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Question about recent bloodwork

Answered on August 19, 2014
Created July 10, 2012 at 3:32 PM

Looking over the results of my last four blood tests and I am curious to know if anyone can help me decipher them.

     Chol HDL LDL Tri A1C

7/2/12 (225) (31) (176) (92) (n/a)

5/4/12 (184) (27) (130) (123) (5.5)

1/20/12 (218) (30) (124) (318) (n/a)

9/16/11 (205) (31) (98) (382) (n/a)

So some basic history behind them is that I went on a "diet" on January 1st after tipping the scales at 275 and went full paleo in mid-March and I am down 55 pounds overall for the year. It is also a lower carb autoimmunity version since I had thyroid issues. I think that is why such the drop in Triglycerides occured. HDL has stayed about the same and I thought that would have increased a bit with all the extra exercise I have been getting. What is strange is my LDL increasing so much. I am actually waiting on the results of LDL particle size so see whether that is what the difference is from. My Vitamin D levels were at 42 ng/l in May (which is up from 11 in Septmeber) and I am still waiting on the current results. Any thoughts would be appreciated.

Thanks, Christian

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 10, 2012
at 05:34 PM

Obviously this is not medical advice, but I would suggest that the raise in your LDL is based more on how the linear formula calculates LDL than reality (i.e. a 74% drop in Trigs vs no change in TC or HDL). And your 9/11 and 1/12 were on the outer boundary and may have underestimated the LDL. You are doing the right thing by working with your doctor to get direct measurements and particle size measurements.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 10, 2012
at 05:33 PM

The 5/4 was the only one I didn't get the exact number for using the Friedwald calculation (I got 132) so that makes sense now. It's a bit more complicated than to directly state that the margin of error is greater. But it's a linear function, the closer you are to the boundaries the less accurate it will be.

0049ae7476c20478fb9a676ddcfde2c9

on July 10, 2012
at 05:06 PM

I did mean 9/16/11 and I edited it. So if my Triglycerides were 92 then the error margin is greater? Looking at the results it stated the measurements for the 5/4/12 were done with this (Lab Test: LDL Cholesterol Direct) while it seems as though the 7/2/12 was the calculated version.

61844af1187e745e09bb394cbd28cf23

(11058)

on July 10, 2012
at 03:45 PM

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3 Answers

1
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 10, 2012
at 04:53 PM

Christian,

I believe that your problem is that your doctor (or the lab) is relying on the Friedewald formula for estimating LDL rather than directly measuring LDL. Here's a link to help you get started - http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

Essentially estimated LDL levels, using the Friedewald formula, is relatively accurate (and cheap for the insurance companies) for people with Trig levels between 110 mg/dL and 400 mg/dL. It becomes increasingly inaccurate on either side of those bounds. The Iranian formula may provide a better estimate in the outer bounds, however there is still a large variance. Getting a direct measurement of LDL levels would be your best option. But, for your information, your LDL estimates, using the Iranian formula, would be (171, 156, 285, 307).

Also, for my own clarification you mean 9/16/2011 right?

0049ae7476c20478fb9a676ddcfde2c9

on July 10, 2012
at 05:06 PM

I did mean 9/16/11 and I edited it. So if my Triglycerides were 92 then the error margin is greater? Looking at the results it stated the measurements for the 5/4/12 were done with this (Lab Test: LDL Cholesterol Direct) while it seems as though the 7/2/12 was the calculated version.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 10, 2012
at 05:33 PM

The 5/4 was the only one I didn't get the exact number for using the Friedwald calculation (I got 132) so that makes sense now. It's a bit more complicated than to directly state that the margin of error is greater. But it's a linear function, the closer you are to the boundaries the less accurate it will be.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 10, 2012
at 05:34 PM

Obviously this is not medical advice, but I would suggest that the raise in your LDL is based more on how the linear formula calculates LDL than reality (i.e. a 74% drop in Trigs vs no change in TC or HDL). And your 9/11 and 1/12 were on the outer boundary and may have underestimated the LDL. You are doing the right thing by working with your doctor to get direct measurements and particle size measurements.

0
874ff271ca3379984344d5f9f760fec3

on January 26, 2013
at 11:45 AM

Fantastic job lowering those trigs! (this is FAR more important than TC) While losing weight a NMR wont help much. Of course you'll have elevated particle counts and TC until your mass stabilizes.

Chasing a cholesterol number is like chasing your tale. Hammer down trigs and sugar with a low-carb diet. Once you've reached a stable weight for a few months, THEN start looking at lipids.

The Five Key Things You Can Do to Lower LDL Cholesterol Healthfully

0
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on November 17, 2012
at 02:55 AM

Your cholesterol components might show that you react to saturated fat in dairy, eggs, beef, etc. That's the old ApoE story. But the high LDL could also be due to your thyroid dysfunction. Or to the temporary LDL increase as its particle size increases. They're myriad possiblities.

At this stage, the numbers are largely meaningless since you are probably not done losing weight. They're in a state of flux. It's a waste of time and money to get a particle size test. Besides, it's correlated to your Triglycerides. And it's an outmoded method of judging LDL risk anyway.

Wait a while. Let your weight stabilize. After you've gone through some hair loss and when your thyroid medication is optimally calibrated. Then take a look at your blood test and and let your TC components fall where they may.

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