LDL cholesterol is one of the most controversial topics in the low carb world. On the one hand, conventional teaching is that elevated LDL is dangerous and needs to be lowered. On the other hand, otherwise healthy individuals following a low carb lifestyle have not been represented in our available data. How do we reconcile what to do? Dr. Ron Krauss helps us understand the nuances beyond LDL-C and how we can use all the available data to help us better understand what we know and do not know about cholesterol, including LDL, HDL, triglycerides and Lp(a).
Dr. Ron Krauss
Hi there
Great podcast. I have, over about a 6mth period of time, lost 10kg in weight, and did this primarily by cutting out processed foods and eating less bread/potatoes/pasta/rice but wouldn’t say I have been entirely low carb. Annoyingly my total cholesterol stayed the same at 6.1 mmol/L and LDL went up slightly from 4.0 to 4.2 mmol/L – triglycerides improved 1.9 to 1.3 mmol/L and HDL went up slightly from 1.2 to 1.3 mmol/L. I really was hoping my total cholesterol and LDL levels would have improved with the weight loss, Drs want to prescribed a statin, I wanted to try lifestyle. With further weight loss are the numbers likely to improve? (53y female)
Hi Sally. Thanks for sharing your story. If there is one thing I have learned by working with lipids and low carb lifestyles over the years, it is that there is no one response. I have seem too many different variations to be able to predict what will happen. That is why the key is finding someone who will work with you, help you self experiment, and work to find the right lifestyle for you. Hopefully your doctor will do that for you. If not, you can work with health coaches like myself and others who can help you with your lifestyle and help the communication with your doctors. Best of luck!
Thank you for this informative podcast. I am a 66 YO female on 40 mg. per day of Pravastatin started 1/25/19 due mainly to high Lp(a)-P of 74 mg/dL (10/2017). I am LCHF since 4/2018, do weight strengthening twice a week and run an average of 12 miles per week. No hypertension or diabetes. My other markers (date) are: CAC 92 (3/2018), LDL-C 130 mg/dL (10/2018), HDL-C 93 mg/dL (10/2018), Trig. 51 mg/dL (10/2018), Non-HDL 140 mg/dL (10/2018), VLDL 9 mg/dL (10/2018), Apo-B 104 mg/dL 2/2017), LDL-P 1542 nmol/L (2/2017), sdLDL-C 36 nmol/L (2/2017), hs-CRP 0.4 mg/L (2/2017), Lp-PLA 221 ng/mL (2/2017), Insulin 2 uU/mL (2/2017), Glucose 78 mg/dL (4/2019), HbA1c 5.3 % (2/2017). Women blood relatives have no CVD or stroke history. I really do not want to take a statin due to the side effects, and only relented because of the high Lp(a). Do you think statin therapy is reasonable even though there is little research on the risks of high Lp(a) in women? I had tried to convince my primary care provider that doing a CAC every 3 years was reasonable for lipid and plaque management but didn’t win that argument. Thank you so much for your time and attention. I look forward to your thoughts.
Hi Ann. Than you for sharing your story. I would love to help, but unfortunately I cannot make specific suggestions over the internet. We would need a full consult first. If you are interested, please sign up for a Health Coaching Consult on my website. Or if you are in California, Colorado or Utah, I will hopefully be able to serve as your physician through telemedicine starting in August. I would be happy to help however I can! All the best, Bret