Lipid Panel on LCHF

I am hoping you guys can share some thoughts on my latest Lipid Panel. It seems to have changed a lot on the LCHF Diet.

11-2015 - 11-2016

Cholesterol 210 - 306

Tri 115 - 83

HDL 53 - 80

LDL 147 - 215

Risk 4.0 - 3.8

My doctor did not talk with me about these numbers, but he already wants me off the LCHF diet. I have done some research, but would love to hear you opinions.

Thanks, this site has be a huge help.

Check out Peter Attia’s blog eatingacademy.com. It has a ton of information about lipids and eating low-carb. The bottom line is pretty simple: high cholesterol is largely genetic, and what we eat doesn’t have a huge effect on serum cholesterol (with a couple of exceptions).

So, one of the things you’re seeing in this lipid panel is interesting, though. You’re calculated CV risk has gone down rather than up: from 4.0% (in next ten years) to 3.8% (in next ten years) of having a stroke or heart attack. That’s positive, and is likely related to the drop in Triglycerides (common on a low-carb diet) and increase in HDL (you must be doing great at eating Omega 3s). Your LDL has gone up, but without differentiating between LDL and VLDL, there isn’t any way to make too much sense out of that.

Your doctor is your doctor, and your doctor generally knows best. However, many doctors aren’t up on current scientific thinking about lipids or low-carb diets. Might be worth getting a second opinion, in my opinion.

First off, half of this is what I remember from stuff I read… so you need to validate it…as said, I think your bloods are better than they were…

If you are concerned … I would probably get a true LDL reading of the various ones that make up the generic LDL given in a standard test.

…The 80 trigs means that you have very few sdLDL They are actually the bad LDL, along with the ones that poly oils and trans fats damage that then aren’t then counted as LDL and also can’t be returned to the liver…(it is the reason poly oils drop LDL).
you need good VLDL and LDL, They are the trucks that carry the fats we are using for energy.
Your HDL is up, that’s good and what you want …it shows that the system is working and there are enough HDL taking the used LDL back to the liver.

did you see the online calculator? other than the LDL will kill you warning…the ratios are very good.
http://www.hughcalc.org/chol.php
Your Total Cholesterol/HDL ratio is: 3.89 - (preferably under 5.0, ideally under 3.5) GOOD
Your HDL/LDL ratio is: 0.372 - (preferably over 0.3, ideally over 0.4) GOOD
Your triglycerides/HDL ratio is: 1.038 - (preferably under 4, ideally under 2) IDEAL

I don’t know if you are, but losing weight can also alter your cholesterol/lipids. You need to be stable for a while to see what it is.
http://www.wheatbellyblog.com/2012/06/i-lost-weight-and-my-cholesterol-went-up/

this video is worth watching (it’s in USA numbers)

this is about the best I’ve seen on blood tests, that I can understand. it’s in aussie numbers, you can either convert or just use as an overview

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Genetics does play a huge role, but that’s just another way of saying that different individuals will have different reactions. Diet can indeed have an influence. As with everything else in physiology, the influence can be relatively insignificant for some individuals and dramatic for others. So someone else’s anecdote is interesting but not necessarily meaningful for a particular person. That being said, many people I know have experienced marked improvement from switching to a low carb diet. In my case, everything improved greatly—trigs, LDL, everything.

Was this a fasting Lipid Panel would be my first question…?
If not…are you bolusing for the fat content in the food you eat?
To me everything but your LDL and Overall Cholesterol are SLIGHTY high…I know My doctor wouldn’t worry about this…especially since your lipids rise and fall through out the day anyway…Are you taking any kind of medication? For example, Antidepressants, Some Beta Blockers, and Steroid use (I.e. prednisone) will cause higher/abnormal Lipid Profiles…I’d have you doctor redo a FASTING, (first thing in the MORNING), Lipid Panel and see where the numbers are again and go from there… when and if you get it redone make SURE you have NOTHING by mouth before the blood draw…NOT EVEN COFFEE…A sip or 2 of water is ok if you have to take medication in the Morning but NOTHING else…This will give your Doctor a more accurate result…Hope this helps.

Antidepressants as a class of medications do not increase lipid values. Where are you getting this information?

Apparently whether or not black coffee can affect lipodbpanels is the subject of some debate-- in my experience it certainly did

I do not do a LCHF diet, but if I did my heart doctor would be bizarro crazy about it. Having said that she is bizarro crazy over my lipid panel even when I hit all the standards in range. I love that she lowers or raises them all and set a new benchmark.

I finally have them to the place where I cannot meet them almost no matter what I do and in some ways that is a comfort. One thing I have been asking for is a retest when I have big changes. I have been amazed at the difference from day to day. I have come to think of these as less than stable and more fluid, even within the same month for better or worse.

I am on a six month standing lipid panel order and I love doing them. The reason is that the numbers can vary by a 20 % up or down and it gives me amination to say hey doctor look, let’s not get too concerned or excited because it is up or a down a little. Like the weather in Indiana, if you do not like it, wait an hour.

I have never had my endocrinologist care very much. When he asks about it we have a good chuckle about the cardiologist being so concerned. But he does says look:

“Rick I practice in a space were we ask how your blood sugar is and we know your meter at home might be 30 points lower or higher than reality. The cardiologist just thinks the can control things, we endocrinologists just know nothing in the body is really that precise”.

He calls that the Higher consciousness of the endocrinologist. Of course he always reminds me that no one sues him for missing a blood sugar by one 1/8 of millimeter like a cardio surgeon is sued for making a cut by 1/8 millimeter too long.

Point taken.

Actually Antidepressants CAN raise your LDL, Wellbutrin is an example…Do the research and you will see the studies done.

I said antidepressants as a class…

There has been a shift from treating based on cholesterol numbers to looking at risk factors. Having diabetes is considered a risk factor and in general PWD under 40 should be on a moderate or high-intensity statin and PWD aged 40-75 and other heart-disease risk factors should be on a high-intensity statin. S79 ADA Standards of Medical Care in Diabetes - 2017 http://care.diabetesjournals.org/content/diacare/suppl/2016/12/15/40.Supplement_1.DC1/DC_40_S1_final.pdf

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Nutrition is mentioned in the Standards starts on page S34. It mentions that the “ideal amount of dietary fat for individuals is controversial” and cites the evidence of a Mediterranean-style eating pattern that is rich in monounsaturated fats. http://care.diabetesjournals.org/content/diacare/suppl/2016/12/15/40.Supplement_1.DC1/DC_40_S1_final.pdf

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Have you considered plant based diet. i do great on it and have been T1 50 years. High carb, low fat.

I recently listened to a Diabetes Daily Grind podcast that featured a T1D young man promoting high carb low fat eating that favored fruits and vegetables. He comes out of the “forks over knives” tradition. Let me say up front that I’m still skeptical as to the appropriateness for insulin-using diabetics even after listening to this podcast.

He was eating lots of carbs every day, 700 or more grams per day was not unusual. That he had any kind of decent blood sugar control did get my attention. He said that eating more carbs makes your body more sensitive to insulin. He said that his insulin to carb ratio led to taking less insulin for the same level of carbs. In other words going, for example, from an I:C ratio of 1:10 to 1:20. The post meal numbers he posted were impressive.

I didn’t know what to think of his claims so I went out to his web-site. I found it light on hard info, heavy on testimonials, and pitch heavy to sign up for his training and seminars. There were many pictures of beautiful produce and attractive people. This level of marketing/selling/hucksterism is an immediate turn-off for me. Yet I sense there must be some value in his claims.

I adopted a low carb high fat way of eating four years ago and I am convinced of its benefits with regard to treating/living with type I diabetes. Bernstein’s law of small numbers makes great sense to me. Fewer carbs = less insulin = smaller mistakes.

I think the room for error in the high carb low fat way of eating must be small. If you’re off by 10% in a 20 unit insulin dose, that could easily turn into a severe hypo incident. I lived that way for many years. I became very good a landing well when my blood glucose came plummeting down from stratospheric levels headed for the depths of severe hypoglycemia. A few times, I wasn’t so fortunate. I’m lucky to survive.

I understand the appeal of eating fruits and vegetables but as I already said, I find it hard to reconcile taking large doses of insulin and staying safe. I listened to this podcast because I like to hear opposing positions to mine. If you listen to this podcast, @lisa_c1, I’d be interested in your comments.

I’d also be interested in your level of control eating this way, if you felt comfortable to share. If you have a CGM, I’d be interested in percentage time in range, time low, and standard deviation (variability). If not, an A1c and average from your BG meter would help me better understand the glycemia that you live with. I fully understand if you’d prefer to keep that data private.

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Terry, the woods are full of web sites and science woo like that one. They’re a dime a dozen. Or better. And the harm they do to anxious, credulous people doesn’t bear thinking about.

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It seems to me that a lot of the “eat vegetables and fruit” advice comes from a version of the natural fallacy. I.e., that food which comes from “natural” sources, and is the least processed from its “natural” state, must “naturally” be the best thing to eat. This completely disregards evolutionary history, the history of human cultural development, the history of cooking, and even the history of plants themselves (and how we’ve bred them), but the fallacy is awfully persistent.

If “natural” was best, most of us diabetics would have died a long time ago, since we aren’t naturally good at producing our own insulin in sufficient quantities to satisfy our natural cravings for food.

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Terri,

All I know is what has worked for me and countless others who adopt a vegan plant based diet. The science is also pretty compelling if you look to Colin Cambell, forks over knives websites and data. he is renowned cornell scientist who wrote THE China Study. I have had T1 50 years. Many complications. Since eating plant based…I am doing great. I take total of 15-18 units/ day. Eat about 250-400 carbs. ITs the fats that make the BGs impossible to control and lead to insulin resistance. FOR ME. guess we all need to do our own body research. A1cs 6-7. Endo is most supportive and impressed. Love to chat more.
Happy new year!

I consider this to be a tragic mistake. We need to be treating people based on science. Where are the random controlled intervention trials? That’s right, nobody bothered to do them. And we call it a “risk factor” but it is actually an “association.” And there is already abundant evidence that high blood sugars are associated with CVD independent of cholesterol. So does diabetes cause CVD or does cholesterol cause CVD. Where is the science?

I would hardly call this compelling work. The China Study is an example of shoddy epidemiological work and simply reports some associations. With a collection of data that big you can pretty much cherry pick anything you want. If you want to read an in-depth critique of the China Study read Denise Minger total takedown of the study. The raw data from the China Study is available which means that others can do more objective and rigorous analysis and unfortunately Campbell did a really bad job as a scientist. A key finding of the further analysis of this data indicates that in fact wheat is a far bigger risk factor than animal, seafood or dairy. I would urge you to read more science on this topic before going vegan and eating 250 - 400 grams of carbs a day. You should ask “Where are the intervention trials?” Epidemiological studies that show an association can be a dime a dozen and can show anything you want.

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While in this case I agree with you, there are excellent epidemiological studies, which is why we have everything from the seasonal flu vaccine to knowledge of emerging diseases like Zika virus… But The China Study was totally overblown, oversold, and over-interpreted to meet agendas. I agree absolutely with you there. My PhD adviser was taken in by that study for a very simple reason: he was looking for an excuse to say that vegetarianism was somehow scientifically better than other ways of eating. So he had his bias before he had any evidence to support it. He was mortified when he later realized that the study didn’t actually support his position at all.

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In 2014 the American College of Cardiology & American Heart Association (ACC/AHA) changed their guidelines and at the American Diabetes Association’s 2014 meeting in June there was a vigorous debate on whether to adopt the ACC/AHA guidelines. A versions was adopted in the ADA Standards in 2015 and the 2017 update has just been released. A good reason to consult the ADA Standards is to have easy access to the references that support the Standards. On page S79 you will see that the Standards are based on 14 randomized trials of statin therapy and additional references follow.

The new Standards also cites the new evidence of heart health benefits of using either Jardiance or Victoza to lower blood glucose in high-risk patients on page S84.

There are still individual choices to be made by each patient with guidance from their physician with input from this research.

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