Brief Summary
I had normal cholesterol, went low carb, and then ketogenic, and saw that my cholesterol started to go crazy. I tried a host of things to bring it down including raising my carbs and taking various supplements to no effect. I finally saw a lipidologist, did some more research, and came up with a 12 point gameplan which surprisingly worked!
I’ve received some fair criticism for doing things in this manner because I essentially added so many variables at once which can make it hard to conclude anything at all. Ash Simmonds probably said things best in the comments here:
You changed too many things at once to be able to conclude anything meaningful whatsoever here.
What if all of this occurred simply because you changed your mouthwash, and the rest was a waste of time?
(He wasn’t the only one btw).
I have to disagree because the one thing we DO know is that these 12 changes worked, we just can’t conclude WHICH of these changes or combination of changes did the trick. High sensitivity, low specificity.
The next step for me was to slowly peel away each of these changes and reassess my labs to see what, if any effects there are. Also this would make my life easier since it’s one less pill or powder to take.
Bergamot was the first supplement I subtracted.
Why Bergamot?
In My Anti-Cholesterol Gameplan post I wrote:
This was another supplement recommended by my lipidologist. She explained that this may help with my cholesterol hypersynthesis because its mechanism of action is similar to that of statins but without the side effects.
In my research, it seems like this is a relatively new substance with one of the main articles touting this coming from the Wall Street Journal in January 2015 citing a study showing:
In a month long study of 77 patients published in 2013 in the International Journal of Cardiology, 1000 mg daily of bergamot extract lowered cholesterol from an average of 278 mg/dl to 191.
Here is a link to the abstract of the study itself. As opposed to Berberine, there really isn’t much data out there, and we still don’t know what the exact mechanism of action is and what the side effects are.
Since I was willing to do anything to bring down my LDL-P, I figured a 30 day trial with this should be ok.
I went with HP LifeScience Citrus Bergamot because their website looked reputable to me… which probably isn’t the best criteria to use.
Because of the lack of research and information on the mechanism of action and side effect profile, this was also the supplement I felt least comfortable taking, and therefore was the first one I wanted to remove.
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What Happened to My Cholesterol?
Here’s how it looks in relation to all my prior tests:
LDL-P: Things took a turn for the worse with a bump up to 1817 from 1489, for a rise in 330 points
Small LDL-P: This got worse also with a rise to 886 from the almost normal 592.
LDL-C: Interestingly this didn’t change much, only going up to 135 from 125. From the looks of things my LDL-P and LDL-C are now moving towards a more discordant pattern.
Triglycerides: Stable at 69, indicating that despite eating more carbs, I’m still not eating enough to raise my trigs.
HDL-C: Slight improvement, rising to 56 from 47. I’m not reading too much into this because this is within the normal range my HDL stays as you can see from the chart. In my case this is probably genetic more than anything, since nothing I do really moves the needle significantly.
HbA1c: When the lipidologist checked my HbA1c in July it had bounced up to 5.9 from being rock solid at 5.7 for the past two years, which made me worry a little. It’s back down to 5.7 now, despite all the changes I’ve made, including increasing my carb intake. This makes me think that the 5.9 value was likely due to lab variation. I normally get my blood tests through Labcorp, but the blood tests done with my lipidolologist went through her lab, Health Diagnostic Laboratory.
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FINAL THOUGHTS
After I stopped taking Bergamot, it looks like both my LDL-P and Small LDL-P increased and got worse. Superficially, this appears as if Bergamot is responsible for this change, but I’m not so sure this is an accurate conclusion that can be drawn.
Another potential explanation is simple variation. It’s been shown that cholesterol numbers can vary 10-20% for no reason at all, so this may account for my numbers.
This isn’t to say that Bergamot ISN’T responsible, it’s just to say that I can’t say that it 100% IS responsible.
In any case, it’s an interesting development and will be something to keep an eye on.
The next component of my Anti-Cholesterol Gameplan I’ll be removing is bionic fiber. I’ll be continuing with:
- Reduce saturated fat intake
- Eat more beans
- Eat low carb but not ketogenic
- Reduce coffee consumption
- Probiotics including VSL#3, Prescript Assist, and Primadophilus Reuteri.
- Berberine
- Omega 3
- Vitamins and Minerals (Athletic Greens, Vitamins D+K, Magnesium Threonate)
- Optimize Oral Hygiene
- Brushing at my gum line with my Oral B electric brush
- Using Oxyfresh Mouthwash
- Flossing
- Brushing with these angled go between brushes
- Maintain exercise (BJJ 4-5x per week, weight lift 1-2x per week).
You may have noticed that I’ve stopped updating my food on MyFitnessPal. I’ve been getting lazy about doing this because my diet hasn’t really changed these past few months and I found having to input info after every meal starting to get tedious. I might start it back up later on, but I’m enjoying this bit of freedom for the time being.
*Image found here
Good blog. How does removing fiber next answer the question about Bergamot? If your numbers go up again, now you have two variables in the equation that you are trying to figure out.
I thought the logical thing to do is to isolate it to one variable, good first selection, and add it back in and re-evaluate.
So what is your goal for this exercise? Identify the supplement that bettered your numbers or to find a supplement program that continues to maintain and improve your numbers. If you remove a supplement and the numbers change significantly, then you should consider adding the supplement back in, baseline the numbers again, and remove a different supplement.
Just a thought.
Definitely the right way to approach things. And if everything were perfect, I’d do exactly as you said.
Few reasons I’m doing this.
Cost – Paying for monthly supplies of all of this stuff is getting prohibitively expensive, so the more I can eliminate the better.
Side effects – Haven’t gone into this much, but there are some side effects that I don’t like, which I’ll blog about later.
Convenience – I’m getting tired of taking so much stuff. It’s really a pain in the ass. I know… not much scientific rigor, but you can imagine that at the end of a long day of work and some BJJ training, having to mix up fiber smoothies and take hand fulls of pills is the last thing I want to do.
If a followup cholesterol panel goes up, then yeah, I’ll probably have to reintroduce whatever I removed… if it goes down or stays the same, I’ll keep on subtracting.
In the future I may get to a point where I stop all the supplements altogether and just go back to square one, and add things one by one.
The scientist in me understands that this completely lacks scientific rigor… but the human inside of me just doesn’t give a crap. So here I am, putzing around somewhere in the middle!
I’m also cheating. 🙂 I have the followup cholesterol panel from the next step and know what happens after removing the bionic fiber. I just need to get around to writing it up!
Understand and yes very expensive.
I am following your program specific to fiber (pre/pro) and my numbers has dropped (LDL-P/ApoB) and have follow up test in two weeks. This would be my 60 day test. I do not focus on Cholesterol – my analysis says its all about the particles. The only change in my routine is that my diet has not been that good since the holidays so I am not looking forward to the results. Too many carbs.
Thanks again and please hurry up writing up the other post… 🙂 🙂
I agree, it’s all about the particles.
I’d love to hear what your 60 day followup is like!
I’m working on the next post… I’m just a very slow writer!
Follow up note:
30 day numbers shows incredible drop in LDL and ApoB (21%, 12%). Not a good dietary month and prebiotic consistency. I also took 4 VLS%3 per day the last 2 weeks prior to test. The study you referred to for VLS was using the higher dosage 450B vs. ~110B and this may be attributed to the drop.
This level of dosage is expensive. Curious what happens when you remove this supplement.
BJJ Caveman–what is your homocysteine. I am hearing that is a better marker than cholesterol.
My homocysteine is 10 (optimal <11).
My lipidologist ordered it in her panel.
Yes! Finally someone writes about satiny.
BJJ Caveman-
read your blog, great stuff! Same exact happened to me my LDL when thru the roof on the low carb paleo diet(180 ish to 240). I am now trying low fat, beans, and just seafood. I just got tested for the APOE test, think I too am a 3/4.
Question why do you think your Cholesterol and LDL are not back to your Jan 2010 levels if you are even eating better now versus the SAD of 2010? Has something else changed, weight?
Thanks!
Hope your changes work out for you! Keep me posted about how things turn out!
I’m not sure why they’re not back down to Jan 2010 levels. Back then I was running a lot more, like 2-3 miles per day, so that may have something to do with it.
My workouts now are less aerobic and more glycolytic.
It would be interesting to try to add in some more aerobic training into my regimen… the only question is how do I squeeze it into my schedule…
Quick question – how much bergamot were you taking a day?
500 mg in AM and 500 mg in PM.
Thanks. I just brought one bottle but will need to get more.
I!m trying some of your ideas and may eventually do all of it in order to get my cholesterol down.
Fantastic! I hope it helps you out too! Please keep me posted to let me know how things go!
My cholesterol had been creeping higher and higher for years. I am genetically predisposed to it. I am a woman 59 years of age. In March of 2020 my profile came back the highest ever at : 256 Total Non HDL- 172 and HDL 84. LDL Calc 155. My doctor wanted to put me on a statin right away but I said, let me see what I can do with my diet. My Mom suggested I start taking Citrus Bergamot. So I did. When I went to my cardiologist in August (five months later) I shared the report with him. He immediately wrote a prescription for a statin. I said, let me just see if it is lower now, so he ordered another test. THe results were dramatically different than five months before!! The total cholesterol was now 205. HDL 81, LDL 111 and triglicerides 43. Non HDL Cholesterol 124. So he said I didn’t have to start on the statin. I was elated! I forgot to mention to him about the Citrus Bergamot. But when I shared these exciting results with my main Dr. and that I attributed it to the Citrus Bergamot she was concerned, saying that these supplements can sometimes mask true high cholesterol levels . So now she has me completely off of the Citrus Bergamont to see what my “true” cholesterol really is. I havn’t gone in yet for the test. (its been five months since I went off of the C. B. ) I know she will want to put me on a statin if the levels are back up. But I don’t know what to believe. The Citrus Bergamot definately worked!
The last research I heard about showed that Statins only work for men (not women) who were elderly (60+ or 70+) who had already had a heart attack. Another case of great marketing by Big Pharma.
BP pays for a lot of ‘research’ and medical school’s facilities, chairs and such. Hence, doctors are taught to do what BP wants them to do, whether it is good for people or not.