Since there is such a large pool of knowledge in this place I thought maybe someone would have heard something about a situation like this . . . or at least have some encouraging words for me!

I'm a 23 year old, healthy weight girl. In September of '04 I tried this cyclical ketogenic diet (low carb, www.c-k-d.com) to try and lose fat; this was before I had ever even discovered John Stone's site . . . I went in for my first physical in 2 or 3 years and part of that was getting my blood cholesterol tested after a 12 hour fast. I woke up the morning to get it tested after five days on 18 or less carbs, and got the results back - that my cholesterol was 350 (if anyone doesn't know, it's supposed to be under 150)!!! My doctor also happens to be my aunt-in-law and she called me very concerned. I immediately cut out all egg yolks, cheese, and everything low carb diets have in them that are supposed to be healthy and said goodbye to low carb forever. I do have to say that I felt absolutely miserable on that diet but I also happened to be stubborn and was doing it anyway because I wanted to lose fat that bad and thought that was a good way to do it.

However, she says she's never seen anyone go down to a normal cholesterol level from that high by diet alone, which is not a very encouraging thing to say. Last night we had a family party and I sat across from her and she brought it up again. Since that day in Sep or Oct, I have eaten oatmeal every day, only eggbeaters instead of eggs, supplemented with fish and flax oil, upped my fiber to at least 30 grams a day, and don't have cheat meals laden with cholesterol anymore. I have also gotten my period back, which had disappeared for several months (I have a history of losing my period for long spans of time). One of my alternative-medicine loving friends told me that a lack of a regular period is linked to high cholesterol, and after taking a natural progesterone cream topically twice a day for two weeks at a time, my period came back so it has now been three months of regularly getting one.

All this to say: with my period back, a new healthy, permanent diet in place (I eat no more than 40 grams of healthy fat per day now), my new fitness plan on track (working out in some form half an hour every single day), and a positive attitude in place, does anyone agree with me that when I go get tested in March my cholesterol will be a much healthier number? I would appreciate some encouragement, since my doctor seems to be pretty dismal, and I really don't want to start taking cholesterol meds at 23 when.

Thanks!

What was your HDL/LDL -ratio? It appears to tell more of your health than the absolute amount of cholesterol.

What was your HDL/LDL -ratio? It appears to tell more of your health than the absolute amount of cholesterol.

Can't remember exactly what it was; I did ask that at the time and remember my HDL or LDL, whatever the good one is, was good, but the bad one was way too high.

If your high cholesterol was caused by 1) being out of shape and 2) bad diet then yes, in theory, diet and exercize should get you back in line. If it has not gone down at all since last September, your doctor can do further exams to see if you have a different condition that can lead to higher cholesterol regardless of diet and activity.

I posted this a while back, I had a physical after three years, The results:



Test 3 yrs ago: Today:

Total Cholesterol 239 162
HDL 36 43
LDL 166 126
Triglycerides 177 55!

Everything else normal.

Chances are good that your tests will be better come march. You're young, you're eating better and exercising, but you may also have a predisposition to having high cholesterol. That being the case, if your cholesterol is still high AT ALL, ask your doctor about going on a statin.

Yeah 350 sounds a little bit high to be the result of just diet. I'm sure since you've been eating healthy it will go down to some extent, hopefully about 200 mg/dl, but unlikely that much. It could just be familial. Getting that checked as a 23 year old is damn good though. I'm 22 and I have no idea what mine is....hmmmmmmm.

The only thing I might suggest is 1000mg of niacin a day. 500 in morning and 500 at night before meals. Not the no-flush kind or naicidmide, they aren't any good. After a month, you could be back to normal with diet change. BTW: it would be interesting to find out, where you were on last blood test before diet change.

If you're at a healthy weight, why were you on a weight-loss diet?

At a fasted cholesterol level as high as 350, and you being only 23, I'm going to guess that you have a genetic defect in your cholesterol metabolism system. Even if your HDL were super excellent, even in the 90s, your LDL would still be at least 250, and that's way too high. Most very obese pizza guzzling middle aged men aren't that high that I've seen.

If that is the case - rtestes is on the money - niacin is a good natural cholesterol lowering agent. It has lots of side effects, though, and some people simply can't tolerate it. Your doctor will know about niacin.

You may have to take prescribed cholesterol medications to lower your risk for early heart disease and strokes. Even so, diet is very key - avoid saturated fat! Most people don't lower their cholesterol much on diet alone because most people don't have the committment to eat healthy and try to avoid all cholesterol... but our livers produce about 4X as much cholesterol every day as we take in on average... exceptions being people sucking down tons. Despite the new gov't regulations (which still limits dietary cholesterol to 300mg, or about one egg yolk) - it is well known that saturated fat has more of an influence on our cholesterol levels than how much cholesterol we eat.

However - blood tests aren't infallable. It could be a laboratory mistake. I'll keep my fingers crossed that it is!

Bisous

As the previous posters have said, the inclusion of exercise and improved nutrition should make a significant modification in your cholesterol score. Let us know how you do and remember to stay positive and encouraged. :tu:

By the way, in the last few months have you noticed a "physical" change? Have you lost weight/bodyfat, has your muscle tone improved, etc?

- Skip :)

Your doctor probably hasn't seen many people make dramatic improvements in their health with diets because so many people do a) stupid diets b) don't follow them well anyway and/or quit and/or fail / give up on them. So of course they don't see the results!

If you actually are on a healthy diet and stick to it, you should see dramatic improvements in your over health "Benchmarks"

Your doctor will say "Wow that is amazing I've never seen someone make such a substantial improvement in their numbers without drugs!" -- because Doctors today are tunnel vision focused on pharmaceuticals as the first, last, and best strategy for dealing with ANY ailment. Drugs Drugs Drugs.

-Allen

Thanks guys for backing me up. I am totally set on proving my doctor wrong, and then using my story to motivate other people. To answer the question about any physical changes in the last few months, Yes, I have definitely noticed a change in the feel and shape of my muscles, and my cellulite/sagginess around my hips are slowly smoothing out. It's slow but it feels more comfortable that way.

More noticeable than that (and what makes me really believe my cholesterol will change) is that I feel great "overall." I have a lot of energy and feel optimistic about reaching my goals.

I originally found this site by asking my husband to find journals on the web where "real" people shared their journey to losing fat while not necessarily losing weight or being unhealthy (I was tired of low calorie diets and 4 hour-a-day-workout fitness professionals' journals, which were the only online journals I could find), and he found JohnStone. Because he found it himself and saw the change in John he's now eating healthier and working out more. It wouldn't have changed him if I had nagged him myself. It sounds so "testimonial" but it's totally true!

Another month and a half or so till I find out my test results, and then I'll let you all know. Thanks again for your encouragement.

Cholesterol is an integral part of your overall metabolism. It makes up 50% of the dry weight of cell membranes, and is the foundation molecule for most of the important sex and anabolic (endogenous) molecules. It is essential.

That said, when your cholesterol level is too high, many many problems arise.
If smoking status and cholesterol profile are taken together, they predict 90% of heart attacks. Yes, that much.

In my home country, Northern Ireland (one of the top 3 countries in the world for coronary heart disease along with Finland and Scotland), the average total cholesterol is 6 mmol/l (231 mg/dl), whilst healthy should be below 5 (193 mg/dl).
Whilst the HDL/LDL ratio is important, emphasis should be placed on lowering LDL, rather than increasing HDL, as HDL levels, even at their very best only seem to get up to about 1.5 mmol/l (58 mg/dl). Generally, HDL levels increase with exercise, so exercise is cardioprotective in a biochemical way, not just in a general fitness manner.

However, she says she's never seen anyone go down to a normal cholesterol level from that high by diet alone, which is not a very encouraging thing to say.
Diet is important, but it only contributes so much to your total cholesterol. Someone not obese, with a high cholesterol can reasonably expect to decrease their cholesterol by 10-20% through diet alone. With obesity, cholesterol increases, so dropping weight will reduce your cholesterol over and above that 10-20%. Encouraging or not, it's the truth sadly.

Your doctor probably hasn't seen many people make dramatic improvements in their health with diets because so many people do a) stupid diets b) don't follow them well anyway and/or quit and/or fail / give up on them. So of course they don't see the results!

If you actually are on a healthy diet and stick to it, you should see dramatic improvements in your over health "Benchmarks"

Your doctor will say "Wow that is amazing I've never seen someone make such a substantial improvement in their numbers without drugs!" -- because Doctors today are tunnel vision focused on pharmaceuticals as the first, last, and best strategy for dealing with ANY ailment. Drugs Drugs Drugs.

-Allen
Cholesterol is manufactured in your liver, and the rate at which it is produced is the most important factor in the setting of your personal cholesterol level. Diet can give you 'substantial improvements' in your cholesterol, but frequently, that's not the case. A healthy lifestyle is hard for many to follow, and often, you have to cater for, and treat to the lowest common denominator. If your cholesterol is very high and you are obese, that greater than 10-20% will be a big number reduction, but will still not get you down to an acceptable figure.

There have been many studies into the effects of statin drugs (the commonest family of drugs used to reduce cholesterol). The numbers in each study are very large, so the total number of studied patients is easily in excess of 1 million. No study to date has shown anything but a benefit in decreasing your cholesterol. No study has shown that reducing your cholesterol to extremely low levels is harmful. The general message from all of these studies taken as a whole is basically lower is better.

What many people forget is that atherosclerosis, the arterial disease caused by elevated cholesterol levels, is NOT a disease of the eldery. Atherosclerotic changes have been found in the fetus, and in one study ( "A Comparison of Coronary and Internal Mammary Arteries and Implications of the Results in the Etiology of Atherosclerosis" F. Simms American Heart Journal 105; 560-6, 1983) when autopsy specimens of patients dying of other causes (mostly injury and war) were examined, ALL patients from the age of 3 upwards had evidence of coronary arterial disease.

Age is immaterial. If your cholesterol is raised, you need it lowered.


does anyone agree with me that when I go get tested in March my cholesterol will be a much healthier number?

Yes, whole-heartedly.
However, don't be surprised if your numbers are still too high.

There are a number of genetic conditions where your cholesterol level is markedly elevated. People can have either 1 or 2 copies of the gene. With one copy, the cholesterol is typically around 10mmol/l (386 mg/dl), and you get heart disease earlier than normal. With 2 copies of the gene, most people will have had their first heart attack BEFORE THEIR 20TH BIRTHDAY.
I'm not suggesting you need genetic investigation, only that a person's cholesterol is a product of their heritage and their environment. You can't escape your heritage however, only modify your environment.

On a personal note, my dad had a stent placed in one of his coronory arteries last year, he was 56 at the time. At the time of his procedure, his cholesterol was 3.3 mmol/l (127 mg/dl), and he was commenced on a statin. I am a cardiac surgeon, my sister is a cardiologist; we were both very very happy to see him being placed on a statin. As I said above, lower is better, no matter what the level to begin with.

I was at a guest lecture in my university recently, concerning cholesterol and coronary disease. No figures were mentioned by the guest speaker (as it isn't published yet) but he strongly hinted that his group (in Glasgow and the US somewhere) had results concerning lowering the cholesterol to about 50 mg/dl (1.3 mmol/l), with continued benefits, and no additional side-effects.

My advice to you would be:-

1 Continue with your healthy diet
2 Go to the doctor, and please take her advice.
3 If that means tablets for life, well, isn't that better than a shortened life?

Andrew.

Cholesterol is an integral part of your overall metabolism. It makes up 50% of the dry weight of cell membranes, and is the foundation molecule for most of the important sex and anabolic (endogenous) molecules. It is essential.

That said, when your cholesterol level is too high, many many problems arise.
If smoking status and cholesterol profile are taken together, they predict 90% of heart attacks. Yes, that much.

In my home country, Northern Ireland (one of the top 3 countries in the world for coronary heart disease along with Finland and Scotland), the average total cholesterol is 6 mmol/l (231 mg/dl), whilst healthy should be below 5 (193 mg/dl).
Whilst the HDL/LDL ratio is important, emphasis should be placed on lowering LDL, rather than increasing HDL, as HDL levels, even at their very best only seem to get up to about 1.5 mmol/l (58 mg/dl). Generally, HDL levels increase with exercise, so exercise is cardioprotective in a biochemical way, not just in a general fitness manner.


Diet is important, but it only contributes so much to your total cholesterol. Someone not obese, with a high cholesterol can reasonably expect to decrease their cholesterol by 10-20% through diet alone. With obesity, cholesterol increases, so dropping weight will reduce your cholesterol over and above that 10-20%. Encouraging or not, it's the truth sadly.


Cholesterol is manufactured in your liver, and the rate at which it is produced is the most important factor in the setting of your personal cholesterol level. Diet can give you 'substantial improvements' in your cholesterol, but frequently, that's not the case. A healthy lifestyle is hard for many to follow, and often, you have to cater for, and treat to the lowest common denominator. If your cholesterol is very high and you are obese, that greater than 10-20% will be a big number reduction, but will still not get you down to an acceptable figure.

There have been many studies into the effects of statin drugs (the commonest family of drugs used to reduce cholesterol). The numbers in each study are very large, so the total number of studied patients is easily in excess of 1 million. No study to date has shown anything but a benefit in decreasing your cholesterol. No study has shown that reducing your cholesterol to extremely low levels is harmful. The general message from all of these studies taken as a whole is basically lower is better.

What many people forget is that atherosclerosis, the arterial disease caused by elevated cholesterol levels, is NOT a disease of the eldery. Atherosclerotic changes have been found in the fetus, and in one study ( "A Comparison of Coronary and Internal Mammary Arteries and Implications of the Results in the Etiology of Atherosclerosis" F. Simms American Heart Journal 105; 560-6, 1983) when autopsy specimens of patients dying of other causes (mostly injury and war) were examined, ALL patients from the age of 3 upwards had evidence of coronary arterial disease.

Age is immaterial. If your cholesterol is raised, you need it lowered.


Yes, whole-heartedly.
However, don't be surprised if your numbers are still too high.

There are a number of genetic conditions where your cholesterol level is markedly elevated. People can have either 1 or 2 copies of the gene. With one copy, the cholesterol is typically around 10mmol/l (386 mg/dl), and you get heart disease earlier than normal. With 2 copies of the gene, most people will have had their first heart attack BEFORE THEIR 20TH BIRTHDAY.
I'm not suggesting you need genetic investigation, only that a person's cholesterol is a product of their heritage and their environment. You can't escape your heritage however, only modify your environment.

On a personal note, my dad had a stent placed in one of his coronory arteries last year, he was 56 at the time. At the time of his procedure, his cholesterol was 3.3 mmol/l (127 mg/dl), and he was commenced on a statin. I am a cardiac surgeon, my sister is a cardiologist; we were both very very happy to see him being placed on a statin. As I said above, lower is better, no matter what the level to begin with.

I was at a guest lecture in my university recently, concerning cholesterol and coronary disease. No figures were mentioned by the guest speaker (as it isn't published yet) but he strongly hinted that his group (in Glasgow and the US somewhere) had results concerning lowering the cholesterol to about 50 mg/dl (1.3 mmol/l), with continued benefits, and no additional side-effects.

My advice to you would be:-

1 Continue with your healthy diet
2 Go to the doctor, and please take her advice.
3 If that means tablets for life, well, isn't that better than a shortened life?

Andrew.

Andrew - excellent post.

As a dietitian in the US, the latest guidelines revised this summer mirror most of your post. The Adult Treatment Panel (ATP) III has made some recommendations that some individuals would be better served by lowering LDL cholesterol to less than 70 mg/dl.

When I completed my training 8 years ago I was a firm believer that diet and exercise could help many people with high cholesterol. With the newer guidelines in 2001 and the revision in 2004 statins are becoming a bigger cornerstone of patient care.

I was curious if the guest speaker you had mentioned stessed the goal was for LDL or total cholesterol to be below 50 mg/dl.

On another note for the original poster - ketogenic diets produce ketosis was which has the ability to definitely affect cholesterol. The high amount of saturated fat and trans fat have been known to elevate cholesterol in some patients significantly. Unfortunately, the diet that are highly effective and currently popular have not been shown in long-term trials to be beneficial at lowering risk of heart disease, cancer, or diabetes.

Consider visiting a dietitian at a local hospital for guidance in a program to help lower cholesterol. However, a statin may be beneficial for someone so young since a heart healthy diet usually can only lower chol by approximately 25% of the total at best which is far from the generally recommended < 200 mg/dl total cholesterol.

Be sure to find out the total chol, HDL (healthy type), and LDL (lousy) type at the March follow-up.

As a dietitian in the US, the latest guidelines revised this summer mirror most of your post. The Adult Treatment Panel (ATP) III has made some recommendations that some individuals would be better served by lowering LDL cholesterol to less than 70 mg/dl. Whilst I agree with these levels, the fact that nearly all of the panel who refined the guidelines last year have links (mostly financial) to the involved pharmaceutical companies. (It was 11 of the 12 members if my memory serves correctly.)
The lower the better in my book (and that seems to be the general trend), but this type of association just muddies the waters. An excellent message is tainted, and so it's impact will be attenuated.
I don't know if the level was for LDL or total cholesterol, but I've a feeling it was for total.

Andrew.

Great post. Every doc has heard hundreds of patients say "Geez I better start working out/dieting" and never do. The general public has let them down in a sense.

Your doctor probably hasn't seen many people make dramatic improvements in their health with diets because so many people do a) stupid diets b) don't follow them well anyway and/or quit and/or fail / give up on them. So of course they don't see the results!

If you actually are on a healthy diet and stick to it, you should see dramatic improvements in your over health "Benchmarks"

Your doctor will say "Wow that is amazing I've never seen someone make such a substantial improvement in their numbers without drugs!" -- because Doctors today are tunnel vision focused on pharmaceuticals as the first, last, and best strategy for dealing with ANY ailment. Drugs Drugs Drugs.

-Allen

Well, I am not sure if you know this, but a reading of 350 is INSANELY high for somebody her age. I don't care if she is eating McDonald's 3 times per day....there is just no way that her cholesterol should be that high. I would guess that she is probably genetically pre-disposed to it....and, not to be discouraging, but I will also guess that she won't be able to bring it to acceptable levels with just diet and exercise alone.

Definately give it a try, but if it isn't under 200 within 6 months, the doctor will probably put her on a statin which she will most likely take for the rest of her life.

A few years ago, my own cholesterol was measured at 323. The doctor couldn't believe it because I was only 28 at the time. That scared me, and I spent the next several months eating almost no saturated fat, eating lots of omega-3's, exercising like mad, losing weight etc....and the best i could do was a reading of 242...still too high. Turns out that I have a genetic pre-disposition for it....and given her numbers, I would bet that she does too.

Your doctor probably hasn't seen many people make dramatic improvements in their health with diets because so many people do a) stupid diets b) don't follow them well anyway and/or quit and/or fail / give up on them. So of course they don't see the results!

If you actually are on a healthy diet and stick to it, you should see dramatic improvements in your over health "Benchmarks"

Your doctor will say "Wow that is amazing I've never seen someone make such a substantial improvement in their numbers without drugs!" -- because Doctors today are tunnel vision focused on pharmaceuticals as the first, last, and best strategy for dealing with ANY ailment. Drugs Drugs Drugs.

-Allen

One other thing I thought I'd mention -- Next time you get blood tests, you might ask the doctor to measure your TSH levels. If TSH is elevated, it would mean that your thyroid is underactive, which can seriously elevate cholesterol levels. Underactive thyroid isn't terribly uncommon in women.

I had a female friend with very high cholesterol ... turns out she had underactive thyroid. Once she was put on medication, her cholesterol dropped pretty dramatically.

Well, I am not sure if you know this, but a reading of 350 is INSANELY high for somebody her age. I don't care if she is eating McDonald's 3 times per day....there is just no way that her cholesterol should be that high. I would guess that she is probably genetically pre-disposed to it....and, not to be discouraging, but I will also guess that she won't be able to bring it to acceptable levels with just diet and exercise alone.

Definately give it a try, but if it isn't under 200 within 6 months, the doctor will probably put her on a statin which she will most likely take for the rest of her life.

A few years ago, my own cholesterol was measured at 323. The doctor couldn't believe it because I was only 28 at the time. That scared me, and I spent the next several months eating almost no saturated fat, eating lots of omega-3's, exercising like mad, losing weight etc....and the best i could do was a reading of 242...still too high. Turns out that I have a genetic pre-disposition for it....and given her numbers, I would bet that she does too.

My general rule with doctors are:

* have one, an internist, stick with him til you die or he does.

*Don't expect any doctor or nurse to know much about two subjects, nutrition and sex.

*Ask questions, get yearly phyicals.

inprogress,

There are so many good informed posts above and I know much less aobut this than the other posters in general but I want to share hopeful thoughts.

I am a 41 year old male. My father has had high cholesterol for longer than I can remember and suggested that I should get checked for that, since it is partly genetic. In fact he sent me a cholesterol test, the kind I could do myself by piercing a finger tip, letting a drop of blood drip into a little device, looking at a colour change and reading a table...

Anyway, I took the test and was quite worried before doing it, nobody needs high cholesterol. There are other health problems running in the family already... I won't go into details, but I was not at peace waiting for the result...

My reading was in fact below the lowest value on the table. I can't remember what that was but let's say it was unusually low.

I swear that I was not in great shape. In fact, I was recovering from near obesity. On top of genetics, I had every reason to have high cholesterol.

Only... when I took the test, I had been on the BFFM program for a few weeks, dropping fat very quickly, and also I was eating a Flora margarine with plant sterols (not knowing if I needed them - as a kind of insurance).

Note that Flora margarine and cholesterol tests to do on your own may not be available where you live... I live in the UK, the test was sent from France.

It may be a coincidence, it could be that the test itself was not reliable, but I tend to believe that exercise and good eating CAN do a lot. I would not accept that 25% is the maximum improvement you can get, because humans constantly create new results that science can hardly keep up with. It's always a case of mind over matter and yes, sometimes it is hard but you can create your health.

"You cannot lower your cholesterol by more than 25% by just exercising and dieting" sounds to me like "you cannot qualify for the Olympic 100m sprint at over 35 years old, let alone pass the first round".

Both statements sound totally true and reasonable.

Yet Merlene Ottey gets to the Olympics at 44 years old and reaches the semi-finals. Her 8th Olympics! Now THAT is not "normal". THAT is mind over matter.

(Well Merlene is my inspiration: when I find things hard, I compare what I have to do to what she has done and suddenly "burning 5 more kilos of fat" or "adding 2.5 kilos to that barbell" sounds soooooooo easy compared to "Qualify for the Olympics, get out there in skimpy tight running gear in front of tens of thousands of people and the millions watching their TV, walk up among runners half your age (or less) - and then beat most of them to qualify for the next stage"). Mind over matter, always. And hope can't hurt.

Genetics are damn hard to beat but if you think it can be done you've taken the first step, I'd say you have already passed the first round of qualifications.

Don't beat yourself up if the next test result is higher than you expect, but on the other hand it may be much lower. If it is, remember to pat yourself on the back.

I suspect your ketogenic diet had a lot to do with it and there is a very good chance that the next result will surprise and delight you. I wish you the best with it.

Please read what Tom Venuto has to say about ketogenic diets, it is worth it I promise. It's in this newsletter:
http://www.fitren.com/res3news.cfm?newsid=35

Tom is the author of BFFM... not sure if he has to do with my seemingly low cholesterol, but I was on his program when I measured it. I certainly recommend his program wholeheartedly, bearing in mind that we are all different... it worked for me anyway (minus around 25lbs in three months, ALL of it fat - in fact I gained a bit of muscle at the same time).

I know it's very stressful to wait for results and wonder about what happens inside your own body as if you had no control. But there is hope, hope is good for you, hope helps you get better, and you can beat this. If it's even a little better next time, you will know you are moving in the right direction. Limits are there to be pushed back. I wish you all the best.

Vincent.