Replying to Avatar Sedj

Results as of 6 months on low-carb/high-fat carnivore diet

I took blood tests at 1 month in, and now at 6 months in. Prior to starting carnivore, I was being treated for slightly elevated cholesterol with a statin (Crestor - rosuvastatin), and have always also had low HDL cholesterol counts. I was narrowly pre-diabetic (A1C at or above 5.7%, at its highest, 5.9%). My weight over the past 10 years has ranged from 255lbs to 310lbs. When I started this diet (and also quit nicotine within a couple weeks), I was pretty close 310 lbs, maybe a little heavier on a bad day. I've also had my gall bladder removed, 10+ years ago.

I stopped taking Crestor several months before starting this diet.

My LDL numbers while on the statin were 83 and 73 (2021 and 2022 tests). HDL was 33/32, on those tests, and triglycerides were 132 and 161. "Total" cholesterol was 139/129. These numbers were keeping the doctors happy, and my cholesterol was "under control". I don't really want to take maintenance medications at all. I'm trying to get to a place where I don't need any medications to live without being deemed high risk for heart disease, stroke, or other internal failure. It may be a bit of a pipe dream, thanks to hereditary high blood pressure.

But the research on cholesterol is, at best, contested. The science hasn't definitively said that having a high cholesterol count causes heart attack, stroke, atherosclerosis (artery hardening), or really much of anything. It has potentially shown some specific correlations, but not causation. Most of the cholesterol scare was based on a hypothesis that didn't end up proving out in studies, but once it had legs through the US FDA and American Heart Association, it refused to die, and now we have doctors trained on old bad science.

So, my numbers a month after going carnivore. anything other than meat, eggs, and dairy was avoided almost entirely. No vegetables aside from herbs, seasonings, or medicines - and these were used rarely and minimally. Mostly because I don't cook my own meals always; part of living in an active family. Cooking in butter, ghee, lard, occasionally crappy olive oil. Not eating expensive meats, either. Mostly stuff on sale at the supermarket. Plenty of sausage, cured meats, shrimp, even sometimes corned beef or baloney. I'm not a purist, but am slowly getting better at my selectivity when it comes to which meats I put in my mouth. Right now I am still a meat whore.

Yes, numbers. 1 month after, LDL was 193, HDL was 39, Triglycerides 160, "Total Cholesterol" 265. My doctor convinced me to be prescribed Crestor again. I never filled the prescription. A1C was 5.6%, technically no longer prediabetic. Glucose at 98. BUN at 24 (twice prior number). I don't think there were any other numbers that changed significantly from past tests, and nothing the doctor was concerned about. He was definitely flipping out about the cholesterol numbers, threatening me with imminent death. Fuck that, still living, and living well!

6 months after (two days ago), LDL was 196, HDL was 39, Triglycerides 170, "Total Cholesterol" 269. Dr still threatening my with imminent death if I didn't go back on a statin. Tried to recommend some plant based margarine substitute sludge, nope. Red yeast rice? nope. It contains the same active ingredient as the statin, but in uncertain quantities. CoQ10? Funny, this one. the best way to get CoQ10 is through MEAT! Organ meat and reindeer meat are the highest, but beef is way better than pork or chicken. I don't fault him for this, he was trying to do exactly what his training told him, and what any medical standards board would expect of him.

I asked for a cholesterol particle size test in our next round of bloodwork, scheduled in 6 months. I'd even done enough research to know the name of the test from the testing service he uses. I will take that test in March. The doc told me that he didn't believe the results of that test would convince him that the cholesterol was not an imminent problem or change his desire to see my numbers reduced, but he also said that he would need to do a little research to even interpret the full results of that test - so I find that a little helpful. I will definitely be doing that research!!!

One thing I did gather from the results - my numbers did not significantly change between 1 month and 6 months. This indicates relative stability, not something running out of control. HDL is still low, but better than it ever has been. We didn't even do the A1C test, but glucose was at 95, BUN at 22, slightly less than the previous test. I want to keep an eye on that BUN number, because I care about my liver and kidney function a lot.

I think the tests were largely as expected. I will happily update with more in 6 months. Happy to answer any questions about numbers, both the ones I shared and any others you may be curious about.

One thing to consider here. The science, the research - it has been done almost exclusively on people that do NOT eat my diet. If I were eating standard American foods, even the "healthy" stuff, I would be 100% agreeing with my doctor that death is imminent and cholesterol needs to come down as soon as possible. I told my doctor this. The reality in my situation is that organs are functioning differently in response to being in ketosis, among other things, and not having to filter out all the toxins and garbage from plant foods. The walls of arteries and veins behave differently when insulin is reduced thanks to lower blood glucose. The efficiency of nutrient absorption is simply different. Having additional cholesterol in my blood does NOT necessarily mean it will create additional plaque on vascular walls. Some of this has also has to do with the particle size of that additional cholesterol.

I know that I will never return to a vegetable and sugar-heavy diet. I may have a sweet dessert occasionally, or have some sauces or other things that I know are not healthy. I may have a glass of bourbon, or worse, rum. Maybe a beer, among friends. However, I will probably never eat another bowl of pasta, rice, or salad. I doubt I will ever eat chips, crisps, fries, or most other potato foods again; if so, very sparingly or incidentally (like my mother in law makes this really good tuna casserole, and uses potato chips to "crust" the top of it. I may have a small portion, just because I really do like the taste, and out of general politeness). This is much different to me than eating a bag of chips. Yes, there are noodles as well, and that is why I would only have a very small portion, not a big bowl or mound on my plate.

Nothing in the last 6 months, including these test results, is convincing me of any need for plants in my normal diet. I don't need fiber to take a shit, or do anything else for that matter. Fiber continually scratches the walls of the intestines, making them slimy with a similar substance to what forms as part of a scab before the scab hardens. This lubricates the intestine making waste that is difficult to pass slide through easier. Well, my waste is much less than normal (normally only need to shit every 3-4 days), and is (actually thanks partially to not having a gall bladder) already more liquid and more comprised of oils and fats, so it is self-lubricating. I don't need scratched up intestines being at risk for inflammation or infection. Because of this major change, as well as differences in where digestion is actually occurring in my system when it comes to digesting meats versus plants, and where stomach acids, bile, etc. are actually concentrated, I think I am likely at far less risk for intestinal and colorectal complications, cancers, etc. I did have a prostate screening blood test and showed no markers for that.

Yes, this was a long read, but with lots of information. Please don't take my word for any of this; these are my best guesses and assumptions based on my own research, which was far from exhaustive. Do your own research, and if it directly contradicts what I am saying, let me know.

I’d focus more on Trig/HDL and fasting insulin than LDL. Try to get the Trig/HDL below 1 and get a fasting insulin test. Based on the ratio, I suspect you need more exercise and lower total calories, but maybe not because your situation is more complex due to the gallbladder removal. Maybe try reaching out to Saladino or Shawn Baker for professional carnivore insight.

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That is planning out to be my focus over the next 6 mos. My trigs aren't at an alarming rate, but I can probably do more to help reduce them. I agree I need more exercise. Not sure about total calories, but I will probably be bouncing that around a bit.

I'm dealing with some knee pain now that is making the exercise more of an issue, got my first steroid shot in my knee yesterday, and early results haven't been promising; need to see how it works out over the next couple weeks. I was told in my 20s I had some degenerative issues with the cartilage under my kneecap, and my doc now thinks this is just a progression of that issue, even though it did seem to come on suddenly a few months back and never get much better since. I expect to go a couple rounds with ortho, maybe PT. the steroid was just an easy opening option.

If Saladino or Shawn Baker are around, happy to have that conversation. I think I am battling a shitload of genetics fucked squarely on a lifetime of shitty self-care. This isn't going to fix itself overnight, and what I'm not going to do is run back to pharma for a solution. I believe there is a way through this, continual improvement, a little better every day, and a little more repairs made to past wounds.