What are the numbers I need to look at for my cholesterol

[RFSMarch]

Hey lovely clever peeps
So I see a lot of people talking about numbers within the cholesterol results (HDL, LDL, Trigs which to be honest reminded me of the days of trigonometry and had me curled up in the foetal position in trauma for half an hour!!!)

I have just had my follow up bloods done since my diagnosis and want to keep an eye on those especially as I focussed a lot more in getting my BG down and not so much on anything else other than BP through more exercise.

I have a whole range of numbers in my first set of results and I have noooo idea!
Serum cholesterol 6.6
Trig 2.46
HDL 1.14 (that at least seemed to be in range!)
Calculated LDL was 4.3 but with a note that said it was borderline and needed a lifestyle change (well durr)
I also have Total cholesterol ratio which had an exclamation mark as it was 5.8

I would love to add these to my sig. If only I knew WHAT I needed to add to my sig!

My results come back next week so I will try and get a docs appointment sorted - still hopeful that whatever comes back might still need action but cannot POSSIBLY be any worse than the current nos in the sig!

 

[ziggy_w]

Hi @RFSMarch,

I keep my fingers crossed for your results next week.

Are the cholesterol numbers you mention in your post the ones you got at diagnosis then? Well, as you say yourself, the numbers aren't brilliant, but the Trigs/HDL ratio that many low-carb proponents consider the most important isn't bad actually.

I typed your numbers into the cholesterol calculator and this is what it came up with:

Your Total Cholesterol of 6.60 is HIGH RISK
Your LDL of 4.33 is HIGH RISK
Your HDL of 1.14 is HIGH RISK
Your Triglyceride level of 2.45 is HIGH RISK
RATIOS:
Your Total Cholesterol/HDL ratio is: 5.79 - (preferably under 5.0, ideally under 3.5) AT RISK
Your HDL/LDL ratio is: 0.263 - (preferably over 0.3, ideally over 0.4) AT RISK
Your triglycerides/HDL ratio is: 0.938 - (preferably under 1.74, ideally under 0.87) NORMAL


Your numbers will almost certainly improve with your next set of results.

Here is the link to the calculator if you want to use it yourself: http://www.hughcalc.org/chol-si.php

 

[RFSMarch]

Hi @RFSMarch,

I keep my fingers crossed for your results next week.

Are the cholesterol numbers you mention in your post the ones you got at diagnosis then? Well, as you say yourself, the numbers aren't brilliant, but the Trigs/HDL ratio that most many low-carb proponents consider the most important isn't bad actually.

I typed your numbers into the cholesterol calculator and this is what it came up with:

Your Total Cholesterol of 6.60 is HIGH RISK
Your LDL of 4.33 is HIGH RISK
Your HDL of 1.14 is HIGH RISK
Your Triglyceride level of 2.45 is HIGH RISK
RATIOS:
Your Total Cholesterol/HDL ratio is: 5.79 - (preferably under 5.0, ideally under 3.5) AT RISK
Your HDL/LDL ratio is: 0.263 - (preferably over 0.3, ideally over 0.4) AT RISK
Your triglycerides/HDL ratio is: 0.938 - (preferably under 1.74, ideally under 0.87) NORMAL


Your numbers will almost certainly improve with your next set of results.

Hi - yes these were the numbers on my results - I guess I got the right ones (basically all but one had an exclamation mark by them!)

The thing that concerned me at the time was that the doctor had mentioned statins but then decided to wait until the next bloods to decide what to do. But his advice was "low fat, cut out dairy".
Of course I found THIS forum and saw LCHF and freaked out a little - how can you fix one thing and kill something else hence following my cousin's advice of focussing on moving to low GI foods instead and stabilising to begin with.

So... I HAVE been eating diary. Greek Yoghurt with mixed berries most mornings doesn't cause too much of a spike and I feel is probably a little healthier than the cereals that see me jump into double figures in the two hours after eating!!!

 

[ziggy_w]

Hi @RFSMarch,

Yes, this is the calculator. Sorry, I forgot to include the link right away.

Have you lost weight recently?

Initially low-carb, especially when losing weight, can screw with your cholesterol numbers. So, you might want to give it another three months. For most people, cholesterol numbers get better in time on low carb (especially HDL and trigs). So, fat in the food generally doesn't lead to fat in the blood.

Those, for whom cholesterol doesn't improve, often seem to do better on non-dairy fats, such as olive oil and coconut oil. This doesn't necessarily mean that you can't have dairy at all any more, just cut back a bit on it.

What were your cholesterol numbers on diagnosis?

 

[RFSMarch]

Hi @RFSMarch,

Yes, this is the calculator. Sorry, I forgot to include the link right away.

Have you lost weight recently?

Initially low-carb, especially when losing weight, can screw with your cholesterol numbers. So, you might want to give it another three months. For most people, cholesterol numbers get better in time on low carb (especially HDL and trigs). So, fat in the food generally doesn't lead to fat in the blood.

Those, for whom cholesterol doesn't improve, often seem to do better on non-dairy fats, such as olive oil and coconut oil. This doesn't necessarily mean that you can't have dairy at all any more, just cut back a bit on it.

What were your cholesterol numbers on diagnosis?

Actually yes - my weight dropped a stone and a half in a matter of months leading up to the first set of bloods and diagnosis. Since then my weight has actually stayed pretty stable - I haven't opted at all for LCHF so hopefully that won't screw the numbers up too much.

The cholesterol nos. on diagnosis were the ones listed and now in the signature.

 

[ziggy_w]

Actually yes - my weight dropped a stone and a half in a matter of months leading up to the first set of bloods and diagnosis. Since then my weight has actually stayed pretty stable - I haven't opted at all for LCHF so hopefully that won't screw the numbers up too much.

The cholesterol nos. on diagnosis were the ones listed and now in the signature.

Sorry, I seem to have misunderstood. So, these are the numbers on diagnosis and you are eating a low GI diet -- is this correct? This should teach me to read posts more carefully and not to jump to conclusions.

Unfortunately, I don't have much experience with low GI -- but I would guess that if your blood sugars have improved, most likely your cholesterol will have improved too. I am keeping my fingers crossed for you.

Please let us know what your results are next week. I would be very interested to learn if low GI works for you.

 

[Bluetit1802]

Did you fast for the test? If not, your Trigs score could be skewed as they will all have been swimming about in your blood, doing their job. Omega 3 foods especially oily fish will help.

 

[marianhf]

there is an interesting article in the BMJ ( http://www.bmj.com/content/353/bmj.i1246 ) that disputes the link between high cholesterol and premature death. The research looked again at the basic data of the Minnasota research that kicked off the low fat advice, and showed how flawed it was. " In meta-analyses, these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease (1.13, 0.83 to 1.54) or all cause mortality (1.07, 0.90 to 1.27)." Also "What is already known on this topic

• The traditional diet-heart hypothesis predicts that replacing saturated fat with vegetable oils rich in linoleic acid will reduce cardiovascular deaths by lowering serum cholesterol
  
  
• This paradigm has never been causally demonstrated in a randomized controlled trial and thus has remained uncertain for over 50 years
  
  
• Key findings from landmark randomized controlled trials including the Sydney Diet Heart Study and the Minnesota Coronary Experiment (MCE) were not fully published (my bolding)

What this study adds

• Though the MCE intervention lowered serum cholesterol, this did not translate to improved survival
  
  
• Paradoxically, MCE participants who had greater reductions in serum cholesterol had a higher, rather than lower, risk of death (my bolding again)
  
  
• Results of a systematic review and meta-analysis of randomized controlled trials do not provide support for the traditional diet heart hypothesis"
  

I'm getting an appointemnt with my GP to discuss coming off statins unless he an actually show peer researched actual evidence that they help. I haven't been able to find any.

 

[RFSMarch]

Did you fast for the test? If not, your Trigs score could be skewed as they will all have been swimming about in your blood, doing their job. Omega 3 foods especially oily fish will help.

Yep I did - last thing was 8pm last night - bloods were done at 8:45 this morning

 

[RFSMarch]

My aim as far as my cholesterol level is concerned is to not have to take statins at all. Last time I saw the GP he seemed to feel that he was going to prescribe a wealth of tablets to treat the diabetes, and add statins and BP tablets to that.

Not if I can bloody help it he won't.

I have no intention of starting on statins if at all possible, from what I have seen about them so really hoping for an improvement although obviously I had to really focus on getting that hbA1C right down first.

Blood Pressure is the only thing I might not be able to avoid - it has at least stayed consistently in the Pre-high area and not sky high as it was for months, but is stubbornly refusing to drop any lower. Anyway will update you all once I get the results.

 

[badcat]

Remember whatever he prescribes, you choose what you take

 

[smw99]

You don't have to take statins if you don't want to. Having read so much about them especially for women over 60 I can so no situation to take them. Your GP will be following NICE guidance about diabetics and cholesterol.

 

[RFSMarch]

Remember whatever he prescribes, you choose what you take

Absolutely @badcat - The very fact that when we were going through the first results he was hesitant to prescribe them speaks volumes.

 

[Nicksu]

Hi @RFSMarch,

Initially low-carb, especially when losing weight, can screw with your cholesterol numbers. So, you might want to give it another three months. For most people, cholesterol numbers get better in time on low carb (especially HDL and trigs). So, fat in the food generally doesn't lead to fat in the blood.

I didn't know that! I wonder if this is why mine had gone up the second time I had bloods done - by that time I'd lost 2 stone. Interesting to know.

 

[librarising]

the Trigs/HDL ratio that many low-carb proponents consider the most important isn't bad actually.

I typed your numbers into the cholesterol calculator and this is what it came up with:

Your triglycerides/HDL ratio is: 0.938 - (preferably under 1.74, ideally under 0.87) NORMAL


Your numbers will almost certainly improve with your next set of results.

Here is the link to the calculator if you want to use it yourself: http://www.hughcalc.org/chol-si.php

I think you've confused yourself by using a US calculator.
US measures are in mg/dl
UK measures are in mmol/L
So far so good.
Now the trouble begins.
US figures convert to UK figures at different ratios, with a difference of 2.29 times.
Take pretend (these wouldn't exist in reality) US figures HDL 1 trigs 2.29. These convert to to a ratio of 1.

UK figures put into a US calculator will underestimate trigs by 2.29 times.
UK figures simply need comparing e.g. HDL 1 trigs 2.46 gives a ratio of 2.46.
HDL of HDL 1.14 and trigs of 2.46 gives a ratio of 2.46/1.14 or (using a simple calculator) 2.15.
If you take your 'result' of 0.938 and multiply by 2.29 you get 2.15, the true result.

HTH
Geoff

 

[ziggy_w]

I think you've confused yourself by using a US calculator.
US measures are in mg/dl
UK measures are in mmol/L
So far so good.
Now the trouble begins.
US figures convert to UK figures at different ratios, with a difference of 2.29 times.
Take pretend (these wouldn't exist in reality) US figures HDL 1 trigs 2.29. These convert to to a ratio of 1.

UK figures put into a US calculator will underestimate trigs by 2.29 times.
UK figures simply need comparing e.g. HDL 1 trigs 2.46 gives a ratio of 2.46.
HDL of HDL 1.14 and trigs of 2.46 gives a ratio of 2.46/1.14 or (using a simple calculator) 2.15.
If you take your 'result' of 0.938 and multiply by 2.29 you get 2.15, the true result.

HTH
Geoff

Hi Geoff,

Thanks for your note. I agree with you -- it is really confusing that some countries some countries use mg/dl and others use mmol/L.

I happen to live in Germany and we use mg/dl as they do in the U.S. --therefore I usually convert my numbers to mmol for this site.

So after your post, I have just checked the site again and there seem to be two versions. I have used the SI version, which specifically states the different levels in mmol/L.

Here is a screen shot:

 

[librarising]

Hi Geoff,

Thanks for your note. I agree with you -- it is really confusing that some countries some countries use mg/dl and others use mmol/L.

I happen to live in Germany and we use mg/dl as they do in the U.S. --therefore I usually convert my numbers to mmol for this site.

So after your post, I have just checked the site again and there seem to be two versions. I have used the SI version, which specifically states the different levels in mmol/L.

Here is a screen shot:

View attachment 23990

I did visit the calculator, where she says "I will have to ..."
I conclude she STILL has to.
This may help explain
"However, when looking at the ideal ratio, you have to check if your lipid values are provided in mg/dl like in the US or mmol/L like in Australia, Canada, and most European countries.

If lipid values are expressed as mg/dl (like in the US);

TG/HDL-C ratio less than 2 is ideal

TG/HDL-C ratio above 4 is too high

TG/HDL-C ratio above 6 is much too high

If you are using mmol/L (most countries except the U.S.) you have to multiply this ratio by 0.4366 to attain the correct reference values. You can also multiply your ratio by 2.3 and use the reference values above.

If lipid values are expressed as mmol/L (like in Australia, Canada, and Europe);

TG/HDL-C ratio less than 0.87 is ideal

TG/HDL-C ratio above 1.74 is too high

TG/HDL-C ratio above 2.62 is much too high"
https://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/

Note how the resulting ratios are different, because the figures in mg/dl and mmol/L have different meanings.
HTH further
Geoff

 

[RFSMarch]

Alternatively.... I will just go off the guidelines on the results report. It helpfully had exclamation marks at the high readings! I just hope it has budged downwards. I focussed more on the BG to be honest as an A1C of 111 was ridic! I needed to focus that asap... so fingers crossed. Anyway, will let you know soon enough!

 

[ziggy_w]

I did visit the calculator, where she says "I will have to ..."
I conclude she STILL has to.
This may help explain
"However, when looking at the ideal ratio, you have to check if your lipid values are provided in mg/dl like in the US or mmol/L like in Australia, Canada, and most European countries.

If lipid values are expressed as mg/dl (like in the US);

TG/HDL-C ratio less than 2 is ideal

TG/HDL-C ratio above 4 is too high

TG/HDL-C ratio above 6 is much too high

If you are using mmol/L (most countries except the U.S.) you have to multiply this ratio by 0.4366 to attain the correct reference values. You can also multiply your ratio by 2.3 and use the reference values above.

If lipid values are expressed as mmol/L (like in Australia, Canada, and Europe);

TG/HDL-C ratio less than 0.87 is ideal

TG/HDL-C ratio above 1.74 is too high

TG/HDL-C ratio above 2.62 is much too high"
https://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/

Note how the resulting ratios are different, because the figures in mg/dl and mmol/L have different meanings.
HTH further
Geoff

Hi Geoff,

Thanks so much for getting back to me. I am not sure whether I get this -- I am probably a bit daft. Admittedly, there might also be a glitch in the conversion and the reported ranges -- mind you I am not an expert.

I entered my numbers (in mg/dl for one version and converted into mmol for the other version) into both versions of the calculator and the ratios turn out to be virtually the same -- with one exception -- and this is the trigs/hdl ratio. However, the ranges also seem to have been adjusted according to what you have suggested above. Here is the screenshot of my personal results with normal and ideal range. The cutoff value for ideal is under 0.87 mmol and normal under 1.74 mmol. As a comparison, I have also included the output of the other version of the calculator.

 

[ziggy_w]

Alternatively.... I will just go off the guidelines on the results report. It helpfully had exclamation marks at the high readings! I just hope it has budged downwards. I focussed more on the BG to be honest as an A1C of 111 was ridic! I needed to focus that asap... so fingers crossed. Anyway, will let you know soon enough!

Hi @RFSMarch,

I will keep my fingers crossed. I also agree with you -- BGs are definitely more important right now.