Cholesterol Levels - Can Someone Explain?

[SweetHeart]

MH has just got his cholesterol levels, I think the overall level is 5.8 (lower than on diagnosis)

HDL 1.4
LDL 4.0

I don't have the trigs.

The doc wants to haul him in and talk about his Statins......he stopped taking the Simvastatin as he doesn't agree with him.

What else can we do to lower the LDL ? We low carb and I think MH eats maybe 80 to 100g carbs per day.

Ju

 

[borofergie]

NICE gudelines for cholesterol levels from about 2004 - don't think they've changed much:

Target levels:
Total - below 5
HDL - above 1.4
Triglycerides - below 1.7 and the lower the better
LDL - below 3.

Very important is the Total:HDL ratio - target is below 5:1, and preferably 3.5:1

Total 5.8
His Trigs are 2, calculated from his Total.
HDL 1.4
LDL 4.0
Total:HDL ratio = 4.1

So the good new is that his HDL is good, as you'd expect on a low-carb diet.

The bad news is that his LDL is high, and his Trigs are a little high. This means that Total Cholesterol and everything associated with it is a bit high too.

Have a read of this:
http://www.marksdailyapple.com/how-to-i ... z1wX3g80at

LDL doesn't mean very much because "Both LDL-C and HDL-C, the standard, basic readings you get from the lab, do not reflect the number of LDL or HDL particles – the number of lipoproteins – in your serum. Instead, they reflect the total amount of cholesterol contained in your LDL and HDL particles."

So you could have a a few LDL particles which carry lots of cholesterol, and get a worse score than someone with many more LDL particles that are less loaded with cholesterol (and therefore a higher amount of cholesterol floating around the blood stream). It also doesn't tell you about the quality of the LDL particles - small dense ones are thought to be much more harmful than big fluffy ones. A high-carb diet generally encourages the former harmful type, a low-carb diet encourages the latter type.

If it were me, I'd be happy to ignored the LDL and Total, but not the Trigs. He needs to bring that down. How low-carb are you currently eating? Could he go any lower?






I don't have the trigs.

The doc wants to haul him in and talk about his Statins......he stopped taking the Simvastatin as he doesn't agree with him.

What else can we do to lower the LDL ? We low carb and I think MH eats maybe 80 to 100g carbs per day.

Ju[/quote]

 

[SweetHeart]

Boro,

MH, I think, eats between 80 to 100g per day (that I know of!) it's possibly less than that. We do need to cut his carb total down as his BG levels have risen, on average, by 1.0mmol since he stopped the 500mg Met daily last week.

I eat a lot less as I don't have his appetite and I don't crave breads, crackers etc etc.

Any help is appreciated here; as I got him low carbing, I feel that I'm responsible for anything that happens to his body dietwise.

Ju

 

[librarising]

Here's what I wrote in this thread on cholesterol :

viewtopic.php?f=25&t=29449&p=275138#p275138

///////////

Re: cholesterol
by librarising » May 17th, 2012, 8:57 am

Davideb wrote :
With not eating all these carbs and more protein, what happens to your cholesterol levels


What few doctors will be telling you at the moment is that it's the carbs which are giving you bad cholesterol readings, particularly high triglycerides.
Doctors believe it's to do with meat, saturated fat, eggs etc (dietary cholesterol).

From my latest library read
(Life Without Bread, How A low-Carbohydrate Diet Can Save your Life) :

"we have convincing proof of falling cholesterol levels in people of different ages who adopt a low-carbohydrate diet over the long term ... the cholesterol level of the diet lies approximately 50 percent above what the general population takes in ... yet patients' blood cholesterol levels dropped, DESPITE a large increase in the consumption of cholesterol and animal fats ... the level of triglycerides in 118 patients in Dr Lutz's practice dropped an average of more than 50 percent after only three months on a low-carbohydrate diet."

There's plenty of other research that agrees with these findings

Geoff

////////////

You might want to read through the thread.
I think a total over 5 is a trigger for GPs to consider statins.
My latest was 5.4 but told GP I wouldn't consider statins.
Ideally I'd want to know what triglycerides were, since I've read that the ratio of tri's to HDL is all important, and the rest is largely irrelevant.
I urge all to read The Great Cholesterol Con by Malcolm Kendrick.

Geoff

p.s. Stephen, how did you calculate the trigs ?
Per Denise Minger (I think) a trigs/HDL ratio under 2 is good.
2/1.4 is therefore good, giving a ratio of 1.4

 

[LittleGreyCat]

MH has just got his cholesterol levels, I think the overall level is 5.8 (lower than on diagnosis)

HDL 1.4
LDL 4.0

I don't have the trigs.

The doc wants to haul him in and talk about his Statins......he stopped taking the Simvastatin as he doesn't agree with him.

What else can we do to lower the LDL ? We low carb and I think MH eats maybe 80 to 100g carbs per day.

Ju

I stopped taking Simvastatin because it turned me into a Zobmie :twisted:
About 24 hours after I stopped the lights came on again.

I am now on Pravastatin which seems to suit me and my cholesterol is O.K. at the moment.

An alternative (have a friend who uses these) is plant stanols.
She had bad responses to statins, has familial hyperlipidaemia, but gets very good cholesterol readings using these.
You can buy them in the shops (e.g. ProActiv) but you have to look carefully at the packaging to calculate 'bangs per buck' and avoid high sugar content and make sure you are getting your 2g per day.
You can also get pills online.
Wikipedia says that it isn't as effective as statins, but then again if you aren't taking statins then this could help.

Finally I am slightly confused (as usual).
If there are three main components (HDL, LDL, Tri) then arithmetic suggests that the tris are (5.8 - 4.0 - 1.4) 0.4.
So it may not be that straightforward.

Cheers

LGC

 

[borofergie]

MH, I think, eats between 80 to 100g per day (that I know of!) it's possibly less than that. We do need to cut his carb total down as his BG levels have risen, on average, by 1.0mmol since he stopped the 500mg Met daily last week.

Any help is appreciated here; as I got him low carbing, I feel that I'm responsible for anything that happens to his body dietwise.

If it were me, I'd try going a little lower, rather than succumbing to statins.

Dietary carbohydrate restriction is the single most effective method (except for total starvation) of reducing triglycerides, and is as effective as any intervention, including most drugs, at increasing HDL and reducing the number of small-dense LDL particles. Beyond lipid markers, carbohydrate restriction improves all of the features of metabolic syndrome.

As I said below, reducing your carb intake further won't reduce the LDL, but it should increase the quality of the LDL (although you can't tell that without further testing).

Your aim should be to knock down the Trigs, which should definitely respond to a lower carb intake:
http://rdfeinman.wordpress.com/2012/02/ ... our-blood/
http://dl.dropbox.com/u/37202414/Volek_ ... s_2008.pdf

Of course, there are a few people that don't respond to this for various reasons. However, MrS's numbers aren't tragically bad, so hopefully a little fine tuning is all that is required.

 

[borofergie]

If there are three main components (HDL, LDL, Tri) then arithmetic suggests that the tris are (5.8 - 4.0 - 1.4) 0.4.
So it may not be that straightforward.

Total Cholesterol = HDL + LDL + Trigs/5

So Trigs= 5*(Total-HDL-LDL).

You have to question what the relevance of the "5" is, and how you can combine two different cholesterol types and a fat measurement in a single equation. The answer is that "Total Cholesterol" a stupid measure that doesn't mean anything. You could get the same score with low HDL and high LDL as with high HDL and low LDL, which are at opposite ends of the cholesterol spectrum. As an engineer, I can see that the equation stinks from about a mile off.

 

[phoenix]

NICE gudelines for cholesterol levels from about 2004 - don't think they've changed much:

Target levels:
Total - below 5
HDL - above 1.4
Triglycerides - below 1.7 and the lower the better
LDL - below 3.

Very important is the Total:HDL ratio - target is below 5:1, and preferably 3.5:1

Total 5.8
His Trigs are 2, calculated from his Total.
HDL 1.4
LDL 4.0
Total:HDL ratio = 4.1

So the good new is that his HDL is good, as you'd expect on a low-carb diet.

[/quote]
The trigs aren't 2.
The formula is LDL cholesterol = Total cholesterol – HDL cholesterol – Total triglyceride ÷ 2.19 (in mmol/l)
http://www.heartuk.org.uk/images/upload ... Method.pdf
therefore:
Trigs =2.19(TC-HDL-LDL)
which equals 0.876mmml/l : much lower.
What these levels mean is open to debate


Sorry about the next bit Sweetheart as it is a bit contentious but we are always reading that HDL is protective , here is a doctor that recommends a lowish carb paleo diet who suggests that this is not necessarily the case in the context of a low carb diet as opposed to a 'standard American diet'

Kurt Harris

HDL and trigs are NOT independent of macronutrient ratios. And you cannot conclude that these lipids are the CAUSE of anything without explaining why they fail to predict the CV risk in the Kitavans.

A high HDL and low fasting trigs do seem to be a marker for low CV risk ON THE SAD. But you are not scientifically justified in concluding that raising your HDL and lowering your trigs by eating low carb lowers your risk BECAUSE of the change in these lipid markers. And there is no clinical evidence that changing these parameters via diet results in fewer CV events, just like there is no evidence that reducing LDL or total serum cholesterol does so.
Belief in the efficacy of low carb to lower CV risk based on “blood lipid” is an unjustified myth being promoted by low carb diet doctors who have simply not thought things through carefully enough.

And to the degree that people stay hyper caloric (stay fat and in energy excess) and reassure themselves that they have “great labs” they are simply whistling past the graveyard.

They would be better to have “bad” HDL and “bad” trigs and be THIN on a high carb diet – just like the Kitavans.

from a reply to
http://carbsanity.blogspot.fr/2012/03/l ... it-ix.html

 

[librarising]

phoenix wrote
The trigs aren't 2.
The formula is LDL cholesterol = Total cholesterol – HDL cholesterol – Total triglyceride ÷ 2.19 (in mmol/l)

following Stephen's announcement of trigs as 2 (think hat, rabbit, and pulling) I thought how did he do that ?
Seems he's following the Friedewald formula which treats trigs as approximately 5 times the level of VLDLs.
5.8 less 4.0, less 1.4 gives a figure of 0.4 to represent VLDL. x 5 gives 2. Works for me.

Geoff (new to this calculation of trigs, so please be gentle with me )

 

[borofergie]

The trigs aren't 2.
The formula is LDL cholesterol = Total cholesterol – HDL cholesterol – Total triglyceride ÷ 2.19 (in mmol/l)
http://www.heartuk.org.uk/images/upload ... Method.pdf
therefore:
Trigs =2.19(TC-HDL-LDL)
which equals 0.876mmml/l : much lower.
What these levels mean is open to debate

Ouch. I had my units wrong. No excuse for that. Sorry.

(Although the fact that scaling number changes witht he units is a further indication that it's a made up number).

HDL and trigs are NOT independent of macronutrient ratios. And you cannot conclude that these lipids are the CAUSE of anything without explaining why they fail to predict the CV risk in the Kitavans.

A high HDL and low fasting trigs do seem to be a marker for low CV risk ON THE SAD. But you are not scientifically justified in concluding that raising your HDL and lowering your trigs by eating low carb lowers your risk BECAUSE of the change in these lipid markers. And there is no clinical evidence that changing these parameters via diet results in fewer CV events, just like there is no evidence that reducing LDL or total serum cholesterol does so.
Belief in the efficacy of low carb to lower CV risk based on “blood lipid” is an unjustified myth being promoted by low carb diet doctors who have simply not thought things through carefully enough.

Which is all fair-enough I think. If you bash LDL choelsterol, you have to bash HDL cholesterol with the same hammer. I'm not sure any of it means very much, especially if you are eating a low-carb diet that was never included when they calculated the relationships between CV disease and choleterol numbers.

All of which will help you not-one-bit when battling with MrS's doctor to keep him off Statins.

 

[librarising]

Seems he's following the Friedewald formula which treats trigs as approximately 5 times the level of VLDL

as in :

http://www.livestrong.com/article/30224 ... lycerides/

Confused :crazy:

Geoff

 

[noblehead]

What else can we do to lower the LDL ? We low carb and I think MH eats maybe 80 to 100g carbs per day.

Take a read of the following Ju:

http://www.bhf.org.uk/heart-health/cond ... terol.aspx


You can also contact the British Heart Foundation and talk to a cardiac nurse should you choose.

 

[librarising]

According to this UK-oriented site

http://www.gpnotebook.co.uk/simplepage. ... 0&mentor=1


The Friedewald Equation

the ultracentrifugal measurement of LDL is time consuming and expensive and requires specialist equipment. For this reason, LDL-cholesterol is most commonly estimated from quantitative measurements of total and HDL-cholesterol and plasma triglycerides (TG) using the empirical relationship of Friedewald et al.(1972).
[LDL-chol] = [Total chol] - [HDL-chol] - ([TG]/2.2) where all concentrations are given in mmol/L (note that if calculated using all concentrations in mg/dL then the equation is [LDL-chol] = [Total chol] - [HDL-chol] - ([TG]/5))
the quotient ([TG]/5) is used as an estimate of VLDL-cholesterol concentration. It assumes, first, that virtually all of the plasma TG is carried on VLDL, and second, that the TG:cholesterol ratio of VLDL is constant at about 5:1 (Friedewald et al. 1972). Neither assumption is strictly true.
Limitations of the Friedewald equation
The Friedewald equation should not be used under the following circumstances:
when chylomicrons are present
when plasma triglyceride concentration exceeds 400 mg/dL (4.52 mmol/L)
in patients with dysbetalipoproteinemia (type III hyperlipoproteinemia

Seems the confusion comes from which measurement system is being used mg/dL or mmol/L

A less confused Geoff :roll:

 

[borofergie]

A
A less confused Geoff :roll:

I'm a bit less confused, but no less embarassed.

 

[Anonymous]

Didn`t want to start a new thread, but I just had my cholesterol results from my blood test last week (no hba1c back yet) No break down from first test, but total was 5.5. Now it`s,

Trig 1.3
HDL 1.9
LDL 2.2
Total 4.7

Needless to say I am delighted that my diet has had such good results, and hope it comes down more by the next test. I have my three month review tomorrow, and I am hoping to be in the 5`s for the hba1c. I am very excited about that result. I am crossing everything it is back.

 

[borofergie]

Trig 1.3
HDL 1.9
LDL 2.2
Total 4.7

Wow, what great results. Another indication that LCHF is great for blood lipids (despite what the propaganda says). I hope that mine are as good as these when I pick them up next week.

 

[Anonymous]

Trig 1.3
HDL 1.9
LDL 2.2
Total 4.7

Wow, what great results. Another indication that LCHF is great for blood lipids (despite what the propaganda says). I hope that mine are as good as these when I pick them up next week.

I am sure they will be!

 

[SouthernGeneral6512]

Here's what I wrote in this thread on cholesterol :

viewtopic.php?f=25&t=29449&p=275138#p275138

///////////

Re: cholesterol
by librarising » May 17th, 2012, 8:57 am

Davideb wrote :
With not eating all these carbs and more protein, what happens to your cholesterol levels


What few doctors will be telling you at the moment is that it's the carbs which are giving you bad cholesterol readings, particularly high triglycerides.
Doctors believe it's to do with meat, saturated fat, eggs etc (dietary cholesterol).

From my latest library read
(Life Without Bread, How A low-Carbohydrate Diet Can Save your Life) :

"we have convincing proof of falling cholesterol levels in people of different ages who adopt a low-carbohydrate diet over the long term ... the cholesterol level of the diet lies approximately 50 percent above what the general population takes in ... yet patients' blood cholesterol levels dropped, DESPITE a large increase in the consumption of cholesterol and animal fats ... the level of triglycerides in 118 patients in Dr Lutz's practice dropped an average of more than 50 percent after only three months on a low-carbohydrate diet."

There's plenty of other research that agrees with these findings

Geoff

////////////

You might want to read through the thread.
I think a total over 5 is a trigger for GPs to consider statins.
My latest was 5.4 but told GP I wouldn't consider statins.
Ideally I'd want to know what triglycerides were, since I've read that the ratio of tri's to HDL is all important, and the rest is largely irrelevant.
I urge all to read The Great Cholesterol Con by Malcolm Kendrick.

Geoff

p.s. Stephen, how did you calculate the trigs ?
Per Denise Minger (I think) a trigs/HDL ratio under 2 is good.
2/1.4 is therefore good, giving a ratio of 1.4

If this is true then it means that people diagnosed with high cholesterol and triglycerides have been put on a high carb diet that will actually make their condition worse :sick:

 

[librarising]

SouthernGeneral6512 wrote
If this is true then it means that people diagnosed with high cholesterol and triglycerides have been put on a high carb diet that will actually make their condition worse

But probably also means they're now on a statin, which will at least lower their LDL (I believe that's their main claim to fame, whether that's a worthwhile thing or not.)
I'm sure their doctor will settle for one 'success' story :roll:

Geoff

 

[SweetHeart]

I feel very stupid, because I'm still struggling to compute the math for MH's levels. Suffice to say that we have to get his LDL and Trigs down , if only to appease the bl**dy quack, whom we are seeing tomorrow.

MH plans to say that he doesn't want to go onto Statins (Simvastatin has crippled my 78 yr old father) but rather wants to try reducing the levels with diet. If that fails then he may accept a stanol at a later date. He has enough movement restriction problems as it is. My worry is that the ED will return....

My father has taken Simvastatin now for about 7 years. He can hardly walk but will not believe me when I tell him his incredibly painful legs and breathing problems are the Simvastatin. I have even shown him the contraindications leaflet that came with the Simvastatin to no avail. As he has had major heart surgery (valve replacement and double bypass in 2010) he will probably benefit from taking a statin, but he desperately needs to change type before my mother bumps him off through sheer frustration at his pigheadedness.

Ju