GP wants me on low fat diet - help!

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GP wants me on low fat diet - help!


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Old 12-10-2017, 01:13   #1
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Default GP wants me on low fat diet - help!

Just had my physical. I'm THRILLED with most of the blood test results but now my GP is advising a low fat diet with less red meat, and medications prescribed in 6 months if I don't bring my LDL down. Advice please! A1c and vitamin D along with lipid panel provided below.

Component (range) result flag
Hemoglobin A1c (4.8-5.6) 4.8%
Vit D, 25-hydroxy (30-100) 52.6
Total cholesterol (100-199) 316 mg/dL HIGH
Triglycerides (0-149) 94 mg/dL
HDL cholesterol (>39) 102 mg/dL
VLDL cholesterol calc (5-40) 19 mg/dL
LDL cholesterol calc (0-99) 195 mg/dL HIGH
LDL/HDL ratio (0-3.2) 1.9

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Old 12-10-2017, 14:48   #2
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Sorry for the problems you are experiencing. How long have you been doing LCHF? What is you targeted daily intake of carbs? If you are truly following LCHF, which I must assume you are, it may take 12-18 months for your Cholesterol readings to improve. With me it was just over 12 months.

As for your doctor and 'fat'....I would find a new doctor, obviously he is not keep up with much of the new science showing that heart disease and fat consumption are not correlated.

Understanding of course that I am not a medical professional, I can only share my experiences on these things....

Good Luck

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Old 12-10-2017, 15:39   #3
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What div2live said.

I am not a medical professional (either). What I know, though, is that ultimately your medical care is up to you. Especially in the case of specialist doctors, they have their areas of interest, sometimes to the exclusion (or even detriment) of other areas.

The other thing I know is that not every doctor is up to date in all areas of treatment. I have a GP friend of mine who is horrified at the idea of LCHF and ketosis in diabetics. He's working on old information/information endorsed by the ADA. He also is not my GP. So I humor him and do what works for me.

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Old 12-10-2017, 15:41   #4
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Yep. Totally doing LCHF. Started this way of eating right after I was diagnosed with Type 2 in 2014. So, a good 3 years of LCHF. Here's the trends over the last three testing dates. Note, though, that 2016 was not fasting so some of the numbers are wacked. I've added some more ratios as well. Essentially, everything seems to be improving except for Total C and LDL. . .and I think my dr. focuses on LDL as that is the value he flagged as concerning.

Component (range) 2014-2016-2017 results
Hemoglobin A1c (4.8-5.6) 6.6 - 5.1 - 4.8%
Vit D, 25-hydroxy (30-100) 26 - 35 - 52.6
Total cholesterol (100-199) 190 - 229 -316 mg/dL
Triglycerides (0-149) 119 - 162 - 94 mg/dL
HDL cholesterol (>39) 58 - 70 - 102 mg/dL
VLDL cholesterol calc (5-40) 24 - 32 - 19 mg/dL
LDL cholesterol calc (0-99) 108 - 127 - 195 mg/dL
LDL/HDL ratio (0-3.2) 1.9 - 1.8 - 1.9
Trig/HDL ratio (<2) 2.1 - 2.3 - 0.9
Total C/HDL (<3) 3.3 - 3.3 - 3.1


Last edited by Buttercup101; 12-10-2017 at 15:43.
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Old 12-10-2017, 21:56   #5
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Can you compromise on trying an LCHF diet where less of the fat is animal fat? You could bump up vegetable oils, avocados, and nuts and seeds and lower the amount of animal fat.

Normally I'd be a stay-the-course kind of guy, but after three years of trying to reduce LDL, maybe some kind of change is in order?

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Old 12-10-2017, 22:52   #6
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Many on LCHF find that their lipid panels show a higher than recommended LDL. (This is the case for me, as well).

LDL is a estimated figure. The standard calculation uses a Freidwald equation which will overestimate LDL when trigs are low – which is the case when one is eating LCHF. When using the Iranian formula LDL estimations are much lower.

Could be that your LDL level is not as high as the lipid panel suggests.

An article by Axel F. Sigurdsson MD, a cardiologiest, on his blog.

Why LDL-Cholesterol May Be Overestimated on a Low-Carb, High-Fat (LCHF) Diet

Another consideration is that after some time (6 month to a year) on LCHF, the LDL size changes from small dense to large fluffy, which is benign. This was the case for me. My doctor at the time wanted me on a statin, but I insisted that she run a particle size test and it came back as mostly Type A (the large fluffy ones). The doctor didn't even know about this and, even with a note from the lab that this was good and not a concern, she was still skeptical.

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Old 12-11-2017, 03:18   #7
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Thanks for that link, VeeJay. My doctor so far has been pretty decent about waiting out the switch to LCHF for my cholesterol -- and has agreed to a pattern test if I'm still "out there" next time I'm checked out.

But it doesn't hurt to know why I'm asking for what I'm asking for. She's receptive to information, not just "I want to..."

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Old 12-11-2017, 14:48   #8
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All.....I had a similar experience when I first started LCHF. I was worried and my doctor was pushing me to watch my fat intake! My father had his first heart attack at 65 and died at 69 of heart disease. His father died at 65 or a heart attack. I was 65 when I started on LCHF and my Cholesterol numbers were high after a year on LCHF...but my A1c and weight loss were remarkable! What to do?

My wife and I both paid $130 to our Diagnostic Imagining company for a health scan they offer. It included a heart scan, Ultra Sound of all neck arteries and veins, and of the aorta descending from the heart running down into the abdomen. My wife got a 100% OK! I did fine on the ultra sounds, all clear! But on my heart they saw something on an artery on the back of my heart (The Widow Maker). That led me to getting a Stress Test that my medical insurance covered. This test was a more comprehensive scan of my heart under stress. They put my in the MRI and injected a drug in a vein in my arm. It made my heart speed up, I felt like I was running a race.

The results were wonderful. I had some calcium on the back of my heart but it was not in the artery, it was on top of it.....all other aspects of my heart were in good shape....I got a clean bill of health! Boy was I relieved. My doctor and cardiologist were also thrilled. My A1c was at 5.8, I had lost 50 lbs. and the conclusion was keep on doing what you are doing.

I share this as you can take your health into your own hands and find out what is going on if anything. For me those blood tests were simply misleading....I plan on doing the health scan every three years.....if for my peace of mind, if nothing else!

"Let not your heart be troubled"
Good Luck

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Last edited by div2live; 12-11-2017 at 14:51.
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Old 12-11-2017, 18:05   #9
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Quote:
Originally Posted by Buttercup101 View Post
Yep. Totally doing LCHF. Started this way of eating right after I was diagnosed with Type 2 in 2014. So, a good 3 years of LCHF. Here's the trends over the last three testing dates. Note, though, that 2016 was not fasting so some of the numbers are wacked. I've added some more ratios as well. Essentially, everything seems to be improving except for Total C and LDL. . .and I think my dr. focuses on LDL as that is the value he flagged as concerning.

Component (range) 2014-2016-2017 results
Hemoglobin A1c (4.8-5.6) 6.6 - 5.1 - 4.8%
Vit D, 25-hydroxy (30-100) 26 - 35 - 52.6
Total cholesterol (100-199) 190 - 229 -316 mg/dL
Triglycerides (0-149) 119 - 162 - 94 mg/dL
HDL cholesterol (>39) 58 - 70 - 102 mg/dL
VLDL cholesterol calc (5-40) 24 - 32 - 19 mg/dL
LDL cholesterol calc (0-99) 108 - 127 - 195 mg/dL
LDL/HDL ratio (0-3.2) 1.9 - 1.8 - 1.9
Trig/HDL ratio (<2) 2.1 - 2.3 - 0.9
Total C/HDL (<3) 3.3 - 3.3 - 3.1
Changes appear typical for converting to LCHF, how long it takes for numbers return to normal levels is different for us all (but isn't everything). The Triglyceride/HDL ratio was not too bad in the past but the present looks very good, it indicates lower risks for heart disease/heart attack/stroke. As VeeaJay suggests, it would be good to get an advanced lipid panel run, especially if you have a family history. The tests can be expensive depending on who and what they run, but it would be nice if your insurance covered all or most of the expense. If those tests included checking for inflammatory markers, finding those to be good should alleviate a lot of worries.

I did as itissteve recommended to you and shifted more toward a Mediterranean style diet. I switched some of the dairy fats to mono and natural polyunsaturated fats. I was eating 8 ounce of cheese a day, I reduced that back to about 2 ounces or so and made up for it with avocados, olive oil, flax seed oil, more nuts, etc.

I'm not a doctor or a medical professional, but I did develop a very keen interest after having quad bypass surgery.

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