Type 2 Lipid Clinic

[connie104]

After an appointment with the diabetic doctor at my new doctors today she was very pleased with my results of 41 but not so pleased about my cholesterol of 6.4.
After the usual conversation regarding statins which I refused yet again pointing out it's marked on my medical records that I cannot tolerate them she then decided I should be referred to the Lipid Clinic as they have other options they can prescribe which are only available from the consultant such as Repatha a weekly injectable.
I did argue that in women over 65 it's beneficial to have slightly higher cholesterol but she said yes but you have had 2 strokes and have diabetes so much higher risk. Still tried to get me on a low dose of statins but in the end agreed to the lipid Clinic so we shall see what they say !

 

[Bluetit1802]

It should be very interesting!

Did you discuss your lipid breakdown and ratios with the doctor? Or was she simply looking at the 6.4? NICE have now changed the goalposts and have asked doctors to look at the Non-HDL level, and experts consider it is the Trigs/HDL ratio that is crucial (should be under 0.87mmol/l) and also the Total/HDL ratio (should be under 4)

Very well done on the HbA1c.

 

[connie104]

It was a non fasting test so only total figure of cholesterol.
I am quite looking forward to the Lipid Clinic as I never knew the existed !

 

[Bluetit1802]

It was a non fasting test so only total figure of cholesterol.
I am quite looking forward to the Lipid Clinic as I never knew the existed !

Well your test was completely inadequate, doesn't follow NICE guidelines, and is meaningless. The total includes all the good cholesterol as well as the not so good,

I hope the lipid clinic can do a better job.

I have a feeling that @DCUKMod has been to such a clinic. Apologies to her if I am wrong.

 

[librarising]

experts consider it is the Trigs/HDL ratio that is crucial (should be under 0.87mmol/l)

Err, that's not a ratio. Want to try again ? Not picking you up. Simply don't want @connie104 confused.
Geoff

 

[Bluetit1802]

Err, that's not a ratio. Want to try again ? Not picking you up. Simply don't want @connie104 confused.
Geoff

I'm afraid I don't understand. In what way isn't it a ratio?

 

[Daibell]

Yes, the test needs to be fasting one and the ratios are the important numbers.

 

[librarising]

I'm afraid I don't understand. In what way isn't it a ratio?

A ratio compares two numbers, so trigs of 2 mmol/L and HDL of 1 mmol/L gives a ratio of 2:1 or 2. It isn't expressed in mmol/L
Geoff

 

[bulkbiker]

After an appointment with the diabetic doctor at my new doctors today she was very pleased with my results of 41 but not so pleased about my cholesterol of 6.4.
After the usual conversation regarding statins which I refused yet again pointing out it's marked on my medical records that I cannot tolerate them she then decided I should be referred to the Lipid Clinic as they have other options they can prescribe which are only available from the consultant such as Repatha a weekly injectable.
I did argue that in women over 65 it's beneficial to have slightly higher cholesterol but she said yes but you have had 2 strokes and have diabetes so much higher risk. Still tried to get me on a low dose of statins but in the end agreed to the lipid Clinic so we shall see what they say !

Well you could argue that with the HbA1c result of 41 you aren't even prediabetic....

 

[connie104]

Just had another look at results and I thought it was non fasting as I was not ask to fast so here is the break down

 

[Bluetit1802]

A ratio compares two numbers, so trigs of 2 mmol/L and HDL of 1 mmol/L gives a ratio of 2:1 or 2. It isn't expressed in mmol/L
Geoff

Ah ..... I used the mmol/l because these are the units we use for triglycerides in the UK. Many of the websites talking about the value of this ratio are from the US who use different units, and the target ratio shown on these sites is different. I wanted to show that the 0.87 was arrived at using the UK units.

 

[Bluetit1802]

The standards are:

Triglycerides under 1.7
HDL 1.2 to 3.5
LDL under 3
Total/HDL ratio under 4
Non HDL under 3.4
Trig/HDL ratio under 0.87

Your ratio of trigs to HDL is 0.75.

If you didn't fast, your trigs score could have been inaccurate and higher than had you fasted.

 

[DCUKMod]

Well your test was completely inadequate, doesn't follow NICE guidelines, and is meaningless. The total includes all the good cholesterol as well as the not so good,

I hope the lipid clinic can do a better job.

I have a feeling that @DCUKMod has been to such a clinic. Apologies to her if I am wrong.

Some time ago, I was offered a referral to a Lipidologist, based on my total cholesterol, but I deferred a decision as I was going overseas for a few months. When I came back my GP no longer considered it necessary for a couple of reasons.

 

[librarising]

Ah ..... I used the mmol/l because these are the units we use for triglycerides in the UK. Many of the websites talking about the value of this ratio are from the US who use different units, and the target ratio shown on these sites is different. I wanted to show that the 0.87 was arrived at using the UK units.

A ratio doesn't give values, and the same ratio will have different trigs and HDL amounts. US or UK is irrelevant.
If I said aim for a fat/carbs ratio of 2, I'm not giving you amounts, only relative amounts.
Good to see those results above give a ratio of 0.75
Geoff

 

[librarising]

The standards are:

Triglycerides under 1.7
HDL 1.2 to 3.5
LDL under 3
Total/HDL ratio under 4
Non HDL under 3.4
Trig/HDL ratio under 0.87

Your ratio of trigs to HDL is 0.75.

If you didn't fast, your trigs score could have been inaccurate and higher than had you fasted.

I've not seen this 0.87 standard for trigs/HDL before. Will have to hunt it down.
Geoff

 

[Bluetit1802]

A ratio doesn't give values, and the same ratio will have different trigs and HDL amounts. US or UK is irrelevant.
If I said aim for a fat/carbs ratio of 2, I'm not giving you amounts, only relative amounts.
Good to see those results above give a ratio of 0.75
Geoff

http://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/

The TG/HDL-C ratio can easily be calculated from the standard lipid profile. Just divide your TG by your HDL-C.

However, when looking at the ideal ratio, you have to check if your lipid values are provided in mg/dl like in the US or mmol/L like in Australia, Canada, and most European countries.

If lipid values are expressed as mg/dl (like in the US);

TG/HDL-C ratio less than 2 is ideal

TG/HDL-C ratio above 4 is too high

TG/HDL-C ratio above 6 is much too high

If you are using mmol/L (most countries except the U.S.) you have to multiply this ratio by 0.4366 to attain the correct reference values. You can also multiply your ratio by 2.3 and use the reference values above.

If lipid values are expressed as mmol/L (like in Australia, Canada, and Europe);

TG/HDL-C ratio less than 0.87 is ideal

TG/HDL-C ratio above 1.74 is too high

TG/HDL-C ratio above 2.62 is much too high

 

[librarising]

http://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/

The TG/HDL-C ratio can easily be calculated from the standard lipid profile. Just divide your TG by your HDL-C.

However, when looking at the ideal ratio, you have to check if your lipid values are provided in mg/dl like in the US or mmol/L like in Australia, Canada, and most European countries.

If lipid values are expressed as mg/dl (like in the US);

TG/HDL-C ratio less than 2 is ideal

TG/HDL-C ratio above 4 is too high

TG/HDL-C ratio above 6 is much too high

If you are using mmol/L (most countries except the U.S.) you have to multiply this ratio by 0.4366 to attain the correct reference values. You can also multiply your ratio by 2.3 and use the reference values above.

If lipid values are expressed as mmol/L (like in Australia, Canada, and Europe);

TG/HDL-C ratio less than 0.87 is ideal

TG/HDL-C ratio above 1.74 is too high

TG/HDL-C ratio above 2.62 is much too high

I'd literally just tracked that down (thanks Google). US/UK does matter (my bad)
0.87 is a not a standard. Those figures seem to make between 0.87 and 1.74 'standard'.
The lower the ratio, the fewer small LDL particles.
Geoff (been balancing this forum with entertaining a guest. Just taking him home)

 

[Bluetit1802]

I'd literally just tracked that down (thanks Google). US/UK does matter (my bad)
0.87 is a not a standard. Those figures seem to make between 0.87 and 1.74 'standard'.
The lower the ratio, the fewer small LDL particles.
Geoff (been balancing this forum with entertaining a guest. Just taking him home)

Yes, there is no official standard, but as you say, the lower the better, and the lower the more good cholesterol there is in your LDL.

 

[connie104]

Just a quick update I have today finally received my appointment for the Lipid Clinic on 20th September.
Before going I have to have a series of blood tests (fasting) and Urine as well no later than 6th September.
Looking at the form sent for tests they want thyroid tested as well. Would high cholesterol be linked to thyroid problems ?
Just one more thing to worry about. Will update after the appointment.

 

[CathP]

I believe low thyroid can cause high cholesterol, so they'll want to check that out. We've got lipid clinic next month as well, for my 6 year old t1.