1

votes

Will you please hack my lab results?

Commented on April 29, 2012
Created April 23, 2012 at 10:32 PM

I have been pretty hard core Paleo since the beginning of the year (so almost 5 months). My primary cheat has been beer (off and on). I do eat a lot of fruit and nuts. I am also not perfect at getting pasture raised meats although I do eat a lot of pastured buffalo. I have dropped about 20lbs and feel pretty awesome. I am currently 6'1" and about 212lbs.

I recently got a comprehensive set of labs done and I would love to know your thoughts on the results. Overall I think I am doing pretty well but I would like to know more.

There were a couple areas that the doctor who analyzed them thought I could improve. I have also included some of the results from before going Paleo.

Thank you for your help.

Lipids
Total Cholesterol (mg/dL) 168 (was 203)
LDL-C Direct (mg/dL) 81 (was 112)
HDL-C (mg/dL) 61 (was 62)
Triglycerides (mg/dL) 42 (was 145)
Non-HDL-C (mg/dL)(calculated) 107

Lipoprotein Particles and Apolipoproteins
Apo B (mg/dL) 68 *Intermediate Risk Range
LDL-P (nmol/L) 1202 *Intermediate Risk Range
Apo A-I (mg/dL) 154
HDL-P (??mol/L) 35.4
Apo B:Apo A-I Ratio(calculated) 0.44
Lp(a) Mass (mg/dL) 4

Inflammation/Oxidation
Myeloperoxidase (pmol/L) 344
Lp-PLA2 (ng/mL) 272 *High
hs-CRP (mg/L) 2.6 *Intermediate Risk Range
Fibrinogen (mg/dL) 413 *Intermediate Risk Range

Myocardial Stress
NT-proBNP (pg/mL) 5
Galectin-3 (ng/mL) 9.2

Platelets
AspirinWorks?? (urine) pg/mg of creatinine) 1841 *High - Doc thinks I should take aspirin daily

Metabolic
Insulin (??U/mL) 3
Free Fatty Acid (mmol/L) 0.50
Glucose (mg/dL) 96 (was 88)
HbA1c (%) 5.2
Estimated Average Glucose (mg/dL) (calculated) 102.5
25-hydroxy-Vitamin D(ng/mL) 53
Uric Acid (mg/dL) 7.8
TSH (??lU/mL) 1.88
Homocysteine (??mol/L) 10
Adiponectin (??g/mL) 8

Renal
Cystatin C (mg/L) 0.79
Estimated Glomerular Filtration Rate (eGFR, mL/min/1.73m2) 133
Microalbumin (urine) (mg albumin/g of creatinine) 4
Creatinine, serum (mg/dL) 1.2

Sterol Absorption Markers
Campesterol (??g/mL) 1.82
Campesterol Ratio (102 mmol/mol Cholesterol) 105
Sitosterol (??g/mL) 2.55
Sitosterol Ratio (102 mmol/mol Cholesterol) 142
Cholestanol (??g/mL) 2.72
Cholestanol Ratio (102 mmol/mol Cholesterol) 161

Sterol Synthesis Markers
Desmosterol (??g/mL) 0.88
Desmosterol Ratio (102 mmol/mol Cholesterol) 53

Other Biomarkers
Albumin (g/dl) 5.0
ALP (U/L) 61
ALT / GPT (U/L) 22
AST / GOT (U/L) 25
BUN (mg/dl) 24
Calcium (mg/dL) 9.8
Cl- (mmol/L) 105
CO2 (mmol/L) 22
K+ (mmol/L) 5.0
PSA (ng/mL) 0.8
Na+ (mmol/L) 145
Total Bilirubin (mg/dL) 0.8
Total Protein (g/dL) 7.1

Particle Concentration and Size
HDL-P (total) 35.4
LARGE VLDL-P nmol/L < 0.7
SMALL LDL-P nmol/L 424
LARGE HDL-P ??mol/L 7.2
LDL SIZE nm 21.0
HDL SIZE nm 9.3
LP-IR SCORE* 20

HS-Omega-3 Index?? (RBC EPA+DHA) 8.5

Omega-3 Fatty Acids
Omega-3 Total 11.7%
Alpha-Linolenic (ALA) < 0.1%
Docosapentaenoic (DPA) 3.2%
Eicosapentaenoic (EPA) 2.2%
Docosahexaenoic (DHA) 6.3%

Omega-6 Fatty Acids
Omega-6 Total 29.8%
Arachidonic (AA) 14.9%
Linoleic (LA) 10.9%

Other Fatty Acids
cis-Monounsaturated Total 16.1%
Saturated Total 41.8%
Trans Total 0.5%

3c6b4eed18dc57f746755b698426e7c8

(5147)

on April 29, 2012
at 01:45 AM

One other question I have is how much you had to shell out to pay for these tests, or did your insurance cover? These are extensive tests and most PCPs wouldn't think of ordering even half of them, as they would be completely clueless.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on April 24, 2012
at 06:24 PM

Coronary calcium? That would be helpful but more important is whither your inflammation? Your family members had heart attack while young (>60)? Before doing Paleo, were u obese/overweight? That could explain legacy inflammation (CRP/LE) but there is CVD-specific inflammation your doc is zeroing in on. If you have hypothyroid symptoms, I would get thyroid antibodies (TPO/TG) and FT3, Rev T3, T4 checked. Plus check ANA for sore joints.

77877f762c40637911396daa19b53094

(78467)

on April 24, 2012
at 05:57 PM

@Namby Pamby - I am scheduled to have a scan done that looks for plaque build up, I can't remember what it is called. I am already taking 5 to 6 mg of fish oil a day. The doc did mention fish oil when he saw my Omega-3 numbers. Blood pressure is normal. We have some CVD in my family but I always assumed that was due to a poor diet and little exercise. I figure that is pretty typical. What are WBCs? Once again, thank you very much for you help.

77877f762c40637911396daa19b53094

(78467)

on April 24, 2012
at 05:52 PM

@Namby Pamby - Also, there was no hypothesis to confirm, this was my first visit to this doctor. I was looking for someone who focused on preventative and blood work. Thank you guys so much for taking the time to help me analyze these results. It is extremely helpful.

77877f762c40637911396daa19b53094

(78467)

on April 24, 2012
at 05:50 PM

@Namby Pamby & Blitherakt - Doc used Health Diagnostic Laboratory. Their site, myhdl.com lets you see your results and trends from one test to the other. I specifically asked for a very detailed test to see how paleo was treating me. Inflammation was a little high and that was one reason for the aspirin. No gout but he did mention this was a risk marker. Definitely not restricting protein... eat all that I can. Not sure about GFR, I'm 43 and white. What is GFR anyway? I am wondering what the inflammation could be from? Over training? Stress? I'm not eating any grains, legumes or dairy.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on April 24, 2012
at 06:25 AM

I've a feeling his doc may have ordered this to confirm his hypotheses. This is why focusing only on cholesterol to manage CVD risk is like looking at an iceberg: you do not know what you're missing. Cholesterol accounts for less than 50% of CVD risk; now I believe it's probably less than 25%.

A4216f1b1e1f5ab3815bd91700905081

(1646)

on April 24, 2012
at 06:04 AM

I have no idea how to interpret that, but I have to ask: did you ask for such a detailed analysis, or does your doctor do that standard? I'm going to use this list as a blueprint for my next draw...

3c6b4eed18dc57f746755b698426e7c8

(5147)

on April 24, 2012
at 04:21 AM

What lab did you use. Is this from a single blood draw? These are good numbers for the most part but you do have some legacy evidence of preexisting inflammation. Crp too high (but it should come down). Fibrinogen too high: that's why doc wants aspirin therapy. Homocystein a bit high. Liver enzymes should be in the teens. Uric acid high-normal (do u have gout)? High BUN / creatinine -- you're not restricting protein. How could your GFR be 133? Are you barely 20? African American?

  • 77877f762c40637911396daa19b53094

    asked by

    (78467)
  • Views
    3.5K
  • Last Activity
    2121D AGO
Frontpage book

Get FREE instant access to our Paleo For Beginners Guide & 15 FREE Recipes!

2 Answers

0
3c6b4eed18dc57f746755b698426e7c8

on April 24, 2012
at 05:59 AM

You seem to have issues with inflammation. Your cholesterol numbers are good for the most part but there are other risk factors that shape your CVD risk. While u have no IR, your issue seems to be inflammation related to blood coagulation: Combined this with high and high normal fibrinogen, homocysteine, crp and, especially, Lp-PLA2. This makes me a bit uneasy and I think you should follow up with a competent cardiologist, if you haven't.

Your cholesterol #s are fine on paper. But looking at total cholesterol and components is like judging a used car without looking under the hood. There are other things matter.

Did your doc ever mention using fish oil perhaps in addition to aspirin? How's your blood pressure and family history of CVD? Also, check low-normal WBCs to see if your inflammation source could be elsewhere.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on April 24, 2012
at 06:24 PM

Coronary calcium? That would be helpful but more important is whither your inflammation? Your family members had heart attack while young (>60)? Before doing Paleo, were u obese/overweight? That could explain legacy inflammation (CRP/LE) but there is CVD-specific inflammation your doc is zeroing in on. If you have hypothyroid symptoms, I would get thyroid antibodies (TPO/TG) and FT3, Rev T3, T4 checked. Plus check ANA for sore joints.

77877f762c40637911396daa19b53094

(78467)

on April 24, 2012
at 05:57 PM

@Namby Pamby - I am scheduled to have a scan done that looks for plaque build up, I can't remember what it is called. I am already taking 5 to 6 mg of fish oil a day. The doc did mention fish oil when he saw my Omega-3 numbers. Blood pressure is normal. We have some CVD in my family but I always assumed that was due to a poor diet and little exercise. I figure that is pretty typical. What are WBCs? Once again, thank you very much for you help.

0
A1a7413b99e03bc77f02d95c4170ea43

on April 23, 2012
at 11:35 PM

I'm by no means a doctor, but things look pretty good here. You said you're feeling "pretty awesome" and you're down 20lbs. Your lipid markers are all improved (HDL varying by 1 point means nothing, really). What else do you need? Sounds like you're in good shape to me.

You also said that you're still drinking beer (which contains gluten, alcohol, and mucho carbohydrates) and eating lots of fruit. So if you want to get things even better, cut out the beer and reduce the fruit. See what happens. Like I said, I'm no doctor, so I don't know about the rest of the results. But I don't think that taking aspirin everyday would be considered healthy, can someone else chime in here? I know that some people need medication, but is this really a good idea? In Robb Wolf's book he lists some important test and what he considers ideal. Check that out.

Otherwise, keep it up. If you're eating as good as you can, then leave it at that and don't fret about the numbers. If you want to change more, then tweak your diet more. That's my two cents, anyway.

Answer Question


Get FREE instant access to our
Paleo For Beginners Guide & 15 FREE Recipes!