Cholesterol Results - Comments?

[maria40nc]

Is it possible for HDL to be too high, or for Triglycerides to be too low?

November 2009
Low carb for 15 months; Paleo 4 months; High frequency exercise.
Total Cholesterol - 259
HDL - 113
LDL 140.4
Tri - 28
Glucose - 99

November 2008
Low carb (Atkins style) for about 3 months; Started walking for exercise.
Total Cholesterol- 217
HDL - 67
LDL - 141.2
Tri - 44
Glucose - 88

November 2007
Prior to low carb; No exercise.
Total Cholesterol - 252
HDL - 81
LDL - 148.8
Tri - 111
Glucose - 88

Interesting how much my trigycerides have dropped, and HDL went way up this year.

[Griffen]

Those are awesome numbers. I regularly deconstruct people's cholesterol numbers for them over on Mark's Daily Apple; here's the same thing for you.

I'd be willing to bet money that the LDL was calculated, not measured, and that calculation (known as the Friedewald equation) doesn't work when trigs are under 100, as yours are. It overestimates LDL.

A quick rundown:

The formula used to calculate total cholesterol is: LDL + HDL + [Trigs/5] = total. But what they usually do is calculate your LDL. They measure your HDL, your Trigs and your Total - so the equation becomes: Total - (HDL + [Trigs/5]) = LDL.

This calculation works fine for trigs over 100. But when your trigs drop below 100, it becomes misleading and usually calculates your LDL far higher than it should be. Always, always demand a VAP test, which is a direct measurement of the LDL. According to Dr. Mary Vernon, "These labs in which the LDL is calculated are not accurate if your triglycerides are below 100... The equation used to calculate these numbers makes assumptions which are not accurate when triglycerides are low." (from http://www.livinlavidalowcarb.blogsp...t-results.html).

Now, the ratios.

The ideal ratio of Total/HDL is 4.4 for women and 5 for men. Also, according to http://wwww.yourmedicaldetective.com/public/532.cfm and several other sites, the ratio of your trigs to your HDL will indicate whether your LDL is small and dense (bad) or large and fluffy (neutral). A larger number indicates smaller LDL particles and a smaller number indicates larger LDL particles. It's an inverse relationship.

Your Total/HDL ratio is 259/113, or 2.29. That's fantastically good. You probably have large, fluffy, innocuous LDL and don't need to worry about it damaging you.

The ideal ratio of Trig/HDL is 2 or below. 4 is high. 6 is "danger!!" Yours is 28/113, or 0.25, the best I've EVER seen anywhere on any low-carbing or Paleo forum.

Additionally, a low ratio of Trig/HDL is great because it's a semi-reliable indicator of lower free insulin levels. Lower free insulin is good. (However, this doesn't appear to work for those of African descent, so take that with a grain of salt.)

Also see: Low-carbohydrate diets increase LDL: debunking the myth | The Blog of Michael R. Eades, M.D. for more information.

[maria40nc]

Thank you so much Griffen!

I read online (random sources) that low trigycerides could mean hyperthyroidism, a very low fat diet, or possibly malabsorption.

I've been very high fat. High fat, tons of eggs, meat, veggies, nuts, some fruit. No grain or dairy.

If exercise truly affects numbers much, that could have some to do with it. I took up running/triathloning and exercise has grown to the 8 - 10 hr per week range.

Seem like most information available comes from sources that support low-fat diets, so I wanted to know what it all means from a low carb standpoint.

I really appreciate you taking the time to explain all that to me.

[NutinHonie]

Your numbers are similar to mine, and I think they are awesome!

[Leo41]

Low triglycerides are GOOD and not a sign of anything except that you're eating properly (low sugar).

With a high HDL and low triglycerides, it's probable that your LDL is the "big, fluffy" kind that's actually good for you.

My endo recently tested my LDL, and that's what I have. He told me that in his experience, patients with high HDL and low trig. always have the 'good' LDL, so the number isn't relevant--i.e., there are NO negatives for heart health.

[maria40nc]

Well, I think this is funny since I average 6 eggs a day (for the past year), cook with lard, and eat plenty of fatty meats, walnuts, and avocados.

Our secretary, who eats a low fat diet (and ridicules my diet) had triglycerides of 240.

[Griffen]

Originally Posted by maria40nc

Thank you so much Griffen!

I read online (random sources) that low trigycerides could mean hyperthyroidism, a very low fat diet, or possibly malabsorption.

I've been very high fat. High fat, tons of eggs, meat, veggies, nuts, some fruit. No grain or dairy.

If exercise truly affects numbers much, that could have some to do with it. I took up running/triathloning and exercise has grown to the 8 - 10 hr per week range.

Seem like most information available comes from sources that support low-fat diets, so I wanted to know what it all means from a low carb standpoint.

I really appreciate you taking the time to explain all that to me.

It's not a problem. I actually get asked about this so much over at MDA that I made a template with all my best advice.

Whoever said that low trigs were a sign of a low-fat diet was demonstrating their ignorance. Trigs are created by the body in response to the carbs you eat. Cut carbs and you cut down the creation of trigs. It's that simple.

The only time that you would see the problems you're mentioning is if you were eating a high-carb diet AND had low trigs at the same time. It's very rare. Of course hyperthyroidism is something to check for every now and then, and you might want to, but I doubt that's the cause of your excellent cholesterol numbers.

[Stevie Renee]

This has been a great thread. Hope you guys don't mind me posting my dilema.

I had my VAP done a year ago and my trigs were 73 I think but I still have small LDL particles. Nothing too bad according to the feedback I received but bad enough to get my act into better gear. I will say that moderation eating the "no-no's" reflects in the small particles if I may over simplify.

I am interested in understanding what the Daily Apple is. Would it be safe to say the web site will tell all, tell enough without having to buy anything?

To lay it all out, my biggest challenge for the last 10 years of low carbing is giving up skim milk. I know thats terrible and silly - I give it up - but then I go back. And I think Fawn told me it is made with dry milk, so its not good for LDL, etc..

I rarley eat cheese, I gave up dairy in my coffee about 3 weeks ago, so now I am ready to move forth on the milk. I think.lol..

In January I am going to get my 2nd VAP test. I know it is in my best interest to give up that milk.

Any words of wisdom?

Sorry for thread jack...

[Griffen]

Stevie Renee: What was your HDL and your Total cholesterol when you got the measurement of 73 for your trigs? It's not the trigs number, it's the ratio of trigs to HDL that will indicate small or large LDL particles.

About MDA: Go to the site (marksdailyapple.com), but you'll definitely want to buy Mark's book, too. It's a damn good book and worth reading.

Skim milk is essentially sugar water. Milk with no fat is just water and lactose. Not good for you at all.

[Stevie Renee]

Originally Posted by Griffen

Stevie Renee: What was your HDL and your Total cholesterol when you got the measurement of 73 for your trigs? It's not the trigs number, it's the ratio of trigs to HDL that will indicate small or large LDL particles.

About MDA: Go to the site (marksdailyapple.com), but you'll definitely want to buy Mark's book, too. It's a damn good book and worth reading.

Skim milk is essentially sugar water. Milk with no fat is just water and lactose. Not good for you at all.

I know
I need an intervention or an arsekick. I wish I could get that through my head.

I will get the book, thanks for posting about that.

So lets see..my total is 217
trigs, 73
hdl, 46
ldl, 156.4

Some numbers..
vldl, 14.6
vldl-3, 9 f
hdl-2, large - 11 R
hdl-3, small - 43 (small, dense?)
LDL 4 - 21.2 (bad?)
LDL 3 - 76.4 (bad?)
LDL 2 -23.1- (good?)
LDL 1 15.3 - good?)

A couple years ago my cholesteral total was 195 and my ldl was118 with trigs 141, hdl 49.


Any thoughts is appreciated. I just made my physical appt for mid January and will get a new lipid panel.

[Griffen]

Originally Posted by Stevie Renee

I know
I need an intervention or an arsekick. I wish I could get that through my head.

You have to frame it as "this is poison." I imagine a skull and crossbones on wheat, beans, sugar, and milk these days. I eat hard cheeses and occasionally use heavy or sour cream in cooking. But never milk.

Originally Posted by Stevie Renee

So lets see..my total is 217
trigs, 73
hdl, 46
ldl, 156.4

Some numbers..
vldl, 14.6
vldl-3, 9 f
hdl-2, large - 11 R
hdl-3, small - 43 (small, dense?)
LDL 4 - 21.2 (bad?)
LDL 3 - 76.4 (bad?)
LDL 2 -23.1- (good?)
LDL 1 15.3 - good?)

A couple years ago my cholesteral total was 195 and my ldl was118 with trigs 141, hdl 49.

I don't know enough about the breakdowns of specific types of LDL to interpret that for you, but here's some ratios for you:

This test:
Total/HDL = 217/46 = 4.7
Trig/HDL = 73/46 = 1.6

Prior test:
Total/HDL = 195/49 = 4.0
Trig/HDL = 141/49 = 2.8

So your Trig/HDL got better but your Total/HDL got worse over time. I'd look at things you're eating that might be causing a lowering of HDL (the milk is probably one of those, because it's just sugar water and sugar anything will cause a lowered HDL total). Do you take any supplements to boost Omega-3s? I'd recommend taking some cod-liver oil (Carlson's Lemon Flavor Cod-Liver Oil is a good one) every day. I take a teaspoon every night and every morning - keep it in the refrigerator so it doesn't go rancid.

Your HDL is affected by many things. If you're eating anything with trans fats in it or any processed anything, stop eating it. Trans fats do a real number on HDL levels, in the wrong direction. If you aren't using olive oil in your regular diet, add it. And, of course, cod liver oil or fish oil (cod liver oil is better) will raise your HDL as well.

Here's a link for you to look at: HDL Cholesterol Raising Food List - Low Carb

[Stevie Renee]

Thank you. I am going to pay closer attention. I ordered the primal book and look forward to reading it. I do take niacin and fish oil.

It was also suggested to me to only eat about 4 ounces a day of fruit since I do have small LDL. So I do try to keep it under control in that regard.

We do cook with olive oil but I am trying to use it on my greens as of late. Is this what you mean with olive oil?

So is there a ratio chart I should look at as far as watching the ratio improve over time? Or gasp..worsen? lol

ps..thanks for the link. Easy read. Appreciate it! And I will add the cod oil. Should I also take coconut oil?

[Griffen]

Originally Posted by Stevie Renee

Thank you. I am going to pay closer attention. I ordered the primal book and look forward to reading it. I do take niacin and fish oil.

It was also suggested to me to only eat about 4 ounces a day of fruit since I do have small LDL. So I do try to keep it under control in that regard.

We do cook with olive oil but I am trying to use it on my greens as of late. Is this what you mean with olive oil?

So is there a ratio chart I should look at as far as watching the ratio improve over time? Or gasp..worsen? lol

ps..thanks for the link. Easy read. Appreciate it! And I will add the cod oil. Should I also take coconut oil?

Olive oil shouldn't be heated too much, most of the time. I'd recommend using it on salads and other non-heated applications. As far as the coconut oil - absolutely! It's a great way of adding good saturated fats to your diet. Check out the book "Eat Fat, Lose Fat" by Dr. Mary Enig and Susan Fallon.

There's no ratio chart. Just do the simple division of Total/HDL and Trig/HDL every time you get a new set of numbers and compare it to what your ratios were before and what the parameters are (Total/HDL should be below 4.4 for a woman or below 5 for a man; Trig/HDL should be below 2 to be great, and below 4 to be average; if it's 6 or above that's NOT a good sign).

The suggestion to limit high-sugar foods like fruit is a good one, because there is a correlation between small dense LDL and high trigs.

I'd say take either cod liver oil or fish oil but not both, and I'd recommend the cod liver oil (CLO) over the fish oil because it's essentially high-powered fish oil. You'll get all the same benefits of the fish oil and none of the risks of rancidity, as you can tell when the CLO goes bad, but can't tell if the fish oil capsules have (and fish oil capsules go rancid much sooner than you'd think). Once it's gone rancid, it actually has negative effects on your body. So stick with CLO.

[Stevie Renee]

Thank you Griffen. I am so glad you are here to help
I have cod oil on my list.

I have never attempted to visualize a food as poison but will attempt to do so. Plus not buy skim milk.lol

[maria40nc]

Stevie Welcome! No worries on the threadjacking.. we all learn from each other's experiences.

I gave up all dairy at the end of July when I switched from Atkins to Paleo. I read Paleo for Athletes and then Neanderthin. I've not read the Primal book yet, but perhaps I will just for additional info; as well as the Eat Fat, Lose Fat book.

But I mostly enjoyed Neanderthin as an easy book to start with for those going in that direction.

I can't tell you how much better I feel since giving up dairy! I dropped it cold turkey with the excpetion of half & half in my coffee. But then some paleo friends convinced me was psychological and I finally dropped it for good.

... and I feel great!

[Stevie Renee]

Maria,
Thank you for being so supportive.

I wouldn't mind being convinced about my addiction to milk! So I rcvd the book Primal Eating yesterday and I did read the part where it was discussed about cows milk. That is my only dairy minus eggs. I just need to grow up about it all ready. I rarely eat cheese and I gave up the creamer in my coffee -my weak coffee...its half water, half coffee. Its really only 8-12 ounces a day.

At first I was not liking the book because I am a believer in Creation, not Evolution. But I moved on and I am familiar with the science and a lot of the specifics in the book after all these years of low carb reading.

What I was bummed about..learning that canola oil and soybean oil are trans fats. I did not know that. So that was an eye opener. And here all this time I would eat hummus or some dressings or whatever with canola, soybean oil. No more on this end for me.

I am going to really try this way of eating and see how well I do.

Is there a differance from Paelo to Primal?

I all ready utilize many of the ideas in Primal with low sugar fruits, raw nuts, red wine and dark chocolate because I have read somuch from Dr. WIlliam Davi blog, heartscan. So that is a bonus. Its just fine tuning...and that cows milk addiction. And not indulging here and there with "no-nos" as best I can.