Type 2 Cholesterol / Lipid profile after low-carb

[bulkbiker]

Hi guys, i initially thought the same as the ratios whether in mg or mmol should be the same if divided in any units, and was happy with my low ratio however then i bumped into this calculator page https://www.omnicalculator.com/health/cholesterol-units and it explains why we can't calculate TG/HDL ratios in mmol simply because conversion from mg to mmol ratios are different for TGs. Please read the article for details.

excerpt:
The rules for converting cholesterol units of TC (total cholesterol), HDL (high-density lipoprotein) and LDL (low-density lipoprotein) are the same:

• To get from mmol/L to mg/dL, you need to multiply by 38.67.
• To get from mg/dL to mmol/L multiply by 0.02586.

Conversion for TG (triglycerides) is calculated differently:

• To get from mmol/L to mg/dL multiply by 88.57.
• To get from mg/dL to mmol/L multiply by 0.01129.

Which is why I used a "good" ratio all measured in mmol/l the 0.87 I mentioned is in mmol/l.
For mg/dl the level is different for exactly the reason you listed.

 

[finsit]

The meter I use is a Veri-q which has the option to measure a full lipid panel, total cholesterol, LDL, HDL, trigs and also shows the ratios, a different test strip (cheaper) can be used to test just cholesterol against HDL. There is a third test strip which just checks glucose but haven't tried these. The equipment was quite expensive as are the test strips and when compared against the bloods taken at the hospital which were done within half an hour of my own testing, the results were lower than what the hospital found, so I was a little bit disappointed but at the same time its a good way for me to keep a basic check on my cholesterol. I don't test very often because of the cost of strips 5 test strips for £29.95. .

As I said in my previous post, I am not sure that diet actually changed anything. or if it was simply due to the passage of time. I still eat a fair amount of saturated fat basically just changed to extra virgin olive oil for cooking and stopped snacking on butter. Did much what @LaoDan has said, I eat a lot more fish and avocados. Also my results could have quite easily been due to just what my cholesterol was on the day. Cholesterol is very dynamic as shown by Dave Feldman at cholesterolcode.com. I actually tested his "Feldman Protocol" and sure enough when I ate very low calorie my cholesterol went up but eating lots of fat and lots of calories my cholesterol went down. Currently its around the same as what my cholesterol was in November so no obvious improvement for a few months.

Thank you for sharing the info. How off was the Veri-q reading compared to your lab reading? Can you give example of both readings? 20% is a standard deviation in all these strips anyway which is legally accepted.

 

[finsit]

One more question, that being on very low carb diet, i was expecting my TGs to go below 1, however i see the improvement only from 1.9 to 1.6. Is that a reasonable achievement in 5 months? I am satisfied for my HDL going from 0.88 to 1.2 as i know its hard to raise HDL than to lower TGs.

 

[Ryhia]

Thank you for sharing the info. How off was the Veri-q reading compared to your lab reading? Can you give example of both readings? 20% is a standard deviation in all these strips anyway which is legally accepted.

Bloods taken after 12 hours fasting.
Home test - time of test 08:43am.
Meter readings as follows:
CHOL 6.24
TG 1.04
HDL 1.50
HDL/LDL 2.8
CHOL/HDL 4.2
LDL 4.27
HDL/LDL 3.5

Bloods drawn at the hospital around 09:40 all in mmol/mol are as follows:
Total Cholesterol: 7.9
Trigs: 1.2
HDL: 1.9
non-HDL: 6.00
calculated LDL: 5.5

I was a little disappointed with the difference in the results as it knocked my confidence in the cholesterol meter but I guess like glucose testers, the meter is more effective to show the trend. I was also surprised that my Trigs had risen generally, they are usually around .8 but that may be a reflection of the stress I was under at the time. I knew I was never going to achieve what the lipid doc required so these blood tests were just so that she could say I needed to be on statins. So far I have resisted but I know that another conversation is coming up in the near future. I did think about cancelling my next hospital appointment which should have been earlier in the year, but my GP encouraged me to simply put it off for a while in the hope that my cholesterol would come down further. Unfortunately it hasn't.

 

[bulkbiker]

Unfortunately it hasn't.

Why do you think it's unfortunate?

Great Trig/HDL ratio whichever figures you use..

0.693 or 0.631 nothing to worry about there.

 

[Ryhia]

Why do you think it's unfortunate?

Great Trig/HDL ratio whichever figures you use..

0.693 or 0.631 nothing to worry about there.

My lipid doctor takes no notice of HDL or Trig ratios, she is only interested in what my non-HDL markers are and my level of LDL and she see those numbers as being far too high.

 

[KK123]

My lipid doctor takes no notice of HDL or Trig ratios, she is only interested in what my non-HDL markers are and my level of LDL and she see those numbers as being far too high.

Hi Ryhia, I know it's easier said than done and we are all different but honestly you really do not have to bow down to your GPs views on statins or your cholesterol. She may well focus only on your LDL (as does mine) but I could not care less, in fact these days I cut her off immediately when she starts going on. I just ask her to explain why my ratios are all well under normal, why my HDL is 2.45, why my trigs are low and if that doesn't matter, then why do they bother recording ratios? When you put them on the spot for a medical explanation they will start to say things like 'heart health and clogged arteries', I say 'So give me an artery test then if you think they are clogged' and then she says 'No need, you are healthy'. I'm not advocating for anyone to ignore their GPs but if you are satisfied with your levels and have come to an educated decision, do not let her intimidate you. I recall you talking about lipid DNA testing, insist on that before you will even consider statins and see what she says.

 

[bulkbiker]

My lipid doctor takes no notice of HDL or Trig ratios, she is only interested in what my non-HDL markers are and my level of LDL and she see those numbers as being far too high.

Time for a new "lipid doctor"?

 

[Jo123]

@zamalik my ldl went up quite a bit when I first low carbed, I’ve reduced it, keeping my haba1c normal, by changing my fat source, lots of nuts, extra virgin olive oil, oily fish, avocados, I do eat a little cheese and 5% fat yoghurt. It's constantly at a level my gp is happy with, my trigs are very low and my hdl is good.

 

[Ryhia]

Time for a new "lipid doctor"?

Its the only one I am likely to ever get to see, and whilst she wouldn't do any genetic testing she did add ApoB and lipoprotein (a) to the blood panel test she arranged, for which I am thankful however, my next appointment is likely to be my last as I am too uncooperative for them.

 

[Ryhia]

Hi Ryhia, I know it's easier said than done and we are all different but honestly you really do not have to bow down to your GPs views on statins or your cholesterol. She may well focus only on your LDL (as does mine) but I could not care less, in fact these days I cut her off immediately when she starts going on. I just ask her to explain why my ratios are all well under normal, why my HDL is 2.45, why my trigs are low and if that doesn't matter, then why do they bother recording ratios? When you put them on the spot for a medical explanation they will start to say things like 'heart health and clogged arteries', I say 'So give me an artery test then if you think they are clogged' and then she says 'No need, you are healthy'. I'm not advocating for anyone to ignore their GPs but if you are satisfied with your levels and have come to an educated decision, do not let her intimidate you. I recall you talking about lipid DNA testing, insist on that before you will even consider statins and see what she says.

Thank you for the encouragement and the sound commonsense.

 

[AndBreathe]

@zamalik - Lipids can seem a bit mystical, and oftentimes I think they are as much a mystery to our GPs as they can be for us. I know I have certainly had some "interesting" conversations with GPs.

These are my historic lipid levels. I have had a more recent set, which have been discussed, but I haven't yet had the consultant's letter with the numbers in it:

The most recent bloods I have had done broadly reflect recent years, with the Total Cholesterol coming in at 7.6, if I recall correctly, and trigs at 0.8. Those bloods were done as part of my participation in a research study (which is still recruiting), looking at cardiac failure in those living with T2. I have no history of cardiac issues of any sort.

I had extensive tests - EGC, Stress/Exercise ECG, CT Scan, including an arterial calcium scan, then MRI and extended MRI, including an Adenosine stress test.

In discussing my results (and watching my own heart beat), the cardiologists were supremely unconcerned by my lipid panel. He was keen to emphasize he might view it differently had I had any form of cardiac event or have other underlying cardiac challenges. I took enormous heart from that.

I would urge you to expand your learning on lipids. If you haven't done so already, you might find some of Professor Ken Sikaris's presentations on YouTube to be helpful. He presentation style is very relaxed and clear.

As has been said, if you are in a weight loss phase, please don't be too quick to draw conclusions where your lipids are concerned. You may find your numbers moderate as your waistline slims.

 

[finsit]

@zamalik - Lipids can seem a bit mystical, and oftentimes I think they are as much a mystery to our GPs as they can be for us. I know I have certainly had some "interesting" conversations with GPs.

These are my historic lipid levels. I have had a more recent set, which have been discussed, but I haven't yet had the consultant's letter with the numbers in it:

View attachment 50294

The most recent bloods I have had done broadly reflect recent years, with the Total Cholesterol coming in at 7.6, if I recall correctly, and trigs at 0.8. Those bloods were done as part of my participation in a research study (which is still recruiting), looking at cardiac failure in those living with T2. I have no history of cardiac issues of any sort.

I had extensive tests - EGC, Stress/Exercise ECG, CT Scan, including an arterial calcium scan, then MRI and extended MRI, including an Adenosine stress test.

In discussing my results (and watching my own heart beat), the cardiologists were supremely unconcerned by my lipid panel. He was keen to emphasize he might view it differently had I had any form of cardiac event or have other underlying cardiac challenges. I took enormous heart from that.

I would urge you to expand your learning on lipids. If you haven't done so already, you might find some of Professor Ken Sikaris's presentations on YouTube to be helpful. He presentation style is very relaxed and clear.

As has been said, if you are in a weight loss phase, please don't be too quick to draw conclusions where your lipids are concerned. You may find your numbers moderate as your waistline slims.

Thank you @AndBreathe . However, i see you have excellent TGs and well above 2 HDL. My TGs and HDL are still borderlines. I have started low carb on Jan 1st this year and was 72 KGs. I went to 55 KGs in April and since then my weight is stable. So shouldn't i be over with my transient hypercholesterolemia by the time i was tested on June 25th? Also do you think improvement on HDL from .88 to 1.2 in 6 months is good enough from your experience?

 

[finsit]

@zamalik my ldl went up quite a bit when I first low carbed, I’ve reduced it, keeping my haba1c normal, by changing my fat source, lots of nuts, extra virgin olive oil, oily fish, avocados, I do eat a little cheese and 5% fat yoghurt. It's constantly at a level my gp is happy with, my trigs are very low and my hdl is good.

@Jo123 thanks. I started losing weight at the start of this Jen till the mid April and now stable for almost over 2 months at 55 kgs. Waistline is at 28 inches, insulin resistance is gone (fasting insulin of 3). So do you think i should have been over with transient hypercholesterolemia by June 25th when blood was drawn? Can you please tell what was your pattern of increased and then normalizing your LDL, how much and how much time it took to get normalized after weight stabilization ?

 

[finsit]

@zamalik - Lipids can seem a bit mystical, and oftentimes I think they are as much a mystery to our GPs as they can be for us. I know I have certainly had some "interesting" conversations with GPs.

These are my historic lipid levels. I have had a more recent set, which have been discussed, but I haven't yet had the consultant's letter with the numbers in it:

View attachment 50294

The most recent bloods I have had done broadly reflect recent years, with the Total Cholesterol coming in at 7.6, if I recall correctly, and trigs at 0.8. Those bloods were done as part of my participation in a research study (which is still recruiting), looking at cardiac failure in those living with T2. I have no history of cardiac issues of any sort.

I had extensive tests - EGC, Stress/Exercise ECG, CT Scan, including an arterial calcium scan, then MRI and extended MRI, including an Adenosine stress test.

In discussing my results (and watching my own heart beat), the cardiologists were supremely unconcerned by my lipid panel. He was keen to emphasize he might view it differently had I had any form of cardiac event or have other underlying cardiac challenges. I took enormous heart from that.

I would urge you to expand your learning on lipids. If you haven't done so already, you might find some of Professor Ken Sikaris's presentations on YouTube to be helpful. He presentation style is very relaxed and clear.

As has been said, if you are in a weight loss phase, please don't be too quick to draw conclusions where your lipids are concerned. You may find your numbers moderate as your waistline slims.

I have done listening to several of Sikaris vids and he also says the LDL to HDL ratio is important that's my worrying point. I still seem to have a high ratio.

 

[finsit]

Talking of cholesterol, this is by far the best video on this topic i have watched so far, its a bit old and im not sure if he has an updated version of it, but this is just phenomenal information !

 

[finsit]

I have couple of interested findings and thought i will share this with you guys and see if you have any comments on em?

First, I read that if you have APOE4 allele that can hamper your lipid metabolism and they say 10-15% of the population have this gene and if they go on VLCD diet, their LDL is going to go up for sure. Now the second interesting finding is that if you have G6PD deficiency (which i have), and you go on VLCD, this is going to raise your LDL as well and they did this in mice which had G6PD def and when they put them on obesogenic diet they had much higher LDL as compared to the mice which didn't have the deficiency and had similar diet.

There is no individual medical care available in this country unless you are willing to pay privately, otherwise a few tests should give me a clear cut information of what has risen my LDL to this high, almost close to 10! I will wait for 3 months and then probably i am going to do few test privately including Ca score and LDL particle size etc, any recommendations in this regard?

 

[finsit]

@zamalik my ldl went up quite a bit when I first low carbed, I’ve reduced it, keeping my haba1c normal, by changing my fat source, lots of nuts, extra virgin olive oil, oily fish, avocados, I do eat a little cheese and 5% fat yoghurt. It's constantly at a level my gp is happy with, my trigs are very low and my hdl is good.

@Jo123 "by changing my fat source" this is something i am working on now. I had a lot of full fat cream, clotted cream and almond flour cakes and things of that sort including butter, sour cream etc. Is that what you are referring to by changing fat sources? which one's helped you most?

 

[Jo123]

@Jo123 thanks. I started losing weight at the start of this Jen till the mid April and now stable for almost over 2 months at 55 kgs. Waistline is at 28 inches, insulin resistance is gone (fasting insulin of 3). So do you think i should have been over with transient hypercholesterolemia by June 25th when blood was drawn? Can you please tell what was your pattern of increased and then normalizing your LDL, how much and how much time it took to get normalized after weight stabilization ?

I wasn't overweight to start with and only went from a bmi of 24 to around 19 at the beginning, it's gone up a little now, I'm at 20.5. My ldl went down in three months, at the next blood test there was no mention of stations. When I've got time later I'll have a look at my blood tests.

 

[Jo123]

@Jo123 "by changing my fat source" this is something i am working on now. I had a lot of full fat cream, clotted cream and almond flour cakes and things of that sort including butter, sour cream etc. Is that what you are referring to by changing fat sources? which one's helped you most?

Absolutely this. I went a bit mad on cream etc., at first after a lifetime of watching my weight! I pretty much cut out the cream, butter, cheese etc., and went for nuts, avocados, extra virgin olive oil and oily fish to get my ldl down before my next blood test. I had to eat the fat because my bmi actually went too 18.5 and I didn't want to get thin. Your almond flour is fine.

I wish we could have our ldl easily tested to see the size, plus I wish there was more actual evidence that the larger ldl is harmless rather than scientists saying it is without the proof.