{"product_id":"paul-d-thompson-extremely-high-cholesterol-12","title":"Why is my cholesterol extremely high? 12","description":"\u003ch1\u003eFinding the Cause of Very High Cholesterol: Family History, Thyroid, Kidneys and Ketogenic Diets\u003c\/h1\u003e\n\u003ch3\u003eJump To Section\u003c\/h3\u003e\n\u003cul\u003e\n  \u003cli\u003e\u003ca href=\"#finding-the-cause\"\u003eHow a doctor looks for the cause\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#inherited-cholesterol\"\u003eInherited high cholesterol in certain groups\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#thyroid-and-ldl-receptors\"\u003eThyroid and LDL receptors\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#nephrotic-syndrome\"\u003eProtein loss from the kidneys\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#weight-loss-and-ketogenic-diets\"\u003eWeight loss, ketogenic diets and a strange exception\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#patient-example\"\u003eA patient example and his advice\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#full-transcript\"\u003eFull Transcript\u003c\/a\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch2 id=\"finding-the-cause\"\u003eHow a doctor looks for the cause\u003c\/h2\u003e\n\u003cp\u003eFinding the cause of very high cholesterol usually starts with the patient's history, according to cardiologist Dr. Paul D. Thompson, MD. Dr. Anton Titov, MD, asks him how doctors find the cause and how dangerous high cholesterol from a ketogenic diet can be.\u003c\/p\u003e\n\u003cp\u003eDr. Thompson says he can tell the problem is genetic if a patient's father had a heart attack at a young age. Belonging to certain ethnic groups is another clue, which is why taking a family history is one of the ways he identifies the cause.\u003c\/p\u003e\n\u003ch2 id=\"inherited-cholesterol\"\u003eInherited high cholesterol in certain groups\u003c\/h2\u003e\n\u003cp\u003eInherited high cholesterol is more frequent in some populations, and Dr. Thompson gives several examples. In Connecticut, one of the groups with high cholesterol levels is people of French Canadian descent. He explains that one of the first 8,000 settlers of Quebec brought in the gene for high cholesterol, which can be traced through Catholic Church records.\u003c\/p\u003e\n\u003cp\u003eHe says that one in 50 people of French Canadian origin has high cholesterol, compared with one in 500 Irish people like himself. He also names the Afrikaners in South Africa, Lebanese Christians in the Middle East and a northern Italian gene.\u003c\/p\u003e\n\u003ch2 id=\"thyroid-and-ldl-receptors\"\u003eThyroid and LDL receptors\u003c\/h2\u003e\n\u003cp\u003eThyroid is the second of the four causes on his list, after genetics. Dr. Thompson explains that LDL receptors on the surface of the liver grab LDL cholesterol and pull it into the liver. Two good things follow: the blood level goes down, and the liver cell registers that it has enough cholesterol and does not need to make more.\u003c\/p\u003e\n\u003cp\u003eThyroid is necessary to make these receptors, he says. Without enough thyroid, the liver does not make enough LDL receptors, and the result can look like inherited high cholesterol.\u003c\/p\u003e\n\u003ch2 id=\"nephrotic-syndrome\"\u003eProtein loss from the kidneys\u003c\/h2\u003e\n\u003cp\u003eNephrotic syndrome can also cause high cholesterol levels. Dr. Thompson describes it as leakage of protein into the urine because something is wrong with the filtering part of the kidney. The liver then gets the message to make more protein.\u003c\/p\u003e\n\u003cp\u003eOne of the proteins the liver makes is apolipoprotein B (ApoB), which he calls the carrier for the bad and the ugly cholesterol. Patients with nephrotic syndrome are often sent to him with high cholesterol levels. A urine dipstick showing lots of protein, he says, is all he needs to know the cause.\u003c\/p\u003e\n\u003ch2 id=\"weight-loss-and-ketogenic-diets\"\u003eWeight loss, ketogenic diets and a strange exception\u003c\/h2\u003e\n\u003cp\u003eKetogenic diets are the surprising cause on the list. Dr. Thompson describes them as very low carbohydrate diets with a lot of protein and foods such as eggs, adding that it is not just the eggs. These diets can cause very high cholesterol levels, especially in skinny people.\u003c\/p\u003e\n\u003cp\u003eHe explains that LDL cholesterol usually comes down while a person is losing weight. When food intake is low, the liver behaves as if a famine may be coming and saves energy by not making cholesterol. Once the weight loss is over and the person is eating enough calories, LDL goes back close to where it started. Thin people on ketogenic diets are a strange exception, he says, because they can have remarkably high cholesterol levels.\u003c\/p\u003e\n\u003ch2 id=\"patient-example\"\u003eA patient example and his advice\u003c\/h2\u003e\n\u003cp\u003eA patient whose chart was on his desk illustrates the point. The man was sent to Dr. Thompson with a cholesterol level of 800, with about 500 of that in the LDL. He was thin and 72 years old. Dr. Thompson reasoned that the cause could not be genetic, because with an inherited level that high he would have died from a heart attack by then.\u003c\/p\u003e\n\u003cp\u003eWhen asked, the patient said he was following a ketogenic diet because he thought it helped his migraines, and he was eating a fair amount of eggs. Dr. Thompson told him to eat more carbohydrate and cut down on eggs, and he has not seen him back since. He says he is not against ketogenic diets, but people who follow them should have their cholesterol measured to make sure they are not among those whose levels rise sharply.\u003c\/p\u003e\n\u003ch2 id=\"full-transcript\"\u003eFull Transcript\u003c\/h2\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Anton Titov, MD:\u003c\/strong\u003e Very high cholesterol, finding the cause of extremely high cholesterol. On your blog you listed the causes of extremely high LDL cholesterol. The causes include inherited disease, an underactive thyroid, kidney disease with heavy protein loss and ketogenic diets. Professor Thompson, how do doctors find the cause of very high cholesterol? How dangerous is high cholesterol from a ketogenic diet?\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Those are great questions. How does a doctor find the causes of the cholesterol? Usually by the history.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e For example, I can tell it is genetic if your dad had a heart attack at a young age. Also, there are certain ethnic groups that have very high cholesterol levels. Let us take an example.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e In Connecticut, in the United States, one of the groups that has high cholesterol levels are French Canadians, people of French Canadian descent. Why?\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Because one of the first 8,000 settlers of Quebec (believe it or not, you can trace this back by the Catholic Church records), one of the first 8,000 settlers of Quebec brought in the gene for high cholesterol levels. So, those French Canadians, right? They are Catholics, so we are not having any birth control.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e They are up there in the cold. One in 50 people of French Canadian origin has a high cholesterol. One in 500 Irish dudes like me has high cholesterol.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e There are other groups. In South Africa, the Afrikaners brought in the gene for very high cholesterol levels. In the Middle East, Lebanese Christians have the gene.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e There is also a northern Italian gene. There are certain ethnic groups. So one of the ways we know what the cause of the cholesterol level is: we take a family history.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Now, I did list four causes of very high cholesterol levels. One was picking the wrong parents, genetics. The second one was thyroid.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e I think I talked about the fact that you have these LDL receptors on the surface of the liver. They grab LDL cholesterol, they pull it into the liver, and two good things happen. The blood level goes down, and the liver cell says, oh, I have got enough cholesterol.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e I do not need to make any more. Thyroid is necessary to make these LDL receptors. So if you do not have enough thyroid, you do not make enough LDL receptors, and it can look like you picked the wrong parents.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Now, something called nephrotic syndrome can also cause high cholesterol levels. What is that? Nephrotic syndrome is when people have a leakage of protein from the kidneys.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Something is the matter with the filtering part of the kidney. So they have leakage of protein into the urine. So the liver gets the message: I need more protein, make me more protein.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e One of the proteins that the liver makes is ApoB, apolipoprotein B, and apolipoprotein B is the carrier for the bad and the ugly cholesterol levels. Okay? So if you have nephrotic syndrome, patients will often be sent to me with high cholesterol levels.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e All I do is a dipstick of their urine, see that there is lots of protein, and know what the cause is. Now here is a very surprising thing: ketogenic diets, very low carbohydrate diets with a lot of protein and a lot of things like egg.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e It is not just the egg. It can cause very high cholesterol levels, especially in skinny people. Now, what is going on there?\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Usually when you lose weight, your cholesterol level comes down. Your LDL cholesterol level comes down when you are losing weight, and when you reach a new low weight, it goes back to where you were. The LDL goes back to where you were, pretty close to where you started.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Now, why does that happen? When you are losing weight and you are not eating enough, your liver thinks this may be the great famine, right? Oh, I better not waste any energy making cholesterol.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e This guy is not eating much. We could be in a famine mode here. Let us save some energy.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e So generally, when you are losing weight, your LDL cholesterol comes down. It goes back to where it was when the weight loss is over and you are eating enough calories. There is a strange exception.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Skinny people, thin people doing ketogenic diets can have remarkably high cholesterol levels. Right over here, on the other side of my desk, I have the chart of one of my patients, sent to me with a cholesterol level of 800. Like 500 of that was in the LDL.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e He was thin, he was 72 years old. Now, why does 72 years old matter? Because I know it could not have been genetic, because if it was genetic and it was that high, he would have died from a heart attack by now.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e So I asked him, and indeed he was following a ketogenic diet for migraines. He thought it helped his migraines. He was not heavy; he was not fat.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e He was following a ketogenic diet, and he was eating a fair amount of eggs. I have not seen him back since I told him he needed to eat more carbohydrate and he needed to cut down on the egg input. If you are one of those folks out on the ketogenic diets, and I am not against them, you have got to get your cholesterol level measured to make sure you are not one of those dudes and dudettes who really raises your cholesterol levels on a ketogenic diet.\u003c\/p\u003e\n","brand":"Diagnostic Detectives Network","offers":[{"title":"Default Title","offer_id":48388611506332,"sku":null,"price":0.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0599\/5449\/5644\/files\/2225152266-cb2cc06a3c26192d5f5ff42ed8b8d47f09561eb7b1429cf7c31cfd48c5d4ebec-d_1920x1080_f757b9ac-b12c-425c-a41d-bac92e6b6321.jpg?v=1794435394","url":"https:\/\/diagnosticdetectives.com\/sv\/products\/paul-d-thompson-extremely-high-cholesterol-12","provider":"DiagnosticDetectives.Com","version":"1.0","type":"link"}