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Cholesterol improvements and questions

mehhh2015

Well-Known Member
Messages
441
Type of diabetes
Type 2
Treatment type
Diet only
Hi there,

I very happy after my first review post diagnosis that was due for a couple of months already but had to be delayed. I was diagnosed in january and went straight into a very low carbing diet and metformin which brought my BGs down almost immediately.

I lost two stones and a bit but had to go through a very stressful time between april and june and that brought back almost half the weight (I'm still very overweight)... so I wasn't expecting great results as the blood tests were taken just before I started low carbing again... but to my pleasant surprise here they are:

HbA1c 112 at diagnosis down to 42 mmol/mol
Total Cholesterol 8.8 at diagnosis down to 6.1mmol/mol
Triglycerides 5.95 at diagnosis down to 3.15 mmol/mol
LDL (NA at diagnosis due to high trigs) down to 3.02 mmol/L
HDL 1.09 at diagnosis up to 1.65 mmol/L
Cholesterol Ratio 8.1 at diagnosis down to 3.7

My nurse and doctor were really happy and positive, they are happy with low carbing and in that respect I feel lucky I get full support, although my dietary advice came from myself never from them (they never told me what to eat... I told them what I was doing and that was it)

I am very happy that I didn't experience the increase in cholesterol that people sometimes present while low carbing and losing weight (I was concerned about it), however I am confused about the levels and the word statins been mentioned again by the nurse.

I can't go on statins (neither I want to) but I wonder if I actually do need to bring my cholesterol further down, and would love to hear your opinions. And how could I fight my corner if they insist in me having lower cholesterol.

I think my cholesterol levels improved dramatically (in my opinion) and I suspect that if in the last few months I wouldn't have put the weight back on that the results would have been even better... but life is rarely perfect... they might keep improving as I have started with my low carb lifestyle again although at the moment my weight loss is very very slow in comparison to the first few months.

However, I am always confused about this all: particles size, ratio, total cholesterol issue. From the ratio perspective my life seems to be almost perfect now at 3.7 (ideal been theoretically 3.5-1 as I understand it) but my total cholesterol is still very high at 6.1

I am also confused by the NHS guidelines about LDL been 3 for healthy people and 2 for people at risk (I am at high risk and tick all the boxes), should I be worried of being at 3.02... I feel I shouldn't...

Also, has anybody here while low carbing achieved the total cholesterol at 4 and triglycerides below 1.8 that are the targets? I wonder...
 

Personally, I always disregard the total cholesterol number, as, frankly, it's meaningless. I'm more concerned about the components. My lipids at diagnosis (October 2013)are the first figures on the list below, with the second in May this year.:

Serum lipid levels
Serum cholesterol level 8.2 > 7.4
Serum triglyceride levels 2.45 > 0.82
Serum HDL cholesterol level 1.5 > 2.6
Serum LDL cholesterol level 5.6 > 4.4
Total cholesterol:HDL ratio 5.5 > 2.8

I have spent a lot of time learning about lipids, and have left my GP with lots of reading and notes each time I have seen her, as initially she was most concerned, but only referring to Total. Following these last results, she comment was, "You must be absolutely delighted with those numbers".

Those lipid levels go with HbA1cs at 73 and 30 on the respective dates.

Primarily, in your shoes, I would want to bring my Trigs down further, but low carbing should take care of that. As changes to lipids can take a while to show up in tests, it could be you are on the way to reducing that element anyway. I have never taken statins, or any other diabetes related medication.

I have no idea why you state you can't take statins, although you say your GP would like you to? Why is there a difference there?

Provided you are otherwise healthy (and that is a decently weighted proviso), I would be negotiating a further 3 months of monitoring before starting statins; bearing in mind how slowly changes are reflected in blood tests. Furthermore, I can find very very little, in terms of medical evidence which persuades me statins have much, that has been proven, to offer women, and particularly those of a "certain age". Apologies if that brackets you inappropriately, but I have no idea how old you are, but I am firmly in that bracket. Most research is conducted on male patients, probably because of their increased risk of CVD, but that doesn't comfort me much in terms of the medics' view.

Good luck with it all, and keep reading and talking to your HCPs. If you continue lower carbing, it is likely your trigs, and probably other components will improve at your next review. If you haven't already, I can strongly recommend you invest some time watching some of Professor Sikaris's videos on YouTube. He has a straightforward presentation style and I have learned a lot from him, and his cohorts.
 
Second all the above, but would add an extra link.

If you want the last word, really the last word, on cholesterol, read this series in Peter Attia's blog:

http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-i

Ten articles. It's hard work. But it's interesting, and really is state of the art.

The short version is, LCHF will improve most lipid indicators for most people very markedly. A few find that their LDL goes way up. For just a few of those few, that may be problematic - if the LDL particle *number* (not size) or that of an apolipoprotein called ApoB is high. But that you can only determine thro private tests.

I'm a total cholesterol-reading addict.

Good luck,

Lucy
 
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My cholesterol is still a tad wrong, due to good cholesterol being too low, nurse wanted it at 1.2 or higher, I got 1.15 this time, up from 0.89 3 months ago. All that fat I've been eating must be doing me some good.
 
Last time I had it checked my triglyceride level was 0.94.
My total cholesterol was 5.28, but I wouldn't want it as low as the guideline!
My LDL was 3.55.
That was a year ago. I'm getting a new test tomorrow, so that should be interesting.
 

Thank you @AndBreathe, It's good to know that it is possible to get ideal levels through the diet only.

Certainly as you said, trigs will come further down with the lack of carbs. And as I said I have a lot of weight to lose so I believe that when the weight comes off eventually, the numbers will keep improving (although it will be a long journey ).

My question was more about how much improvement should I expect, and judging by your experiences and my recent tests I should expect positive outcomes, which makes me happy.

Lol, I do consider myself of a "certain age" so no worries there lol. There is no discrepancy between my GP and me in terms of not taking statins but everytime I see them they mention them saying they wouldn't want me on them for treatment but numbers need to improve.

I am in the odd position where I do have to find a way to bring all my numbers to the levels they want as much as possible because I need fertility treatment.

I cannot be on statins long before the treatment, and to go through my treatment I need to be as close as possible to the normal levels suggested by the NHS, so I am at the mercy of their opinions and rules. They have the power to delay treatments etc... in any case I am giving myself 6 months from now to lose a significant amount of weight and normalize my numbers.

Thank you for reminding me about Dr. Sikaris videos. They are good, I might have to watch them again, to have more arguments in case my numbers don't get as good as they want them to be.
 
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Yeah, I love Peter Attia, I didn't remember about it at all. I might print that and bring it to my GP.
 
NoCrbs4Me said:
Last time I had it checked my triglyceride level was 0.94.
My total cholesterol was 5.28, but I wouldn't want it as low as the guideline!
My LDL was 3.55.
That was a year ago. I'm getting a new test tomorrow, so that should be interesting.
Click to expand...

It'd be nice to know your latest test results, keep me posted. Certainly the numbers are great even if not at their ideal level. I get what you are saying about not wanting them as low as the guideline... but I am at their mercy... I have to be within their rules...
 
I have and can get my Chol in the required ranges (Trigs <0.75, LDL< 2.3) , but I am not convinced that the targets are optimal
also the LDL doesnt show whether the lDL is large/fluffy(good) or small/dense(bad)
You have started to improve your ratios, so tell them you are moving in the right direction
Trig/HDL 3.05 > 1.91
Tot Chol/HDL 8.07 > 3.69
 
Here are my numbers, if of any interest:

Feb > April 2015

HDL 2.6 > 2.4
LDL 4.7 > 3.3
Trigs 0.8 > 0.6
Trigs/HDL (desired range >= 0.87) 0.3 > 0.25

Doc doesn't like the LDL but can see it's the LCHF diet that's put it up (it was lower before my LADA/Type 1 diagnosis). The Feb figures were nine months into LCHF; the April figures were LCHF plus eleven months.

So I'm one of those guys with massively improved figures, but LDL a bit higher. I might get an ApoB test privately in the UK one day, just to be sure I'm not doing myself a disservice.

Edit: the thing to do if LDL-P/ApoB is high (= high risk) is to shift from high sat fats to higher monounsats: avocados, olive oil etc.
 
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But mehh, losing weight would be brilliant for your health in every possible way, so I do hope you can feel strong and supported.

You'll get those people off your back if you can manage it!
 
LucySW said:
But mehh, losing weight would be brilliant for your health in every possible way, so I do hope you can feel strong and supported.

You'll get those people off your back if you can manage it!
Click to expand...



Yes, losing weight will make everything better, I know. I have lost weight already... then put back some, then lose a bit again, so I am getting there, working on it full on at the mo
 
Good luck then. I was so shocked and terrified at Dx it wasn't hard for me. Harder now - I keep seeing lovely things that others are eating around me, and I can't.
 
LucySW said:
Good luck then. I was so shocked and terrified at Dx it wasn't hard for me. Harder now - I keep seeing lovely things that others are eating around me, and I can't.
Click to expand...

Yeap, I know what you mean. Definitely don't want the complications associated with this, but I'm not really sure I can actually escape them, we will see.

I don't find difficult to stick to a low carb eating style (although I have my days when I want to throw everything out of the window and wonder why I couldn't have different genes...) but during periods of too much stress my live becomes much more complicated and I find it really hard to deal with stress without carbs in my system for many different reasons, at those times my weight is very difficult to manage, and it creeps back on.

I lost two stones at the beginning of the year, and then in two months put half the weight back on. I'm back on the track now but the weight loss is happening at a much slower rate, but it is happening so I need to hang in there.

I see you like Berstein too, I find his suggestions of constant non diabetic levels at all times the best advice one can get for dealing with this.
 
Hi @mehhh2015 Have you had your thyroid checked? Low thyroid can cause high cholesterol, particularly high LDL. It also causes infertility. In Sweden they recommend a TSH below 2 when TTC.
 
Totto said:
Hi @mehhh2015 Have you had your thyroid checked? Low thyroid can cause high cholesterol, particularly high LDL. It also causes infertility. In Sweden they recommend a TSH below 2 when TTC.
Click to expand...

Not recently but a few times over the last couple of years and it always came back normal. Thanks anyway
 
Fasting has a influence, blood lipid tests are normally messured fasting, ISRT in the hours after eating Trigs go up and LDL and HDL go down by a few 1/10ths.

After going LCHF my total cholesterol went down from low 5s to below 3 with my total/HDL ratio 2.2 my Trig number is also good.
 
What is your triglyceride level?
 
mehhh2015 said:
Not recently but a few times over the last couple of years and it always came back normal. Thanks anyway
Click to expand...
Normal is far too wide, particularly if trying to conceive. The upper cut off is far lower in that case.
 
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