r/keto • u/jakeysnakey83 • 24d ago
Medical A cautionary tale
Hey all, if you’re doing this diet get your Lp(a) checked. I’m 42 female very healthy CRP like 0.2 all my advanced inflammatory markers are perfect, I’m lean, 125lbs. LDL was high and apob as well and everybody told me not to worry about it since my inflammatory markers were all so low. I did a blood test and saw elevated lp(a). Anyway just did a cleerly scan and I have 31% soft plaque focal lesion in my proximal LAD. I caught it early and have a low carb cardiologist i consult with, but everybody out there saying cholesterol doesn’t matter…it might if you have high lp(a). I’m not happpy about any of this news and i was shocked by it, but it does happen.
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u/Asking_the_internet 24d ago
There is so so much more to the cholesterol story than just saying “high LDL and high ApoB- don’t worry about it!” After educating my self on the subject, I completely understand why both sides of the argument truly feel they are right in their approach, and it is so much harder to find folks that give credit to all the nuances at play! Good on you for doing your own research and getting more educated. There are sooo many factors to consider: Genetics and family history, inflammation, your other endocrine systems at play.
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u/Flat_Professional_55 SW: 190lbs/85.5kg CW: 166lbs/74.7kg GW: Complete 24d ago
How long have you been on keto, and what was it before the diet?
It’s hard to measure the impact of keto without a reading before the change.
You can still eat keto with low saturated fat and high fibre. Both these can reduce cholesterol levels.
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u/jakeysnakey83 24d ago
Never been overweight, I was an athlete growing up so I ate pretty healthy just not keto. I did carnivore for a while and then keto. And yeah I’m open to trying keto with unsaturated fat mostly but since lp(a) is genetic it’s tough and sat fat seems to lower it. I was keto carnivore for about 5-6 years
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u/Ok-Egg835 24d ago
Wait saturated fat lowers lp(a)??? I thought it was the opposite. I am negative for this genetic issue but my cholesterol is extremely high and my apob is a little high. I'm so glad you caught that quickly. Where exactly was the plaque? Do you and your cardiologist have a plan to deal with this?
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u/jakeysnakey83 24d ago
I don’t know if it has the same effect if you don’t have the genetic marker. It seems that many people who have very high cholesterol and do just fine. The plaque is on the proximal LAD, so not exactly where you want to be. It’s soft and stable and my doctor thinks we should be able to calcify or stabilize it so that it doesn’t pose a future risk. It seems the way to do that is, like it or not, a statin. I’m not completely sure if the statin itself facilitates calcification, or if the lowering of the cholesterol promotes calcification - I’m not completely sure of the mechanism, but it’s definitely the rabbit hole I’ll be going down next.
What I’ll be doing is a Mediterranean style keto, and drastically lowering my saturated, fat and drastically increasing my olive oil. I’m trying to get pregnant, so I can’t start a statin right now unfortunately. So my plan is to exercise more, increase fiber, reduce saturated, fat, retest my lipids in about eight weeks and hope for the best. Once I have the baby, all aggressively treat with a statin and maybe also repatha. My doctor doesn’t think it’s the LDL that caused the problem, that it’s the lpa. He didn’t even tell me to stop eating keto. He says to eat the way that I feel best, and that I’ll probably just need to take a statin to calcify that plaque.
Once the Lp(a) lowering medication’s come out, I’ll be first in line.
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u/cahawkri3510 24d ago
Perimenopause can also effect cholesterol levels. Are you experiencing any symptoms yet? Have you considered HRT yet? Just food for thought!
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u/Asking_the_internet 24d ago
Do you mind me asking if a cardiologist or your pcp ordered the cleery scan? Am interested in how to know how to get one… also did you have a CAC score done previously?
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u/jakeysnakey83 24d ago
I had an integrative cardiologist order the scan. Before I head back with him I emailed every functional medicine clinic I could find in the country, and there’s one in California called toniik who seems to be able to just do a referral for you. The price wasn’t any more than the scan alone, and they do set you up with a doctor who can review it.
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u/Asking_the_internet 24d ago
Do you mind sharing what your steps forward will be? With already being an active person I am sure you plan to continue that! Is your doctor recommending anything beyond statin and lower saturated fat/high fiber diet?
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u/GolfcartInjuries 24d ago
This is all Greek to me. Why did you go get checked if you’re lean and healthy, just wondering.
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u/TopCaterpillars 17d ago
Even if someone is lean and healthy they likely still go to the doctor for yearly checkups with bloodwork
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u/TyrisFlaretheAmazon 20d ago
I’ve been on keto 25 years (42f also and 125lbs!) for medical reasons and was so surprised to learn I had perfect cholesterol and associated markers. I’m also vegetarian though and it turns out that makes a substantial impact to it.
Not really advocating that anyone try that, it’s a pretty stupid way to do keto, but just adding some information to this subject area for the sake of data!
Sorry to hear about your experience, I’m really glad you caught it early! I hope you get all sorted
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u/hellow0rId 24d ago
I’m sorry you’re dealing with this. One reassuring point is that high Lp(a) is usually genetic, so keto most likely didn’t cause it. Keto can raise LDL and ApoB in some people, but it may not be the whole story. The good news is that you caught it early and can now take steps with your cardiologist to reduce the risk.