Florida man’s diet of meat, cheese and butter caused cholesterol to leak into his hands

If you’ve ever wondered why we’re always told to eat in moderation, this recent case study of a man in Florida provides a perfect example. The man’s doctors detail how his “carnivore diet” caused him to have cholesterol levels so high that they literally began seeping out of his body.

Cardiologists at Tampa General Hospital described the strange case in an article published Wednesday in JAMA Cardiology. According to the report, the man sought medical attention weeks after he began developing painless but highly visible “yellowish nodules” emerging from his hands and elbows. It turned out that his problem was an unusual but known complication of high blood cholesterol, likely caused by the man’s diet of high meat, cheese and lots of butter.

About eight months before his symptoms appeared, the man, aged around 40, had switched to a so-called carnivore diet. The diet, he told doctors, required him to consume large amounts of fat. He achieved this by regularly eating six to nine pounds of cheese, copious sticks of butter, and daily hamburgers stuffed with even more fat. Remarkably, the man reported losing weight, increasing his energy and improving his mental clarity after starting the diet. But unfortunately, this had obvious negative consequences.

Doctors found that his blood cholesterol level exceeded 1,000 milligrams per deciliter (mg/dL), well above the usual range. As a reminder, a healthy blood cholesterol level is supposed to be below 200 mg/dL, while high cholesterol levels start at over 240 mg/dL. Based on this finding and his physical symptoms, doctors diagnosed the man with a rare but known disease known as xanthelasma.

Xanthelasmas are cholesterol deposits that accumulate under the skin. Normally, excess cholesterol and other fats in our blood are removed by white blood cells called macrophages. But when this process is impaired, these macrophages transform into “foam cells” overfilled with cholesterol; it is these cells that form the deposits that eventually come out of the skin.

Although there are other medical conditions that cause xanthelasma to appear, such as certain thyroid problems, about half of these cases are linked to high blood cholesterol levels. This man’s case was particularly unusual because these deposits typically form around the eyelids, likely because the blood vessels in that area weaken over time due to constant blinking. But xanthelasmas can theoretically occur anywhere on our body. This disease is quite rare: research has estimated that about 1% of women and 0.3% of men get xanthelasma.

As gross as they may seem, xanthelasmas are harmless and can be removed through surgery or other cosmetic procedures. In contrast, high blood cholesterol is known to increase the risk of future cardiovascular problems, including heart attack and stroke. The doctors don’t detail what happened to their patient after their diagnosis, but they do emphasize the need for people to avoid high blood cholesterol levels.

“This case highlights the impact of dietary habits on lipid levels and the importance of managing high cholesterol to prevent complications,” they wrote.