Blood work results comparison and a question

macchiatto

I know some of you are interested in seeing how blood work changes over time when eating low carb so I'm posting my comparison. In Fall 2012, at 150 lbs, I found out I had prediabetes and high triglycerides (then started eating low carb/low fat, lost 12 lbs and reversed the prediabetes). Also, I found out today that my doctor recently started eating keto herself and loves it! She was happy with my labs, though I do see total cholesterol has climbed higher.

For reference, I am a 41y/o, 5'7" (171cm) female.

10/30/14 (eating low to moderate carb/low fat/higher protein)
Weight: approx 137 lbs
Fasted labs:
Total cholesterol: 144
Triglycerides: 80
HDL: 59
VLDL: 16
LDL: 69
LDL/HDL ratio: 1.2
Glucose: 81
A1C: 5.4


3/22/16 (after 4 months of eating keto)
Weight: approx 131
Fasted labs:
Total cholesterol: 174
Triglycerides: 68
HDL: 75
VLDL: 13
LDL: 85
LDL/HDL ratio: 0.882
Glucose: 80
A1C: 5.5

3/20/17 (after 15 months of eating LCHF, often keto)
Weight: 133
Fasted labs:
Total cholesterol: 187
Triglycerides: 60
HDL: 73
VLDL:12
LDL: 102
LDL/HDL ratio: 1.4
Glucose: 91
A1C: 4.9!!!

4/9/18 (after 2.5 years of eating LCHF, some keto; looser over the past 6 months but dropped back to keto just a week ago)
Weight: 139
Fasted labs:
Total cholesterol: 196
Triglycerides: 76
HDL: 79
VLDL: 15
LDL: 102
LDL/HDL ratio: 1.3
Glucose: 97
A1C: 4.9

One thing I'm wondering is that my fasting glucose has gradually gone up over the past two years and is now awfully close to the top of the normal range; yet my A1C has been great the past two times. What would you make of that?

Running_and_Coffee

Could it just be age related, as you started tracking this in your mid 30s and are now 41?
(Signed, a 44 year old expecting similar numbers changes this year!!)

cstehansen

Regarding the higher FBG, it likely has to do with glucose sparing effect (aka physiological insulin resistance). This just means your brain gets used to you not having a lot of glucose through diet so it preferentially holds onto a bit more in your bloodstream for your emergency use in for the few cells in your body that must have glucose. As you can see from your A1c, this is not causing you harm as it is not actually "high" blood sugar. The term physiological insulin resistance sounds bad, but it really isn't as it isn't really insulin resistance so much as it takes a bit more BG to stimulate the insulin response.

Keto_Vampire

Fasting Blood Glucose (FBG) is only a temporary/short term marker (a snapshot or photo) vs. your HbA1C which is a 4 month measure of glucose control (RBC lifespan is about 4 months time in which old cells sequester/die) - (a more continuous video vs photo/FBG). Note: no reason to be excited about a 4.9% HbA1C - it's good/at goal but lower does not show any additional benefit (re: !!!)

I wouldn't stress over analyzing why FBG is slightly higher appearing over the years...again to get a more clear picture of whether this is even accurate to assume, you would need multiple daily measures of FBG throughout the day. 1 value of FBG can be greatly affected by many factors (time of day/cortisol release, hydration status, blood volume, immunity at the time, stress, time fasted, catecholamines, etc.). HbA1C says you are fine

Anything < 126mg/dL is fine for FBG

macchiatto

Thanks for the replies!
@Keto_Vampire, my A1C was a little close to prediabetes level for comfort previously (especially since I had prediabetes before, and both parents are diabetic) so having more margin in there is a relief. Also, someone on here had posted an article about how aiming for lower A1C does have benefits.

GaleHawkins

Thanks for sharing the results of your efforts.

catherineg3

Your A1C is doing better at 4.9%, so I would not worry about blood glucose being higher at a momentary spot. a lot of non-food things can affect blood glucose like being sick or stressed.

danceandplay

There is something called the "Dawn Phenomenon" in some people. You've been fasting all night and your body starts up some glucogenisis in preparation for your waking up so you have enough energy to find food. It used to spike my blood sugar every morning. I started taking my measurements before every meal and before lunch, it was lower than before breakfast. Same with dinner. You might just need to adjust the time of your measurements.