Sunday, November 11, 2018

New Cholesterol Guidelines 2018- What is an Artherogenic diet and more important, what is MY risk, whatever works!

If you don't read my whole post, read this tweet thread
(I'll repost with screenshots if the emedding doesn't work)

*Edited to update TG/HDLc ratio- (correcting ratio)
**Edited to update pattern A (outdated biomarker, but still on my lab work)

Where I stand as an interested party in cholesterol guidelines

My History, so I can assess my own risk. 

My opinion: YO! Dudes and Dudettes, risk assessment will help with decision making. And, I can ask or pay a small amount for a second opinion to top experts, with the most current info and are used to seeing people like me.

If you are accessing your own risk, then making risk based decisions = You are winning at life.

The details: long story

Before 2012
A. Perfect lipid panels while obese-

  •  40 years of obesity and yo-yo dieting. 
  • 20 years of WW style low fat dieting,
  • f requent and painful binge eating sessions
  • Nearly diagnosed type 2 diabetes (corrected by diet and fasting before diagnosis),
  •  borderline high blood pressure, 
  •  had to get off birth control pills to bring down blood pressure, still higher 
  •  Hashimotos disease at age 31. 
  •  My hs-CRP was 6.8. 
  • My HA1c was 5.7
  • My fasting glucose was 90-100's
  • BMI was 35!!!! 
  • Massive joint pain
  • Frequent migraines to the point I missed work and travel.

DANG, the visceral fat tells a story
May 2011, perfect lipid panels!

B. SNP's: I have that 23NMe report with Promethease , so I don't shy away,

Genetics that code for

  • multiple SNP's for childhood and adult obesity
  • multiple SNP's 2 diabetes,  
  • joint pain with statins, 
  • poor outcomes on statins, aka- likely not effective
  •  low cardiac risk, no family cardiac history, 
  • one grandparent with stroke and high blood pressure. 
  • Some funky gene SNP's that lend them selves to good outcomes with 16:8 fasting.

Now, I have to figure out what to do: Meds or No cholesterol Meds? LCHF? Fasting or no?

As most of you know, I'm a cholesterol hyper responder. Three of my cholesterol values run higher when I fast and when I eat Low Carb and fast 16:8

So I run high
1. Total Cholesterol
2. LDL
3. HDL

While my other bio markers are low and have gone lower or favorable.

4. low Triglycerides
5. favorable TG/HDLc ratio *
6. low Fasting glucose
7. low HA1c
8. low BMI
9. low Resting heart rate
10. normal Blood pressure
11. clothing size 6, petite
12  Joint pain super low, no ibuprofen in a year
13. No migraines after a 30 year history
14. Little or no binge urges after binging 40 years
15. 0% coronary calcium scores
16. Normal carotid medial thickness and vascular screening
17.  **Pattern A Lipporotein
18. Normal Lp (a)

October 2018, loving low visceral fat life

No one can assess risk except you ,with your doctor's help and some second opinions and biomarkers and imagining tests. 

  • statins, no statins
  • low carb, low fat
  • abstain from sugars & grains, moderate all foods
  • migraines (no meds) or eat migraine triggering food (cover with meds)
  • skinny jeans vs XL stretchy pants

Hmmmm.  That's my N=1. Do your own. It costs me $130 a doctors office visit. Can you imagine my personal finance situation if I had stayed obese? Not to mention the many prescriptions I escape. I can cover my thyroid meds easily- I would have been on 5-10 other meds had I not changed up my situation.

Good risk based decisions means health outcomes I can live with , day in day out. 

Onward and here's to using good tools, new reference ranges, and getting second opinions as needed.

Time go get comfortable with personal risk assessment, decision making, and life in general. I can await and donate for new cholesterol reference ranges. I'm sitting on weight maintenance island. Waiting with and for others.


  1. Karen, like you my cholesterol runs a little higher. But I am not yet taking statins, and my doctor has not recommended them for me. I do think I want to get tested again once I reach my final goal weight. (I have new goal weight after maintaining higher for these few years.) I want to be at about a 22 BMI. Some say BMI does not matter, but I just saw a study that says those with lower BMIs have fewer health risks. So I'm waiting to get my cholesterol tested. I do take bp medication and have for many years. I know many people can come off their bp meds once they lose weight. That has not been my case though.

    1. Hi Ali, thanks for stopping by. Yes, I've had a lot of good data over the years, since my employer has been testing me for 10 years now. LOL. I passed 5 out of 5 health parameters for my insurance discount, so that is something. :)

      I agree, getting to a lower BMI (closer mid) Best wishes with your goals. If I ever get high BP again, I would definitely take meds to lower. As far as statins, so far, so good without them. Of course I could change my mind.

      I'm fasting a little less, weighing slightly more, but also doing well- no colds, flu (had my shot), and good temperature control. so there's that! Take care.

  2. My cholesterol also runs on the high side. I also know that when I’m eating eighth and at a lower weight that I’m right at a healthy level. So for me no meds...just trying to clean up my diet and weight!!!

  3. Yes! Funny thing is I looked completely "normal" when morbidly obese, and "abnoral" when a normal weight. It caused me to reevaluate what I considered to be important for biomarkers. I'd rathrer have high total cholesterol and super low inflammatory markers than the other way around.. best wishes.