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Total Cholesterol and Triglycerides

AndBreathe

AndBreathe

Master
Retired Moderator
Messages
11,592
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Guys, I had a diabetic profile run locally yesterday, which included cholesterol and triglycerides, but, unbeknown to me, only total cholesterol and triglycerides. It was my error, assuming that if I got twigs, I would also get the cholesterol breakdown. Wrong!

The upshot is my levels have notched up a bit since last time, although still well down on my diagnostic numbers (thank goodness). Can I realistically garner anything more meaningful from the total cholesterol plus trig, other than the frank data? I'm disinclined to have the lipids run again independently, as I have no intention of taking statins.

I'm due back in UK for my next formal review in August, so it'll be done then. This interim panel for just for my own peace of mind.

On an aside, the service for a third world country was impressive.

Check in at the lab at 07:30, fasted, and do the paperwork and pay
Blood drawn: 07:45
Result report in my email inbox 13.20
 
My recent cholesterol test asked total, HDL and LDL split and trigs and the lab only reported total cholesterol, HDL and total to HDL ratio. I told the DSN it wasn't what was requested and she just shrugged and said it was good enough and we'd have to wait until next years tests to get the splits. Wonderful eh? At least I know my total cholesterol was 3.6 and the HDL was 1.38 which is comforting at a basic level, but not the total reassurance I wanted.
 
My GP is 4500 miles away. It can wait.
 
Just to be certain, when your back in the UK and booking the appointment to get your bloods taken be sure to say it's for a fasting cholesterol lipid check, also when the nurse is taking the blood be sure to mention it to them too otherwise you'll just get a TC result.
 
So do triglycerides fall inside or outside the total cholesterol number? My diagnosis lipids said total 6.9, HDL 1.22, and trigs 5.66. It said they couldn't state LDL because 'Friedewald equation not valid ... when trigs > 4'. From this I assumed trigs were outside TC and that I could get some idea of LDL from TC less HDL. Otherwise all my TC would be HDL and trigs which can't be right.
 
noblehead said:
Just to be certain, when your back in the UK and booking the appointment to get your bloods taken be sure to say it's for a fasting cholesterol lipid check, also when the nurse is taking the blood be sure to mention it to them too otherwise you'll just get a TC result.
Click to expand...


Noblehead, when I'm back in UK in August, I'll be due my next review anyway. Both times before the split has been done routinely, and that's what tripped me up, when I saw tries were to be done. Obviously I should have clarified......

I have to say, I'm not a believer in statins for women, without a history of CV disease, so it's for my information and consideration only really. I'd just rather not blindly stroll into a conversation where I'm having to defend my stance, if I can avoid it.

Yesterday's tests were an interim measure, and my decision. UK practise were supremely ambivalent about it being done, or not.
 
sanguine said:
So do triglycerides fall inside or outside the total cholesterol number? My diagnosis lipids said total 6.9, HDL 1.22, and trigs 5.66. It said they couldn't state LDL because 'Friedewald equation not valid ... when trigs > 4'. From this I assumed trigs were outside TC and that I could get some idea of LDL from TC less HDL. Otherwise all my TC would be HDL and trigs which can't be right.
Click to expand...

I tried to work out what my numbers meant using this document which also explains how HDL, LDL and trigs make up TC --> Cholesterol
 
sanguine said:
So do triglycerides fall inside or outside the total cholesterol number? My diagnosis lipids said total 6.9, HDL 1.22, and trigs 5.66. It said they couldn't state LDL because 'Friedewald equation not valid ... when trigs > 4'. From this I assumed trigs were outside TC and that I could get some idea of LDL from TC less HDL. Otherwise all my TC would be HDL and trigs which can't be right.
Click to expand...
Here's the "equation" which would be better called "Friedewald's 1972 Assumption".

http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20030114211535665170

In simple terms it assumes that your quantity of LDL is whatever isn't HDL and VLDL, and that your quantity of VLDL is a fixed proportion of your quantity of trigs. This assumption is based on 'empirical data' as it existed in 1972. Though to be fair that was before the obesity epidemic so the data may reflect reasonably healthy lipids!
 
Thanks guys, so basically I need to get my trigs down ... :eek: (Hopefully they already are).
 
These are the target cholesterol numbers that people with diabetes should be aiming 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.
 
I'm at the blood clinic on Monday. From my November diagnosis to my last HBa1C in February I cut out cheese completely amongst other strategies. In February it was 4.5 with all the split numbers going in the right direction. The nurse mentioned statins but I refused. Since February I have introduced the HF element of the LC diet. I have seen all the good results this has produced on the forum but my brain has been conditioned to think otherwise. Well, if the results are bad I will still refuse the statins and cut out the butter etc. my diet has been roughly 60% fat 20% carb and 20% protein. I eat lots of nuts, olives and fish too. Chicken is the only meat I eat.

Fingers crossed.


Sent from the Diabetes Forum App
 
Thanks noblehead - I've done all the conversions now. Bloods here are reported to US protocols, and obviously I'm still missing the HDL/LDL splits. So, my total is over 5, but trigs are 0.85. Probably can't draw too many conclusions from that, but as I'm in the auto-anti-statin camp, for my gender and history, I guess it's immaterial for now.
 
AndBreathe said:
Thanks noblehead - I've done all the conversions now. Bloods here are reported to US protocols, and obviously I'm still missing the HDL/LDL splits. So, my total is over 5, but trigs are 0.85. Probably can't draw too many conclusions from that, but as I'm in the auto-anti-statin camp, for my gender and history, I guess it's immaterial for now.
Click to expand...
The Total Cholesterol is the least important, so if all your other lipids are good, don't worry about TC. By itself TC doesn't have any demonstrated correlation with any bad outcomes.
 
AndBreathe said:
as I'm in the auto-anti-statin camp, for my gender and history, I guess it's immaterial for now.
Click to expand...
I'm in the anti-statin camp too, but I take that to mean (since I am going against my doctor's advice) that I need to take full personal responsibility for my lipids. I wouldn't say they were "immaterial". But I may have misunderstood what you mean. :-)
 
noblehead said:
These are the target cholesterol numbers that people with diabetes should be aiming 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.
Click to expand...

And TC/HDL ratio target <4

Trigs will be higher if you are low carbing, which is something that the targets don't take into account.
 
Spiker said:
I'm in the anti-statin camp too, but I take that to mean (since I am going against my doctor's advice) that I need to take full personal responsibility for my lipids. I wouldn't say they were "immaterial". But I may have misunderstood what you mean. :)
Click to expand...

Yes, I could have been clearer. I meant, as I am 4500 miles away from any potential statin discussion, and I would decline in any case, that I can't completely understand my ratios is a bit of white noise for now. As my UK doc was content, in February to run the next set of bloods in August, when I will be back in UK, I'm currently content to believe I am doing the right things for my health, and will look more closely at the lipids in August. Fortunately, aside from my T2 and my age, I have no other elevated risk factors to fog my thinking, or drive me back for further investigations.

I was just a bit frustrated with myself for not ensuring I would receive the breakdown from the original test.

Altogether now; what do assumptions do?
 
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