Cholesterol Update with Berberine AND Bergamot, April 2017

In the last episode of “Let’s Tinker With The BJJ Caveman’s Cholesterol,” I took Bergamot 500 mg 2x/day and saw that it brought my Small LDL-P to 407 which is the lowest it’s ever been and the fist time it was in the normal range of <527 nmol/L.  My LDL-P remained in the high range of 1600-2000 at 1756 nmol/L.

So now we’ve seen what my cholesterol looks like with a dietary intervention alone (eating Whole 30), with Berberine 500 mg 2x per day, and with Berberine 500 mg 3x per day.

The next step of my experiment involved taking both Berberine AND Bergamot.  These are the brands I took:

Thorne Research Berberine 500 mg 2x/day
Jarrow Citrus Bergamot 500 mg 2x/day


Um.. WHAT?!  When I first saw these results I was flabbergasted.  This made no sense.  Why did both my LDL-P AND my small LDL-P go up?!?!

I then realized that this may have been related to my diet.  In the week or so before I took the blood test, my folks came up to visit so of course my normal diet went out the window.

The BJJ Cavemom makes some of my favorite all time dishes in the world and she didn’t disappoint when she stayed with us.  Knowing that we don’t get to eat her cooking that often, she pulled out all the stops and made a large pot of one of my this one thing that I just can’t get enough of.

It consists of braised pork belly, eggs, and various salts and spices slow cooked over a number of hours.  It was just as delicious as I remembered and I ate to my hearts content.  I imagine that the saturated fat content of this was out of control.

Because of my ApoE 3/4 genotype, I know that eating a diet high in saturated fats can lead to a worsened lipid profile, so I typically try to limit the amount I eat, but on this special occasion I left myself enjoy this delectable home cooking.

I waited a little over a week while eating my normal diet which is mainly Whole 30 and continuing to take my Berberine and Bergamot and retested my cholesterol.

And for context:

Any Changes?

I’ll be ignoring the data from 4/3/17 because that was when I was eating all the saturated-fat laden goodness.

LDL-P: Dropped slightly from 1756 to 1715.

Small LDL-P: Climbed 95% to 797 from 407.  Not good.

LDL-C: Went down to 141 from 155.

Triglycerides: Increased to 115 from 64.  Not sure what to make of this since my trigs hardly ever climb above 100.

HDL-C: Essentially unchanged at 49

Total Cholesterol: Ticked down to 213.

Final Thoughts

My LDL-P remained stubbornly in the 1700-1800 range that I saw while taking either Berberine or Bergamot individually, so this may reflect a floor to how low I can bring things with just these two supplements.  I was hoping there would be an additive effect which would bring me into the 1400 range which is what I managed to get it to when I was using the entire Anti-Cholesterol Gamepan.

Even more puzzling is why the combination of Bergamot and Berberine actually lead to an increased small LDL-P.  I actually can’t even think of a hypothesis as to why this would be.  Maybe they interfere with each other?  Maybe I didn’t wait long enough for the effects to take hold?  Maybe my body was still affected by all the saturated fat I ate?  It’s hard to say.

After fiddling around with these supplements for the past few months, I want to take a supplement holiday and let my body get back to it’s normal-supplement-free state to see where things stand.

Some things I plan to tinker with are apple cider vinegar, intermittent fasting, and cutting out all red meat and eggs.

Let’s see where this takes me.

16 Responses to Cholesterol Update with Berberine AND Bergamot, April 2017

  1. Sa Bo says:

    Really appreciate your detailed tracking, I’m in the same boat currently and I’m taking Berberine and Bergamot to see if my markers improve. Can’t wait to see what your baseline without supplements looks like. When you talk about your problem with saturated fat, do you only consider the saturated fat from animal products or would you also count the saturated fat from MCT’s and other good oils?

    • Robin Christianson says:

      Yes, I want to really know the answer to this also!

    • BJJ Caveman says:

      I consider all saturated fats. I’ve really backed off my MCT intake and coconut oil intake. We only use it for cooking now, but no more bulletproof coffee or taking it willy nilly like I did before.

  2. Robin Christianson says:

    David, Please see my questions in reply to your AdaptLive youtube video. I better start reading all your posts here….I’m in the same boat. I can’t find peace with my bad lipid panel after 4 months on keto under 20: TC 287, LDL 207, HDL 65, TG 74. When I was vegetarian, low fat: TC 153, LDL 61, HDL 52, TG 199. I’m in a panic.

    • Robin Christianson says:

      Funny. I’m 68, eat clean organic, walk every day. But my 74 year old sister who eats the SAD diet, uses a walker, zero exercise for decades, 40 lbs overweight has a pristine blood panel. What the? I’m lost now. 🙁

  3. Eric Robinson says:

    I think your numbers show the strong force of genetics. No matter what you do, how you eat or what supplements you take you still have bad “cholesterol” numbers. I would guess that if you took red rice yeast this would be the only supplement that you would see significant changes in your LDL-P. (Because it’s basically a statin ). I doubt anyone would ever say you are anything less than an A++ patient with regards to lifestyle modifications either. The big question remains though: to treat your numbers with a statin and/or zetia or not? You should get a CT calcium and a CIMT and follow progression closely if you don’t want to take meds. Depending on your age, if your LDL-P remains elevated year after year the chance of plaque formation and arteriosclerosis is high. I’ve got almost identical numbers to you as well as being APOE3/4 and having extremely high lp (a). No diet changes did anything to lower my num
    bers. I got a CT scan which showed plaque in my LAD and a CIMT that showed carotids that looked 10 years older than what it should. This was the straw that broke the camels back. After 3 years of working out, 40 lbs of weight loss and maintained it for 3 years, low carb x3 years (not keto) i threw in the towrl. Good luck!

    • BJJ Caveman says:

      Love hearing from you Eric.

      Yes, CIMT and Calcium scans are on my agenda this year.

    • Robin Christianson says:

      Thank you Eric! I’m embarrassed to say I let my “mainstream” doctor bully me yesterday into Atorvastatin 20 mg (generic Lipitor)….she agreed however on my INSISTANCE of ONLY for 3 months. She freaked when I told her I was LCHF and said she only recommends that for diabetics and recommended the Mediterranean diet. I’m going to switch to Dr. M. Greger’s eating plan (with cheats of a little salmon and yogurt) and retest in 3 months. She agreed with me that doing that will improve my LDL, but the statins will give immediate help. I’ll report back here with the results in 3 months.

      Question: Why did you say my cholesterol was bad no matter what I ate and it’s my genetics? My TC and LDL were cut in half when I was low fat vegetarian. My LDL was 61 on low fat and 207 on keto. So I’m confused.

      Wow, I’m concerned about your CT scan. You’re throwing in the towel? What are you going to do now? Very interested!!!

      You know, I’m not scientific minded like you and David. I’m just getting my insurance paid basic lipid panels every months, nothing more. I’m weary with youtube videos of the great debates on Atkins vs. vegans. I want my life back.

      Where I’ve landed for now: If I follow my gut instincts and not the “experts”, it tells me vegetables are better for me than bacon, avocados better than butter. I’m going to try to ignore the war of diets world for now. My current plan: Whole foods, no processed, organic, nuts, avocados, vegetables, a few fruits, whole oat groats, some legumes, flax seeds, turmeric, ginger..a little cheats of salmon, eggs, greek yogurt. (I may start leaning toward Ayurvedic.) The end.

      Please share, if you care to, your game plan. I’m interested;

      • Eric R says:

        Robin, by throwing in the towel I mean that I am going to try pharmacological treatment. I have been on Crestor and Zetia as well as niacin for about 1 month now. I went through the whole evolution of thinking with regards to cholesterol, functional medicine, alternative medicine, mainstream medicine, Etc. It is a minefield out there and one must feel very comfortable with the decision that they are making.

        There are always people that are going to swear that what you are doing is wrong no matter what you do. It really has to be a personal decision that you make between you and a trusted provider.

        Robin, With regards to diet, I think diet makes a difference. The question is does it make a disease altering difference. (The only caveat to that would be that there is definite proof that eliminating trans fat and excessive carbs does have a profound change on someone’s health.) That is the big question. I’m of the opinion (after more than three years of study for myself as well as for my patients) that a diet lower in long-chain, animal, saturated fats in the setting of APOE4 patients, is probably the best way to go. APOE4 atients almost always see markedly elevated LDL p, total cholesterol and LDL cholesterol on a high saturated fat, ketogenic diet. That is some very strong genetics at work. Everyone else seems to do well and their cholesterol stays the same or in some cases goes down on saturated fat. It is what it is! Life isn’t fair I guess!

        Robin, if I was a betting man I would bet that if you went on a diet of fish and salad, basically a Mediterranean diet that is low carb, your numbers will improve but will they improve enough? You really should pay for your own NMR lipid profile. LDL-P over 1000 increases risks. You can get one done at LabCorp by ordering it online for yourself and paying for it with a credit card. Just go to, create an account and look for NMR lipid profile. Pay for it with your credit card, print out your lab requisition and go to your nearest LabCorp in the United States to have your blood drawn. It could be life changing. You don’t need a doctor’s order all you need is a credit card and a little bit of motivation. Who knows, you may have a normal LDL particle count even in the setting of extremely elevated total LDL. This would be called discordance. It is extremely rare but it does happen at times that someone will have very high total cholesterol but have a very low LDL particle count. This is actually the best of both worlds as having a low particle count but elevated total cholesterol seems to be protective!

        Robin, Don’t feel bad about starting Lipitor. If you trust your doctor and you and your doctor have decided on a plan then go for it. There are always risks involved with medications. Make sure you understand the risks of starting medications or not starting medications as there are risks with both choices. Just looking at your numbers in the above post those are quite remarkable LDL numbers. I mean remarkable in a bad way. Whatever you were doing with diet isn’t working so I would not hesitate to change course.

        • BJJ Caveman says:


          This is some of the best, most nuanced advice you’ll get.

          Stay away from the diet wars. Certain diets will work better for some people and not others, and we don’t know why. It probably has something to do with genetics and gut bacteria and activity level and maternal environment and other things we haven’t even thought of.

          The best thing you can do is test for yourself and see which diet does best for your body in terms of how you feel and how your blood tests look.

        • Eric says:

          FOLLOW UP… Bit the bullet 3.5 months ago and started Crestor 5mg and Zetia 10mg. Tested yesterday. Ldl-p went from 1930 to 960! Crazy 49.5% reduction. Small ldl-p went from 841to 418! HDL-p went up from 44 to 46.5. I also started eating more carbs and way less saturated fat. A1c stayed the same at 5.4. Only wish the lp (a) had improved. Still in the 250 range which is so scary. Anyway, thought you might be interested. BTW, just finished the 3 month old school p90x work out for the 2nd time this year and no myopathy or issues. Eric

  4. Hi BJJ — long time!

    You know when I was first learning anxiously about lipidology and cholesterol waaaaaay back in 2015 (seems like a million years ago), yours was one of the few websites that had extremely relevant data as someone with (1) LCHF-ish diet, (2) ApoE3/4 — like me, and (3) mega high LDL-C and LDL-P. I mention this because I was excited my research could potentially give back some value yours has given to me.

    So with that said:

    – I have to start with giving you the ornery face — did you track your diet closely for the 5 days prior to your blood test?!? I’m going out on a limb and guessing you haven’t. If there’s any single thing my research is giving substantial weight to, it’s that 30-50% of our cholesterol markers are influenced by a small three day window. This window appears is the three days pre-test for cholesterol markers (LDLc and HDLc), and three days, with a two day gap for all particle markers (LDLp, smLDLp, and HDLp). I presented this with my own markers, and those of others at my presentation at Breckenridge earlier this year.

    – Given this, I’d presume Cavemom’s cooking that was a “week or so” prior to the blood test had little effect other than maintaining your existing energy baseline (primarily fat over carbs). In fact, I’d have preferred you had it just prior to the test as I’d predict it would have *lowered* your LDLc and/or p given what window you had it in — since the pattern is an inversion. (Again, see presentation or blog for more info)

    – Regarding the baseline, I agree with Robin Christianson from above regarding a vegan/vegetarian diet. If you derive more of your energy from carbs and less from fat, I believe your “baseline” cholesterol and particle numbers will drop (both LDL and HDL), and your trigs will likely rise.

    Is this a good thing? I don’t claim to know for certain as all these studies on deleterious cholesterol numbers were made with carb-centric diets and often included subjects with metabolic syndrome. We’re now in uncharted territory with healthy, low (or lower) carb, high fat folks that *may* have higher LDL markers for a good reason. After all, low density lipoproteins wear many hats and it can be argued their primary one is distributing energy from fat (via TG).

    To speak geek with you for a moment… both your Chylomicrons (ApoB48) and VLDLs (ApoB100) spend the first stage of their existence providing TG to cells mainly, which is a much more prevalent job when you are getting more of your energy from fat. The Chylomicrons get cleared right away, of course. But once the VLDLs are remodeled to their final LDL stage, they go on “patrol” in larger numbers for us hyper-responder when we are primarily fat-fueled.

    Like you (I suspect), I’m less an advocate than I am a scientist, so I’m following the data. If my frequent CIMTs or CACs or the many other markers I track show plaque progression, I’ll report it and change gears. But there’s no denying that this basic process of providing fatty acids to cells in absence of glucose makes perfect sense and I’m hard pressed to change in the absence of inflammation or oxidative stress (which *do* have a strong correlation to atherosclerosis). We don’t ultimately care if cholesterol is circulating in our bloodstream — we care if it’s building up in our arterial walls, of course.

    – As a final point to drive this home, I urge you to look at my post on “Lean Mass Hyper-responders” . While still preliminary, since posting about this profile I’ve had dozens of LCHF/Keto athletes contact me (many in the comments of the article itself) lending lots of weight to this mechanism as described above.

    In short, it’s about energy, not cholesterol. Energy is the driver, cholesterol is the passenger.

    • BJJ Caveman says:


      I’m really happy to see how your site has grown! I’ve been following peripherally and writing my thoughts on your work has been on my to-do list for a long time… the problem is you keep writing more and more!

      thank you so much for your thoughts here. I really appreciate the fact that like me, you’re ‘less an advocate’ than you are a scientist, which I think the health space needs more of.

      While I haven’t quite detailed it yet in my blog, I’ve been running a three month experiment where I actually AM tracking everything I’m eating, so this may provide some insight into my next blood test.

      Would you be interested in writing a guest post for my site regarding your theory and findings thus far? I know the for sure it would help a lot of people here!

      • I’m extremely thrilled you’ve been tracking so closely. If my research is exposing anything, it’s just how relevant knowing that Inversion Pattern impact is for all of us who are tracking cholesterol.

        I’d love guest post. I’ll concede I’m a bit stretched thin until next month, (where I’ll still be stretched, but slightly less thin) but I feel it’s the least I can do for the level of jumpstart you gave me in my early lipid researching days. 🙂

  5. Robert Whigham says:

    I’ve been HFLC for about 3 years. For the first 2 years I did not seem to be a hyper-responder. I started intermittent fasting (only lunch) about a year ago and now am a hyper-responder with LDL-C 195 mg/dL, Apo-B 166 mg/dL, LDL-P 2700, and small LDL 1300,. From a nutrient viewpoint, with reduced glucose from low-carb and fasting, I am more dependent on LDL to feed my body. Once the triglycerides are used for nourishment, the LDL become small. (Taking berberine would likely increases the need for LDL to replace glucose.) I firmly believe atherosclerosis is caused by damaged LDL that is pulled over by endothelial receptors and attacked by monocytes which turn into macrophages which put out even more receptors for damaged LDL. If our diet prevents damage to LDL we should be fine. (For example avoid easily oxidized fats and sugar, keep glucose low, and take astaxanthin). A low Lp(a) indicates low oxidized phospholipids and likely low oxLDL.

    • BJJ Caveman says:

      I actually really like this explanation and think that this is what is actually going on in my system…. now to only prove it…

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