• Guest - w'd love to know what you think about the forum! Take the 2026 Survey »

Help! Hba1c down, cholesterol UP


What about women? Lol!! I didn't and don't have any other abnormal tests to indicate fatty liver... And I never drunk excess either..perhaps it is just 30 yr+ T1??
 

Ah, good, I am pleased for you.

I felt a bit mean, not being more helpful, in my last post, but it's such a great video, and he explains so clearly, it is an investment in time, watching it. And far better to hear it from an expert, than "some nutter on the Internet".
 
Hello

Good to see another success story with A1C. Don't know if this will help but here is what i think.

I lost 65 pounds in about 7 months. Won't discuss the overwhelming benefits of LCHF here.

My LDL went from 4 to 8. Total Cholesterol from 6 to 10.

HDL & Trigs up/down but relatively stable although overall my HDL has dropped & Trigs gone up since starting LCHF.

I monitor my lipid panel regularly. There is a LOT of info & advice out there. Best to read as much as you can & decide for yourself.

I refused statins when it came to lowering cholesterol BUT later the decision was taken out of my hands when faced with a different, more immediate medical problem.

the consensus is that massive/rapid weight loss pours Cholesterol/Triglycerides into your bloodstream and this is probably true. but it takes a LOT of faith to refuse statins when you see your personal numbers start to climb & stay there!!

However, your ratios are pretty good so i would NOT worry too much about it!!

All the best!!
 
Last edited by a moderator:

Yes, the video is really good - so well-explained.
 

Thank you - really useful to hear your experiences!
 

And, you were very helpful!
 
AndBreathe, OP and everyone. Yes, Kenneth Sikaris is wonderful, and he is the person who knows most about this I n the world, but even he in that video says, some people's LDL rockets - really rockets, not like yours, OP - and they don't really know what that means.

I've been concerned about this as my LDL went up on LCHF too. Everything else great: trigs down, HDL up. But LDL df up. If I wanted to be sure, I would get an LDL particle number (not size) test or ApoB test privately. It seems rather than size, the total number of LDL particles is what indicates bad news if there is any.

Sikaris is brilliant, but Peter Attia, another MD working with Gary Taubes on nutrition issues, goes into more detail. He's really good (link below). And he says, check LDL-P. And if it's too high, the person may be intolerant of sat fats and should maybe reduce them.

Here's what Attia says on LCHF if you're one of the ones in whom it raises LDL-P. He puts it all very technically, but he's basically talking about LCHF (aka ketogenic diet producing nutritional ketosis, which he is massively pro), and what happens in the small set of cases where this raises LDL cholesterol when it might matter. Most of the time, as per Sikaris, raised LDL is probably big and fluffy and therefore benign. You can check tho, by having an LDL-P test.

"some readers may interpret the data I present to mean it’s perfectly safe to consume, say, 25% (or more) of total calories from SFA [saturated fats]. I realize I may have to turn in my keto-club card, but I am convinced that a subset of the population—I don’t know how large or small, because my “N” is too small—are not better served by mainlining SFA, even in the complete absence of carbohydrates (i.e., nutritional ketosis). Let me repeat this point: I have seen enough patients whose biomarkers go to hell in a hand basket when they ingest very high amounts of SFA. This leads me to believe some people are not genetically equipped to thrive in prolonged nutritional ketosis.

In one particularly interesting case, a patient in self-prescribed nutritional ketosis presented to me with an LDL-P of more than 3500 nmol/L (i.e., more particles than could be measured by the NMR machine so the report simply said “>3,500 nmol/L”) despite feeling, performing, and looking great. Based on his through-the-roof desmosterol and cholanstanol levels, and a curb-side consult from the Godfather I mean Dr. Tom Dayspring, I decided to try an experiment. You see, the logical thing to do in this setting would have been to start two drugs immediately (a potent statin to address the hypersynthesis and ezetimibe to address the hyperabsorption) or tell him to abandon ketosis altogether. But this patient was adamant about staying in ketosis given the other benefits, though obviously worried about the long-term coronary implications. So, we agreed that for a 3 month trial period he would reduce SFA to an average of 25 g/day (vs. about 75 to 100 g/day) and make up the difference with monounsaturated fat (MUFA). Parenthetically, we also reduced his omega-3 PUFA given very high RBC EPA and DHA levels.

So, on balance, he consumed about the same number of calories and even total quantity of fat, but his distribution of fat intake changed and he heavily swapped out SFA for MUFA.

The result?

His LDL-P fell from >3,500 nmol/L to about 1,300 nmol/L (about 55th percentile), and his CRP fell from 2.9 mg/L to <0.3 mg/L (and for the lipoprotein cognoscenti, both desmosterol and cholanstanol fell). [CRP is an inflammation marker,]

Pretty cool, huh? So, my point is this: while I believe the population-based guidelines for SFA are not supported by a standard of science I consider acceptable, it does not imply I believe SFA is uniformly safe at all levels for all individuals.

Some of you may be wondering about me. It turns out I’m in the group (recall: I have no idea how large or small this group is) that seems to do well—at least by the tools we have available to assess risk—with large amounts of SFA in my diet, if and when I elect to. Even when I was in ketosis, eating 4,000 kcal/day (literally getting 40 to 45% of my calories from SFA alone) my biomarkers—cardiovascular, insulin resistance, inflammation—were excellent. Better than they ever were or even are today. Though, my point still stands: there are some people who do not appear able to safely consume massive amounts of SFA."

Peter Attia's blog is at http://eatingacademy.com. He has a series of nine articles on cholesterol which are exhaustively thorough. If you plough your way thro those, you will know more than all e
But the lipid specialists.

LucySW
 
Last edited by a moderator:

Thanks Lucy.

My current thinking is, subject to my forthcoming lipid panel results, I'll accept my GPS offer to refer me to a specialist in lipids, to ensure I've listened to all opinions, and perhaps even manage to have a few additional tests.

It's a fascinating, but emotive subject, and being women, there are fewer meaningful studies for us, which is somewhat unfortunate.

I'll definitely have a look at the link(s) you post.
 
I've pasted everything in now, have a read.

I'm going to wait a while, then if I still have the very high LDL, I might get tested privately for LDL-P. I've no chance of getting a test thro the health service. And I am *never* taking statins.

Dx T1 late onset last June and have been LCHF-ing since August and lost 11kg, so this could be temporary.

Posting my cholesterol figures here, just for comparison. As you can see, LDL isn't thro the roof, but it's high, and it's clearly come from the LCHF diet. (Which I love and am not stopping.)

Total cholesterol: 7.7 mmol/l or 298 mg/dl (high)

HDL: 2.6 mmol or 101 mg/dl (really good)

LDL 4.7 mmol or 181 mg/dl (high)

Triglycerides: 0.8 mmol or 71 mg/dl (excellent, very low. Could go down even more.)

Ratio trig/HDL: in mmol, 0.3 or in mg/dl, 0.7. (This is considered the most significant marker by up to date people like Sikaris. Excellent.)

Oof.

Lucy
 
Last edited by a moderator:

Principally, I'm with you on statins, Lucy, although (bearing in mind the fat journey we've all endured) I feel I need to lift as many metaphoric stones as I can in making that informed rejection. A referral is the best chance I'll have of a deeper testing opportunity, as my GP admits she's not great on lipids and is very much guided by the guidelines. Whilst far from ideal, at least we had an open, honest discussion, which is all I can ask for from such a generalist.

Like you, I'm guessing, I'd prefer it to be more clear cut, but we have to work with what we have.
 
Lucy - thank you for taking the trouble to post. This kind of detailed discussion is exactly my thing. I'm going to read the Attia articles. I think lipids will become my new obsession.
 
Blessedarethecheesemakers said:
Lucy - thank you for taking the trouble to post. This kind of detailed discussion is exactly my thing. I'm going to read the Attia articles. I think lipids will become my new obsession.
Click to expand...

I'd be interested to hear where your thinking develops to, in that our scenario are sort of variations on the same theme.
 
Yes - and this keeps coming up with LCHF. My own view as a non-medical but critical reader is that it's a wrinkle, rather than a major problem, with LCHF. I like to read thro a good description of the science, though.
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…