My cholesterol is sky high — here’s why I’m not acting on it
Full disclaimer: this article may be considered controversial. I am in no way encouraging anyone to discard professional medical advice or to naively assume any of the things they read online ‘somewhere’ to be true. Doctors are there for a reason, which is to help you not die. They know many things that you and I don’t. Trust them. I do. Most of the time.
Back in February of 2019, I wrote a piece on my lab results. Back then, I had been eating primarily fat for over three years. I started eating a high-fat diet because I had been feeling terrible for years, and none of the medical or psychiatrical help I reached out for actually made any difference.
Because being and eating fat is associated with many terrible conditions, I was curious to find out what my diet had done to my general health. The lab test turned out fine. In fact, it told me that I was pretty darn healthy. Hooray for me, and hooray for eating fat — which I continued to do.
I Ate 385 lb. of Fat over Three Years Time — Here Are My Lab Results
Back in 2015, I was overweight, tired and depressed. I craved sleep throughout the day. Today, I feel absolutely great…
At that time, I did have somewhat increased cholesterol levels. Total and LDL cholesterol were only just within their so-called safe zones at 6.4 mmol/L and 4.4 mmol/L (155 mg/dl and 79 mg/dl).
Recently, I took a new lab test. It turns out, my total cholesterol has skyrocketed right into the danger zone, and so has my LDL cholesterol. Red flags everywhere. If I take these results to my doctor, he will put me on statin drugs right away. At age 33. Can you imagine?
Well, you probably can imagine. Cholesterol is as scary as hell. It is like an anagram for ‘death’, if only the letters would match. High cholesterol has been linked to cardiovascular disease and cancer numerous times in trustworthy studies. LDL cholesterol, of which my levels are in the red zone, too, is the worst, and is touted as ‘the dangerous cholesterol’.
So why am I not on drugs yet? Am I suicidal? Ignorant? Or just plain stupid? Maybe. But before I’m ready to admit to the drugs (or to being ignorant), I want to figure some stuff out. Namely; what the hell this cholesterol thing is about, and why it freaks everyone out.
Here’s what I found, and why I’m not going to take drugs to lower my cholesterol.
The story will continue below the image.
First, let’s have a quick look at the results provided by Check-U. I’ve incorporated the previous results, too, so you can see how the values changed over the past 8 months.
“Values between 5.0 and 6.5 mmol/L are considered high, and the Hartstichting (the Dutch Heart Health Association) recommends additional testing to be done. Any value higher than 6.5 mmol/L requires you to contact your doctor immediately.” — Description by Check-U
My value of 7.1 mmol/L (127.8 mg/dl) is up by 11% from 6.4 and falls well within the danger zone.
“Considered as the ‘bad’ cholesterol. Responsible for transporting cholesterol through the body and likely to pile up in vessels and arteries.” — Description by Check-U
My value increased by 9%, from 4.4 mmol/L (which was already on the edge of the safe zone), to 4.8 — again, well into the red zone.
“Considered the ‘good’ cholesterol. Carries any surplus of cholesterol to the liver which in turn disposes it through the large intestine.” — Description by Check-U
My value of HDL cholesterol increased quite significantly, by no less than 28.5%. Any value above 1.6 is considered healthy, meaning I was on the lower side in my previous lab test.
This is not listed by the test, but calculating remnant cholesterol is as simple as subtracting HDL and LDL from your total cholesterol, giving us a value of 0.5 mmol/L (or 9.0 mg/dl).
For the sake of transparency, I’m also including triglycerides, which are basically energy particles in the form of fat traveling through the blood, ready to be used by muscles and organs. When you’re fasted (as you are during a lab test), you want these low, just like glucose, because the bloodstream is meant for transportation, not for storage.
The evidence is clear, so why am I not on drugs yet?
To be able to understand why I’m not worried by my severely elevated cholesterol levels, we’re going to need an analogy to simplify why high cholesterol is not always a problem. To give credit where it’s due, my analogy is heavily inspired by Dave Feldman’s work, who is a “Software Engineer, Low Carb enthusiast, N=1 Adventurer, and Cholesterol Controller” as he puts it himself.
A tale of two takeout restaurants
Imagine a city with millions of people living in it, but just two restaurants that deliver takeout food. One of the restaurants, Glyco’s, is accredited for their fast delivery and huge portions. The other restaurant, named Lippy’s, can be a tad slower in terms of delivery, but they do offer a special service that we’ll get back to in a second. Nevertheless, people just don’t seem to be into Lippy’s that much. Glyco’s is king.
So, every day when dinner time comes, the streets are flocked by Glyco’s delivery dudes, easily recognizable by their bright orange caps and jackets. They’re blazingly fast. As the streets color orange, everyone is happy with their big portions of food delivered right to their doorstep.
Meanwhile, there’s not a Lippy’s delivery guy to be found. But who cares — this is how it has been forever, and everyone is fine with it. As far as anyone knows, this is how it should be.
Unfortunately, there’s a problem. Glyco’s is fast and affordable, but people tend to have a bunch of leftovers. So they chuck them in their freezers and fridges. Some people even buy bigger freezers, just to be able to save all of those Glyco’s leftovers. Over time, the leftovers pile up quite badly.
And that’s where Lippy’s delivery guys come into play. Not only do they deliver great food — but they’re also willing to take some of your Glyco’s leftovers with them, and then share those with the community. This way, the food gets distributed more evenly, and people who aren’t in the position to order takeout can get their hands on a decent meal, too. Plus: nothing goes to waist — pun intended.
If only there were enough Lippy’s drivers out at night to distribute all of these leftovers…
Now imagine that, quite coincidentally, Glyco’s runs into a terrible plumbing problem, greatly limiting their output. The city grows hungry, and, lazy as the people are, they refrain from cooking their own meals. Instead — you’ve guessed it — they turn to Lippy’s.
Within a few days, the orange delivery guys make way for Lippy’s riders to appear in their bright green jackets, painting a completely different picture.
Anyone returning from a holiday right now would be shocked to see how many Lippy’s riders there were out on the streets. They might even try to put the green riders to a halt, just because it doesn’t add up to see so many of them.
But looking at the entire picture — knowing that Glyco’s is currently only delivering a minimum amount of meals — it makes perfect sense that there are so many Lippy’s riders out on the streets.
Besides, there is a collateral benefit. Not only does Lippy’s do just as good a job to supply the city with food — having this many riders out also makes it much easier for people to clear out their fridges over time.
Maybe it wouldn’t be that bad of a deal to have Glyco’s on the low every now and then.
Bringing it home
Of course, the analogy misses nuance and details. Human metabolism is wildly complex. But the gist of it is that, when there are many carbohydrates to be delivered in the form of glucose (by Glyco’s), there are naturally few lipids (Lippy’s) being mobilized.
Leftovers pile up and the body has no means to do anything about it.
When carbohydrates are limited, more and more lipids can be transported (because insulin remains low). Cholesterol is neatly tied into the processes of transporting lipids, including body fat.
So when someone is on a diet that is high in fat and low in carbohydrates, it makes sense that there are many more lipid transporters found in the bloodstream compared to someone that mainly runs on carbs.
And there we have the exact reason why I’m not going to take drugs to lower my supposedly dangerously high cholesterol levels. As I see it, those levels are bound to be elevated compared to a normal Western diet. On a high-fat diet, the majority of energy being carried around is fat. As cholesterol is related to much of this work being done, you will naturally see more of it in the bloodstream, and taking drugs to fight this would make no sense.