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Suggest Treatment For High Cholesterol Levels After Following LCHF Diet

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Posted on Mon, 16 Jan 2017
Question: Followed Lchf diet after prediabetes diagnosis. Result after 6 months... fbs..4.6, hb1ac 5. Chol 3.8, ldl/chol 2.4. Weight loss 13kg. Came off statins. Continued lchf diet. After 6 months re tested. Fbs 4.6. But Chol shot up to 7.6 and ldl/chol 5.5. Doctor put me back on statins, now I'm unsure how to proceed. I 'm maintaining my weight loss and don't need to loose more. Advice on how much carb/day and fat to bring my lipid picture to normal? I live in Australia, not much help with lchf diet. Thank you. XXXXXXX .
doctor
Answered by Dr. Shehzad Topiwala (13 minutes later)
Brief Answer:
LCHF diet

Detailed Answer:
Sorry to learn about your cholesterol challenges.

I do not advise a LCHF diet for managing cholesterol. It helps lose weight for some people but raises cholesterol.
A balanced diet at this stage is more appropriate, now that you have achieved weight loss. Regular physical activity is needed additionally.

Other causes of high cholesterol need to be ruled out first, such as thyroid and kidney problems.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (46 minutes later)
Kidney function, liver function, haematology, all normal. I had partial thyroidectomy 40 yrs ago. Now take thyroxine 75mcg daily and thyroid function was euthyroid. 5yrs ago Vit D3 was very low 19. After taking Vit D3 supplement it is now 70. I continue to take D3 supplement daily. Should I just lower the amount of fat and increase the carbs to bring my lipid profile back to normal?
Kind regards, XXXXXX
doctor
Answered by Dr. Shehzad Topiwala (5 hours later)
Brief Answer:
Follow up

Detailed Answer:
Yes consider doing so but consult a dietitian in-person to get a fair idea about a balanced diet and specifically to obtain guidance on nutrition for a healthy cholesterol pattern.

I generally recommend the following:

HEALTHFUL EATING (also called MNT = Medical Nutrition Therapy) (A) has proven to reduce HbA1c and result in cost savings

Please see a DIETITIAN at least once to get an Individualized plan based on your nutrition needs, personal and cultural preferences, health literacy and access to healthful foods

GENERAL GUIDELINES:

1 Eat a variety of NUTRIENT dense foods in appropriate PORTION sizes, in order to achieve and maintain the following 4 goals:

TARGET 1 body weight, 2 blood glucose, 3 blood pressure and 4 cholesterol

It is important to maintain the pleasure of eating while making practical food choices.

2 Try to REPLACE refined carbohydrates (like muffins, pastries, cookies, sugary cereals) and added sugars with
Whole grains like whole wheat bread and roti and brown rice
Legumes
Vegetables and
Fruits

3 AVOID sugar sweetened beverages (ie pepsi, coke, thums up, fanta, limca etc ) and sucrose (table sugar) containing foods (examples are frosted cornflakes, chocolate milk, sweetened fruit juices and drinks, sweetened yoghurt and ice cream, popular dessert items like chocolate mousse)

4     Learn from a dietitan how to include Mono Unsaturated Fatty Acids (MUFAs) and long chain omega 3 fatty acids (fatty fish, nuts and seeds) in your daily intake.

5      Alcohol is best avoided but if you must, then moderation is key. (one drink per day for women and two for men)

6     Sodium is to restricted to less than 2300 mg a day and even less if you have high blood pressure

7     Vitamins , minerals , herbs, spices, anti oxidant (vitamin E and C and carotene) or omega 3 dietary supplements have shown no benefit.

if you have high cholesterol levels in your blood (HYPERLIPIDEMIA or DYSLIPIDEMIA), ask the Dietitian how to reduce
SATURATED FAT (BEEF, MUTTON, LAMB, PORK, CHICKEN WITH SKIN, WHOLE MILK, CREAM, BUTTER, CHEESE, ICE CREAM, FRIED AND BAKED FOODS)
, TRANS FAT ( Doughnuts, cookies, crackers, muffins, pies and cakes )
and CHOLESTEROL
And increase
Omega 3 fatty acids (NUTS, SEEDS AND Oily fish LIKE – salmon, tuna, mackerel, herring and trout ),
viscous fiber (BLACK BEANS, asparagus, Brussels sprouts, sweet potatoes, turnips, apricots, mangoes, oranges, legumes and oat bran)

and plant stanols/sterols (grains, vegetables, fruits, legumes, nuts, and seeds)

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest Treatment For High Cholesterol Levels After Following LCHF Diet

Brief Answer: LCHF diet Detailed Answer: Sorry to learn about your cholesterol challenges. I do not advise a LCHF diet for managing cholesterol. It helps lose weight for some people but raises cholesterol. A balanced diet at this stage is more appropriate, now that you have achieved weight loss. Regular physical activity is needed additionally. Other causes of high cholesterol need to be ruled out first, such as thyroid and kidney problems. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH (checks your thyroid) 25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter) None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.