Alright, I just couldn’t resist. While I no longer catch a lot of heat for my potato eating ways, there are still a few of the low carb Paleo zealots around. I have in the past reported on my lipid panels, back in 2008 and then again in early 2009, almost two years ago.
Despite the fact that I don’t really see cholesterol as any sort of problem to be managed (manage your diet, i.e., eat Real Food, and let the numbers take care of themselves) it is, at least, some measure of confidence that something’s amiss in conventional “wisdom,” since I ought to have “awful numbers,” given the high amount of fat and saturated fat I ingest, albeit mostly all from Real Food sources.
So here’s the latest results:

Lipid Panel 1-11-2011
Of course, calculated LDL is bullshit, and especially so when you have low triglycerides. But, the Iranians of all people came up with a better formula for calculating LDL when trigs are low. And so:
Friedewald (1972) Formula: LDL = TC – HDL – TG/5.0 (mg/dL)
Iranian (2008) Formula: LDL = TC/1.19 + TG/1.9 – HDL/1.1 – 38 (mg/dL)
Plugging the numbers into the Iranian formula calculator yields a calculated LDL of 57 mg/dL vs. 91 mg/dL for the Friedewald equation. Well, let’s see how it stacks up, because I requested an LDL Direct, where they actually measure LDL instead of calculate it.

LDL Direct 1-11-2011
So actually, in my case, the Friedewald was actually off by only 9 units, so far closer than the one rendered by the alternative. However, what’s important to note is that in my experience for those with low trigs, the Friedewald equation almost always overstates LDL, a very convenient situation for the statin pushers.
Let’s take a look at the various ratios. Here they were from March, 2009 (percentages are improvements from the July, 2008 tests).
- Total/HDL = 1.68 (19% improvement; I’m now off the scale)
- HDL/LDL = 2.02 (98% improvement; again off the scale)
- TG/HDL = 0.35 (20% improvement; off the scale)
And now:
- Total/HDL = 1.96 (average is 4-6 and ideal is 2-3; still off the scale)
- HDL/LDL = 1.24 (average is .3-.4 and ideal is above .4; off the scale)
- TG/HDL = 0.36 (optimal is <2; off the scale)
And so, I guess those higher carb days, mostly from potatoes are not actually dumping fat into my bloodstream as high triglycerides. 37 mg/dL is pretty dam low. If that’s not evidence of an overall low carb diet, I don’t know what is.
I have one other issue to discuss and that’s alcohol consumption. I’m sure most everyone knows I’m a bit of a boozer. I love my scotch and I tolerate it pretty well. And while I’ll go a day or so without, it’s pretty much a daily deal for me to ingest a few. And so, I was curious to see what my alanine aminotransferase (ALT) would be.
The alanine aminotransferase (ALT) blood test is typically used to detect liver injury. It is often ordered in conjunction with aspartate aminotransferase (AST) or as part of a liver panel to screen for and/or help diagnose liver disease. AST and ALT are considered to be two of the most important tests to detect liver injury, although ALT is more specific than AST. Sometimes AST is compared directly to ALT and an AST/ALT ratio is calculated. This ratio may be used to distinguish between different causes of liver damage.
The last one I had was in July of 2008, roughly 9 months into pretty clean eating, a year into my working out at the gym, and 6 months into my fasting. I believe my weight was around 210 at the time, down from 235 (I’m now 175ish).

ALT 1 11 2011
You can click to enlarge, but what you want is 36 U/L or less. Less is better. My test from 2008 was 28, pretty close to the top of the range. I’m now at 16. Here’s the graph.

ALT Comparison
Pretty much cut that enzyme in half. But how can that be? I could see it staying the same, given my boozing ways, but to cut in half?
Here’s my speculation: the crap that the “experts” and “authorities” tell you to eat, such as grain products, cereals, much with sugar and in particular, high levels of fructose is, in the final analysis, far worse for you than even heavy alcohol consumption, especially if you drink spirits like I do and not beer and sweet drinks.
Pretty counter intuitive, but I guess I expect nothing less from our Puritanical culture that just has to glorify the stuff really making you fat and damaging your liver while demonizing the stuff that’s probably a wash in the context of an otherwise good, Real Food diet that eschews the garbage “foods.” Perhaps Dr. Robert Lustig ought to rethink his quote that “fructose is alcohol without the buzz,” to something along the lines of fructose and other sugary crap is far worse than alcohol (and still without the buzz).
Still on the subject of alcohol, Martin Berkhan has up a very informative post about alcohol in the context of fat loss and muscle growth.
I do find it interesting that over these two and a half years since first tested, that both my LDL and ALT liver enzymes have dropped. It made me think about Chris Masterjohn’s recent post about how elevated LDL on a LC paleo or low-carb diet in general is possibly being caused by your liver clearing out its fat deposits over time.
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After losing 80 pounds eating Paleo in under a year, dropping my blood pressure dramatically and looking better than ever, my doctor made me go see a nutritionist because she wasn’t convinced, and my cholesterol was still high, in her opinion.
The nutritionist said, “keep doing what you are doing – it works for you – and lowering the fat in your diet while reintroducing the grains will do nothing for your cholesterol (and we both know the numbers are all screwed up anyway)”.
:)
A nutritionist that doesn’t follow CW? WOW!
Ha, that’s awesome. We had a Benefits Fair at my office a few months ago and I had my numbers checked after about 10 months of eating paleo. All of them were excellent. Then just for fun I got a bone density test – actually off the charts on how good that one was. They said 1.0 was perfect for the “low risk,” I clocked in at 1.6. The doctor asked me how I did it. Paleo and lifting heavy stuff, baby, that’s how.
I had some pretty high liver function tests once about a month after starting weight training. My doc was concerned and got me to retest a few weeks later. So I took a week off of weight training just before the test and my numbers went back to normal. There’s some study floating around about how some men show pathological liver function after lifting heavy (relative to their training) and I guess I could be one of them.
Anyway, that made me wonder how much confounding is going on with Paleo types and liver tests, especially since it seemed easy for me to randomly swing them so easily via physical activity.
Richard, do you have a plot of your cholesterol over time? It would be interesting to see if there was an early days bump in TC which is now hitting a low. There seem to be a fair number of paleo types who end up with high TC and I often wonder if that’s a permanent thing (ie, it would be high as long as they ate their brand of paleo) or if it’s temporary and would decline as the body adjusted to the new diet. I forget at what frequency you have these tests done but it might make for an interesting chart.
Haha, my triglycerides were 36 when they were last tested. Guess we are twins. Go potatoes!
That looks great Richard, my last BT was in Mar. 2010. My ALT was 13U/L, AST was 19U/L. Lipid Panels not as good as yours. TG at 80mg/dl and HDL at 63mg/dl.TC @ 209mg/dl and LDL at 130mg/dl. I drink mostly beer and wine, very little scotch or gin martini’s. The beer however is very low carb of 5.0 gm per 12 oz. bottle. Coors Light.
But, the Iranians of all people came up with a better formula for calculating LDL…
Why would the Iranians be any less apt to come up with valid science than any other group? Historically, Islamic science has been quite valid, and Western science has borrowed much from it.
Because Iran is no longer any bastion of science, nor is any Theocracy.
You are unfortunately conflating the citizens of a country with their un-elected government.
No Sol, that’s where you are dead wrong. The context of what I said WAS about the regime. It was the hair-trigger victims who were quick (and happy) to conflate (and then obfuscate my original context).
I’m not wrong. You mentioned their Iranian origin as if it mattered. It doesn’t.
“the Iranians of all people came up” – I’m pretty sure it wasn’t the government. To be shocked their citizens can come up with something, and then clarify in the comments about a theocracy … well yeah, that is conflating.
My many friends from that region always refer to themselves as Persians.
You don’t know what you are talking about, and you don’t know me. But you want to be a victim. That’s all that’s clear.
Victim? How am I the victim? I’m from South America.
Heh. Persians. In case you didn’t know, Iran is comprised of Persians, Kurds, and more.
Still – who mentioned Persians? Your having Persian friends doesn’t explain the way you crapped on Iran as if any kind of innovation or smart thinking from that country is shocking.
Thanks. Ergo, it wasn’t racist, which if you’ll check was the original complaint.
I decided to forego testing of anything, for all I know I’m at death’s doorstep. I figure if I feel good and look good who the hell cares.
I gave up beer and wine myself when I went paleo, nothing but vodka and scotch for over two years. It’s a lot healthier.
I was going to mention this is the post and forgot, but I went in for a shoulder injury that’s not getting better and it has been about three weeks. Impinged rotator cuff is best guess. Anyway, doc wanted me to get a blood panel since I was there, so I said fine. But yea, I’m no longer knocking on the door for tests, as though it’s going to convince me to eat junk in place of real food.
I damaged my right rotator cuff twice, takes a LONG time to heal. It varies from person to person but what has worked for me is to avoid the flat bench like the plague and stick to the incline bench …. don’t know why that works but it does.
Done. It was after a session on the flat bench, then going to incline where I first felt it and STOPPED. But it seems that all upper body work has exacerbated it since. So right now, it’s legs only. But I’m over 200# on squats for 3 sets and 500# on incline leg press for 2-3 sets.
Richard, if I can give you any “generic” recommendations (having not seen you in person) with regards to that shoulder it’s this: for a bit, do twice as much horizontal pulling as you do horizontal pushing. Or, even better, buy this DVD by Eric Cressey and Mike Reinold (THE shoulder guys!!!), and get to know everything shoulder related :) Meanwhile, DO check out these two articles for some great info t-nation.com/free_online_article/sports_body_training_performance_repair/shoulder_savers_part_i and t-nation.com/free_online_article/sports_body_training_performance_repair/shoulder_savers_part_ii
Good luck my friend.
Eric:
Very helpful. Saw a phys therapist yesterday and his appearance signaled to me he walks the talk. Excellent body comp, lean strong, very well developed. He echoed much of what I read from your link. Today I did my squats at about 200 but narrowed my grip to reign in the scapula. Then I did some light DLs at 185, some incline leg presses at 430, but then some light cable rows at 120 and some lat pulldowns at about 100. Slow and easy, and while I had shoulder discomfort, it was not stabbing pain and now, couple hours later the shoulder feels excellent.
I’ll keep at it.
Narrowing my grip in the squats helped me. Doing 2 to 3 times as many back exercieses than chest exercises might be the best exercise programming choice I ever made. I’m lifting for the first time tommorow since the car accident in August. As the back has gotten weaker the shoulders have resumed a rounded, forward posture.
Just a quick update, Eric, but what I’m finding is that even doing air rows when the shoulder hurts, really tucking in and squeezing those scalpula together, is better and more immediate than ibuprophen for pain relief.
I got past impingement by keeping my elbows close to my sides, being careful to never flare them out.
It worked great, steady improvement until it was completely gone, and I didn’t have to back off the weight amounts.
Richard, have you considered “Charles Atlas” types of exercises for your arms? I ask because I have shoulder and elbow trouble too and am looking into options.
Regarding the rotator cuff, you might want to look into Hyaluronic acid capsules or injection. I injured my wrist playing basketball a few years ago and even after it healed I had residual pain that wouldn’t go away, especially when I did certain motions. Long and short of the story, the only thing that worked really well for me was Hyaluronic acid tablets (I took Solgar brand). I don’t really know whether the injuries are comparable, but just putting that out there.
I never had a rotator injury but you might be interested by this: in Tim Ferriss’ new book The Four Hour Body there’s a chapter on reversing injuries and he writes about a method to speed up rotator recovery called Active Release Technique (ART).
quote:
“ART sessions are typically 5-15 minutes in length and cost $45-100 each. Most client injuries are treated in one to six sessions. Soft-tissue injuries eligible for ART treatment include rotator cuff impingement, tendinitis, low-back strain, ankle and wrist sprain, shin splints, hip flexor impingements, and carpal tunnel syndrome. But ART isn’t perfect. As Charles (Charles Poliquin) noted: “ART is 100% effective in 70% of patients.””
he recommends checking that website to find local ART specialists: http://www.activerelease.com
I’ll look into it, Michael. There’s two providers less than a mile from where I live.
Ever think of testing c-reactive protein? Or any thoughts on its usefulness?
Matt
Had that done in 2009 I think and it was super low. No worries.
Congrats! It is great that you and others are working to bust these myths about “high” cholesterol being related to a “fatty diet.” Thanks for posting actual numbers to show objectively the benefits of this way of life for you. My dad had similar results after his switch to a more paleo lifestyle, and his doctors still didn’t believe the results of the bloodtests they took!
Convincing people that fat is not the culprit in their health problems and weight issues is still one of the toughest parts of working with people on nutrition! Hopefully posts like this will eventually help to change common perception over time.
Great news about the tests. I thought I was stalling because of the scotch intake. Are you maintaining or losing with the Scotch? I read Martin Berkhan’s article and found it insightful. He suggests lean fat on drinking days but it doesn’t seem like you subscribe to that. Any insight?
There is no doubt in my mind that alcohol keeps my progress very slow. But it is what it is. I just keep plugging along and am satisfied with progress in the ounces. I’m certainly not gaining.
:(
R.I.P.
Thanks Richard for continuing to post your numbers (even though you say that cholesterol isn’t something that needs to be managed). I think that all this self-experimentation (and reporting) is a great way for us to rebuild some “cultural wisdom” that we have collectively forgotten.
Thank you Richard, for this. I have been concerned for some time that my alcohol consumption – mostly red wine and scotch (Dalwhinnie is my tipple of choice for that), with the occasional dry Hendrick’s martini thrown in for good measure – was harming me beyond slowing my weight loss, despite good liver function test results. I’ll feel much better about pouring that glass of Apothic Red tonight.
Oh – and the Greek olive oil? Holy mother of pearl, I could drink that stuff by the glass. I tasted it, then the Italian oils I hoard in my fridge, and couldn’t believe how bitter the Italian oils tasted. Now I don’t know how to get rid of them, because I don’t want to eat them any more…
Use the olive oil on your skin :)
Now THAT is a thought!
The only problem with this is that it makes your clothes REEK. If anyone knows the secret to getting this stench out of the fabric, please do tell! :)
Getting oil out of fabric is a problem (nutritionist by day and esthetician by night:) ) and any oil ruins sheets. So best to go au natural with some body oil or use it prior to a shower (obvious caution on the feet and tub) Don’t need to use too much a little oil goes a long way. Don’t forget to put some on your hair too (avoid the scalp area) then shower and shampoo (with or with out shampoo since you are one of Richards readers!)
Not sue about using the olive but we use sesame for “pulling” you know swishing in the mouth for a minute or so as a cleansing why not use up some of the olive doing the same ?
Sorry I have no miracle cure for the “stench”.
Hey Richard, Thanks for sharing. Interesting to see what is what :I guess.
I’m going with Kurt on the testing and well …not having any!
Trying your soapless experiment.No deodorent, no shampoo, no soap.Washing hands with soap but that’s it.I’m not cheating by buying some over priced all natural product.Works great.No more illusions from the cosmetic world.Won’t go back.Sorry to hear about the shoulder energy.Rest and maybe some swimming when the inflammation goes.Swimming in the sea or a river is good.I avoid Gyms.And use my own body weight to exercise.Who needs a gym- some buckets of water, a river, and a bit of yard work.Gyms are a bit industrial.All those robotic movements with those robotic machines aren’t natural.Climbing a steep hill or carrying something heavy is.Mixing and matching.Indians in the amazon are strong and they don’t have a girly gym to go to.Charles Manson the english prisoner wrote about working out in his jail cell with no equipment.To hill with the fitness industry.The movements on all that machinery is to robot like and less paleo.Hit the river and swim-you’ll get strong lungs, no injuries, and feel like tarzan rather than gym boy.Or girl?
I like the gym because that is where they keep the 45 pound plates.
Ow. That hurt my brain. What’s the takeaway? You did good, right?
I’m happy to answer specific questions, wilberfan. I did good? Yes.
I’m with Wilberfan, my brain hurt too.
You’ve never had a blood test, or you have no idea what the results mean, or you don’t care?
I’m sorry guys, but let me be frank since we’re all public in comments your youz brought it up: I’m not dumbing down my stuff for anyone. I built up to over 100K visits per month (actually, @107k now, 12th of month) posting stuff like this and even more (check the archives).
Frankly, I would be too embarrassed to admit to difficulty understanding such basic stuff that folks including teenage girls have been gobbling up for years. I’m going to assume you’re both smart enough. You just need to get off your fucking lazy, pussy asses and bone the fuck up.
And stop complaining.
Jesus Christ, already.
Nailed it! With 165 blog subscriptions, I tend to, uh, *skim* through most of them. Your post today will require some actual CONCENTRATION, and THOUGHT. /wince
Thanks a lot!
Now thanks for being a good sport, you! It’s just my “style” getting the best of me in that last comments.
I take it you were born by C-section, then, or grown in a test tube?
I can’t think of a much more useless euphemism for “lazy and weak” than “pussy.” “Testicle” might be more appropriate, especially when Mr. Nut says hello to Ms. Foot.
Just sayin.
Fucking get off it, Dana. People have gone through this a million times already. I use the word, always will. Stop being such a fuckin’ pussy, or a dick — take your pick — and a pain in the ass to boot.
Grow the fuck up, or get the fuck out.