UPDATE: My Battle with High Cholesterol and How I Avoided Statins

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A few weeks ago I was stunned, when after being paleo for eighteen months, I’d seen my cholesterol, my ‘bad’ cholesterol – LDL – skyrocket. My primary care physician immediately wanted to discuss treatment. High cholesterol? Statins? Me?

The results were bad. So I had more tests. The results were still bad. My quest to live a drug-free life wasn’t looking like it would have a successful outcome.

But I hold the viewpoint as presented in Mark Sisson’s The Primal Blueprint that drugs are wonderful – in the case of emergencies – but I wasn’t clear at that point that this was an emergency. So I demurred.

As I detailed in my earlier post about having a huge increase in my cholesterol despite being paleo for eighteen months, I got a second opinion from a paleo-centric doc, a repeat of the basic lipid panel, which confirmed the results of the first, and developed an action plan. This is an update to that post.

Lifestyle dialed in

In my case, lifestyle changes had already been made: I’m not overweight, I eat healthily, exercise regularly and have minimal stress beyond the daily parking lot battle at school pick-up. There was nothing much to be done there.

So, faced with a situation about which I could, apparently, do nothing, I wanted to study the true nature of the ‘disease’ to examine if the risk it presented to me was as bad as conventional wisdom would have me believe.

However, I was not prepared to ‘play with fire.’ If it was absolutely necessary, I would take pills. But in this case, things just didn’t add up. How could I live the most healthiest of habits and yet be drug-dependent?

Testing, testing

The test I had done after the basic lipid panel measured the types of LDL floating around in my blood. It was called a Vertical Auto Profile or VAP. My doctor and I were particularly interested in the cholesterol profile of the Pattern A and B particles. Pattern A are large and fluffy and considered mostly benign while Pattern B are small and dense and strongly correlated with heart disease.

Fit, healthy people often have a concentration of pattern A as did Chris Kresser. Turns out I did, too. Good, you’d think, huh?

Good news turns to bad

However, I had another marker that was concerning to my doctors. The cholesterol variant Lp(a) was more than twice what it should be. Lp(a) is sometimes called the ‘widow maker’ because of its role in heart disease. The recommendation was still to go on a statin. Bummer. :-(

Controversy

I had read so much in the intervening period between my first and second test results, I’d come to realize the controversy over cholesterol as a predictor for heart disease is simply raging.  There is huge disagreement between paleo community leaders and the medical establishment over this and the situation is far from clear.

As part of my research, I read Chris Kresser, Mark Sisson, Chris Masterjohn, Peter Attia, William Davis and Kurt Harris. I synthesized it all as well as I could and applied it to my own situation. I devised courses of action based on different outcomes, weighed the risks and developed a plan. It wasn’t easy.

As a person with young children who tends to tread a moderate path, I wasn’t prepared to ditch conventional wisdom entirely, possibly playing Russian roulette with my heart. I wanted to make a decision that made me, and my doctor, happy. Taking a statin at this point wasn’t going to achieve that. I needed to know what the true risk of a heart attack in my case was.

The heart of the matter

My resistance to drugs being what it is, and my desire to really evaluate the picture being so strong, I had one other option offered to me: to have a CT heart scan. This would reveal whether I had calcium deposits (plaque) in my arteries, the stuff that clogs them up and leads to heart attacks. I didn’t think twice.

As I was being rolled into the scanner, my arms above my head, holding my breath for so long I thought I was more likely to die of suffocation than heart disease, I did wonder what the outcome would be. Maybe for all my lifestyle efforts I would still ‘live long and die’ – the phrase Mark Sisson uses to describe the idea of living healthily and independently until just before death – but perhaps not as long as I’d hoped.

Thoughts of mortality

Was I in danger of keeling over in just a few years? Was I at 48, entering the later stage of my life rather than the middle as I had thought? These thoughts might seem morbid and a little melodramatic but they are what went through my head. I had the scan, got dressed and went home to wait for my results.

He had me at ‘zero’

I received an email from my doctor later that night. My calcium test, known as a ‘CT Heart without contrast’ or EBCT, came back with no discernible calcium deposits at all. It is possible that there are microscopic elements that cannot be picked up but for all intents and purposes, I am clear. The recommendation to take statins was dropped for at least 5 years and I was waved on my way.

Was I a happy bunny? I do believe I punched the air and gave a little scream which for a reserved Brit is quite a departure. :-)

This is my story.

These are my results; this is my outcome. I had access to a paleo-aware (but not anti-drug) doctor who was willing work with me and to test until I was satisfied. I have excellent health insurance. I, in no way, want to leave you with the impression that if you have lipid panel results with a profile similar to mine, you can project my situation onto yours and rest easy.

Please don’t make assumptions for yourself based on my case study. That would be reckless.

Avoid passive patient syndrome

Taking responsibility, being proactive, researching and testing as thoroughly as possible to build up a picture from a number of angles are essential for great health in my opinion. I call it avoiding ‘passive patient syndrome.’ If I hadn’t gone through this investigative process and had instead blindly followed my first doctor’s advice, I’d be on statins for (and this is what particularly irked me) the rest of my life. By doing my due diligence, I have been able to avoid that for 5 years at least.

Dr. Davis says on his Track Your Plaque blog:

“The followers of the Track Your Plaque program who…

  1. get a heart scan that yields a coronary calcium score (for long-term tracking purposes)
  2. identify the causes such as small LDL particles, lipoprotein(a), vitamin D deficiency, and thyroid dysfunction
  3. correct the causes

…enjoy virtual elimination of risk.”

So:

  • Find a doctor who is willing to partner with you
  • Do your due diligence, reading and researching, know what you need to know
  • Test as far as it makes sense to do so.
  • Implement and experiment with lifestyle factors and other methods that are relevant to you
  • Keep your eye on the prize – a long and healthy, vibrant life
  • Develop a plan to achieve that

(Have you noticed that preparing a plan seems to feature in nearly every paleo blog post I write? It is key.)

Interpreting the results

The controversy around cholesterol and the unclear nature of the role it plays in heart disease means that my results could be interpreted in a number of ways. Some might say I have a genetic predisposition to produce cholesterol and my healthy lifestyle prevents there being any fallout from that. Others would say that cholesterol is a complete red herring especially for women. But I think there is a clue in what Dr. Davis says which indicates my next move – thyroid dysfunction.

I have long suspected a problem with my thyroid. I have a family history of thyroid problems, a low body temperature and despite having normal thyroid results over many years, I have felt very tired, sick even, for extended periods.

Eventually I discovered my reverse T3 number was too high (this was well before I went paleo and considered at the time to be the result of my continually fighting the Epstein Barr virus.) Compounded, slow release T3 never helped though and I turned back to working on my diet.

Two-for-one deal

Good initial results with paleo passed after a time and although I have not gone back to the listless, exhausted, toxic state I was in two years ago, as I wrote last month, some of my symptoms returned (my interstitial cystitis was rapidly despatched, however, after I realized that the HCL I was taking as a digestion aid was the culprit – doh!)

I’m now speculating that my high cholesterol number might be the canary in the coalmine for my sleepiness and an under-performing thyroid the reason behind both the low energy and high cholesterol. A two-fer. That would be cool.

Paul Jaminet examines high LDL on paleo and the role of the thyroid on his Perfect Health Diet blog and suggests that:

“The proper solution, I think, is simply to eat more carbs, to provide other thyroid-supporting nutrients like selenium and iodine, and allow the body to adjust its T3 levels naturally. The adjustment might be quite rapid.”

Chris Kresser also suggests, for those who test negative for Hashimotos – an autoimmune disease affecting the thyroid – a trial of selenium and iodine.

So I continue to celebrate my drug-free status and marvel at the turnaround of events while experimenting with those two supplements over the next couple of months. Lucky I wanted to be a detective when I was a kid, huh? I’ll let you know how I get on – why not subscribe in the box below to make sure you don’t miss anything? :-)

Do you have thyroid issues? How have you turned them around? Tell us in the comments!

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Alison Golden writes on the topic of paleo over at Paleo/NonPaleo. She aims to share ideas, inspire and motivate readers by teaching them how to live paleo in a non-paleo world. She is also the author of the bestselling book, The Modern, No-Nonsense Guide to Paleo, a unique tool that gives the reader hundreds of strategies to navigate the learning process to successful paleo living.

{ 82 comments… read them below or add one }

Paula May 29, 2012 at 1:49 pm

Wonderful news! Summer will be sweeter than ever – and statin free. What a scare. I’m amazed at how many of our generation just take a prescrip, a lifetime sentence and all its side effects, and just accept it, don’t even put up the slightest struggle. Aren’t you psyched you didn’t just submit – what a lesson for our peers. Great detective work!

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Alison Golden May 29, 2012 at 2:09 pm

I *am* psyched, Paula and you’re right, there is a real lesson in this – due diligence. We wouldn’t buy a house or enter a business deal without it, why not do the same with our health?
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Darren May 29, 2012 at 2:14 pm

Hi, thanks for that, have been waiting to see how you got on. Among other issues, dehydration, absorption probs – due to my colostomy, I have had high ish cholesterol myself and statins were thrown at me – I ducked, but have never pushed to sort it out properly.
Now I am

Thank you again for a comprehensive run through events

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Alison Golden May 29, 2012 at 4:52 pm

You’re welcome, Darren, and I’m delighted to hear you’re going to pursue things further! :-)
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berj May 29, 2012 at 9:57 pm

So happy to hear that you didn’t take statin. I like your planning strategy and most people should do the same to be out of statin drugs. There’s always a natural ways to prevent any diseases and I will always believe it.

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Amber @ Busy, Bold, Blessed May 30, 2012 at 5:27 am

Way to advocate for your own health. Congrats on your results :)
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Jess K May 30, 2012 at 5:41 am

Great news! I am so happy for you. I am in a similar situation. I have “high cholesterol” and although all tests say I am “normal,” I still believe there is something wrong with my thyroid. I am always cold. (Today it is almost 80 and I have a sweater and gloves– yes GLOVES– on to stay warm. My skin is constantly dry, I put coconut oil on it every day, sometimes twice a day. And my hair is falling out. Like post-pregnancy hair fall out. Seriously. It is a good thing that I have thick thick hair or I am pretty sure you would see bald spots.

My GP says I am unhealthy, the endocrinologist says eat more whole grains to bring everything in line. UGH. It can be frustrating. And enough to make this lady say “I am done with modern medicine!” But you give me hope. ‘Nough said.

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Alison Golden May 30, 2012 at 6:38 am

Wow, you’re not getting very helpful advice are you, Jess? And you do seem very affected. Have you had a reverse T3 test (rt3) done? Or you could go forward based on your symptoms, maybe get a consult with Chris Kresser?
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Lauren May 30, 2012 at 8:02 am

Hair loss sent me to a naturopath who treated me for parasites, gut disbiosis, and heavy metals, in that order, as well as prescribing an anti-candida diet (which lead me to paleo) before the symptoms gradually retreated. Hang in there!
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Lauren May 30, 2012 at 5:45 am

This is *exactly* my position (minus the plaque scan) – I’ve just tested neg for Hashi’s (but with a test Chris Kresser would consider insufficient. NTL I didn’t suspect it in the first place) but something is not right. Being pregnant throws things off but I’ll be watching this. Keep us posted!
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Alison Golden May 30, 2012 at 6:31 am

Hi Lauren:

I think undiagnosed/borderline thyroid issues are *huge* especially for women. Whenever I see women doing all the right things and not getting results, I think ‘Thyroid?’ Thyroid issues are poorly understood generally, IMO and so key to health.
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Lauren May 30, 2012 at 7:58 am

I react the same – thyroid? (or bad fat ratio, or vit D deficiency) – but then I wonder if I’m being dogmatic. Pandemic, or blinders on? And IS thyroid the root issue, or is it gluten/leaky gut? What a rabbit hole! At any rate, enjoy your 5-year hiatus :)
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Alison Golden May 30, 2012 at 8:22 am

I think leaky gut may be the root cause but, as I am finding resolving it, takes energy and if you’re thyroid isn’t on top of things, you’re stuck in a vicious cycle – you can’t heal your gut because you don’t have the energy and you can’t get the energy until you fix your gut. Plus the need for energy tends to drive us to sabotage in the form of sugar and other stimulants. So it seems the priority is energy and supporting the thyroid (if that is the issue) in a tactical way seems like it would resolve a whole host of issues in the short term.

My experience in doing this kind of thing for 6 years now is that is like solving a mystery. Each step (and sometimes each $1000 of dollars spent on treatments or practitioners) uncovers a clue that takes me to the next step, the next tactic, which uncovers another clue and so on.
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Lauren May 31, 2012 at 3:58 pm

See that’s your much-noted patience and persistence at work!
This just in: what about vit D? http://thatpaleoguy.com/2012/05/31/high-cholesterol-and-sunlight-deficiency-2
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Alison Golden May 31, 2012 at 5:59 pm

Thank study is very interesting. I looked at the vitamin D aspect, Dr Davis mentions it, my levels are high – I live in California and supplement – but as you’ve probably guessed by now I take test results, normal or otherwise, with a pinch of salt. Whenever I’m feeling a little wan, I go outside and get some extra and laying in the sun when I’m sore *really* helps. I think Vit D is a wonderful thing.

I was *very* interested to see their posit that heart disease is likely caused by a microbe possibly chlamydia pneumoniae (not to be confused with chlamidia trachomatis – the STD, completely different thing.) I hadn’t read that before. C. pn is a nasty, nasty bacteria, highly evolved and very resistant. It’s also dead easy to get infected (perhaps you get sneezed on in the subway kind of thing) and many, many of us walk around with it with no idea…http://en.wikipedia.org/wiki/Chlamydophila_pneumoniae
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Joy May 30, 2012 at 9:37 am

What an informative post! I admire the way you stayed calm and fought through the layers of information to get the answers you needed. Nice work!

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Alison Golden May 30, 2012 at 9:47 am

Thanks, Joy. I covered a lot of ground over these past few weeks and figured it might be useful to others. :-)
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Dannielle May 31, 2012 at 6:37 pm

thanks for all of the great info. I, myself, have seen an increase of my cholesterol by over 100 points in just the past year. needless to say, i have numerous hormonal issues and vitamin deficiencies going on. I think my doctor has me on the right path, but only time will tell. We are addressing my adrenals first, she thinks getting them functioning will help put everything else back on track. Tried a Myer’s cocktails this week. Dont really feel any different but will try it again and see if it helps. Again, thank u for the valuable info…

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Alison Golden June 3, 2012 at 2:58 pm

Wow, that’s cocktail must pack a punch. Interesting.
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Glenna June 2, 2012 at 11:01 am

I so very much want to see a serious study for oat bran for cholesterol control. It upsets me very much the first thing often done is prescribe a drug of any kind when a better solution might be to simply eat a bowl of cereal each morning (or at least half the time). If a person cooks 1/2-3/4 cup of oat bran for cereal and has that for breakfast each morning, the cholesterol should significantly lower as well as having many other health benefits including reducing the risk of colon cancer (fiber). It can be sweetened with natural sweeteners such as fennel leaves added to the water before bringing it to boil, fruit, etc. It can also be used in muffins for snacks (not oat bran and flour but straight oat bran!). This is oat bran, not oat flour or oatmeal, but oat bran; I purchase mine in bulk and organic.

I challenge anyone with questionable cholesterol levels to have a test of their levels and then eat a bowl of oat bran cereal each morning for one month and have a retest of their levels. It will be very interesting for people to report their results!

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Lauren June 4, 2012 at 6:42 pm

Oats aren’t really a tenable solution for those who forgo grains, but I take your point about simpler being better.
Here’s a review of the risk assessment for 10-year all-cause/cvd mortality based on cholesterol. It’s stats heavy but the texty bits are comprehensible. Basically they used a huge sample and found a J-shaped curve for risk correlated with lipids, with those in the bracket officially considered “moderately high” to have the LOWEST risk of adverse health effects over a decade. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303886/
This underlines how sensible Alison’s fact-finding mission was, as opposed to willy-nilly just-get-those-numbers-down tactics.
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Jimmy Moore June 3, 2012 at 2:18 am

Congrats on working your way through all this. I’ve done the same thing and blogged about it in recent years. I get a dozen emails a week from people like you who are concerned about their lipid panel. A publisher has offered me a book contract on how to read cholesterol test results from a layman’s perspective. I had the NMR Lipoprotein test which is similar to VAP. Would love to chat with you about your experience sometime. Email me at livinlowcarbman@charter.net. :) Again, great job!
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Amy D June 3, 2012 at 4:23 pm

I have a a high RT3 issue as well. I am on slow release T3 and doing very well on 90mcg a day, down from 120 a day. I do notice, however, that the second my diet slips that I also feel sluggish, tired and unmotivated. I wonder if that is why it didn’t work for you before? I also desire to be drug free, but iodine and selenium just weren’t enough for me. For now, I’m sticking with my T3 and hope to wean off over the next couple of years. I have to find that place of balance where I am finally binge free and stop throwing away all my hard work. Good luck!!

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Alison Golden June 3, 2012 at 4:41 pm

Amy, I wasn’t doing paleo back then so it may well have helped me if I’d had that piece of the puzzle. For now I’m supplementing and very happy to be doing great! But I’m only a few days in and too early to tell for sure. Need a couple of complete cycles under my belt before I reassess.
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Brian Mikesell June 4, 2012 at 8:42 am

I have similar symptoms with my LDL increasing after going paleo the last 5 months but my HDL and TG being in great shape. Can you tell me how much iodine and selenium you are taking? I’d like to do a similar experiment. Did you find a supplement that does both?

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Alison Golden June 4, 2012 at 12:34 pm

Hi Brian:

Chris Kresser recommends 200 mcg/d selenium and 12.5 mg – 50 mg per day iodine if you don’t have autoimmune disease – iodine can flare it. I do have autoimmune disease though not Hashimotos so I am very cautious about the amount of iodine I take and am watching things carefully.

As he says in the post linked below, one should work up to taking iodine very slowly. I was planning to take selenium and iodine (Ioderal) separately but simply because I had it in my drawer I’m taking a combo supplement which contains amongst other things, 200mcg selenium and just 450mcg iodine.

http://chriskresser.com/beyond-paleo-5
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Ann Wendel June 5, 2012 at 8:05 am

Alison -
I loved reading your story! We all really do have to become detectives, don’t we! And even once we find “answers” we have to continually play detective because of the changing nature of AI. What works one week/month/year may not work the next, as our body continually changes. Keep up the good work.

One question: did your insurance company pay for the EBCT? Many of my patients struggle with getting the tests they need because of insurance restrictions.

And, in answer to your question “How have you turned your thyroid issues around?” here’s my story: http://whole9life.com/2012/05/ann-wendel/

Thanks again for a great article,
Ann

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Alison Golden June 6, 2012 at 9:19 am

Hi Ann: Yes I had coverage. Would likely have been a different story if I hadn’t. :-( I’ll check out your post. :-)
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Vicki June 6, 2012 at 3:06 am

That is very good news. I am in a very similar situation to you where my LDL has skyrocketed since going paleo. Previously it was very low. My HDL has gone higher and my triglycerides have lowered. My father, who is also my doctor, uses my cholesterol results as ammunition to tell me how unhealthy the paleo lifestyle is. Every time we eat together and I try to sway anyone in the family to try the paleo way of eating, he pipes up to tell them that they too will be doomed to high cholesterol and heart disease.
I am not too worried about my high LDL, as it is only through paleo eating that I truly feel healthy. Back in my pre-paleo days I ate no fat, exercised like crazy and felt like I was dying inside. My insides were being ravaged by gluten, and my insulin resistance meant that I had to eat every half an hour. Now I feel healthy, full of energy and can go all day without eating. I wouldn’t care if 100 doctors told me that paleo eating was unhealthy – there is no way that I would ever go back.

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Lauren June 6, 2012 at 6:04 am

Try giving your dad that recent article I linked to about total cholesterol NOT being a reliable predictor of heart disease: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303886/ It’s a robust analysis; he’ll have to either take it seriously or ignore it completely. If he ignores it, you have a simple and non-inflammatory rejoinder to his little “quips” about your diet.
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Alison Golden June 6, 2012 at 9:21 am

I would also add to not bother trying to sway anyone. If they seem interested in paleo, I’d take them aside out of Dad’s earshot. BTDT. :-)
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hannah August 15, 2014 at 6:39 pm

A good example of why in Canada, doctors are not allowed to have patients who are family members.

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Laura June 9, 2012 at 2:49 pm

Congratulations! I’ve recently been tested and found to have higher LDL than they’d like. Only now, through my own research, have I discovered the types of LDL. I’ll be asking for a more detailed panel at my retest. I’m glad you shared your journey as this blog post alone has provided me more information and directional guidance than I’ve found previously.

So congratulations again! And thanks for the information and some links I’ve found in the comments. I’ll keep my fingers crossed that you’re still in the clear in 5 years!

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Alison Golden June 13, 2012 at 8:46 pm

Thanks, Laura. I wanted it to be helpful as well as simply a tale, albeit an inspiring one.
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Suze June 12, 2012 at 6:36 pm

OMG, my dear Alison. You have been sucked into the healthcare vortex. I am currently trying to escape it as well. My primary care doc drank the kool-aid on the whole cholesterol thing, so I have been trying to get my numbers down more to please him (read: shut him up) than anything else. He keeps pushing lovastatin on me. I keep not taking it. I think it’s harmful to use statins.
I think I may tell them I am allergic to all statins and describe a plenty scary progression of allergic reaction. Make them put it on my record. Then they won’t be able to try to make me take them anymore!!!

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Brian Mikesell July 7, 2012 at 5:15 pm

any updates on how things are going for you?

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Peter July 11, 2012 at 11:14 am

Did you consider taking NMR Lipoprofile instead of VAP or CT Scan? NMR would have given you the exact LDL-P particle count, another indicator on CVD risk level.

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Alison Golden July 11, 2012 at 4:17 pm

Peter, I wasn’t offered the NMR. To be honest I am skeptical of both that and the VAP giving meaningful results but I was hoping that the VAP would show up nothing to concern the doctors and I could avoid having the heart scan. That wasn’t the case and I still did end up getting scanned but all in all that was a small price to pay for complete peace of mind and best of all, no drugs!

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Karen C. July 29, 2012 at 9:20 am

Thank you for sharing your story. This is so timely for me! I just got back my latest lipid panel results, and the for the first time had particle counts done (NMR, though, not VAP). I was shocked at my low HDL, high LDL and high LDL-P counts after being Paleo for 16 months. I haven’t talked to my doctor about the results yet (appt next week), but I’m looking forward to reading the articles and posts you linked and putting together some info to take with me to my appointment next week. My doc is also Paleo-friendly (I switched to her after she recommended “Primal Body, Primal Mind” to a friend), so I am sure she won’t recommend statins, but I always love to go in with my own ideas :)

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James July 29, 2012 at 1:24 pm

As I have had a similar experience since going Paleo, I enjoyed reading your post. Unfortunately, I didn’t get tested before going Paleo so I can’t compare before and after. My first test after about 11 months of Paleo came back with high total cholesterol, high LDL, good HDL and low triglycerides. Instead of taking the statin prescription offered by my doc, I started adding some “safe starches” (sweet potatoes and white rice). I also used lots of turmeric and pepper on the rice as I read about curcumin lowering cholesterol. I also started using iodized salt on my food, got vitamin D from sun and fish oil from whole foods instead of supplements. Three months later I got retested and my total cholesterol dropped nearly 100 points, mostly from LDL. I went another three months and was retested with nearly the same results. Total and LDL are still borderline high, but I’m not too concerned at this point. Even following conventional wisdom and plugging my results into the risk calculator at the heart association web site shows my risk to be at the lowest level, which is much lower than the risk of side effects from statins. It’s impossible to know what caused the change since i changed more than one thing at a time.

Another issue to consider is that, on the standard tests, LDL is calculated and can be incorrect if triglycerides are low. Search for Iranian equation.

I haven’t gone so far as to get a scan yet, but I certainly will before taking statins. My doc even mentioned it and I inquired whether insurance would cover it. She said it probably would and that she thought it was only about $50 anyway. That seems like a small price to pay to know whether or not the LDL is collecting in my arteries.

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Bill July 29, 2012 at 3:56 pm

Great story, Alison. Awesome!
From what I have gained from the literature, total cholesterol levels are pretty meaningless (I personally just pay attention to my TG/HDL ratio). Cholesterol levels are set by your liver, and are genetic. Everyone differs in their levels of everything else (e.g., normal hormone levels can vary between healthy individuals by many orders of magnitude), why not some variation in TC levels? As long as you’re sticking to the paleo way of eating, your body will be aided immensely in running itself.
Also, current medical norms may be way off, since we’re deriving these from a diseased population. Maybe in 20 years, new norms (if even pertinent to use a norm) will come from paleo people, and be somewhat different from today’s.

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DRK August 2, 2012 at 8:44 pm

“Diseased population” is one of the factors that seems to always be left out of the equation. Is it ethical to treat a number on a piece of paper absent any real cardiac signs or symptoms? “first do no harm”.

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Michelle July 30, 2012 at 6:41 am

super that the testing allowed you to go Statin Free! It’s great to find a doctor who is willing to work with you like that.

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Jane July 30, 2012 at 8:08 pm

Great story! Thankyou! Whilst I haven’t had my bloods done since starting my paleo journey, I think I have also made the conection with my thyroid and other issues. I was waking up feeling like I’d been assaulted around the kidneys with a baseball bat and with sore acheing feet. I finally linked it to adrenal fatigue and thyroid issues. Upping my (safe) carbs has actually helped get rid of these symptoms and has helped me start losing weight again. I’m going to get my bloods re-done at about the 1 year mark which will be the end of August.

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Ken August 30, 2012 at 7:37 am

Alison, my own recent history is very similar to your own. Low-carb/ketogenic diet more than 30 months now, LDL-c ~250mg/dL (having risen ~50% after starting carb restriction) , zero calcium score. I have normal thyroid function based upon previous panels (TSH, free-T4), but recently did self-referred (i.e. w/o doc) reverse-T3 and free-T3 tests. The fT3 was low (out of lab range) and the fT3/rT3 ratio was 20 OK), as I had begun to suspect.
The seemingly esoteric theory is that fT3/rT3 ratio is indicative of thyroid hormone activity in the target tissues (including hepatic LDL receptors), according to some. I don’t think that this interpretation is at all widely accepted in clinical practice, but a lot of those that ARE are absolutely wrong (including serum cholesterol markers) in my opinion.
I am now experimenting with iodine supplementation as well. I am not completely convinced that my fT3/rT3 ratio is an indicator of a problem — unlike yourself there has never been even a hint of thyroid problems (from annual bloodwork) for me. But it will be interesting to see what the effect upon the LDL-c and other parameters might be after 6 mo. or so.
You have probably done a lot of reading similar to my own, and seem to have come to similar conclusions. I will try to remember to report back to you next year on results of the high-iodine supplementation for myself, and will be interested to follow yours as well.

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Ken August 30, 2012 at 7:46 am

P.S. A section of my previous comment seems to have been deleted. My recent lab results are as follows.
fT3: 1.9pg/mL (2.0-4.4), rT3: 32.1 ng/mL (13.5-34.2),
fT3/rT3: 5.9×10^-3 (with 20×10^-3 min. apparently considered normal)

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Alison Golden August 30, 2012 at 4:47 pm

Thanks for sharing your experience, Ken. I’m losing interest in my own test results in favor personal experience even though I love data. I feel I’ve got to the end of the road with them in my case even though I think they can be helpful and provide a lot of guidance especially early in our health journeys.

I’m finding the iodine supplementation to be outstanding – it’s been around three months now and I have steadily got better and better despite challenges. Good luck!
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larry September 16, 2012 at 6:16 am

But, I don’t have a comment!

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Maggie September 18, 2012 at 7:32 am

Good advice on being an active patient, not passive. Unfortunately, that can be hard to do for some people, especially as more and more of us are losing our insurance or seeing our benefits cut. Sometimes it can be difficult to be particularly active, especially if your finances cannot handle it.

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Susan November 15, 2012 at 8:09 am

Hi,

I have similar lipids to you. I also have high Lp(a). I also have Apo E4. For what it’s worth, I was told by Dr. Tara Dall’s (Tara Dall is a lipidologist) nurse practitioner that a heart scan will not show up calcium deposits until an older age (older than I am, and I am older than you are). Their recommendation is a carotid ultrasound.

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Martin December 28, 2012 at 11:03 am

Very similar to my story. I went on Paleo and indulged in butter and coconut oil with the aim of gaining weight (and I happily did). Routine cholesterol test (numbers close to yours here http://goo.gl/ZMnzP) and my doctor almost getting a heart attack when reviewing results (I felt great). I assume I am in the 14% of population having the Apo E4 gene however no tests to confirm. No heart calcium scans available where I live so I refused statins and decided for the following dietary changes :
1. sigificantly reduced coconut oil and butter however they still remain the main cooking oils for me
2. reduced eggs although this may not be contributing to my cholesterol reduction
3. oats and coconut for breakfast for 6 monts The oats are not paleo but what the hell, at least they are gluten free and I needed them anyway as the contribute to healing leaky gut
4. 100 grams of grated carrot daily

Now 6 months down the road my cholesterol numbers match the reference values.
Few points:
1. Although the paleo community does not take the cholesterol numbers seriously I agree with the Travis Culp opinion that any significan deviation of biomarkers should be addressed
2. During the winter when my cholesterol numbers peaked I experienced zero bacterial and viral infections (unusual for me) however gained a fungal rash, both of which I attribute to the cholesterol (Paul Jaminet)
3. In my view eating real food is still the right way to go, it just needs to be adjusted to suit every individual.
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Melinda January 14, 2014 at 4:43 pm

Just make sure your oats are gluten free. As a celiac I can absolutely tell if I don’t get certified gluten free oats.

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Jacquie December 28, 2012 at 2:25 pm

Hi Alison,
What are your thoughts on comment by Susan re calcium deposits not identified by scan till older and carotid ultrasound. I had high cholestrol, but largely only Hdl, my Ldl & Tri below marker, i rectified by cutting out butter and sugar, and reduce stress, my weight is low, 51kg at 163, and i exercise daily via qigong, yoga & walks.
Love your blog

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Alison Golden January 13, 2013 at 5:05 pm

Hi Jacquie:

It isn’t feedback I’ve heard before (not that it’s wrong) and as I can’t control for my age, I’ve stored the info away and will keep monitoring my numbers and maybe have another heart scan in a few years. I’m definitely not complacent but have used this experience to put the data into an appropriate context.
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Christine January 26, 2013 at 2:12 pm

Thank you so much for writing this blog! About 18 months ago, I was diagnosed with Hypothyroidism and then 6 months ago, high cholesterol! I’ve done everything in my power to change my lifestyle, eating habits an excerise, so how can I be so healthy, yet my cholesterol has gotten worse? I’m not going on another pill! I was so upset about getting on thyroid medicine and I vowed to get off it and now, being told I might need cholesterol medicine? I won’t do it, at least, not without a fight. Ill get the CT scan as you recommended first and if I must take another pill, so be it.

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Paul Skavland February 26, 2013 at 12:05 pm

Hi, I just stumbled upon this researching some of the very same stuff you did. I just wanted to thank you for such a well-written and informative post. I’ll be back …

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Scott March 8, 2013 at 5:49 am

I was really interested when I came across this article a while back as I started paleo last February. As a relative newbie, one of my biggest concerns about going against the SAD, was that my cholesterol would skyrocket or I’d encounter the same issues as yourself and have a doctor thinking I need some meds.
So after doing this for a year, I went and got a standard cholesterol panel done. I happen to have my cholesterol #’s from May 2007 and September 2011 for comparison purposes and here’s what happened for me and my new 4 fold increase of bacon ingestion:
Total numbers dropped from 225 to 219, LDL dropped from 143 to 136, HDL rose from 60 to 72, and my triglycerides dropped by 50%. I couldn’t be happier with the results and my new LDL/HDL ratio dropping to a perfect 1.89. My exercise program has stayed nearly exactly the same over the last 2 years, and the diet is the only significant change in that time frame.

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karina April 19, 2013 at 2:11 am

Are u taking syntriod? I went paleo n my tsh went from 2.7 – 7.1 n my cholestrol went up 2!! Dnt kno if this diet works for me…plz help

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Michelle Dill April 20, 2013 at 1:00 pm

Following…

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Michelle April 20, 2013 at 2:13 pm

…let me also add, as I am hypo with low Vit D and B12 (taking supplements) and ask to get my cholesterol rechecks asap as a result of this article:

Researchers concluded that hypothyroidism is a cause of hyperhomocysteinenemia and that it is treatable. For Homosysteine to synthesize, B12 and Folic Acid are required or it accumulats within the body. In cases of B12 and/or Folic Acid deficiencies (and am B12 deficient despite 16 months Paleo with plenty of meat), homocysteine accumulates in the body. This is toxic to the cardiovascular and nervous systems. Homocysteine has been proven to increae the risk of heart disease and increase the levels of LDL.

In summary, have your B12 and Folic Acid levels checked. I just happened to ask my dr to do labs to recheck my Vit D. (5000IU/day and still only at 43) since I’ve changed my diet to Paleo. She checked B12 and viola, it was normal but low. For anyone on thyroid medicine, I read that you want B12 to be in the highest range.

So much to learn and try to balance out, and I’m still on my way. Really nervous now to get my cholesterol checked.

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MCM May 21, 2013 at 9:24 am

I have Hashimoto’s (an autoimmune thyroid disease that is hereditary) as well as hereditary high cholesterol levels. My endo tells me that there is a high co-morbidity with Hashi’s and genetically high cholesterol. I cannot tolerate statins (the pain was so unbearable that they had me off of it in 4 weeks. My body did not like statins at all). I was then placed on a 30 year old drug called WelChol and it provided the same exact benefits as a statin without any of the side effects. (Not to mention that without a copay, the drug is only $30! versus the $150+ for a statin. Ridiculous.)

For the posts referencing B12 deficiencies, this is common among those with thyroid dysfunction. Be sure to get properly checked for pernicious anemia, which is the body’s inability to absorb B-12. Supplements won’t work – because your body won’t absorb it, so all you get is expensive urine. The best way is to get a B-12 shot monthly or if you don’t have insurance, try a sublingual B-12 under the tongue. The latter isn’t as effective but it helps. Pernicious anemia is also hereditary and has a high co-morbidity with Hashi’s.

Unfortunately, since then, I’ve lost my health insurance and would love to know what can I do to reduce my cholesterol levels due to an over-achieving liver? For the most part, I’ve always followed a Paleo diet. I keep a well balanced diet high in fiber. But would love to know what can be done to limit the damage being done for something that cannot be controlled by diet alone (it just keeps the condition for being worse).

Thanks.

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Alison Golden May 30, 2013 at 1:43 pm

I would check out Chris Kresser, http://chriskresser.com. He has done LOT of work on cholesterol.
Alison Golden recently posted..Paleo Recipes: Italian-Style Peppers with CapersMy Profile

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Mirian June 7, 2013 at 8:32 pm

I feel like your twin. I am experiencing the same thing you are, too. I am 50-years old, active, eat well but tested very high for LDL. But my HDL went up, too. She said that the HDL is not enough to buffer the skyrocketing LDL. I am in Canada and the medical system pays for a generic cholesterol test every 9 months.

I will have to pay out of pocket for the VAP test and don’t know if we have such a text and I will have to pay out of pocket for a CT scan.

Have you adjusted your paleo menu? I don’t know what GAP is but are following that?

Thanks for giving us your progress. This is very helpful.

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Martin June 16, 2013 at 6:01 am

Single serving of 20-50g of brasil nuts increases HDL and reduces LDL for up to 30 days
http://www.hindawi.com/journals/jnume/2013/653185/
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John Wagoner June 21, 2013 at 6:43 am

Hi:
If you take the time to study what the critics of the Lipid Hypothesis of Heart Disease have to say , you may come to the conclusion as I have that worrying about your serum cholesterol level is pure nonsense.
Cholesterol is not toxic wast! If you don’t supplement with dietary cholesterol such as butter, then your liver makes up for the deficiency. Your brain is twenty percent cholesterol. You can’t make a sex hormone without it ! All your cell walls are made rigid with cholesterol. People who have lowered cholesterol with drugs have higher rates of cancer, dementia of all types, and fatal infections.
LDL cholesterol is a major part of your immune system. Your liver may raise your cholesterol as a response to infections.
The only group of people who have been shown to be helped by Statin drugs are young men who have already have had a heart attack before the age of 55. This represents 5 percent of heart attack victims. It is pure speculation that any of the slight benefits seen in these trials ( an absolute reduction risk of 1 per cent ) are applicable to healthy people. There are many other benefits of Statin drugs, such as anti inflammatory, etc, . Benefits that can be obtained with natural compounds that don’t poison your liver’s ability to make cholesterol. Any benefits of Statins cannot be attributed just to cholesterol lowering because of these pleiotropic results.
I mention several good books on this subject in the last part of my review of the book The Truth About Statins as seen on Amazon. If you really want to know how mainstream medicine has come to their position on cholesterol and how off base it is, plow through Anthony Colpo’s book The Great Cholesterol Con.

I know these statements sound crazy, but remember the proponents of the theory of continental drift put forth their evidence in 1910 and were dismissed and ridiculed for fifty years. Now we measure the drift of continents on a yearly basis, and the original evidence is now accepted as fact. At least give the alternative viewpoint a hearing, so you will have informed consent.

Cheers

John Wagoner

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Glenna June 21, 2013 at 7:13 am

Amen!

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Dana June 25, 2013 at 11:32 am

I pretty much avoid Paul Jaminet. I have heard from enough people who saw their thyroid activity *improve* on lower carbs that I no longer take anyone seriously who can’t let go of the idea that we somehow can’t live without carbs. There’s a point past which one ceases to subscribe to science because they have been bankrupted by dogma.

If someone does all their due diligence, the labs come back and some thyroid hormone’s off, they’ve cleaned up their diet and they make sure they are getting enough selenium and tyrosine (I think it is?) and iodine, and they don’t have any other hormones out of balance (as far as that can be tested), and they want to experiment with increasing non-grain-based starch carbs then OK, but unfortunately what’s going to happen with Jaminet’s position on this is that people will just go straight to upping the carbs without doing that due diligence. And given the damage that ingested glucose does to the body, even when you’re not fat, I think that is a sad state of affairs.

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Dr Bruce White PhD November 23, 2013 at 3:30 pm

I too was diagnosed with high bad cholesterol. I couldn’t believe it! I did heaps of exercise and ate good foods (at least I thought that I was eating healthy foods). But I quickly changed my diet and successfully lowered my bad cholesterol in only 12 weeks. It was great to do this naturally.

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Boykin December 18, 2013 at 5:16 pm

I eat a Perfect Health Diet version of Paleo and have great blood work except for LDL. After reading Kresser, Masterjohn, Jaminet, etc. I upped iodine from 325mcg to 975mcg of iodine daily and it seems to have lowered my Ldl-c from 225 to 180. I will titrate the dosage to 1.5mg and retest in a few months.

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Drew January 8, 2014 at 11:13 am

Here’s a great podcast that explains very well what tests really matter:

http://www.askthelowcarbexperts.com/2012/10/29-dr-thomas-dayspring-cholesterol-testing-what-matters-most/

It definitely sheds light on cholesterol testing.

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Melinda January 14, 2014 at 4:35 pm

I read your post…but I haven’t read through the years of comments. I have celiac and psoriasis and recently (like yesterday) started a Paleo challenge with friends from work. Going gluten free made amazing changes in how I feel, but I have continued to struggle with my weight and fatigue. We’ve tested Vitamin D-which was deficient, but is now corrected. We have tested my thyroid multiple times, with no unusual numbers. My LDL levels are high, but my HDL and triglycerides are excellent. I was hoping to understand if you LDL levels have leveled off with the addition of Selenium and Iodine. One of the quotes you shared stated “increase good carbs”. What are those? Thanks for all the info!

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Alison Golden January 22, 2014 at 3:55 pm

Melinda, good carbs are those such as starchy root vegetables, maybe fruit if you can manage them (I can’t), and of course, green veggies. You can read more about thyroid and food from this post: http://paleononpaleo.com/thyroid-heal/
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lana January 26, 2014 at 3:47 pm

Very interesting. I have experienced good health all my life with some teenage anemia, middle-age fatigue and aching joints, and now that I have been grain free for twenty years and full paleo for two years, my cholesterol numbers are similar to yours. Results arrived at my doc’s office and then filed. I made an appt 5 months later and then (THEN!!) learned the results. He suggests a heart scan, but I would like to know the current numbers. You don’t tell the end of you story and what brought your numbers to normal. Is this because you would suggest we all pursue our own path? I get that, I’m just so surprised at this health scare. I’m twenty years older than you, but am often told I seem decades younger. Anything more to add to your story?

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April February 21, 2014 at 12:21 pm

Respecting everyone’s opinion I’ll say this: I have HASHI’S/CELIAC. All grains including oatmeal were lethal to me. My chronic low level of Vitamin D contributed to the gut health/thyroid problem. I switched to paleo about 1 year ago and just recently the autoimmune paleo protocol. My only concerns are cholesterol (comma not working) calcium/D ratio and definitely staying the heck away from radiation. YES!!! Even low doses (cell phones etc.) over time will kill it. Most people don’t care until there’s is dying then it’s too late. I told my dentist if he didn’t get a neck collar I was leaving. He got one!!

Most doctors downplay any damage that can be done to this organ because they can always medicate you. And good luck when you try to find a Natural Thyroid Medication and the doctor won’t prescribe it because ????. Big Pharma I guess. Anyway I’m on my 6th endocrinologist with my 7th lined up….just in case he refuses to listen. I have done my homework….your thyroid affects everything. Your heart beats slower your stomach acid is low…YADA..YADA..you get the point. But please…limit your radiation exposure…it may save your life.

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Lisa S March 7, 2014 at 1:21 pm

Your story sounds much the same as mine. I refused to take Statins for years even though they were telling me that my cholesterol was high, along with triglycerides. I got the Triglycerides down with fish oil daily. I am 49 and they have told me this for over 10 years now. I had all of the workups and nothing was found wrong with my heart as far as plaque or anything else. I started Paleo last October, so I am anxious to see if it changes, but after reading your story it may not. I am on a list to see a Dr who specializes in the endocrine system (GP). I have low thyroid and am taking the Levothyroxine daily and feel much better. The Paleo plan has helped me to stop taking arthritis medicine and reduce the prilosec to 1x a day. I am hoping to eventually be off of the prilosec. I never feel bloated anymore. Thanks for sharing your story!

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alyr April 20, 2014 at 11:47 am

My simple (female gender) story is at age 40 I had a routine screening. “HUGE CHOLESTEROL PROBLEM, STATINS!”. I told my doc he was crazy and no way. I even accused him of mixing up the vials because a guy around 400 lbs had his bloods drawn right next to mine.

I had previously lost 40 lbs eating paleo even though I never heard that term. I blew it off as my body adjusting itself or whatever but I was NOT about to start drugs. I think I did fish oil and some red rice caps for about a year but lost interest.

That was 15 years ago so draw your own conclusions. I own a dog walking business and am very active.

LOL he ALSO told me I had to start BP drugs because in fact, my readings were high the two times I went. WHY? Because I came running in the office after an hour commute and threw myself in the chair without getting resting reading and the tech never said a word.

I purchased my own machine and for the next 60 days I was totally on the low end of normal!

I have a history of taking synthroid in my early 20′s so perhaps I’ll go get the thyroid panel and another cholesterol series since I’m a masochist.

I wish they’d spend as much energy in preventing hot flashes for 10 years. Can’t be a healthy thing. If it were men having them, I’m quite sure there’d be a miracle “cure”. ;)

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Clare Woodman June 3, 2014 at 2:25 pm

I would love to subscribe to this blog but am having trouble locating the subscribe button, any help would be appreciated :)

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Deb July 10, 2014 at 4:55 pm

Same here- I can’t locate a box in which to subscribe. Thanks.

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Alison Golden July 21, 2014 at 7:31 pm

Deb, there is a box in the sidebar in which to subscribe or you can go here: http://paleononpaleo.com/sign-up-to-receive-the-ten-tragic-mistakes-report/.

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Sue F. June 5, 2014 at 11:05 pm

Alison – I was reading your site after googling paleo and cholesterol and so it came up. I got really interested when you mentioned interstitial cystitis because that is what I have (a mild to moderate case for over 40 years )I also have some joint and tendon aches. I decided to try paleomoms autoimmune protocol but I am concerned that my slightly high LDL will go up. I’m going to try it about 6 to 8 weeks because yikes, it is so strict. Well, I would like to know how your IC is and what have you found that are triggers for it. I am not like many who cannot eat any tomato or chocolate because I can, but I have given them up for this diet to see if my joint pains are related to leaky gut. After 2 months I will have my cholesterol tested. I’m keeping my fingers crossed that all my ailments improve but not at the expense of higher LDL.

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Alison Golden July 21, 2014 at 7:37 pm

B6 triggers it, Sue. I avoid B6 or take copious amounts of B1 and 2 to offset it. Good luck!
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Caroline July 17, 2014 at 3:07 pm

The only source of cholesterol outside of what your body produces is animal products. I am 48, a Cross Fitter, healthy, and I too tried paleo and saw my cholesterol steadily increase. All I had to do was cut down on all animal products (I do a weekday vegan plan) and within 2 months my cholesterol went from 200 to 174. As my body ages I believe it produces more than enough cholesterol on its own. I find that’s it’s not necessary to eat animal at every meal. I’ll never be 100% vegan but my body certainly doesn’t need eggs and bacon for breakfast, turkey at lunch and steak for dinner. I have plenty of energy to get through my workouts and I do t have a food hangover after meals from the effort it takes to digest so much protein. Moderation has been the key for me.

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