"Houston, We Have a BIG Problem."

motown13

I was supposed to have my physical on Monday.... I thought it was for Tuesday, and I missed it. It is rescheduled for later this month.

But today the doctor's office called and told me my "numbers". I didn't write them down because I will see the doctor in 2 weeks, and I will go over them in depth at that point.

Good news first: My A1c dropped 2 points ( I was hoping for 3 ) to 7.9..... after 2 months of LCHF.

REALLY bad news.... my triglycerides went up..... way up. I was under 300 last time, and was 457 this time.

With the 2 point drop in A1C, I would have guessed everything would be getting better.

Thoughts?

anglyn1

You are currently in the process of losing weight, correct? If so your triglycerides will be higher because you have more fat being released into the blood stream. Once you finish losing weight your numbers will be more accurate.

macchiatto

That's great your A1C went down!
Sorry about your triglycerides but what @anglyn1 said made sense. @anglyn1 I'm curious; if I just shifted to maintenance mode recently (a week ago although I haven't really lost anything to speak of since January anyway), and had blood work done today, will my tri's still be elevated or should they have dropped back down by now?

Dragonwolf

What's your HDL?

High trigs, especially coupled with low HDL, on low carb is sometimes indicative of thyroid troubles (no, low carb didn't cause, simply uncovered it). It's probably worth getting your T3 and T4 checked.

neohdiver

I agree about waiting to see where things settle out. If your doctor is concerned s/he can order a more refined test for the LDL particle size (the bad cholesterol) - which I believe is ultimately related to triglycerides (or at least to triglycerides/HDL ratio.

Eating a LC/HF diet tends to make bigger, puffier, relativley harmless LDL particles.

Here's an article with a bit of information. http://care.diabetesjournals.org/content/23/11/1679.full.pdf

(My triglycerides went down in response to my change in diet - but if things ever go in the wrong direction, my doctor will order an NMR test for LDL particle size.)

Fvaisey

I have seen this reported by a number of people in their first stages of a keto diet. I haven't done the research however some of the responses I've seen are that the Triglyceride number doesn't actually indicate a heart risk. It was also reported by a number of people that sticking with the diet led to the numbers eventually getting back down to "normal" levels. I think that many of them attributed this to the damage they had done to their metabolism over a long period of time. I can't tell how long you've been using this WOE however it looks as if you are seeing good results almost everywhere else.

I hope you see some responses from people who have been thru this themselves before you get discouraged. I would say that the A1C drop is much more significant than the rise in Triglycerides.

anglyn1

macchiatto wrote: »

That's great your A1C went down!
Sorry about your triglycerides but what @anglyn1 said made sense. @anglyn1 I'm curious; if I just shifted to maintenance mode recently (a week ago although I haven't really lost anything to speak of since January anyway), and had blood work done today, will my tri's still be elevated or should they have dropped back down by now?

From what I've read about 4 weeks of being at a stable weight should make for accurate numbers so you should be good!

lithezebra

Talk to your doctor about your triglycerides. I have no idea whether your numbers can be attributed to weight loss or not. Ugh. I'm about to have that test too, and I'm stressing on it.

KnitOrMiss

I second the suggestion about high trigs being related to thyroid issues. Hopefully the doc can run those tests. The ratio between HDL and trigs is more important than the individual numbers.

But yes, during active weight loss your numbers are hella wonky!

CONGRATS on the 2 point drop in A1c!

Dragonwolf

Oh yeah, don't forget, too, that with an A1C that high, the body is likely "more concerned" with doing what's necessary to get and keep all that sugar out of your system, and is devoting resources to that, because it's the most pressing issue. In other words, it's healing your liver and pancreas, for which cholesterol is needed, elevating your numbers until that's taken care of.

Assuming your thyroid is okay, I wouldn't be surprised if your cholesterol starts normalizing after your A1C/blood sugar drops back down to healthy levels.

KarlynKeto

Wow, I had to Google this. What Anglyn said makes the most sense, IMO. And I remember reading about it a few times too. Here is something I found. I am not sure how accurate it is, but it sounds plausible.

Fat is stored energy. Energy is stored as . . . triglycerides.

So when there is substantial weight loss, there is a flood of triglycerides in the blood, and triglyceride levels in the midst of weight loss can commonly jump up, not uncommonly to the 200-300+ mg/dl range. When triglycerides go up, there is also a drop in HDL (triglycerides interact with HDL particles, modify their structure and make them more readily destroyed, thereby dropping blood levels). Occasionally, substantial weight loss like Brad experienced will drop HDL really low, as low as the 20's.

Once weight stabilizes, this effect can last up to 2 months before correcting. Only then will triglycerides drop and HDL rise. The rise in HDL occurs even more slowly, requiring several more months to plateau. - See more at: http://www.cureality.com/blog/post/2008/08/13/i-lost-30-lbs-and-my-triglycerides-went-up.html#sthash.fpjnPSrd.dpuf

motown13

Well I hope you are collectively right. 2 weeks until I actually take my physical, and I will find out all of my numbers, and then ask for another blood test for 6 weeks after that. Thanks for making it not seem so bad.

KarlynKeto

motown13 wrote: »

Well I hope you are collectively right. 2 weeks until I actually take my physical, and I will find out all of my numbers, and then ask for another blood test for 6 weeks after that. Thanks for making it not seem so bad.

Motown, I found an article today on just your situation, so posting it here for you. It looks VERY likely that the situation is due to the rapid weight loss. In other words, while the numbers do not look great you are doing the right stuff! http://www.wheatbellyblog.com/2012/06/i-lost-weight-and-my-cholesterol-went-up/

On a different note, I read that if the elevated numbers do not go down once weight is stable, it could be due to high consumption of sat fat when it far exceed daily recommendations. Nearly all articles I read pointed to the bulletproof coffee as a culprit ('drinking high amounts of fat'), and that giving it up helped in nearly every case. Not sure if you drink them. I do not, so that isn't an option for me.

I got my blood results back today and while my triglycerides and HDL were good, my LDL (a rather meaningless 'gobbledygook' number) went way up. Likely for the same reasons as yours. At the time I drew blood, I had been in keto about 9 weeks. Add that to a recent 60 pound weight loss over the last 6 months. My numbers were TRI 100 /HDL 91 /LDL 191 . This also meant my overall number was high - 302 . However, since everything else looked great or fantastic, and my doctor is on board with my diet (yeah!) and she agreed that rapid weight-loss can skew the numbers, she wants to me to continue on the same path. So no request to take drugs and no changes in my diet. I asked that my next panel in 4 months include the LDL particle tests, and she said OK. Until we see that result, I have no clue if my LDL is good, bad or otherwise.

Good luck!

motown13

TY, I do drink BPC, but really only started 2 weeks ago.