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Cholesterol confusion

H

hels

Well-Known Member
Messages
312
Location
Bristol, UK
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I thought I'd start a new thread regarding my cholesterol as I cannot decide if I should be concerned about my lipid profile results or not. I'm trying not to worry but at the same time want to do what I can to keep healthy but am struggling to decide the best course of action.

Quick summary of my situation. Having been fit and healthy all my life and hardly set foot in a doctors I was diagnosed with type 1 diabetes and hypothyroid 2.5 years ago whilst pregnant. Straight onto insulin and levothyroxine. Have recently had 2nd child.

I Have also had a number of lipid profiles done over the last couple years, all showing 'high' cholesterol however the most recent showed 'very high'. Here are the numbers for the latest test:

Total cholesterol 8.7 mmol/L
Cholesterol/HDL ratio 2.9
HDL 3 mmol/L
LDL 5.4 mmol/L
Triglycerides 0.6 mmol/L
Non HDL 5.7 mmol/L

This test was done when my son was 7 weeks old and he is being breastfed. My diabetes team noted the levels and suggested the elevated values may be pregnancy related and to retest in 4 months.

My GP requested to see me and acknowledged that I cannot take statins while breastfeeding but recommended that I should take them - not sure if he thinks I should stop breastfeeding to take them or wait until I finish feeding my son. I asked how breastfeeding effects levels, since milk contains cholesterol which I guess is made in the liver then transported in the blood to be included in the milk, so I was wondering if this may increase levels.

It does concern me that I may have increased risk of CVD. I requested hs-CRP and Lp-PLA2 tests which look for inflammation so he has referred me to a lipid specialist.

I said I won't consider statins at the moment. I am not overweight (169cm and about 58 kg) and did not put on much weight in pregnancy. I usually stay pretty fit and did throughout pregnancy . We discussed diet, that I follow low carb and he suggested Mediterranean diet. I am going to look at low carb Mediterranean - which I think I'm quite close to doing anyway.

Anyway, not sure what I'm hoping to achieve from this post. Just trying to work out what course of action to take.
 
You could wait until you see the lipid specialist before making any decisions about where to go from here, if you want to know the target cholesterol levels that they want people with diabetes to aim for then have a look at the following:

  • 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/
 
Thanks @noblehead

Yes, I think I will see what the lipid specialist says. I'm glad I've been referred to a specialist. It can't harm to look at my diet. Hopefully my levels are still elevated from pregnancy and will come down by themselves.
 


Allegedly the total of 8 is a bit of a trigger point for GP referral to a lipid specialist. Of course, only someone who had "achieved" that stellar total would know this!

In my case, I deferred the referral as I was about to leave the country for a few months and didn't want to risk missing any appointment sent during my absence. When I came back last month, my levels had dropped back below the magic number and my breakdowns had also improved further, to the extent the same GP who wanted to refer me declared my May levels as being excellent. My total in June was still 7.4, so at long last, this GP at least, is awake to the ratios.

I would certainly see the lipid specialist, and in fact I sort of felt I was missing out when I saw my GP a couple of weeks ago and the referral was quashed, but then I'm a bit of a knowledge and data freak.

Good luck with your referral, I will be interested to hear how it goes.
 
While breastfeeding, you should only control your cholesterol through diet and exercise (though how you'll find the time for exercise, I don't know!)

You say you're low carbing, I hope that doesn't mean "high fat" as well.
Good luck in reducing your cholesterol!
 

@dancer, yes, I will just do what I can with diet and exercise. I live in a hilly area and walk a lot whilst carrying a baby and pushing a toddler and I tend to walk quickly. Whilst pregnant I swam 2k 2 or 3 times per week and hope to get back into that as well as circuits/HIIT when I can get childcare.

As for the diet I low carb with what I'd call normal fat intake. I don't consciously eat extra fat but don't avoid it. I will reduce red meat and cheese consumption and increase the fish. I already eat lots of veg/salad. I'm going to try to introduce porridge (maybe in the evening rather than breakfast to see if I tolerate oats better).

I'm still hoping that the extreme value was due to only being 7 weeks post partum & breastfeeding. Usually in the uk they recommend leaving at least 6 weeks before doing lipid test but some other places advise 4 months and other literature has suggested it can take a year for levels to return to normal.
 
Ok, so I have the results from last week. Reading on the left is from June and reading on the right last week. Slight improvement but I was hoping for much better. Still referred to lipid specialist but not heard anything yet.

Total cholesterol 8.7 mmol/L
️ 8.3 mmol/L
Cholesterol/HDL ratio 2.9
️ 2.1
HDL 3 mmol/L
️ 4 mmol/L
LDL 5.4 mmol/L
️ 4.1mmol/L
Triglycerides 0.6 mmol/L
️ 0.5 mmol/L
Non HDL 5.7 mmol/L
️ 4.3mmol/L

I've signed up for the gym and the little chap is going to have to get used to the crèche. Still breastfeeding which may cause increased levels.
 
I had an appointment with my diabetes team. I saw a registrar I haven't seen before and he told me that my lipid profile looked good, I had an excellent HDL and didn't need to worry. He said of course my total cholesterol was high as my HDL is 4.0 and ratio was good.

When I got home I had a letter with an appointment for the lipid clinic next week so I'll be interested to see if they have the same opinion.
 


Hi

From what I've read, your triglysoride level would indicate that near on 100% of your LDL particles are the 'big fluffy, good' type - check out Professor Ken Slkaris (on Youtube. There's a video relating to blood test results).

The up to date 'gold standard' markers have changed yet again . Apparently, it's not the size of the LDL particle that matters (with reference to CVD), it's the actual number of particles (LDL-p) - the lower the number the less risk. With HDL it seems that the higher the number of particles (HDL-p) the better, as this would indicate (taking with a high HDL cholesterol score) that your HDL particles are the 'good, small type'.

Also, don't panic over the cholesterol in your diet. Over 50% of the cholesterol in food is 'esterified' (attached to another molecule) and can not be absorbed through the gut. Most of the remainder will, also, pass through as the body - which is more than capable of producing sufficient cholesterol itself - will reject it.

Totally confused? So am I

For a deeper understanding check out http://eatingacademy.com Search the blog for 'the straight dope on cholesterol'. It's very informative (if a tad technical in places).

Gook luck
 
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