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Annual review today - numbers help please!

Snapsy

Snapsy

Well-Known Member
Hi folks,

My first annual review since starting on a pump in October was today. The registrar was lovely, very interested in my pump, and my Libre, and was very thorough. He very kindly congratulated me on my HbA1c of 46, which he felt was amazing, but when he saw my disappointed face he looked back in my notes and realised that this was quite an increase since my result of 42 in January! But I guess that's okay.

Two lots of figures absolutely horrified me, though.

Firstly, is anyone able to offer any insight or reassurance into my lipid profile (listed below)? I eat relatively low-carb (120g ish per day), avoiding most grains (although I have porridge on days when I'm exercising) and most fruits, and I snack on eggs, cheese and nuts. I have been eating in this way for around the last three months. My kidney function results are fine so I don't fear that I'm overdoing the protein.

Serum Chol: 6.6 (up from 4.1 in July 2015)
Calculated Non-HDL Chol: 3.9 (up from 1.9)
Serum HDL Chol: 2.7 (up from 2.2)
Calculated LDL Cholesterol: 3.6 (up from 1.6)
Serum Cholesterol/HDL radio: 2.4 (up from 1.9)

The blood sample was not fasting - and in fact in my letter from the hospital it said that they didn't require my pre-review sample to be a fasting one (just as well as my doctors' surgery only had appointments from 11am that week!).

The registrar said that his instinct would be to double my dose of Atorvastatin (a sore point already - I've been taking this since a total cholesterol result of 4.1 - GASP - which occurred in the same week that advice to doctors was to now put anyone with diabetes and with a level of over 4.0 onto statins).

The second result that horrified me was my TSH - which came back as 21.33, putting me in the 'sub-clinical hypothroid' camp. I don't feel hypothyroid. I don't have any symptoms. In fact, I have more energy than I have had in years, thanks to the low-carbing (my opinion) and newly-achieved fitness. I am on replacement levothyroxine of 200mcg daily as my thyroid gland is inactive due to radioiodine treatment, and there is nothing symptomatic to suggest I need any more than this.

Fortunately the registrar went to talk to the consultant, who advised against doubling the statin without more testing. Feeling that the two sets of weirdly high numbers were connected, he said it is perhaps an issue with 'absorption', and he requested tests for coeliac disease (I don't have symptoms of this), vitamin D and folate deficiency, as well as repeat TSH and T4, and full lipid profile.

He then sent me straight to phlebotomy and told me to get the sample taken there and then, where I was told - after they'd taken the blood already - that the lipid test needed to be fasting.....!

I think I need a glass of wine and it's only 5pm.

Sorry to sound so ditsy but I'm a little flummoxed by it all. I await a call from the registrar in a couple of days, as promised - which is fine, but I'm not really feeling comfortable with it all.

Thanks for reading this, and for any insight you're able to offer.
 
Snapsy said:
The blood sample was not fasting - and in fact in my letter from the hospital it said that they didn't require my pre-review sample to be a fasting one (just as well as my doctors' surgery only had appointments from 11am that week!).
Click to expand...

@Snapsy, when the cholesterol check includes a full lipid breakdown you should fast before the bloods are taken, I had this confirmed by my Endo a few years back.
 
Hi @Snapsy,
With regard to the cholesterol test, if you do not fast the night before then the test will be influenced by your last meal of the previous day.
 
Thanks @noblehead - in fact I'd been intending to be fasting for the pre-review blood tests, having read about cholesterol testing on this forum, even though the letter says - and I quote - 'You do not need to fast for these blood tests.'

Kicking self for not checking with doctor - as he pointed me in the direction of phlebotomy just now at the hospital, telling me to do it right now - if I shouldn't wait and do it in the early morning instead - I wish I had!

Still, I guess if the tests come back at bonkers level for a second time, I'll be tested yet again (and I'll make sure I do it by the book!). I feel like such a fool.......!

:banghead:
 
Snapsy said:
even though the letter says - and I quote - 'You do not need to fast for these blood tests.'
Click to expand...

Hi again @Snapsy

I believe for a TC check it doesn't have to be fasting but for full lipid breakdown it does.

I always ask for a full lipid (have a family history of CVD) so always book the first available appointment in the morning with the practise nurse.
 
I'll definitely know for next time, despite what it says here. I think I should have gone with my gut feeling, which was to fast - so why I didn't question it at the hospital just now I've no idea!

Oh well.

:)


File_000.jpeg
 
Thanks @noblehead and @azure - so the total cholesterol (is that what you mean by TC?) of 6.6 is a 'valid' result, even though it's non-fasting?

Bit worried that it's scarily high.

That's it, I'm opening the wine....

:happy:
 
Snapsy said:
(is that what you mean by TC?)
Click to expand...

That's right, I'm going off-line in a moment but here are the target cholesterol levels that they want people with diabetes to aim for:

  • Your total cholesterol level should be below 4.0mmol/l.
  • LDL levels should be less than 2.0mmol/l.
  • HDL levels should be 1.0mmol/l or above in men and 1.2mmol/l or above in women.
  • Triglyceride levels should be 1.7mmol/l or less.
https://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Testing/

Best wishes.
 
@Snapsy

I can't see any Triglyceride score. It is these little beggars that are important when deciding on statins. Next test you must ask for these to be tested, otherwise you are working half blind.

Your HDL is ideal and an improvement on your last test, and your TC/HDL ratio is also ideal. It is just your LDL that needs attention, and your "missing" triglycerides need testing.

I concur with the others. For a lipid panel you need to fast at least 10 hours and not drink any alcohol the previous evening.
 
Thank you so much @noblehead and @Bluetit1802 !

When they get back to me with the results of the tests they requested today I will ask for a fasting test for the full lipid panel, as it is clear these numbers need work. In the meantime I'll leave any suggested hike in statins well alone!

Really appreciate the support, folks - thank you. I'm feeling a little pathetic at the moment as am unwell with sinusitis, which has sent my sugars haywire. Grateful for this forum!

:)
 
They've been doing Tc tests on me at each of my last hospital appointments. I've come to find it fairly consistent at 5.0 after a nice LC breakfast of scrambled eggs and bacon or salmon, or other such meals.

As my full lipids fasted consistently show HDL and trigs where they should be, I ignore it.

I suggest you do the same until the proper tests are complete.


Sent from my iPhone using Tapatalk
 
Hi @Snapsy. Sorry you seem a bit stressed at the moment. Don't you just hate it when you feel great only for some numbers on a piece of paper to go and spoil the moment. Obviously I have no intention of offering any advice as I believe everyone one else has done that far better than I ever could.
What I will say though is that I find you inspirational and a leading light on the forum, so chin up.
I hope you get the numbers sorted and we get our positive Snapsy back.
 
Awwww @therower you're a real tonic! Thank you soooooo much!

I think I'm feeling better already. Small glass of wine, a good read of all of this fabulous advice and reassurance, a big old pinch of our old friend 'perspective', counting my blessings that a few numbers slightly out of the ideal range are NOT the end of the world, plus the husband's arrived home and our sausages and cauliflower cheese are nearly ready.

All will be well.

:happy:
 
Morning all, would somebody please ban me from Google for at least 24 hours?
I have diagnosed myself with everything under the sun! :banghead:

It reminds me of that bit in 'Three Men and a Boat' by Jerome K Jerome!

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch – hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into – some fearful, devastating scourge, I know – and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it.

I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever – read the symptoms – discovered that I had typhoid fever, must have had it for months without knowing it – wondered what else I had got; turned up St. Vitus’s Dance – found, as I expected, that I had that too, – began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically – read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee.

I felt rather hurt about this at first; it seemed somehow to be a sort of slight. Why hadn’t I got housemaid’s knee?

There, I feel better already! I have NOT got housemaid's knee!

:)
 
Hi @Snapsy. Self diagnosing? Tut tut. I have put all the data you have recently given us into a special search engine.
It appears that you do actually have Housemaids Knee. Upon further investigation you may also be suffering from a condition called " a sense of humour".
If untreated this can lead to a " warped sense of humour". Which is something not everyone gets.
;-);-);-);-);-);-);-)
 
The only solace i can provide is that you ate before your blood profile, and that would naturally increase your levels.

Depending on what and when you ate it maybe have raised them up quite a bit perhaps.

You mentioned that you 'snack' on nuts and eggs and cheese - these are all things typically high in fats, and eggs in cholesterol (cheese can be a cholesterol issue depending the amount). So it may be that your new diet has indeed raise your levels due to all the eggs and cheese, or maybe you just had a 3 egg cheese omelet 3 hours before your test and that raised them lol

But also i got really into the egg as a breakfast thing until i realized that 2 eggs is just about our entire daily amount of cholesterol, So I feel better of only eating eggs occasionally on weekends or vacations to keep cholesterol down lol maybe try cutting back, and re testing in a month or so after fasting.

Just remember its not a trend until it happens multiple times, until then its just a random outlier and shouldn't be counted haha
 
Two eggs at 6am, blood taken at 11am - and yes I think that my recent dietary changes (lower carb, higher fat) must have made the difference, as it's the only thing that's different compared with all of the other tests back to 2012, which were also non-fasting (total cholesterol consistently in the 3s and 4s) - the 6.6 this time is massive in comparison!

Shall sit tight and see what they say when they contact me (I hope tomorrow).

:)

PS I eat 3-6 eggs a day but had been reassured that dietary cholesterol doesn't contribute to stored cholesterol - hmmmmmm, might need to do more research!
 
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