I Goofed up.......

Oldvatr · Oct 15, 2020

Just had my annual MOT, and Doc is not happy.

My HbA1c was 40, down from 42 last year, and he says he wants me up around 50 because I must be getting hypo's galore at that reading. I thought he understood LC and keto, but he is treating me like an Insulin patient. I have and will push back on this since I am happy with 40.

More worrying is the annual chitchat about cholesterol. This year my TC was raised ( up to 7.7 from 7.3 last year), My HDL was 1.8, my LDL was 4.8, and my Trigs were 2.5 (all in mmol/l) My TC./HDL ratio was 4.3

I have been following an LC diet with added fat, and it is much the same as I had been following from the previous year. I am not sure why the figures have worsened like they have this time, I am not going low enough for much in the way of keto to occur, but I have done in the past. One difference this year is that last year was a non fasting blood test, and this year it was an 18 hour fasting test. I am wondering if my liver put me into fat burning mode for the test, and the LDL responded, but the HDL remained where it was. I am about to repeat the blood letting event next week and propose to do a non fasting test instead just to see. However the Trig value is still atrocious so not sure how to deal with that one.

The repeat was necessary since my other parameters show that I was either in terminal kidney decline, or possibly I was dehydrated. I have stopped my diuretic med since my sodium level was also low so we shall see. I hope it is a case of throwing the baby out with the bathwater. I wonder if being dehydrated might have affected my cholesterol panel, but can't see why it would. However, the good news is that I am no longer anemic.

Just to cap things off, I have stopped my Gliclazide medication, and my sugar levels since have remained in the ballpark so I was probably correct in surmising it was no longer doing anything for me,

Edit to add: Just consulted Dr Google, and it seems high trigs can be caused by diuretics, steroids and Beta Blocker meds which am taking for the other condition. So now I know. One major cause of trigs is of course a high carbohydrate diet, which is not applicable in my case.

bulkbiker · Oct 15, 2020

I'll stab at a guess that your 18 hour fast pushed up your trig number..
My last test followed an upset tum period where I hadn't eaten much for 5 days and trigs certainly went up too.
Fat burning for energy would imply that more trigs would be circulating.. might be that you are more dynamic than most with trig increases.
Feldman et al suggest 12-14 hours as the fasted state sweet spot. Non-fasted could push the figures either way depending on what you have had before the blood draw.

lessci · Oct 15, 2020

I must admit to "fool" the lipids blood test I restrict my fat for 3-4 days before hand, loads of fish and low carb veg, HDL 1.1 Trigs 1.9 estimated LDL 3.6 at my last test

Lamont D · Oct 15, 2020

We are not all perfect like me! And I'm modest as well!

Did you drink enough water before the test?
I say this, because my liver was giving up and down results.
The answer was drinking up to 2 litres of water if fasting for a test which I must do before all my blood panel tests.
My cholesterol levels were not perfect but enough to be slightly up but of no concern.

Keep safe

ziggy_w · Oct 15, 2020

Hi @Oldvatr,

Maybe this article is helpful. (Personally, I found this really interesting as I suffer from white coat syndrome.) The way I understand it is that stress leads to a decrease in blood volume (due to dehydration), which again leads to increases in blood lipids. https://pubmed.ncbi.nlm.nih.gov/8310113/ Is it possible that fasting for 18 hours increased stress levels?

DavidGrahamJones · Oct 15, 2020

Oldvatr said:
I have stopped my Gliclazide medication, and my sugar levels since have remained in the ballpark so I was probably correct in surmising it was no longer doing anything for me,

That's interesting, good though.

Oldvatr · Oct 15, 2020

ziggy_w said:
Hi @Oldvatr,

Maybe this article is helpful. (Personally, I found this really interesting as I suffer from white coat syndrome.) The way I understand it is that stress leads to a decrease in blood volume (due to dehydration), which again leads to increases in blood lipids. https://pubmed.ncbi.nlm.nih.gov/8310113/ Is it possible that fasting for 18 hours increased stress levels?

Could well be since my haematocrit was indeed raised because I had high levels of creatinine due to a high red meat protein diet and/or dehydration (i.e. low plasma volume was dx'ed) Think stopping the diuretic should help. Will do your trick of drinking before the test, but must be careful since I will not have access to a loo due to the practice being closed for business, and the blood draw taking place in the carpark in a lean to tent thingy.

Oldvatr · Oct 15, 2020

DavidGrahamJones said:
That's interesting, good though.

Worrying since it may indicate that my pancreas cannot be squeezed any more. On the other hand it may be that I am running at max insulin 24/7 But my bgl is not rising, and I am able to eat some carbs without blushing. I am up to 2 slices of toast a day now. Last night I had a whole bag of kippers on one slice of toast, and my 3 readings were all 4.7 and this is 1 week after stopping the Glic

Dr Snoddy · Oct 15, 2020

Did your 18 hour fasting test include black coffee by any chance?

Oldvatr · Oct 15, 2020

Dr Snoddy said:
Did your 18 hour fasting test include black coffee by any chance?

Immaterial, my bgl read 3,6 when I got home so definitely in ketoland. Anyway I use instant coffee so caffeine is not a factor as far as I know. I am also not convinced by that report the other day since it was very poor analysis.

Tophat1900 · Oct 16, 2020

I would have to speculate that the 18 hr fast and potential dehydration do warrant the repeat. Dehydration can skew levels. And so can a few drugs like you have mentioned. I'd do the fasted one if it were me and fast for 12 hr if possible. I don't think a non fasted one would help with the thing you seem most concerned with, the trigs.

Your doc wants you up around 50?.... wow, just lunacy.

Andydragon · Oct 16, 2020

Tophat1900 said:
Your doc wants you up around 50?.... wow, just lunacy.

My doctor was absolutely thrilled with 39. Why would any doctor have a problem with 40? Absolute madness as you say

DCUKMod · Oct 16, 2020

Tophat1900 said:
I would have to speculate that the 18 hr fast and potential dehydration do warrant the repeat. Dehydration can skew levels. And so can a few drugs like you have mentioned. I'd do the fasted one if it were me and fast for 12 hr if possible. I don't think a non fasted one would help with the thing you seem most concerned with, the trigs.

Your doc wants you up around 50?.... wow, just lunacy.

Andydragon said:
My doctor was absolutely thrilled with 39. Why would any doctor have a problem with 40? Absolute madness as you say

Certainly not wanting to speak for @Oldvatr , who is perfectly able to state his case, but until very recently Oldvatr was taking Gliclazide, which can cause hypos. Oldvatr has also had some significant health challenges in recent years, and probably wouldn't need the physical stress of a bad hypo, were they happening.

Now, we can all have a view on that, but of course, that could be the very reason Oldvatr has come off the Gliclazide.

I'm sure the man will speak more eloquently for himself.

Tophat1900 · Oct 16, 2020

DCUKMod said:
Certainly not wanting to speak for @Oldvatr , who is perfectly able to state his case, but until very recently Oldvatr was taking Gliclazide, which can cause hypos. Oldvatr has also had some significant health challenges in recent years, and probably wouldn't need the physical stress of a bad hypo, were they happening.

Now, we can all have a view on that, but of course, that could be the very reason Oldvatr has come off the Gliclazide.

I'm sure the man will speak more eloquently for himself.

Yes, well aware of all that. And he does speak rather eloquently. I consider him the detective of the forum with his work on studies and his ability to dissect and detect bias.

Andydragon · Oct 16, 2020

DCUKMod said:
Certainly not wanting to speak for @Oldvatr , who is perfectly able to state his case, but until very recently Oldvatr was taking Gliclazide, which can cause hypos. Oldvatr has also had some significant health challenges in recent years, and probably wouldn't need the physical stress of a bad hypo, were they happening.

Now, we can all have a view on that, but of course, that could be the very reason Oldvatr has come off the Gliclazide.

I'm sure the man will speak more eloquently for himself.

Very fair points, thank you!

Daibell · Oct 16, 2020

Hi any GP who says 40 it too low and needs to be increased needs to stop dealing with diabetes patients.

Oldvatr · Oct 16, 2020

DCUKMod said:
Certainly not wanting to speak for @Oldvatr , who is perfectly able to state his case, but until very recently Oldvatr was taking Gliclazide, which can cause hypos. Oldvatr has also had some significant health challenges in recent years, and probably wouldn't need the physical stress of a bad hypo, were they happening.

Now, we can all have a view on that, but of course, that could be the very reason Oldvatr has come off the Gliclazide.

I'm sure the man will speak more eloquently for himself.

He would if only his stoopid 'pooter had not expired suddenly. Borrowing one and just managed to log in again. The GP is worried about hypo;s I am not. I have them on occasions, but on the dose of Glic I was on they were not challenges at all, and in the last 5 years of LC eating I have never needed any assistance. Even on 320 mg dose twice a day. I was taken off all diabetic meds after my incidents last year, but the operation I had placed me firmly back again in the cesspit. So I am working my way slowly and steadily out of the midden. I am still on a holding dose of Glic so that I still qualify for GP scrip assistance with test consumables, and the DVLA wrt driving a motor vehicle.

NicoleC1971 · Oct 16, 2020

Oldvatr said:
Just had my annual MOT, and Doc is not happy.

My HbA1c was 40, down from 42 last year, and he says he wants me up around 50 because I must be getting hypo's galore at that reading. I thought he understood LC and keto, but he is treating me like an Insulin patient. I have and will push back on this since I am happy with 40.

More worrying is the annual chitchat about cholesterol. This year my TC was raised ( up to 7.7 from 7.3 last year), My HDL was 1.8, my LDL was 4.8, and my Trigs were 2.5 (all in mmol/l) My TC./HDL ratio was 4.3

I have been following an LC diet with added fat, and it is much the same as I had been following from the previous year. I am not sure why the figures have worsened like they have this time, I am not going low enough for much in the way of keto to occur, but I have done in the past. One difference this year is that last year was a non fasting blood test, and this year it was an 18 hour fasting test. I am wondering if my liver put me into fat burning mode for the test, and the LDL responded, but the HDL remained where it was. I am about to repeat the blood letting event next week and propose to do a non fasting test instead just to see. However the Trig value is still atrocious so not sure how to deal with that one.

The repeat was necessary since my other parameters show that I was either in terminal kidney decline, or possibly I was dehydrated. I have stopped my diuretic med since my sodium level was also low so we shall see. I hope it is a case of throwing the baby out with the bathwater. I wonder if being dehydrated might have affected my cholesterol panel, but can't see why it would. However, the good news is that I am no longer anemic.

Just to cap things off, I have stopped my Gliclazide medication, and my sugar levels since have remained in the ballpark so I was probably correct in surmising it was no longer doing anything for me,

Edit to add: Just consulted Dr Google, and it seems high trigs can be caused by diuretics, steroids and Beta Blocker meds which am taking for the other condition. So now I know. One major cause of trigs is of course a high carbohydrate diet, which is not applicable in my case.

Interesting that steroids and BB mdes can cause hyper triglycerides. There's also genetics but with low insulin levels and good blood sugars that seems to rule out high carb.
Fasting ironically will push up LDL since this means as a fat burner there's a lot energy being ferried around your blood stream (hopefully the large fluffy type).
Are you going to test again to see what happens when the drugs aren't there?

Oldvatr · Oct 16, 2020

NicoleC1971 said:
Interesting that steroids and BB mdes can cause hyper triglycerides. There's also genetics but with low insulin levels and good blood sugars that seems to rule out high carb.
Fasting ironically will push up LDL since this means as a fat burner there's a lot energy being ferried around your blood stream (hopefully the large fluffy type).
Are you going to test again to see what happens when the drugs aren't there?

Re-test planned and booked, but I put the date into my 'Pooter that went PHUT!!! yesterday. Repairman says he has had to put it into an induced coma and the memory is wiped. Will need to consult the GP surgery next week for details, but, yes, it is in hand and I will not be doing fasting this time and the meds have gone. Unfortunately my Doc has prescribed statins for moi, which I will ignore for the moment.

I thought it was intersting about what also causes trigs, and since I am male the estrogene/progesterone link seemed immaterial, but was also in that list. without my 'pooter I am not able to get that website back yet, but think it was Medscape or Healthline. You echoed my thoughts about the fasting too long may have influenced the TC, but probably not the ratio. But I am no expert in this, which is why I raised it.

DCUKMod · Oct 16, 2020

Oldvatr said:
He would if only his stoopid 'pooter had not expired suddenly. Borrowing one and just managed to log in again. The GP is worried about hypo;s I am not. I have them on occasions, but on the dose of Glic I was on they were not challenges at all, and in the last 5 years of LC eating I have never needed any assistance. Even on 320 mg dose twice a day. I was taken off all diabetic meds after my incidents last year, but the operation I had placed me firmly back again in the cesspit. So I am working my way slowly and steadily out of the midden. I am still on a holding dose of Glic so that I still qualify for GP scrip assistance with test consumables, and the DVLA wrt driving a motor vehicle.

Apologies, Oldvatr, I must have misread that you had dropped the Glic. I thought you meant all of it.

Computers going belly-up are frustrating. My laptop needed some attention the ther day too. Fortunately, I took it in and had it back the same day. I think it too me longer rebuilding my settings to the way I like them that it took to repair the machine.

Fingers crossed it's not too painful on the wallet for you.

I Goofed up.......

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