A man who ate “very extreme amounts of fat and protein” as part of the carnivore diet suddenly developed yellow lumps on the palms of his hands — deposits of excess cholesterol under his skin, his doctor says.
The unnamed patient, who is in his 40s, was eating up to 6 to 9 pounds of cheese a day, plus sticks of butter and other fat that he would add to his daily hamburgers, says Dr. Kostas Marmagkiolis, an interventional cardiologist at Tampa General Hospital, USF Health and Tampa Heart in Florida, who treated him.
Tests found the man’s total blood cholesterol was more than 1,000, one of the highest results Marmagkiolis has ever seen. Healthy levels for adults are less than 200.
“This patient was not aware that his cholesterol was that high,” Marmagkiolis tells TODAY.com, noting he had a normal cholesterol for many years.
“Abruptly within one year, his cholesterol dramatically increased, and at the same time, those lesions appeared. So we have to assume — based on the history of this patient — that those lesions were directly caused by the high cholesterol, which was directly caused by the type of diet that he was (eating).”
The patient developed yellow lumps in the creases of his palms — deposits of excess cholesterol under his skin.
For eight months, the man had been following the carnivore diet — a high-protein, no-carb plan that focuses on eating only animal products, especially meat, eggs and some dairy; and excludes fruits, vegetables and grains. It means eating lots of saturated fat, which can raise cholesterol, registered dietitian Kristin Kirkpatrick warns.
The patient said he lost weight, had more energy and experienced improved mental clarity, according to a case report in JAMA Cardiology. But his primary care doctor noticed the fatty yellow bumps on his hands and referred him to Marmagkiolis.
Warning sign of high cholesterol
The yellow deposits under the skin are a red flag for cardiologists to check cholesterol levels, Marmagkiolis says.
“We believe that is a way of the body to eliminate the additional cholesterol from the bloodstream whenever it cannot process it,” he notes.
When the bumps appear on eyelids, the most common location, they’re called xanthelasmas.
This file image shows xanthelasma on the eyelid.
Whey they show up on other parts of the body, including hands, elbows and soles of feet, they’re called xanthomas.
Only about 1% of patients with high cholesterol will develop these lumps, with a genetic predisposition playing a role, Marmagkiolis says.
The yellow deposits themselves are completely painless and harmless — they’re simply a visual signal of a possible metabolic disorder, he adds. Once they appear, they generally don’t go away, but can be removed by a dermatologist.
In this patient’s case, the bumps indicated “an amazing amount of cholesterol in his bloodstream,” the cardiologist notes. In general, such extreme levels are an urgent condition that needs immediate medical attention, Marmagkiolis says.
This patient had a total blood cholesterol of more than 1,000, about five times the healthy level for adults.
High cholesterol leads to plaque buildup in the arteries, raising the risk of heart attack and stroke, according to the National Heart, Lung and Blood Institute.
Doctors advised the patient to immediately switch to a more balanced diet and take medications to lower cholesterol.
Is a carnivore diet healthy?
Many people are interested in the carnivore diet and other keto diets because they feel full while losing weight, Marmagkiolis says. The lack of carbohydrates forces the body to burn fat for energy rather than glucose.
Other benefits include eliminating sugar, refined grains and ultraprocessed foods, which have been linked to obesity and Type 2 diabetes, Kirkpatrick says.
The carnivore diet provides nutrients including riboflavin, zinc, vitamin B6, vitamin B12, selenium and vitamin A; but it falls short on magnesium, calcium, vitamin C and fiber, studies have found.
People can experience nutrient deficiencies because they’re cutting out plant-based foods, which are high in fiber, antioxidants, vitamins and minerals, Kirkpatrick notes. Not eating enough vegetables can lead to poor gut health and constipation, she adds.
In general, patients who follow such extreme diets are at much higher risk of having abnormal cholesterol levels, Marmagkiolis says.
Dr. Jeremy London, a Georgia heart surgeon who was not involved in the case report, says the carnivore diet may work for some, but most people will be healthiest when eating a balance of nutrients.
“Our bodies are made to run on proteins, fats and carbohydrates,” London tells TODAY.com.
“Anything in the extreme is rarely going to be beneficial. … In general, if you are focusing on whole foods where you’re eating lean meats, leafy greens, vegetables and fruits and fiber, you’re going to do fine.”
The Mediterranean diet is the healthiest, both doctors say, pointing to studies that show benefits for the heart and beyond.
People who are still interested in following the carnivore diet should keep an eye on their cholesterol profile with blood work and consult with a dietitian or a physician who can monitor the effects of eating only animal products, Marmagkiolis says.
This article was originally published on TODAY.com
