Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
26 Jun

Why Did My Cholesterol Go Up After Going Primal?

cholesterol2While the majority of people who go Primal see their blood lipids improve, a significant minority do not in the short term. They see LDL cholesterol skyrocket, or their total cholesterol increase, and sometimes triglycerides even mysteriously elevate despite a low-carb intake.

What’s going on here? Should you go on statins? Should you add grains back in? Should you start jogging for a couple hours every night? Should you even worry about it?

Before you freak out, let’s go over a couple things:

Even though it may be sufficient to get your doctor to write a statin prescription, keep in mind that a total cholesterol level of between 200 and 240 is associated with the lowest risk of all-cause mortality (PDF).

If it’s LDL you’re worried about, total particle count is the thing to watch. Standard lipid panels, including LDL-C (amount of cholesterol inside the particles) and total cholesterol, can certainly give you an idea of your particle count, but you might want to read up on advanced lipid tests, too, if you’re not satisfied. Confirm that your “elevated cholesterol” is actually an issue.

That said, seeing a host of beyond-end-range numbers on your lipid test can be scary. It can also be confusing, especially if everything else appears to be going so well for you health-wise. So today, I’m going to explore a few of the reasons why your cholesterol might have gone up after going Primal. Some reasons will quell your fears, while some may provide avenues for further experimentation. At any rate, you’ll learn something.

You’re losing weight.

Going Primal often means weight loss. This is a good thing, as excess body fat is unhealthy. We want to increase lean mass while decreasing fat mass. Usually, such weight loss leads to improvements in lipid numbers. If you get your cholesterol checked when you’re fifty pounds overweight, lose it all, and check it again once your weight stabilizes, your numbers will likely have improved. That’s what the studies tend to suggest.

When you lose weight the good way – by burning body fat rather than lean mass – you are consuming pure animal fat. Say you’re dropping a pound of body fat every four days or so – that’s releasing a stream of 3500 calories-worth of animal fat into your blood stream as triglycerides and free fatty acids. If you take a snapshot of your lipids in the midst of this rapid weight loss, there’s a chance that your numbers will look off. Triglycerides in particular may be up, way up (since your blood is now full of them, newly liberated from adipose tissue).

Solution: Recheck once your weight has stabilized.

You’re deficient in some key micronutrients.

Yeah, the food we get to eat on Primal is delicious and incredibly nutritious, but that doesn’t mean we’re completely immune to nutritional deficiencies, especially considering a lot of the food we stopped eating – grain products like breakfast cereal and granola bars, and processed foods of all kinds – were our most reliable sources of vitamins and minerals thanks to the wonders of fortification.

A few of the most common include:

  • Iodine  - Iodine is required for production of thyroid hormone, and too large a reduction in thyroid activity can lower the expression of LDL receptors. Without enough LDL receptors, LDL doesn’t get cleared from the blood. Primal eaters who give up iodized salt for sea salt without making up the difference with adequate seaweed and seafood may be missing out on iodine (eating tons of goitrogenic cruciferous veggies at the same time might compound the problem).
  • Copper – Copper deficiency is associated with elevated levels of LDL, as well as increased particle number. Both oysters and ruminant liver are excellent sources of copper. You eating your offal and shellfish?
  • Selenium – Selenium deficiency is associated with reduced LDL receptor activity (and subsequent elevated LDL levels). Salmon, kidneys, and brazil nuts are great sources of selenium.

Check out my post on micronutrient deficiencies (plus this one) to see what else you might be missing.

Solution: Eat some liver, shellfish, seaweed, salmon, brazil nuts, and check your diet against a nutritional database for a couple weeks to see if you’re hitting all your targets.

You’re grazing all day.

People coming from a standard Westernized diet are usually ravenously hungry at all times. They have trouble going several hours between meals. And then they switch to Primal eating, their hunger issues improve, but the snacking remains. It’s tough to beat. After all, we live in a culture of snacking (those of us in the US, at least). If you work in an office, snacks abound. Donuts are always being trotted in and paraded about. Jars of candy beans and M&Ms adorn every second desk. People keep “snack stashes” in their desk drawers.

And so we snack. Instead of giving our bodies and digestive systems a break, we remain in “fed” mode. As soon as our bodies start to get a handle on the nutrition we’ve recently ingested, we send in some more – just as our guts were about to crack a beer and take a load off. Admittedly, I don’t have any studies to reference, but I don’t think it’s a stretch to say that staying in the fed state hampers our ability to utilize the fatty acids in our blood (since there’s a constant influx of nutrients, why bother burning what we have?), and thus might cause elevated cholesterol.

I’m not saying you have to fast, because you don’t. But I would caution people against grazing – against always having something on hand to absentmindedly munch on, against gallivanting around with a sackful of salted nuts on your belt, against eating 6-12 small “meals” per day so as to avoid imminent muscle catabolism. Just eat real meals, substantial plates of food that keep you sated for four to five hours a pop.

Solution: Eat real meals.

Your activity levels don’t match your carb intake.

While I’m a proponent of tailoring your workouts so that you don’t require a high-carb diet, many people enjoy maintaining a high level of sustained intensity in their workouts. That’s cool. I get it. Just don’t think you can stay very low carb and enjoy good health while maintaining high-intensity endurance or metcon training on a daily basis.

What’s this have to do with cholesterol? Well, if you’re hitting the metcons regularly without the necessary glucose infusions, your body conserves what glucose is available. We need some glucose for brain function (ketones and other sources can handle a lot of our brain’s needs, but not all of it), so in order to preserve what little glucose is available, T3 thyroid hormone is reduced. Normally, T3 increases glucose utilization, but when the body doesn’t have enough due to mismatched exercise output and carb input, T3 must drop to conserve glucose. Unfortunately, this lowered T3 can lead to lowered LDL receptor activity, which leads to increased lipid levels.

Solution: Align your activity levels with your carb intake.

You’re still not moving frequently at a slow pace.

I’ve said it before, and I’ll say it again: low level aerobic activity in the form of walking, hiking, easy cycling, or even light rowing is absolutely essential. There’s a reason it forms the base of my Primal Blueprint Fitness pyramid. When you go for a good-sized walk, you’re not burning calories. You’re not blasting your abz, bunz, and gunz. You’re not vomiting on yourself from overexertion. It’s not exciting. It won’t make a good Youtube video set to Linkin Park. But what you will be doing is utilizing those free fatty acids that might be throwing off your lipid panels.

In one study, patients who walked briskly were far less reliant on cholesterol, blood pressure, and diabetes medications. Those who took the longest walks at the briskest pace were the least likely to have LDL cholesterol high enough to warrant statins. In another, brisk walking was enough to reduce triglycerides and LDL particle count in overweight women.

Lifting heavy things and sprinting once in awhile are excellent acute stressors that elicit fantastic health and performance benefits, but constant low-level movement is the foundation of it all, especially if you’re eating more fat and trying to become a true fat-burning beast.

Solution: Do I even have to say? This isn’t optional. Go for a walk!

You’re not lifting heavy things.

Cholesterol isn’t out to get us, you know. We don’t manufacture the stuff to commit slow suicide. It actually serves a purpose in our bodies. From cholesterol, we produce steroid hormones, sex hormones, and make vitamin D (with a little help from the sun, of course). With cholesterol, lipid particles transport nutrients and antioxidants to various parts of the body. Research shows that, following weight lifting, we also use cholesterol to repair and rebuild muscles.

In fact, acute bouts of resistance training can cause large reductions in blood lipids. One study found that total cholesterol was reduced up to 48 hours after a single weight training session. Another (PDF) found that the cholesterol reduction persisted at 72 hours post workout. Interestingly, the drop in cholesterol in both studies accompanied a rise in creatine kinase, an indirect marker of the degree of muscle damage caused by strength training. The fact that the effects persist for days after a single bout of weight training suggests that regularly lifting heavy things can effectively manage your cholesterol.

Eating fat can increase cholesterol. Not in everyone, not even in most, but enough people see a (usually neutral) increase in cholesterol when they start eating more fat. That’s all well and good as long as you make use of it. Lifting heavy things, whether it’s your own bodyweight, someone else’s, a barbell, a log, or a machine, breaks down and then repairs muscle. Cholesterol is required to repair muscle, to make it stronger. To make you stronger. If you squander the opportunity to use all that cholesterol by failing to lift anything heavy, don’t be surprised if things get a little screwy with your blood lipids.

Solution: Lift heavy things at least twice a week.

Notice a common thread? Most of these reasons for elevated cholesterol are easily testable. And if you can test them, you can probably find a solution. Think back to the recent series on self-experimentation if you need some pointers.

That’s what I’ve got. What about you? Has your cholesterol increased since going Primal? Do any of these sound familiar? If so, how are you going to approach the issue – if at all? Or, if something else was causing your increase, tell us how you fixed it. Thanks for reading, everyone!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Wow, this was the perfect post for me! I’ve been Primal for a couple of months now and loving it. I’ve lost 47lbs so far and have never felt better. However, as of earlier this month, my cholesterol is also not looking so good. My HDL is low and my LDL is sky high. In fact, my doctor said my ratios are so bad that at this point she’s supposed to recommend statins (but she didn’t — I have an awesome doctor who is on-board with my Primal lifestyle and she is willing to watch my progress before freaking out.) Anyways, I did do a little research and discovered a few things that could be causing my elevated LDL, some of which Mark mentioned here. It’s nice to see it reaffirmed! I also discovered a few things that could be attributing to my slightly slow thyroid reading, but that’s another story. All in all, I’m not worrying too much at this point, and just continuing to do what I’m doing and trusting that in time, I will level out.

    PrimalNewborn_M wrote on June 26th, 2012
  2. Is 375 TC high enough to make you worry? LDL~260. Is this a case where statins may actually be a valid option?

    Jerome wrote on June 26th, 2012
  3. I’m in the UK and get regular bloods done due to arthritis meds….I was talking to the nurse about cholesterol while she took my last set and suggested that she could add the test on if I wanted….I was curious so agreed as they had my blood anyway :)

    Barry wrote on June 27th, 2012
  4. I never had my cholesterol checked before I went Primal, so I have no basis for comparison. Actually, I’m glad to see that so many people have results like mine.

    Total: 228
    HDL: 104
    LDL: 112
    Trig: 50

    What was funnier was the reaction the woman who discussed my results with me had. She couldn’t stop talking about my amazing HDL numbers because the only people who ever came into the Naval Health Clinic with those numbers were the occasional admirals. To see an enlisted GIRL made her so happy she was beside herself.

    I am experimenting with a few of the things mentioned here. I can be prone to overtraining and under-carbing, but I recently decided to do a lot more slow-movement stuff and push harder during my intense workouts. So far, that’s left me feeling better on lower carbs.

    I’m kind of a grazer. I eat breakfast, I eat lunch, and then I come home, have a snack, and then sometimes graze until dinner. It’s always on veggies, but still, maybe I could use to do less of that.

    I’m also buying offal from a local farmer; just had some amazing Cajun Blackened Chicken Livers for lunch yesterday, and I thought I died and went to heaven. It’s going to become a regular part of my diet just due to budget constraints.

    I’ll be curious to see what my numbers turn out to be in a month or two when I go back for another test.

    Deanna wrote on June 27th, 2012
  5. I wish my parents’ doctor would get his act together and stop pushing back statins on my mother who stopped taking them when her memory started to get affected early last year. They would change him in a heartbeat but there is a dearth of doctors here and waiting lists are insanely long. My mother’s total cholesterol increased by 50 points but that is because her HDL increased, her Triglycerides dropped but her LDL increased (the Trig/HDL ratio indicates that it’s pretty much the large fluffy neutral LDL particle, not the small dense one).
    The FDA issuing warning labels on statins re memory loss helped my mother’s case with her doctor but he still not completely on board.

    Sophia wrote on June 27th, 2012
  6. I think it is interesting reading the comments how varied everybody’s cholesterol levels are. They are as varied as the levels among those who eat a more standard diet. Perhaps the whole idea that there is a diet that can create the cholesterol levels doctors would prefer to see is suspect. Since most of us feel so incredibly healthy eating this way, that ought to count for more than lab numbers with weak correlations to actual illness.

    Diane wrote on June 27th, 2012
    • +1

      Deanna wrote on June 27th, 2012
      • +1, too!

        defrog wrote on June 27th, 2012
  7. I never realized Cholesterol repairs muscles, will switch from lifting weight to aerobics.

    Chris wrote on June 27th, 2012
    • Why?

      Greg wrote on June 27th, 2012
  8. Great article,had my annual checkup Chol 274, Tri 183, LDL 208, HDL 37. I’ve only cut out grains for about 3 months so far.
    I’m on some medications for life, but this information helps,and maybe I can get myself off the others. Hopefully, next year the results will be different.

    Jay Booth wrote on June 27th, 2012
    • Good luck to you, Jay! I hope a year of this works wonders.

      Joy Beer wrote on June 27th, 2012
  9. My numbers are pretty good both from a primal standpoint and from a traditional CW standpoint.

    After one year paleo I had this result last summer:

    total: 176
    HDL 59 (ish, can’t remember exactly it was high in the 50s)
    LDL 112
    Triglycerides 49

    My doctor was pretty happy with it.

    I actually worry my total might be too low, but I’m not doing anything specific about it. I still have a tiny spare tire to contend with so I started the Whole 30 last week with my wife. On day 11, So far so good. Only real difference has been the excision of dairy and alcohol.

    I’m 5’7″, moderately muscular and currently weigh 179 I don’t know what my Cholesterol numbers were back before paleo, when I was 225 and raw vegan because I was honestly too scared to test. I’m thinking about getting another test this summer to see where I’m at after year two. If it’s again good, I’ll probably not bother with it for a while.

    You’d think I have great genes but I’d beg to differ. We have heart disease, diabetes, obesity, and cancer in abundance in the various wings of my family.

    -Tim

    Tim wrote on June 27th, 2012
  10. I have been fighting high trglycerides for 10 years and going primal is the first thing that has gotten them down!

    Tom wrote on June 27th, 2012
  11. I’ve been putting off having my numbers rechecked, for fear of having the numbers be higher. In August 2011, I had my worst results ever: TC was 240+, TG were very high (I forget the exact #, but it was awful), HDL were the lowest they’ve ever been (below 60). My GP has wanted me on a statin for years, but as an under-40 year old female, I’ve been very resistant (still not taking any).

    I found this website in January 2012, and have gradually been transitioning to this eating style while lifting very heavy weights w/a trainer twice a week. I have dropped 25 pounds since January, and in thinking back to what I was eating in August, I would say that all of the “healthy” grains were contributing to the numbers, especially the TG. I was living on oatmeal, quinoa, and starchy vegetables, with very little meat and fat. I was hungry all the time, but weighed more than 200 pounds at 5’3″, with a 42 inch waist.

    Yesterday I made an appointment to have my annual physical in a few weeks. I still have some anxiety about how the numbers will come out, but I need to test the hypothesis in order to consider this a self-experiment. We’ll see how it goes!

    defrog wrote on June 27th, 2012
    • And, for what its worth, my waist is now under 35 inches, which may be a better indicator of health!

      defrog wrote on June 27th, 2012
  12. Hey Mark @lowcarblearning,

    Read your blog entry on your cholesterol panel results.
    Standard Lipid Panel results provide cholesterol concentration, not details such as particle count on individual markers. Your latest TG/HDL ratio of .69 is ideal, from which one can infer size pattern A in your LDL particles and good cardio health.

    According to Dayspring and others, the inference has a 20% chance of discordance, in that you may have an excessively high LDL-P particle count. Too many particles of LDL (even pattern A) is the root cause of arterial clogging.

    NMR Lipoprofile outcome can confirm the TG/HDL inference.

    Peter wrote on June 27th, 2012
  13. I haven’t even had a lipid panel done in almost 10 years. I don’t see the point.

    Don! wrote on June 27th, 2012
  14. NMR test done on 5/10/12

    HDL-C 59
    Trig 36
    Total Cholesterol 254
    LDL-C 168

    LDL-P (particle #) 1500
    Small LDL-P 127
    Large LDL-P 1373

    LDL Size 21.1

    LP-IR (Insulin Resistance) 6 S/B <=45

    TGL/HDL = .61

    SO – do I have too many particles even though they're large and buoyant??

    charles grashow wrote on June 27th, 2012
    • Ratios are as important and maybe more important than total numbers. Your ratios are actually pretty decent.

      RATIOS:
      Your Total Cholesterol/HDL ratio is: 4.31 – (preferably under 5.0, ideally under 3.5) GOOD
      Your HDL/LDL ratio is: 0.351 – (preferably over 0.3, ideally over 0.4) GOOD
      Your triglycerides/HDL ratio is: 2.288 – (preferably under 4, ideally under 2) NORMAL

      Plus – the Large LDL (which is the majority of the LDL) is associated with lower risk of atherogenesis.

      The other things that we don’t see here though are: is this an initial reading? If not – how is it different than other readings?

      Another thought – what kind of balance do you have in your diet? Even though protein and fat are great – we really should probably be consuming a relatively large quantity of plants too….which will change a lipid panel dramatically.

      Oh yeah – and genetic background makes some difference. If you’re ancestrally from a relatively extreme northern hemisphere location (think really short summers) you’ll make more cholesterol naturally – because it’s a precursor to Vit. D (and lots of hormones). It’s there to take advantage of any possible sun for conversion to Vit. D. Diet only goes so far to change that….

      rhintz wrote on June 28th, 2012
  15. Gee could it also maybe because you are eating more meat which is the only thing we eat that contains bad cholesterol?

    Ryan wrote on June 27th, 2012
    • How dare you use common sense and scientific facts! Thanks to you, Mark will be selling one less book this week and will have to wait a WHOLE 24 HOURS more until he can buy his new porche.

      thediva wrote on June 28th, 2012
  16. At 22 I was a vegan with a cholesterol over 215 with bad ratios.
    At 45 paleo I’m 167 total cholesterol, 59 triglyc., 60 HDL, 96 LDL.
    I’ve owned my own flock of chickens & for 15 years i’ve eaten 2-5 eggs every day. I have a high fat diet consistant with weston price & paleo. People have told me for years not to eat so many eggs & have tried to offer egg beaters. The proof is in the bloodwork.

    momupthecreek wrote on June 27th, 2012
  17. Looks like I have more bio research to do. If the people who are arguing against me (the people closest to me who have watched me do well eating this way and insist I’m still wrong) get a hold of this, they’ll totally go off saying that these unfounded “solutions” to rising serum numbers are just a way to deflect the fact that bacon and butter will kill us all. Therefore, I have more reading to do.

    I wondered myself what would happen if my numbers went up. Panic, probably. I’m having a significant amount of trouble building strong arguments against conventional diet advice as it is. I’ve stuck to the “credible” sources trying to develop a concise, mechanistically sound explanation of the physiological reasons why reducing carbohydrates in general and grains in particular is a good idea, because as a future medical professional and an insufferable know-it-all I have to have more than the usual fat=fat, carbs=fat explanations that most people are satisfied with. I need physiological functions, cell metabolism, and chemical mechanisms!

    I’ve read Wheat Belly, by a cardiologist. “Circumstantial,” my fiance says about the patient cases cited.

    I’ve read The Paleo Solution, by a research biochemist. “They just want to sell a book and make money,” my mother says.

    I’ve read the Paleo Diet, by a PhD. “Not a real doctor.”

    I have designs on The Art and Science of Low Carbohydrate Living, by an RD, PhD and an MD, PhD, and the Protein Power books by the dynamic MD duo. “They aren’t really trying to help, they just want to sell a book and make MORE money.”

    I also plan on reading some of the top books my vegan friend recommends, to assess the claims made there, because if I only read Paleo resources seeking validation of Paleo, then I’m just as bad as the “bad science” people who form a conclusion first, then seek out data to support the conclusion instead of forming a hypothesis and seeking and assessing all data to accept or reject that hypothesis. (I also believe that the main argument of one MD–that tons of vegetables are key to health because of all the phytochemicals and other goodies we don’t get on a SAD–is fundamentally correct… I just think that the blame for too little plant matter in the diet falls on a crapton of starchy carbs and not on the animal products we supposedly gorge on.)

    I guess I’ll get to that when I’m done with my six weeks of accelerated premed summer courses…

    Kristina wrote on June 27th, 2012
    • I don’t think anyone who is trying to sell you a glossy book is credible when peer reviewed dietary guidelines are available for free. A credible health site would clearly mark its advertisements for its products as ‘ADVERTISEMENT’ or better yet, not have any.

      I totally promote thinking critically (Where would science be if we didn’t) but please don’t bother reading all the peer reviewed stuff promoting a grain based diet without an open mind. That is not how science works either. Read everything critically, think of the motivation for writing, but do it without bias.

      Ally wrote on June 27th, 2012
  18. I’ve had two blood work ups done within the past year. The first test showed total lipids and LDL just slightly above the maximum end of the reference range.

    The second test (compared against the first test) showed an increase in total lipds, a slight increase in LDL, a huge increase in HDL (where most of my total lipid increase came from), risk ratio went way down, and triglycerides moved up 3 points.

    I can live with that. =)

    Jim wrote on June 27th, 2012
  19. Very nice post, as always Mark. My father is currently suffering from high cholesterol, and this article is one which I will show to him, in the hope that nutrition will help his health issues.

    Matt A wrote on June 28th, 2012
  20. I can’t understand sth- on Friday there was a story about 2 athletes who train very hard and don’t use any carbs, and now Mark says if we train intensively- we should eat carbs- who is right? I am confused when I read contradictory info.

    Vessela wrote on June 28th, 2012
  21. On the menopause front: the section on iodine sent me to the kitchen, where I’ve been eating liver and kelp with every meal since I read this post, AND MY HOT FLASHES ARE GONE!

    Due to hypertension, I’ve been avoiding table salt.

    Previously, I was using a combination of fish oil, vitex (poor man’s progesterone), and black cohosh–the 2011 PDR for herbs/supplements says fish oil can raise your BG levels–sugar is what brings hot flashes on. I dumped the pills and am using food instead…and am surprised at the miracle Mark brought forth.

    I printed out this whole article to take to my doctor, including the part about iodine (she says there’s nothing wrong with my thyroid, yet I get cold in 76 degrees). The cholesterol part is what I intend to use to justify my NOT going on statins like she’s been begging me to!

    Wenchypoo wrote on June 28th, 2012
  22. Although there is a belief that raising HDL is protective of artheriosclerotic development,particularly in the Paleo community, there is evidence that this may not be the case. From a recent study: “It’s been assumed that if a patient, or group of patients, did something to cause their HDL levels to go up, then you can safely assume that their risk of heart attack will go down,” said senior author Sekar Kathiresan, director of preventive cardiology at MGH, associate professor of medicine at Harvard Medical School, and an associate member of the Broad Institute. “This work fundamentally questions that.”

    http://www.eurekalert.org/pub_releases/2012-05/biom-rhn051512.php

    Read more: http://www.marksdailyapple.com/why-did-my-cholesterol-go-up-after-going-primal/#ixzz1z6XKHexI

    Brian wrote on June 28th, 2012
  23. My LDL is high but my HDL is good. I’m theorizing for me, the high cholesterol has a lot more to do with my stress level and lack of sleep in recent years (pregnancy and nursing a minimally-sleeping baby). I went to a medical grand rounds this morning on sleep and current research shows people who sleep under 6 hours/night are at a significantly higher risk for heart disease, and cardiac-caused death. It’s nothing MDA hasn’t covered before, but I’m hopeful it answers my high cholesterol question and that my numbers will improve once I’m out of the sleep-deprived little kid years.

    Kara wrote on June 28th, 2012
  24. Hey, Charles Grashow,

    According to NMR site, http://www.theparticletest.com/get-the-test.html#understand-your-results

    A LDL-P count of 1500 is at borderline high.

    I suspect your result is common to LCHF eaters. Some say try increasing carb and other say meidcation. I myself is trying to find an answer.

    Peter wrote on June 28th, 2012
  25. my CHO has increased to almost 300 .
    (HDL ~ 80, TG < 70) + hypothyroidism after switching diet.

    Paul Jaminet also mentioned that hypothyroidism may be what raises cholesterol & suggested similar things.

    i've been supplementing to reduce it.

    PHK wrote on June 28th, 2012
  26. Mark:

    I had a 310 reading of total cholesterol yesterdat following a fasting blood test. Visited the doc following day. He wants to do the advanced lipid profile. The report showed a number for non-HDL. Are you familiar with this? My doc doesn’t seem to be worried about the 310 because the HDL us very high. Ur thoughts, please sir.

    Yvette Combel wrote on June 28th, 2012
  27. Good info! Thanks for sharing with us on your blog.

    HB wrote on June 28th, 2012
  28. to kritina,

    My post and numbers are right before your post. Check out the numbers. Due to digestive issues I have eliminated all milk, grains & legumes from my diet for years. I eat alot of veggies, nuts, meat, eggs & oil. I also limit my fruit. I also eat alot of fermented vegetables & soak all nuts.

    When I was a previous vegan I stuck to the food pyramid. This is a great before & after.

    momupthecreek

    momupthecreek wrote on June 29th, 2012
  29. I love this blog post! really excellent approach to explaining the problem! good read..

    Aloka wrote on June 30th, 2012
  30. A number of authors, including Gary Taubs (Good Calories, Bad Calories), have pointed-out recently that the connection between dietary intake and blood-serum cholesterol levels is virtually non-existent. Also, the connection between cholesterol and cardiac risk is not supported by evidence either. Only triglycerides have minor connection to heart-attack/stroke risks.

    Eating primal can help triglyceride levels.

    Concern over HDL/LDL levels etc. is a myth propagated by drug companies making multiple fortunes from statins and other cholesterol-reducing drugs. (The actual efficacy of statins on reducing cardiovascular/stroke incidence is the same as that for an aspirin regimen.)

    Sean wrote on June 30th, 2012
  31. The documentary “Fat Head” is available on Hulu.com and is about one man’s challenge to “Supersize Me.” By eating low-carb (and an essentially primal) diet, he loses weight and reduces all his important blood chemistry numbers — even while eating fast food all the time.

    Sean wrote on June 30th, 2012
  32. I don’t believe the “you’re losing weight” reason is accurate.

    Triglycerides in the adipocytes (fat cells) must be broken down into their fatty acid and glycerol components to enter the blood stream. Once in the blood stream, they remain as free fatty acids (carried by serum albumin) and glycerol until used by tissue for energy or packaged back as a triglyceride by the liver (mainly). This repackaging is not substantial enough to cause high triglyceride levels in the blood – if your liver is pumping out an elevated level of triglycerides, your fat cells won’t be releasing any fatty acids.

    The overwhelming cause of higher triglyceride levels in the blood is due to ingestion of carbs (even protein) and the resulting (relatively) high levels of insulin signalling your liver to convert the carbs to fatty acids package up thes fatty acids (esterification of fatty acids) into triglycerides, primarily for transport to the fat cells. This corresponds with your reasoning behind “constant grazing” – a constantly fed state will cause a constantly elevated level of insulin, causing the liver to constantly package up those fatty acids into triglycerides at a higher rate as well as synthesizing fatty acids and packaging them into triglycerides from other compounds (i.e. carbs).

    Tyns wrote on July 2nd, 2012
  33. So after a year of Paleo, I’m down 80# (28.6% my original weight) and feel amazing. I was hoping that my numbers would prove the same thing!

    Now, I’m thankful for an understanding and supportive doctor, but we were both surprised to see that my total Cholesterol went up (207 to 243) at my year checkup, after having gone down a bit mid-year. My triglycerides, though, went from 251 to 85. She says to keep doing what I’m doing (don’t have to tell me twice) and that we’ll check in another 6 months.

    After reading these responses, I checked my ratios and I put any fears or worries to rest:

    My TC/HDL ratio went from 5.5 to 4.4 (“at risk” to “good”)
    My HDL/LDL ratio went from .3 to .32 (“good” to “good”)
    My TG/HDL ratio went from 6.76 to 1.54 (“very high risk” to “ideal”)

    I love how this makes me feel – and I love knowing that I’m doing such GREAT THINGS for myself.

    Peas wrote on July 6th, 2012
  34. Excellent post Mark.

    I would also suggest that sunbathing will diminish your cholesterol. It has been studied and there’s a link between the two. There’s even a evidence that statins increase calcidiol. (http://www.ncbi.nlm.nih.gov/pubmed/19543962)

    I’d recommend David Grimes’ book called ‘Vitamin D and Cholesterol: The Importance of the Sun’.
    It is really an enlightening read.

    Jorge Tafich wrote on July 9th, 2012
  35. LDL cholesterol will increase if you decrease intake of carbohydrates and increase intake of fats because of improvement in the distribution of LDL particle size as LDL becomes larger and less atherogenic. The total number of LDL particles, however (as estimated by apo B) remains about the same.

    For example, in a Berkely study, (pubmed 8299884) healthy men alternated between a diet with 24% fat and one with 46% fat for six week periods and their LDL was 17% higher, on average, on the high fat diet than on the low fat diet.

    The response of the men to different amounts of dietary fat was not uniform. About half the men had pattern A particle distribution (non-atherogenic) on both high and low fat diets and their ratio of TG/HDL was 2.1 on the low fat diet and 1.5 on the high fat diet indicating improved particle distribution on the high fat diet. LDL increased by 12%.

    About 35% of the men had pattern A distribution on high fat (TG/HDL = 2.0) and Pattern B distribution on the low
    fat (TG/HDL = 4.0)diet. LDL increased by 14% on high fat.

    About 17% of men had Pattern B distribution on both high and low fat diets. LDL increased by 21% on the high fat diet. These are guys with a genetically influenced atherogenic profile.

    So when you switch to a paleo diet that is higher in fat and lower in carbs there is bound to be some increase in LDL due to improvement in the pattern of particle distribution.

    The most important factor is not LDL level, but the ratio of TG/HDL which is a more accurate measure of CHD risk as it is an indication of inflammation.

    On a different subject, I highly recommend the book “How Statin Drugs Really Lower Cholesterol and kill you one cell at a time.” While there are many good books on the toxic effects of statins, this is the best book I have found that describes how statins actually work.

    Jack Cameron wrote on July 10th, 2012
    • Thank you for the book recommendation and interesting comment, Jack!

      Joy Beer wrote on October 16th, 2012
  36. I went primal/modified with Nourished Traditions Sally Fallon cook book. One year now.
    My doctor is freaked out because she has never seen numbers like mine. Total 308/HDL 104/Trig 37…excellent ration but she wants me to go to cardiologist, no history of heart problems. I’m 59, workout and walk etc…now my stress is up due to her reaction. I have taken statins and they really make me sick…so I went modified primal. Total went up but HDL up and Trig way down!!i’m thinking of staying away from docs…very fit and healthy except for the numbers! also a breast cancer thriver!! Thanks Mark love you information.

    Elizabeth Barksdale wrote on August 7th, 2012
    • + 1,000 for Nourishing Traditions! Got a copy of it years ago, and it pretty much laid the groundwork for going Primal without me even realizing it. Although, I did bring out the sugar last week, to make the sweet potato soda for a party – it was quite popular with the ‘I like to try strange new things’ crowd.

      Well, I’ve got nothing to say about cholesterol, because I’ve never bothered to check it – I’ll stop hijacking the forum now.

      Erok wrote on August 7th, 2012
  37. Interesting reading. My wife (40) just had her annual physical and we were placing bets on what her cholesterol might be. Last year it was 160. We have been following the primal eating plan for 6 weeks now…She came back today with blood results and it was at 207! I don’t have all of the details of good to bad, but she was pretty floored.

    So what did her doctor say? (My doc too). Told her stop eating eggs (just the whites, cut back on all fats, increase fiber, etc. This was a great post, but I need to learn more on this as well.

    PH wrote on August 21st, 2012
  38. New to paleo- 30 days

    51 years young and workout regularly.

    So here are my numbers – I expected them to be high but was shocked at how high. I have to admit I was thrown a bit off stride. The ratios seem good though and my HDL seems pretty solid.

    Any reason for concern?

    Total 327
    Triglycerides 72
    HDL 119
    LDL 160
    NMR particle size test pending

    Greg wrote on October 16th, 2012
  39. I should mention. I was not truly fasted at the time of the blood draw as required. I had 3T coconut oil and hiked 2 hours early that morning. Would this impact the lipid profile?

    Greg

    Greg wrote on October 16th, 2012
  40. Cholesterol helps repair damaged cells as far as I’m aware. So when you go Primal, you remove all the crap that was damaging your cells, because there is no more interference, your body creates more cholesterol because for the first time in your life your body is free to send out as many helpers to repair all the crap you’ve been doing to your body when you weren’t primal!

    Another reason could be is that your body was always producing the same amount of cholesterol, except when you were not primal the cholesterol was being used up to constantly to repair cells that were constantly being damaged, as soon as you go primal your body heals all your cells but your cholesterol creating mechanism has not caught up, so it keeps producing the same amount as before you were primal for a while, eventually it levels out and balances…

    Firefighters are used to there being 100 fires so they have been sending out 100 firefighters for 20-30 years, suddenly there are only 20 fires, but because there have gotten used to there being 100 fires for so long the firefighters automatically send out 100 firefighters anyway untill they get used to the fact that there are only 20 now. :p

    Goran wrote on November 11th, 2012

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