Cholesterol test

[Dark Horse]

The European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine compared fasting and non-fasting lipid profiles and found that the differences between the two were not clinically significant. They recommend that routine lipid profiles are non-fasting but are repeated when fasting if any abnormalities are found.
https://academic.oup.com/eurheartj/article/37/25/1944/1749006

 

[kitedoc]

But, on a highish carb diet with even just moderate control of BSL are not the triglycerides likely to be high? Both non-fasting and fasting?
Yes, I know for Type 1s and LADA on insulin that fasting is a bit of a hassle but to have to go twice seems such a waste of time if on high carb and not so good HBA1C, say.
Also if you are not going to accept stain treatment come what may, why do the cholesterol test at all?
Perhaps if it is to ease the doctor's mind they should pay for it!!

 

[hankjam]

The European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine compared fasting and non-fasting lipid profiles and found that the differences between the two were not clinically significant. They recommend that routine lipid profiles are non-fasting but are repeated when fasting if any abnormalities are found.
https://academic.oup.com/eurheartj/article/37/25/1944/1749006

With respect, I am struggling to follow their logic, don't fast except when it's odd, cut to the chase, fast keeps it simple...

 

[Bluetit1802]

The European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine compared fasting and non-fasting lipid profiles and found that the differences between the two were not clinically significant. They recommend that routine lipid profiles are non-fasting but are repeated when fasting if any abnormalities are found.
https://academic.oup.com/eurheartj/article/37/25/1944/1749006

I am also wary of this because it does show there is a correlation between fat and higher trigs - it does say that fat consumption prior to the test will raise the trigs. This reinforces my belief that those of us following a high fat diet should fast before a test.

A couple of years ago I found a standard range for trigs in mmol/ls for a non-fasting test, but have no idea where I found it now.
Whereas the range for fasting trigs is 0 to 1.7, for non-fasting it is 0 to 2.3.

Just found this in Heart UK
https://www.heartuk.org.uk/cholesterol/triglycerides

Triglyceride levels should be measured at the same time as cholesterol as they can also contribute to our risk of developing heart and circulatory disease. The triglyceride test measures the triglycerides carried in the two main carrying particles (chylomicrons and VLDL). National guidelines in the UK no longer recommend the need for a fasting blood test and HEART UK experts state that we should aim for a non fasting triglyceride level below 2.3mmol/L.

If your doctor has asked you to fast for a test (usually for 10-14 hours) then this level should be below 1.7mmol/L. This "fasting test" number is lower because in the fasting test only the triglycerides made by the liver and carried in the VLDLs will be measured.

As you have not eaten then there will be no chylomicrons present in your blood.

I am no biochemist, but I read this as meaning that a fasting test measure just the trigs made by the liver and carried on VLDLs. Surely this is what should be measured to find our true trigs level - the natural trigs that our liver make, and not the trigs and not those contained in the foods we eat, which clearly changes meal by meal.

 

[Atad heavy]

1.15

@Bluetit1802. My result was 1.15 & that was after 2 good desert spoons of full fat Greek yoghurt & a good dollop of double cream in both my coffees

 

[Atad heavy]

But, on a highish carb diet with even just moderate control of BSL are not the triglycerides likely to be high? Both non-fasting and fasting?
Yes, I know for Type 1s and LADA on insulin that fasting is a bit of a hassle but to have to go twice seems such a waste of time if on high carb and not so good HBA1C, say.
Also if you are not going to accept stain treatment come what may, why do the cholesterol test at all?
Perhaps if it is to ease the doctor's mind they should pay for it!!

I should have explained my reasons for not wanting statins. About 10 years ago I was prescribed statins following a MI, for about 8 of those years I was pre diabetic. Last year I decided that the side effects of statins were getting really serious so I simply stopped taking them. 6 months on & I feel back to normal apart from some muscle pain. I had to own up to my Dr about not taking them when my cholesterol results came back higher than when I was on statins. He said another test in 3 months & he would review the results. This test has come back lower & I hadn’t fasted, so there is a possibility of them being even lower and I’m following LCHF diet

 

[hankjam]

I should have explained my reasons for not wanting statins. About 10 years ago I was prescribed statins following a MI, for about 8 of those years I was pre diabetic. Last year I decided that the side effects of statins were getting really serious so I simply stopped taking them. 6 months on & I feel back to normal apart from some muscle pain. I had to own up to my Dr about not taking them when my cholesterol results came back higher than when I was on statins. He said another test in 3 months & he would review the results. This test has come back lower & I hadn’t fasted, so there is a possibility of them being even lower and I’m following LCHF diet

You and me both on the side effects. I've gone through 3 "brands" of statins and given up.... my TC are pretty high but the downside of statins really was not worth it..... time will tell.

 

[Bluetit1802]

@Bluetit1802. My result was 1.15 & that was after 2 good desert spoons of full fat Greek yoghurt & a good dollop of double cream in both my coffees

According to Heart UK (see my previous post) they are happy with triglycerides under 2.3 on a non-fasting test. (1.7 for a fasting test). So you are within range. I wouldn't be worrying too much about it.

 

[kitedoc]

You and me both on the side effects. I've gone through 3 "brands" of statins and given up.... my TC are pretty high but the downside of statins really was not worth it..... time will tell.

Just so you know on low carb diet triglycerides tend to be quite low.

 

[Cobia]

Just so you know on low carb diet triglycerides tend to be quite low.

It will be interesting mine was just done for my driving review..... endo specified fasted and im vlc . Lipid pannel so far with me is just a yo yo. Trigs generally have been low to date.
See endo during the week.

 

[kitedoc]

Hi @Cobia,
Yo-yoing results are going to be a challenge to interpret i reckon.
Low trigs sounds good.
Hope the appmt goes well in all respects.
Best Wishes and hope the crop is thriving.

 

[Pinkorchid]

I have always heard even what you eat the day before can affect your cholesterol levels. However here in the US some doctors are telling their patients not to fast for the test anymore. The theory is to get a more accurate rate of what daily is going through your veins and that it is more accurate. ( I have a bias thinking they just want more people on statin drugs, but that's me) I have not ever had to care as I'm a vegan and don't ever have any cholesterol issues.

But here is an article on it that explains the new trend.

https://www.statnews.com/2016/04/29/fasting-cholesterol-testing/

My surgery did say not to fast for the blood test for a while but now have gone back to the 12 hour fast

 

[Atad heavy]

@kitedoc
Thanks for your reply, I did not realise that but it has atleast delayed the argument about not going back on statins for 6 months

 

[Atad heavy]

You and me both on the side effects. I've gone through 3 "brands" of statins and given up.... my TC are pretty high but the downside of statins really was not worth it..... time will tell.

I felt so bad that I honestly thought I was dying. I will do anything I can to stay off statins.

 

[bulkbiker]

I felt so bad that I honestly thought I was dying. I will do anything I can to stay off statins.

How about saying "no thank you doc I don't want them.... ever".

 

[Atad heavy]

@bulkbiker
That’s exactly what I plan to do, if he said to me that you can live for another 5 years as you are or 10 years with statins - I would take the 5 years

 

[bulkbiker]

@bulkbiker
That’s exactly what I plan to do, if he said to me that you can live for another 5 years as you are or 10 years with statins - I would take the 5 years

He would also be lying... there is little evidence that statins protect against all cause mortality..

 

[Tophat1900]

I felt so bad that I honestly thought I was dying. I will do anything I can to stay off statins.

No one can tell you that you have to take them and given the side effects you've experienced, I can't see why anyone would argue a case in favour of you taking them.

It's your decision to make in the end. Good luck at your next appt.

 

[Atad heavy]

@bulkbiker
Exactly & what was really priceless was when I told him why I had stopped taking them. He said I could try a different one which has less effect on the muscles. My immediate thought was - well why wasn’t I on those in the first place & also confirmation that they know statins cause muscle damage

 

[Atad heavy]

@Tophat1900
My only fear in refusing to take them is how they will treat me in future. If I refuse medication they may take the opinion that I don’t care about my health