCYTES 5.17 M/cmm 4.44-6.1 GRANULOCYTES.IMMATURE/100 LEUKOCYTES 0.20 % 0.00-2.00 HEMATOCRIT 47.0 % 41-52 HEMOGLOBIN 16.2 g/dL 13.9-18 IMMATURE GRANULOCYTE # 0.02 k/cmm 0.00-0.2 LEUKOCYTES 9.48 k/cmm 4.6-10.8 LYMPHOCYTES 1.31 k/cmm 1.2-3.6 LYMPHOCYTES/100 LEUKOCYTES 13.8 Low % 25-33 MEAN CORPUSCULAR VOLUME 90.9 um3 80-98 MONOCYTES 1.12 High k/cmm 0.14-0.76 MONOCYTES/100 LEUKOCYTES 11.8 High % 3-7 NEUTROPHILS 6.76 k/cmm 1.8-7.8 NEUTROPHILS/100 LEUKOCYTES 71.4 High % 54-65 PLATELET MEAN VOLUME 12.0 High um3 7.4-10.5 PLATELETS 171 k/cmm 130-440
ALANINE AMINOTRANSFERASE 72 High U/L 17-63 Details
ALBUMIN 4.1 g/dL 3.5-4.8 ALKALINE PHOSPHATASE 46 U/L 32-91 ANION GAP 5 mEq/L 4-13 ASPARTATE AMINOTRANSFERASE 38 U/L 12-50 BILIRUBIN 0.8 mg/dL 0.2-1.3 CALCIUM 9.2 mg/dL 8.9-10.3 CARBON DIOXIDE 30 mEq/L 22-32 CHLORIDE 101 mEq/L 101-111 CREATININE 1.02 mg/dL .64-1.27 GLOMERULAR FILTRATION RATE.PREDICTED 84 mL/min >60 GLUCOSE 86 mg/dL 74-118 POTASSIUM 4.2 mEq/L 3.6-5.1 PROTEIN 7.4 g/dL 6.3-8.2 SODIUM 136 mEq/L 136-144 UREA NITROGEN 18 mg/dL 8.0-20.0
DECEMBER 2011 is at the very top.
You are producing LDL at too high of a rate and not clearing them. I would get off creatine, reduce dairy fat, and add low to medium resistance exercise to your weight training regimen. Personally, I added 3x per week jogging and still maintain weight lifting 4x per week. Usually I jog on my rest days, and I almost always jog in a totally fasted state (like on a weekend mornings before breakfast or before dinner on weekdays).
Also, I would consider your thyroid as others here have mentioned. You may need to get a full thyroid test. Poor thyroid function can easily mess up your LDL, which brings us to our next point. I am almost certain that you have very very low LDL receptor activity. This is why your HDL is on the floor and your LDL is in the clouds. It is a vicious circle. Your diet and workout routine is strikingly similar to mine. And while I've never had LDL that high (mine is always about 160-180), we have a similar issue with the bad ratios.
Here is what I would do first if I were you:
Very little dairy (perhaps for a time)
Add cardio and preferably in a fasted state to specifically target and burn FFAs
Add some turmeric to your diet somehow. This has been shown to increase LDL receptor activity.
Reduce the strain by reducing the weight in your weight lifting. (For example... I was doing 5 reps of 285 twice on the bench, and using EVERY ounce of muscle and girth within me to do so. But I switched to 8-10 reps of 250 for the first set, and 8-10 reps of 200 for the second set). This is just an example for me. But I think you get the idea. To repeat my first sentence here, what I am saying is... reduce the strain by reducing the weight in your weight lifting. I am not sure if this helps with lipid numbers, but I just know that after a full year of nearly maxed out workouts, my numbers were not good at all. I posted a question about it here a while back: http://paleohacks.com/questions/75513/could-lifting-weights-to-failure-regularly-be-problematic-for-blood-lipids-due-to .
Hopefully some of this helps. Keep us posted.
I'm not qualified to hack this, but have you taken a look at this? http://www.marksdailyapple.com/how-to-interpret-cholesterol-test-results/#axzz1hrHmi35m
You need to get a complete lipid panel with the apolipoproteins & particle numbers plus genetic markers. Also you should always do your follow-up checks with the full breakdown as well. Just getting a standard profile like this leaves a lot of missing information. You have a form of hyperlipidemia that will be difficult to follow with a standard lipid profile.
Based on the remaining information, it does not appear that the 20 hour fast created any artifacts in your results, so you can assume the results are accurate unless there is more info you have not shared such as intense exercise, etc. prior to the test.
Just some things that I do which raised my hdl a lot and lowered ldl and trigs. Lots of Coconut oil (cold pressed, organic, etc). Grass fed animals... saturated fat from aforementioned animals, canned sardines, salads, eggs... Herbs like olive leaves, green tea, hibiscus, hawthorne berry, camomille, cayenne pepper, rose hips comfrey
My personal experience:
I had a ton of problems on low carb paleo including low thyroid and skyhigh cholesterol (350 ldl) I was eating full fat cheese and yogurt, a couple servings a day. My doc ordered me off all dairy to help balance my hormones and my cholesterol fell back to normal before my thyroid improved at all (that was a few months of starches that eventually did the trick). So my thyroid may have made it worse but it wasn't the major cause.
I never cut back on meat fat and kept eating plenty of beef and bacon and even cooking in coconut oil. So it was absolutely the dairy fat that caused the up and downs in my cholesterol. Some people just shouldn't eat it, like how others just can't eat gluten, nuts, eggs, shellfish, etc. because of reactions.
How much Creatine Monohydrate are you taking? That is throwing some #s off, especially your creatine and GFR. Your cholesterol #s shouldn't be affected too much by this, although your LDL could increase by as much as 10% just by taking CM. RU a bodybuilder? How long have you been on it?
Did you have fatty liver before starting Paleo? How much weight have you lost? Or how much LBM did you gain through Paleo, exercise and CM supplementation AFTER 11/2010. Your blood test in 11/2010 shows liver-related metabolic derangement. What were your ALT and AST, then (~50 or higher)? Your current liver enzymes should be much lower but your ALT is 2x your AST, common in recovering fatty liver sufferers. It should fall to about the same level as your AST.
Second, were you sick (had a flu or infection / allergies) when you took the test? Your WBCs are jiggered all over. Retest to make sure the WBCs are within range, and rule out something more serious.
Third, you have a normal platelet count but high mean platelet volume. This could again be inflammation/infection but I'd retest when you recover from a flu or infection.
Now, when you combine all these with your LDL, they do increase the risk of CVD (incl. stroke). I'd try to see if you have additional, independent risk factors of CVD (hypertension, high platelet vol, Lpa) along with inflammation markers (CRP, IL-6, Ferritin, Fibrinogen, etc.). If you have the same #s as before (incl. your WBCs, platelets) plus high CRP, ESR, Lpa, etc., I'd be very concerned.
First order of bidness: (-1) Check your prior labs for liver enzymes to see if you had NASH. (0) Quit CM ASAP. (1) Retest lipids and CBC but after you're cleared of a flu or whatever you're suffering from. Add CRP, ESR, and inflammation markers as items. (2) Take particle size test (VAP) to assess your Lpa and ApoB. (3) If LDL is still high, have your genes mapped with 23andme and confirm your ApoE4 status. Take the result to a cardiologist along w/your new CBC / inflammation result. (4) If CBC items r abnormal and confirmed by inflammation markers, you need to be referred to a specialist for further screening.
Try this; ditch that coffee; especially if its french press or expresso.
4 years ago, when 50 pounds heavier, my TC was 220. October this year (2 years primal) TC=530! (tested twice due doctor disbelief)
Dropped my daily 6-8 large cups expresso/french press. (I knew this addiction was not 'ancestral'! but it helped my daily 16 hr 'IF').
Last week: TC 230.
Let's say u had your gallbladder taken out in 2005. That would make sense as your liv enzymes fell to the teens in 5/2007. However, they rose to fatty liver levels in 2/2008, when you supposedly became overweight at 240 lbs. Were you overweight/obese in 2007 and in 2005 as well, when you had surgery?
If so, that's probably fatty liver due to SAD: processed carbs as shown by 192 trigs -- it's not bad but this was prior to your weight loss in 2009 via "slow carbs" (beans but no dairy), when your liv enzymes were halved. No cholesterol #s here but I trust they were normal at this time.
Your #s went bonkers in 11/2010 when you hit 320 trigs w/high liver enzymes. This was your zero-carb, meat only diet; you weren't doing dairy and non-meat SAFA like u are doing now. But your LDL wasn't bad (116). U must have had episodes of running to the bathroom, eating that much fat without the gallbladder.
In short, it seems to be Apo E4. You hit FH territory (TC>=350) with SAFA. I'd try taking out all non-meat SAFA as posted above and see how you fare. U can quickly confirm your Apo status through 23andme for $200. Also take out coffee and CM. I'd increase carbs to about 150-200g using yams, sweet potatoes, peas, and lentils, if they don't bother u. That should reduce your TC and at least turn your LDL to type A. For that to happen, though, your HDL has to go up and trigs have to go down.
If not, the only option I see is increasing carbs more. That's because you have additional issues:
Your creatinine is chronically elevated and this is not due to CM. Seems like your BP was not under control back in 2007-8: GFR of 68 when you were only 30, very similar with another poster here, Berger. U have hypertension? Your doc must've talked to you about low kidney function? Hypertension is a separate risk factor for CVD.
You have a consistently high mean platelet volume, another risk factor of CVD that affects blood clotting. I'd get tested for Lpa and Fibrinogen: they could be similarly elevated.
WBC abnormalities could just be noise but keep an eye on them, since they're more often out of the range than not when you're supposedly healthy. Ask for inflammation markers like Ferritin, CRP, IGF-1 and ANA to rule out autoimmunity and other conditions, since u r complaining of unexplained fatigue. Watch out for increased risk of colorectal cancer for those with no gallbaldder.
Very low HDL throughout, even when exercising. Like above, more cardio vs. weights, more reps vs. heavy weights. For u, trigs may not serve as a marker of insulin as it does in most people. No blood sugar issue but u seem to become hypoglycemic when fasting (back in 2007-08).
Your doc will recommend a low-fat diet, citing your missing gallbladder. If your #s don't improve, I'd opt for a lower fat (i.e., higher carb) diet with lean meats, no dairy & eggs, given your risk factors that do require attention.