March 7, 2010

Does the Low Carb Diet Raise Cholesterol?

You may see studies that purport to prove that eating a low carb diet raises cholesterol. There was one reported in the latest edition of Diabetes in Control which you can see HERE. You may even see your cholesterol go up when you start to eat a low carb diet.

Is this reason for concern?

No. And here's why. The studies that show a rise in cholesterol are always studies of very short duration. The study reported in Diabetes in Control lasted six week. If you look at long term studies, you will see the exact opposite occur. Over time people eating low carb diets develop more favorable cholesterol profiles than those eating high carb/low fat diets.

You can see this finding documented in this metastudy published in the Nature journal, Obesity:

Cardiovascular and Hormonal Aspects of Very-Low-Carbohydrate Ketogenic Diets. Jeff S. Volek* and Matthew J. Sharman. Obesity Research (2004) 12, 115S–123S; doi: 10.1038/oby.2004.276

The very slight and short-lived rise in LDL--and it is very slight--12 mg/dl in the study described by Diabetes in control--is nothing to be afraid of. By six months into the diet it will be gone in most people, replaced by a better cholesterol profile.

The only people who may not experience this improvement are the very small number of people with diabetes who, because of some specific genetic issue, are very fat sensitive. You can tell if you are one of them because if you are, when you eat a low carb diet for six weeks your blood sugar will go up, not down. This is very rare. I have heard from two people over the past five years who experienced it.

No research has ever shown an increase in any negative health outcome from long-term adherence to a truly low carb diet--one that does not exceed 100 g per day--and trust me, they have looked for them. Because these diets are so effective in lowering blood sugar, they lower the incidence of new diabetic complications.

You can find links to many more studies proving the safety and efficacy of the low carb diet HERE. You'll also find the huge, multi-million dollar, multi-year study that proved beyond a doubt that the low fat diet, whatever its short term effect on cholesterol might be, has no effect at all on the incidence of heart disease or cancer.

Analyzing Your Cholesterol Results

If your cholesterol goes up after you start a low carb diet, it is important to understand that cholesterol is only very weakly associated with the incidence of heart disease--despite the myth promoted by the companies that sell drugs that lower total cholesterol.

Here are the measurements that actually map down to a slight rise in heart disease. To find more discussion of the studies that document this, with links, visit THIS PAGE:

1. High fasting triglycerides. If your triglycerides are over 150 mg/dl, your risk of heart disease may rise. Triglycerides are blood fats, but they rise in response to carbohydrate consumption.

2. Low HDL cholesterol. HDL the so called "good cholesterol" is protective for most people, especially when it rises to levels above 60 mg/dl. However total cholesterol is computed by adding in HDL, so it is possible to see your total cholesterol rise because your HDL has moved from a low, dangerous level to a high protective level. It is not uncommon to see people who eat long-term low carb diets develop HDL that ranges from 80 to over 100 mg/dl. This is not a problem.

3. Apo(a). This is a factor family doctors rarely measure, but it is a much more sensitive indicator of heart attack risk than cholesterol measures. If you have a family history of early heart attack, it would be a good idea to get it measured.

4. Cardiac Specific CRP. Heart disease is now understood to be an inflammatory disease that affects the arteries. The Cardiac specific CRP (C-Reactive Protein) test will tell you if your arteries are inflamed. High levels on this test suggest that you would benefit from a statin drug, because what statins actually do that prevents heart attack is NOT lower cholesterol but lower inflammation.

5. A1C Rising over 5% and Post-Meal Sugars over 153 mg/dl at 1 Hour. This is starting to look like the single strongest predictor of heart attack. Details HERE. Since lowering your carbohydrate intake is the single most powerful tool you have to lower A1c, the long term benefit of cutting carbs becomes very clear.

One Last Thing: You Don't Have to Lose Weight to Get The Benefits

Doctors often tell you that you have to lose weight to improve blood sugar and heart attack risk. While losing weight takes strain off your heart, you will get significant benefits from a diet that cuts carbohydrate even if you don't lose a single pound. That's because that kind of diet lowers blood sugar, and it is high blood sugar that is so damaging to your capillaries, nerves, retinas, and kidneys.

Many people think that to get the benefits of a low carb diet they have to eat at extremely low levels--ones many people find difficult if not impossible to sustain. However, this is not true. Many people can see impressive improvements in their health by eating at higher levels of carbohydrate intake--closer to 100 g a day, with no meal exceeding 35 g, rather than 20 g a day.

The key to health is to eat at a level that keeps your blood sugar below the levels that cause damage to your organs. Using the strategy you'll find described here, you can determine what carbohydrate intake level normalizes your blood sugar. It is different for every person:

How To Get Your Blood Sugar Under Control

If diet alone can't give you normal blood sugars, carefully chosen, safe drugs plus lowered carbohydrate intake will.



ShottleBop said...

LDL can be a pretty bouncy number. I was first diagnosed as pre-diabetic, in February, 2008 (A1c of 6.5; successive FBGs of 127 and 123). On January 28, my lipids were:

TC: 281
LDL (direct) 215
HDL: 40
Trig: 142

A week later, my TC and LDL were both nearly 12% lower than that baseline:

TC: 248
LDL (direct): 190
HDL: 40
Trig: 148

I was prescribed a meter, and attended a single pre-diabetes class, which addressed basic nutrition using the food pyramid approach. My doctor, however, had also told me that I would have to cut out fruits and other things that raised my BGs. I ate to my meter, but didn't count carbs or cut out bread--I mostly cut out desserts, most fruits, and white bread, and experimented with wholegrain and Ezekiel breads. I also restricted my fat intake. I lost 30 pounds.

By May, my A1c was 6.0, and my lipids were:

TC: 221 (down 21%)
LDL (direct): 155 (down 28%)
HDL: 41
Trig: 71

It was in May (following a Passover during which I ate virtually no grain, and realized the difference that made in my BGs) that I discovered Gretchen Becker, Richard Bernstein, and Blood Sugar 101, and started restricting carbs more. I stopped restricting fat intake. From May to August, I lost another 20 pounds, my A1c dropped to 5.5, and my LDL climbed back from 155 to 194:

TC: 269
LDL (Direct): 194
HDL: 48
Trig: 77

Between August and November, I lost another 15 pounds (total weight loss: 65 pounds, from 220 to 155, on a 6-foot frame). My total cholesterol soared 100 points:

TC: 369
LDL (Calculated): 287
HDL: 65
Trig: 85

In March, 2009, my A1c was 5.3, but I didn't have another lipid panel until September, 2009 (A1c 5.4):

TC: 337
LDL (Direct): 219 (essentially, back to baseline)
HDL: 79
Trig: 41

nonegiven said...

Feb 08, your Trig/HDL is
142/40 = 3.55 with LDL 215

Sept 09, your Trig/HDL is
41/79 = 0.5 with LDL 219

It's really not baseline at all. In the first instance there is probably quite a bit more of the small dense LDL that causes the problems cholesterol gets blamed for. In the second instance there is most likely much less of the small dense variety and more of it is the large fluffy kind that is safe. The large fluffy kind takes up more space than the small, dense, dangerous kind, therefore even though the 2 LDL measures are essentially the same, you probably have much lower particle count, which would be shown by a different test.
The change in trig/HDL ratio also indicates you have most likely cut your insulin resistance from moderately high to practically nothing which helps your true risk profile tremendously.
Also, your HDL of 79 is considered protective, raising HDL and lowering triglycerides is a known, welcome consequence of low carb/high fat diets.
I consider your numbers a great improvement. If it was me, I wouldn't let anyone put me on a statin or change my diet over these numbers. I would be happy with it as it is. If I needed anything for inflammation I would take aspirin and/or increase my fish oil, krill, or DHA intake and/or further decrease omega 6 fats over taking even a small dose of a statin.

Liz H. said...

Wow, a post meal blood sugar of 153 at ONE hour is associated with cardiovascular disease? That's really something to note when most(if not all) doctors are still saying "The one hour result means nothing" When will these doctors wake up?!

ShottleBop said...

Well, I had a newblood test yesterday, and my lipids were:

TC: 357 (up 20)
LDL: 231 (up 12)
HDL: 95 (up 16)
Trig: 44 (up 3)

My doctor admits that my ratios place me at below-average risk, but the high LDL makes her nervous. My health care provider does not perform tests that would determine the size/density of LDL particles.

Jenny said...

The only reason your doctor worries about the LDL is that the statin drug pushers have demonized LDL since it is the only lipid factor that statins lower.

The Framingham data found little connection between LDL level and heart attack.


Michael Barker said...

I've always been irritated by this use of LDL. What type of LDL is it? Is it dense or is it fluffy.
My endo initially tried to get me on a statin but my meter was telling me I needed to go low carb so I passed on the statin.

When my lipid numbers came back 6 months later my LDL had only dropped 20 points to 219 but my HDL was 75 and my Trigs were below 70. Nothing more was said about statins because you can't have dense LDL's with Trigs below 70.


ET said...

I had an NMR Lipoprotein test done and even though my HDL was 52 and Trig 61, my LDL was solidly pattern B, and my small LDL-P particle count was 1,612. All this on a low-carb diet.

The only thing that significantly improved my LDL profile was niacin.

lightcan said...

There are some people who are not diabetic and have very high LDL on high fat low carb diets. Some of Kwasnievski's followers too.
My HbA1c was 5.2 last time I measured it, but my LDL is at around 400 for the last 6 months out of more than 18 months of low carb. I had a LDL of 181 in sept 2008.
One possibility, in my case, is that weight loss made T3 go down (my T3 is lower than normal) and that influences the clearance of LDL.
what do you think?

Jenny said...


I think you need to get that specialized test that measures the particle size of the LDL. There are some of us, self included, who have a gene varient of CETP which produces very large LDL molecules which give very high readings but are protective. Here's a link. My dad and I were in the CETP study and my dad's cholesterol was 340 when he was in his 70s. He lived to 100 in great health until the end.

But it is also possible that you are someone who has other issues going on making a high fat diet not so healthy.

The current way of measuring cholesterol seems like a total waste of energy, as it doesn't predict anything.

scall0way said...

Hmm, I sure wish that low carb didn't raise cholesterol.Well maybe it didn't but something sure is doing it. I've been low carb since 2006 and ultra strict (no grains, no sugars, no high PUFA oils, carbs low) since January 2009, but my cholesterol keeps going up and up. I feel like ShottleBop.

In October my numbers were
TC: 229
HDL: 58
TG: 65
LDL (calculated): 165

I was not totally upset with those numbers but my doctor was utterly rabid to put me on statins ASAP to get my LDL down (and yes this was a calculated LDL, and no, there were no tests done to determine particle size) and she was livid with me when I refused.

At my vist three months ago TC had risen to 279. We got into such a shouting match about statins that I don't even remember the rest of the numbers. Then it was back to the doctor again today. TC is now 280, LDL is 206 - so even higher, though HDL is 62 and TG is 60-something.

But again her story to me was "It's statins or else" and that as a diabetic (though a well-controlled one) I am putting one foot in the grave if I don't take statins, and that EVERY SINGLE STUDY shows them to be of immeasurable benefit.

I am so depressed. I just want a cholesterol number that I don't have to get into a shouting match and bitter argument with my doctor every time, just so I can get my prescriptions for metformin and levoxyl.

Jenny said...

Your doctor is probably getting paid for producing low cholesterol scores. This is part of a poorly conceived "prevention" strategy some insurers are following.

The data doesn't support statins for anyone but males over 45 who have had heart attacks and people with elevated CRP. Have you had CRP tested? If it is high, take the statin.

Your HDL and Triglycerides are excellent and improving which point to large LDL, the kind not associated with plaque.

Apo(a) is another useful test, as is the one that tells actual LDL particle size. If small, it might be helpful to take the statin, if not, don't.

If not, you really need to find a doctor who is better educated.

nonegiven said...

Or else what? First, we know the calculated number is way wrong, with triglycerides <100.

If it's just CRP, there are cheaper, safer ways to lower it than statins.

Those studies that show immeasurable benefits, actually show much less benefit than the pharmaceutical salesmen are telling her unless you have massive amounts of small dense particles.

I'd ask her if she's getting a kickback on statin prescriptions. OK, maybe not.

Don't shout, tell her she is raising your BP by shouting at you. Write a letter if you have to, back it up with research. You can fight the pharmaceutical salesmen since that is who she is obviously getting her information from.

I've taken copies of CME materials and research papers to my doctor. I've also refused statins and so has my husband, she doesn't bring it up anymore, at least to me. I don't think my total cholesterol has ever been even as high as normal. Before the statin craze, the lab used to flag it as abnormally low. It's even lower than my mother's which runs about 160.

Margreet said...

My DH is a cardiac transplant patient. The last time he had a blood test at the clinic he attended for 15 years, the nurse told him "your cholesterol number stinks!" His total cholesterol number was 247. Not so bad for a 50+ year old guy. When I asked for the breakdown, we noticed his HDL was 111. Had his good cholesterol been normal for a guy his age, his total number would have been perfect!
We switched to a cardiologist who looked at his cholesterol numbers and asked "What's the problem?

lightcan said...

Thanks, Jenny.
I can't get that test (NMR) done over here.(Ireland)
My grand-parents on my father's side lived longer than those on my mother's side. Unfortunately I read that we're supposed to inherit rather our mother's genes (as women? I don't remember the details) so not so sure about longevity, high lp(a) and huge LDL particles.
I was thinking too that the high fat diet might not be good for me due to some unknown epigenetic factors (my great grand parents' diet) What exactly are you thinking of? Fat metabolism, enzyme deficiency, bile problems, LDL clearance? Sometimes I have a feeling of indigestion after a high fat/high calorie meal and taking a Chinese pill for upset stomach helps.

Jenny said...


I know for a fact that I inherited my father's cholesterol gene because I was in a genetic study with him and my mother and they told me I have his.

Read this:

The book, Good Calories, Bad Calories by Gary Taubes gives you several hundred dense pages of research backing up this finding.

otterotter said...


I was diagnosed as T2 on Sept.10th 2010, then went on low carb diet since Sept.16th, 2010.

The lipids on Sept.10th 2010 (normal American diet, with lots of carbs):

Total: 231
HDL: 43
Trig: 372
LDL: 114 (calculated I believe)
Fasting sugar: 198
A1C: 8.6%
Weight: 157 lb

The lipids on Dec 16th, 2010 (3 months on low carb, less than 20 g carbs per day, 1 egg for breakfirst, lots of cheese, ham, white and red meat, didn't really pay attention to Saturated fat, lots of olive oil, nuts and vegs as well) (40 minutes brisk walking + 20 minutes weight training everyday)

Total : 382
HDL: 60
Trig: 211
LDL: 280 (calculated)
Fasting sugar: 90
A1C: 5.6%
Weight: 137 lb

As you can see, the only "catch" of the low carb diet is that "it increases your total cholesterol !!". For good or bad, that's another topic.

Now my question is: For the increase of total cholestorel, is it really because of eating less carbs, or is it just because I am eating more egg yolks and saturated fat ?

Jenny said...

Total cholesterol goes up short term when you are actively losing weight. Give it six months and you should see some improvement. You've already improved your HDL dramatically as well as triglicerides.

Eating cholesterol in food does not raise cholesterol. That's a myth.

jkim said...

My LDL has not "normalized" after 2 1/2 years on VLC. I just got my labs back and I know my doc is gonna say statins.

In July 2008, eating LC, my labs were TC 276, Trigs 36, HDL 99, LDL 170. Because of the HDL and Trigs, my doc wasn't too concerned but told me to cut out the saturated fat. I went VLC instead and ate even more fat to keep up my weight. I'm thin.

Last month my labs were TC 476, Trigs 79, HDL 146, VLDL 16, LDL 314!! I think the Trigs were up because I'd had wine less than 24 hours before the labs--they're usually in the 30s.

How concerned should I be about the LDL?

Jenny said...

Jim, You have an abnormally high HDL and extremely low VLDL, both of which are supposed to be good. The LDL is probably calculated rather than measured.

This is an unusual combination, but may point to very large LDL which is extremely healthy and correlates to longevity. If you can have the LDL particle size measured it would help but most doctors don't know about that test.

OTOH, since the HDL is much higher than I've ever heard of before, you might want to contact Dr. Davis, the cardiologist who writes the blog at and ask him what he thinks. He is very knowledgeable about lipid profiles.

jkim said...

Thanks, Jenny. You're right, the LDL was calculated. I'll see what Dr. Davis has to say.

Btw, I read your post about your high calcium level and cutting back on Vit D. On this same lab test, mine was 10.2, at the top of the "normal" level. I'd nearly eliminated calcium supplements last year (I do eat cheese & Greek yogurt). And I reduced my D from 2,000 to 1,000 in January.

Would the higher D still have had an affect on the mid-Feb lab test?

Jenny said...


I wish I knew. There's very little research about Vitamin D except for the fad-driven stuff and most of that is just analyses of large population studies where an association is found. I.e. people with condition X have low Vitamin D. Whether the low level is the cause or a result of condition X can't be told, and so far most of the studies with supplementation haven't found that Vitamin D improves most of the conditions where it is low.

But beyond that, not much information is available.

jkim said...

Jenny, a quick question ... Was your dad's cholesterol high throughout his life, including ldl? Or did it develop later in life?

Mine has just been high the last few years, in my 60s and since low-carb, high-fat.

Jenny said...


I only know what my dad's Cholesterol was in in 1970s because my brother found an old medical record when clearing out his things. So I don't know if it was ever measured before that.

Mine wasn't measured until I was in my 40s at which time it was 308. I turn out to have the same "longevity" version of the CETP gene that my dad had. When I eat very low carb with high fat, my total cholesterol drops and my HDL goes up from the 60s to the 70s. But the lowest it ever gets to is the 280s.

jkim said...

Thanks, Jenny.

Dr Davis hasn't responded to my question about my lipid tests, but I've seen my doc. He says a particle count wouldn't really change the numbers--and that my ldl is just way too high to be anything but bad. He thinks it's my genes and wants to start me on a statin. When I asked what he based that on, considering my lab test was a standard lipid profile, he ended up referring me to a cardiologist--maybe the cardio will say additional tests are needed to figure this out.

Jenny said...

I hope you have a better experience with the cardiologist than I've had. I've seen two and both were dangerously ignorant. One prescribed me a drug whose prescribing information contains a black box warning for a condition I had just told him I had. He told me the drug was completely safe. In face, because it would have built up in my body to toxic levels, it could have killed me. Hence the black box warning.

He had obviously not read the prescribing information and most definitely didn't have a clue what the condition was that I told him I had.

Dr. Davis suggests in many of his posts that cardiologists make their money by scaring patients into expensive invasive procedures and have no motivation to look into more benign treatments.

I have yet to meet one who has any knowledge of the link between blood sugar and heart attack risk. They tend to worship at the shrine of statins.

Anna said...


Dr. Davis doesn't generally answer specific reader questions on the Heart Scan Blog very often anymore now that there are so many readers, so it's unlikely he will respond to your specific questions. He posted this policy some time ago, but new readers don't often know about it. He's just too busy with his practice and with the Track Your Plaque subscriber program. You might consider subscribing to Track Your Plaque program where members, advisors, and Dr. Davis discuss more specifics in the member forum. Dr. Davis also does individual consults (for a fee, of course), which is another option to consider (you fax your test results in advance I think).

jkim said...


My visit to a cardiologist wasn't bad at all, even though he said my high-fat diet was terrible. : )
He agreed with me that my numbers were diet related, but instead of prescribing meds he had me get a calcium scan. That way we'd get a real picture of what was going on in my arteries. That made sense to me, too.

My calcium score was 7!!! My estimated Framingham 10-year Hard CHD Risk is 3% using my age, and 1% using my arterial age.

It sure seems that saturated fat does convert ldl to large fluffy particles that don't stick to or burrow into artery walls.

Jenny said...


That's wonderful news. I hope you told your doctor to consider the possibility that if more of his patients were eating high fat/lower carb diets, more would have scan results like yours.

jkim said...

I didn't comment about his other patients, but I certainly advocated for low-carb and high-fat as advantageous for both glucose and arteries. I figured my test results would send a more powerful message than anything I personally told him.

He didn't say so, but I got the impression he was more concerned with how much cholesterol I ate rather than how much fat. Then again, I thought I'd read that the cholesterol a person ingests has little effect on the cholesterol ultimately in the veins.

I wonder how my doc will react when I get my next lipid test. And I also wonder what size my ldl particles were when I had 87 ldl several years ago--before vlc.

Jenny said...

The intake of dietary cholesterol has very little impact on blood cholesterol, but cardiologists rarely know anything about diet and metabolism. Most seem to have been told "eating fats raises cholesterol" back in school 20 years ago and that's all they "know."

otterotter said...


This is OtterOtter again. More updates on my numbers.

The repeated test on Jan. 6th, 2011:

Total : 429
HDL: 77
Trig: 178
Weight: 137 lb

Then test on April 15th, 2011 just came back, and here are the numbers:

Total : 250
HDL: 69
Trig: 104
LDL: 160
Fasting sugar: 98
A1C: 5.4%
Weight: 138 lb

During the last 4 month, I was still doing the very low carb < 30gram, all sorts of meat, nuts, tons of vegs, egg whites.

No more cheese and egg yolks though.

Not too sure what has worked here. My doctor took the credit for the Lipitor she gave me, but I didn't tell her I only took Lipitor for 2 days, then stopped because of the muscle weakness.

May be it is simply the fact that everything has settled after 6 month of low carbs ?

I will try to get back to cheese and egg yolks to see what happens next.

Jenny said...


Congratulations on some extremely good numbers, especially that low triglyceride count and the A1c.

That definitely looks like the 6 month effect to me. Years ago when I cut out all cholesterol-containing foods at my doctor's command my total cholesterol dropped a whopping 3 points. So much for not eating cholesterol to lower cholesterol.

otterotter said...


The lab results on July 15th just came back:(doing VLC for 9 month now)

Total : 332
HDL: 77
Trig: 98
LDL: 200
Fasting sugar: 94
A1C: 5.3%
Weight: 136 lb

So the only thing I changed with my diet was adding the egg yolks back (one per day), I didn't even touch any cheese yet.

So for me, eating egg yolks does seem to raise my LDL and HDL quite a bit.

My doctor has raised the dosage of Liptor which I didn't take in the first place. I will see an endo specialist in October. At the same time, I'll try removing egg yolks again for another 3 month to see whether I can duplicate the success.



Jenny said...


You might consider asking for a test of LDL particle size (or VLDL) because the TGs and HDL are very good, so it is possible that you have one of the genetic varients that make for light fluffy LDL which does not clog arteries.

It is the small dense LDL that is the problem. Dr. Davis, the cardiologist over at the has written about this extensively. Click on LDL etc. in the cloud on the left hand side of his blog to see some of the articles.

otterotter said...


If I can confirm that egg yolks raise LDL, then it is actually a good news for me because then I know how to lower it without Liptor, I can live without egg yolks.

I am not too concerned with my total colesterol being 250 or even 300, but 400 is probably too unusual.

Just wondering how many people are like me ? because if you read the main stream medical papers, "dietary cholesterol raises LDL" seems to be true for quite a percentage of the US population.

I will try to get a heart scan if necessary, just to be safe :)



otterotter said...


Removed the eggs from the diet again, just got an expanded blood test results from SPECTRACELL LAB in Huston.

VLDL Particels: 122 nmol/L (needs to be < 85)
Total LDL Particles : 1271 nmol/L (needs to be < 900)
Non-HDL Particles: 1394 nmol/L (needs to be < 1000)
RLP(Remnant Lipoprotein) 205 nmol/L (needs to be < 150)
Small Dense LDL III: 552 nmol/L (needs to be < 300, marked as very high risk right now)
Small Dense LDL IV: 96 nmol/L (needs to be < 100)
Total HDL Particles : 8297 nmol/L (needs to be > 7000)
Large Buoyant HDL 2b: 2045 nmol/L (needs to be > 1500)

Apo B-100: 127 mg/dL (needs to be < 80)
Lp(a) : less than 5 mg/dL (needs to be < 30)
C-Reactive Protein-hs : 0.2 mg/L (needs to be < 1)
Insulin: less than 4.0 uIU/mL (needs to be < 35)
Homocycteine: 12.3 umol/L (needs to be < 11)

Total Cholesterol: 259 mg/dL
LDL: 159 mg/dL
HDL: 59 mg/dL
Triglycerides: 118 mg/dL
Non-HDL-Chol : 200 mg/dL

I suspect I am APOE 4, which means my LDL level is super sensitive to dietary cholesterol and/or fat, and there are 25% percent of the population are like me.



Jenny said...

otterotter, Those particle sizes might point that way. At least the hs-CRP is very low, which suggests that you don't have massive system-wide arterial inflammation.

Dr. Davis at the Heart Scan blog has some good ideas for some other steps you might take.

ShottleBop said...

There really are no sure things, however:

For the past couple of years I have been running average monthly BGs of less than 100 (and for much of that time, 90 or less). I have been climbing 24 flights of stairs 4-5 days a week, and regularly riding a stationary bike for 25-30 minutes. In July of this year, I started experiencing some tightness in my chest around the 18th-20th floor, and after 10-15 minutes on the bike. I had an NMR test run in September:

TC: 373
LDL: 282
HDL: 82 (large: diameter 14.2, 39.1 nmol/L)
Trig: 47

More than 92% of my LDL was pattern B (large, fluffy): diameter 22.1 nm; 1793 nmolL
My small LDL particle count was only 146 nmol/L

Earlier this week, a stress-echocardiogram has revealed that I have some arterial blockage. My doctor wants to put me on a statin.

alok yadav said...

jul2011 my lipid test results were
hdl 50
tri glys- 100
fasting sugar 64
last 1 yr very less exercise and stressful period
now 10 jul my lipid test result is
ldl -90
tri gly -248
sugar fasting-89
now why this bad change. worried abt tri glys and inc in sugar levels which was constant at 64/98 for last 10 yrs. is it some indicator. what i need to do now

Jenny said...

Your blood sugars have risen quite a lot. What are you eating?

Get yourself a blood sugar meter and try this strategy to lower blood sugar:

Daily emotional stress rarely raises blood sugar, though short burst of intense stress do. But whatever the cause of raised blood sugars, cutting back on starch and sugar should help. Triglycerides rise in response to rising carbohydrate intakes.

nada said...

Hi Jenny ,You said "Your blood sugars have risen quite a lot. What are you eating? "

Do you mean to say fasting sugar of 89 mg/dl and postprandial of 119 mg/dl is high?

Jenny said...

Well, if I'm reading it right, your fasting blood sugar has risen from 64 to 89 in one year which seemed like a lot. Your triglycerides, which reflect how much starch and sugar you are eating are way over normal, too, at 248. Since they are the one fraction of lipids that correlate closely to heart disease, it looks like you are eating more carbs than are compatible with health.

gredib said...

I am a 53 yr old male,type 2. I have a very interesting story about carbohydrate and cholesterol,tryglyceride. I was first diagnosed at age 36. A fasting sugar of 360. My doctor went with the normal low fat, high carb, and put me on glyburide. I was scared into being willing to do something. But had already read enough about diabetes , previously,that I knew low fat and high carb was not the answer. And had witnessed other type 2 diabetics who followed low fat high carb. Who were on all kinds of meds and some even on insulin. So I prescribed my own diet. It was a simple diet. It consisted of simply cutting out all high starch food and cutting out all sugary food. (which I had been eating much of before). And I allowed myself to eat most anything else , in any amount, exept I replaced my high carb with unlimited very low carb. In two weeks I had a hypoglycemia episode (was still on glyburide). I , on the same day, went to get a blood test for cholesterol , tryglyceride, etc. And explained the hypo episode to doctor. She recommended I eat some carb every few hours. I argued and said I refuse to take Glyburide anymore. I went and bought a glucose meter to make sure my sugar was staying good. It was normal every time I checked it.

About six months passed and I had lost 25 pounds. I was still about 55 lbs overweight. With my blood sugar staying normal. One day I twisted my knee while at work. My employer sent me to doctor. She examined the knee and noticed many vericose veins in my leg. And pushed on some of these veins in my leg. One of the places she pushed on caused extreme pain and made my foot go numb. She sent me immediately to hospital for a test for a blood clot in my leg. And ordered a blood test for blood lipids. Asked me what I had been following as diet. I told her. She said I was eating way too much fat , not enough grains, and I was overweight due to this. And that my blood work would come back showing that I had terrible blood lipids.

The test came out that I had clear arteries in my leg. Hospital released me and simply treated me for a twisted knee. The next day I seen doctor and she told me she had the results of my blood work. But she informed me that It had to be a labratory error. Because my total cholesterol was 190. Tryglyceride was 89. LDL 140, HDL 40. So she ordered more blood be taken and sent to lab and double checked. When blood work came back she was still insisting that the lab made a mixup or something had to be wrong with their testing. Because numbers were the same.

I argued to Doctor and said; "Six months ago you found I had diabetes. You wanted me to eat low fat and high carb". "I went on a lower carb, high in low carb veggies, but loaded with fat and moderate protein". "If you go through my chart you will clearly see I had high blood sugar when first diagnosed". "And you will also see that I informed you that I was going to cut out my high starch and sugar". "And you will see that it was chartet in my rechords". "Also, you will see that I went off Glyburide in two weeks and had normal blood sugars"

She read back through medical rechord charts and it confirmed what I told her. But she insisted that I could not eat all the fat and cholesterol and get the results in my blood work that she was seeing.

I told my doctor to go look at the actual research on this subject. Which , was not actually all that much back then. I am sure she had to be thinking , in the back of her mind, that there had to be something to this low carb quackery that doctors were missing. That was back in 1996. She is not my doctor anymore. But I will always remember this. And know that In this day and age there is a load of research to prove why my blood lipids were good.

Last note; I slipped off my diet off and on over the years and regressed into being an insulin dependent diabetic. I am just now getting back on track. And I bet I will again see good blood lipids when I get all the carb cut again.

Jenny said...

Gredib, Great story, which also points out how hard it is to maintain longterm control with diet alone. Too often initial success is followed by carb creep. The research I review on my Diet 101 book suggests that combining low carb high fat intake levels with a daily intake of 150 g of carb or more is harmful. As carbs go up , fat MUST go down.

mk07 said...

Please help me with my lab tests... I think I have reactive hypoglycemia but I am a bit confused and doctors are not helpful... I'm 19.
Friday I did a fasting of 12h and my resuls were:
Glucose is 80 (4.4)
Insulin is 3.3
Peptid C is 1.72

Yesterday I did an OGTT in the hospital and:
Fasting glucose is 82mg/dL (4.6 mmol/L).
After drinking the 75g of glucose :
60'min - 68mg/dL (3.8 mmol/L)
120'min - 65mg/dL (3.6 mmol/L)
180'min - 75mg/dL (4.2 mmol/L)

Fasting insulin is 11.6mU/L.
After drinking 75g of glucose:
1h after is 79.4mU/L.
2h after is 37.3.mU/L.
3h after is 12.9mU/L

My C-Peptide results were:
Fasting - 2,55
After 60 min' - 11,20
After 120 min' - 5,75
After 180 min' - 2,63

please help me understand what is wrong...

Jenny said...


From what I can tell, your blood sugars in these tests are pretty normal, though you might be a bit insulin resistant as you are making a lot of insulin.

The 1 hour reading is very slightly hypoglycemic, but I have heard from people who are seeing blood sugars drop into the 50s for hours after the OGTT, so yours aren't particularly bad.

Since you are making a lot of insulin, you would probably feel better if you cut back on your carbohydrate intake in every day life. There is no need to be extreme here, just cut back on the portion sizes of the starchy and sugary foods you eat until you feel better after eating.

mk07 said...

What confused me the most was the difference between fasting insulin in both different days. As far as Peptid C results I don't know much about it but I believe they are not a problem in my case. I appreciate your help, thank you very much. Will follow your advice and also measure with the blood sugar meter. Another thing I wanted to know that I am uncertain is that if the half hour or 45min reading matter? Or it's just 1h peack?

Jenny said...

Only the 1 hour reading matters.

Insulin and C-peptide results change every few moments so both readings were high enough to show you were making high-normal amounts of fasting insulin.

Only measure at 1 and 2 hours. Everyone's blood sugar goes up during that first hour, it's only a problem when it stays up.