Breaking down the blood work

OK, here are the results of my 6-week blood work.

This is another example of how this way of eating is turning much of the health world upside down.

The main markers that indicate disease are low.

Great numbers in Insulin, Glucose, and A1c.

No indication of inflammation or anything stressing out the body.

Testosterone levels are ok and Thyroid looks good.

What's up with the Cholesterol?

Here's the upside down part. Almost none of those Cholesterol numbers really matter by themselves.

We used to think that high Total Cholesterol or LDL was bad. According to all the old school information, I should have heart disease and have a severely increased risk for a heart attack right now. All the yellow and red items were flagged by the lab as being out of a healthy range.

That's old news. Still important to have the information but, I'm not concerned with the numbers based on all the new information that's available now. Here are why I'm ok with high Cholesterol.

Triglyceride:HDL Ratio - This gives you an idea of the size of your LDL particles. Having a lot of LDL Cholesterol isn't necessarily bad if the particles are large in size. The smaller this ratio, the more you reduce your risk of heart disease. Anything 1 or lower is considered good. Mine is right at 1.

HOMA-IR - This is a rating that tells us how well the body is managing Insulin. It's not always good enough to look at just Blood Glucose or Insulin by themselves. When we look at how they work together, we can get a better view of any issues with Insulin resistance. Anything under 1 is considered good. Mine is at .80.

C-Reactive Protein - This measures the amount of stress and inflammation in the body. It can be an indicator of heart disease, arthritis, and other inflammatory conditions. My High Sensitivity CRP number is super low at .8. Anything below a 1 is a very low risk and indicates no disease is present.

Anyone concerned with heart disease or Insulin resistance and having high Cholesterol should look at things in the big picture.

My LDL is high and according to what we've been told our whole lives, this means I'm at a super high risk for heart attack. But am I really?

Let's look at the generally considered risk factors for heart disease from the old school point of view.

Age, Gender, Race, and Family history I can't do anything about.

Smoking - Nope
Cholesterol - At RIsk
Blood Pressure - Last check it was great. (110/64)
Resting Heart Rate - Great (55bpm)
Physical Activity - #CrossFit
Obesity or Overweight - 12% body Fat, 185lbs, I"m good here.
Diabetes - Not even close (HOMA-IR <1)
Stress - stress, and inflammation in my body is very low
Alcohol - Not in 9 weeks
Diet - #carnivore

Looking at all these factors as a whole, even under the old standards, I think I'm doing pretty good.

If you take into account the new info we have on cholesterol and what it should look like, I think I'm doing Great!

Other Observations


My Glucose level may seem high until you read this.

There are more and more people going zero carbs that are seeing their blood glucose rise to higher than we currently think it should be. There are a few possible explanations for this. The most plausible to me is that when we don't have the spikes and crazy insulin responses from having carbs in our system, our bodies can regulate glucose and insulin in relation to each other better which allows for a little more of it in the bloodstream. Also, if someone is active and has a higher demand for glucose the body is better able to handle making more instead of having to force itself to use whats being shoved into by food.


What is TMAO and why is it red?

There is a compound made in the gut that has been observed to be at high levels in a percent of people that have serious cardiac events. There is no direct link, just an observational study.

Here is Cleveland Heart Labs take on TMAO.

Here is a really good breakdown of the study and what it could really be saying...

I'm a data head. I'm not tied to anything until I can see data that is definitive. I've spent 20 years evaluating data and making decisions based on the information.

Phrases like these are red flags for me when I'm evaluating any data. "This would be expected to increase CVD risk, and indeed there are studies that demonstrate that people with higher TMAO levels had a 1.5 times greater risk of a major cardiovascular event over the next year."

This is a claim of risk without a declaration of a cause. It's a logical contradiction. To reword this statement. "We hypothesize that this may increase CVD risk and because people that have had a major cardiac event have also had high levels of TMAO, then we're going to assume that there is something about TMAO that indicates a higher risk."

What if those same people all had more than 10 freckles on their left arm? The same jump in logic could make a claim that there was a risk factor in left arm freckles.

In the technology world, we call this kind of information, leading data. It provides a platform to develop a hypothesis that must then be proven or disproven. It is not definitive enough to take action on other than initiating further research.

From what I've read so far, TMAO may be an indicator of something. There needs to be more research as to what and if TMAO itself is the problem or if it's pointing to something else that is, (if it's really a problem, to begin with).

Questions I have, that I'm not sure will ever be answered.
- If TMAO levels are an individual gut characteristic, will eating more meat than what someone has been eating make it worse?
- In the people that had major events, was TMAO the cause of those events?
- Are there other factors in play that go along with high TMAO? Of the people in the study that had major events, how many were low carb, vegetarian, or standard western diet? How many were sedentary, lightly active, or active? What were the ages, ethnicity, or region? How many were insulin resistant, diabetic, or neither?
- Outside of the TMAO observation, were there any other risk factors evaluated and what were they?
- If all other factors are at levels below risk, what does it mean if TMAO is above the current established risk level?
- Of the people in the study, how many of them had a serious event but did not have high levels
- How many of them didn't have a serious event but did have high levels?

Bottomline for me. I"m not worried about TMAO yet.


  1. Lots of great information; thanks for sharing. I'm looking forward to my annual wellness checkup, because I'll be 6 mos into my ZC WOE.


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