Dr. Sarah Hallberg: Are high LDL-P numbers on a ketogenic diet dangerous?


– For our next question, how
concerned should I be about high LDLP numbers if my HDL
numbers are in a normal range while I’m in nutritional ketosis? – So LDLP is again going
back to what we talked about a little while ago, a
much better assessment of cardiovascular risk than LDLC. And so if someone has got
really great improvements decreasing triglycerides,
increasing good cholesterol, but struggled with an elevated
LDLP, what do they do? And this is not a solidly
certain answer yet. We don’t, there has
been no evidence one way or the other 100%. So this is one of those
places that you really need to work with your physician on. So again, the Virta physicians
may ask other questions. What are other risk
factors that you may have, and how are those controlled? Or this is another place where
we may say let’s go ahead and get something called
a coronary calcium score to assess is there really
any burden of cardiovascular disease already present. But once again, this
is an individual call, and this needs to be worked
out one on one between patients and their physicians. And Virta physicians are all
very, very expert in this area to be able to ensure that
they are doing whatever we need to do to promote
cardiovascular risk factor reduction for each and
every patient individually. – So do you say it’s fair
that it’s not just one number that’s driving that you’re in
bad health or great health? It’s really a big picture of everything. – Absolutely, it is, Catherine. There’s not one biomarker when
it comes to cardiovascular health that we can point
to and say if this is good or if this is bad, you’re in
the clear or you’re doomed. It’s not like that. You know, what we have is we
have a whole bunch of things that we know are associated
with increased cardiovascular risks, and we have to look
at the larger picture. You can’t get lost in
the forest for the trees. So each one of those and
taking a look at the whole in each individual patient
is really important, and that take personalization. – I think that’s an excellent
reminder because it’s very easy to get caught up on that one number.

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Reader Comments

  1. Jaesha

    The jury is still out on LDL-P. My calcium score was 0, yet my doctor wants me on a statin as a preventative. I refuse to do that as the side effects are not worth the risk and this may simply not be needed. I'm on Keto and doing my best to stay healthy. Statins are a last resort.

  2. Millard

    Question:
    I just found out i have a TG 550 and Chol 250 and HDL 30. Do you think starting full keto is safe for me orshouldi start slowly? I dont want to go on statin

  3. M 85

    Coronary Calcium Score only detects older calcified plaques not more recent softer ones….

    LDL is strongly linked to atherosclerosis, it's probably even causal: https://www.eas-society.org/page/LDLcausesASCVD

  4. JanEric Channel

    Great answer Sarah. I do have a question, did you ever publish the data that you were working on with regards to extremely elevated LDL particle counts while on a ketogenic diet? I know that you were researching it and were trying to get something published when I met you at the obesity medicine association conference back in 2015. (Fellow DMU DO (‘03) grad). I can tell you my experience personally is that four years of low-carb high-fat has accelerated my cardiovascular disease as measured yearly by worsening carotid intima media thickness as well as a positive coronary calcium score. Everything else in my life looked great but it was very difficult to ignore LDL particle counts consistently around 2500 and the worsening cardiovascular disease. I must say though that I do have lipoprotein (a) in the 99th percentile (bad) so that is a little bit of a negative factor for me personally. Anyway, I would love to hear from you about any trends or preliminary data you were seeing in your research. I personally find very little comfort in hearing multiple doctors tell their patients on YouTube and other places that they don’t really need to worry about the lipids that are going up. So much respect for you for giving a truthful and honest answer!

  5. Me

    Consult a medicine salesman, no way, they don't know squat about health, probably can't even spell Keto and are mainly there to massage their egos, make money and sell medicines.

  6. Lloyd Hlavac

    My LDL-P Was very high on a recent NMR cholesterol panel. But my LDL size break down was mostly large size particles, A pattern. And most markers of inflammation, such as CRP (hs) were good. So this really confuses me. And no place near me currently does a heart CT scan for a CAC score without a doctor's prescription, and I do not have a doctor.

  7. Erast Van Doren

    Zero useful info. Dislike. BTW, increasing good cholesterol on keto mostly means that HDL is overburden with the task of bringing cholesterol back from arteries.

  8. Peter Glenn

    In an effort to raise the existence of the “good” cholesterol and lower the “bad” cholesterol I possess, I tried employing this unique cholesterol solution “Hοzantο Axy” (Google it) . I don`t know whether it`s finished yet; I never have had any new blood check-up since I started taking it. Therefore i`m incredibly excited for a month to come in order to have my cholesterol level analyzed. I`m hoping this could assist me. I am considering certainly based upon exactly what I’ve read. .

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