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 found that my LDL-P dipped back down.
Most recently I screwed things up by stopping everything at once and found that my LDL-P rebounded back to the stratosphere.
Because I suspected that the main factors responsible for lowering my LDL in 2015 were between the probiotics, berberine, and bergamot, my plan to isolate each of their effects was to:
- 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
So here we are, after 6 weeks of taking VSL#3, I checked my lipids.
VSL#3
Before jumping into the results, I just wanted to highlight again why this was my choice of probiotic. I wrote a review of VSL#3 showing why I felt this was the most legit probiotic on the market. There are over 200 entries in PubMed referring to VSL#3 which has been studied in all sorts of patients including babies and breast feeding mothers.
It’s also shipped in a sturdy styrofoam container filled with ice packs to keep everything cooled properly. This definitely isn’t one of those shady fly-by-night operations.
A paper out of India showed that
… the probiotic preparation VSL#3 affected insulin sensitivity, lipid profile, and atherogenic index favourably and reduced hsCRP, a marker of inflammation, in overweight/obese adults. Probiotic given in combination with omega-3 was more effective than probiotic alone.
The improvement in the lipid markers was specifically:
HDL increased by 23.2% and LDL decreased by 10.7%; triglycerides decreased by 7.78% and VLDL by 7.78% in the probiotic with omega-3 group, compared with baseline levels
And oh yeah… VSL#3 has been shown to be protective against weight gain.
Unfortunately it’s not cheap. Just basing it off of prices from Amazon:
- Pack of 30 VSL#3 Sachets for $94.91 = 142 billion bacteria per dollar
- Bottle of 60 VSL#3 Capsules for $56.49 = 119.5 billion bacteria per dollar
To make sure I was taking enough, I aimed for around 500 billion bacteria per day.
I started off with the bottle because of the convenience, but then decided to try out the Sachets since it offered 33.5 billion more bacteria per dollar.
[otw_is sidebar=otw-sidebar-1]
Oh yeah, I started tracking my diet again
To get a more quantitative sense of what I’ve been eating, I’m now regularly logging my diet. If you want to see what kind of stuff I’ve been eating just add me as a friend on the myfitnesspal.com site. Fair warning: I haven’t been as paleo as I should have been. The hospital I work at serves these breaded chicken tender things that are pretty tasty… and just so damn convenient.
Here is the macronutrient break down from last January to now:
- Calories: 2310
- Carbs: 147
- Fat: 126
- Protein: 144
- Sat Fat: 46
What Happened to my Cholesterol?
The Tabulated Version
[otw_is sidebar=otw-sidebar-2]
LDL-P: Slight reduction to 2269 from 2468
Small LDL-P: Slight reduction to 996 from 1159
LDL-C: Slight reduction to 180 from 196
Triglycerides: Slight reduction to 85 from 98
HDL-C: Stable at 58
Total Cholesterol: Slight reduction to 255 from 276
CRP: 0.41 meaning no real systemic inflammation going on in my body.
So what does this mean?
My LDL-P, Small LDL-P, LDL-C, and Total Cholesterol all dropped 8-10%. I’m just not sure what to make of it. Were these changes real? Or just noise?
I mean, this coincides with that study from India showing a drop in LDL-C of 10.7% but we also know that variations of 10-20% can occur. I guess the one thing I CAN conclude is that VSL#3 alone wasn’t responsible for the huge drop in my LDL-P in 2015… but it may have played a role. Maybe it wasn’t a single factor that lowered my cholesterol but a summation of factors.
I can imagine a scenario where VSL#3 lowers my LDL by 10-20%, Berberine by another 10-20%, and Bergamot by another 10-20%.
Maybe the Prescript Assist and Primadophilus Reuteri played important roles too…
Before I muddy the waters though, I think it’s best for me to continue on with my current plan. Next up 2 weeks of no probiotics followed by Thorne Research Berberine.
And of course, I’m still doing all of this stuff:
- 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
*Image found here
Have you ever considered doing a stool test along with an organic acid test or something similar? Maybe you have excess amounts of more toxic bacteria and yeast that need to be cleared up before you get the real benefits from the vsl3? Some would suggest antifungal and antibacterial meds/herbs first if warranted . A good detox plan would help too. Your 30 day plan is pretty close to what most would consider a detox plan. When you detox you can get rid of a lot of the damaged cholesterol that keeps getting recirculated. Maybe that’s why it worked? I met a brilliant doctor in the Atlanta area who opened my eyes to a lot of this stuff. I’ll give you his name of you want.
Funny you should ask. I actually just ordered a ubiome and it just got shipped out. So stool analyses is on it’s way!
Would love to know the name of that doc and if he’s got any resources I could look over!
Have you ever had a CAC scan?
Not yet. I don’t think it’ll be helpful at this point.
Interesting. Based on your age, we will all eventually have a positive score and if you have a zero score then research has shown this is a great window into the likelyhood of an event for 10 years. Personnally, based on your testing regiment, you need to know if have plague and the growth of it. The test is $60, 5 minutes, and low radiation. Geez, less then the cost of VSL # 3.
Great post.
BTW, we are all trying to stop the large number of particles from being absorbed and calcified. Based on your extreme number of particles, it may be a consideration for the future.
I agree 100% with this.
Ya, it’s something I’ve considered in the past. But after talking through it with Dr. Dall, we both agreed that it wouldn’t really change my management at this time.
Scenario 1: I have pristine arteries with zero coronary calcification. Does that mean I’d continue to let my LDL-P stay high? Of course not. I’d still want to try to do what I can to bring them back down.
Scenario 2: I have coronary calcifications. Would this change my current line of therapy? Nope. I’ve already found a combination of non-statin related over the counter therapies that work. Therapies that I’m more comfortable taking… and which I’m currently dissecting at the moment.
This is my thinking at least… It might be something fun to try in the future, but at this point it’s low on my list.
Interesting point of view, BJJ. What if you get the CAC score and you see no calcification, and a year later with a high LDL-P you still don’t see any? I guess what I’m trying to say is, the more info the better – even if you’re LDL-P is high, it might be mitigated by something and you would need less intervention (if any at all).
I have similar numbers to you. I am only 30 but I did a CAC score and had 4 pathways with no blockage, but 1 pathway with a blockage score of 6 – which I was told is advanced for my age.
Yelp Dr. Dall is not a fan of the CAC test. We should remember that she is a Lipidologiest and not a Cardiologist. Just from a baseline perspective. The key fact is that if you have a positive score of > 0 then you have heart desease and you see a Cardiologist. Great posts
Hey Willie, thanks for the response. Do you have any good references on average CAC scores over age? Everything I find is for 45 years old and up.
Johnny,
Regarding CAC scores based on your age, the score is zero regardless of age. I have read when you are over ~70 then you changes goes up. I tested there times in 10 years and the last one was positive. A low number but positive. A positive score means I have heart disease and now I have to track the growth of it. The goal being < 30% growth per year. I get a CAC test yearly now.
Just stumbled across you site. Great blogs! I just got my NMR results and they are similar- 1916 LDL-P, 919 small LDL-P, 81 trig. I have been low carb for a long time and currently have been ketogenic for several months. I am going to start cutting out much of the saturated fat and do some of the other things you mention. Question – have you thought of trying metformin to reduce LDL-p?
Yes. It’s something that the Lipidologist suggested.
Apparently Berberine has a lot of similar mechanisms of action as Metformin. I want to isolate what worked first. Then I may try metformin out in the future.
Two other suggestions:
Niacin an1d Pantethine
I’ve had quite a few people bring this combination up to me. I’ll add it onto the list of things to check into.
I have been using Pantethine, Berberine, and Bergomat over the last 2+ months. My LDL-P has dropped from 1602 to 1270, HDL increased and and all other markers improved.
That’s impressive. What daily doses?
Yes, I too would love to know the doses!
Jarrow Formulas Pantethine, 450 mg 2/day
Biotics Research, Berberine HCL 500 mg 2/day
Citrus Bergamot (Citrus Bergamia Risso) “juice” 650mg 1/day
(currently Jarrow Formulas Citrus Bergamot 500 mg 2/day)
Also take
American Health Ester-C with Citrus Bioflavonoids – 500 mg 2/day
CoQ10, Probiotics, and sauerkraut
Thanks!
Would you be interested in writing a short guest post here about your cholesterol experience and how you successfully treated it? I know a lot of the readers here would love to learn!