Need HDL cholesterol help
 

My 3-month blood work just came back.

Things are mostly great: I no longer meet the diagnostic criteria for diabetes.

My total cholesterol, trigliceride, and LDL levels have all plummeted... not quite to "normal" range (except the first) but pretty darned close. (For the previous blood work, that we're comparing this to, I'd spent several months eating a diet deliberately high in wheat, to get an accurate Celiac disease test... so those numbers had been scarily high)

The thing is, my HDL is still really low. And, honestly, this has usually been the case when I've had my cholesterol tested -- it's just that now, I see my results online, instead of the doctor seeing them and giving me verbal information.

I eat LC. I eat lots of fat, including lots of saturated fat. (LOVE me some saturated fat! It's what makes pork chops & steak taste so darn good!) I take fish oil supplements, and coconut oil is a staple in our home (running out sends everyone from my hubby and kids to the DOGS into a panic!

And yet, my HDL has DROPPED since November (and in November, it was half what is "should" be.)

I'm sure I'll be reviewing all this with my doctor in a couple days... but I wanted to see what else I might do.

There is a good discussion and quotes about HDL from the Cholesterol Clarity book in this thread. https://forum.lowcarber.org/showthread.php?t=471974

Advice has not changed...HDL is very slow to rise, while the Trigs fall rapidly. The advice to eat more fat, exercise, no alcohol, IF, etc is all the same. The HDL shouldn’t have gone down further, but then when you are actively losing weight, all blood lipids can can get messed up. Likely a temporary blip.
Dr Westman's advice 3 months into weight loss...don’t run a lipid panel. Wait until weight stable.

Yeah, I was prepared to see my triglycerides be screwed up because of the weight loss...

I haven't been hitting the gym like I should this past month, but am doing everything else.

We're 5 months into LC -- started on Nov. 1, after the Celiac test was over. Last lipid panel was mid-Nov, and she was alarmed... but I knew going LC would fix a lot of it.

In the past, my lipids always looked great, but I'd consistently hear, "Your HDL is low, but overall it looks great so I wouldn't worry".

In the past 8 months, I've had 3 doctors VERY concerned about my low HDL. And now I see why....

My HDL is 28.

I can't remember the last time I drank alcohol. (Oh, wait... 1//4 glass of wine on Thanksgiving!) I literally cannot eat more fat than I do (for reasons that should be obvious -- the more fat you eat, the less you can eat, and I'm ALREADY on a HF diet!) and I'm doing the IF fairly often. (At this point, hubby asks me on a daily basis if I'm going to eat, before he makes coffee. So he knows whether to make me "breakfast coffee" or just regular.)

IF is part of how I manage the depression-fueled days when I just want to eat. (This isn't hunger, it's depression. And my world has been a little too chaotic this month to take care of myself in that regard. The depression tells you to do all kinds of stuff, and eating is one of them. Being able to tell the depression, "I can't eat. I'm fasting today," has been really helpful. Really need to find a counselor again & deal with some of the depression, but I need TIME for that, which won't happen until next week.)

But seriously... IF. I typically go for 2 days, at least once a week. After that, I'm happy enough to eat, but I'm still really only hungry for about one meal a day... Usually lunch, and then dinner looks like a snack (for me) eaten with the family. Every once in a while, I have a really hungry day where I eat more... but even when I'm not fasting, I'm "almost" fasting, I swear!

Guess I need to hit the gym more... that's literally all that's left to raise it.

Janet's advice is excellent, and it sounds like you're following a solid protocol that should result in higher HDL. Janet mentions that it takes time to see a change in HDL, particularly since you've tightened up your LC eating consistency after prepping for the Celiac test, you may simply need some more time. Exercise is always a good thing, however, so it would make sense to add a regular workout to your routine at this time.

Are you taking any medication for depression?
Be aware of interactions, how to taper off, a good article by Dr. Georgia Ede: https://www.psychologytoday.com/us/...ric-medications
Apparently a schizophrenic med can lower HDL, https://www.psychiatryadvisor.com/h...-schizophrenia/ so check the side effects on Drugs.com of any medications in this class. Unlikely, but if you are on any medications, it doesn't hurt to check both the Common and Uncommon side effects...always long lists, sometimes with surprises. And if your stats are correct, your BMI by itself, and still having metabolic syndrome, can be a risk factor for low HDL.