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TripSwitch
05-22-2013, 12:48 PM
So I followed a fairly strict low carb diet (LCHF/Paleo) to lose weight... and I saw my Dr. before I started and my lab work was OK... although, my BP was starting to creep up, but nothing to really be concerned with... so basically, I was overweight and possibly heading towards metabolic syndrome... time to do something about it.... Anyway... I lost weight and have become a lot more active on top of the running I was already doing...

Well the good news is that my BP is great and I have the resting heart rate of a marathon runner... BUT now I have some serious lipid abnormalities that even have me concerned...

So of course my Dr. who is not only a colleague of mine, but also a close personal friend told me to stop the diet... He actually wanted me to start on a statin... Which is funny, because I write prescriptions for them all the time and I would have in this case too if I were him.... But I told him I really wanted to change my diet and see if things went back to normal...

So now I've got to figure out what to do about my diet.... after I feel I already found something that was working, at least as far as losing weight goes... but apparently not from a CV risk profile standpoint is concerned...

So basically, I guess I'm just kind of "bummed out" about the whole thing and not really sure what I'm going to do about it...

That's it.... sorry for the long story....


ICUwishing
05-22-2013, 01:37 PM
Trip, sorry to hear about the unnerving numbers. Especially since you've been so successful with the way you've been eating, scale and energy-wise! Before you change anything ... is there any chance that there could have been an error with the bloodwork? I only ask because once I did get someone else's results; I only noticed it because my HDL consistently tends to run very high, and this one was closer to average. I also had a laughably inaccurate result from one of the finger-prick type cholesterol tests - a machine very much out of calibration!

ronni62
05-22-2013, 01:39 PM
The only thing I have to say is that maybe you should read "The Great Cholesterol Myth" by Jonny Bowden, Ph.D, CNS, and Stephen Sinatra, MD, FACC or "The Great Cholesterol Con" by Dr. Malcolm Kendrick. They are great resources. We no longer worry about those lab numbers, except those measuring inflammation. And, we watch out for sugars and processed foods.

You're doing a great job with your weight loss!


Stars
05-22-2013, 01:43 PM
ICUwishing has a good point.

Do you think you can get retested?

I was going to suggest weight watchers for a diet change but changing your diet might not be unnecessary if the results are questionable. I would see about retesting and if that isn't an option, I would go on a different diet program just incase.

JohnP
05-22-2013, 01:58 PM
How long have you been low carbing? I've heard of cases where blood profiles were initially made worse by low carb but after 9-12 months things returned to normal.

TripSwitch
05-22-2013, 02:00 PM
Actually it's funny you should mention that... because I have definitely seen lab results that have been completely wrong over the years in my career... I can't tell you how many times I've had to re-order labs on a pt. because of lab "issues" ... So I actually, did re-order them and double-checked everything... and unfortunately, the numbers were not good...

TripSwitch
05-22-2013, 02:20 PM
How long have you been low carbing? I've heard of cases where blood profiles were initially made worse by low carb but after 9-12 months things returned to normal.

Actually.... this was exactly what I was hoping for... since I have heard this as well, and that's why I wasn't overly concerned about it when my numbers were going in the wrong direction last year.... But from the doctors I've talked to the consensus seems to be that things should have returned to baseline by now... and that it's the amount of fat in my diet among other things unfortunately...

It's funny but it looks like I might be one of those people that does OK with more carbs... especially, from an endurance training standpoint...

Lolo70
05-22-2013, 02:25 PM
What exactly changed? I am curious because I lowered carbs now for about a week back to under 50g. I have the skin itch back and am developing Xanthelasmas. I had the same thing happen to me when I started low carbing. Indicates my liver is having some problems and I am accumulating cholesterol deposits. I am now thinking about doing labs.

TripSwitch
05-22-2013, 02:25 PM
The only thing I have to say is that maybe you should read "The Great Cholesterol Myth" by Jonny Bowden, Ph.D, CNS, and Stephen Sinatra, MD, FACC or "The Great Cholesterol Con" by Dr. Malcolm Kendrick. They are great resources. We no longer worry about those lab numbers, except those measuring inflammation. And, we watch out for sugars and processed foods.

You're doing a great job with your weight loss!

I've actually read those books.... and I won't go into a critique... But unfortunately, complete analysis of the numbers would even have them concerned...

saharag
05-22-2013, 02:29 PM
Sorry about your lab results. Hope you can figure out a plan that works for your weight loss and those numbers. If you don't mind sharing, how low in carbs were you going and how high in fat? Thanks.

TripSwitch
05-22-2013, 03:24 PM
Sorry about your lab results. Hope you can figure out a plan that works for your weight loss and those numbers. If you don't mind sharing, how low in carbs were you going and how high in fat? Thanks.

I was following a plan that had its basis from "The Art and Science of Low Carbohydrate Performence".... So 60g or less or carbohydrate a day.... usually in the 30g to 50g range.... along with serum ketone testing to stay within range for a nutritional ketosis plan...

joefla70
05-22-2013, 03:50 PM
How much fat is optimal to eat on a low carb diet?

TripSwitch
05-22-2013, 04:21 PM
How much fat is optimal to eat on a low carb diet?

I'm sure we'll get A LOT of differing opinions on this one... Since you have diets like IP and Medifast that are low carb and low fat... But they are also very low calorie... And then you have low carb, moderate protein, and higher fat plans that aren't so calorie restricted...

But basically, if you're lowering your carbs and meeting your protein needs... Well then the rest of what you're eating is fat... So depending on your energy needs that can be a pretty high % of fat as part of total calories...

Arctic Mama
05-22-2013, 07:11 PM
What's bad? Which panels, specifically, and what were the values? The standard cholesterol recommendations are completely wonky and quite useless, especially for low carb and Paleo folks.

Peter had a great little post about this recently, and it's also a topic Mercola has a good article or three about. But basically cholesterol recommendations are extremely low for what a healthy person on a whole foods diet WITHOUT statins can generally attain. My husband, for example, has much lower cholesterol than me. But his HDL is extremely low, his triglycerides are very high, and his diet is complete crud. A diet low in saturated fat and high in sugar can actually produce better numbers by the standard recommendations than one that is far more healthful in the components but completely out of line with ADA recommendations.

My cholesterol is 'dangerously' high by the standard ratios, but the actual values, themselves, are in the IDEAL range if you disregard total cholesterol. I have very high HDL and extremely low trigs, along with an LDL profile that is very healthful, too. But at first glance the numbers are way off the normal recommendations (because they're based on a faulty premise of what actually comprises healthful serum cholesterol numbers, let alone what those numbers mean in reality).

http://high-fat-nutrition.blogspot.com/2013/05/a-peek-at-paleo.html

http://articles.mercola.com/sites/articles/archive/2010/08/10/making-sense-of-your-cholesterol-numbers.aspx

Both of these are really great and not overly lengthy reads.

Arctic Mama
05-22-2013, 07:16 PM
And for the record, with that heart stoppingly high total cholesterol I displayed, I also had blood pressures in the 110/65 range, an A1C of 4.7%, and a diet with dark chocolate and the occasional diet coke as the most processed things I ate on a daily basis. I looked pretty flawlessly healthy by every metric but cholesterol, and yet despite the 'risky' cholesterol readings I had NO symptoms of systemic inflammation or arterial blockages, low liver function, taxed kidneys, etc.

Kind of makes one skeptical about the value of the litmus, eh? ;)

TripSwitch
05-22-2013, 08:49 PM
Actually it's the LDL particle assessment that has me concerned... LDL-P, Small LDL-p, LDL particle size and Lipoprotein-a....

angeleyes24
05-22-2013, 09:22 PM
Hi, this may be a silly question, but did you make sure you fasted prior to th bloodwork? I would have the labs repeated. Just a thought :)

Arctic Mama
05-22-2013, 09:31 PM
Again, what are the specific numbers?

joefla70
05-22-2013, 10:06 PM
Can you switch to a lower fat paleo? Does it need to be high fat for it to work? I don't count my fat, but I try to eat low fat -- while doing low carb, and it has worked for me.

HungryHungryHippo
05-23-2013, 01:18 AM
Hey TripSwitch--that sucks--I'm sorry!! Not much to say, as I don't understand most of it--and I know that's your field, and you do--but, fellow New York girl--I know you've done EVERYTHING right, and hit your goal, and it sucks to have something like that happen!

carpediem
05-23-2013, 05:52 AM
I belong to another forum of women on a featherweight range who do strength training and other types of exercise. For many of them in that particular situation low carb brought some other health problems, particularly hormone related. I think low carb can be a useful strategy in some situations but if you are exercising a lot and in a low weight range it's probably not the best idea.

You can read different perspectives on the paleo diet more focused towards athletes or people on similar weight ranges as you are. I like Nate Miyaki's approach. He is 80% paleo but includes white rice to support all the anaerobic training he does. He says his diet is similar to the diet of a Japanese village. Anyway, this is just a suggestion, hope you can find something that makes you healthier and works for your goals.

Emma4545
05-23-2013, 06:08 AM
I know I am living on the edge but, my cholesterol results are simply horrible. Even though I have great blood sugar, great insulin, great ratio, and great blood pressure. It is over all 240 to 270.

I am starting to think there is nothing to be done. My doctor tested me for the big and small particles and it seems the LDL is mostly the large particles.

My doctor wants me on the meds but I have refused. I just cannot see taking a medication that could have serious effects. There is a lot of evidence that cholesterol is not the problem.

I believe possibly my normal cholesterol level is what it is.. and it isn't bad. I have to find a way to be healthy with that cholesterol level. So for example... Vitamin K2 has been implicated in keeping the hardening of the arteries from happening.

I am not eating low carb but I do have a lot of eggs. I just cannot stop doing that because eggs are soooooo healthy.

TripSwitch
05-23-2013, 11:46 AM
What's bad? Which panels, specifically, and what were the values? The standard cholesterol recommendations are completely wonky and quite useless, especially for low carb and Paleo folks.

Peter had a great little post about this recently, and it's also a topic Mercola has a good article or three about. But basically cholesterol recommendations are extremely low for what a healthy person on a whole foods diet WITHOUT statins can generally attain. My husband, for example, has much lower cholesterol than me. But his HDL is extremely low, his triglycerides are very high, and his diet is complete crud. A diet low in saturated fat and high in sugar can actually produce better numbers by the standard recommendations than one that is far more healthful in the components but completely out of line with ADA recommendations.

My cholesterol is 'dangerously' high by the standard ratios, but the actual values, themselves, are in the IDEAL range if you disregard total cholesterol. I have very high HDL and extremely low trigs, along with an LDL profile that is very healthful, too. But at first glance the numbers are way off the normal recommendations (because they're based on a faulty premise of what actually comprises healthful serum cholesterol numbers, let alone what those numbers mean in reality).

http://high-fat-nutrition.blogspot.com/2013/05/a-peek-at-paleo.html

http://articles.mercola.com/sites/articles/archive/2010/08/10/making-sense-of-your-cholesterol-numbers.aspx

Both of these are really great and not overly lengthy reads.

Thanks for the links... I actually think I remember seeing that post from the first link and the study that it links to now that I think about it...

TripSwitch
05-23-2013, 12:05 PM
Hey TripSwitch--that sucks--I'm sorry!! Not much to say, as I don't understand most of it--and I know that's your field, and you do--but, fellow New York girl--I know you've done EVERYTHING right, and hit your goal, and it sucks to have something like that happen!

Thank you... Actually now that I've had some more time to think about it all I'm sort of finding it slightly amusing (or at the very least I'm enjoying the irony of it all) I mean I start eating better, lose weight, and start exercising a lot more.... So of course I was expecting much better numbers... And of course my doctor, who I already mentioned is also a close personal friend and already thinks that my "diet" and all the running that I do as a "bit extreme".... But I do trust him and he does know what he's talking about.... So I definitely think that he's right and some changes are in order.... And we"ll see what happens... :)

TripSwitch
05-23-2013, 12:27 PM
I belong to another forum of women on a featherweight range who do strength training and other types of exercise. For many of them in that particular situation low carb brought some other health problems, particularly hormone related. I think low carb can be a useful strategy in some situations but if you are exercising a lot and in a low weight range it's probably not the best idea.

You can read different perspectives on the paleo diet more focused towards athletes or people on similar weight ranges as you are. I like Nate Miyaki's approach. He is 80% paleo but includes white rice to support all the anaerobic training he does. He says his diet is similar to the diet of a Japanese village. Anyway, this is just a suggestion, hope you can find something that makes you healthier and works for your goals.

Thank you.... I too am coming to believe for me that the very low carb and higher fat approach just wasn't right for me with the amount of running that I like to do....

I actually just picked up a book this week called "Feed Zone Portables : A Cookbook of On-The-Go Food for Athletes" it's got all these great recipes for making real food that you can take with you while training and a lot of the ingredients are all rather "paleo" friendly, but they also use rice as well...

And what a coincidence, but I also just bought a really beautiful cookbook this week as well called "Japanese Farm Food" that just looks amazing....

TripSwitch
05-23-2013, 12:37 PM
Can you switch to a lower fat paleo? Does it need to be high fat for it to work? I don't count my fat, but I try to eat low fat -- while doing low carb, and it has worked for me.

Actually, I've been looking at vegetarian "paleo" approaches.... Which I know is heresy to paleo true believers.... But I'm starting to think that perhaps if combined with something like a VB6 approach or some sort of variation on that theme from Mark Bittman.... Might be the way to go for me....

JohnP
05-23-2013, 02:58 PM
Maybe I'm missing something.

Why don't you just eat some fruit before or after you workout (or both before and after.)

Why does it have to be complicated?

TripSwitch
05-23-2013, 03:17 PM
Maybe I'm missing something.

Why don't you just eat some fruit before or after you workout (or both before and after.)

Why does it have to be complicated?

Don't get me wrong... I still love a good banana or an orange... but I'm talking about 2 to 6 hour workouts.... So runs in the 2 to 4 hour range or bike rides in the 4 to 6 hour range...So I would really like to get away from bars and gels.... And all I can say is when I'm on a bike that long.... Nothing tastes as good a PB & J sandwich, even if it is all "mushed" up from being in my back pocket all day long... :D

TripSwitch
05-23-2013, 09:09 PM
I just wanted to take a moment and thank everyone here for all your words of encouragement.... It really has helped me gain some much needed perspective...

I really do appreciate it...

Rana
05-23-2013, 09:26 PM
I'm not a doctor, obviously, but I've looked into Paleo for endurance training because I was cycling 50 miles in one go - which was easily a 3 hour ordeal.

What I learned is that we can't be afraid of carbs in Paleo, but we have to remember that Paleo is not about eating all the bacon we want and living off the fat. It's about eating a lot of vegetables, including root vegetables like carrots, turnips, even potatoes and sweet potatoes. Also, for athletes, they do recommend white rice, to supplement for endurance.

I don't know if incorporating more carbs will help your lipid profile, if you do reduce the amount of fats.

But I did want to post the reminder that veggies are our friends and should be a good part of our diet -- I know its easy to forget that part! You can lower your fat and protein intake and increase your veggies and root vegetables to make up for it, without going off Paleo. Yes, this means that you're probably eating more than 50g of carbs, but women in the Paleo community are arguing that we need between 100 - 150 grams to maintain hormonal health anyway... we shouldn't continuously be under 100 grams.

TripSwitch
05-23-2013, 11:03 PM
I'm not a doctor, obviously, but I've looked into Paleo for endurance training because I was cycling 50 miles in one go - which was easily a 3 hour ordeal.

What I learned is that we can't be afraid of carbs in Paleo, but we have to remember that Paleo is not about eating all the bacon we want and living off the fat. It's about eating a lot of vegetables, including root vegetables like carrots, turnips, even potatoes and sweet potatoes. Also, for athletes, they do recommend white rice, to supplement for endurance.

I don't know if incorporating more carbs will help your lipid profile, if you do reduce the amount of fats.

But I did want to post the reminder that veggies are our friends and should be a good part of our diet -- I know its easy to forget that part! You can lower your fat and protein intake and increase your veggies and root vegetables to make up for it, without going off Paleo. Yes, this means that you're probably eating more than 50g of carbs, but women in the Paleo community are arguing that we need between 100 - 150 grams to maintain hormonal health anyway... we shouldn't continuously be under 100 grams.

Thank you for your post... I am definitely coming to believe that 150g of carbs is the way to go for me.... And perhaps 200g + depending on the level of endurance training that I'm looking at moving back up to... For me trying to train in keto-adapted state just wasn't right for me...

rubidoux
05-23-2013, 11:43 PM
I'm sorry, Trip. I'd be pretty bummed about that, too.

I just had a strange thing happen, though, which is that I had a surprise lipid panel (went in for an ear infection!) done yesterday and the results were kinda interesting. I have been doing nutritional ketosis solidly since january and I had been playing with it for a couple of years before that. During a period of deep ketosis a couple of years back and in march of this year, when I was also in deep ketosis, I had similarly poor lipid results for the only time ever. My LDL went up quite a bit (70s to 135) and my HDL went down a bunch (80s to 40). The day before I had my blood drawn this week I went insane with carbs... started off with a low blood sugar and then ate myself into oblivion, a proper binge. :( And, the test came out much closer to what it used to be LDL was 95, HDL was 48. I am wondering if the high LDL's were just a result of actually burning fat, like it was all liberated and floating around bc I was burning it. And, I imagine, that, if so, it would right itself when I got to a healthy weight and stopped losing. I'm going to have it repeated again in July, and I'm really looking forward to seeing what happens. With any luck I'll be solidly in ketosis when I have the blood drawn.


but women in the Paleo community are arguing that we need between 100 - 150 grams to maintain hormonal health anyway... we shouldn't continuously be under 100 grams.

I'm curious about why we shouldn't be continuously under 100 grams. I feel so great and I'm eating between 7 and 12 grams most days.

Lolo70
05-24-2013, 01:40 AM
Maybe check your thyroids.

http://perfecthealthdiet.com/2011/09/high-ldl-on-paleo-revisited-low-carb-the-thyroid/comment-page-3/#comment-83409

TripSwitch
05-24-2013, 04:55 PM
I've decided that I'm really going to try make some changes to my diet... especially where fat is concerned.... And even though I still want to lose some more weight I'm not expecting that to make much of difference, but who knows it might help... And even though I'm planning on ramping up my running as well... I'm not expecting that to make much of a difference either.... But I am definitely going to be increasing carbs to support the increase in running that I'm planning...

Basically I'm going to try everything possible to avoid having to take a statin, especially now with the studies that have been come out linking them with the development of new onset diabetes.... Which worries me more because I have a strong family history of diabetes, but no real family history of heart disease, so to speak of....

Emma4545
05-25-2013, 10:55 AM
Basically I'm going to try everything possible to avoid having to take a statin, especially now with the studies that have been come out linking then with the development of new onset diabetes.... .

Also have you considered plant sterols? I used to take them with a spread for bread but they took it off the market. It did drop my cholesterol. By about 30 pts. They do actually have them in a lot of food, I believe minute maid has an orange juice with them.

http://www.webmd.com/cholesterol-management/features/low-cholesterol-diet-plant-sterols-stanols

Rana
05-25-2013, 02:47 PM
I'm curious about why we shouldn't be continuously under 100 grams. I feel so great and I'm eating between 7 and 12 grams most days.

I read this blog and this blog post touches on the whys:

http://www.paleoforwomen.com/carbohydrates-for-fertility-and-health/

I would take a look peruse around the blog. There are other women in the Paleo community that also advocate looking at this from a different perspective (i.e. more healthy carbs for women; low-carb for a set period of time).

Obviously, this isn't saying going back to 300 grams of carbs a day (which I would often hit with no trouble at all prior to getting on a healthy diet), but that carbohydrates aren't evil either -- they are a necessary component for maintaining our health.

Lolo70
05-25-2013, 03:19 PM
Thanks for the link Rana. I think I just lived through all those problems the past months. I truly love the concept of ketosis and what it does in terms of fat loss. It has also so far been the only way to loose for me. But going down in carbs to 40g/day did cause a marked imbalance to my hormones and I had some signs of liver stress and cholesterol accumulation (this on a low fat diet!). So, I think that women who are subclinical hypothyroid like me, there needs to be some caution. I am still trying to find the sweet spot that allows me to loose weight, but without the associated problems. or maybe I just have to take the time and supplement with thyroid hormones.

KittyKatFan
05-25-2013, 07:18 PM
Does high cholesterol run in your family? Maybe it's not the diet at all, and it's hereditary instead?

I have great cholesterol numbers, well under 200. My HDL used to be alarmingly low at 33 but over the past year I've gotten it up to 49 - not optimal yet but improving. My diet was more along the lines of paleo, with lots of lean proteins and veggies/some fruit and not a lot of carbs, but now I eat more carbs and the numbers (weight, triglycerides, blood glucose, etc.) haven't changed. Some have even improved. I don't prescribe to the view that carbs are bad; just the highly processed carbs that taste so good to me and are so bad for me.

Anyway, my dad was diabetic and had heart problems but he had low cholesterol and normal blood pressure. So maybe if your health stats are like your parents, you don't need to tinker with your food plan.

rubidoux
05-26-2013, 01:52 AM
I read this blog and this blog post touches on the whys:

http://www.paleoforwomen.com/carbohydrates-for-fertility-and-health/


Thanks, Rana. I'll go do some reading...

Arctic Mama
05-26-2013, 05:07 PM
Eh, most of what that blog is discussing in terms of problems comes from energy restriction, not ketosis itself. Going low carb and too low on the calories is where women get into trouble, and more dramatically than men.

But women who are experiencing low-thyroid symptoms, menstrual dysregulation, sleep and or mood and mental health related issues may find significant relief from adding carbohydrates back into their diets. What the blogress doesn't seem to understand (or is ignoring) is that these are hallmark symptoms of anyone under energy restriction, not of using ketosis over glycolysis for ATP :)

Several of the studies advocating moderate to high carb for fertility, for example, did not adequately control for energy as a whole. Anecdotally I'd say low carb and high/maintenance calories is ideal for fertility - it acts positively on insulin while not placing the body under any physiological stress (ie: perfect for conception).

Different bodies run well on different diets - it's a spectrum of ideal human nutrition. But as for me, I am both extremely energetic AND fertile on about 25 net carbs per day, so long as I'm not eating below my BMR by too steep of a margin.