How to Persuade Your Doctor About Your Low-Carb Diet

‍Ask Theresa is a weekly advice column by Theresa Link. A Virta Health Coach since 2015 and a loyal follower of the ketogenic lifestyle, Theresa is a Registered Dietitian who is an expert in living a metabolically-healthy life. 

In this week’s column, Theresa shakes her head at old-school beliefs and outdated mindsets, ideas more nonsensical than socks with sandals. Despite the slow churn of change, she's cheered by the budding recognition of low-carb diets and nudges people to keep questing for providers who aren't stuck in the nutritional dark ages.

❓Question

Theresa,

I'm one of the minority of Virta participants who went from having "normal" cholesterol numbers to having crazy high LDL. Neither my Primary Care Doc, nor the cardiologist he sent me to, know anything about "hyper-responders”. My cardiologist, who basically fired me after my first and only visit, came very close to saying that a little prediabetes is not necessarily the end of the world if it gets your LDL down. How do you navigate through the maze of medical doctors who don't know a thing about keto, and who tell their patients that it will do them great harm?

Sincerely,
Irate

👩🏻‍💻 Theresa

Dear Irate,

It must be incredibly frustrating to take a leap of faith, join Virta, and enhance your metabolic health, only to feel let down by an unsupportive medical provider. Moreover, it's shocking to hear the assertion that high blood sugar is an acceptable sacrifice for lower LDL cholesterol. Regarding this topic, I’ve got good news, bad news, and some words of advice.

The Bad News

Changing the mindset of someone so entrenched in status quo thinking takes longer than opening your email in the 90’s. This mindset change requires a significant and compelling body of evidence (which we have), but even then, they must be open enough to consider this evidence and – don't hold your breath – possibly admit they were wrong.

Second, the idea that elevated blood sugar is a reasonable tradeoff for achieving lower LDL levels is utterly nonsensical. LDL cholesterol, or Low-Density Lipoprotein cholesterol, is one of the types of lipids (fats) found in the blood. LDL is largely considered “bad cholesterol” in the medical community, but like other lipids, it’s part of a more complex story regarding heart health. Dietary choices impact LDL cholesterol, so that’s where the focus should remain. Check out this column for a deeper dive on that topic.

How to Persuade Your Doctor

Good news: the medical community is slowly recognizing the impact of low-carb diets, though not as quickly as we might hope. The improvements in metabolic health achieved by Virta members are undeniable, and over time, even the staunchest skeptics must acknowledge that there could be an alternative to the pervasive high-carb/low-fat narrative that has dominated American healthcare for over six decades.

To persuade your doctor, you first need to advocate for yourself… ahem… respectfully. Keep in mind that doctors get minimal nutrition training in medical school, so they may not be as well-versed in this subject as you’d expect. What’s more, our standard nutrition recommendations are based on cherry-picked studies, and this dogma has persisted long before most current doctors even entered college. 

Here’s what you do: before your appointment, write down the main points you’d like to discuss. Let them know ahead of time what you’d like to talk about and why it’s important to you. To avoid having the appointment dominated by one single health marker (like LDL), be ready to showcase your other health improvements, for example – you’ve lost weight, you’ve improved your blood sugars, you’ve reduced your medications, and best of all – you can now fit into your bell bottoms from high school. Don’t forget to bring a list of reputable resources that your doctor can peruse in their free time, assuming they are open to learning more.

‍When It’s Time to Move On

You’ve prepared for the appointment. You’ve discussed your concerns in a respectful manner. You handed them a sticky note including Virta’s website and a compelling collection of reads: The Art and Science of Low Carbohydrate Living, Rethinking Diabetes, The Big Fat Surprise, and Status Quo Thinking is Harming Your Health. You even wore your bell bottoms.

I’m not saying elevated LDL should be ignored – it shouldn’t - but if your primary provider is simply unwilling to budge on their “low carb is dangerous” stance and you find it frustrating to continue the relationship, it could be time to move on. On the other hand, if you still value your relationship with your primary provider, you might choose to keep them and also consult with your Virta provider for additional support.I’d suggest a couple starting points when shopping around. First, try asking for recommendations for low carb-friendly providers from other members in the Virta Community. While possibly out of state, many are able to provide telehealth primary care visits. Second, the Diet Doctor website has a list of low carb clinicians in each state. 

The landscape is changing, so remain hopeful, but advocate for yourself. If your current provider isn’t giving you the quality care you deserve, there are plenty more who will!

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