My Cholesterol Craziness Continues
One of the things I like to do here at my blog is share very candidly about my experiences while livin' la vida low-carb -- good, bad or ugly. There are no pretenses here because my story is my story. It is what it is and I make no apologies for it.
With that said, I never claim to be the prime example of what a typical low-carb experience is all about in regards to weight loss success and other health indicators. All I do is share with you about what is happening to me so you can see the world through the eyes of one man whose life was radically altered for the better because of the low-carb lifestyle.
Although I have lost 180 pounds and kept it off for a couple of years now, there is one area of my health that has seen some rather peculiar fluctuations in just the past 7 or so months. That would be my cholesterol.
My blood work from October 2005 showed my lipid profile as nearly ideal with HDL at 71, triglycerides at 57, VLDL at 11, LDL at 119, and total cholesterol at an acceptable 201. This was what my numbers looked like after livin' la vida low-carb for about 22 months and I was proud to see them doing so well.
Fast forward six months later to March 2006 and I had my blood work taken again. This time, my lipid profile seemed to improve in many areas because it showed an HDL reading of 72, triglycerides had fallen to 42 (that's a good thing and evidence that I'm sticking with my low-carb eating plan!), and VLDL dropped to a microscopic 8.
Despite these good things, though, my LDL jumped over 50 points to 172 in just six months bringing my total cholesterol up to 252. That number caused my doctor to freak out and start talking about putting me on a statin drug again.
Unfortunately, statins have become the quick and easy response from doctors to treat high cholesterol because they do work so well to lower cholesterol numbers, but I'm very concerned about medical professionals to quickly recommending higher and higher doses to people without regarding to the negative effects these drugs are having on people.
Because of these and other concerns about this kind of medication, the consensus from most of my readers and several low-carb friendly medical professionals was to avoid taking statins if at all possible (because taking them could be a literal nightmare!).
However, despite the fact that my trigylceride/HDL ratio is immaculate compared to most, my doctor gave me four months to get my LDL down. But even the renowned low-carb expert Dr. Michael Eades says that raising your HDL by eating more fat is protective against heart issues and should be the main focus for anyone concerned about cholesterol.
Before I started livin' la vida low-carb, my HDL was a dismal 21 and my triglycerides hovered over 250. My LDL was about 250 which brought my total cholesterol to around 275. It wasn't a pretty picture.
Now, though, my HDL is much higher (and healthier!) while my triglycerides are a whole lot lower (again, that's healthy!). What about my LDL? In October 2005 it was 119, but then it rose 53 points in six months! But what happened next has baffled me to no end and I am sincerely looking for answers about why this would happen.
In April 2006, I decided to have the LipoScience particle test done on my blood since the particle count and size of your cholesterol is a better indicator of the kind of cholesterol moving through your body than the more traditional cholesterol tests that are usually done in your doctor's office. I fully expected my cholesterol to be the large, fluffy kind that is less dangerous than the more dense particles. And I was right!
The total small LDL particle number was 496, lower than the 600 considered healthy. Additionally, my LDL particle size was 22.1, which is on the high end of large. My large HDL was measured at 12.1, which is supposed to be greater than 9.0, and my large VLDL was 0.3, which is even lower than the 0.5 that shows a lower risk for developing metabolic syndrome. So far, so good, right? Unfortunately, the good news stopped there.
The LipoScience particle test found my LDL particle number to be 1724, which is considered a lot higher than the optimal number of less than 1000. What puzzled me more than anything is what happened to my cholesterol numbers in just ONE MONTH after having them measured at my doctor's office to the time it was tested by LipoScience.
Check out the comparison of the numbers from March 2006 to April 2006:
LDL - from 172 to 230
HDL - from 72 to 57
Triglycerides - from 43 to 84
Total cholesterol - from 252 to 304
What the &*#%^@ happened to my cholesterol numbers?! Although I started taking red yeast rice, a plant stenol, garlic tablets and a baby aspirin (all recommended by my doctor after my cholesterol test in March 2006), let me assure you that I haven't changed a thing about my eating habits or exercise habits during that one month between these tests and I still haven't. In fact, I haven't really changed anything else about my low-carb program since I finished losing weight at the end of 2004. That's what makes this cholesterol craziness so perplexing to me.
A trusted low-carb friend informed me that perhaps I am overdosing on Vitamin A because of the supplements I was taking, including a multivitamin, cod liver oil, and natural sources from the nutrient-dense foods I eat as part of my low-carb plan. She noted that consuming too much Vitamin A can cause something called hypervitaminosis A which is considered "toxic" because it causes cholesterol to rise too much as well as the blood serum levels of calcium to soar upward. Yikes! Because of this, fat soluble vitamins such as A and D need to be limited to the recommended dosage. You've been fairly warned! Who knew you could OD on vitamins? :-~
So, I had my blood tested for the Vitamin A content and I got the results back on this test on Thursday. However, this wasn't my problem as my doctor said my blood work on the Vitamin A content showed a reading of 88 ug/dL, considered on the high end of normal, but it was normal. Even still, I have since switched to fish oil supplements instead to get my omega-3 and omega-6 essential fatty acids.
Now what do I do about my LDL going haywire? If it's not my diet or my supplements, then what in the world could be causing this to be happening to me? I will tell you that I had the VAP test done on my blood about a week after the LipoScience test and I am still awaiting the results of that test to come back in the next few weeks. It will be interesting to see if the numbers are even remotely similar to the LipoScience test. Could it have just been a fluke?
Regardless, my doctor saw the results of my LipoScience test and almost demanded that I go on a statin (additionally, a cardiologist that LipoScience put me in contact with also recommended that I go on a statin drug immediately!). After holding my ground and refusing to do that because I don't want to experience the intense joint pain from taking Lipitor or Crestor again, my doctor responded that he doesn't want to see me hurt either. That's when he said I probably have a genetic predisposition for cholesterol issues which will need to be treated with several drugs since my body can't handle statins.
To that end, he prescribed for me to take the three following medications: Zetia, WellChol, and the prescription form of Niacin. My doctor said each of these have little to no side effects at all and will each lower the LDL by 10-15 percent. I relented and said I'd be willing to take these drugs if they won't harm my body and will lower my LDL cholesterol.
When I asked about how and why my LDL would spike up like that, my doctor said it could be brought on by stress. My response was that I am under no more stress now than I was six months or a year ago. So, I'm still scratching my head on this one.
Now I am taking these medicines because frankly I am concerned about the LDL continuing to rise. Am I justified in my concerns? Why would this be happening all of a sudden after being on low-carb for 2 1/2 years? In fact, this probably has nothing to do with my low-carb lifestyle, right?
Any thoughts about this from low-carb researchers, practitioners, or knowledgable low-carbers would be greatly appreciated! In the meantime, I'll keep you informed about the results of the VAP test as well as my follow-up visit to the doctor in August 2006. Can anyone provide some answers for me?
5-28-06 UDPATE: Well, I'm getting what I asked for -- opinions about why this is happening to my cholesterol. Here's just a few of the responses I have received so far:
Jimmy,
Regarding your recent lipid increases, some people say that as long as you're losing weight, a high-fat diet won't raise your lipid levels, but when you stop losing weight, it can. Gerald Reaven
is one who claims this.
You mention that you've stopped losing weight, and after that your lipids increase, although not immediately. You might look into this as a factor in your increased cholesterol.
Also, I think for someone on a high-fat diet, Zetia is the best drug. If you're eating a lot of fat, statins won't do much because you're not producing much cholesterol yourself. All the statistics concern people who started out on a NCP Step 1 low-fat diet, so they're producing all their cholesterol.
In fact, my LDL didn't change on 80 mg of Lipitor. Zetia brought it way down.
Hang in there,
Gretchen Becker
co-author of The Four Corners Diet
P.S. "The Four Corners Diet" is a low-carb, low-saturated fat, high-fiber diet designed for people who see their lipids increase on an Atkins-style diet. It used to be called the GO-Diet. You might want to look into it. It's not my diet, but I felt it was the healthiest one, so I helped the authors rewrite a second edition.
THANK YOU for your feedback. It makes me feel a little better about taking Zetia now. Hmmm, when you stop losing weight on livin' la vida low-carb, you should cut back on saturated fat? Really? Does anyone else have an opinion, expert or otherwise, on THAT subject?
Here's another intriguing theory about my cholesterol going up from another reader:
Eat the way you do now but try lowering calories, because this is should be just as or more effective than statins.
Choleseterol synthesis is dependent on many things and one of those is energy intake. Cutting back say 10%-20% would probably bring your total cholesterol down to ranges of around 115-180mg/dL , lower LDL and keep HDL high.
First I'm eating too much fat now that I've stopped losing weight. Now this person says I'm eating too many calories. Yikes! It's amazing I have been livin' la vida low-carb for 2 1/2 years and neither of these factors played a role in my LDL cholesterol going up before. Sigh.
Okay, let's look at one more comment from a very regular reader and friend of this blog who has some scientific knowledge about low-carb diets and their effect on the human body:
The list of things that can impact cholesterol are numerous:
Stress
Oxidative stress & free radicals
High carbohydrate diet (regardless of fat content)
Medication
Vitamin A overload
Supplements and/or prescription drugs
Activity level
Trans-fats
Omega-3 deficiency
Eating damaged polyunsaturated fats
So then.....from March to April your cholesterol numbers changed significantly - enough to set off louder alarm bells with your doctor (and frankly, me too).
The big change you made wasn't in your diet, but in the supplements you took - red yeast rice specifically. The UC Berkeley Wellness Newsletter contained an interesting piece on red yeast extract that is a must-read - Red Yeast Rice Extract. I didn't know this myself and thought you would want to know. If the addition of the supplement, garlic and baby aspirin were the only things you changed - I think you might have your answer about what is negatively impacting your numbers in one month.
But that still doesn't answer what impacted your numbers August to March. You're not eating a high carb diet, you had your vitamin A tested, you exercise every day, you're taking omega-3 fatty acid supplements, you avoid foods with partially hydrogenated oils and you're not taking any prescription drugs. That eliminates almost all of the above items.
What's left? Stress, oxidative stress & free radicals and eating damaged fats.
Let's just say you're not under any new stress (even though you might be and not realize it).....so what's in your diet that might be causing oxidative stress & free radicals? Eating damaged fats. The cod liver oil and/or fish oil supplements you take might be rancid - which means it's damaged before you ever put it in your body.
Damaged fats cause oxidative stress in the body and produce free radicals --- if they aren't countered with antioxidants, over time they can impact your cholesterol numbers since your body makes more cholesterol in an attempt to repair the damage occurring. It's one more piece of the puzzle to explore.
Well, well, well -- perhaps the new things I started back in March to LOWER my cholesterol are actually the culprit in RAISING it now. Eeeek! How the #^&*# is the average person supposed to know what to do about cholesterol when there's so much junk science thrown around about this and that supplement?! Sheez, somebody throw me a bone here. Perhaps I should get off the red yeast rice, garlic and plant stenol to see if there is any change for the better.
Yet another knowledgable regular reader wrote this about my LDL:
I just read your newest article about your "high" LDL cholesterol worries. I thing you should not worry too much and be careful with those medications, even if the PDR guide of your doc shows no or only minor side-effects for those drugs. Don't forget that the pharmaceutical companies PAY to have their stuff listed in the PDR - so expect that thing to be rather biased.
Furthermore and moreover, don't forget that high LDL is not a bad thing by definition. In fact, there is much evidence from a number of major studies showing that high cholesterol - even high "bad" LDL cholesterol - is very beneficial and preventive for, for example, CHD!
Personally, I think your higher total cholesterol (again, as far that's worrisome!) is due to perhaps a too low intake of antioxidants. A higher intake of green leafy veggies and perhaps even some more fruit and especially berries can help change that.
Consider the following:
In 1997, Swedish researchers published a comparison of CHD risk factors among men from Vilnius in Lithuania and Linkoping in Sweden. These two groups were selected because the former had a four-fold higher death rate from CHD than the latter. Very little difference in traditional risk factors existed between the two groups, except that (read this carefully!) the men from CHD-prone Vilnius had lower total and LDL cholesterol levels!
According to common wisdom, the lower total and LDL cholesterol of the Lithuanian men should have placed them at reduced risk of heart disease. When the researchers probed further, they discovered that the men from Vilnius had significantly higher concentrations of oxidized LDL. They also displayed significantly poorer blood levels of important diet-derived antioxidants such as beta carotene, lycopene, and gamma tocopherol (a form of vitamin E). Blood levels of these particular nutrients are largely determined by dietary intake, especially from the consumption of antioxidant-rich fruits, nuts, and vegetables. So while the Lithuanian men had lower LDL levels, they had a greater susceptibility to oxidized LDL due to what appeared to be a poorer intake of antioxidant-rich foods.
This may well have explained their greater susceptibility to cardiovascular disease; in tightly-controlled clinical trials, individuals randomized to increase their intake of fruits and vegetables have experienced significant reductions in cardiovascular and all-cause mortality.
During the massive GISSI-Preventione trial in Italy a RISE in LDL showed significant mortality benefits. And in the Lyon Diet Heart Study, an experimental group advised to increase consumption of root vegetables, green vegetables, fish and fruit, and omega-3 fatty acids also experienced greatly improved cardiovascular and survival outcomes. One particularly little publicized finding from this well-known trial was that the total and LDL cholesterol levels of the treatment and control groups were virtually identical throughout the entire study. Those in the treatment group, however, did show significantly higher blood levels of BOTH omega-3 fatty acids AND antioxidants.
In other words: high LDL has been proven to be beneficial (!) IF sufficient antioxidants are consumed and available.
Then what about statins, as your doc wants? According to medical "opinion leaders" - you know, those who tell the rest of the unthinking masses what we are to believe - recent trials with statin drugs have proven once and for all that LDL reduction is beneficial. Allegedly, these trials have also shown that the greater the LDL reductions, the better. Again, this is
completely false.
Statin drugs exert their lipid-lowering effect by blocking an enzyme in the liver that is involved in the early stages of cholesterol synthesis. Statins inhibit the synthesis of mevalonate, a precursor not only to cholesterol, but also to a substance known as geranyl-geraniol. Inhibition of geranyl-geraniol produces beneficial effects on levels of nitric oxide, a substance with anti-inflammatory and artery-dilating properties. In fact statins have a multitude of effects - most of which are not recognized or even ignored.
So the fact that statins exert a whole host of biochemical effects beyond mere lipid-lowering is beyond question. In light of this inescapable fact, how can anyone confidently conclude that it was LDL reduction - and not amplification of one or more of these other effects - that produced the favorable cardiovascular outcomes seen in numerous studies like the PROVE-IT or TNT studies?
The answer, of course, is that they can't. In January 2005, the New England Journal of Medicine published two studies examining the interplay between statin use, CRP levels, and subsequent coronary event rates. The first of these, using data from the aforementioned PROVE-IT study, found that: "Patients who have low CRP levels after statin therapy have better clinical outcomes than those with higher CRP levels, regardless of the resultant level of LDL cholesterol." Another study found that "Atherosclerosis regressed in patients with the greatest reduction in CRP levels, but not in those with the greatest reduction in LDL cholesterol levels."
These results reinforce what is already obvious: The favorable results were due to the NON lipid-lowering actions of statins. The strong correlation between CRP and improved clinical outcomes indicates that the anti-inflammatory effects of statins played a key role. So, decades of dietary and drug intervention trials have repeatedly shown a complete disconnect between total and LDL cholesterol reduction and clinical outcomes but do show that anti-oxidants, causing lower CRP levels, do have greatly beneficial effects.
Ergo conclusio: I think the best you can do is NOT WORRY about your (high) cholesterol at all, and consume more antioxidants - as mentioned above - specifically those that influence CRP levels. Fruits, berries, nuts and green, leafy veggies. And even if your LDL stays relatively high: this has been shown to be beneficial! Why try to lower it?
The truth to keep in mind here is the fact that a growing number of highly esteemed and accomplished individuals, researchers and scientists are joining the campaign to alert the public to the fact that this lipid hypothesis (the cholesterol myth) is a total sham. Check out this link: www.thincs.org.
Perhaps I am not eating enough berries and green leafy veggies. I admit I could probably start eating MORE of these than I currently am and would enjoy it, too. This is something I can DEFINITELY start doing immediately! THANKS for the feedback!
But what should I do about taking all these drugs my doctor wants me to? I've got one person that says Zetia is good, but I'm also taking the Niacin. I haven't started the WellChol yet, but I am very interested in hearing from people about what you think of these drugs and whether it is a necessary step that I need to take to lower my LDL. Am I overreacting to this as the last e-mail from one of my readers indicates or am I right to be as concerned as I am? THANKS for sharing your comments!
5-28-06 UPDATE: There's a case to be made against taking the medicines my doctor has prescribed.
Check this out from one of my readers on Zetia:
I am not too happy to hear you are taking this Zetia stuff. See the following:
Cholesterol-Lowering Drug Increases Hepatitis Risk
The Australian drugs watchdog is investigating claims that a cholesterol-lowering medication increases the risk of catching hepatitis. Ezetrol (Ezetimibe, also known as Zetia in the U.S.) has been available in Australia since October 2003 and is made by US company Merck Sharp and Dohme.
Therapeutic Goods Administration (TGA) spokeswoman Kay McNiece said the drug increased the risk of catching clinical hepatitis.
"The adverse drug reaction unit has received 115 reports of suspected adverse reactions where Ezetrol is suspected of contributing to the event," Ms McNiece said. "We have 10 cases where abnormal liver enzymes or hepatitis were reported."
Clinical hepatitis has been confirmed in three cases.
"As Ezetrol is a relatively new medication all the risks associated with its use, particularly the less common ones, may not be fully identified," she said.
Ferntree Gully woman Loreto Kelly was diagnosed with clinical hepatitis after taking Ezetrol. "I think it would have killed me, I really didn't think I was going to survive," she said.
Click here to read the full story.
And then there's this about the Niaspan I'm taking:
Jimmy,
I just came across this new information about Niaspan. I hope it's not Niaspan you are taking? That's a cholesterol lowering product based on Niacin. It is the same as the stuff your doc prescribed. Read the below story sent to a patient taking the stuff. He wrote to researcher Colpo the following letter, please read carefully:
Six Little Pills
Prior to taking the drug Niaspan, I was in top physical condition for a 44 year old male. I was a runner, swimmer, and active in weight training. I enjoyed the best health of my life. My sleep was peaceful and refreshing. I awoke to each new day with energy and vitality. Disciplined dietary habits along with daily exercise left my mind sharp. As a Private Pilot, I flew every morning working towards my instument rating.
I had incredible success with diet and exercise on my health. I lost 18 pounds. Total cholesterol dropped 42%, Triglycerides down 75%. Good cholesterol up 50%.
But according to my Doctor, this was not good enough, and he told me that I would have to take the cholesterol lowering drug Niaspan for the rest of my life to avoid a heart attack. I recieved a hard sales pitch on the drug. I was told that I had the lowest cholesterol possible, but the cholesterol I had was "bad, very bad"! The atmosphere resembled being with a timeshare
salesman, not a Doctor. I could not understand why I had to take this drug for life.
With a six foot, 162 pound slender frame, a total cholesterol of only 126, and an LDL of only 51, I was prescribed a cholesterol lowering drug, unaware of the inevitable disaster that lay ahead.
The first symptom was difficulty climbing stairs, followed by a 'Parkinson like' tremor in my right arm. My peaceful sleep was interrupted by vivid nightmares. Then my arms and legs began to tingle. With each pill, nocturnal attacks became worse until the tingling was unbearable, much like a shock from the house wires. I developed intense chills that lasted for hours. I awoke the next morning exhausted.
Each night the nocturnal attacks intensified. I tried to get out of bed but fell to the floor unable to walk. The muscle pain in my legs was intense and I wanted to scream. At 2 AM I lay on the living room floor unable to walk. With relentless determination I attempted to walk, but only covered 12 feet before collapsing to the floor again. By 6AM the episode was over.
The last night on the drug was the worst. It attacked my respiratory muscles and I fought for breath. I experienced a hard forceful pulse. Tingling intesified untill I was unable to move or speak to call for help. I knew I was in trouble and wanted to call 911, but was unable to reach for the phone. I just told myself " Whatever happens, don't stop breathing."
By the 7th day I made the connection to the drug and discontinued the Niaspan, but it was too late. The damage had been done.
I found myself bedridden. Muscle tremors and spasms persisted around the clock. With visible twitching of muscles, I watched in horror as my calf muscles wriggled like a snake beneath my skin.
I encountered extreme difficulty walking, and standing meant clinging to the countertops. But I could not remain standing very long. The next three weeks were spent in bed with tremors, spasms, irregular heartbeats, shortness of breath, and falling in and out of consciousness.
Repeated calls to my physicians office were primarily ignored. I spoke with the nurse who was very short with me. "The Doctor says Niaspan does not make muscles weak. Have a nice Christmas" and she hung up on me.
Visibly struggling to walk, I eventually made it in to see my Doctor. I was told lab tests were normal and therefore there was no damage from the drug. My Doctor said I was "overly conscientious and needed to see a psychiatrist."
Determined to get medical help, I drove myself to ER at midnight while having tremors and shortness of breath. At the Emergency Room I was turned away, denied services, and told to see my Doctor during the day.
The next 12 months endured painful neuropathy in my legs.
Almost four years later I have improved, but live with the long term consequences. Chronic fatigue, occasional shortness of breath, muscle tenderness and intolerance of exercise are part of life now. The allergic reaction I suffered is now in the medical literature that comes with the drug, and urges emergency medical attention.
Today I counsel others who have taken this drug or other lipid lowering agents that have caused muscle or nerve damage. My personal studies into cholesterol lowering drugs, their side effects, and the relentless marketing by the drug companies has revealed a very alarming picture.
Bobby Olson,
Tyler, Texas.
My Background: Grew up in Dallas, Texas. As a young adult I engaged in adventure sports. At age 17 became a private pilot. Was active in sport skydiving, scuba diving, and wilderness backpacking. Learned Real Estate investing, and bought, renovated, and sold single family housing. At mid life, returned to flying and earned a Commercial Pilot certificate and instrument rating. Have lived in Dallas, Minneapolis, and Coeur d' Alene Idaho. Now reside with my wife and 3 children in Tyler, Texas.
Yikes, yikes, and YIKES AGAIN!!! Me thinks I'll stop taking the Niaspan now. The worst thing the doctor said it would do to me is cause flushing. From Bobby Olson's story, it does a lot more than THAT! Any comments anyone?
5-29-06 UPDATE: More pearls of wisdom from my readers have poured in.
First of all, I am by no means an expert on any of this. I teach a weight loss class for Curves and in my 'research' for this, I have discovered FLAX SEED MEAL. This is 0 carbs, high fiber, and protein, and is supposed to be even better for fighting high cholesterol than oatmeal. I have a bowl each morning as a hot cereal. Mix 4-5 Tbsp with hot water, cinnamon, and splenda and YUMMY. Look into this for yourself and see what you find out.
I have eaten flax seed products before, but never just the flax seed meal. I do like to eat oatmeal and have it often for breakfast as well. Maybe I need to check out this flax seed meal.
But another reader said I probably need to chunk my fish oil because they're probably rancid:
Fish oils - any highly polyunsaturated oil for that matter - is highly susceptible to rancidity at room temperature! You won't know it by taste or even smell....Mary Enig is one of the leading authorities on fats and even with her position on the lipid-hypothesis, she's untouchable because her science is solid.....she basically says the capsules are all rancid because of how they're processed and then shipped in fluctuating heat conditions.
You might want to spend the extra money to get the liquid fish oils at the health food store - in a green or brown bottle (light also oxidizes poly fats) and keep it in the refrigerator so it is cold. Almost everyone those are the least processed and have the least contaminants and least likelihood of being rancid on the shelf.
If fish oil goes rancid, then you'll know it because you'll burp fishy burps...as long as you're not burping fishy burps your oil is OK!
Also - refrigerate your flaxseeds - they're highly susceptible to rancidity also since they're so high in polys.....grind only as you use them!
I ALWAYS BURP FISHY BURPS! Yikes! Did you know about this regarding fish oil supplements? I suppose I should try to find these fresher fish oil supplements to see if it makes a difference. I'm learning so much about this and I hope you are, too. Anyone else have a comment to share on this subject?
5-30-06 UPDATE: I sent an e-mail to Dr. Barry Sears requesting his comments about my cholesterol situation. Here is what one of his representatives wrote back to me in an e-mail:
Dr. Sears has written in earnest about the downfalls of a low-carbohydrate diet. He does not advise anyone to follow such a diet. Most individuals see a return to negative bloodwork over time after low-carbing.
His suggestions are always to follow the Zone Diet and take 2.5 - 5 grams of OmegaRX daily for improvements in the lipid profile.
For more information: www.drsears.com.
Best,
Theoni Gray
I was hoping for a little different answer than that, but I guess it stands to reason he would say to go on his diet. If I hear back from anyone else, I'll let you know.
6-6-06 UPDATE: I heard back from Drs. Michael and Mary Dan Eades today about my cholesterol issue.
Dear Jimmy-
We don't know if you've read the follow up book to Protein Power (i.e., The Protein Power LifePlan) or not, but we dealt more with the issue of cholesterol and various natural lowering remedies in that book. Read or re-read the chapters about cholesterol, iron storage, and micronutrients, which should prove helpful.
Regarding cholesterol, in our patients, we generally didn't stress too much about LDLs in the 200 range that were composed primarily of particles of large size as long as other measures, such as ferritin, homocysteine, and inflammatory markers (CRP, for instance) were in line.
Explore some of this information and keep in touch to let us know how you're doing.
Cordially,
The Drs. Eades
Well, my LDL particles are mostly the large kind despite the fact that they are currently measured at 230. I'm beginning to worry less and less about my cholesterol thanks to people like the Eades and Anthony Colpo educating me further about this issue. THANKS again to everyone who contributed to this discussion.
With that said, I never claim to be the prime example of what a typical low-carb experience is all about in regards to weight loss success and other health indicators. All I do is share with you about what is happening to me so you can see the world through the eyes of one man whose life was radically altered for the better because of the low-carb lifestyle.
Although I have lost 180 pounds and kept it off for a couple of years now, there is one area of my health that has seen some rather peculiar fluctuations in just the past 7 or so months. That would be my cholesterol.
My blood work from October 2005 showed my lipid profile as nearly ideal with HDL at 71, triglycerides at 57, VLDL at 11, LDL at 119, and total cholesterol at an acceptable 201. This was what my numbers looked like after livin' la vida low-carb for about 22 months and I was proud to see them doing so well.
Fast forward six months later to March 2006 and I had my blood work taken again. This time, my lipid profile seemed to improve in many areas because it showed an HDL reading of 72, triglycerides had fallen to 42 (that's a good thing and evidence that I'm sticking with my low-carb eating plan!), and VLDL dropped to a microscopic 8.
Despite these good things, though, my LDL jumped over 50 points to 172 in just six months bringing my total cholesterol up to 252. That number caused my doctor to freak out and start talking about putting me on a statin drug again.
Unfortunately, statins have become the quick and easy response from doctors to treat high cholesterol because they do work so well to lower cholesterol numbers, but I'm very concerned about medical professionals to quickly recommending higher and higher doses to people without regarding to the negative effects these drugs are having on people.
Because of these and other concerns about this kind of medication, the consensus from most of my readers and several low-carb friendly medical professionals was to avoid taking statins if at all possible (because taking them could be a literal nightmare!).
However, despite the fact that my trigylceride/HDL ratio is immaculate compared to most, my doctor gave me four months to get my LDL down. But even the renowned low-carb expert Dr. Michael Eades says that raising your HDL by eating more fat is protective against heart issues and should be the main focus for anyone concerned about cholesterol.
Before I started livin' la vida low-carb, my HDL was a dismal 21 and my triglycerides hovered over 250. My LDL was about 250 which brought my total cholesterol to around 275. It wasn't a pretty picture.
Now, though, my HDL is much higher (and healthier!) while my triglycerides are a whole lot lower (again, that's healthy!). What about my LDL? In October 2005 it was 119, but then it rose 53 points in six months! But what happened next has baffled me to no end and I am sincerely looking for answers about why this would happen.
In April 2006, I decided to have the LipoScience particle test done on my blood since the particle count and size of your cholesterol is a better indicator of the kind of cholesterol moving through your body than the more traditional cholesterol tests that are usually done in your doctor's office. I fully expected my cholesterol to be the large, fluffy kind that is less dangerous than the more dense particles. And I was right!
The total small LDL particle number was 496, lower than the 600 considered healthy. Additionally, my LDL particle size was 22.1, which is on the high end of large. My large HDL was measured at 12.1, which is supposed to be greater than 9.0, and my large VLDL was 0.3, which is even lower than the 0.5 that shows a lower risk for developing metabolic syndrome. So far, so good, right? Unfortunately, the good news stopped there.
The LipoScience particle test found my LDL particle number to be 1724, which is considered a lot higher than the optimal number of less than 1000. What puzzled me more than anything is what happened to my cholesterol numbers in just ONE MONTH after having them measured at my doctor's office to the time it was tested by LipoScience.
Check out the comparison of the numbers from March 2006 to April 2006:
LDL - from 172 to 230
HDL - from 72 to 57
Triglycerides - from 43 to 84
Total cholesterol - from 252 to 304
What the &*#%^@ happened to my cholesterol numbers?! Although I started taking red yeast rice, a plant stenol, garlic tablets and a baby aspirin (all recommended by my doctor after my cholesterol test in March 2006), let me assure you that I haven't changed a thing about my eating habits or exercise habits during that one month between these tests and I still haven't. In fact, I haven't really changed anything else about my low-carb program since I finished losing weight at the end of 2004. That's what makes this cholesterol craziness so perplexing to me.
A trusted low-carb friend informed me that perhaps I am overdosing on Vitamin A because of the supplements I was taking, including a multivitamin, cod liver oil, and natural sources from the nutrient-dense foods I eat as part of my low-carb plan. She noted that consuming too much Vitamin A can cause something called hypervitaminosis A which is considered "toxic" because it causes cholesterol to rise too much as well as the blood serum levels of calcium to soar upward. Yikes! Because of this, fat soluble vitamins such as A and D need to be limited to the recommended dosage. You've been fairly warned! Who knew you could OD on vitamins? :-~
So, I had my blood tested for the Vitamin A content and I got the results back on this test on Thursday. However, this wasn't my problem as my doctor said my blood work on the Vitamin A content showed a reading of 88 ug/dL, considered on the high end of normal, but it was normal. Even still, I have since switched to fish oil supplements instead to get my omega-3 and omega-6 essential fatty acids.
Now what do I do about my LDL going haywire? If it's not my diet or my supplements, then what in the world could be causing this to be happening to me? I will tell you that I had the VAP test done on my blood about a week after the LipoScience test and I am still awaiting the results of that test to come back in the next few weeks. It will be interesting to see if the numbers are even remotely similar to the LipoScience test. Could it have just been a fluke?
Regardless, my doctor saw the results of my LipoScience test and almost demanded that I go on a statin (additionally, a cardiologist that LipoScience put me in contact with also recommended that I go on a statin drug immediately!). After holding my ground and refusing to do that because I don't want to experience the intense joint pain from taking Lipitor or Crestor again, my doctor responded that he doesn't want to see me hurt either. That's when he said I probably have a genetic predisposition for cholesterol issues which will need to be treated with several drugs since my body can't handle statins.
To that end, he prescribed for me to take the three following medications: Zetia, WellChol, and the prescription form of Niacin. My doctor said each of these have little to no side effects at all and will each lower the LDL by 10-15 percent. I relented and said I'd be willing to take these drugs if they won't harm my body and will lower my LDL cholesterol.
When I asked about how and why my LDL would spike up like that, my doctor said it could be brought on by stress. My response was that I am under no more stress now than I was six months or a year ago. So, I'm still scratching my head on this one.
Now I am taking these medicines because frankly I am concerned about the LDL continuing to rise. Am I justified in my concerns? Why would this be happening all of a sudden after being on low-carb for 2 1/2 years? In fact, this probably has nothing to do with my low-carb lifestyle, right?
Any thoughts about this from low-carb researchers, practitioners, or knowledgable low-carbers would be greatly appreciated! In the meantime, I'll keep you informed about the results of the VAP test as well as my follow-up visit to the doctor in August 2006. Can anyone provide some answers for me?
5-28-06 UDPATE: Well, I'm getting what I asked for -- opinions about why this is happening to my cholesterol. Here's just a few of the responses I have received so far:
Jimmy,
Regarding your recent lipid increases, some people say that as long as you're losing weight, a high-fat diet won't raise your lipid levels, but when you stop losing weight, it can. Gerald Reaven
is one who claims this. You mention that you've stopped losing weight, and after that your lipids increase, although not immediately. You might look into this as a factor in your increased cholesterol.
Also, I think for someone on a high-fat diet, Zetia is the best drug. If you're eating a lot of fat, statins won't do much because you're not producing much cholesterol yourself. All the statistics concern people who started out on a NCP Step 1 low-fat diet, so they're producing all their cholesterol.
In fact, my LDL didn't change on 80 mg of Lipitor. Zetia brought it way down.
Hang in there,
Gretchen Becker
co-author of The Four Corners Diet
P.S. "The Four Corners Diet" is a low-carb, low-saturated fat, high-fiber diet designed for people who see their lipids increase on an Atkins-style diet. It used to be called the GO-Diet. You might want to look into it. It's not my diet, but I felt it was the healthiest one, so I helped the authors rewrite a second edition.
THANK YOU for your feedback. It makes me feel a little better about taking Zetia now. Hmmm, when you stop losing weight on livin' la vida low-carb, you should cut back on saturated fat? Really? Does anyone else have an opinion, expert or otherwise, on THAT subject?
Here's another intriguing theory about my cholesterol going up from another reader:
Eat the way you do now but try lowering calories, because this is should be just as or more effective than statins.
Choleseterol synthesis is dependent on many things and one of those is energy intake. Cutting back say 10%-20% would probably bring your total cholesterol down to ranges of around 115-180mg/dL , lower LDL and keep HDL high.
First I'm eating too much fat now that I've stopped losing weight. Now this person says I'm eating too many calories. Yikes! It's amazing I have been livin' la vida low-carb for 2 1/2 years and neither of these factors played a role in my LDL cholesterol going up before. Sigh.
Okay, let's look at one more comment from a very regular reader and friend of this blog who has some scientific knowledge about low-carb diets and their effect on the human body:
The list of things that can impact cholesterol are numerous:
Stress
Oxidative stress & free radicals
High carbohydrate diet (regardless of fat content)
Medication
Vitamin A overload
Supplements and/or prescription drugs
Activity level
Trans-fats
Omega-3 deficiency
Eating damaged polyunsaturated fats
So then.....from March to April your cholesterol numbers changed significantly - enough to set off louder alarm bells with your doctor (and frankly, me too).
The big change you made wasn't in your diet, but in the supplements you took - red yeast rice specifically. The UC Berkeley Wellness Newsletter contained an interesting piece on red yeast extract that is a must-read - Red Yeast Rice Extract. I didn't know this myself and thought you would want to know. If the addition of the supplement, garlic and baby aspirin were the only things you changed - I think you might have your answer about what is negatively impacting your numbers in one month.
But that still doesn't answer what impacted your numbers August to March. You're not eating a high carb diet, you had your vitamin A tested, you exercise every day, you're taking omega-3 fatty acid supplements, you avoid foods with partially hydrogenated oils and you're not taking any prescription drugs. That eliminates almost all of the above items.
What's left? Stress, oxidative stress & free radicals and eating damaged fats.
Let's just say you're not under any new stress (even though you might be and not realize it).....so what's in your diet that might be causing oxidative stress & free radicals? Eating damaged fats. The cod liver oil and/or fish oil supplements you take might be rancid - which means it's damaged before you ever put it in your body.
Damaged fats cause oxidative stress in the body and produce free radicals --- if they aren't countered with antioxidants, over time they can impact your cholesterol numbers since your body makes more cholesterol in an attempt to repair the damage occurring. It's one more piece of the puzzle to explore.
Well, well, well -- perhaps the new things I started back in March to LOWER my cholesterol are actually the culprit in RAISING it now. Eeeek! How the #^&*# is the average person supposed to know what to do about cholesterol when there's so much junk science thrown around about this and that supplement?! Sheez, somebody throw me a bone here. Perhaps I should get off the red yeast rice, garlic and plant stenol to see if there is any change for the better.
Yet another knowledgable regular reader wrote this about my LDL:
I just read your newest article about your "high" LDL cholesterol worries. I thing you should not worry too much and be careful with those medications, even if the PDR guide of your doc shows no or only minor side-effects for those drugs. Don't forget that the pharmaceutical companies PAY to have their stuff listed in the PDR - so expect that thing to be rather biased.
Furthermore and moreover, don't forget that high LDL is not a bad thing by definition. In fact, there is much evidence from a number of major studies showing that high cholesterol - even high "bad" LDL cholesterol - is very beneficial and preventive for, for example, CHD!
Personally, I think your higher total cholesterol (again, as far that's worrisome!) is due to perhaps a too low intake of antioxidants. A higher intake of green leafy veggies and perhaps even some more fruit and especially berries can help change that.
Consider the following:
In 1997, Swedish researchers published a comparison of CHD risk factors among men from Vilnius in Lithuania and Linkoping in Sweden. These two groups were selected because the former had a four-fold higher death rate from CHD than the latter. Very little difference in traditional risk factors existed between the two groups, except that (read this carefully!) the men from CHD-prone Vilnius had lower total and LDL cholesterol levels!
According to common wisdom, the lower total and LDL cholesterol of the Lithuanian men should have placed them at reduced risk of heart disease. When the researchers probed further, they discovered that the men from Vilnius had significantly higher concentrations of oxidized LDL. They also displayed significantly poorer blood levels of important diet-derived antioxidants such as beta carotene, lycopene, and gamma tocopherol (a form of vitamin E). Blood levels of these particular nutrients are largely determined by dietary intake, especially from the consumption of antioxidant-rich fruits, nuts, and vegetables. So while the Lithuanian men had lower LDL levels, they had a greater susceptibility to oxidized LDL due to what appeared to be a poorer intake of antioxidant-rich foods.
This may well have explained their greater susceptibility to cardiovascular disease; in tightly-controlled clinical trials, individuals randomized to increase their intake of fruits and vegetables have experienced significant reductions in cardiovascular and all-cause mortality.
During the massive GISSI-Preventione trial in Italy a RISE in LDL showed significant mortality benefits. And in the Lyon Diet Heart Study, an experimental group advised to increase consumption of root vegetables, green vegetables, fish and fruit, and omega-3 fatty acids also experienced greatly improved cardiovascular and survival outcomes. One particularly little publicized finding from this well-known trial was that the total and LDL cholesterol levels of the treatment and control groups were virtually identical throughout the entire study. Those in the treatment group, however, did show significantly higher blood levels of BOTH omega-3 fatty acids AND antioxidants.
In other words: high LDL has been proven to be beneficial (!) IF sufficient antioxidants are consumed and available.
Then what about statins, as your doc wants? According to medical "opinion leaders" - you know, those who tell the rest of the unthinking masses what we are to believe - recent trials with statin drugs have proven once and for all that LDL reduction is beneficial. Allegedly, these trials have also shown that the greater the LDL reductions, the better. Again, this is
completely false.
Statin drugs exert their lipid-lowering effect by blocking an enzyme in the liver that is involved in the early stages of cholesterol synthesis. Statins inhibit the synthesis of mevalonate, a precursor not only to cholesterol, but also to a substance known as geranyl-geraniol. Inhibition of geranyl-geraniol produces beneficial effects on levels of nitric oxide, a substance with anti-inflammatory and artery-dilating properties. In fact statins have a multitude of effects - most of which are not recognized or even ignored.
So the fact that statins exert a whole host of biochemical effects beyond mere lipid-lowering is beyond question. In light of this inescapable fact, how can anyone confidently conclude that it was LDL reduction - and not amplification of one or more of these other effects - that produced the favorable cardiovascular outcomes seen in numerous studies like the PROVE-IT or TNT studies?
The answer, of course, is that they can't. In January 2005, the New England Journal of Medicine published two studies examining the interplay between statin use, CRP levels, and subsequent coronary event rates. The first of these, using data from the aforementioned PROVE-IT study, found that: "Patients who have low CRP levels after statin therapy have better clinical outcomes than those with higher CRP levels, regardless of the resultant level of LDL cholesterol." Another study found that "Atherosclerosis regressed in patients with the greatest reduction in CRP levels, but not in those with the greatest reduction in LDL cholesterol levels."
These results reinforce what is already obvious: The favorable results were due to the NON lipid-lowering actions of statins. The strong correlation between CRP and improved clinical outcomes indicates that the anti-inflammatory effects of statins played a key role. So, decades of dietary and drug intervention trials have repeatedly shown a complete disconnect between total and LDL cholesterol reduction and clinical outcomes but do show that anti-oxidants, causing lower CRP levels, do have greatly beneficial effects.
Ergo conclusio: I think the best you can do is NOT WORRY about your (high) cholesterol at all, and consume more antioxidants - as mentioned above - specifically those that influence CRP levels. Fruits, berries, nuts and green, leafy veggies. And even if your LDL stays relatively high: this has been shown to be beneficial! Why try to lower it?
The truth to keep in mind here is the fact that a growing number of highly esteemed and accomplished individuals, researchers and scientists are joining the campaign to alert the public to the fact that this lipid hypothesis (the cholesterol myth) is a total sham. Check out this link: www.thincs.org.
Perhaps I am not eating enough berries and green leafy veggies. I admit I could probably start eating MORE of these than I currently am and would enjoy it, too. This is something I can DEFINITELY start doing immediately! THANKS for the feedback!
But what should I do about taking all these drugs my doctor wants me to? I've got one person that says Zetia is good, but I'm also taking the Niacin. I haven't started the WellChol yet, but I am very interested in hearing from people about what you think of these drugs and whether it is a necessary step that I need to take to lower my LDL. Am I overreacting to this as the last e-mail from one of my readers indicates or am I right to be as concerned as I am? THANKS for sharing your comments!
5-28-06 UPDATE: There's a case to be made against taking the medicines my doctor has prescribed.
Check this out from one of my readers on Zetia:
I am not too happy to hear you are taking this Zetia stuff. See the following:
Cholesterol-Lowering Drug Increases Hepatitis Risk
The Australian drugs watchdog is investigating claims that a cholesterol-lowering medication increases the risk of catching hepatitis. Ezetrol (Ezetimibe, also known as Zetia in the U.S.) has been available in Australia since October 2003 and is made by US company Merck Sharp and Dohme.
Therapeutic Goods Administration (TGA) spokeswoman Kay McNiece said the drug increased the risk of catching clinical hepatitis.
"The adverse drug reaction unit has received 115 reports of suspected adverse reactions where Ezetrol is suspected of contributing to the event," Ms McNiece said. "We have 10 cases where abnormal liver enzymes or hepatitis were reported."
Clinical hepatitis has been confirmed in three cases.
"As Ezetrol is a relatively new medication all the risks associated with its use, particularly the less common ones, may not be fully identified," she said.
Ferntree Gully woman Loreto Kelly was diagnosed with clinical hepatitis after taking Ezetrol. "I think it would have killed me, I really didn't think I was going to survive," she said.
Click here to read the full story.
And then there's this about the Niaspan I'm taking:
Jimmy,
I just came across this new information about Niaspan. I hope it's not Niaspan you are taking? That's a cholesterol lowering product based on Niacin. It is the same as the stuff your doc prescribed. Read the below story sent to a patient taking the stuff. He wrote to researcher Colpo the following letter, please read carefully:
Six Little Pills
Prior to taking the drug Niaspan, I was in top physical condition for a 44 year old male. I was a runner, swimmer, and active in weight training. I enjoyed the best health of my life. My sleep was peaceful and refreshing. I awoke to each new day with energy and vitality. Disciplined dietary habits along with daily exercise left my mind sharp. As a Private Pilot, I flew every morning working towards my instument rating.
I had incredible success with diet and exercise on my health. I lost 18 pounds. Total cholesterol dropped 42%, Triglycerides down 75%. Good cholesterol up 50%.
But according to my Doctor, this was not good enough, and he told me that I would have to take the cholesterol lowering drug Niaspan for the rest of my life to avoid a heart attack. I recieved a hard sales pitch on the drug. I was told that I had the lowest cholesterol possible, but the cholesterol I had was "bad, very bad"! The atmosphere resembled being with a timeshare
salesman, not a Doctor. I could not understand why I had to take this drug for life.
With a six foot, 162 pound slender frame, a total cholesterol of only 126, and an LDL of only 51, I was prescribed a cholesterol lowering drug, unaware of the inevitable disaster that lay ahead.
The first symptom was difficulty climbing stairs, followed by a 'Parkinson like' tremor in my right arm. My peaceful sleep was interrupted by vivid nightmares. Then my arms and legs began to tingle. With each pill, nocturnal attacks became worse until the tingling was unbearable, much like a shock from the house wires. I developed intense chills that lasted for hours. I awoke the next morning exhausted.
Each night the nocturnal attacks intensified. I tried to get out of bed but fell to the floor unable to walk. The muscle pain in my legs was intense and I wanted to scream. At 2 AM I lay on the living room floor unable to walk. With relentless determination I attempted to walk, but only covered 12 feet before collapsing to the floor again. By 6AM the episode was over.
The last night on the drug was the worst. It attacked my respiratory muscles and I fought for breath. I experienced a hard forceful pulse. Tingling intesified untill I was unable to move or speak to call for help. I knew I was in trouble and wanted to call 911, but was unable to reach for the phone. I just told myself " Whatever happens, don't stop breathing."
By the 7th day I made the connection to the drug and discontinued the Niaspan, but it was too late. The damage had been done.
I found myself bedridden. Muscle tremors and spasms persisted around the clock. With visible twitching of muscles, I watched in horror as my calf muscles wriggled like a snake beneath my skin.
I encountered extreme difficulty walking, and standing meant clinging to the countertops. But I could not remain standing very long. The next three weeks were spent in bed with tremors, spasms, irregular heartbeats, shortness of breath, and falling in and out of consciousness.
Repeated calls to my physicians office were primarily ignored. I spoke with the nurse who was very short with me. "The Doctor says Niaspan does not make muscles weak. Have a nice Christmas" and she hung up on me.
Visibly struggling to walk, I eventually made it in to see my Doctor. I was told lab tests were normal and therefore there was no damage from the drug. My Doctor said I was "overly conscientious and needed to see a psychiatrist."
Determined to get medical help, I drove myself to ER at midnight while having tremors and shortness of breath. At the Emergency Room I was turned away, denied services, and told to see my Doctor during the day.
The next 12 months endured painful neuropathy in my legs.
Almost four years later I have improved, but live with the long term consequences. Chronic fatigue, occasional shortness of breath, muscle tenderness and intolerance of exercise are part of life now. The allergic reaction I suffered is now in the medical literature that comes with the drug, and urges emergency medical attention.
Today I counsel others who have taken this drug or other lipid lowering agents that have caused muscle or nerve damage. My personal studies into cholesterol lowering drugs, their side effects, and the relentless marketing by the drug companies has revealed a very alarming picture.
Bobby Olson,
Tyler, Texas.
My Background: Grew up in Dallas, Texas. As a young adult I engaged in adventure sports. At age 17 became a private pilot. Was active in sport skydiving, scuba diving, and wilderness backpacking. Learned Real Estate investing, and bought, renovated, and sold single family housing. At mid life, returned to flying and earned a Commercial Pilot certificate and instrument rating. Have lived in Dallas, Minneapolis, and Coeur d' Alene Idaho. Now reside with my wife and 3 children in Tyler, Texas.
Yikes, yikes, and YIKES AGAIN!!! Me thinks I'll stop taking the Niaspan now. The worst thing the doctor said it would do to me is cause flushing. From Bobby Olson's story, it does a lot more than THAT! Any comments anyone?
5-29-06 UPDATE: More pearls of wisdom from my readers have poured in.
First of all, I am by no means an expert on any of this. I teach a weight loss class for Curves and in my 'research' for this, I have discovered FLAX SEED MEAL. This is 0 carbs, high fiber, and protein, and is supposed to be even better for fighting high cholesterol than oatmeal. I have a bowl each morning as a hot cereal. Mix 4-5 Tbsp with hot water, cinnamon, and splenda and YUMMY. Look into this for yourself and see what you find out.
I have eaten flax seed products before, but never just the flax seed meal. I do like to eat oatmeal and have it often for breakfast as well. Maybe I need to check out this flax seed meal.
But another reader said I probably need to chunk my fish oil because they're probably rancid:
Fish oils - any highly polyunsaturated oil for that matter - is highly susceptible to rancidity at room temperature! You won't know it by taste or even smell....Mary Enig is one of the leading authorities on fats and even with her position on the lipid-hypothesis, she's untouchable because her science is solid.....she basically says the capsules are all rancid because of how they're processed and then shipped in fluctuating heat conditions.
You might want to spend the extra money to get the liquid fish oils at the health food store - in a green or brown bottle (light also oxidizes poly fats) and keep it in the refrigerator so it is cold. Almost everyone those are the least processed and have the least contaminants and least likelihood of being rancid on the shelf.
If fish oil goes rancid, then you'll know it because you'll burp fishy burps...as long as you're not burping fishy burps your oil is OK!
Also - refrigerate your flaxseeds - they're highly susceptible to rancidity also since they're so high in polys.....grind only as you use them!
I ALWAYS BURP FISHY BURPS! Yikes! Did you know about this regarding fish oil supplements? I suppose I should try to find these fresher fish oil supplements to see if it makes a difference. I'm learning so much about this and I hope you are, too. Anyone else have a comment to share on this subject?
5-30-06 UPDATE: I sent an e-mail to Dr. Barry Sears requesting his comments about my cholesterol situation. Here is what one of his representatives wrote back to me in an e-mail:
Dr. Sears has written in earnest about the downfalls of a low-carbohydrate diet. He does not advise anyone to follow such a diet. Most individuals see a return to negative bloodwork over time after low-carbing.
His suggestions are always to follow the Zone Diet and take 2.5 - 5 grams of OmegaRX daily for improvements in the lipid profile.
For more information: www.drsears.com.
Best,
Theoni Gray
I was hoping for a little different answer than that, but I guess it stands to reason he would say to go on his diet. If I hear back from anyone else, I'll let you know.
6-6-06 UPDATE: I heard back from Drs. Michael and Mary Dan Eades today about my cholesterol issue.
Dear Jimmy-
We don't know if you've read the follow up book to Protein Power (i.e., The Protein Power LifePlan) or not, but we dealt more with the issue of cholesterol and various natural lowering remedies in that book. Read or re-read the chapters about cholesterol, iron storage, and micronutrients, which should prove helpful.
Regarding cholesterol, in our patients, we generally didn't stress too much about LDLs in the 200 range that were composed primarily of particles of large size as long as other measures, such as ferritin, homocysteine, and inflammatory markers (CRP, for instance) were in line.
Explore some of this information and keep in touch to let us know how you're doing.
Cordially,
The Drs. Eades
Well, my LDL particles are mostly the large kind despite the fact that they are currently measured at 230. I'm beginning to worry less and less about my cholesterol thanks to people like the Eades and Anthony Colpo educating me further about this issue. THANKS again to everyone who contributed to this discussion.
posted by Jimmy Moore at
5/27/2006 12:03:00 PM
9 Comments:
I don't have any qualifications such as nutritionist etc but I have always thought that following a whole food diet was the best. No processed foods. Mostly, Atkins encourages this also. I know you endorse many of the low carb products that are out there and while I think that they are OK on an occasional basis, I'm not so sure that using them a lot, even tho they are low carb, is a good choice. Not knowing your daily diet, I can only suggest maybe looking at the amount of processed foods you use and if it is high, try just real food only and see if it makes a difference. Just my thoughts.
Indeed, I'd stick to non-processed foods for now, Jimmy, and concentrate on meat, fowl, fish and sufficient intake of fat - including saturates like coconut oil - all supplemented with generous portions of green, leafy veggies, berries, nuts and some fruits. A Paleolithic low-carb diet, in short. It would be good, IMHO, to supplement a broad spectrum of antioxidants for now, and see what difference that makes. And stop taking those meds! Many -if not all- medications have all kinds of side-effects; most of them impair weight loss and weight maintenance.
Jimmy,
First, yes, as your carbs increase in Maintenance your fat needs to decrease in direct proportion.
Second, it may be that 100g of carbs a day (didn't you say that's what you ate?) may be too much for you.
Third, with ANY medication there are going to be horror stories. I know one girl who hates all anti-depressants because she had a bad reaction to one. She goes around finding and posting stories of other cases where people have had bad reactions.
She totally misses that most people on ADs have only minor side-effects and tolerate the drugs quite well. I've been on 5 different meds for depression and anxiety and the worst side effect from one was weight gain and another made me sleepy all the time. The first 5 days on Zoloft I had insomnia, but it went away and I spent over two years on it before it stopped working and I had to switch.
So just because one person has a serious adverse reaction doesn't mean you will. I know one person who went on Wellbutrin and had the most serious side effect - a grand mal seizure. She HAD to warn me when she heard I was starting the med. I was on it the better part of a year. I never had a seizure. In fact, I don't recall ANY side effects from the med. I stopped taking it because it wasn't working on my depression the way it should, so I switched to Celexa and the Celexa is working better.
My doctor ordered a complete metabolic profile for me. He said Celexa could cause liver and kidney problems. Somehow, I think those tests will come up clean. I'm so totally NOT concerned.
I asked for a cholesterol retest.
I'm not going in for these tests for a while yet, but since I won't see the doctor again until the fall, I have the paperwork in hand.
I'm a bit nervous about the cholesterol numbers, though I suspect they will be okay. I don't know of any history of high cholesterol in my family, except for my mom who treats it with ground flax seed and nothing more.
About the rancidity of oils:
It's not just fish oils, it's any oils. They can all go rancid, just as any fat can become rancid. Think in terms of butter that smells "off" - you wouldn't want to eat that either.
Even whole wheat flour can go rancid, because of the naturally occuring wheat germ oil in it. This is one reason why refined flour is so cheap - it can stay on the shelf so much longer without any fear of anything in it going bad, mainly because there's nothing left in it of any nutritional value to go bad. Whole wheat flour has a fairly short shelf life, by comparison.
Nuts and seeds are much the same way. Once you shell a nut (removing it from the sealed protective shell, exposing it to air), it can go rancid quite quickly too. The whole grain/nut/seed seldom becomes rancid (cashews are the only ones that regularly go rancid in the shell), but once you process it, it can go quite quickly, and should either be refrigerated or frozen to prevent the oils from becoming rancid.
I'm not a medical professional and don't really know (at least not anything professionally speaking) anything about how this truly affects cholesterol levels, although your body has to work hard and stress itself to deal with rancid oils/fats. The only thing I'd heard years ago (when I first heard about the rancid oil problems, primarily from health food stores) was that they would make you sick to your stomach. Perhaps they were also referring to things like fishy burps from fish oils, not just severe gastro-intestinal distress.
~~~~~~~~
One more point - I'd also read years ago that the reason peanuts are always salted when they're roasted is not so much to prevent rancidity, as to cover up the rancid odor and flavor of the peanuts. I don't know how true it is, but I'd also heard that such hidden rancidity of the oils in peanut products is the real reason peanuts are a common allergen.
I don't know what part all of your reviews of low carb products plays in the continuance of your blog, but as Darlene suggested, I'd be careful about eating much in the way of low carb pre-fab foods. You really don't know how truly fresh the ingredients used in those foods are, since it's so difficult to spot an "off" ingredient in a pre-processed food.
Personally, I try to avoid using much in the way of processed low carb products, and just concentrate on basic sources of protein, along with lots of fresh veggies.
[Ironically, I just got back from a few days away from home, and had to use several Atkins bars and a few servings of chocolate flavored whey protein to supplement the quick restaurant type food I was able to find on the road, which never includes nearly enough high quality vegeables (mostly iceberg lettuce based salads). It's very good to be home again, where I can have a full sized serving of meat, plus broccoli, zuchinni, peppers, spinach, etc.,that haven't been overcooked.]
Hey 1Peter3,
I'm not owned by anyone at my blog. My blog is about what I think and what I want to talk about. If I happen to mention a product on my blog, it is because I genuinely like it and think it could fit into someone's low-carb lifestyle. I wouldn't promote anything I wouldn't eat myself. :)
With that said, I appreciate your concerns and am constantly reevaluating what I put in my mouth. THANKS for everyone's GREAT comments!
At church we have to keep the peanuts in the refridgerator after the seal on the bottle is broken. Otherwise they will go bad (this happened once). Keeping them in the fridge during the week when they are not being used keeps them fresh.
Personally, I wouldn't trust Wikipedia for anything... there's much misinformation and even outright lies on Wikipedia, unfortunately. The idea could be nice, but the implementation is weak. There are plenty much more reliable sources of information than Wikipedia.
Hi Jimmy. Love you blog!
Instead of asking Dr Sears, how about asking Dr Mike.
When I read Protein Power and many other articles, I've seen many cautions about oils becoming rancid. Saturated fats are much better than unsaturated and they are much more stable and so turn quicker. The Eades recomend that all fish oil should be checked periodically for freshness. The recomendation is to bite into a capsule once a week or so....if one is rancid, consider the whole batch bad. I've done this, but only after cutting the cap and smelling it. Every time they smelled "fishy" they also tasted "fishy".
I would say also to stop the red yeast rice, especially if you had problems with statins, as RYR is simply a natural statin.
The problem I have with zetia and other drugs to block fat absorption? How are you expected to get the benifit of fats if you're blocking your body from using them????
Also, do you know what your homocysteine and CRP levels are?
My opinion is that, in absence of true genetic abnomailites (and that should be evident long before now), if your cholesterol levels change like this in the absence of and diet, activity, lifestyle, etc change....it's either a lab error....or it's your body trying to fix something. The thing that makes me suspicious of the lab is that your HDL fell so dramatically.
Anyway....I hope you don't worry about this too much....that's probably more damaging to your heart health!
I DID contact Dr. Mike Eades, but he has not yet responded. And I'm not worrying about my cholesterol, just asking questions so I can learn more about what this all means. I'm staying away from the drugs right now and doing this more naturally. THANKS for your comments!
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