High Cholesterol = Panic!

[Colin of Kent]

Hi all,

I've been following a ketogenic diet for six months now, and my control has been utterly exceptional, no question. However, I've just had my first lot of blood test results, as I'm seeing my consultant this week, and they've given me cause for concern, so wanted to get a few views from folks here.

Cholesterol 21.5
Triglycerides 3.5
HDL 3.1
LDL 16.8
Chol:HDL ratio 6.9

Historically, my cholesterol level has always been around 4 to 5. I've not had a full profile done before, so don't know how it would compare, but pretty sure it would have been better than this!

On the plus side, my HbA1c has come down to 51. Previously, it was usually around low 60's, never lower than 57.

Any thoughts / comments welcome.

 

[Guzzler]

If I have done my sums right your trigs to HDL ratio is 0.88. The recommended target is <1.0 and the ideal is 0.87, so you're good on that but your total is higher than the current recommendation of <5.
Is there a history of FH (Familial Hypercholesterolaemia) in your family?
A decent GP would refer you to a lipidologist for further investigations but expect the talk on statin treatment at the very least. Good luck.

 

[lindisfel]

Those readings are so far outside normal parameters nobody here is qualified to make a comment unless a HCP and urgent attention is required by your health care professionals.
D.

 

[Dark Horse]

1. Was the sample non-fasting? (It has little effect on cholesterol measurement but could affect your triglyceride results, particularly on a high fat diet.)
2. Never trust a single blood test - make sure the tests are repeated to rule out laboratory error.
3. Agree with @lindisfel - you need to be seen by a specialist in the field.

 

[Colin of Kent]

1. Was the sample non-fasting? (It has little effect on cholesterol measurement but could affect your triglyceride results, particularly on a high fat diet.)
2. Never trust a single blood test - make sure the tests are repeated to rule out laboratory error.
3. Agree with @lindisfel - you need to be seen by a specialist in the field.

I fasted until lunchtime most days last week, so I think it was a fasting test, but couldn't be absolutely sure.

 

[Colin of Kent]

If I have done my sums right your trigs to HDL ratio is 0.88. The recommended target is <1.0 and the ideal is 0.87, so you're good on that but your total is higher than the current recommendation of <5.
Is there a history of FH (Familial Hypercholesterolaemia) in your family?
A decent GP would refer you to a lipidologist for further investigations but expect the talk on statin treatment at the very least. Good luck.

No history of FH that I know of, no. I doubt it's a genetic thing anyway, more likely high fat diet.

From what little I've read so far (including this), it seems it's not as clear-cut as 'high = bad'. I know that cholesterol is an essential bodily substance, and I know I need to find out more about it and my situation!

 

[LittleGreyCat]

Have you been losing weight at all? Perhaps quite quickly?

If you are burning up your own body fat that can sometimes mess with your lipid readings.

That said, your LDL is remarkably high, so probably best to have another test and make sure that it is fasting.

 

[Guzzler]

No history of FH that I know of, no. I doubt it's a genetic thing anyway, more likely high fat diet.

From what little I've read so far (including this), it seems it's not as clear-cut as 'high = bad'. I know that cholesterol is an essential bodily substance, and I know I need to find out more about it and my situation!

I agree, a repeat test is essential and a further investigation if the repeat result warrants it. Always a good idea to learn more about what may affect one's health.

 

[Brunneria]

Wot they all said!

Second test, and see a doc, and ask for a referral to a lipid clinic.
My personal view is that your results are far enough out of the norm that you should get a referral whether you want to go the statins route or not.
And I would suggest you have a look at your way of eating. Not suggesting that you are doing anything wrong, but more so that if you are challenged on it by your doc or the lipidologist (not even sure if lipidologists are a thing) then you will be able to explain what you are doing, and why, and have a sensible conversation with them, rather than them just telling you Low Fat is The Way to Go! (it may be, in your case, I don't know, but you want a sensible discussion about it, not just being ordered about).

 

[bulkbiker]

I fasted until lunchtime most days last week, so I think it was a fasting test, but couldn't be absolutely sure.

Had you fasted for the recommended 10-12 hours before the test? Or even longer?
Longer fasts pre blood drawer have been shown to have a significant impact of cholesterol levels.
Would I be correct in thinking that you are fairly slim? You could well turn out to me a Lean Mass Hyper Responder (LMHR) Dave Feldman has evidence of quite a few people who exhibit raised LDL when following a keto way of eating.
Have you checked out www.cholesterolcode.com ? You may find it interesting.

 

[Colin of Kent]

Had you fasted for the recommended 10-12 hours before the test? Or even longer?
Longer fasts pre blood drawer have been shown to have a significant impact of cholesterol levels.
Would I be correct in thinking that you are fairly slim? You could well turn out to me a Lean Mass Hyper Responder (LMHR) Dave Feldman has evidence of quite a few people who exhibit raised LDL when following a keto way of eating.
Have you checked out www.cholesterolcode.com ? You may find it interesting.

Thanks for that. I hadn't been told to fast, but by good fortune, I did fast (just checked mySugr records), for about 15 hours. I also had a look on ketogenicforums.com, and quickly came across posts about LMHR's and links to cholesterolcode.com. I am ideed slim, and always have been.

So now I'm mainly concerned about the elevated triglyceride level, as it was a fasting test. But I don't know my pre-keto level, so I've no easy way of knowing if it's actually increased.

I also agree with you, @Brunneria -- stay informed to stay ahead. Lots more reading to do tonight and tomorrow! Clinic is on Wednesday!

 

[Colin of Kent]

Okay, well I've read as much as I can for now and have decided to call it a night. It seems like maybe I don't need to panic after all. Worrying doesn't actually achieve anything, of course. But I still think my triglycerides are too high...

 

[Guzzler]

Okay, well I've read as much as I can for now and have decided to call it a night. It seems like maybe I don't need to panic after all. Worrying doesn't actually achieve anything, of course. But I still think my triglycerides are too high...

Good luck at the clinic.

 

[Colin of Kent]

Quick update: doctor is really pleased with my numbers overall, congratulated me on getting my HbA1c down so much and happy with my CGM graphs. Happy that my HDL has gone up, too. He was very reassuring, and said he wasn't concerned about the triglycerides. Nor is he concerned about the total level in the short term, but would like to see it come down in the longer term.

Thanks all for your input.

 

[bulkbiker]

Quick update: doctor is really pleased with my numbers overall, congratulated me on getting my HbA1c down so much and happy with my CGM graphs. Happy that my HDL has gone up, too. He was very reassuring, and said he wasn't concerned about the triglycerides. Nor is he concerned about the total level in the short term, but would like to see it come down in the longer term.

Thanks all for your input.

Wow an enlightened doc... well done for finding them.

 

[Colin of Kent]

Wow an enlightened doc... well done for finding them.

I know! He is one of the more open-minded consultants I've had, and I'm lucky to have been seeing him for nigh on a decade now. It gets even better, though: when I asked for repeat lipids, I also requested an NMR to differentiate my LDL types; he laughed and said 'I knew you were going to ask me that!' And apparently, the head of the lab is a biochemist with a keen interest in lipids! The sun is indeed smiling...

 

[bulkbiker]

I know! He is one of the more open-minded consultants I've had, and I'm lucky to have been seeing him for nigh on a decade now. It gets even better, though: when I asked for repeat lipids, I also requested an NMR to differentiate my LDL types; he laughed and said 'I knew you were going to ask me that!' And apparently, the head of the lab is a biochemist with a keen interest in lipids! The sun is indeed smiling...

Wow I'm moving to Kent immediately!

 

[Colin of Kent]

Wow I'm moving to Kent immediately!

Haha! I'm in Somerset, actually. I originate from Kent, south of the Medway, hence I'm a 'Man of Kent' (not a Kentish Man).

 

[bulkbiker]

Haha! I'm in Somerset, actually. I originate from Kent, south of the Medway, hence I'm a 'Man of Kent' (not a Kentish Man).

Ok not a problem...

 

[librarising]

If I have done my sums right your trigs to HDL ratio is 0.88.

I'm posting merely to help you next time
Trigs/HDL is essentially a fraction where the trigs appear above the dividing line, and HDL below it, so the relevant figures are
3.5/3.1 or 1.13. That fraction is still okay as a result.
Geoff