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High A1C, Low Trigs, high LDL - Mass confusion

Answered on August 19, 2014
Created March 30, 2012 at 4:32 PM

All,

Just got my labs back after being pretty strict paleo for about 4 to 5 months.

*Component Your Value*
CHOLESTEROL (LAB) 276 TRIGLYCERIDES 39
HDL CHOLESTEROL 85
LDL CHOLESTEROL, CALCULATED 183 VLDL CHOLESTEROL, CALCULATED 8 NON-HDL CHOLESTEROL 191

A1C Fasting 5.9%

My previous labs a year ago were a TC of about 180 and Trigs of 100, HDL of 61 or so.

I'm about 5'7", frequently crossfit and have bodyfat easily down in the single digits. I think th.e thing that concerns me the most is the A1C results. My carbs are 99% veggies and I don't eat many. I occasionally take my FBG and it varies form 83ish up to 100 sometimes and everwhere in between. Post meal (1 hour) is a 100 or less on the few occasions I've checked it. Also, I had a major surgery about 7 weeks ago (hernia repair, I'm all healed up and back in the gym, but it was 5 to 6 weeks of misery recovering).

I have an appointment to see a my paleo friendly dietician who is pretty money, so i think he'll help me sort this out (e.g. test my pattern a/b), but I wanted to get input from the group on the following.

  1. The A1C concerns me, could I be overdoing it with carb restriction? or do some people simply operate at a higher BG level and how reversible is this? Either way, this is my biggest concern.

    • Can too much sat fat (e.g. coconut oil) have an effect on BG?
  2. Tips on ways to lower LDL but keep the gains I've made on my nice low trigs, and good HDL numbers.

  3. I've exchanged my "chronic cardio" of yesteryear for more Crossfit and some low intensity walking, should I entertain a little bit more running/cycling/swimming again?

I realize this is a lot and some of these items have been discussed, but I'm freaking out a bit, so some input would be great! Also I'm trying to understand where the "one number fits all" plays into this.

Thanks!!!!!

Dea9ff82beb31797d2033d2c939ff65d

(0)

on March 31, 2012
at 04:17 PM

Thanks for the tip. I've started to hear that. I've grabbed my wife's finger pricker (she had gestational diabetes) and my BG seems to range from around 90 to 125 (fasting, 1-hour post-meal). I'm starting to become a bit skeptical of the A1C results which claim that my 3 month average BG is 133 (a number I have yet to get up to).

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6 Answers

1
4815ce60a36f08fb6878bb458c249034

on March 31, 2012
at 05:57 PM

Try this formula for calculating your ldl (LDL = TC/1.19 + TG/1.9 - HDL/1.1 - 38). Probably 130 or less, roughly calculating. The Friedewald formula the lab uses is not accurate if the trigs are over 400. The lab will not do the calculation in this case. Less commonly known is that the formula is not as accurate if the trigs are less than 100. It is probably bigger ldl, not more ldl. If you are losing weight, it may go down with wt loss.

Do you know where your a1c started? It lags behind other results, because it is related to the normal turnover of red blood cells. I don't think you can assume a 5.9 is related to long lived rbcs. If normal is 4 - 5.6, something other than lower blood sugar would have to explain the longer life of the rbcs. Somebody has to be in the 4s. It's because their sugar is normal. We are all a little different and that may be part of the equation, but more carbs is not likely the solution. Recently, I tried the "more carbs" approach, to see what my consistent 5.5 would do. In 2 months it was 6. The post meal recommendation of Kresser might be your best bet to know where you are right now, if you want to bother with it. I would guess, based on the changes in your lipids, your a1c started higher and is on the way to a better number. If you know your a1c was lower and it has gone up, that's a new ball game.

0
874ff271ca3379984344d5f9f760fec3

on December 06, 2012
at 10:19 AM

I know this thread is old but... Most likely your protein intake is too high. Your liver is converting too much protein to sugar. Less than 1g per kg of body weight if you are consuming less than 100 g Carbs daily.

Your HDL is to be envied by all...

0
Medium avatar

(10611)

on March 31, 2012
at 08:12 PM

My doctor was all over me when my A1C hit 8 and was happy when I got it down to 5.7. I'm happy with that. I don't feel it's useful to obsess over lab tests unless there's a real problem. My body's not superstock, just an old beater.

0
0d1dbb006a8d9d409663db4118c707e1

on March 31, 2012
at 07:42 PM

My cousin with similar problems told me that he found on http://cholesterol-lower.info/ the help for his problems.I heard the tips from here are very goo to combat cholesterol problems. I hope this helps.

0
Ff1dbd6cecad1e69a8234fb2c2c5c5ed

(1409)

on March 31, 2012
at 10:42 AM

Your red blood cells may live longer than average. You could get fructosamine checked to eliminate this confounding factor.

Dea9ff82beb31797d2033d2c939ff65d

(0)

on March 31, 2012
at 04:17 PM

Thanks for the tip. I've started to hear that. I've grabbed my wife's finger pricker (she had gestational diabetes) and my BG seems to range from around 90 to 125 (fasting, 1-hour post-meal). I'm starting to become a bit skeptical of the A1C results which claim that my 3 month average BG is 133 (a number I have yet to get up to).

0
Fab409ac4a30957e3ed508514f7bff02

(295)

on March 30, 2012
at 05:37 PM

Here is something to east your mind about A1c: http://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker

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