I learned in March 2015 that my LDL-P and small LDL-P were still elevated and my Lp-PLA2 (marker of vascular inflammation) was also elevated.
I experimented with a trial of daily anti-inflammatory supplements including, Athletic Greens, Thorne Curcumin, and Thorne Omega 3, Lemon Berry while bumping my carbs up from 100 gm to 120 gm. When I retested in May 2015, I discovered that this didn’t really have any effect at all on my cholesterol AND caused a nominal bump in my Lp-PLA2.
At this point I wasn’t sure exactly what to do except to vary my macros a little more by increasing my carbs and decreasing my dietary fat.
While I continued to train BJJ 3-5 times per week and weight lifted 1-2 times per week I decided to take a complete supplement holiday just because I was getting a little tired of all the pill popping and powder mixing, especially since none of it seemed to have any real effect on my cholesterol.
If you want to see exactly what I ate during this time period you can check out my diary on MyFitnessPal here.
I exported the data as a tabulated excel spread sheet for easier viewing here.
These are my averaged daily macros from May 7, 2015 to June 8, 2015.
- Calories: 2044
- Carbs: 146 gm
- Fat: 100 gm
- Protein: 125 gm
- Saturated Fat: 44 gm
You can see that compared to the prior time period, my carbs increased by around 20 gm, fat decreased by 30 gm, and saturated fat decreased by almost 10 gm.
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On June 9, 2015 I re-checked my NMR Lipoprofile and my thyroid panel (just for kicks) and here are the results:
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Cholesterol
Here is my data in a tabulated format including all of my historic values. You can click on it to make it bigger:
I’m not entirely sure what to conclude from this. My LDL-P and Small LDL-P actually fell slightly to their lowest levels since I’ve been testing but since the change was so small, I can’t be sure if this isn’t just normal variation.
My total cholesterol and HDL-C are essentially unchanged. My triglycerides bumped up to 105, likely reflecting the increased carbs.
Thyroid
Here is my data in a tabulated format including all of my historic values. You can click on it to make it bigger:
All the numbers actually look pretty good. The rT3 bumped up a bit which can be due to a lot of things. I suspect my training volume and/or my lowered caloric status are probably to blame, but I’m not too concerned because everything else is looking dandy.
At this point it doesn’t look like my cholesterol issues are related to my thyroid issues which seem to be under control.
So What Next?
It’s been almost 2.5 years since my first NMR Lipoprofile that showed my out of whack numbers and despite experimenting with all kinds of things, they’re still out of whack.
It’s just so puzzling that everything was stone cold normal in 2010 and then when I started tweaking my diet first thanks to Tim Ferriss’ 4 Hour Body and then Volek and Phinney’s Art and Science of Low Carb Performance, my numbers started going haywire. It’s almost like a flip was switched in my body.
I really want to get to the bottom of this… so it looks like there’ll definitely be more research for me in the near future.
*Image found here.
I’ve noticed that your HDL is LOW and TRIGs are HIGH ? Don’t you think so ?
Since you are willing to spend some money tracking your panel, why not spend a little bit more to have a professional to look into your numbers ? Not sure what your budget are BUT I have watch a few videos on youtube of Dr. Mager of WellnessFX and seems like he knows what he is talking about, he fixed Dianne Fu. Maybe Ben Greenfield. He has a couple of video podcast showing how he was interpreting his own panels. He prolly can do that for you for a fee.
I’d say that my Trigs are high normal and my HDL are low normal. Both could definitely be better, I’d agree with you on that…. but not as crazy as some people with terrible metabolic syndrome with HDLs in the 20s and Trigs in the 300s.
You have very astute observations. We seem to think a like. My next step was to do more research and to consult a lipidologist.
I plan on writing more in the near future, but as a teaser, I’ve already spoken with the doctor, drawn labs, reviewed the labs with the doctor, and am beginning to institute a plan! 🙂
More to come…
What were you eating in 2010 when everything was “stone cold normal’??
2010 was pre 4 hour body, pre ketosis, pre paleo… so at that time I was eating a lot of taco bell and hot pockets and burgers and occasional salads. Lots of sandwiches too.
I was trying to keep the calories lower.. but in terms of macros it was probably 60% carbs 30 protein 10 fat. Something like this.
If you look at the nutrition info of a taco bell beef burrito supreme (I still love these), that’ll probably reflect what my macros are.
Kinda nuts right? Maybe I need to go back on a Taco bell based diet…
How do you feel on this diet? Are you able to train with intensity and have energy throughout the day?
Have you considered going to 25% P, 45% C and 30% F for your next experiment? I think it could be interesting to see how you do with more carbs than fat.
I feel fine!
Energy is good. I train with good intensity… in fact I’m stronger now than before. The BJJ warmups use to gas me out about half way through.. and now I can make it through only slightly winded. I can train longer and harder than before. I mean, if I didn’t have these blood tests right in front of me, I’d say that I’m in the best shape I’ve ever been in!
Not sure playing around with my macros will do much now… As I said in a post above my next step was to meet with a lipidologist to get to the bottom of things. Just got the blood tests back and spoke with the doctor, and will begin to implement a plan.
I promise to write more of course!
I have had a similar experience. After reading Peter Attia and later Bulletproof, in 2012 I went all in. Bulletproof all the way. Luckily I had bloodwork taken at the very beginning and my numbers looked similar to what they had been over the previous 5 years. Thirty days later my cholesterol went from 250-350, my trig went up and my crp went up to 7. Assuming that it was temporary I stayed the course. I did find a Paleo friendly doc who did a multitude of test and allowed me to continue my science experiment. My ldl_p was off the chart >3500, (don’t know what it was since it exceeded their range. After two years I decided that it was not working for me. I reduce my sat fat and started taking a statin. After a year of tweaking my total cholesteral is 150 Hdl 50 ldl 105 crp 0.5 and fasting blood sugar 90 ( it had gone up to 95 with very low carb) my TSH is normal and my LDL-P is 1750 still high. I don’t know what my LDL-P was before this because no one had taken it. I assume you read “The Four Hour Body” book. I didn’t see it mentioned in your posts (maybe I missed it.) You state that you were on the slow carb diet which is a lot like carb night with beans. I am wondering if you have any observations about the two. I am reading FHB and he mentions ALH among other things. I observed that in all of my blood test ALA levels are unmeasurable so I started taking it to seem if it matters. I started looking a heavy metals, to try to understand. My thought was excess of sat fat allowed my body to try to detox(just a thought.) I do have an MTHFR mutation (it seems that everyone does) that I am trying to deal with by taking supplement including sanction B vitamins. My latest A1C if 5.2 which seems high considering my diet at the time. They also took a beta-hydroxybuterate reading which was 7.7 ug/Ml which seems like I deep into ketosis if I understand the reading. Your thoughts are appreciated
Ben
The 4 Hour Body was what got me started on all of this! I really enjoyed that book and tried to follow a lot of it’s principles.
I’m sorry, I’m not sure what ALH and ALA is. Do you mean alpha lipoic acid?
I’m also not sure what the beta hydroxybutyrate reading is because of the units. What I’m used to are in mmol/L.
I can’t say too much about your situation now, and it’s a little unnerving that despite statin therapy and cutting back on your saturated fats, your LDL-P is still 1750, but I think you may find what I write about in the next few weeks to be helpful, and maybe applicable. It may give you some ideas for things to try and other tools to explore.
Get ready to learn more than you ever wanted about Cholesterol….
You are correct I meant ALA. The units on the bhb confused me as well which is why I included them. although I think micro/milli is the same as milli/liter. In both cases it represents 1 part per thousand I think. Tim mentions Policosanol for lowering cholesteral, did you ever try that.
My bad ug is not ul so I don’t have any idea how the numbers translate. In the test it was flagged as red, but I assume they are concered about ketoacidosis not ketois.
I did try the PAGG stack during my slow carb diet days, and haven’t revisited it since…
Saw my cardiologist this last week
Agrees that the Lp-PLA2 test is useless as an indicator of anything
Aced my EndoPat test – An EndoScore is the final analysis of a 15-minute EndoPAT assessment based on the ratio of the post- to pre-occlusion PAT amplitude of the tested arm, divided by the post- to pre-occlusion ratio of the control arm. The higher the EndoScore, the better the health of the endothelium and the lower the risk for heart disease.
http://arterialhealth.net/physicians/physician-information/
Green Zone. Score between 2.1 and 3
Your endothelium is functioning optimally, and you have maximum protection. Keep up whatever it is that you are doing, because the foods that you have been eating and the physical activity you have been performing regularly have affected a number of risk factors implicated in vascular health and longevity, particularly blood cholesterol levels, hypertension, and obesity.
My score was 3.56!! YEA
Started on 5 mgs of Enalapril – genetic high blood pressure cannot be controlled by diet or supplements
HbA1C was 5.6 on 1 test and 5.8 on another test – same lab, same day and fasting glucose was 96. She advised to cut down on fruit and increase veggies BUT not to go higher saturated fat – confused.
Also – LDL-P is VERY, VERY important especially small LDL-P so that’s where I feel you need to concentrate your efforts.
Hmmm.. I might need to get that endopat test in the future, although right now I don’t think I have much vascular disease. Still too young. Which is why I don’t think a coronary calcium test would be applicable to me right now either.
But I do find the idea of the endopat test interesting. Thanks for sharing that with me! It would be an intriguing way to track vascular health. I think I may have heard it mentioned on Dave Asprey or Tim Ferriss’ podcast because now it’s starting to sound fmiliar.
My lipidologist agrees with you about LDL-P. That is the most concerning thing, and what we need to address first!
You also may have to consider this test
http://www.bostonheartdiagnostics.com/science_portfolio_cholesterol_balance_test.php
Then adjust your diet based on the results
Yup, we checked my sterol markers, just through a different lab.
What were the results? Do you over produce, over absorb?
I promise to write about it in the near future! 🙂
http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-v
Summary
At first glance it would seem that patients with smaller LDL particles are at greater risk for atherosclerosis than patients with large LDL particles, all things equal. Hence, this idea that Pattern A is “good” and Pattern “B” is bad has become quite popular.
To address this question, however, one must look at changes in cardiovascular events or direct markers of atherosclerosis (e.g., IMT) while holding LDL-P constant and then again holding LDL size constant. Only when you do this can you see that the relationship between size and event vanishes. The only thing that matters is the number of LDL particles – large, small, or mixed.
“A particle is a particle is a particle.” If you don’t know the number, you don’t know the risk.
This was the sentiment of my lipidologist too. Pattern A vs Pattern B is all ancient nonsense.
http://advancedmediterranean.com/2013/10/07/heart-attacks-it-all-boils-down-to-ldl-p/
Agree.
Have you ever thought about just going back to “normal” standard eating? Seems like your best # started there as you alluded to.
Yes… I’ve considered this and have experimented with increasing my carb intake to see if there are any changes. Nothing significant happened though.
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