Bulking with cholesterol issues

[simon77]

Hey y'all, I'm 20 (male) and relatively new to fitness. I've been trying to do some light bodybuilding stuff, and to that end I've been on a bulk for the better part of a year. My goal is vague but think something along the lines of a Baki/Bruce Lee/Modern Kumail Nanjiani sort of thing. Completely natty so far despite some temptations.

I was diagnosed this week with a very genetic hypercholesterolemia + Fatty liver grade 1.
I don't drink, smoke, or do drugs because of my chosen faith, and after discussing with a dietician, my diet came out to be relatively fine (very light chinese/Korean style high protein diet, no excessive oils) so after some investigation of my family history it turns out we all have it and it's genetic. I've been put on Statins which cause some weakness and aching as side effects, as have the rest of my family.

I want to continue my bulk but my doctors have recommended I go entirely vegetarian to control the cholesterol, basically take my diet from being 80% healthy to 100%. On top of that, I'm being advised to focus on zone 2 cardio. So far I've had a successful bulk, going from 65 kilos at 17% bf to 84 kilos at 23%. (old blood tests showed high cholesterol, 5 mmol/L LDL then too, to back up the fact it's genetic).

In terms of my planned diet, I'm probably going to focus on my culture's traditional foods like lentil stews and beans, but I don't think it'll be easy to meet my protein needs. I've also been told to drop creatine (5g/day alternating week cycle so far) because it lowers serum bicarbonate levels which is bad for statins apparently? Annoying, but I'll take it on the chin.

What advice do y'all have to achieve my goal physique under the conditions above? Medically I have all the advice I need but I was thinking maybe one of y'all had a similar experience?

 

[travis93]

@simon77 That's a tough one. I'm no expert on hypercholesterolemia, but one thing to think about/look into is that cholesterol is a precursor to testosterone, which drives men's ability to build/maintain muscle, drop fat, have strong bones, more energy and so much more. But your body literally can't make testosterone without cholesterol. So an anti-cholesterol diet/drug is inherently an anti-testosterone diet/drug. I had cholesterol concerns when I started researching natural ways to improve testosterone. And, despite a family history of high cholesterol and multiple heart attacks on my father's side, I started eating a lot more [high quality] saturated fat and it worked out well to help improve my testosterone. My LDL even went down like 20 points despite including way more animal fat in my diet. Again, I don't have hypercholesterolemia and I'm not a health expert, but just something to think about.

There's a lot else about diet choices and testosterone too, like you mentioned eating beans and legumes, which are loaded with things called phytoestrogens, which mimic estrogen in your blood throwing testosterone out of balance, and they also have a lot of phytic acid which binds to minerals your thyroid needs. (Thyroid is critical for testosterone as well, so when phytic acid binds to the minerals the thyroid needs, those minerals become non-absorbable for use in your body so your thyroid gets short changed and some people become hypothyroid.)

And creatine also helps a ton with testosterone. So that's another tough one.

I recently wrote an article here about how I eat to improve testosterone in case it helps on some of the other non-cholesterol angles: https://medium.com/@andy.m.creighto...ol-in-simple-terms-part-2-eating-d765cce0831d

Hope this helps some, but I'd definitely do all the research you can on this.

 

[simon77]

@travis93 Interesting stuff with some parts I agree with. I'd you don't mind me asking, what was your LDL/HDL and ratio? LDL pathways do indeed contribute to testosterone bioavailability but only to a point, since if your LDL is high enough to begin plaque depositing it wouldn't be absorbed anyways. HDL and test have a more complex link and statins do increase HDL; from what I'm seeing the studies on statins and test didn't explicitly seek out men with hypercholesterolemia. Curious how that changes the calculus, although I'll definitely be dealing with lowered test. Fatty liver comes first though since that'll lead quickly to cirrhosis if I'm not careful.

You mentioned shellfish, prawns and shrimp are available to me as replacements for my proteins. Egg whites are too, sadly not the yolks. In terms of supplementation, I could potentially lower my creatine intake and supplement bicarbonates to compensate. Any other suggestions?

 

[travis93]

@simon77 Yeah studies are tough because not only do they tend to exclude statistical anomalies like yourself, but they also don't tend to control for other contributing factors like chronic stress, etc.

I don't recall my LDL/HDL ratio (this was a while ago) and honestly my whole experience with learning about how to improve testosterone has made me a little annoyed with my doctor, so I don't tend to see him or get blood work done too often. I was in my late 30s following all of his advice on health and fitness (the typical stuff, lean protein, low fat, avoid carbs, watch calories, low salt, hydrate until water comes out of my ears, cardio cardio cardio, don't do compound lifts at my age, etc.) and getting nowhere as all of that flies in the face of how testosterone works in the body. He was shocked to see me just several months into this whole natural testosterone journey, coming in 50lbs lighter, stronger, leaner and more energetic than my college years, etc. And my doctor himself is just a few years older than me was also about 50lbs overweight and looked visibly unwell, mentioned that he's on stains too. So I switched doctors, but still getting the same runaround about looking into statins, not even based on my numbers but throwing it out there in conversation when I shared how I've gotten into the best shape of my life in my 40s by going against doctor's orders. And honestly it makes sense as were in a major low-T epidemic right now as most guys follow doctor's orders and main health guidelines etc. and guys on average have literally half the T of men the same age only 50 years ago - truly scary to think about.

As for proteins, if you're just concerned about the cholesterol piece, I'd opt for lean cuts of red meat over poultry or large ocean or farmed fish for the much higher testosterone-supporting nutrient content (assuming you can get good quality red meat, grass-fed/finished, no hormones or antibiotics, etc.). Good quality organ meat like liver are even more nutrient dense. I'd also just watch out for things like soy as a protein source for similar reason I mentioned about beans with phyto estrogens. Not sure how well you tolerate dairy, but high quality dairy could work, and/or a good clean whey protein.

Do you take vitamin D3 (or get plenty of sun) along with a K2. I think K2 helps shuttle the calcium in your diet to your bones and away from your arteries.

Again, I'm not an expert, but I think if I had to do this with some limitation on my cholesterol intake, then I'd focus on supporting my testosterone in every other way possible. If you checked out that article, you probably saw I linked to other things I do for testosterone support across the other angles of exercising the right way for testosterone, as well as lifestyle factors that affect testosterone, but the biggest one for most guys is stress which I wrote about as well. Most guys only think of stress as the stuff going on in their lives, but that's usually just the tip of the iceberg with a ton of other stress hormone responses going on under the surface from various common diet, exercise and lifestyle choices. So, I also wrote about how stress impacts testosterone on all these fronts and how I try to mitigate it.

 

[dinafrancis]

@simon77 So i'm not a doctor, but I dunno if I'd go vegetarian. Now I don't have your issue, but my LDL was slightly high (HDL was golden). I actually increased my red meat consumption and my LDL has gone down. Vegetarian isn't inherently healthy, if that's what you were implying from "80% healthy to 100%".

I have also pretty much eliminated seed oils from my diet (I cook exclusively in butter or rendered beef or lamb fat). And my red meat has all come from a locally purchased grass fed cow. Grass fed vs corn fed have different nutritional profiles, so that very much could have something to do with it as well.

But you can try going vegetarian for a while, see how you feel. Stick with it for like 6 months and get re-tested. Personally, i'd see where the statins alone get your levels, and then change your diet and test again in 6 months or so.

BUT ANYWAYS, if you get your protein in and lift consistently, you should be able to meet your goals. Plenty of vegetarian and vegan lifters out there. Creatine isn't needed for gains anyway, it's such a minor boost, assuming you even notice it.