What can I do to lower my cholesterol? It seems I've tried everything!

Image Credit: Russ / flickr

What can I do to lower my cholesterol? It seems I’ve tried everything!

Help! I went vegan for 4 months with no statins. My cholesterol shot up to 280. (From 180). On statins and a diet with rare “tastes” of meat and dairy, I am at 170-180. I would hate to take more statins, any suggestions?

Carolynn / Originally posted in Everything in Moderation? Even Heart Disease?


For those who have tried eating a whole food plant-based diet and still have high LDL, you should make sure you’re not eating plant sources of saturated fat, such as palm kernal oil, palm oil, coconut oil, and cocoa butter (found in chocolate). Of course if you were you wouldn’t be eating a whole food plant-based diet, but you’d be surprised how many people tell me they are and they’re like “Yeah, and I eat a spoonful of coconut oil a day.” I’d also cut out unfiltered coffee. Then once you have gotten rid of the things that increase your cholesterol you need to pack your diet with foods that actively lower your choleserol. So, for example, the components of the portfolio diet for lowering cholesterol. I’ll highlight some of the diet tips found in Dr. Jenkins protocol using Dr. Greger’s videos as reference. 

1) Load up on foods high in soluble fiber. This means tons of beans (see what kind are best: canned or cooked), vegetables like okra, plenty of whole fruit, oatmeal, and flax/chia seed. Find ways to use beans. Lentil stew, dal, curries, bean burritos, bean soup. If you don’t like beans whole, like in a salad, maybe try them as a spread or as hummus? 

2) Take about 2 Tablespoons of ground flaxseed daily and 4 Brazil nuts monthly. Sprinkling ground flax on oatmeal in the morning is an easy way to get enough. Or add it to a smoothie. If you buy the flax whole just add it in the blender first, grind it, and then add the rest of your ingredients. 

3) Focus on several cups of greens daily to help keep nitric oxide flowing. Vegetables loaded with nitrates have been shown to improve heart health. Beets and arugula have tons! (See video on where other vegetables rank on nitrate levels). Yes, green smoothies count if you’re adding the right foods like berries and dark green leafy vegetables (kale, spinach, even parsley). What’s better? Raw or cooked vegetables? Well, it may depend on what veggies are cooked. Lastly, a word of caution for those going wild on greens is that overdosing on raw greens can happen.

Dr. Greger says to get thyroid function tested, too. A low-functioning thyroid can contribute to high cholesterol so it’s good to rule that out. Weight loss is also important if there is too much abdominal fat. Is your height more than twice your waist circumference? So  there are a lot of factors to consider, but if folks are practicing heathy eating and managing body weight and still find their LDL is not coming down they should definitely consider a statin. As I always say make sure to check with your doctor about all of this. It’s important to be transparent and communicate with everyone. 

Lastly, here are some of the best videos to help understand more about diet and cholesterol. Sometimes folks will ask questions like does cholesterol have a lower limit, or, what about the size of LDL particles does that matter? ​Thankfully Dr. Greger addresses this in his video: Does LDL size matter? and Cholesterol does not appear to have a lower limit. A few concerns with dietary cholesterol is that there’s a plateau effect issue and the postprandial (after eating) issue. These videos explain the issues further: When Low Risk Means High Risk and Eggs and Arterial Function. Find out what’s an Optimal Cholesterol Level to shoot for. 

 Image Credit Russ / flickr


160 responses to “What can I do to lower my cholesterol? It seems I’ve tried everything!

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  1. I really am doing all the above: vegan diet, wholeplants, no oil, no salt, no sugar, no processed footds, lots of all the foods mentioned above + I exercise 1 hour a day (running) and I am very lean. Neverthelss, my LDL is still 116. As far as I am aware, it’s not my genetics, since heart disease doesn’t run in my family. What can I do more??

    1. I am similar to you except I eat salt, some sugar and do not exercise. My LDL is 134. I just will not worry about it. I just don’t believe they know all there is to know about it and I have seen too many studies showing higher cholesterol equals lower overall morbidity. My non-professional opinion is, do not take statins and don’t worry about it. Maybe spend some time looking up studies about cholesterol and health. And notice how many times in medicine they say “we used to think” and were wrong.

    2. Lynn,
      I am exactly situated as you. My local plant based doc spoke to Dr. Esselstyn on my behalf. He told he I shouldn’t worry about the numbers so much as long as I am eating a whole food no oil plant based diet. But I would like to hear from other plant based experts on whether I should still supplement with a statin. I read one can take a low dose statin just once a week to still get some benefit with little to no side effects.

    3. I have noticed over the years how “normal” lab work parameters have become more restricted. For example, blood pressure was once considered textbook perfect at 120/80- now it’s 100/70. Blood sugar ranges were once considered healthy at 80 to 120; now if it’s at 100 or more and we are cautioned and monitored for pre-diabetes or treated. Cholesterol values have also changed. I sometimes wonder what impact big pharmacy gurus have had on these changes over the years? After all, they need to make a living too!

      1. Hi Kim,

        I am a volunteer for Dr. Greger. Thanks so much for your question. You raise an interesting point.

        However, most of the studies showing that lower blood pressures, cholesterol levels, white blood cell levels, etc. are done on people that don’t use medications to drive down their levels. For example, we often see a step-wise decrease in BP, cholesterol, and WBC counts as you move from omnivore to semi-vegetarian to vegetarian to vegan. The evidence is pretty strong that individuals that get their levels lower without medications get less chronic disease and live longer. The pharmaceutical industry may use this evidence against people to suggest that people with “normal” blood pressures or cholesterol levels use medications to lower them further, but we know from the research that this can be done without medications–just a healthy, whole food, plant-based diet, with assistance from other healthy lifestyle changes.

        I hope this helps!

      2. Kim,

        Your insights might be partially correct however, the changes have taken place with new and emerging evidence of better health outcomes with as an example, lower sugar levels.

        We also have better and more sensitive testing methods. The science behind many of our current tests methods has really improved, with advanced lab equipment. You might have noted how even in small medical clinics there is a move toward quick lab results, in minutes. Not just the dipsticks but also for a number of more complex testing.

        One of the larger overviews in our health has been a greater emphasis on the role of inflammation system wide. As a focus this has changed many of the recommendations and because it’s easy to measure, has been impactful in many medical arenas, including lab tests.

        Couple this with a social need to reduce health care costs and we have a number of factors changing many of the lab values.

        1. Health care costs can be reduced immediately by reducing the cost of meds ( highest costs are in US) and eat whole food (wf)vegan diet.Pharmaceuticals don’t/won’t lower costs; the public is encouraged to need them less. With a wf vegan diet we may see people needing meds a lot less and living a lot longer!

    4. Lynn, I am the same. I do all the above too… also take amla+turmeric+pepper+daily-dozen daily and my levels are still.. LDL=110, HDL=41, total=168, triglycerides=90
      Been doing WFPB for about 1 year, vegan for 7 years.

      Only thing I do bit out of ordinary is eat tonnes of peanut butter (organic crunchy, nothing added) and raisins (high energy snack for all the exercise I do)

      Can anyone shed any light on why my levels aren’t great? Maybe a year isn’t long enough?

      1. Peanuts (and other nuts/seeds) have plenty of saturated fat, Dr Greger recommends 30g per day (2Tablespoons) of nuts, which is not much. And raisins are very high in fructose (with very little fibre or phytonutrients compared to most other fruits).
        So saturated fat plus fructose could likely explain your problem.
        You could try fuelling your exercise with starches (especially with resistant starch like reheated (wholemeal) pasta (brown) rice and potato).

        1. “Dr Greger recommends 30g per day (2Tablespoons) of nuts”

          .. i thought his daily dozen recommendations were minimum recommendations? ..I eat about 4 Tablespoons of peanut butter and maybe half a hand full of almonds+seeds

          “And raisins are very high in fructose (with very little fibre or phytonutrients compared to most other fruits)”

          .. raisins have higher fibre than most fruits (banana, apple, mango, etc) and lots of phytonutrients?
          I eat plenty resistant starch too

      2. I was vegan for several years, but was addicted to sugar( candy, donuts). Even when I controlled my sugar, my LDL cholesterol kept going higher (137). Statins took my short term memory away. I didn’t have heart disease so I didn’t eat like Caldwell Esselstyn recommended. Then I saw “Vegan Zombie “ on YouTube with the same problem. He did the strict version ( no meat, dairy, oil, NUTS, AVOCADO or salt and sugar). His cholesterol responded like most vegans. I tried it and my LDL dropped to 97 after 3 weeks. I included salt in my food still. Total cholesterol was 147! It is probably your oil and nut butter. Some of us have to do more for diet to fix bad cholesterol.

        1. Gosh I thought olive oil and avocado lowered LDL and raised HDL, and I also thought nuts were good fat which would lower LDL and raise HDL, am I totally off here?

          1. Olive oil and avocado oil can lower LDL as compared to saturated oils like coconut, palm and hydrogenated oils found in plant based “butter”, but all free oils paralyze our arteries which is highly associated with an increased risk for heart attack and stroke (read about Flow Mediated Dilation). Nuts will also lower LDL as compared to saturated fats, but I have not seen research showing that nuts paralyze arteries like oils do. Nuts are associated with decreased disease and premature death, but the nut studies are pretty much all funded by the nut industry, so we don’t know if all the purported benefits are true. We do know that nut butters are likely not as health supportive as the unground nuts.

  2. What about Ubiquinol, or CoQ10 to lower blood pressure and cholesterol? I know our bodies make it, but is there any evidence of an advantage to taking supplements?

  3. I have had digestive problems with diarrhea as long as I can remember. This Fall a gastroenterologist asked. me to try the FODMAP diet, and I have some relief, but I am also taking Bentyl 4 x daily and Imodium 8 x daily. since the diet is very restrictive for the cole family vegetables, most greens and legumes, it is almost the opposite of high fiber diets discussed here. I am really sold on plant based diets, but can’t see how to reconcile it with FODMAP. I will try try peppermint and cayenne suggestions first, but has anyone had successful ideas on how to meld these two ways of eating?

    1. Dcs- your digestive issues are likely caused by your brain. Google search TMS and Dr. Sarno and IBS. You can also Google mind gut connection. Also go to TMS wiki

  4. Cholesterol particle size question. Doctors dont know what to do with the results. I am eating a whole food/plant based diet 100% for 4 years. The doctor ordered the particle test at my request. It showed small particle size ( type B) and noted a high risk for heart disease. The question i have is this. While eating a whole food/plant base diet, is there any other natural intervention that helps to increase the fluffy LDL particles in the blood over the small dense LDL? Or is the WF/PB diet protective enough? I understand that the particle size testing is gaining traction with cardiologist. Thank you very much. Your book and viseos are greatly appreciated and well done!

    1. Hi Judy,
      Anything that impacts insulin sensitivity should affect particle size, so aside from dietary intervention (WF/PB and low calorie, depending on your current body weight), your best bet is regular exercise to decrease intramuscular and intrahepatic (liver) fat stores. Hope that helps!

    2. Judy: Dr. Greger addressed particle size in a video a couple years ago: http://nutritionfacts.org/video/does-cholesterol-size-matter/. The bottom line is that the focus on particle size is severely misplaced / a misinterpretation of the data. I can’t answer the question about whether your diet is 100% protective or not, but I do think that an effort to increase fluffy LDL would be very misguided. Based on the scientific evidence, the goal for high LDL people (those with LDL above 70) should be to decrease that total LDL number (regardless of particle sizes). Hopefully the ideas at the top of page (plus David’s exercise point to you earlier) would help you control your LDL. Make sense? What do you think?

    1. Rebecca West: I’ve been struggling to figure out how to answer this question. I finally decided that it came down to this: Why do you think you need red meat and other animal products to have healthy blood? I’m guessing you have been told this idea your whole life. But the evidence does not back up this idea. It turns out, most people’s bodies can make all the red blood cells that it needs on a healthy whole plant food diet.
      I found this quote: “Anemia has three main causes: blood loss, lack of red blood cell production, or high rates of red blood cell destruction.” from: http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/ When it comes to diet, the first one is not an issue. The second two causes of anemia would be affected by diet I would think. But there is no reason to think that we need to eat animals to have our bodies properly make red blood cells.
      Dr. Greger addresses a similar question in this “Ask the Doctor” page: http://nutritionfacts.org/questions/second-opinion-for-8-year-old-with-anemia/ And here is the whole list of videos and articles that mention anemia. There may be something in here that clarifies things for you: http://nutritionfacts.org/?s=anemia
      Does that help?

    2. Red meat can supply iron and Vit B12, both needed for blood (but you need leafy greens for the folate you also need). Anyway, vegans (and many vegetarians) do need a B12 supplement. For iron, it is important to eat some of the more iron rich plant foods if you have high iron needs (eg women 15-50): dark cocoa, seeds like pepitas, beans or tofu, spinach or kale, skin on potatoes, oats, nuts, apricots or prunes and tomato concentrates. Here is a high iron day:

      Food Iron in mg (approx).

      Serve of Porridge 3.5
      (just over 1 cup cooked)
      5 apricots 1
      Prunes, mulberries and olives are also good ‘fruit’ sources
      1oz pepitas 4
      2 oz dark choc 6.5
      (or pure cocoa if avoiding saturated fats in chocolate)
      1 cup cooked spinach 6
      Other leafy dark: kale, rocket etc are good too. Spinach is the queen but for other health benefits best to
      rotate to various other greens
      2oz almonds 3
      Most nuts are good, especially cashews, macadamias and pine nuts, as well as almonds.
      1 cup lentils 3
      or 1/2cup tofu, or other beans just a bit less iron but still good
      2Tb Tahini 2.5
      60ml tomato paste 2
      1 large potato(skin on) 3
      Serve brown rice 1
      (Or 2 slices wholegrain bread)

      Total 35.5mg

      This should be enough even for someone who is anaemic, eg due to very heavy periods, as often seen in teenage girls.
      Men normally need 12mg if from plant sources .
      Pregnant women have high needs, might need 40mg+/day if purely plant sources, but they often take an iron/folate supplement anyway.

      Maximizing absorbtion by eating with a little fruit or veg containing VitC (tomato strawberry lemon juice etc) might mean you need a bit less. Cooking in a cast iron pot helps, and avoiding tea or coffee at the same meal as your iron rich food, as they can drop absorbtion by more than half!

      Although Heme iron from redmeat is well absorbed regardless of other factors, this can be a bad thing, as too much iron is toxic even for people who don’t have hemochromatosis, and the body cannot regulate absorbtion of heme iron, whereas plant iron is absorbed to the degree needed (except in those with hemochromatosis who lack this ability).

      Food Iron in mg (approx).

      Serve of Porridge 3.5
      (just over 1 cup cooked)
      5 apricots 1
      Prunes, mulberries and olives are also good ‘fruit’ sources
      1oz pepitas 4
      2 oz dark choc 6.5
      (or pure cocoa if avoiding saturated fats in chocolate)
      1 cup cooked spinach 6
      Other leafy dark: kale, rocket etc are good too. Spinach is the queen but for other health benefits best to
      rotate to various other greens
      2oz almonds 3
      Most nuts are good, especially cashews, macadamias and pine nuts, as well as almonds.
      1 cup lentils 3
      or 1/2cup tofu, or other beans just a bit less iron but still good
      2Tb Tahini 2.5
      60ml tomato paste 2
      1 large potato(skin on) 3
      Serve brown rice 1
      (Or 2 slices wholegrain bread)

      Total 35.5mg

      This should be enough even for someone who is anaemic, eg due to very heavy periods, as often seen in teenage girls.
      Men normally need 12mg if from plant sources .
      Pregnant women have high needs, might need 40mg+/day if purely plant sources, but they often take an iron/folate supplement anyway.

      Maximizing absorbtion by eating with a little fruit or veg containing VitC (tomato strawberry lemon juice etc) might mean you need a bit less. Cooking in a cast iron pot helps, and avoiding tea or coffee at the same meal as your iron rich food, as they can drop absorbtion by more than half!

      Although Heme iron from redmeat is well absorbed regardless of other factors, this can be a bad thing, as too much iron is toxic even for people who don’t have hemochromatosis, and the body cannot regulate absorbtion of heme iron, whereas plant iron is absorbed to the degree needed (except in those with hemochromatosis who lack this ability).

  5. I switched to a whole food plant based diet a month and a half ago. My total cholesterol is down to 189 off my statin med, but my LDL/HDL ratio is still out of whack. I am losing weight, but still considered obese at this time with a good portion of my weight being on my abdomen. Is this likely related to my weight? My Dr. wants me to resume my statin and I am just wondering if this would be a good idea until I get my weight under control.

    1. I had this same conversation with my doctor. When you are losing weight, you’ll likely have some of that fat traveling through your blood stream. Having lost a brother to a heart attack at 42, I’m cautious. I’m looking forward to being slim enough to go off the statin safely. Best wishes!

  6. I had a heart attack in 2011, with stent to the RCA, & on Plavix, Carvedilol, Valsartan & Simvastatin (40 mg.) ever since. I’ve had a host of medical conditions arise since then, & because of that I may have missed the possibility that some of the issues might be from the Simvastatin. I was so sick I went off of it on my own for abt a week & actually started to feel better, but went back on until I could talk to the MD. I finally asked her if I could ‘treat’ cholesterol with food (there is nothing familial or genetic in my history), but she said I can’t do that because of the stent. I’ve done some online research but really can’t find anything definite. Is there ever a chance of safely going off statins with a stent by maintaining a plant based diet? It seems senseless that the statins help the stent keep me alive only to very possibly fight cancer, liver & kidney diseases. I’m so sick right now I am thinking it best to have quality rather than longevity of life, just like the lady featured in the FOK movie. She really has been blessed that she could manage her heart condition without a stent. Please know that I’m eternally thankful that my life was (literally) saved, but now I don’t know in which direction to go. My MD is calling in Crestor to see if that has fewer side effects…..the pharmacist said that many are finding it has less negative effect on the liver. PS I take 200-300 mg. Ubiquinol daily, to help in being so tired, but still have headaches, terrible muscles spasms, weakness, trouble breathing, & some low blood pressure.

  7. I went on a whole foods plant based diet (thanks Dr. G) and in 3 months my bad cholesterol dropped 100 points. I ate much walnuts, chia seeds, pumpkin seeds and ground flaxseed. Had no oil. The only highly refined food I ate was bread, which I didn’t eat too often, and it was Ezekiel.

    1. Google Portflio Diet created by Dr David Jenkins. Advocates stressing these cholesterol lowering foods: Plant sterols, nuts, soy soluble fiber

      This might help: http://www.lipidgeneticsclinic.ca/pdf/2015%2009%2022%20The%20Portfolio%20Diet.pdf

      Dr Greger’s videos seem to jive with the Portfolio Diet.

      I’ve been on WFPB diet for about 6 months after a couple years as ovo/lacto veg with high BP and Cholesterol. BP is now normal but LDL/HDL is hanging around 117/79–still high. So, I’m going back thru Greger’s blogs/videos for specific cholesterol lowering food help and discovered there’s a lot I can eat more of. Here’re a couple good ones on phytosterols:


  8. I wonder whether I have a problem and would really appreciate your thoughts: My cholesterol is 223. However, it splits like this: HDL is 109, LDL is 104. Triglycerides is 45. My family doctor says that there is no reason to worry, just in contrary, since in my case the high cholesterol number is caused by HDL, and the significant ration of LDL to HDL would be a perfect 1.0. But is it true that I can just lean back? I am worried by the absolute number of the LDL. I started on a WFPB diet nevertheless – makes just sense to me.

    1. Eva J.: I wouldn’t panic, but you do have cause for concern. Safe levels of cholesterol are 150 or below for total cholesterol and 70 or below for LDL. Levels at 150/70 or below are safe in terms of people not getting heart attacks. Above those levels, you incur risk. Hence, it is very good that you are starting on a whole plant food based diet. If you want to see the data that backs up my assertions and to learn more about what the science says about cholesterol, you can work your way through the NutritionFacts topic page for cholesterol: http://nutritionfacts.org/topics/cholesterol
      Good luck to you. But I don’t think you will need luck since your common sense seems to be very good! ;-)

      1. Oh, Thea, thank you so much for this very very quick reply! I had been told that these high HDL parameters are kind of a protective genetically coded feature. My mother has them, too – but she also had suffered from a stroke and light Alzheimer. Though I am from Germany, my very good friend of the US has been Cholesterol tested in her company as well – and they found the same thing: Elevated total cholesterol but high HDL. And she has been told the same thing: Don’t worry, that is a very good result. Thus, it seems that this results are not completely rare, and a whole (though maybe small) part of the population believes itself to be safe… Well, sorry for this long reply – I am just really glad not to be alone anymore with my “common sense”. Of course I will work my way through the pages, and through Dr. Greger’s book, which I just ordered :)

        1. Eva
          I think that you may be right to be concerned. Recent research indicates that high HDL cholesterol may also be harmful.

          Although this finding is not in fact entirely new

          You may want to discuss this with your doctor. Certainly, a well-planned whole food plant based diet should set you on the road to lowering your total cholesterol.

  9. Hello, tried to get to the ‘portfolio’ site, but got a Not Found error when it attempted to access: https://www.ncfamilydoctor.com/wp-content/uploads/2013/07/Portfolio-Diet.pdf Also, Dr. T. Colin Campbell stated in an interview with Guilt Free Vegan (youtube channel) that ldl levels for those of us who consumed dairy in childhood could remain high regardless of our current whole food plwnt based diets. Do you know of any studies on this? Thx very much!

  10. Since switching to WFPB eating in January, my cholesterol has been great. Total = 95 LDL = 45. But my doctor has kept me on a high dose statin drug because of my 2014 heart surgery. He did agree to reduce dosage from 80 mg to 40, and my cardiologist agreed with this. My problem is that I don’t see any research/reports on people in my situation, that is being a post heart surgery patient on a successful whole food plant based eating regimen with excellent cholesterol figures, and still on a statin drug. My other vitals are also excellent, weight is good (but I am not at goal yet,) and I get good daily exercise. Do I keep working with the doctors to reduce my statin use, maybe on a phased reduction to none? Reduce on my own over time? The doctors tell me that there is more benefit to statin use than just cholesterol control. I don’t seem to have side effects from the statin use.

    1. navyron: Even if you are not aware of any side effects to your statin use right now, my understanding is that those problems can build up or appear in the future–and they are very serious. I can’t think of any reason to stay on statins if you don’t have to. Did your doctors actually list the benefits that they think a statin drug provides beyond cholesterol lowering?

      Or put another way: My understanding is that the entire point of a statin drug is to lower cholesterol, with or without surgery. If you lowered you cholesterol using food alone, why on earth would you keep taking a potentially dangerous drug?

      I can’t recommend reducing the drugs on your own without supervision, because I’m not a doctor and don’t know what that would do. If your doctors are willing to work with you to phase out the drug, great. If not, hopefully you could find a responsible doctor who will. And if worse came to worse and you were able to, you might look up Dr. Klaper who does phone consultations. Dr. Klaper is a well-known, well respected plant based doctor who I’m sure can help you. He may even tell you to stop the statins right now since his opinion is that statins may lower cholesterol, but do nothing to prevent heart attacks. (At least, that’s what I understood him to say based on an article in a medical journal he read. I may have misunderstood.)

      Good luck. Let us know what happens.

    2. Your doctors are correct. There are more benefits to statin use than just cholesterol lowering. This Harvard article provides a good summary of the argument:

      You can also look at the latest guidelines if you have the time. They are not easy reading but they are very informative:

      As Thea says, it is very important to keep working with your doctors on this.

      1. I have been on a Whole Foods plant based diet for two years. I briefly went on a statin and then my numbers were great, but I went off thinking the whole food plant-based I would be enough but my numbers of going through the roof my total this last blood work was 226 with a very high LDM I don’t know what to do I’m really afraid of the statins and the doc said even with this that I would only have a 1% decrease any chance of having a heart attack or a stroke in the next 10 years right now he feels it’s a 10 percent chance. I don’t know what to do went to put me on a Statin 10 mg every other day.

      2. Copied from “Harvard health Publishing: Cholesterol and satins, It’s no longer just about the numbers.”
        New guidelines recommend a statin for anyone who has cardiovascular disease, including angina (chest pain with exercise or stress), a previous heart attack or stroke, or other related conditions
        anyone with a very high level of harmful LDL cholesterol (generally an LDL above greater than 190 milligrams per deciliter of blood [mg/dL])
        anyone with diabetes between the ages of 40 and 75 years
        anyone with a greater than 7.5% chance of having a heart attack or stroke or developing other form of cardiovascular disease in the next 10 years.

        Copied from the comments section: While many aspects of these new guidelines concern me, one of the biggest is the concerns I have is the recommendation to use statin in people with diabetes. First off, statins can actually contribute to type 2 diabetes. In fact, last year the FDA began requiring statin manufacturers to put a diabetes warning on their labels. So giving statins to people who already have diabetes doesn’t make sense.

        Plus, the data demonstrates that for men with diabetes statin drug use can lead to calcification of the coronary arteries. There’s also documented evidence that cataracts are more common in those taking statin drugs. And since people with diabetes are already more prone to cataracts, the use of statins for this population can be harmful.

        A far better intervention for people with type 2 diabetes, or pre-diabetes, is lifestyle changes—including diet therapy; weight reduction; avoidance of sugars; exercise; use of raw foods, particularly vegetables; and targeted nutritional supplements.

        Dr. Stephen Sinatra
        Board Certified Cardiologist
        Assistant Clinical Profession, Connecticut University School of Medicine

        To which I add the question, what is the ratio of the number of people who have one or more of the listed risks and normal cholesterol (50, <100) to the number of people who have one or more of the risks and elevated cholesterol? In other words, What exactly caused those risks to be present in the first place? Maybe the SAD? Maybe over weight? Maybe lack of regular exercise? How about we Rx Life style changes First? As noted in the other comments here there are genetic issues that outweigh life style changes, but again are they 1 in 100, 1 in 1000, 1 in 10,000? Honest question, not rhetroical.

  11. Greetings from Spain! I would like to know your opinion on the following study: http://bmjopen.bmj.com/content/6/6/e010401.full#responses This was published in a fitness and nutrition website I follow and sounds rather strange to me (I went vegan only 3 months before but am reading a lot about health issues). We have a little discussion going on in that page about this study. And as you are used to analizing all sorts of studies and know their strong and weak points, please read this one and tell me your opinion. Any arguments I could use to prove this study isn’t serious or completely wrong? Thank you and congratulations for your great work!!!!

    1. Hola, Manuel.

      This study was authored by people who are notorious for denying the evidence about cholesterol and health.

      The study shows nothing new. Previous studies have shown the same thing. This has been known for a long time. The reason for these results has also been known for a long time. See this commentary from 20 years ago:
      “”…….. a recent meta-analysis10 of cause-specific mortality (including unpublished data on noncardiovascular causes of death) from 10 large cohort studies and 2 international studies …… concluded that reduced serum cholesterol is not related to excess mortality among cohorts of employed individuals, whereas population-based studies did show a relationship. The investigators proposed that the discrepancy in results was probably due to a higher frequency of risk factors associated with low cholesterol, eg, alcohol abuse and ill health, in population-based study samples compared with employed cohorts.”

      For a full answer, see my response to deepcleavage above.

  12. A study just published in the British Medical Journal (lead researcher from University of South Florida) that looked at previous studies of 68,000 people over age 60 found no association or a small inverse relationship between LDL-C levels and cardiovascular death. There was speculation that the higher levels of LDL-C levels are protective of neurodegenerative disease in elderly people. The study also questions the prescribing of statins for such individuals. It would seem that the science is not supporting Dr. Greger. I remember reading back in the mid 1980’s that the Framingham study found that there was no correlation between high cholesterol and heart disease in people over the age of 50. Maybe this new study is lending confirmation to that.

    1. Sorry but this is all flim flam .Older people tend to have higher rates of disease than younger people. Many diseases in older people lower cholesterol. It is therefore a commonplace that older people with low cholesterol seem to have increased mortality risk. However in Western societies, most older people have low cholesterol not because they eat whole food plant based diets or because they have genetically low cholesterol. They mostly have low cholesterol because declining cholesterol is a pre-clinical symptom of disease.

      “This conclusion is consistent with results of a recent meta-analysis10 of cause-specific mortality (including unpublished data on noncardiovascular causes of death) from 10 large cohort studies and 2 international studies that concluded that reduced serum cholesterol is not related to excess mortality among cohorts of employed individuals, whereas population-based studies did show a relationship. The investigators proposed that the discrepancy in results was probably due to a higher frequency of risk factors associated with low cholesterol, eg, alcohol abuse and ill health, in population-based study samples compared with employed cohorts.

      Two additional pieces of evidence that suggest that low cholesterol is not a causal factor for noncardiovascular disease are the normal to extended life expectancy experienced by individuals with genetically determined hypobetacholesterolemia11 and populations with low average blood cholesterol levels, such as the Japanese and Greeks, who do not exhibit an excess of noncardiovascular disease deaths.12

      One strength of the investigation by Iribarren et al9 is its ability (albeit limited to two measures) to track cholesterol over time. In an effort to eliminate the possible cholesterol-lowering effects of latent disease, previous studies have excluded from analyses deaths within the first 2, 5, or 10 years of follow-up. The results found by Iribarren et al7 suggest that a drop in serum cholesterol may occur over a decade before disease is diagnosed. This is plausible; at least two examples of long-term morbidity leading to cholesterol reduction are hepatitis B virus infection13 and chronic respiratory disease resulting in repeated respiratory infections.14”

      As for your reference to a single trial that did not find a benefit for cholesterol lowering, this is contrary to many other trials which have have found reductions in death and other adverse events from cholesterol lowering eg

      “Reduction of LDL cholesterol with a statin reduced the risk of major vascular events (RR 0·79, 95% CI 0·77–0·81, per 1·0 mmol/L reduction), largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular and all-cause mortality. The proportional reduction in major vascular events was at least as big in the two lowest risk categories as in the higher risk categories (RR per 1·0 mmol/L reduction from lowest to highest risk: 0·62 [99% CI 0·47–0·81], 0·69 [99% CI 0·60–0·79], 0·79 [99% CI 0·74–0·85], 0·81 [99% CI 0·77–0·86], and 0·79 [99% CI 0·74–0·84]; trend p=0·04), which reflected significant reductions in these two lowest risk categories in major coronary events (RR 0·57, 99% CI 0·36–0·89, p=0·0012, and 0·61, 99% CI 0·50–0·74, p<0·0001) and in coronary revascularisations (RR 0·52, 99% CI 0·35–0·75, and 0·63, 99% CI 0·51–0·79; both p<0·0001). For stroke, the reduction in risk in participants with 5-year risk of major vascular events lower than 10% (RR per 1·0 mmol/L LDL cholesterol reduction 0·76, 99% CI 0·61–0·95, p=0·0012) was also similar to that seen in higher risk categories (trend p=0·3). In participants without a history of vascular disease, statins reduced the risks of vascular (RR per 1·0 mmol/L LDL cholesterol reduction 0·85, 95% CI 0·77–0·95) and all-cause mortality (RR 0·91, 95% CI 0·85–0·97), and the proportional reductions were similar by baseline risk. There was no evidence that reduction of LDL cholesterol with a statin increased cancer incidence (RR per 1·0 mmol/L LDL cholesterol reduction 1·00, 95% CI 0·96–1·04), cancer mortality (RR 0·99, 95% CI 0·93–1·06), or other non-vascular mortality."

  13. My son has inherited my husband’s high cholesterol. His Total is 259 and his LDL is 180. Since he is young, we are not interested in putting him on medication. He eats a healthy diet; we have tried the brazil nuts for three months but they have not had any impact. Other suggestions?

    1. Iacole: I can definitely understand not wanting to put a young person on statins. I’m not a medical professional, but I have some thoughts for you.

      You mention that your son eats a healthy diet, but the devil is in the details. Is your son eating a diet of whole plant foods without any oils? Is your son following the recommendations listed on this page? I mention this because you mentioned trying brazil nuts. I think that it would be a good idea to hit a difficult case like this with all the tweaks possible at once. Just trying one little thing like nuts might not make a difference. But trying brazil nuts *and* greens *and* beans *and* etc seems to me like the way to go. The following topic page on cholesterol has some additional tweaks to try: http://nutritionfacts.org/topics/cholesterol

      I’ll also point you to the book: Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure — by Dr. Esselstyn. The book would be well worth your whole family’s time, and it even includes recipes. If you want Dr. Esselsytn’s latest thinking in the big picture, here is his FAQ page: http://www.dresselstyn.com/site/faq/ . Also note that you can find several of Esselstyn’s talks for free on YouTube.

      Good luck!

  14. I’m confused. About 6 months after I first gave up animal products I went to Walgreens and bought a cholesterol test. Using the test kit I pricked my finger and got a reading of 128 for my total cholesterol which i was very excited about. Last week I got my cholesterol tested again and there was no change from what it was prior to starting a WFPB diet. My total cholesterol was up to 210! About three months ago I stopped cooking with salt, sugar and oil, but I have been buying black bean burgers from the store (they probably have oil). Also, I have been using cocoa powder (in smoothies) and eating dark chocolate occasionally. Is the chocolate messing me up? Maybe the test from Walgreens was inaccurate too? I’m so disappointed but I’m committed to giving it another shot. How soon after eliminating these items can I expect to see results and have another blood test?

    1. Those home lipid test thingies are far from reliable. Sorry, but you wasted your money, just discard it. Chocolate does have saturated fat, so eat it sparingly, or not at all. Want a great chocolate fix? Dice some fresh juicy fruits and add about half a teaspoon of natural unsweetened cocoa powder, stir.

      To give an approximation to your answer with regard to time, 6 months is about right, but changes will still occur even a year or more later. Just keep eating well, be sure and incorporate regular exercise (absolutely essential), and strive to eliminate all processed foods. Since you’re having smoothies, you should have one with a 1/2 cup of oatmeal daily.

  15. I am wondering if anyone knows much about Lipoprotein a. I am trying to research it because both my dad and I have high levels of Lipoprotein a and we can’t find much information. What we are finding is unsettling since it goes against what I have always learned to be heart healthy eating and against what this website teaches. I would love any help if anyone knows much about it.

  16. I am a strict ethical vegan, aged 68. Became vegan only 9 months ago but totally plant based, zero animal products ever. I eat too much whole grain bread and use Smart Balance on my toast and a bit of olive oil for soups but that’s it. Lots of greens, fruit, veggies and always whole grains, never refined. But I am at 238 cholesterol, down from 278, so that’s something but my LDL AND HDL went down, too. I am going to see an endocrinologist now. My vitamins and minerals and protein are fantastic and so is the B-12. (People don’t believe how you can be well nourished on a vegan diet.) Wish me luck.

      1. Thank you! My dermatologist and internist think I have had a lifetime of an endocrine disorder which causes high cholesterol but I wanted desperately to avoid stating and do this all by diet

  17. With my latest lab tests, my total cholesterol was 219, LDL 118, HDL 76, and Triglycerides 124. I am a 52 year old woman. I have been a vegetarian since I was 18 and 90% or more vegan for the past 2 or 3 years. I eat tons of beans, grains, greens, fruits and vegetables. I exercise at least 7 or 8 hours a week. I am surprised at the high total cholesterol and LDL level. Previously, while on certain birth control pills, my total level creeped up some, but never above 200. I believe menopause does indeed contribute to increased cholesterol level, but, given my diet and lifestyle, any words of wisdom for me? At what level does the benefits of statins outweigh the risks? What about hormone therapy? Would that be beneficial? Thank you!

    1. Hi Corinne, the first thing I would ask is have you gone through all of the suggestions offered in this blog post? If not, that’s where I’d start. The large majority of people I find who aren’t able to get their cholesterol numbers down on a plant based diet are eating more processed foods than they realize and unhealthy plant based fats and inflammatory foods are finding there way into the diet. Let’s presume you have covered all the bases listed above, there could be a genetic component at play however people who have genetically elevated cholesterol generally tend to have significantly higher numbers so without even knowing you I wouldn’t think that was your case just based on your numbers. The final thing I would do is try and evaluate your risk (of a future coronary event) based on the numbers you have. For that it would be helpful to know if you have any other medical history but presuming you don’t, I’m not sure I’d be all that concerned about these numbers. If you do have other medical history that increases your risk then it may be worth considering the benefits of supplements or even medications to help you lower your numbers. I do agree that your numbers are higher than usual for someone who eats no animal products but in someone who has no other risk factors I don’t think I’d lose sleep over these numbers provided I had as I said earlier, done all the other things listed in the blog post above.

      1. Thea – Thanks for responding and for your information. I agree with you. My other list factors are limited. When I feed my numbers and other information (BP, weight, smoking status, family history) into the heart risk calculators, my 10 year heart risk is about 2% so I know I should not worry. I was just curious and surprised mostly. I do eat all the items suggested on the blog post and follow the suggestions, and I limit my intake of processed foods, indulging occasionally. I looked around some last night after making my post and did indeed found that women’s cholesterol numbers jump almost exactly the amount mine did after menopause. So, I will talk to my doctor about these things when I go back in. Thank you for affirming what I expected already was the case. Your insight and information was helpful.

        1. Corinne: Just to clarify, you did get a response from a moderator, but it wasn’t me! One of our excellent medical moderators (I’m just a plain moderator) gave you that nice reply above.
          But since we are talking, I wanted to wish you well. I was really happy that payoung chose your post as one to answer today. She gives great answers and I wanted to know what the answer would be to your question. :-) Best of luck to you!

  18. Dr. Greger mentioned about a Portfolio Diet to help with Lower Cholesterol in a recent holistic holiday conference for folks already on a WFPB diet but cannot get numbers low enough. Any study showing the benefits of this diet you can provide?


    1. Hi Michael, here’s a study that compared a portfoilo diet, to a statin and had a third group called a very low saturated fat diet which was used as the control group. The study found that the portfolio diet and the statin lowered cholesterol equally. In effect this means that the Portfolio diet could be used in place of other current therapeutic lifestyles in people whose cholesterol had not reached goals instead of adding a statin.


  19. Hello Sam, This site focuses on getting your sterols through your food. When you take a supplement for sterol you are taking in added fat (vegetable oil plant sterol esters) and with supplements there’s less chance of effectiveness. Please check out: http://nutritionfacts.org/video/optimal-phytosterol-dose/ and http://nutritionfacts.org/video/dangers-of-dietary-supplement-deregulation/ Since you’re taking a statin, why not focus on whole foods to help bring that cholesterol down? Although plant sterols are generally considered safe, they again are packaged in fat. Whole foods are a smarter approach and provide you with more benefits than just lowering cholesterol.

  20. This site focuses more on getting your nutrients including your sterols though whole foods, Sam, so while a review of PubMed indicated Plant Sterols are genrally considered safe , there are good reasons why you might consider a more natural approach, thus avoiding the added fat found in the supplements
    Check out these videos: http://nutritionfacts.org/video/dangers-of-dietary-supplement-deregulation/ and

  21. Michael M- You asked about research on the Portfolio diet. THese links should point you toward what you’re looking for:
    https://www.ncbi.nlm.nih.gov/pubmed/26552742 The effect of a dietary portfolio compared to a DASH-type diet on blood pressure.

    https://www.ncbi.nlm.nih.gov/pubmed/26552742 The effect of a dietary portfolio compared to a DASH-type diet on blood pressure.

    http://jamanetwork.com/journals/jama/fullarticle/1104262 Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in HyperlipidemiaA Randomized Controlled Trial

    1. Is there a vegan portfolio diet I can follow? I am a bit concerns about the recommendation to use enriched margarine products to meet the plant sterols requirement of this diet.
      Also, the daily 40-50g (1/3 cup) of nuts/seeds are significant amount of calories.

      Sent from michael’s mobile

  22. High dose Niacin will lower your cholesterol. It has to be the flushing kind however, not the sustained release. I take 1000 mg of Niacin as nicotinic acid every day. my cholesterol which was over 200 has now gone down to almost perfect as well as my HDL raised significantly.

  23. I have Hashimoto’s thrombosis, my antibodies are elevated and I have become hyperthyroid. I have been eating mostly vegan for 8 months but occasionally have cheese when eating out or oil when I can’t control how my food is made. My total cholesterol has not gone down or my weight. My endocrinologist says diet doesn’t make a difference. I would like to see more information on this if available.
    Thank you.

      1. Hi CrystalM,

        Thank you for your quick reply, I will check out the videos on autoimmune diseases as you suggested.

        Hopefully Dr. Greger will do a video about Hashimoto’s in the future.

  24. Help!! Hi i am 34 yrs, not overweigth, for the last 4 years i became vegetarian. I eat fruit vegetables nuts and legumes, mostly vegan, just on the weekend when i go out eat wheats, and maybe cheese once a week. My triglycerides are 360; hdl 38; ldl 160; vit b12 315, and D 19. I did not take flax or chia, and eat 2 avocados a week. Avocado have 15 times omega 6 than 3. For sure i lack omega 3, and i searchs studys (not vegans) that says that the 3, vit d, vit 12 and omega 3 suplementation, can improve the lipids. Can it be that the problem? Thanks.

  25. It’s good you’ve become vegetarian, Guillermo, but you can improve your cholesterol numbers more by becoming vegan, replacing that cheese and avoiding processed foods and oil. ARe you still eating eggs?
    Yes, Vit D, and B12 are important as well as Omega 3s, but you need to consider how you are obtaining that Omega 3 supplementation? If it’s from fish oil, that is a problem. Why don’t you start by reviewing some basic information on cholesterol and triglycerides?
    https://nutritionfacts.org/topics/cholesterol/ and https://nutritionfacts.org/topics/triglycerides/
    You will then see Dr. Greger has many videos that can help you work on those elevated triglycerides.

    1. No, i didn´t consume eggs. So I start taking 1 tablespons of flax oil, and 1mg of epa+dha per day (fish oil, I live in Argentina, there is no algal or vegan dha oil) for the moment, b12 and D supplements. Do you thinks its ok? Thanks

  26. Guillermo, I am glad you are not consuming eggs. To lower your cholesterol it would be better to stick with the flax seeds and not the flax seed oil and to minimize any processed foodsr.
    It may take a while to lower that cholesterol so stick as closely as you can to a whole food, plant-based diet with some good cardiovascular exercise, following Dr. Greger’s suggestions for lowered cholesterol and then best of health and improved cholesterol numbers.

  27. Hello, I just recently started your plant based diet after discovering I have an LPa of 296 with the hopes that this is going to be the right diet that I should be following. I have been supplementing with fish oil and flax seeds to try and help lower. I was not able to tolerate the effects of niacin. I am a female 5.4 165 pounds and trying to lose weight but it seems impossible. I am just looking for any advice as to ways to lower my LPa ? I am also concerned because I developed kidney stones and am not sure of how strict I should be with avoiding oxolates? I do drink 4 mason jars a day of green and herbal teas throughout the day but sometimes I only get 2 or 3 jars in.
    I take methyl protect for mthfr and have one variant for thrombosis and have recently been plagued with a lot of pain due to some reticular and spider veins in my legs . I am considering sclerotherapy but am wondering if this might be a bad idea with my known history? Thank you any help or advice on this subject would be greatly appreciated

  28. Mgrassel2003,

    Two medical inputs that do show reductions in Lp(a) include niacin and estrogens. You can get a higher niacin input via….the following foods:

    Peanuts 1 cup: 21.9 mg (over 100% DV) Mushrooms 1 cup: 7.6 mg (34% DV)

    Green peas 1 cup: 3 mg (15% DV) Sunflower seeds 1 cup: 3.8 mg (19% DV)

    Avocado 1 whole fruit: 3.5 (17% DV)

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

  29. My husband and I, ages 70and 65, started a low/no fat whole food plant based diet 3 1/2 months ago. I cook almost all meals following guidelines of Dr.s Greger, McDougall, etc. We both had lipid testing done recently and both saw increases in total cholesterol, LDL and triglycerides. The increase in triglycerides was significant for us both. We do not eat a lot of bread products or white rice. We were so perplexed and disappointed at these results and do not know what to do now. Any help would be appreciated.

  30. Carol, It is frustrating to work hard to bring cholesterol and triglycerides down with a healthy diet and get results that are not what you’d hoped for. Are you still eating oil? That may be a factor and also the fact that you’ve not been on a WFPB diet for that long. Perhaps you’ll get better results at the 6 months mark.
    One of wise commenters had good advice on this topic so I’ll give you Joseph Gonzales RD had some good ideas for you to consider, so I’ll include them below. Don’t get discouraged because you are indeed minimizing your risks even if the blood tests temporarily do not reflect this.

    “For those who have tried eating a whole food plant-based diet and still have high LDL, you should make sure you’re not eating plant sources of saturated fat, such as palm kernal oil, palm oil, coconut oil, and cocoa butter (found in chocolate). Of course if you were you wouldn’t be eating a whole food plant-based diet, but you’d be surprised how many people tell me they are and they’re like “Yeah, and I eat a spoonful of coconut oil a day.” I’d also cut out unfiltered coffee. Then once you have gotten rid of the things that increase your cholesterol you need to pack your diet with foods that actively lower your choleserol. So, for example, the components of the portfolio diet for lowering cholesterol. I’ll highlight some of the diet tips found in Dr. Jenkins protocol using Dr. Greger’s videos as reference.

    1) Load up on foods high in soluble fiber. This means tons of beans (see what kind are best: canned or cooked), vegetables like okra, plenty of whole fruit, oatmeal, and flax/chia seed. Find ways to use beans. Lentil stew, dal, curries, bean burritos, bean soup. If you don’t like beans whole, like in a salad, maybe try them as a spread or as hummus?

    2) Take about 2 Tablespoons of ground flaxseed daily and 4 Brazil nuts monthly. Sprinkling ground flax on oatmeal in the morning is an easy way to get enough. Or add it to a smoothie. If you buy the flax whole just add it in the blender first, grind it, and then add the rest of your ingredients.

    3) Focus on several cups of greens daily to help keep nitric oxide flowing. Vegetables loaded with nitrates have been shown to improve heart health. Beets and arugula have tons! (See video on where other vegetables rank on nitrate levels). Yes, green smoothies count if you’re adding the right foods like berries and dark green leafy vegetables (kale, spinach, even parsley). What’s better? Raw or cooked vegetables? Well, it may depend on what veggies are cooked. Lastly, a word of caution for those going wild on greens is that overdosing on raw greens can happen.

    Dr. Greger says to get thyroid function tested, too. A low-functioning thyroid can contribute to high cholesterol so it’s good to rule that out. Weight loss is also important if there is too much abdominal fat. Is your height more than twice your waist circumference? So there are a lot of factors to consider, but if folks are practicing heathy eating and managing body weight and still find their LDL is not coming down they should definitely consider a statin. As I always say make sure to check with your doctor about all of this. It’s important to be transparent and communicate with everyone.

    Lastly, here are some of the best videos to help understand more about diet and cholesterol. Sometimes folks will ask questions like does cholesterol have a lower limit, or, what about the size of LDL particles does that matter? ​Thankfully Dr. Greger addresses this in his video: Does LDL size matter? and Cholesterol does not appear to have a lower limit. A few concerns with dietary cholesterol is that there’s a plateau effect issue and the postprandial (after eating) issue. These videos explain the issues further: When Low Risk Means High Risk and Eggs and Arterial Function. Find out what’s an Optimal Cholesterol Level to shoot for. “

    1. Thank you for your reply. The issue is that my husband and I had much better lipid values on a SAD than on a very low fat WFPB diet. My triglycerides went from 133 in March of this year to 192 in early October after 3 1/2 months on a WFPB diet. My husbands triglyceride went from 59 to 262. This goes against everything I have read about the benefits of a WFPB diet and the reason we so drastically changed the way we eat. I have no idea what to do.

    2. I am increasingly confused re the subject of lowering cholesterol. I have been a vegan now for 6 months and eat all the correct things. Except coffee 1-2 cups a week-I can stop those…..my cholesterol was tested normal for the first time in 6 years-but I am on statins. I would like to stop using those but don’t want to risk rising cholesterol levels. Esp. as I also have DM type I. I have a pump and my glucose levels are in general exemplary.

      Articles such as the one below add to my confusion. Please help?


      1. Gabs,
        Yes, I know it can be frustrating when there is so much information overload, and often seems contradictory. Ill try to shed a little light on the situation. The bacteroidetes referred to in the study are bacteria that live in the gut. Your diet greatly affects your microbiome (gut bacteria) and gut barrier. Animal food products, especially high fat, tends to reduce gut barrier function and trigger release of inflammatory factors. This could explain why the chemical signature of the bacteroidetes were found in the atheromas.( Keep in mind this article is just speculating at this point). In any case, the best course of action to protect your health is still the same. Eat a WFPB diet to reduce inflammation and boost your health. Check out this link for more information on your microbiome https://nutritionfacts.org/topics/microbiome/.

        1. Thank you so much for your swift reply! What a great service. I’am also grateful that you brought all the NF videos and texts to my attention….lots to read and listen to.

          Happy holidays,

          Gabriëlla (Gabs)

        2. Dear Kjgrier,

          I do have a completely different question. I have a prescription for medical marijuana tea against muscle spasms. In the preparation for 0.5 liter of tea it states that I should mix in one sachet of coffee milk powder. This is essential as the active ingredients would otherwise stick to the pot and cup. Please advise me what I could use instead of coffee creamer. Would soy milk work for example?? Or is it the fat and should I use sunflower oil? ( we don’t have canola oil here).

          Kind regards Gabriëlla

  31. Thanks for your great question. There are plant based food that can raise triglycerides such as processes sugars. You may want to inventory your diet and make sure added sugars and oils are not sneaking in. There are also plant based foods that are known to lower triglycerides. You can try adding more of these foods into your diet. Please see this link:

    You may also like this video Dr. Greger has:

    Good luck.

  32. I went Vegan for 5/weeks then Vegetarian for 2.5 months. I stopped taking Crestor, but my cholesterol is really high. I do use some oils (Olive and coconut oil) and do use cheese once in awhile. I went vegetarian because I missed cheese. So…for now I will go back on the Crestor, but I am going to request the VAP Test and CRP test. I will reduce the amount of coconut oil and coconut milk, too. I will use the vegetable broth more. Thank you for the info!

  33. my cholesterol has always been in the 300-380 range. I wonder since cholesterol is a repair for other things in the body. If something else needs adjusting ie hormones, thyroid, liver function. The WFPB diet does make me feel better but the numbers never change. What other things should I have checked to see if changing something else will make the numbers go down. Info- I had children when I was 35 and by 45 I had gone thru menopause. To me that is weird but the drs always say Im in normal ranges.Any info would be great. Thanks

  34. Let me please first quote Wikipedia: “

    Biosynthesis of cholesterol is directly regulated by the cholesterol levels present, though the homeostatic mechanisms involved are only partly understood. A higher intake from food leads to a net decrease in endogenous production, whereas lower intake from food has the opposite effect.”

    I am testing on myself following tricks:
    1. Amla (Indian goosberry). 3g/day for 21 days decreases Total and LDL cholesterol as well as triglycerides
    2. As Jason Curry suggests walnuts, flax seeds, chia seeds have proven effects. E.g. Walnuts 85g/ day has very little effect on gaining weight, but decreases TC and LDL-C
    3. As moderator suggested Phytosterols should summ up at 2g per day
    4. Visceral fat corelates with synthesis of cholesterol Link Avoiding transfats,alcohol and doing resistance training are best tools to decrease visceral fat. Link
    Combination of all the above should bring TC down in about 3 years to the fat lesion free artheries if your BMI is around 21,5.

  35. I went on a whole foods plant diet for exactly one year. My starting weight was 105 lbs and ended right at 101. 38 yr old F. My LDL actually increased a bit and total chol only dropped 2 points. Please don’t insinuate that I didn’t follow diet correctly, I did. I actually followed the Estelynn plan for the most part. I was extremely disappointed in the results. My father is 70 and has a total chol of 280. Had a heart cath done recently and only has 10% blockage. His mother is 94 and only takes BP meds.

    I am beginning to think after tons and tons of research that these cholesterol numbers don’t mean anything at all. How can you have a total chol of 280 and only 10% plaque build up in your arteries. By the way, my father I’m referring to is a physican. He believes now as I do that cholesterol is not what causes heart disease. Just food for thought unless someone can explain and prove otherwise.

  36. I have been on a WFBP diet for almost a year and experienced tremendous benefits however my cholesterol is still high as well. January 2017 (before I started) = 245, July 2017 (6 weeks after starting WFPB = 184 and February 2018 = 212 (HDL 71). In one year though my triglyceride level came down from 161 to 90. My naturopath says not to worry about cholesterol levels (that they are manipulated somewhat by the pharmaceutical industry), that triglycerides is what she worries about. The rest of my blood work is great. I am not anemic, have strong immunity (backed up by not getting a cold or flu this season), lost 20 pounds, and have more energy than I did when I was in my 20’s. I may be able to lower my cholesterol level by eating less nuts and nut butter and cutting eating out (oil) a bit. I understand that not everyone will be able to achieve cholesterol levels of 150 or lower as well. I feel great and would never go back to eating animal products. I’m going to scale back a bit on my nut consumption but will follow my naturopath’s advise and not worry about my cholesterol numbers for now.

    1. Dr. Ornish and Dr. Esselstyn both have published clinical studies showing reversal of artery blockage in patients eating an unprocessed whole food plant based diet. Dr. Ornish is convinced that there is an additional psychological component that can be addressed with things like psychological counseling or yoga. Even if he’s wrong, you’ll feel better, so these things should be added in my opinion.

      Dr. Ben

  37. My son saw tremendous improvements in cholesterol with a 100% plant-based diet and asked me to try it for 3 weeks. He prepared a 3 week menu with recipes and a shopping list. I had my BP and blood work done before and afterwards. The good news is my subjective improvements like energy, skin, bowels and cravings all improved. The bad news is my objective metrics were worse (initial to final). BP (112/70 to 120/78), HDL (50 to 46), LDL (149 to 173), Total (228 to 245) and Ratio (4.6 to 5.3). My BMI remained constant at 23. I love the plan, learning new recipes, skipping the meat and dairy sections and intend to continue and pay for new blood work in 3 months. My question is – is it possible for people (like me) to simply have a genetic quirk that responds differently than expected?

  38. It all depends on what you’re eating and how much. If you list it here, we might be able to help. “plant based” is often not enough to improve health. It often needs to be unprocessed whole food plant based. Ie. from farm to mouth with no processing in between. Your BMI could possibly mean that you don’t have significant visceral fat causing metabolic syndrome, or not, as BMI often misses significant visceral fat which can be an important cause of your dyslipidemia.

    Dr. Ben

  39. Dr. Ben – thank you very much for volunteering! I’ve listed the recipes I used over the 3 weeks below. In a nutshell – I’m shocked my cholesterol went up after giving up all meat and dairy. Before starting I had either an egg & cheese bagel or bagel w/cream cheese every morning. Dinner was primarily chicken, tilapia and beef burgers. Would be great to get your help in figuring it out! Thank you, Mike
    Dinners (with leftovers for lunch and dinner):

    – 30 Minute Portobello Stir Fry 30 Minute Portobello Stir Fry
    – Thai Red Coconut Curry http://minimalistbaker.com/coconut-red-curry-with-chickpeas/
    – Root Veggie Power Bowl with Tahini Dressing https://www.veganosity.com/root-vegetable-power-bowl-roasted-garlic-tahini-dressing/
    – Black Bean Plantain Tacos http://minimalistbaker.com/spicy-plantain-black-bean-tacos/
    – Our Favorite Veggie Burger (on whole wheat buns) http://ohsheglows.com/2011/07/13/our-perfect-veggie-burger/
    – Corn Chowder with Chives (Minimalist Baker recipe book) no link
    – Thai Baked Sweet Potatoes (Minimalist Baker recipe book) no link
    – Baked Quinoa Black Bean Falafel (on whole wheat pita w/tomato and lettuce) https://minimalistbaker.com/baked-quinoa-black-bean-falafel/
    – Taquitos with Chipotle Crema https://www.summerinseason.com/blog/2018/2/4/vegan-taquitos-with-chipotle-crema
    – 8-Ingredient Zucchini Lasagna http://minimalistbaker.com/8-ingredient-zucchini-lasagna-gf/
    – Pulled BBQ Carrots (on whole wheat buns) https://www.veganosity.com/pulled-bbq-carrots/

    – Perfect Green Smoothie https://www.summerinseason.com/blog/2017/7/9/the-perfect-green-smoothie
    – The Best Avocado Toast (on an everything bagel instead of toast) https://www.summerinseason.com/blog/2018/1/7/the-best-avocado-toast
    – Banana Bread Overnight Oats (frozen berries and honey) https://www.summerinseason.com/blog/2017/6/4/vegan-banana-bread-overnight-oats
    – Cheerios with frozen berries, almond milk and honey

    Drinks other than water: (no change from prior diet)
    (2) 8 oz cups of coffee/day (no crème or sugar)
    La Croix
    (3) beers per week (Blue Moon Wheat)

    1. Three thoughts moving forward –

      1) My son bought me the how not to die cookbook for my Bday last week. Starting 4/16 my next 3 weeks of meals will come from there.

      2) Some believe the menu I listed above is high in oils. Will pay more attention to that.

      3) I looked up visceral fat – I’m 5’9″ / 155 lbs. May not be an issue for me.


  40. Hi Dev Daniella – I’m Janelle, a Registered Dietitian as well as a Health Support Volunteer for NutritionFacts.org. Thanks for your question! I would encourage you to first take a look at your current food choices within your vegan diet. While vegan diets are all “plant-based”, they do not always have an emphasis on “whole foods” and may instead include many processed vegan foods that have added plant sources of saturated fat (palm oil, coconut oil, cocoa butter), causing an increase in LDL. Aim for choosing whole, plant foods that are minimally processed to make up the bulk of your diet.

    We also see that foods rich in soluble fiber help to lower cholesterol by reducing absorption of cholesterol into our bloodstream. Try adding more oats, peas, apples, pears, barley, beans, lentils, Brussel sprouts, and citrus to eat on a regular basis. Eating 2 Tablespoons of ground flaxseed daily can help too – it is important to do so on a consistent basis to reap the greatest benefits. I hope this helps give you some further insight!

  41. I guess this post here will be my “bible” for the next 6 months, haha! I had NO idea about the unfiltered coffee aspects! I’ve been a long time French press person (decaf organic coffee). I bought a filtered coffee maker over the weekend! I quit all oils, including coconut a long time ago and eat a vegan, WFPB diet. I am working on getting more flax meal into my diet. I eat tons of beans, gluten-free oats, but okra is one I hadn’t heard about as good for reducing cholesterol. I don’t ever touch processed food or peanut butter. Some of mine might be family history. Dang, I’m 100-105 pounds and 5’2 or so in height and walk 2-6 miles per day with daily yoga. I noticed my total cholesterol went up 33 points when I quit avocado. I was only eating 1/4 of one daily, but of course, I have been researching here on this site about the benefits of avocado. I added amla powder recently too. I have 6 months to get my total cholesterol down and my slightly raised LDL. They’re saying I will need a statin. My ratio is healthy though, hahaha! I appreciate the info. about low thyroid possibility contributing to high cholesterol. In the past two years, I’ve had my meds (NatureThroid) more than doubled…slowly over time. I have to go for a thyroid ultrasound soon. This is all such craziness for me…ugh! :(

  42. I am here…so very frustrated. I started out a year ago with a total cholesterol of 234, LDL of 126. I went very strictly plant based with no added oils and very little nuts and avocados. Had it checked in December and total was down to 200 and LDL 111, not as great as I’d hoped but at least better. In January I began reading some of the Fuhrman books and began making my own salad dressing and some other items that include a bit more nuts than usual. However, I was very careful not to use any sugars (dates are the extent of that and not many oh those) and very few carbs. Really mostly tons of healthy greens, fruits, and veggies, and some nuts. Just had my bloodwork done and my total cholesterol is 226 and LDL higher than ever at 140!! I’m at a loss…I am 41 and very lean. I will try to add in cardio, not much at the moment. I am also on thyroid medication and wonder if the thyroid could be contributing? Also on hormonal birth control which I’ve been reading could contribute to high cholesterol and I would like to get off of for multiple reasons. Sure would appreciate any helpful info or suggestions.

    1. I literally just discovered that hashimoto’s can can your cholesterol to increase and cause heart disease. I’m devastated after learning this and I’m in state of shock right now. You can see my post below I’m in similar situation as you and literally right after I posted the below question is when I found out that hashimoto’s can significantly increase cholesterol, NOT good!! I was extremely suprised to see how high my LDL was on my recent bloodwork… it just made NO sense and is not cohesive with my VERY healthy diet and lifestyle… my LDL should be very very low… not high.

      I’m not on any medications… but I’m trying to research whether treating hashimotot’s with medication will STOP it from DESTROYING my cardiovascular health. How long have you been on thyroid medication?

      Hashimoto’s has suddenly become a lot more serious of a problem than I initially realized! I’m asymptomatic and NEVER have any symptoms of any illness and fell perfectly healthy and normal… I feel as though I’m a ticking time bomb and my luck will run out eventually.

      1. Riley Rubio, I am so sorry and can most definitely relate! It is SO very frustrating to feel you’re doing all that you can and still not get the results you feel you should be achieving! I’m right there at this moment! I’ve only been one year strictly plant based, no added oil and my cholesterol levels are very high. I would love to have your levels myself actually. :) I know that is not reassuring when levels have gone up despite best effort though. I was diagnosed hypothyroid 4 years ago, while pregnant, and I’ve been on levothyroxine ever since. I’ve just recently been doing a LOT of reading/research because I really don’t want to be on medication the rest of my life if at all possible. Also, I do know that an under active thyroid can contribute to high cholesterol. I know there must be factors other than my diet that are contributing to this high cholesterol! I’m hoping that perhaps if I try to get my thyroid healing and more active that maybe my cholesterol will respond favorably as well. I eat healthier than pretty much anyone I know and yet they all have lower cholesterol levels than I do!! Riley Rubio – how were you diagnosed with Hashimotos? Have you had your TSH and other thyroid levels checked to know if you have an under active thyroid? I’ve just recently been reading a lot about thyroid health and am just realizing that most hypothyroid cases are actually caused by Hashimotos. Last week I had my thyroid antibodies tested on my own (my dr. never mentioned this) and my tpo level was 16. I know that is within normal but I still haven’t quite figured out whether or not that means I have hashimotos. I’ve read varying info that you have it if you test positive for any amount of antibodies all the way to you don’t really have it unless your antibodies are above 500. Maybe you have some knowledge/expertise you could share on this?

        1. High Cholesterol Mommy, thanks for your reply! I have NO physical symptoms of Hasimoto’s whatsoever and am 100% asymptomatic (I feel completely normal). My MD decided to do bloodwork on me and for NO reason he threw in a hashimoto’s testing… I guess because I have MS (he claims he does this testing on all his patients… I am also asymptomatic with the MS for many years now ever since going low fat whole foods plant based). Below is the labs results I took last week for my thyroid and the reason I took the test is because I felt like I don’t have hasimoto’s at all… so I wanted to confirm myself just incase the labwork he did on me back in 2014 was really accurate:

          TSH: 1.82 FREE T4 INDEX (T7): 2.7 T3 REVERSE, LC/MS/MS: 29 (out of range) T3 UPTAKE: 29 FREE T3: 3.2 T3 TOTAL: 112 T4 (THYROXINE), TOTAL: 9.4 T4, FREE: 1.2 THYROGLOBULIN ANTIBODIES: 3 (out of range) THYROID PEROXIDASE ANTIBODIES: 180 ( out of range)

          Looking at my current lab numbers above… do you feel it could indeed be my thyroid causing my huge spike in LDL? This is EXTREMELY frustrating to have a massive spike in cholesterol is simply NOT cohesive with my insanely healthy diet and lifetsyle!! =( NONE of it makes any sense!! I strongly feel that perhaos my hasimotto’s has progressed and somehow its not converting the hormones correctly.. meaning even though my thyroid levels look OK?? Do they look OK? (I’m not sure).
          … but body is unable to actually use the hormones needed hence why my cholesterol has sky rocketed from its NORMAL levels… NORMAL levels I’ve had for many years until I got this hasimotot’s!! I don’t know but all I know is that there is something SERIOUSLY wrong and it’s clear by witnesses my EXTREMELY abnormal cholesterol levels. What I mean by “extremely abnormal is that it’s not normal for me. I’m 125 pounds, a gymnast… weigh the exact same I did back in high school… NO weight gain problems…
          nothing I can think of other than this blasted hashimotot’s is destroying my vessels!

          1. Riley Rubio, I’m certainly not an expert on the subject but from what I’ve read and experienced your thyroid levels all look quite good. My TSH had gotten up above 6 at times and went back and forth for years with no further testing or medical intervention. However, thankfully, while pregnant my TSH was monitored well and they started me on levothyroxine because my levels were concerning for the baby. I have been on them ever since (that was about 4 years ago). My TSH hovers around 2.5 now which is really still a bit high for being on medication. It’s great that your doctor tested all of your thyroid levels! There are still some of mine that have never been tested and the antibody test I actually just did on my own through an online request a test website. From what I understand, an under active thyroid can lead to increased cholesterol. Yours doesn’t appear to be under active based on your numbers (again, I’m no medical professional). I’ve been reading…which I probably do way to much of…that an over production of estrogen can cause an increase in the tpo antibodies, which you do seem to have though not as high as some people with hashimotos. I’ve also read that over production of estrogen can lead to an increase in LDL cholesterol!! I wonder if there is some connection there? Has me wondering if this hormonal birth control I’ve been on has contributed to my ridiculously high cholesterol. I’ve also had high cholesterol since high school, so there may be a bit of a hereditary component with mine. Despite being very active and thin it was above 200 even as a teenager. I lowered it lower than it had ever been when I first went plant based about five years ago, but after all of my thyroid issues I just can’t seem to get it in check! Thus, the reason for delving into the subject of thyroid health here lately. There just must be some connection. Do you eat gluten? One thing pretty much every single resource I’ve encountered has agreed upon is that gluten is terrible for your thyroid and your tpo antibodies. I’ve never had any sensitivity that I know of, and I do love my Ezekiel bread. I don’t eat many carbs beyond that, but from what I’ve read I’m thinking I need to make a change at least for a while. With being plant based I’m sure you have no dairy, that was another big offender. Plant based and gluten free seems to be a little tricky and one book also mentioned avoiding soy and corn products. I eat lots of veggies and fruits, but no gluten, soy, or corn is going to take some getting used to for me.

            1. High Cholesterol Mommy, Thanks so much again for your response. OMG I’m going to sound like the biggest idiot on earth here… but I think I might have solved the mystery as to what has caused my LDL to skyrocket from 64 to 95 and I can’t believe I didn’t realize this sooner. I’ve been low fat whole foods plant based vegan for many years but very recently bought an Omega NC800 juicer and started juicing TONS of tangerines/pineapples/apples making homemade juice for the 1st time in my life. Dr. Caldwell Esseltyn HATES smoothies and juicing because it raises the blood glucose too fast and then a crash then adrenals have to kick in to release cortisol to bring the blood glucose back up and this stresses the thyroid. This is why Dr. Caldwell Esselstyn always says CHEW YOUR FOOD, don’t blend or juice it! CHEW YOUR FOOD like Mother Nature intended. You have teeth use it… I’ve heard him say something along those lines :)

              I then just stumbled upon this video on Youtube titled “PROOF That Green Smoothies Raise Cholesterol” https://youtu.be/aZw6xD6JdhQ this woman beautifully demonstrates what Dr. caldwell Esseltyn says is true (she demonstrates various experiments check out her YouTube channel and this video it’s fantastic and very eye opening!)… she is a whole food plant based vegan and her cholesterol was high at (TC: 178, triglycerides: 85, LDL: 114, HDL: 42.9, VLDL: 17) when she was blending green juices with fruit. She then did an experiment and CHEWED these foods instead of blending and this brought her cholesterol down to: (TC: 152, triglycerides: 67, LDL: 80, HDL: 58.7, VLDL: 13).

              I now suspect that perhaps the reason my LDL has shot up to an unexplained number which is VERY out of the norm for me to have such a high LDL is because I was juicing so much fruit instead of simply eating the fruit as a whole food and chewing it!! I am now going to do the same experiment this woman did and will update you in two weeks when I retest my lipids. I’m REALLY hoping this will have solved the mystery. I used to take birth controls for many years but stopped once I realized the dangers of birth control pills.

              I was also eating gluten free diet (which I know is not easy to do!)…
              most people who think they are gluten free are not really gluten free. It takes a ton of discipline and a HUGE commitment to be gluten free. I must buy certified gluten free nuts, certified gluten free oats, and always have to be very diligent to ensure there is no cross contamination. After being strict gluten free for many years I suddenly said screw this! I HATE being gluten free!! I then ate tons of gluten for an entire week and then had my bloodwork done for my thyroid which are the results I shared with you in prior post. I don’t have bad reactions to gluten but that doesn’t mean there aren’t internal consequences happening in my body so I’ve gone back to being strict gluten free. I eat lots of corn and soy though with no issues. The reason I started eating gluten is because I honestly did not believe I actually have Hashimoto’s since I’m asymptomatic… then when I got my bloodwork recently I was like “oh no” I guess I do have it afterall so I better go back to being gluten free =(

              Check out that video I linkedin the above… I’d love to hear you input and feedback once you watch it!! I’m very anxious to see what happens to my LDL once I’ve completed the experiment. Thanks and wishing you a healthy and happy weekend!! :)

              1. Riley Rubio, thank you so much for this reminder!! Oh. My. Goodness. I seriously just got a vitamix a few months ago and have been making green smoothies almost every day!!! I did remember reading or hearing Dr. Caldwell Esseltyn’s concerns about smoothies, but I sure didn’t realize it could raise cholesterol! I thought it had more to do with nutrient absorption. In one of Joel Fuhrman’s books he combats that nutritional absorption idea by basically saying that you absorb the nutrients even better in a smoothie because “a blender efficiently crushes the plant cell walls, making more beneficial phytochemicals available and optimizing nutrient absorption”. So, I started adding a smoothie every day thinking that it was a way to get extra greens, tasty, and convenient. By the way, I just ordered an Omega juicer as well!!!!! Hasn’t even arrived yet! Do you think if I stick to mostly veggies it might be ok? Or might that raise cholesterol too?

                Thank you for sharing about the birth control pills. I have really just realized what havoc they cause and I was appalled that I’d been taking them off and on for almost 15 years. =( When I mentioned my concerns to the doctor last visit I was told that I could actually stay on them until I turn 50!?!?!? I would really not like to do that, thank you very much!

                I applaud your determination to continue in your low-fat plant based ways all these years! I know it is not always easy!! I definitely feel so much better and I know it is best for me to eat this way, just really frustrating to not see the results in my blood work. My LDL is higher now than when I ate pretty much whatever I wanted and it wasn’t always super healthy. But, I have been extremely diligent this last year to stick to very healthy plant based eating. Do you include any nuts or avocado? What about nut milks? Just trying to figure out what else might help. I’m definitely going to be cutting out the smoothies!! I’ll have to figure out a different way of getting my flax in each day. Do you include flax? I sure do appreciate your willingness to share and I look forward to hearing what your numbers are when you retest in a few weeks! I’m really not even certain if I have Hashimotos…and not sure how to know for certain. I never really felt that bad and wouldn’t have even know my thyroid was under active if it weren’t for the lab work. However, my thyroid definitely has issues and most everything I’ve read says to at least leave out gluten for several months while trying to heal the thyroid and best would probably be to leave it out for good. Soooo, as I embark on this very new idea of trying to be gluten-free & plant based, do you have any tips or products that you really have found helpful? I did get some gluten-free oats today and tried this gluten free raisin bread by food for life. If you are plant based, gluten free, nut free, and avocado free I REALLY am not sure how you do it!!! I love a little almond butter on my Ezekiel bread in the morning! But, if it’s the few nuts in my diet that are keeping me from a healthier cholesterol level then I will try to cut back to just the flax each day I guess. Would love to hear your thoughts on this!

                1. High Cholesterol Mommy, Being whole foods plant based is super easy and very enjoyable… but being gluten free on the hand hand… well it REALLY sucks!! I’ve been whole foods plant based (gluten free) for many years now) however I eat nuts, corn, avocado (healthy fats) without any problems. I’ve heard Dr. McDougall say that most people with Hashimotot’s do just fine consuming gluten (a friend of mine emailed him directly last year and this was his exact his reply). This got me EXTREMELY confused because so many others document that hashimoto’s and gluten are a big NO NO… so I honestly don’t know what to think… and to be honest I’m not even 100% certain I will remain gluten free forever (I will be whole foods plant based forever of course). What is so incredibly frustrating is NOT KNOWING for 100% certain whether gluten really is a big NO NO for this with hasimoto’s or not…. and to be honest I’ve NEVER experienced any negative side effects when eating gluten! …
                  but as mentioned this doesn’t mean that there aren’s serious consequences going on in my immune system because of gluten consumption.

                  I REALLY miss being able to eat healthy homemade bean burritos. The gluten free wraps taste soooo bad! =( So I end up buying those oil free corn tortillas from Trader Joes and simply heat them up in the oven to make crispy taco shells and eat bean burritos that way instead :) Amazon sells those trays were you can make taco shell molds with. I also suspect it was me juicing high amounts of citrus.pineapple,apples with my Omega NC 800 that might have spiked my LDL… once I redo bloodwork in less than 2 weeks I will definitely update you on the results. I don’t know if I’ll stop making smoothies forever… I’ll know more in about 2 weeks… but strictly juicing 100% green (kale, spinach, chard etc with NO fruit) with your Omega Juicer should be just fine and shouldn’t affect your cholesterol :) You can also juice some ginger/turmeric with it to bring down inflammation.

                  I also LOVE little almond butter on my Ezekiel bread… I used put a little bit of chashew butter on it with banana before I went gluten free. The one thing I REALLY miss is being able to eat a healthy sandwich!! Not being able to eat gluten is the ONLY difficult part I’m facing. If I eat at Chipolte I have to tell them to change their gloves because their gloves are heavily contaminated with gluten and when they put their hands into my tray it will contaminated it. I must confess recently when I saw “srew this!” and ate gluent for one week for the first time in many years I was in heaven!! LOL. But once I got my thyroid bloodwork back it scared me and I immediately went back to be gluten free.

                  Only advice I can think of is what are you fav foods to eat? Try to make them gluten free and build from there. What were your TPO levels… so sorry if you already mentioned the numbers… and your TSH? I recall from your prior posts you mentioned you are currently on thyroid meds for under active thyroid. I guess that must mean you definitely have hashimoto’s? So sorry I”m no expert and just lost as can be. Did you check out The Fruit Doctor’s video? She has a PhD and is very nice… she might be helpful to you if you email her she will respond and be able to give more knowledgable advice than I can :)

                  Hope you have a great weekend and I’ll update you in exactly two weeks what my lipids are after having STOPPED juicing fruit and smoothies. The really sucky part of all this I KNOW people who are whooe foods plant based and they drink fruit smoothies every single day with excellent lipids levels. I suspect some people do just fine with smoothie whereas other do not. Life is not fair! ;)

                  1. Riley Rubio, thank you SO much for all of the info!!! My TPO level was 16…but that is the one and only time I’ve had it tested. I don’t know if they were higher at one time and have come down with taking thyroid meds. My TSH is 2.58 and that’s with medication. I’d rather try to naturally increase my thyroid health instead of adding more synthetic thyroid hormone (levothyroxine right now) to bring that level down more. So, I’m really not sure if I definitely have Hashimotos or not, though I’ve read that most hypothyroid is actually caused by Hashimotos. It is SUPER frustrating to not know for sure whether gluten is bad for Hashimotos! Thank you for the bean burrito taco shell idea. I’ve looked at those taco shell things on Amazon before, may have to go ahead and get some! I would’ve never even thought about having to have the server change gloves at chipotle!!! You’re right, a ton of commitment and determination to be gluten free for sure! And it just really limits the eating options. I’ve reached out to the fruit doctor (thank you for that recommendation) and turns out she does consultations for a small fee. I’m thinking that may be really helpful. She recommended getting an omega 3 bloodwork panel done prior to speaking with her. Have you ever had that done? It sounds like the way I’ve been eating the last year is pretty similar to yours, with the exception of not being gluten free. My cholesterol numbers are still SO high! =( Did you have elevated cholesterol prior to going plant based? I am excited about my juicer again! =) I’ll aim to stick to mostly veggie juices! Long ago I used to LOVE carrot juice with a Granny Smith apple mixed in, so good! Your juicing explanation made me laugh though!! I will try and power through the veggie juices. =)

                  2. By the way I’ve been binge watching all of these fruit doctor videos!! =) SO much great info!!!! I think I’ll try making some changes (nuts, etc) and get my cholesterol checked again in a couple of weeks! Definitely some encouraging info on her site!!! Just wanted to say thanks again!!! =)

                    1. High Cholesterol Mommy , So sorry for my slow reply… that’s great! I’m so so happy that channel is being helpful to you :) I just very recently discovered her channel and I must confess I too have been binge watching it LOL! ;) I’m not sure what my cholesterol was prior to eating healthy as I never had it checked unfortunately until I actually started eating healthy. My cholesterol was definitely low once I started eating healthy though… I WISH I knew what it was prior to eating healthy vegan whole foods plant based when my diet used to be horribly bad, oh well. I’ve never had an omega 3 blood panel done. Very interesting. I’d love to have one done! :) In regards to the Omega Juicer… please don’t be scared to use it because it really is a fantastic way to pack in those extra mega doses of nutrients so it’s GREAT you have one! :) In LESS than two weeks I shall see the verdict as to what my LDL is after omitting nuts/fruit juices/smoothies…
                      I’m DYING to know!!! LOL I’d totally do the same two week experiment if I were you… cut out all nuts and no fruit juices or smoothies. Make sure you’re getting flax or daily chia in as I think that should also help. Good luck and let’s see what happens!! :) Thanks!!

                    2. I am SO excited to hear the results of your test!! And excited to get mine as well! This is probably a silly question, but I’m trying to figure out what else I can try to to do in order to get these numbers down. Do you have ANY added oils in the food products you eat? I don’t ever add oil and always request no oil if eating out (don’t do that often, but my family enjoys it). However, I do on occasion get a can of Amy’s vegan chili or one of the Amy’s burritos which does include a small bit of oil. Just trying to get to the bottom of this and figure out what else to try leaving out of my usual foods. I also eat a ton of leafy greens, veggies, fruits, etc.
                      Could you maybe share some of your favorite gluten-free breakfast ideas? I’m struggling a bit there…I’ve probably eaten the same thing (Ezekiel raisin bread w/almond butter) for breakfast every day for the last year! I’m excited to use my juicer too!! It should be here this week and I can’t wait to add in some veggie juices. =) Thanks again for sharing all the info!!

                    3. High Cholesterol Mommy , OMG I’m so sorry for my sloooow reply! :( I didn’t check my emails until just now, my bad. I took my lipid test again and should have the results in a few days! :) In regards to the oils in those processed foods… l suspect from everything I’ve learned those added oils in processed foods can affect cholesterol. I used to eat those Amy’s bean burritos which have oil in them but now after learning what I have from Dr. Caldwell Esselstyn, The China Study, Dr. Greger etc and learning the harm that results from those oils I’ve become much more strict! Especially since heart disease runs in my family.

                      I usually eat tons of fresh fruit for breakfast with homemade granola and almond or cashew milk… it’s SUPER delicious and very very filling :) Sometimes I eat dinner for breakfast. I keep things simple…. I eat what I feel like eating, not what society says you should eat at a certain hour :) Sometimes I make an Acai bowl topped with lots of fresh berries and chia seeds. If you install the Forks Over Knives app onto your cell phone it has TONS of super healthy breakfast ideas which you can easily make gluten free. I also LOVE taking 100 grams of oat flour, 100 grams of canned sweet potato puree, 100 grams of any plant based milk and mixing all these ingredients together and make AMAZING waffles with it. I’ve seen many people on YouTube who make these waffles and they are sooo tasty!

                      I’ll update you on the lipid results soon :) Thanks & hope you’re having a great weekend!! PS: Depending on my lipid test results… I might be having to make changes to my current diet… bummer!! I plan on continuing to do experiments to see what foods affect my lipids in a positive or negative way….

                    4. High Cholesterol Mommy, I just got my lipid tests back!!! WOW!!! In only two weeks I managed to lower my LDL from 95 to 65!! It REALLY worked!!! The ONLY thing I did was I simply omitted fruit juices from my diet (because as you know I was juicing TONS of citrus) and I also omitted ALL nuts and of course I ate NO oils of any kind… not a single drop (I usually NEVER consume oils on my whole foods plant based diet though). I’m in total shock that it really is true… fruit juices and/or nuts raised my LDL tremendously!! To be honest I DO NOT KNOW whether it was me omitting nuts or fruit juices/smoothies from my diet that did the trick. So I will be doing another experiment to try to pinpoint which of the two suspects are the culprit!! Unfortunately I suspect BOTH of them were the culprit but hoping that’s not the case because I LOVE my homemade tangerine juices and smoothies! I’m dying to know your lipid test results once you complete your experiment… it’s CRAZY how fast one can change their cholesterol with making very simple changes to their diet!! :) Good luck and keep me posted!!! :) Thanks! PS: My total cholesterol went from 151 two weeks ago to 117!!

                    5. Riley Rubio!!!!! I’m so excited for you about your results!!! That is absolutely an amazing drop in cholesterol!!! And, I’m interested to hear your homemade granola recipe! Though, after my test results I’m thinking I will be taking out my yummy homemade almond milk for at least a while.

                      Soooo, I was going in to get the omega 6 and 3 blood work that The Fruit Doctor recommended and I decided to go ahead and get my cholesterol checked then even though it had only been ONE week with no nuts and very strict no oil. In just ONE week no nuts my total cholesterol went from 226 (taken early June) to 190!!! My LDL went from 140 to 115!!! These are definitely not where I want my numbers to be, but it’s for sure a marked improvement and that was after just one week! I’m going to retest in a month of no nuts along with some other changes (going gluten free bc of my thyroid and trying to eliminate flour products to help my triglycerides that are under normal range but higher than they really should be). So hopefully I’ll have even better levels in a month or so.

                      And, can I just thank you again for recommending The Fruit Doctor’s video?! I actually had a phone consultation with her today and gained a wealth of information! I feel like I now have a good plan of action to get my cholesterol and omega 3 and 6 closer to where they need to be!

                      I look forward to hearing your future lipid panel adventures!! Here’s hoping I can stick to this no nut and NO oil (even in Amy’s food products!!!!) plan! :)

                    6. High Cholesterol Mommy, So sorry again for my slooow reply! Congrats on getting your LDL down!!
                      That’s great!! You had some significant improvement and in only one week which is amazing and I’m sure it’ll keep getting better! :) Did you also cut out all smoothies and fruit juices.. or just the nuts? I’m going to do another experiment where I still consume smoothies and fruits juices but will cut ALL nuts. I also still plan to do the omega 3 to 6 bloodwork as well and that’s really cool you got to speak to The Fruit Doctor on the phone. In regards to the homemade granola recipe I actually got it off this YouTube video here’s the link to the recipe: https://youtu.be/1Cm0rCuIW2I The girls who owns that channel is also vegan and ironically going through the same thing were are! Hope you’re having a great weekend and keep up the great work with them lipids!! haha ;) Thanks!

                    7. Riley Rubio, Thanks so much for the granola recipe! And, yes, I did take out all smoothies too. However, when I explained my smoothies to the fruit doctor she really thought it was most likely the nuts. So, I’m bringing back some smoothies once in a while with lower sugar fruit. But no nuts, and strict no oil in anything. I’ll retest in a month to be sure it’s definitely helping. :)

                    8. High Cholesterol Mommy,

                      Cool! Keep me posted on how thing go ;) I’m currently doing a NO nuts experiment for the next two weeks but I’m going to be drinking fruit juices and smoothies. I’m technically not starting the experiment until a couple of days from now as I have tons of delicious almond milk I need to drink up in my fridge first haha. Good luck!!! :)

                    9. Riley Rubio! Hope you’re doing well. Just got my blood work done today after a full month of no nuts, avocado, and stringent no oil. I’m ready to get these results and see if this has helped! Will post again soon once I get them back in a few days!!!! :)

                    10. Results are in!!!!!!!! One month no nuts, avocado, strict no oil on top of whole foods plant based diet and my total cholesterol is down to 162!!!!!! LDL is 99!!!! Lower numbers than I’ve ever seen!! Back in June, just over 2 months ago, my LDL alone was 140!!!

                    11. High Cholesterol Mommy, OMG I’m soooo SORRY for my slow reply!!!! I hadn’t been checking my emails at all lately I’ve been so swamped I’m so sorry. I HOPE you see this reply?
                      That is AMAZING your numbers went down so much lower… congrats!!! :) I still need to do an experiment to see if it was mostly the high amount of tangerine juice I was drinking or if it was the nuts I was eating that made my cholesterol sky rocket… but it’s so comforting to know that you do have control over your cholesterol. It’s crazy how low mine got when I made simple change to my diet. Please keep me posted and I promise I will make sure to check my email more often for updates. Time flys buy so fast I didn’t realize just how much time has gone by!
                      … but this whole gluten free thing is indeed a true nightmare. I mean it truly is. Not knowing if it is SAFE or % not SAFE to eat gluten if you have hashimoto’s is the most frustrating thing ever!!… because this means I might be torturing myself unnecessarily by being gluten free, yikes!!
                      Thanks so much for sharing your update hope you have a wonderful days!! :)

                    12. High Cholesterol Mommy, Oops my bad! I forgot to mention the link I just gave you to the granola recipe in my prior reply contains nuts… so just void out all the nuts and it’ll taste just as good. It’s such a delicious recipe and with no added sugar.. it’s sweetened with dates!! You can also void out the raisins :)

                2. High Cholesterol Mommy, I just replied to you 3 seconds ago and forgot to answer your questions about flax and nut milk, oops. Yes I consume cashew milk or almond milk but not during this two week experiment :) I LOVE making mashed potatoes with soy milk.
                  Flax seeds I usually grind up in my fruit smoothies or put it on my oats or I just put it in a tiny amount of water and chug it down in one gulp :)

                3. High Cholesterol Mommy, I forgot to say… I think it’s great you got an Omega juicer! I think it’s fantastic for creating green juice shots… it enables you to really slam in those extra nutrients. Just don’t juice fruit and you’ll be good :) It’ll taste horrific… but just create shots and get it down that way. I could NEVER juice strict greens if it were any larger than a shot or two :) I just juiced strict greens this morning and I juiced so many greens it turned into 1 cup of green juice. It was sooo NASTY but I got it down. Just focus on the health benefits :) The amount of greens I just juiced I wouldn’t want to eat… well unless it’s kneaded with some avocado and balsamic and lemon… then it tastes good :)

  43. I’d be REALLY grateful for some help I’m EXTREMELY CONFUSED!! :(

    3 months after I went low fat whole foods plant based vegan my lipids were EXCELLENT (Total Cholesterol: 118, LDL: 64, HDL: 34, CHOL/HDLC RATIO: 3.5, NON-HDL CHOLESTEROL: 84, TRIGLYCERIDES: 101)… but now 4 short years later my lipids are terrible compared to what they used to be!!!

    My current lipids are: (Total Cholesterol: 151, LDL: 95, HDL: 36, TRIGLYCERIDES: 106 LDL/HDL RATIO: 2.6). Heart disease runs in my family and I’m EXTREMELY concerned as to WHY my LDL is so HIGH? LESS than 1% of the population eats as HEALTHY as I do… my LDL should be UNDER 80 the way I eat and my lifetsyle!!

    I do NOT consume nor cook with oil and I NEVER eat in restaurants nor do I consume processed food and I’m also very young (in my 30s). I’m a strict WHOLE FOODS PLANT BASED vegan and I consume LESS than 40 grams of unsaturated fat per day and far LESS than 10 grams saturated fat per day if any at all. I have MS thus eat a VERY low fat diet which has kept me in remission for many years.

    I did eat at a restaurant twice recently and the food was HORRIBLE drenched in oil… could that be the problem from just those TWO meals? I avoid restaurants at all costs, they are POISON!!

    WHY is my cholesterol getting WORSE? LDL went from 64 to 95!! NONE of this makes any sense!! :( Please help I’m VERY confused and worried!!

    1. Hi Riley,

      Your case is really interesting. I have not heard or known of any other case like yours. Are you overweight?

      Perhaps you are not eating enough fats. I know that sounds a little contradictory.
      But you need to eat some fats in order that the body does not produce them. You might need to review with a dietitian the food you’re eating and the quantity. My advice as one is to eat good amounts of nuts, almonds, seeds. Also add daily up to 1 tablespoon of flax seeds to your foods or smoothies.

      Another explanation is that you are overeating whole grains.

      I really need to know more about your diet to solve the problem. I truly hope that this helps though.

      Yared, Health Support Volunteer

      1. Nutriyared,

        Thanks for your reply. I’m not overweight. I’m 5 ft 7 and weigh 125-130 pounds… same weight I weighed back in high school and I’m almost 40 yrs of age (I have never had weight problems). I eat unlimited amount of whole fruits (bananas, blue berries, melons etc) and starches which make up the bulk of my daily caloric intake (rice, potatoes, sweet potatoes, corn, beans). I basically eat Dr. McDougall’s The Starch Solution style. I also eat either flax seeds or chia to get omega 3 every day along with a vegan DHA/EPA supplement. I honestly eat healthier than 99% of the population…
        so other than my recent fruit juicing extravaganza I can’t think of anything that would cause this insane spike in my LDL from what my normal levels would be… other than a lab error?? I also have ALWAYS eaten a tiny handful of nuts (cashews or almonds) every day or walnuts whatever I have around (oil free). I have been eating like this for many years with excellent lipid levels and it has kept my MS in full remission. Dr. Roy Swank conducted a 40 year long study and his patients who kept their fat intake at these levels… 95+% of those patients did not progress and the ones who cheated went downhill badly.

        However since I have MS I cannot consume more than 10 grams saturated fat per day or more than 40 grans unsaturated fat per day and based on cronometer I get about 10% fat. Too low fat is definitely not the problem and I very eat more than 5 grams saturated fat per day. It is crucial my saturated fat intake be as low as possible.

        I love rice, beans, salsa with a tiny bit of avocado,.. or I make healthy oil free veggie stir frys or I make healthy brown rice n’ steamed veggies or baked sweet potatoes or taters with kethup (I eat very very simple)….
        followed by fruits and oatmeal etc… really healthy stuff. I honestly feel like maybe the lab made an error I have no idea but this mystery is driving me CRAZY!! :) :( PS: On my labs it said my (T3 UPTAKE is 29) which is out of range… that is VERY high level. I then read on google (I don’t know if I understood what I read and I can’t seem to find that documentation again) it said something along the lines of: Since my T3 Uptake is so high that even though my thyroid hormone levels look OK my body is unable to convert bla bla in order to actually use the needed hormone… do you know anything about this? I suspect if that is true it would make sense why my thyroid would be screwing up my LDL?? Thanks so much for your advice and input!!

      2. Oops sorry I had typo… I wish I could edit my posts but I guess that’s not possible? I meant to type: I RARELY eat more than 5 or 8 grams saturated fat per day. It is crucial my saturated fat intake be as low as possible…. less than 10 or 15 grams per day max…. lower the better for someone with my condition.

        Thanks! :)

  44. I was a vegetarian in 2016 (but I ate eggs and cheese and fish) and my cholesterol was excellent (139 total, 80 LDL)

    In 2017 I fell off the wagon and my cholesterol got much worse (189 total, 109 LDL).

    So in 2018 I went vegan (although I cheat a twice a week with sushi and meat once or twice a month) and my most recent numbers are terrible (221 total, 126 LDL).

    I am thin, I walk everywhere and my other blood numbers are all in the range. I worked so hard in 2018 to eat healthy but my numbers are terrible and I am angry and scared.

  45. To Avoid statins and reduce cholesterol you might consider
    Check with a high quality Health Food Store for good
    Gord Aldridge

  46. If you are not eating any cholesterol (plant diet), what does soluble fiber do for you? (I thought it merely prevented cholesterol from being absorbed?)

  47. Hi, Larry! The human body makes cholesterol, which is why we don’t need to eat it. Some people make more than they need, and have high blood cholesterol even if they don’t eat cholesterol. Cholesterol is used for a variety of processes in the body, including synthesis of hormones and bile. Cholesterol from bile is usually reabsorbed in the intestines. Soluble fiber helps prevent this reabsorption, allowing the cholesterol to leave the body. I hope that helps!

  48. I have been vegan since the end of 3/19. When my cholesterol was tested in July it had dropped to normal levels, but now it has risen considerably. It is still within the normal range (barely), but I don’t understand why it went up, especially my LDL. I do not eat processed or junk food and I exercise. I also practice intermittent fasting. I have no idea what is causing this rise.

  49. My daughter is 22 and has been on a plant based diet for two years. She eats all of the right foods and limits oil intake . Occasionally uses olive oil but mainly cooks with water . She exercises 3/4 times a week but has never lost any weight even with keeping the recommended calories needed to safely lose a pound a week. We decided to get her thyroid checked and other labs. We were shocked to learn her cholesterol is 267 and triglycerides are 277! We are getting no help from the Primary Care doctor. They are telling her lower her saturated fat and take fish oil ! She barely has saturated fat and eats chia seeds flax seeds daily . We are desperate to get advice from a professional that will listen this isn’t adding up with her plant based diet to have these alarming numbers . Could it be some underlying issue ? They aren’t even offering what other testing we can have done though I’ve read on my own possible cortisol issues . I would desperately appreciate some advice. Thank you

  50. You might consider finding a licensed doctor that is familiar with the vast body of published medical evidence in support of an unprocessed plant based lifestyle. This way, you can have confidence in your health care professional which is of the utmost importance. There is the 1:250 to 1:500 chance that she has genetic hyperlipidemia, but that needs to be tested by a doctor.

  51. I’m really despondent after two and a half months of strict wfpb eating during which my total cholesterol went up from 209 to 211 and my triglycerides on a non-fasting lipid panel shot up to 422. It is the first time in my life that my HDL went over 40 at least. I had been eating vegan before, but not especially careful. Now I have no oil, low salt, ground flax or hemp daily, oats daily, beans and lentils once or twice a day, berries daily, no processed sugar, whole grain breads and pastas….I’m really discouraged by these test result and now the doc wants me to take statins which I’ve been trying to avoid like crazy.

    Since going plant based, I’ve lost close to 60 pounds over about 8 years, but have been bouncing back and forth between 190 and 200 for a couple of years. I should weigh between 145-150. I don’t get much exercise but have made the decision to give up my car and spend more time on my feet, so maybe that will help a little. Now I wonder if I’d be happier giving up.

  52. I recently started AMLA powder daily in my oatmeal for cholesterol reduction. I am not on blood thinners. Does anyone know of any danger in taking it daily on a permanent basis?

  53. Dr Matt,
    Thank you so much for the quick reply!
    One new question….My 28 year old son has been 90+% plant based since Jan 2020. He is very fit, active and the only health issues he has are environmental allergies (he has been getting allergy shots for 2 years), and very mild exercise induced asthma (rarely needs Albuterol). His LDL was elevated so he too started (March 2020) on AMLA powder 0.5 teaspoon daily in oatmeal. His recent testing (June 2020) showed that his total cholesterol dropped 27 points and his LDL dropped 20 points (since his last testing done Nov 2019)! This is obviously great (and likely due to a combo of change in diet and AMLA)! However his bilirubin went from a normal 0.9 up to a high 1.5. His Alk Phos, ALT, AST and GGT are all WNL. He is asymptomatic with no other changes to his healthcare. Do you have any concerns that the elevated bili is AMLA related?
    Thank you!

  54. My husband has been a vegan for over 30 years. This morning he was admitted to the hospital for a stroke. Apparently his right carotid artery has plaque buildup. They want to put him on statins. I know my husband won’t want to go on them. Suggestions, studies, and any information would be appreciated so I can make good choices for him.

  55. I’ve been vegan 11 months and I don’t eat a lot of processed stuff. I eat at least 50g of fiber / day – sometimes as high as 80g. I keep my saturated fat below 20 g/day. I just got my blood tested: Total cholesterol: 200, HDL 91, LDL 99. My thyroid function was normal, as were all other markers. I’ve got a genetic predisposition for high cholesterol (both parents). I am pretty lean (I have visible abs) and I work out all the time.
    Either it’s genetic or I need to cut out any of the oils I eat (I admit I sometimes use vegan butter on popcorn and I eat popcorn about 3x per week).
    I should be happy I’m healthy with low blood pressure and that I love exercise but it is frustrating to not see my LDL budge from when I ate mean to going vegan. Still, I’ll stay vegan and just do the best I can with oil, etc.

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