122 Rules by Deek Rhew

Showing posts with label wellness. Show all posts
Showing posts with label wellness. Show all posts

Wednesday, March 6, 2019

Cholesterol Scare - Follow Up

Two months ago, I posted about my frightening cholesterol numbers being almost double the legal limit. See: Cholesterol Scare.

In my due diligence, I read A LOT of articles and did a TON of research. It turns out that it's possible high cholesterol isn't the death sentence we believed it to be. See: Cholesterol Scare - Part 2: Not as Scary as We Thought?

During my last post about lipid levels, Erin and I had theorized that I fall into a sub-group of Keto reactors known as a Lean Mass Hyper Responder. Basically, it means that when I get my body fat low enough and I'm on a high-fat diet, my cholesterol numbers and LDL go through the roof.

And, brother, let me tell you they did!

As of December 27, 2018 they were:
  • Total Cholesterol = 375mg
  • Triglycerides = 100mg 
  • HDL = 51mg 
  • LDL = 291mg

If you've ever gotten back elevated lipid levels, you know that these are frightening numbers.

Frightening!


So, it's been two months, what's been happening?

Plenty!

We decided to test the Lean Mass Hyper Responder theory. I modified my Keto diet and meds as follows:
  • Increased calories by 300 to a maintenance level of 2400
  • Increased carbohydrates from ~30-40 to 100
  • Removed egg yolks from my diet
  • Switched from 10mg of Lipitor to 5mg of Crestor

That's it. No additional exercise, no other anything. The rest of my diet remained the same and on the same schedule.

The results <drum roll plllleeeeease>:
  • Total Cholesterol = 233mg
  • Triglycerides = 75mg 
  • HDL = 52mg 
  • LDL = 163mg
I can live with that...literally.

In two months that's a pretty phenomenal change. We're going to ride it out a little longer and see where my body settles in, but the long and the short of it, is that Lean Mass Hyper Responder is a real thing.

In the future, if I need to lose more weight, then I *may* still do the low-carb version of Keto, though perhaps not as low as I was doing. I don't know just yet. We only got these blood results yesterday, so I haven't had a chance to process it all.

When we cross that bridge, I will write another post about it. For now, I'm going to bask in the I'm Not Going to Die from Cholesterol Tomorrow glory!

Gloriously Relaxed!


What am I fighting before besides the chance to add more candles to my birthday cake?

Years and years more of this...


And this...

And this...

And this...


Yes, please! A very long life of this!


I'm incredibly lucky to have a partner that's worried and researched and kept a level head and listen to me ramble about cholesterol and lipids and fats and blood levels and lean responders and on and on. Thank you, Erin, for standing by me through all of this. I epically love you!


Until later, adventure on my friends!

Friday, January 4, 2019

Cholesterol Scare - Part 2: Not as Scary as We Thought?

If you haven't read my first blog post, Cholesterol Scare, where I got back my lipid profile back and was startled to find my numbers almost double the legal limit, stop in and give it a read.

Over the last six months, I've lost 32 pounds on the keto diet. During that time my migraines have all but vanished, my energy levels are way up, my body fat % has dropped a ton, and I feel great. So, all good things. Unfortunately, my blood work up wasn't what we'd hoped.

As I mentioned in my last post, I'm not a doctor, just a guy with Google and extra fat packets in his bloodstream. So, in this blog post, I'm going to give you the research I found that says that not only does cholesterol NOT cause heart disease. But having elevated levels may actually make you live longer and fight off cancer, diabetes, and other diseases.

US and UK Translations
If you or someone you love has high cholesterol (and you're in the States), you'll want to convert your mg ratings to mmol/L that they use in the UK. A lot of the data I'm linking to is from there and almost all their reports and articles use mmol/L instead of mg. To do that use the OMNI Calculator.

Alright, you have your report from the doctor, you have it in mg and mmol/L. On with the research!




Are You a Lean Mass Hyper Responder - LMHR?
For years, I've known I'm a bit over the top. What I didn't know was that my body is too!

One of the things that Erin discovered is that there is a segment of the population that reacts differently to keto than all the rest. This subgroup is known as Lean Mass Hyper Responders. Basically, what it means is that when you get your body fat low, and you are on a high-fat diet, your cholesterol levels and LDL go through the roof.

Most people respond by a serious drop in cholesterol, but not us LMHRs! We get excited about it and want more and more! But, it's not necessarily a bad thing. Read on to see why.

Is there an inverse relationship between high cholesterol and heart disease?
Dr. ZoĆ« Harcombe--Ph.D. in Public Health Nutrition--is off the charts brilliant and working dilligently to weed fact from fiction. Check out her write up about the relationship between heart disease and cholesterol. This article explores the fascinating purpose of cholesterol in our bodies. It's in our brains, it's the mechanism that delivers energy and nutrients to every cell, and, oh yea,  we would be DEAD without it.

I honestly had zero idea about its plethora of purposes which range from digestion, to reproduction, to mental functions. She also talks about how LDL and HDL aren't actually, cholesterol at all, but proteins.


Wut? Yep. So anytime you hear or read someone that says LDL is "bad" cholesterol and HDL is "good" cholesterol, they are wrong. They're actually lipoproteins, hence:
LDL - Low Density Lipoprotein
HDL - High Density Lipoprotein
AKA: NOT cholesterol

Dr. Harcombe ran several reports from the World Health Organization database trying to find a correlation between elevated cholesterol and cardiovascular death. She actually found that the higher the level, the lower the death rate from cardiovascular episodes especially in women.

The question she poses is: Do we have cholesterol completely wrong?

Another leading researcher, Dr. Malcolm Kendrick, did a massive amount of studying on the correlation--or, by his research--the lack thereof, between elevated cholesterol levels and cardiovascular death. Below you find his 30 minute presentation and I think you find it incredibly fascinating.

The long and the short of it is that the relationship between elevated levels and death are actually inverse.

Wut the wut?

Yes. According to his report, the lower your cholesterol the HIGHER your chances are of dying from a cardiovascular episode.



Wait! My doctor told me it's in my genes!
Yes. Me too. What our doctors are talking about is Familial Hypercholesterolemia or FH. Unfortunately, FH isn't nearly as common as we are lead to believe. FH is a genetic mutation and is revealed by a simple test. Usually what happens is that your doctor says you have FH because you have high cholesterol.

Maybe, but probably not. Check out Dr. Harcombe's article that reports only 1 in 500 people actually have the gene. Here's another great article by Dr. Axel Sigurdsson on FH mutation carriers.


Cholesterol, Triglycerides, Ketones, and Lipoproteins
Wow. What a mouthful. Just the sheer number of syllables in the title makes my eyes blur and my head swim. Fortunately, this article on CholesterolCode.com makes it easy to understand what each of these components are and why we need them.


Another Lean Mass Hyper Responder
Stephen Richert is a documentary adventure photographer. In 2015 he was diagnosed with very high cholesterol--his numbers are almost exactly the same as mine. But he has the added complication of having diabetes. Here's his first article in 2015 when he talks about being on keto and getting those results back.

As of 2017, he was still doing keto and still has high cholesterol numbers. However, he is no longer trying to "fix" the lipid levels. Here's his reasoning.


How do I know if I'm Healthy?
Okay, so if cholesterol levels are not necessarily the best indicators of your cardiovascular health, then what are? Unfortunately, there's nothing that's 100% guaranteed, but our research has turned up two tests that can give you a really good idea.


CIMT - Carotid Intima-Media Thickness Test
https://www.radiologyinfo.org/en/info.cfm?pg=carotid-intima

CAC - coronary artery calcium scan
https://www.headsuphealth.com/blog/self-tracking/low-carb-lab-testing-part-8-the-cac-test-a-better-way-to-evaluate-cardiovascular-health/


What's Next for Me
Now that we've ruled out thyroid, cortisol, and any other health-related causes, we've decided to switch my statin (I've been on one since I was in my early 20s). I'm changing from Lipitor to Crestor's lowest dose (half of what I was on before). I'm also modifying my keto diet slightly. Instead of staying below 50g (usually well below) of carbs a day, I'm upping it to 100g.

The extra carbs are almost all veggies and a little bit of fruit. I'm good with this since I've reached my weight goal and am switching to maintenance.

We are pretty certain that I'm a LMHR--remember I'm over the top about almost everything!--but we want to be totally sure. I know that changing two things kinda skews the results, but being on such a low dose should cut down on potential side effects if we decide to increase it.

Right now, we are going to see what happens to my levels over the next two months. It's a make a change, then wait kinda game. But I'm in it for the long haul.

Still haven't decided my feelings on the health benefits of high cholesterol. Still need to do more research--which I will share--and weigh that with the risks of more statins.

Until next time, my friends, adventure on!


Ready to see what happens next?
And the Two Month Follow-Up.

Friday, December 28, 2018

Cholesterol Scare

NOTE: I'm using my REAL numbers in this blog post. I've done hours and hours of research, and for whatever reason, no one seems to feel comfortable disclosing actual information. Needless to say, it has driven me completely apeshit to read an article that use vague words like "elevated," "moderate," and "high."



WTH do those even mean? If we don't even know what the definition of "is" is, then how can we expect people to understand "moderate?" Anyway, I'm going against the grain and probably violating a HIPPA rule or something, but I'll actually say what I mean.

Also, it should be noted, I am NOT a doctor, nor do I play one on TV. I'm just a guy with Google, some extra packets of fat in his blood, and a propensity for research. My goal is to share my research as I go along.

Knowledge is power.

Alright, with all of that said, I had a scare this holiday. I went in for my annual physical and blood workup in the middle of December. I expected great lab results and a high-five from my doctor for losing over 30 pounds (yes, 30!-Thank you Keto diet).



Unfortunately, the blood work didn't come back the way I expected. When Erin did her test, her cholesterol had dropped 20 points since she started Keto. I was hoping for something similar, but mine not only didn't drop, it increased by 149 points. My total cholesterol level as of 2 weeks ago was 349. To weed out a fluke test, I took it again yesterday.

As of this morning, my number is 375 (for my Brit friends, that 9.698 mmol/L).

375

Anyone that has experience with "elevated lipid levels" will know that the level of risk runs kinda all over the place. Generally speaking "high risk" is considered somewhere in the neighborhood of 200-240.

To say that this number frightens me a bit, is an understatement.

Here are my total numbers as they stand right now:

Total Cholesterol = 375mg (9.698 mmol/L)
Triglycerides = 100mg (1.129 mmol/L)
HDL = 51mg (1.32886 mmol/L)
LDL = 291mg (7.525 mmol/L)

I can practically feel the creators of HIPPA snapping their pencils in half and drooling into their pocket protectors.

This fat in the blood propensity runs in my family (both my grandfather and father have it), and I have been on a statin since I was 20. Up until just recently, that's been enough to keep it "below borderline high," aka 200ish.

So the fact that my body is up to some kind of shenanigans, even after losing 30+ pounds, didn't come as a complete surprise. I've evidently got some overzealous little fat-generating liver gnomes who are putting in some serious overtime.

So...



That's the big question, right? Well, it could be a whole slew of things. The big ones: diet, exercise, obesity, smoking, diabetes, liver disease, thyroid, stress. Well, for now, I've scratched obesity off the list. I'm down 30+ pounds and really only need to lose a few more to be right about where I want to be.

I don't smoke, and diabetes and liver problems came back as a big negatory in my blood work.

Exercise: I lift three days a week, and Erin and I walk. A lot. I could add some high intensity cardio to my morning routine, but since I haven't done early cardio in years, I don't think that a lack thereof is the cause of this sudden flareup.

Stress: My life is certainly not without it, but who's is?! While this little episode can make one's sphincter pucker, compared to what I was experiencing stress-wise 6 years ago, my life is a walk in the park. Now my body could be like, "Um no, I just can't roll with it the way I used to." That's certainly a possibility, but this reaction seems extreme. For now, I'm going to focus on other factors but keep this one in the back of my mind.

So, that leaves a couple of possibilities: diet and thyroid.

Let's start with diet.

I've made it no secret I'm on Keto and have been very successful at it. The basis of the diet is low carb, moderate protein, and high fat. The principal behind is it is your body becomes "fat adapted." Meaning, instead of using carbs for fuel, it burns fat. Once it runs out of fat in your diet, it looks for other sources in your body.

But the concept of Keto flies directly in the face of everything I've ever known about a cholesterol conscious diet. The latter is all about low fat. To add more confusion to the whole mix, when I was first diagnosed with "elevated lipids," my doctor told me that eating cholesterol doesn't cause high cholesterol.

I've read this online in many many other times, but still, it's a difficult fact to ignore.

To argue with myself about this, I also need to point out that my diet before Keto sucked. Fried foods, carbs, so on and so on. Unfortunately, I didn't track my food before, so I don't have anything to compare it to. But my guess is that overall my fat, especially my cholesterol and saturated fat intakes, are way down now compared to the fried food life before.

Another possibility is thyroid.

There are a lot of articles I've read that there is a direct link between hypothyroidism and cholesterol levels. I don't really have many of the other symptoms of a thyroid problem, but it certainly isn't off the table.

Quick Weight Loss

The last possibility (thus far) is rapid weight loss. In someone who doesn't process cholesterol out of their blood very quickly, rapid weight loss can cause "elevated levels." (Damned vague articles. Give me real numbers!!!)

The concept behind it is that when your body breaks down fat cells, that fat gets dumped into your bloodstream. Losing 1 pound of fat is equivalent to 3500 calories. If you lose, say two pounds, like I did between my two cholesterol tests, that's my body dumping 7000 calories of triglycerides and fat into my bloodstream. Yowza!

Unlike other diet plans, Keto is focused on fat. I've lost a lot of weight before, but when I did it, my body stripped itself of muscle as well as fat. So, it had a nice mixture of the two to work with. But on Keto, my muscle has mostly been left alone.

So, that's where things stand right now. Erin and I are drawing up battle plans, and I'm doing research, which I will share with y'all as I find it. We will be talking to the doc when she gets back from her vacation at the beginning of the new year, so we'll see what she says.

Until then, adventure on!


Ready to see what happens next?
Check out Cholesterol Scare Part 2: Not as Scary as We Thought?
And the Two Month Follow-Up.