Newest Lab Results not quite what I expected
Aquawave
Posts: 260 Member
F Cholesterol, Total 252 H 100-199 (mg/dL)
F Triglycerides 190 H 0-149 (mg/dL)
F HDL Cholesterol 77 >39 (mg/dL)
F VLDL Cholesterol Cal 38 5-40 (mg/dL)
F LDL Cholesterol Calc 137 H 0-99 (mg/dL)
A1C 5.7
Glu 106
Current Weight 147
Height 5' 8"
I have been on the LCHF diet since June, lost 28 pounds. I am happy with the reduction of the A1C from 7.2 last year, but am concerned about the lipid profiles, specifically the high triglycerides. I went off statins in June also, do to long term unexplainable joint and muscle problems that have since gone away. They refused to order the LDL particle count.
My labs posted before my Dr's appointment on Thursday. Any thoughts about what is happening and how do I talk to my doc about this? I do not want to go back on statins. I am 62 and female, on Metformin XR 1000 twice a day.
F Triglycerides 190 H 0-149 (mg/dL)
F HDL Cholesterol 77 >39 (mg/dL)
F VLDL Cholesterol Cal 38 5-40 (mg/dL)
F LDL Cholesterol Calc 137 H 0-99 (mg/dL)
A1C 5.7
Glu 106
Current Weight 147
Height 5' 8"
I have been on the LCHF diet since June, lost 28 pounds. I am happy with the reduction of the A1C from 7.2 last year, but am concerned about the lipid profiles, specifically the high triglycerides. I went off statins in June also, do to long term unexplainable joint and muscle problems that have since gone away. They refused to order the LDL particle count.
My labs posted before my Dr's appointment on Thursday. Any thoughts about what is happening and how do I talk to my doc about this? I do not want to go back on statins. I am 62 and female, on Metformin XR 1000 twice a day.
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Replies
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What were trigs prior to LCHF?2
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http://www.healthynutritionguide.info/nutrition-tools-calculators/cholesterol-hdl-ldl-triglycerides-ratio-calculator
Doesn't seem to be concerning according to this risk calculator.
Don't let the numbers get your imagination going. Ratios matter and of course actual presence of atherosclerosis more than anything...
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Looks like a win to me! Lots of great improvement even without knowing your previous numbers.0
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The only number that is concerning, IMHO, is the trig number. You want that trig/HDL ratio to be below 2, and below 1 removes almost all risk.
Three points/questions on that though.
[*]First, what were your numbers before?
[*] Second, trigs can temporarily rise while losing weight on keto. In these instances, they will typically stabilize within 6 months of becoming weight stable. There is a video that is in a couple of threads and possibly also somewhere in the launchpad where Dr Phinney discusses this ( @RalfLott ).
[*] Third, you mentioned you went off a statin in June. If these numbers are even close to what they were previously, it means you have essentially replaced any improvement you had with statin with the diet. My guess is your HDL is improved (higher) since going off the statin and changing to this WOE. That in and of itself is a positive in terms of actual risk.2 -
If your weight has not been stable for at least 6 months, then your cholesterol results are going to be artificially elevated due to fat metabolism.6
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A bit more history.
Previous lipid numbers a year ago, were "normal" since I was on generic Lipitor. My A1C was 7.2 then and my weight one year ago this month was actually 180. My endocrinologist told me that Diabetes was a progressive disease and asked me how long I wanted to live! He then put me on Jardiance.
On Father's day, we took my husband to a Chinese buffet and afterward both of us felt very strange. Took our sugars and they were close to 300. Wake up call for both of us and we subsequently went on this diet.
I dropped Jardiance and the statins at the same time.
These are my intermediate lab results from August 2016. I did not think they showed a true picture of my lipids since I had only been off of the statins and on the diet for 2 months.
T Chol 241 high
HDL 66
Trig 144
LDL 146 high
A1C 6.3
Glu 117
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tcunbeliever wrote: »If your weight has not been stable for at least 6 months, then your cholesterol results are going to be artificially elevated due to fat metabolism.
So, since I am still losing weight, my Trigs are going to be high? One has to ask when do I stop losing weight? I am 2 pounds away from my goal of 145, which seemed insurmountable in June. How low should my goal be? Female, 5'8" and age 62. This new fangled BMI index flummoxes me as I grew up with weight charts.
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tcunbeliever wrote: »If your weight has not been stable for at least 6 months, then your cholesterol results are going to be artificially elevated due to fat metabolism.
So, since I am still losing weight, my Trigs are going to be high? One has to ask when do I stop losing weight? I am 2 pounds away from my goal of 145, which seemed insurmountable in June. How low should my goal be? Female, 5'8" and age 62. This new fangled BMI index flummoxes me as I grew up with weight charts.
145 is smack dab in the middle of what is considered a healthy BMI for 5'8". I am one who takes that with a grain of salt since we aren't all built the same way.
Also, new studies have shown as we age, longevity and health improve if weight goes up slightly. At 62, you are nearing the age where this will affect you. I believe the beginning age the studies showed were either 65 or 70. This did not show it being good to be obese, but rather being at the high end of healthy and even into the first category above of overweight turned out to be healthier in older people.
I don't think you should be looking at getting any lower than 145, personally. Risks from being underweight (below 130 at your height) pose a bigger risk to health and longevity than being overweight as we age.
I would assume you will be essentially weight stable soon, so tests in 6 months should be a more accurate measure of where you are.
Again, the trigs are the primary number of any concern in your numbers. VLDL is on the high end, but not to the point of concerning.
Lastly, here are a couple of studies on cholesterol which I think could broaden your understanding on true risk as the traditional model saying high is bad seems to not hold up under scientific scrutiny:
https://www.ncbi.nlm.nih.gov/pubmed/24906678
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2674557/
Also, here is a risk tool that has been proven to be between 30% and 50% more accurate than the traditional Framingham score in predicting CVD.
http://www.reynoldsriskscore.org/default.aspx3 -
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I think you should concentrate on maintenance, that is the biggest challenge of them all. Keeping your weight stable will help with a lot of health concerns. Your goal weight sounds good to me. But cstehansen is correct, current studies show slightly higher weight is better for women over 65. So somewhere near the borderline of overweight and normal should be a good target for maintenance.
Once you hit your goal weight, slowly up your daily calories @100. So a tad more fat would be good. Keep adding till you see a lb. gain. That should be your calories for maintenance. I know this WOE is not all about cals, but getting into maintenance might require some slight focus in that direction.
As for the discussion with your dr. tell him you want to continue what you are doing and recheck everything in another 6 months. The muscle pain is a known issue with statins and you should not get any grief from stopping because of it. All the best with the visit.3 -
Thank you all. Just hope my doctor understands that not taking statins is my decision and not everyone can be "saved". I had to drop my endocrinologist since my insurance changed and my PCP (Internal Medicine) will now be overseeing my diabetes care and prescription for metformin and glucose strips. Hopefully, he is not argumentative and puts me on a 12 month schedule in order to coincide with my wellness visits for less cost to me.0
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Here a short clip of Stephen Phinney talking about the effect of weight loss on LDLs.
https://youtu.be/MNfjkTyBUdQ 1 -
I don't know how much protein you get daily but bring a woman and 62 makes higher protein very very important.
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@Sunny_Bunny_ can you explain in more detail why being a woman and 62 (I'm 60) makes higher protein very important? I'm wondering if my protein intake is enough for me?
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Here's just 1 article that can be found on the internet if you are an advocate of higher protein for older adults, choose to take the position and search for one in support of.
Many other articles would state otherwise.
http://www.todaysdietitian.com/newarchives/040715p16.shtml0 -
Get cardiac calcium scan- insurance won't cover- mine cost about $140.00 USA - best test ever paid for-will show calcium deposits in arteries of heart- inflammation causes etc. etc. my cholesterol high( pre lchf) >300 however cardiac ca+ score 0 and non smoker- so no need for statin drug- you likely experienced rabdomylosis- can be s/e r/t use station drug- (your doctor knows this given your symptoms)1
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@Sunny_Bunny_ can you explain in more detail why being a woman and 62 (I'm 60) makes higher protein very important? I'm wondering if my protein intake is enough for me?
Here's one I found quickly.
He says "elderly", but I will be keeping an eye on protein intake long before anyone will date call me elderly
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Here's another.
http://www.newsmax.com/t/newsmax/article/561756
Quoted at the bottom
"The study was published in American Journal of Clinical Nutrition.
A study published last month in the journal Cell Metabolism found low animal protein intake among the middle-aged decreased cancer risk, among other adverse health effects, but said that increased protein consumption might protect people over the age of 65."
I don't buy the cancer risk because it's always coupled with a high carb diet and meat and processed meats are considered the same.0 -
Get cardiac calcium scan- insurance won't cover- mine cost about $140.00 USA - best test ever paid for-will show calcium deposits in arteries of heart- inflammation causes etc. etc. my cholesterol high( pre lchf) >300 however cardiac ca+ score 0 and non smoker- so no need for statin drug- you likely experienced rabdomylosis- can be s/e r/t use station drug- (your doctor knows this given your symptoms)
Here's a thread on CAC scoring:
http://community.myfitnesspal.com/en/discussion/10443327/coronary-artery-calcification-cac-scoring
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Take a look at Dave Feldman's presentation on cholesterol and his high and low cal eating experiments to see why cholesterol is not the best indicator of your health...
https://www.youtube.com/watch?v=jZu52duIqno
Here is his website: http://cholesterolcode.com/?s=cu
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Sunny_Bunny_ wrote: »I don't know how much protein you get daily but bring a woman and 62 makes higher protein very very important.
I don't log my food since most everything is homemade. Simplified menu. 2 eggs, bacon or sausage for breakfast every day, Meat, fish (canned Sockeye or Sardines) or cheese for lunch (4 ounces), meat or fish for dinner, (six ounces). Included daily are fresh veggies, olives, butter, olive oil, coconut oil and nuts.1 -
Get cardiac calcium scan- insurance won't cover- mine cost about $140.00 USA - best test ever paid for-will show calcium deposits in arteries of heart- inflammation causes etc. etc. my cholesterol high( pre lchf) >300 however cardiac ca+ score 0 and non smoker- so no need for statin drug- you likely experienced rabdomylosis- can be s/e r/t use station drug- (your doctor knows this given your symptoms)
I will put this on my to do list. I will also discuss with my doctor if he knows where I can get this done at low cost in the Atlanta area. (as well as the elusive LDL-P test) I want my dear hubby to get this as well.0 -
Here's just 1 article that can be found on the internet if you are an advocate of higher protein for older adults, choose to take the position and search for one in support of.
Many other articles would state otherwise.
http://www.todaysdietitian.com/newarchives/040715p16.shtml
Because I like to look at the actual research that lead to the opinion article, I looked up a couple of these. One of the parts I found interesting is from the second cited study which said in part:The 13-wk change in appendicular muscle mass, however, was different in the intervention and control groups [+0.4 ± 1.2 kg and -0.5 ± 2.1 kg, respectively; β = 0.95 kg (95% CI: 0.09, 1.81); P = 0.03]. Muscle strength and function improved over time without significant differences between groups.
Basically, there was muscle gain in the group that had 1.11g/kg of body weight in daily protein intake and loss in the group that was at 0.85g/kg.
Although this is advocating more protein, this is not advocating HIGH protein as 1.11g/kg of body weight is not that high. This study was also only looking at obese people (BMI ave 33) and average age of 63.
This study and another also indicated the importance not just of protein but it being combined with other nutrients like vitamin D and calcium.
The type of protein is also important. One of the ones specifically mentioned is leucine because it is necessary for recycling the protein your body naturally breaks down each day. As a point of reference, eggs are a great source of leucine. I believe one egg has between 1/3 and 1/2 of what you need for the day, but I would need to look that up.
Anyway, using the numbers for "enough" protein, from the actual studies a 150 lb person (68 kg) would need about 75 g of protein. I don't think these studies or this article was intended for people on this WOE as much as for the general population who tends to not get enough protein (and especially leucine) because they have been scared off from the good sources because they have the dreaded saturated fat like eggs and beef. All of the studies seem to be comparing their "higher" protein against either 0.8g/kg or 0.85g/kg, which is probably lower than most in this group as that comes out to only 0.36g per lb of body weight.1 -
Hi, Just got back from my doctor's. He has switched me to regular dosage of metformin, 2 500s twice a day in order to reduce my dependence on metformin gradually. He does not want to see me for another YEAR!!! Happy Happy, Joy Joy!
As for my lipid profile, he agrees there is no necessity for lowering my LDL with statins at this time, and has ordered a Coronary Calcium Scoring test.
This diet is awesome and so are the people on this forum. Thank you!
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Hi, Just got back from my doctor's. He has switched me to regular dosage of metformin, 2 500s twice a day in order to reduce my dependence on metformin gradually. He does not want to see me for another YEAR!!! Happy Happy, Joy Joy!
As for my lipid profile, he agrees there is no necessity for lowering my LDL with statins at this time, and has ordered a Coronary Calcium Scoring test.
This diet is awesome and so are the people on this forum. Thank you!
Does your doc want you to dump metformin specifically, or do you personally want to take as few meds as possible?
Good luck with the CAC!0 -
cstehansen wrote: »Here's just 1 article that can be found on the internet if you are an advocate of higher protein for older adults, choose to take the position and search for one in support of.
Many other articles would state otherwise.
http://www.todaysdietitian.com/newarchives/040715p16.shtml
Because I like to look at the actual research that lead to the opinion article, I looked up a couple of these. One of the parts I found interesting is from the second cited study which said in part:The 13-wk change in appendicular muscle mass, however, was different in the intervention and control groups [+0.4 ± 1.2 kg and -0.5 ± 2.1 kg, respectively; β = 0.95 kg (95% CI: 0.09, 1.81); P = 0.03]. Muscle strength and function improved over time without significant differences between groups.
Basically, there was muscle gain in the group that had 1.11g/kg of body weight in daily protein intake and loss in the group that was at 0.85g/kg.
Although this is advocating more protein, this is not advocating HIGH protein as 1.11g/kg of body weight is not that high. This study was also only looking at obese people (BMI ave 33) and average age of 63.
This study and another also indicated the importance not just of protein but it being combined with other nutrients like vitamin D and calcium.
The type of protein is also important. One of the ones specifically mentioned is leucine because it is necessary for recycling the protein your body naturally breaks down each day. As a point of reference, eggs are a great source of leucine. I believe one egg has between 1/3 and 1/2 of what you need for the day, but I would need to look that up.
Anyway, using the numbers for "enough" protein, from the actual studies a 150 lb person (68 kg) would need about 75 g of protein. I don't think these studies or this article was intended for people on this WOE as much as for the general population who tends to not get enough protein (and especially leucine) because they have been scared off from the good sources because they have the dreaded saturated fat like eggs and beef. All of the studies seem to be comparing their "higher" protein against either 0.8g/kg or 0.85g/kg, which is probably lower than most in this group as that comes out to only 0.36g per lb of body weight.
I'm missing your point. As I think you missed mine. Carry on. 0 -
@kpk54 - my point was getting enough protein is important and more important as we age, but some tend to overestimate how much that is. For most, going higher than necessary in protein will not have any negative effect, but if therapeutic ketosis is the goal, which I believe is the case for you, too much protein may not be a good idea, therefore, I thought I would put out there what these studies were showing as higher amounts of protein.
I am by no means against high protein, if you are someone whose body deals well with higher amounts. I just think it is important to base personal n=1 experimentation on direct scientific research rather than on opinion pieces which may or may not reference specific research.3 -
Hi, Just got back from my doctor's. He has switched me to regular dosage of metformin, 2 500s twice a day in order to reduce my dependence on metformin gradually. He does not want to see me for another YEAR!!! Happy Happy, Joy Joy!
As for my lipid profile, he agrees there is no necessity for lowering my LDL with statins at this time, and has ordered a Coronary Calcium Scoring test.
This diet is awesome and so are the people on this forum. Thank you!
Does your doc want you to dump metformin specifically, or do you personally want to take as few meds as possible?
Good luck with the CAC!
He wants me off the metformin gradually, hence the change to regular metformin, changing the dosage as needed by self monitoring my glucose levels. No meds and good health/life is my ultimate goal.
The appointment for CAC is with Emory University later this month. $150 gets you a package that includes CAC, Lipids, BP, Blood Vessel Aging and consultation with a cardiologist. Self paid, as insurance does not cover it. I saw a Groupon for this with another company that was less than $50, but since the interstate burned and fell down, traffic would be a total and complete nightmare. Plus, my family has used Emory before; they are the best in Atlanta.
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Hi, Just got back from my doctor's. He has switched me to regular dosage of metformin, 2 500s twice a day in order to reduce my dependence on metformin gradually. He does not want to see me for another YEAR!!! Happy Happy, Joy Joy!
As for my lipid profile, he agrees there is no necessity for lowering my LDL with statins at this time, and has ordered a Coronary Calcium Scoring test.
This diet is awesome and so are the people on this forum. Thank you!
Does your doc want you to dump metformin specifically, or do you personally want to take as few meds as possible?
Good luck with the CAC!
He wants me off the metformin gradually, hence the change to regular metformin, changing the dosage as needed by self monitoring my glucose levels. No meds and good health/life is my ultimate goal.
The appointment for CAC is with Emory University later this month. $150 gets you a package that includes CAC, Lipids, BP, Blood Vessel Aging and consultation with a cardiologist. Self paid, as insurance does not cover it. I saw a Groupon for this with another company that was less than $50, but since the interstate burned and fell down, traffic would be a total and complete nightmare. Plus, my family has used Emory before; they are the best in Atlanta.
That's a bargain, especially if the cardiologist is attentive!
Note that there are differing thoughts on how to weight the variables that go into the scoring equation.1 -
Hi, Just got back from my doctor's. He has switched me to regular dosage of metformin, 2 500s twice a day in order to reduce my dependence on metformin gradually. He does not want to see me for another YEAR!!! Happy Happy, Joy Joy!
As for my lipid profile, he agrees there is no necessity for lowering my LDL with statins at this time, and has ordered a Coronary Calcium Scoring test.
This diet is awesome and so are the people on this forum. Thank you!
Does your doc want you to dump metformin specifically, or do you personally want to take as few meds as possible?
Good luck with the CAC!
He wants me off the metformin gradually, hence the change to regular metformin, changing the dosage as needed by self monitoring my glucose levels. No meds and good health/life is my ultimate goal.
The appointment for CAC is with Emory University later this month. $150 gets you a package that includes CAC, Lipids, BP, Blood Vessel Aging and consultation with a cardiologist. Self paid, as insurance does not cover it. I saw a Groupon for this with another company that was less than $50, but since the interstate burned and fell down, traffic would be a total and complete nightmare. Plus, my family has used Emory before; they are the best in Atlanta.
That's a bargain, especially if the cardiologist is attentive!
Note that there are differing thoughts on how to weight the variables that go into the scoring equation.
Forgot, they also give a Framingham score.1
This discussion has been closed.