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’m now in the process of peeling away parts of my gameplan to see what changes, if any happen to my cholesterol levels.
This past October I stopped taking bergamot and saw a bump in my LDL-P. My next step was to stop taking bionic fiber and in December… and found myself caving into my desire for coffee, and found that my LDL-P dipped back down.
The next thing I planned to stop taking was Berberine.
Screwing Things Up
So um… yeah… that was the plan. I dutifully put away my bottle of Berberine and continued with everything else… but after a week or so I noticed that my supply of probiotics was running low.
The probiotics I’ve been taking include VSL#3, Prescript Assist, and Primadophilus Reuteri… and I ran out of all of them at the same time.
December was a busy time for me at work, so I kept putting off reordering another supply… and I also upped my coffee habit to two cups a day. Suddenly, the holidays were upon me and I still hadn’t replenished my stash.
Finally, the middle of January approached and I realized that it had been almost 6 weeks since my last dose of probiotics.
So there we go… I did what scientists should never do: screw with more than one variable at a time.
- I stopped taking berberine.
- I inadvertently stopped taking probiotics.
- And I added an additional cup of coffee to my day, (this I don’t feel too guilty about)
I figured I’d get a blood test anyway just to see where things stood, but anticipated that it’d be hard to draw any conclusions from the results… as if drawing accurate conclusions has been easy thus far 😛
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What Happened to my Cholesterol?
Here s the tabulated data including all of my prior tests. You can click on it to make it bigger.
LDL-P: This soared back into the stratosphere to 2468 from 1611 for an increase in 857 points. DAMN!
Small LDL-P: This also skyrocketed back up to 1159 from 547, more than doubling. DAMN DAMN!!
LDL-C: Back up to 196, now showing more of a concordant pattern with LDL-C and LDL-P.
Triglycerides: Bounced slightly higher to 98… probably reflecting some of the holiday treats I enjoyed.
HDL-C: Minimal increase to 60.
Lp-PLA2: Still high and not really changed since July 2015.
Vitamin D: Increased to 49.2 from 35.2, indicating that the Vitamins D+K I’ve been taking has been doing it’s job. I had to increase my dose to 8000-12000 IU per day.
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So Where Does That Leave Me?
I’m right back to square one!
Here are the things that I’ve still been doing:
- Reduce saturated fat intake
- Eat low carb but not ketogenic
- Omega 3
- Vitamins and Minerals (Athletic Greens, Vitamins D+K, Magnesium)
- Oral Hygiene
- Exercise regularly, BJJ 4-5x per week and weight lift 1-2x per week
It doesn’t look like these things played a major role in lowering my LDL-P, especially since these have been pretty constant for the past 6 months. Nevertheless, I’ll continue doing these things for general health and well being.
The answer has to lie somewhere between the probiotics, berberine, and bergamot.
I’m also going to start tracking my diet again in MyFitnessPal to get a better sense of what I’m eating.
My next steps will go something like this:
- Take ~500 billion bacteria of VSL#3 daily for 4-6 weeks
- Check lipids
- Go off VSL#3 for 2 weeks
- Take 1000 mg Thorne Research Berberine daily for 4-6 weeks
- Check lipids
- Go off Berberine for 2 weeks
- Take 500 mg HP LifeScience Citrus Bergamot daily for 4-6 weeks
- Check lipids
This will be a good opportunity to test the effects of probiotics vs berberine vs bergamot independently and will hopefully reveal which of these individual components was responsible for my improved LDL-P.
*Image found here
This is not the post I wanted to see but I am glad you have a gameplan moving forward!
So, if I’m reading correctly, you did not change your saturated fat intake when your LDL-P went down, right? I don’t want to give up Bulletproof Coffee but I would do so if it was screwing with my numbers. I only drink a large BPC with about 1tbsp butter, 2 tbsp MCT oil, and enough coffee grinds for 2 cups.
I’m worried that our APOE-e3/e4 status makes us sensitive to saturated fats. But still not sure if we can blame our high Lp-Pla2 on that yet….
I cut my saturated fat intake back in July/August of 2015, and it hasn’t really changed since then despite the recent fluctuations with my LDL-P, so I don’t thinks this is playing a big factor in my case. I rarely eat bacon now. I rarely use butter now. I mainly use olive oil for cooking and salad dressing.
I do treat myself to an occasional coffee with 1-2tbsp of heavy cream once or twice a week, but that’s about it.
Interesting. So just to be clear – changes in saturated fat did not move the needle for you, but you cut it just because? Thanks dude.
Essentially yes.
The lipidologist recommended I cut it out… and most of the APOE3/4 stuff I read recommended I cut it out… so I’m trying to cut it out.
My LDL-P is still doing whatever it wants whether or not I cut out saturated fat.
Thanks dude.
I think the research will one day, hopefully soon, explain WHY things like bergamot, berberine, and probiotics can have a profound effect (sometimes) on lipid profiles. I think it will all come back to our individual microbiomes, which I think is as important to our health as our human genes. Bergamot is known to reduce gram negative bacteria. Berberine is also anti-microbial, and of course throwing in a bunch of live bifidobacterium, lactobacillus and that kind of stuff is going to displace some of your routine, settled microbiome.
You’ve already spent a lot of money on all this stuff, but uBiome, which I’ve seen you mention before, is $99 per test. I’d say that could help indicate the direction you need to take your gut microbiome so that you get the results your’re looking for.
American food project might be something to review. Rob Knight has (or at least had) a Coursera course you could take to immerse yourself in the amazing “revolution” taking place in mapping the human microbiome.
I think checking my stool would be a reasonable step… I’m just still grossed out at the idea of collecting a sample. I know I know.. I’ve been around a lot worse as a physician, but when it comes to my own excrement… yuck.
Berberine is for blood sugar NOT cholesterol – it’s effect is like Metformin
My bad – berberine does work on cholesterol
In combination with red yeast rice it’s very effective
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461797/
Effects of a New Combination of Nutraceuticals with Morus alba on Lipid Profile, Insulin Sensitivity and Endotelial Function in Dyslipidemic Subjects. A Cross-Over, Randomized, Double-Blind Trial
Methods
At study start patients were given dietary counseling and received placebo for 2 weeks. After this run-in period, patients were randomized: (1) Combination A [Policosanol, Red yeast rice (Monakolin K 3 mg), Berberine 500 mg, Astaxantine, Folic Acid and Coenzyme Q10] for 4 weeks followed by 4 weeks of Combination B [Red yeast rice (Monakolin K 3.3 mg), Berberine 531.25 mg and leaf extract of Morus alba]; (2) Combination B for 4 weeks followed by 4 weeks of Combination A.
Results
Combination B reduced LDL cholesterol below 130 mg/dl in 56.5 % of the patients, and Cambination A only in 21.7 % of them (p ≤ 0.027). Both treatments reduced plasma levels of triglycerides, total and LDL cholesterol and increased HDL cholesterol (all p < 0.03). Total and LDL cholesterol reduction was more pronounced in patients taking Combination B (p < 0.005). Combination B reduced also glycated hemoglobin, fasting glucose and insulin plasma levels as well as HOMA index (p < 0.005).
Looks like I’m going to have to learn more about red yeast rice…
Have you tried Tocotrienols + Pantethine? Chris Kresser recommends this combination for high cholesterol. These brands in particular: Designs for Health Annatto Tocotrienol + Jarrow Formulas Pantethin
It would be very interesting to isolate effects of each of these two and see which one is more impactful.
I haven’t heard of tocotrienols or pantethines.
Do you know what their mechanism of action is? Can you send me one of Kressers links?
It’s a recommendation from supplemental materials that go with his book “Your Personal Paleo Code”. Though probably you can find more information here too:
http://highcholesterolplan.chriskresser.com/
I’m not sure if he posted online free articles on this though…
I’m giving this combination a try myself and planning to test LDL-P in a few weeks.
Thanks for sharing this.
I might give those a shot after this experiment runs its course.
Please be sure to let me know how things work out with your LDL-P!
Very interesting the LDL levels are so high compared to the 2010 time frame. The APOE 3/4 gene you have would suggest a higher levels in 2010? Perhaps the SCD and the Ketosis diet messed up your gut flora and it has yet fully recovered, hence not eliminating cholesterol properly.
Are you sill eating the beans/lentils and fiber every day?
That’s what I’m tending to think regarding a plausible theory… messed up gut flora.
My bean consumption has definitely waned… Chipotle was my main source of beans and I just haven’t been feeling it these past few weeks. Therefore no beans…
First time to the site, and guess what lead me here?
After 9 months LCHF Paleo I’d lost a bunch of weight and was feeling good, but had a basic cholesterol test that showed high LDL. So I decided to spring for the advanced bloodwork to get it checked out. Turns out my results are very similar to yours in the test you posted about on Sept 21st 2015. My LDL-C and LDL-P are lower, but small LDL-P is almost identical, and Lp(a) is higher at 158. They recently changed the baseline for Lp-PLA so I don’t think I can compare, but the thing that freaked me out the most was hs-CRP of 12.3.
I scored 5.6 on HbA1c, so insulin resistance looks like a factor as well.
And for the kicker, guess what… ApoE 3/4. I’m seeing a trend here.
I’m hoping the high CRP was due to some other issue but my Dr. has me on an AIP diet and we’re working on gut health with high dose probiotics and lots of other supplements. I’ll retest in a few months. Meanwhile I’ve cut way back on saturated fat consumption, cut out dairy, and am mainly eating lean meats, fish, vegetables and berries.
I’m going to read the rest of your posts now, but after spending a bunch of time over the last few weeks on MDA forums, paleohacks, Kresser’s blogs, Dr. Browns, etc. I’ve seen at least a couple of dozen posts from people with ApoE 3/4 on LCHF paleo with bad blood work.
Please keep posting on this as it is very hard to find information and good advice.
Hey MrToad, thanks for posting here. I came across this blog the same way. I have spent the last month doing the same thing you did. There definitely seems to be a trend and its scary.
What’s weird to me though is that you guys have such high HbA1c results. Mine was 4.7 last month. I know everyone is different (for example my Lp-PLA2 is much higher than both of you at 339) but I still think that it doesn’t make sense for you guys to have such high A1c results if you’re on a low carb diet.
I don’t take any probiotics so I might try VSL3.
Exactly the same thing which got me here – i have had high cholesterol over the last two years (240 – 275 range). Started Keto a month back, and now it 362 with a LDL of 315 (up from 176 on the last test!!). Planning to increase the sources of healthy carb and see if it helps. Also cutting down on Saturated fat. Including more veggies, reducing the non-veg to mainly fish and chicken with occasional beef and mutton (2-3 times a week). The only supplements I am taking is Cod Liver Oil (Omega 3), somehow don’t like supplements too much. Will come back and post my results if there are any changes.
Yeah! I’m not sure what to make of my HbA1c of 5.7%. I’ve literally been testing randomly throughout the day and my blood sugars are always in the 80’s and 90s… According to an HbA1c of 5.7% my blood sugar should be averaging 112… so who knows what to make of this. I do suspect it has to deal with the longevity of my red blood cells… that can cause a spurious elevation in HBA1c.
Your CRP is pretty high. I’m hoping you’ll be able to get that sorted out! If you find out what the cause of it is, please let me know!
What other gut supplements did your doc put you on?