Cholesterol

[Squire Fulwood]

Why wouldn't they do your trigs? These are the most important indicators for CV disease.

Can't say I know the answer to that. My concern at the time was that I associated blood tests with fasting and was not sure what to do if I got an appointment that did not mention fasting. I tried to negotiate for positive instructions instead of negative (absent) ones. I was greeted with the patronising grin they use when they have a thick patient who does not understand the terribly difficult life they live every day. To this day this point remains unresolved so I just don't fast if they don't mention it and if I get it wrong I have the appointment letter in my pocket to show them.

I don't understand triglycerides ('cos I''m thick) and only understand the cholesterol numbers because they have target numbers on my Care Plan. I watch my Hba1c like a hawk though.

 

[Scandichic]

Can't say I know the answer to that. My concern at the time was that I associated blood tests with fasting and was not sure what to do if I got an appointment that did not mention fasting. I tried to negotiate for positive instructions instead of negative (absent) ones. I was greeted with the patronising grin they use when they have a thick patient who does not understand the terribly difficult life they live every day. To this day this point remains unresolved so I just don't fast if they don't mention it and if I get it wrong I have the appointment letter in my pocket to show them.

I don't understand triglycerides ('cos I''m thick) and only understand the cholesterol numbers because they have target numbers on my Care Plan. I watch my Hba1c like a hawk though.

What's a care plan? Think my doc has a don't care plan!
I know I'm meant to have one but no one has shared it with me so far! There is one doc there who approves low carbing but not high fat. He's my best option and I have managed to get strips out of him so I try to plan in advance and ask for him. Our docs gives nothing to anyone despite some of the poorest and most vulnerable people being attached to the practice. One doc treats people differently if he knows what they do for a living. He was very rude to a friend of mine who turned up with her 2 kids and was completely dismissive of a friend of a friend who took her very ill undiagnosed T1 son - said it was a virus not diabetes and sent him home. Mercifully she took him to A&E where they told her the next day that if shed left it any longer he would have died. Bs was 89 on admittance! I think he might be on my plan - lol! He got a roasting from the hospital and did so for me from the consultant!

 

[Sid Bonkers]

Scandichic, if you have a lipid panel test you need to fast for at least 8 hours as it takes that long for your triglycerides to return to their base level.

Triglycerides are higher after eating as dietary fat is converted into triglycerides when it enters the blood stream, this is why blood will be seen to be slightly milky after a high fat meal if you were to draw some and look at it in a test tube.

So if you have your trigs tested without fasting it will show a higher false reading.

If you are just having an HbA1c or a total cholesterol test there is usually no requirement to fast.

 

[Squire Fulwood]

What's a care plan? Think my doc has a don't care plan!

I shall precis what I said elsewhere. My nurse told me off. She said that with all the feedback I had I should be doing better. At another meeting I was able to show her the single post-it note with Hba1c number on it which was all the feed back I had for a period of two years.

She issued me with a Care Plan which is a set of forms on which is recorded all my results and targets. It has two columns for each year so I can review progress or lack of it over the time since I got the Care Plan. Nursie can also make comments or leave instructions on it.

Prior to the issue of the Care Plan my information was only kept on the computer but I was never allowed to see what was on the screen so I never got much out of it.

 

[CollieBoy]

So if you have your trigs tested without fasting it will show a higher false reading.

If you are just having an HbA1c or a total cholesterol test there is usually no requirement to fast.

Sid,
I agree about there being no requirement for fasting for a total cholesterol test , but as I have told HCPs in the past, "A total cholestorol test is as much use as a fishnet condom, I require a full LDL/HDL/Trig go away and do it properly!2

 

[Ambersilva]

Sid,
I agree about there being no requirement for fasting for a total cholesterol test , but as I have told HCPs in the past, "A total cholestorol test is as much use as a fishnet condom, I require a full LDL/HDL/Trig go away and do it properly!2

Somehow a vivid image has been planted in my mind!

I did have one Registrar who stressed how high my total cholesterol was but hid the low trigs when writing a report to my GP.

 

[Scandichic]

Scandichic, if you have a lipid panel test you need to fast for at least 8 hours as it takes that long for your triglycerides to return to their base level.

Triglycerides are higher after eating as dietary fat is converted into triglycerides when it enters the blood stream, this is why blood will be seen to be slightly milky after a high fat meal if you were to draw some and look at it in a test tube.

So if you have your trigs tested without fasting it will show a higher false reading.

If you are just having an HbA1c or a total cholesterol test there is usually no requirement to fast.

Thanks for your reply. Is it possible you could explain a bit more? I have lost 2 stone 11lb since 28th of Jan. People who eat LCHF seem to lose more than me and I wanted my vit d levels checking out. I went to have that checked and my understanding is that it isn't necessary to fast so I didn't. When I have gone for an hba1c test I have been told to fast. Although as this is a 3 month average so not sure why. When went to have cholestrol checked in the past I was told to fast. Anyway, they did an hba1c test and a cholestrol test without telling me when they did the vit d test and then rang me up in a flat panic the next day to say my cholestrol was at 8. Is it possible that it's a false reading as it wasn't fasting?

 

[noblehead]

Scandichic, there's no reason to fast just for an Hba1c test by itself, however if they are doing a full lipid breakdown of your cholesterol at the same time then it's necessary to fast.

 

[Scandichic]

Scandichic, there's no reason to fast just for an Hba1c test by itself, however if they are doing a full lipid breakdown of your cholesterol at the same time then it's necessary to fast.

This is what I'm trying to work out. The problem is I am not a scientist. As far as I was aware I was just having a vit d test, then I got a panicked call wanting to increase my statins. I have not been taking them since I read how bad they are and saw all the letters from prominent people against them. I found they impacted massively on my memory. When I stopped I didn't have these problems.

 

[noblehead]

This is what I'm trying to work out. The problem is I am not a scientist. As far as I was aware I was just having a vit d test, then I got a panicked call wanting to increase my statins. I have not been taking them since I read how bad they are and saw all the letters from prominent people against them. I found they impacted massively on my memory. When I stopped I didn't have these problems.

TBH I'm not sure what the procedure is for a Vit D test.

They would probably want you to increase your statin dosage (thinking that you still take them of course) because of your TC level being at 8, might be worth mentioning to them that you don't now take them and see if they can offer you an alternative to bring your cholesterol levels down, the choice is yours of course.

 

[Totto]

Thanks for your reply. Is it possible you could explain a bit more? I have lost 2 stone 11lb since 28th of Jan. People who eat LCHF seem to lose more than me and I wanted my vit d levels checking out. I went to have that checked and my understanding is that it isn't necessary to fast so I didn't. When I have gone for an hba1c test I have been told to fast. Although as this is a 3 month average so not sure why. When went to have cholestrol checked in the past I was told to fast. Anyway, they did an hba1c test and a cholestrol test without telling me when they did the vit d test and then rang me up in a flat panic the next day to say my cholestrol was at 8. Is it possible that it's a false reading as it wasn't fasting?

Total cholesterol is of no use at all, so no need for panic. And why would they do a cholesterol test anyway?

As has been said above, triglycerides needs to be fasting test. Get the breakdown cholesterol if you are interested but as the reason you went for a test was vitamin D and HbA1c concentrate on them.

My triglycerides were 0.7 last test and they wanted me on statins, no chance of that with HDL at 2.2. They don't like my LDL at 3.3 but that is the lowest reading I have ever had for LDL so am not too worried. Oh, total was 6.3, down from 6.9 but who cares? It is breakdown that counts.

 

[Bluetit1802]

This is what I'm trying to work out. The problem is I am not a scientist. As far as I was aware I was just having a vit d test, then I got a panicked call wanting to increase my statins. I have not been taking them since I read how bad they are and saw all the letters from prominent people against them. I found they impacted massively on my memory. When I stopped I didn't have these problems.

Fasting or non fasting will not affect your cholesterol at all. It will only affect your triglycerides.

 

[Scandichic]

@Totto @noblehead @Bluetit1802
When I saw the doc at the start of July my HDL was 1.3 and my LDL was 6. On diagnosis my LDL was 4.5. Can't find print out to give more info. Don't want to take statins. Don't know if being stupid! Just don't like the memory thing. Also am thinking that weight, bs, bp, cholestrol, diet all interlinked so thinking that I'd like to get down to 10 stone which, as my weight loss has slowed down, should be next May and stay off statins and see what everything looks like then.

 

[Bluetit1802]

@Totto @noblehead @Bluetit1802
When I saw the doc at the start of July my HDL was 1.3 and my LDL was 6. On diagnosis my LDL was 4.5. Can't find print out to give more info. Don't want to take statins. Don't know if being stupid! Just don't like the memory thing. Also am thinking that weight, bs, bp, cholestrol, diet all interlinked so thinking that I'd like to get down to 10 stone which, as my weight loss has slowed down, should be next May and stay off statins and see what everything looks like then.

Find out what the breakdowns are and calculate your Trig/HDL ratio (divide trigs by HDL) if this is under 2 that is good. Then look at your non-HDL cholesterol (Total minus HDL)

above 5.7 is considered very high
4.9 – 5.6 is considered high
4.1 – 4.8 is considered borderline high
3.4 – 4.0 is considered near ideal
below 3.4 is considered ideal for people at risk of heart disease
below 2.6 is considered ideal for people at very high risk of heart disease

 

[phoenix]

Scandichic
I'm not sure where the 8 came from in one of the posts above but if so that is high for a total cholesterol figure.

I've posted this link before but maybe if you haven't read it then it would be worth reading,
The writer is a dietitian but an advocate of LCHF diets. She, like a proportion of people on these diets has reported a rise in her cholesterol levels, She has adapted her diet to still be low carb but to include fewer saturated fats and has seen a fall in her cholesterol levels.
She does go into figures from more complex tests, none of us are going to get LDL (P) ie particle number tests, but as you will read she is concerned about a rise in LDL to above 200mg/dl .
An LDLof 6 equates to 232 mg/dl. If you find th e earlier bit hard going:skim it until the last bit Dietary Changes and NMR Results from June 2014 to see the sort of changes she made which improved her levels . Some of the comments are worth reading too, a couple of them are from doctors who work with people on this sort of diet.
http://www.lowcarbdietitian.com/blo...ery-low-carb-ketogenic-diet-my-own-experience

 

[cold ethyl]

I assume you have had your thyroid function checked as this can affect both weight loss and cholesterol levels?

I'm not sure how much fat you eat, but it maybe that you need to switch from saturated fats like butter to monounsaturated ones like olive oil and reduce your intake of fattier meat products. I know you have sausages every day and it maybe that these need to be swapped for something lower in fat- you could try venison sausages as they are leaner- maybe drop the homemade ice cream or swap the cream for yogurt. Not all low fat products are full of sugar so you could substitute some of the higher fat items for them. There's .2g difference per 100g for Total low fat Greek yogurt for example which in normal quantities isn't going to impact on the BS levels greatly but it has 0g fat and is far lower in calories.
I think Low carbing works but you have to combine it with portion control to keep shifting the weight. I think once the body gets over the shock of our not stuffing carbs down our necks, we have to start looking at other aspects of our diet in order to keep losing weight. I know that if I ate unlimited cheese and nuts for example, although both great LCHF foods, I'd soon put weight back on so I restrict my intake to controlled portions of cheese and occasional nuts.
I guess what I am saying is that your diet needs tweaking as your cholesterol is going up and you aren't losing weight as quickly as you would like.

This is quite interesting take on the issue.
http://authoritynutrition.com/low-carb-diets-and-cholesterol/

 

[noblehead]

@Totto @noblehead @Bluetit1802
When I saw the doc at the start of July my HDL was 1.3 and my LDL was 6. On diagnosis my LDL was 4.5. Can't find print out to give more info. Don't want to take statins. Don't know if being stupid! Just don't like the memory thing. Also am thinking that weight, bs, bp, cholestrol, diet all interlinked so thinking that I'd like to get down to 10 stone which, as my weight loss has slowed down, should be next May and stay off statins and see what everything looks like then.

Certainly weight loss and increased activity help with bp and cholesterol levels but it still may not be enough, as I said before if I were you I'd have a chat with the Dr and explain to them about your memory problems when you had last taken statins, there's quite a few that you could try that may not give you the same side-effects.

However, it's entirely up to you at the end of the day and you could leave it till next year if you choose, all I would say is be careful what you read on the internet about statins as there's a lot of nonsense and scaremongering out there about cholesterol and the role of statins, much of it from authors who are trying to go against the grain about the Scientific Hypothesis about cholesterol and make a killing from selling books.

It's also worth keeping in mind that those that write on the net to deter people from taking their cholesterol levels seriously won't be there to pick-up the pieces when someone has a stroke or heart attack, as diabetics we are already at a heightened risk so it makes sense to monitor bp and cholesterol levels as we do our bg control. Just my opinion.........................

 

[Sid Bonkers]

Sid,
I agree about there being no requirement for fasting for a total cholesterol test , but as I have told HCPs in the past, "A total cholestorol test is as much use as a fishnet condom

Even if it is close to or under the recommendation for diabetics?

Surely the need for a beakdown must be greater the higher ones total cholesterol. So in that sense a total cholesterol figure is quite useful, no?

 

[CollieBoy]

Even if it is close to or under the recommendation for diabetics?

Surely the need for a beakdown must be greater the higher ones total cholesterol. So in that sense a total cholesterol figure is quite useful, no?

not really IMHO! One may have a high total chol that is made up of a v high HDL

 

[Sid Bonkers]

Thanks for your reply. Is it possible you could explain a bit more? I have lost 2 stone 11lb since 28th of Jan. People who eat LCHF seem to lose more than me and I wanted my vit d levels checking out. I went to have that checked and my understanding is that it isn't necessary to fast so I didn't. When I have gone for an hba1c test I have been told to fast. Although as this is a 3 month average so not sure why. When went to have cholestrol checked in the past I was told to fast. Anyway, they did an hba1c test and a cholestrol test without telling me when they did the vit d test and then rang me up in a flat panic the next day to say my cholestrol was at 8. Is it possible that it's a false reading as it wasn't fasting?

I would think that total cholesterol tests are fairly accurate, certainly mine have not varied much over the years although I am lucky that I have always seemed to have low cholesterol anyway.

I dont know 100% if total cholesterol tests can be lower after fasting but Ive always been told and read that there is no need to fast for a total cholesterol test so my best guess is that it would not affect it. The only fasting tests Ive seen are for the full lipid panel or the fairly rare fasting blood test which Ive seen on the phlebotomy paperwork but have no idea what it is for, ive certainly never had one nor have I ever seen a thread here or elsewhere discuss them.

I would guess then that your not fasting would have had little effect on total cholesterol and that it is 'probably' correct, or at least as accurate as the test usually is.

Although as I say I dont know for sure so I would talk to your doctor and ask him/her just to be 100%.