Posted by: Sabio Lantz | August 15, 2009

My 7 Month Parameters

I began my Paleo Lifestyle on Jan 5, 2009.  I went to my doctor for my yearly labs and asked that additional ones be done since I am doing a new lifestyle.  Below are results of 7 months of Paleo.  OK, probably way too much information, but this site is about exploring and being honest.  Feedback would be deeply appreciated.

BENEFITS

Below are benefits I am very grateful for so far (actually, nothing else concrete to fix — I am just trying to slow aging and limit possible future poor health):

  • Weight:  I was not trying to loose weight, but I went from a #195 (5’11” – 181 cm – clear love handles) to #165 (skinny).  This is the weight I was at 25 years old.  (I am 54 years old)
  • Blood pressure:  My blood pressure has returned to normal and I went off my meds I took for 4 years.
  • GERD:  My reflux is completely gone.  I am off my reflux meds which I took for 10 years now.  I can now have beer at night, lots of tomatoes, soup and much more without consequence.
  • Skin: My mild, albeit chronic, skin rashes (Atopic Dermatitis and Rosaceal acne) has essentially disappeared.
  • Tongue:  Coat on tongue almost nil.  This may sound weird, but in oriental medicine (in which I have a degree), tongue analysis is part of health evaluation.  I had always had a rather thick white coat which goes along with stomach problems.
  • Endurance & Strength:  I no longer get winded when I run up 7 flights of stairs at the hospital.  I lift more — not amazing though.
  • Personality ! OK, nothing has changed there !  Same old guy

Labs

Below are my labs from 8/6/9.  Normal values are in parenthesis.  Older values are in brackets with dates.  “Wow-Optimal” levels are in Blue, abnormal values in Red, mildly abnormal in Orange.  I will include comments too.

Sugar & Inflammation Values

My values have always been fine but I expected much improvement here and we see it !

  • Fasting Glucose: 97 (75-110) [85 — 11/2007] — nice and stable even on low-carb
  • Insulin: 4.0 (2.6-24.9) — nice and low
  • CRP: 1.0 (<1.0=low risk, 1.0-3.0 – Avg Risk, >3.0 High Risk, >10 = possible acute Inflammation) — wow, nice and low  (CRP = C-Reactive Protein, an inflammation marker)

Kidney Values

Always been fine – I will have to read more, because higher protein and ketogenic diets challenge the kidneys but I have not read here yet.

  • BUN: 21 (6-20) [10 — 11/2007]
  • Creatinine: 1.0 (0.7 -1.2) [1.0 — 11/2007]

Lipid Profile :

Always been fine.  This is something I really have to look into.  I am already cutting back a little in fat.  Note, since 2007, I have eaten duck eggs almost daily. My fat during these 7 months has been:  2 duck eggs daily, bacon about 4 days / week, 1-3 tsp of cod liver oil daily, olive oil poured on salads with sesame oil,  teaspoon of coconut oil 3x/wk, lots of beef.   I will have to start thinking about all this.

  • Cholesterol:  337 (0-200) [WOW ! 176 — 11/2007; 147 — 9/1997; 141 — 5/1994; 145 — 3/1990]
    American Heart Assoc: <200 desirable, 200-239 Borderline-High Risk, > 240 High Risk.
  • Triglycerides:  59 (0-150)  [59 — 11/2007; 56 — 9/1997;  51 — 5/1994; 38 — 3/1990]
  • HDL:   83 [Improved, 64 — 11/2007, 55  — 9/1997]
  • LDL:  242 (0-99)  [100 — 11/2007, 81 — 9/1997] note, these Low Density ones aren’t separated out to small and large, so maybe I have few small ones (the bad ones).
    American Heart Association: <100 Optimal, <129 Near Optimal
    <160 High >190 Very High
  • LDL/HDL Ratio: 2.92 (0.00 – 3.05) [1.57 – 11/09/2007]

Nutrition

  • Vit B12:  438 (211-946)
  • Vit D, 25 OH: 70 (25-80) — remember, I take 4,000 IU /day + codliver oil and it is summer time.  Desired level 50-80 ng/ml.
    • 25-Hydroxy D2: <4.0
    • 25-Hydroxy D3: 70  — the good stuff, D2 not that helpful, from what I gather.

Hormones

  • Testosterone: 696 (280-800)
  • TSH: 2.790 (0.270-4.200) [2.450 — 11/2007]

Others

  • PSA: 1.210 [1.130 – 11/2007] (my Dad died of Prostate Cancer)

Responses

  1. Sabio,

    Total cholesterol is essentially meaningless. It is like knowing the total score of a baseball game. Unless you know the specific scores from each team you don’t know anything.

    What are you triglycerides and HDL? My guess is your HDL is high and Trigs are low, but it would be good to see. The ratio between HDL and trigs are far better predictors of health than the Total(or LDL for that matter).

    wholehealthsource.blogspot.com and http://www.freetheanimal.com are good sources of older posts on CHO as well. I suggest checking those out.

    I “struggle” with higher cholesterol as well(270 total last time I had it checked), but my HDL is ~80 and triglycerides are ~60. I think I have very little to worry about.

    jeff

  2. You are not alone in this. I think this is a natural part of going Paleo. Everyone in my family had their cholesterol increase as a part of switching over. This forced me to dig into it a lot since my doctor was looking to put me on statins(I never will).

    I see your HDL and trigs are close to mine, a very very healthy ratio. This suggests your LDL particles are “large and fluffy” which are supposedly helpful rather than harmful as they don’t get oxidized nearly as easy and are too large to get in nooks and crannies in arteries. Nooks and crannies get there due to inflammation rather anyway, which is likely low due to low trigs since low trigs means low carb for the most part.

    You can find out for sure by getting a NMR lipoprofile. That will tell you the particle size.

    Good luck. I am curious as to your results, so please let me know if you get that done.

    jeff

  3. Vitamin D: “remember, I take 4,000 IU /day”

    “Since immune suppression can promote the increase of pathogens, the effect of vitamin D supplementation is not likely to be harmless in this situation, but appears to have long-term effects associated with increased levels of bacterial pathogens.”

    1) Townsend Letter: The Examiner of Alternative :
    Reversing Bacteria-Induced Vitamin D Receptor Dysfunction to Treat Chronic Disease: Why Vitamin D Supplementation Can Be Immunosuppressive, Potentially Leading to Pathogen Increase
    by J.C. Waterhouse, PhD

    2) Archive Article

    etc

  4. linked in from Mark’s blog. About your total cholesterol, I would ignore it. It will probably go down. But that LDL is calculated and the equation if way off at low and high triglycerides levels. I believe it was an Iranian study that recently came up with a more accurate equation. Check either proteinpower.com/drmike or wholehealthsource.com for the equation. I’m pretty sure its out there somewhere. You’ll get a much lower LDL number I bet.

  5. @ Joe — Thank you very much to both you and Jeff.
    Up to just now, 60 people have taken time to read these labs, and you both have responded.
    I have also heard great stuff from Art DeVany and Peter at Hyperlipid.
    You info helped much.
    I still want to sort out the difference between the low-fat , med-fat and high-fat crowds among low-carb folks.
    So much to learn.
    Thanx again

  6. There should be no such thing as “low-fat” amongst the low-carb crowd. Being both low-fat and low-carb indicates an excess of protein in the diet, which will lead not to kidney damage but to starvation*, and is artificially difficult to achieve anyway. You’d have to cut all the fat off of your beef and bacon and take the yolks out of your eggs, which is certainly not something Grok would have done. Medium fat (what would this be? about 50% fat calories?) is fine, but high fat is ideal on a low-carb diet – remember that the Inuit got 80% of their calories from fat, and practically none from carbohydrates. Two Arctic explorers ate a similar diet under medical supervision for an entire year and were perfectly healthy throughout.

    Your cholesterol numbers are fine. The AHA is overly eager to put anyone with high total cholesterol on statins, as are most medical bodies. Remember that total cholesterol and LDL cholesterol are poor markers; HDL and trigs are much better, and your numbers are excellent. Given your diet and your HDL & trigs, your LDL are likely to be the large, harmless, tough-to-oxidize kind, and not the small, harmful kind. The former is produced by fats (sat fats in particular) and the latter is produced by carbs. Something to think about.

    Also, I’m curious to know where you got the idea that ketogenic diets damage the kidneys. It certainly doesn’t in epileptic children. In the rabbit, well-known to be an herbivore, feeding an excess of soy, egg whites and beef protein induces kidney damage, but similar findings have never been reproduced in humans, who have been hunting and eating meat (and therefore lots of fat and protein) for more than 400k years. In case you’re wondering, the rabbit study (by Louis Newburg) was the original source of that particular medical urban legend.

    *Your body has difficulty utilizing too much protein, say, more than about 1/3 of calories (33%) for energy. This is why it is crucial to eat fat on a low-carb diet – without carbs, and with only a limited ability to convert amino acids to ketones and glucose, you must have SOME source of energy and the best is dietary fat. On the other hand you don’t have to worry about macronutrient ratios too much – just eat the amount of fat that is pleasing to you and no less.

    Cheers,

    Icarus D

  7. Oh, and the other thing to check is dental health. If you have ever struggled with dental health on a high-carb diet, you will likely find that incidence of tooth decay will go down. Way down. Mine went to zero after six months. Just another one of the many benefits of going paleo/primal/low-carb.

    Cheers,

    Icarus D

  8. You can’t assume that your LDL is mostly class A and large because your trig is low and HDL high. With trigs (62) and HDL (55) not quite as good as yours, I had 75% small LDL-P by NMR, LDL-P 1458. Best to just get a NMR test instead of making assumptions.

    I think your TSH is high. You need to get a Free T3 and Free T4 to properly evaluate your thyroid function, but hypothyroidism will definitely jack up the cholesterol. I see definite changes in my cholesterol level when I increase/decrease dosage of supplemental thyroid. You might try iodine supplementation (Iodoral or Lugol’s solution are best, most kelp has high arsenic levels) to see if it helps your thyroid function.

  9. 55 HDL is normal, not high. And diet plays a huge factor in the size of LDL; given the diet he describes it would be very strange for his particle sizes to be small. A test would be best, but given not only the other markers but also the diet described, small LDL would be strange, unless he’s eating a fair amount of carbohydrates that he hasn’t mentioned.

    Also, couldn’t you just use iodized salt if you needed to up your iodine intake? Or is the eeeeevil salt industry less trustworthy than supplementation somehow?

    Cheers,

    Icarus D

  10. I just got an NMR Lipoprofile and may have a take on things for you. My HDL is up to 93 now, yowza! and ALL of it is very huge fluffy particle type. My LDL is a calculated 185 (Freidwald equation) but the NMR ACTUAL measured is 135 (far better) PLUS I found out that my LDL is all HUGE Fluffy (and potentially protective type) particles, NO SMALL LDL PARTICLES detectable. So that is awesome. My Triglycerides are at 50, which is hunky dory. I am a full HIGH Animal fat low carber, recently full carnivore.

    YOUR panel looks great. The NMR will likely show HDL is all huge and fluffy, LDL will likely be less than the calculated number (and likely all huge and fluffy).

    Plus, you have inflammation of nil, and that is what causes cholesterol (the small dense, oxidized LDL which you have none, I’ll wager) to stick in to repair the epithelial cells. Pay for the NMR to be certain. Stressing over this will only bring up your CRP!

    Hang in there and don’t worry on it, Cholesterol is NOT a problem to be managed. Read Taubes’ Good Calories, Bad Calories to get educated on the science behind this “Cholesterol Myth” that dominates our health culture.

  11. Icarus,

    The info I find on the internet says sdLDL is associated with higher triglycerides. But my experience shows that is not always true. My trigs were just 3 points higher than Sabio’s, so my LDL size may be relevant here.

    I dont’ recall reading about an association between HDL and sdLDL, so I don’t know what difference the 23 point difference between Sabio’s HDL and mine makes as far as the size of his LDL.

    My diet is not that dissimilar to what Sabio describes (where you assuming otherwise?) The comparable trig. values confirms that. So even though you think it would be very strange for Sabio to have small LDL, with his trigs and diet, my experience shows that it does happen. The point of my post is to show that the kind of assumption you made isn’t always true.

    And I also seem to be the only person I know of with lower trigs (62) whose LDL-P value is actually 22 points higher than the Friedewald calculated LDL-C. Normally the LDL-C is higher in people with low trigs.

    Salt is a poor vehicle for iodine and competes with the iodine for absorption. You’d have to eat an unhealthy amount of iodized salt to get beneficial levels of iodine. Salt was chosen as a substrate for iodine because it is a cheap and widely used means of getting enough iodine to prevent goiter. But the body needs much more iodine than you get from iodized salt.

    Refined salt is what is used for iodizing. I think unprocessed salt with a full complement of trace minerals that has not been heated to over a thousand degrees is healthier. By supplementing iodine separately, you know what your intake is and have a better guarantee of sufficiency.

  12. Hi Sabio. Notice the LDL you refer to was calculated using Friedewald formula, LDL=TC-HDL-TG/5=337-83-59/5=242 mg/dl. Friedewald overestimates LDL when TG are low, like in your case. You real/measured LDL should be much lower, my estimate using other formula is LDL = 190 mg/dl. Best wishes. Anyway, you should only worry about HDL and TG, and ignore TC. And you’re fine in these two parameters. Also, your vitamin D status is wonderful, you’ll live forever;))!

  13. I hate to keep being a naysayer, but in my case, with a TG only 3 points higher than Sabio’s, my LDL-P was 23 points higher than my LDL-C. Friedewald doesn’t always overestimate LDL when TG are low, sometimes it can underestimate.

    Rules of thumb aren’t always true. Best to just get a NMR or VAP or BL test.

  14. I have to chime in here and say that Lynn is right, you need to get an NMR done to check for sdLDL. I’ve also seen the phenomenon she describes.

    A friend of mine had great HDLs (85) and fantastic triglycerides (38!) — with LDL-C at 112 — yet, upon testing per NMR, almost all her LDLs were small. This is unusual, granted, but it does happen from time to time, and it’s just best to be sure. The test isn’t terribly expensive.

  15. David,

    Thanks for the back up.

    Was your friend able to reduce her sdLDL? I was thinking if I got my HDL up and ate lower carb to reduce my trigs, maybe my sdLDL would convert into class A LDL. Now I’m not so sure.

    I wonder if this higher sdLDL despite good TG and HDL is more of a female thing (I’m also female), possibly related to female hormone levels or thyroid levels.

  16. Another value that I noticed was a vitamin B12 of 438. Although that is in the “normal” level, it may not be optimal. Testing serum B12 is far from accurate. Have you had a homocystine or methylmalonic acid tests? These may be a little better indication of B12 deficiency but there is no perfect test. My doctor feels that a serum level less than 600 is deficient. The Gluten File has some information on B12 deficiency. http://jccglutenfree.googlepages.com/b12deficiency

  17. The help here has been fantastic. I will compose a post to tell you my actions and learnings. Thank you kindly for thoughts and advice — I am learning much.

  18. Lynn,

    My friend is still struggling a bit with her diet, and eats a lot of low-fat “health” food (quite a bit of wheat). Actually, it surprises me that her triglycerides are so stinking low when I look at what her diet is like. But it does explain the sdLDL. I’m guessing she is very efficient in dealing with carbohydrates (she’s also very thin), but just doesn’t take in enough saturated fat to get the larger lipoproteins.

    I’ve talked to her at length about diet, but she’s reluctant to get away from the low-fat diet she’s been indoctrinated with over the years. It seems scary to her to eat fat and to give up her whole wheat crackers!

    Her doctor tried to put her on a statin, but she refused, and I suggested niacin instead, as this will at least help to address the sdLDL (unlike statins, which have the opposite effect, actually making LDL smaller– especially in those with low trigs). She tried the niacin, but freaked out at the flush (despite my warnings to taper up slowly, drink plenty of water, etc.), and now she’s scared to touch the stuff again. Sooo, she’s pretty non-compliant. We’ll see, I guess. She might still come around.

  19. History is written by those who did not croak from jacking their cholesterol through the roof!

    Seriously are there outcome studies on longevity and adverse outcomes with this diet? It just seems like if you are hanging out with giant blobs of fat floating though your blood vessals you are asking for trouble.

    Does the paleo diet allow for HMG CoA inhibitors like Lipitor? If it did you could goose (duck?) your numbers in a better direction. But I suppose that would be cheating, even if it made you live longer!

  20. Earnest,

    Do you have proof that CoA inhibitors will make you live longer? Do you have any proof that the side effects are reasonable for the drugs?

    For my money the bet is on what is tried and true for millenia.

    jeff

  21. Thanx Jeff. Earnest works with a standard, drug-rep-fed model but he has good intents !


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