Blood work
mongoosealamode
Posts: 112 Member
I really want to get for my blood work from 2 years ago to compare
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my DH AIC dropped from .087 to .607 in 3 months and he doesn't have to go back for 6 months. If it continue to drops, they will consider reducing medication. YEAH!!!! Diabetes under control and hopefully on the run.0
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Excellent labs. Great HDL. LDL is too high. If you have DM or CHD consider a statin to try and get it below 70.
No.
LDL alone doesn't mean much. Of all the individual numbers, HDL and trigs are far better indicators, and ratios are better yet, and hers are pristine:
Additionally, the LDL is calculated, and with HDL that high and trigs that low, it's very likely that actually an inaccurate number (the calculation is known to break down at very low or very high level trigs).
Finally, LCHF is known to change the composition of the LDL particles, which increases the number on these tests, but doesn't actually mean there's an issue (it basically comes down to the fact that the test is asking the wrong question).
The following tests should be done before a doctor or patient even considers going on statins, especially when the patient is known to be on LCHF:
1. Direct measure of LDL levels (is the calculated number even right?)
2. LDL particle size measurement (small dense, which are bad, or large fluffy, which are benign?)
3. LDL particle count (is it a ton of little ones, or a handful of big ones? Latter is good, former is bad)
In other words, if she or her doctor are concerned about it, more tests need to be done to assess the risk, before medications are brought into the picture.0 -
I agree. That looks great! Don't change a thing.
If you get those old labs, post them. I'd love to see how they're change (improved).0 -
2012
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mongoosealamode wrote: »2012
Yep, your before and after numbers are consistent with what's common on LCHF. Increase in HDL, plus decrease in trigs indicates the LDL increase is likely due to size/density changes in the LDL particles, which is a good thing. 0 -
Agreed. Your results are consistent with low-carb diet effects.
If your doc is concerned about LDL, ask about getting a VAP or NMR. VAP should show that your LDL are the large fluffy type. NMR should show that your LDL particle count is in range.
If YOU're concerned about high LDL, how this works is kind of interesting.
High-carb causes the LDL particles to be loaded up with smaller fat droplets produced by DNL. Low-carb causes them to be loaded up with large fat droplets from digested fat. The size of the fat droplets determines the CONCENTRATION of LDL, but doesn't tell you anything about particle COUNT.
In terms of risk, one theory is that the smaller denser LDL particles are more likely to penetrate the arterial wall. Another is that only the particle count matters. Phinney and Volek like to say that triglycerides and HDL are the better risk markers, but my guess is that plaques are multifactorial.
IMO, high triglycrides and low HDL are a marker for insulin resistance, which seems to be one of the risk factors. Probably independent of LDL count, but that hasn't been determined AFAIK.0 -
Additionally, the LDL is calculated, and with HDL that high and trigs that low, it's very likely that actually an inaccurate number (the calculation is known to break down at very low or very high level trigs).
The Iranian formula is supposed to be better when triglycerides are very low. Using that one with these numbers gives an LDL of 81.
These numbers aren't bad at all. I would never consider a statin with numbers these great.0 -
Dragonwolf wrote: »Excellent labs. Great HDL. LDL is too high. If you have DM or CHD consider a statin to try and get it below 70.
No.
LDL alone doesn't mean much. Of all the individual numbers, HDL and trigs are far better indicators, and ratios are better yet, and hers are pristine:
Additionally, the LDL is calculated, and with HDL that high and trigs that low, it's very likely that actually an inaccurate number (the calculation is known to break down at very low or very high level trigs).
Finally, LCHF is known to change the composition of the LDL particles, which increases the number on these tests, but doesn't actually mean there's an issue (it basically comes down to the fact that the test is asking the wrong question).
The following tests should be done before a doctor or patient even considers going on statins, especially when the patient is known to be on LCHF:
1. Direct measure of LDL levels (is the calculated number even right?)
2. LDL particle size measurement (small dense, which are bad, or large fluffy, which are benign?)
3. LDL particle count (is it a ton of little ones, or a handful of big ones? Latter is good, former is bad)
In other words, if she or her doctor are concerned about it, more tests need to be done to assess the risk, before medications are brought into the picture.
Do you have a link to this calculator? I'd love to plug my numbers in, too. My cholesterol is higher, but most of my other stats are quite similar.0 -
KnitOrMiss wrote: »Dragonwolf wrote: »Excellent labs. Great HDL. LDL is too high. If you have DM or CHD consider a statin to try and get it below 70.
No.
LDL alone doesn't mean much. Of all the individual numbers, HDL and trigs are far better indicators, and ratios are better yet, and hers are pristine:
Additionally, the LDL is calculated, and with HDL that high and trigs that low, it's very likely that actually an inaccurate number (the calculation is known to break down at very low or very high level trigs).
Finally, LCHF is known to change the composition of the LDL particles, which increases the number on these tests, but doesn't actually mean there's an issue (it basically comes down to the fact that the test is asking the wrong question).
The following tests should be done before a doctor or patient even considers going on statins, especially when the patient is known to be on LCHF:
1. Direct measure of LDL levels (is the calculated number even right?)
2. LDL particle size measurement (small dense, which are bad, or large fluffy, which are benign?)
3. LDL particle count (is it a ton of little ones, or a handful of big ones? Latter is good, former is bad)
In other words, if she or her doctor are concerned about it, more tests need to be done to assess the risk, before medications are brought into the picture.
Do you have a link to this calculator? I'd love to plug my numbers in, too. My cholesterol is higher, but most of my other stats are quite similar.
http://www.hughcalc.org/chol.php
One nice thing about it is that you only need three of the four numbers. If you don't enter trigs or LDL, it will calculate it (and it will do a calculation even if you enter in all of the numbers, which shows that the numbers will end up slightly different depending on which numbers are directly measured and which are calculated).0 -
Yeah, my total was 241, trigs 76, hdl 50, ldl was 176 calculated (158 with the iranian method), but if I set the ldl at 158, it changes my trigs to 160, which apparently makes everything normal, but with my trigs at 76, then I'm high risk in several categories. I've had the sizes checked 6 months ago, and all those risks were high/bad, too, but from what I recall of the discussions and research I could do (can't get Cholesterol Clarity where I am), during active weight loss, those total and LDL numbers don't mean as much...
Decided I'm not going to worry unless I had other symptoms. All other stats improved!0 -
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People are concerned about the side-effects of statins. And they're also concerned that they're treating the wrong thing.
The science supporting pushing LDL down below 70, or even below 100, isn't very strong.
FWIW, my doc recommended statins to me even though my cholesterol wasn't high. It's now a standard recommendation even if you have other risk factors. In my case, it was metabolic syndrome. All my risk markers went to normal after a few months of low carb.0 -
Why not a statin? Consider it cheap insurance.
Cheap insurance? I hardly consider the side-effects of statins to be cheap especially when compared to the absolutely mediocre benefits they offer. What was it? For those at high risk, when 100 people take statins two of them will have a heart attack compared to three people in a group of the same 100 people not taking statins? All that benefit in exchange for the increased risk of diabetes (for those without it already), muscle damage, memory loss, liver damage, etc. On top of that, it's not even the cholesterol that is the problem. That's the symptom of an underlying issue. It's like trying to reduce fires in a city by reducing the number of firefighters (because you always find a lot of them near fires).
I don't doubt that you'll be held liable for malpractice, though. It's well established that big Pharma has more say in medicine than common sense. There are great books and resources investigating the cholesterol myths (Cholesterol Clarity is supposed to be good, I haven't read it though). I know there's a really interesting all-cause mortality graph posted where total cholesterol is graphed against all causes of deaths, and the mortality is lowest at levels considered "too high" by modern medicine (200-240 mg/dL).
http://highsteaks.com/cholesterol/
The above link has the graph and some more discussion. While this is one person's opinion, it's one that I tend to trust because he is very well versed on the research and science. He's basically written the book when it comes to studies on low carb diets.
I have seen lots of studies that show both sides, but I have found myself solidly on the anti-statin side. This is something my doctor is not fond of, because my cholesterol is "borderline" in her eyes (bounces around 190-210) and she wants to "watch it."0 -
As a practicing physician I would offer any DM2 pt with a calculated LDL > 70 a statin. If I didn't, I could be liable for malpractice. Why not a statin? Consider it cheap insurance.
I just completed 4 weeks of LCHF. It's in a lovely honeymoon. My FBS have gone below 90. Before from 120-140. My 2hBS are now below 105. Before 130-170. As a nice bonus, I've lost 7 lb.
I am not diabetic, nor prediabetic. I have PCOS and Insulin Resistance, Hypothyroidism, and Medication Caused High Blood Pressure, among minor other things. My doctor wanted to talk about meds last time, but the ratios of my HDL and Trigs is outstanding, and more nad more research is showing that LDL is not the horror story it's said to be. If my PCP is still worried about this, I might opt for one of those $50 out of pocket heart screenings, just to get everyone off my case.
There would have to be some huge giant red flags far beyond what I've seen this far for me to worry about this in the slightest. While I'm busy burning tons of stored fat, the readings of total and "bad" cholesterols are not anywhere close to valid anyway. I'm not about to add another unnecessary medication with a laundry list of risks of side effects worse that what it could MAYBE help treat. I'm using this WOE/WOL to reduce all my medication needs, not add something as a maybe...
EDITED TO ADD:
During the time I've been low carb, my fasting glucose has dropped from 92 MG/DL to 85 MG/DL, my A1C from 5.3% to 5.1%, my fasting glucose from a high of 9 uIU/mL to 5.8 uIU/mL. Additionally, ever other blood statistic I have had tested in this last year and before has improved...0 -
Well... my numbers are good. I'm not diabetic or even prediabetic (i don't even know why that was brought up at all). I'm only 29 and would never even consider statins...0
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mongoosealamode wrote: »Well... my numbers are good. I'm not diabetic or even prediabetic (i don't even know why that was brought up at all). I'm only 29 and would never even consider statins...
Agreed. Nice changes over the last couple of years. Congrats.
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As a practicing physician I would offer any DM2 pt with a calculated LDL > 70 a statin. If I didn't, I could be liable for malpractice. Why not a statin? Consider it cheap insurance.
I just completed 4 weeks of LCHF. It's in a lovely honeymoon. My FBS have gone below 90. Before from 120-140. My 2hBS are now below 105. Before 130-170. As a nice bonus, I've lost 7 lb.
@tsazani do you not have a concern in the above case of needlessly inducing risks of arteriosclerosis, cancer, liver damage, transient global amnesia, lowering level of CoQ10, etc by writing a statin Rx?0 -
KnitOrMiss wrote: »Yeah, my total was 241, trigs 76, hdl 50, ldl was 176 calculated (158 with the iranian method), but if I set the ldl at 158, it changes my trigs to 160, which apparently makes everything normal, but with my trigs at 76, then I'm high risk in several categories. I've had the sizes checked 6 months ago, and all those risks were high/bad, too, but from what I recall of the discussions and research I could do (can't get Cholesterol Clarity where I am), during active weight loss, those total and LDL numbers don't mean as much...
Decided I'm not going to worry unless I had other symptoms. All other stats improved!
I used the first one, and it erased my real trig number of 59 and calculated it at 102! So then I used the one at the link he has above, and got "ideal" (phew).
edited to add: these numbers are from May 2015. I have been eating LCHF since May 2013. Lost 11kg.0 -
People are concerned about the side-effects of statins. And they're also concerned that they're treating the wrong thing.
The science supporting pushing LDL down below 70, or even below 100, isn't very strong.
FWIW, my doc recommended statins to me even though my cholesterol wasn't high. It's now a standard recommendation even if you have other risk factors. In my case, it was metabolic syndrome. All my risk markers went to normal after a few months of low carb.
What were the other risk factors?
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As a practicing physician I would offer any DM2 pt with a calculated LDL > 70 a statin. If I didn't, I could be liable for malpractice. Why not a statin? Consider it cheap insurance.
You ought to be interested in this:
http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-i
and this:
https://player.vimeo.com/video/45485034
and this:
http://drhyman.com/blog/2010/05/19/why-cholesterol-may-not-be-the-cause-of-heart-disease/
Others have already pointed out the reasons for why not statins. Frankly, the fact that you're so willing to prescribe any medication based on one number in isolation -- which has already proven to be a poor predictor of heart disease risk -- and disregarding the others, when those better predictive numbers say it's not necessary, without further tests to verify your concerns is what's most concerning to me and illustrates everything that's wrong with our current healthcare industry. The fact that you're willing to prescribe the medication, because it's favorable to risking a malpractice suit just compounds the issue, in part because it illustrates just how ruled by fear the industry is.0 -
_Terrapin_ wrote: »People are concerned about the side-effects of statins. And they're also concerned that they're treating the wrong thing.
The science supporting pushing LDL down below 70, or even below 100, isn't very strong.
FWIW, my doc recommended statins to me even though my cholesterol wasn't high. It's now a standard recommendation even if you have other risk factors. In my case, it was metabolic syndrome. All my risk markers went to normal after a few months of low carb.
What were the other risk factors?
They now look at your 10-year heart disease risk. If it's above a certain threshold (8%?), they recommend statins.
The information required to estimate ASCVD risk includes age, sex, race, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure lowering medication use, diabetes status, and smoking status.
http://www.health.harvard.edu/blog/cholesterol-guidelines-update-controversy-over-heart-risk-calculator-2013111968860 -
_Terrapin_ wrote: »People are concerned about the side-effects of statins. And they're also concerned that they're treating the wrong thing.
The science supporting pushing LDL down below 70, or even below 100, isn't very strong.
FWIW, my doc recommended statins to me even though my cholesterol wasn't high. It's now a standard recommendation even if you have other risk factors. In my case, it was metabolic syndrome. All my risk markers went to normal after a few months of low carb.
What were the other risk factors?
They now look at your 10-year heart disease risk. If it's above a certain threshold (8%?), they recommend statins.
The information required to estimate ASCVD risk includes age, sex, race, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure lowering medication use, diabetes status, and smoking status.
http://www.health.harvard.edu/blog/cholesterol-guidelines-update-controversy-over-heart-risk-calculator-201311196886
Did the blog say >191 for LDL? Did I read this correctly? Thank you for the link.
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Yeah, LDL>190 is the cut-off for "very high," and statins aren't very controversial at that level. They don't even bother using the risk calculator for those levels.
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The Harvard link has (I think) 4 different criteria one was diabetic and LDL above >70 I think. IDK, interesting to read and Attia's talk by Dragon Wolf I'll keep going back to; the link for Dr Hyman takes it too far for me(the whole it is the sugar) gets me a little batty. Good links by folks in this thread. Next month I'm hoping to start seeing a Cardio group to discuss preventative measures and on going research. I'd rather prevent the CVD as opposed to going once an event occurs. IDK proactive instead of reactive in my head seems to work.0
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_Terrapin_ wrote: »Next month I'm hoping to start seeing a Cardio group to discuss preventative measures and on going research. I'd rather prevent the CVD as opposed to going once an event occurs. IDK proactive instead of reactive in my head seems to work.
Let us know what they say. Most of medicine is geared towards fixing what breaks rather than prevention.
You can play "what if" with the risk calculator. Since age is a risk factor, it's pretty much impossible for me to get my 10-year risk below 3%, but diet and exercise can get me pretty close.
http://tools.acc.org/ASCVD-Risk-Estimator/
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I don't believe the good doctor is coming back! My father is type 2 diabetic and has struggled with trying to keep his blood sugar under 150 (fasting) for a long time. He also takes statins, suffering the muscle pain that can be a side effect. He stopped the statins and his fasting blood sugars have been in the 70s and 80s! THAT IS REAL!!! "Good doctor" could really help some people if he wanted to! Big Pharma, big insurance be dam~€©¡¡.0
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You can play "what if" with the risk calculator. Since age is a risk factor, it's pretty much impossible for me to get my 10-year risk below 3%, but diet and exercise can get me pretty close.
http://tools.acc.org/ASCVD-Risk-Estimator/
Thanks for the link, I can rest assured now, even at my age, as long as I keep on ketoing on:
Based on the data entered (assuming no clinical ASCVD and LDL-C 70-189 mg/dL):
Gender: Female
Age: 58
Race: White/Other
Total Cholesterol: 221
HDL-Cholesterol: 87
Systolic Blood Pressure: 120
Hypertension Treatment: No
Diabetes: No
Smoker: No
Not In Statin Benefit Group Due To 10-Year ASCVD Risk <5%0
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