WIERD BLOOD TEST RESULTS - any advice?

[KiaKaha]

OK so I got my blood tests results and I dont really know what to think. Dont know if we have the same measuring system as you but I was wondering what you'd take it to mean and what dietary changes you recommend I make (if any) to sort it out.

Blood Results from 3 months ago, 2 weeks into Lo-Carbing.

A1C 7.8 (My usual lower than expected a1c result)
Chol. 7.0
HDL 5.1
LDL 4.8
TRIG 1.8


Blood Results this week

A1C 5.7 (higher than I expected)
Chol. 5.5
HDL 1.4
LDL 3.6
TRIG 1.1

Also, liver test results from a month ago showed normalisation of my fatty liver with all 3 enzymes back within range. One of these is now elevated.

Thyroid results all normal.

Currently eating averages: 2649 Cals
242 FAT 82%
119 Saturated
15 Poly
66 Mono

35 Carb 4%
11 Fibre
24 net Carbs

92 Protein 14%

Typical Menu

3 Coffees with 2 tbsp cream each, and 2 with 1tbsp Coconut Oil

Nut Muffin
OOpsie Roll with 1.5 oz high fat cheese

3 oz filet steak + mushrooms all fried in butter
or 2 - 3 oz smoked salmon + a cocktail tomato + a few slices avocado + avocado/olive oil dressing

Meat, roasted or fried, sometimes with a cream sauce (mustard, horseradish etc)
Small - medium salad with 1/2 tomato, 1/4 avocado, lettuce and 1 oz red pepper + oil dressing
1/4 cup rhubarb with 1 tbsp cream - sometimes fruit fool, 1/3 cup raspberries in 1/3 cup cream.
1 oz high fat cheese.

(Eat this way about 5 times a week)

Blood glucose resting about 110, after main meal about 100

Why I think this is wierd - I am eating so much fat, its unbelievable. Why would cholesterol drop so much? LDL has dropped but so unfavourably against HDL? HDL has gone through the floor and liver function is above normal again? Why?

I am still struggling to maintain the 1lb a week weight loss so can anybody pinpoint how I can improve what I am eating to both lose weight a bit more reliably and to get my HDL back in line?

I upped the fat and calories because I wasnt losing any weight at 28C and 1800Cals but I feel bad that I am not eating as many veg as I would like. What would you suggest?

Any thoughts from anyone?

[Lottadata]

Outside of the liver enzymes, I'm not sure what the problem is. Your blood sugar is much better. Your triglycerides are much better. The HDL dropped but so did LDL. You are actively losing weight, so the lipids are going to be fluctuating for a while. But they're going down, not up, so you are way ahead of many people losing weight.

Are you taking a statin or some other drug that can damage the liver? You need to talk to your doctor about what might be going on with the liver enzymes. Perhaps you were right under the top limit normal last time and now just a bit over normal this time and that is normal fluctuation? Eating low carb can reverse fatty liver, I have read, but it takes a while.

I am not as convinced as some that raising calories is an effective weight loss strategy. And I am also convinced that eating a lot of healthy vegetables is very important to people on a low carb diet.

In fact, I just read a wonderful book by a New Zealander, Quentin Grady, all about the wonderful vegetables he buys at his local farmers market and all the nutritional value in them. So it sounds like you can eat locally grown food year round where you live and really ought to. There are so many nutrients in food that are not found in pills, and if you eat the ones that taste good to you it has got to improve your health.

So my advice would be to eat more lc veg, eat that very high fat level only if you feel like eating that much fat, and talk to your doctor about the liver enzymes. If you have fatty liver from your previous diet it may take a while to reverse. I believe Metformin has been found helpful for fatty liver.

But that blood sugar improvement is great. And long term those lower blood sugars are going to make a great difference. And you are still losing so keep at it.

[KiaKaha]

I was wondering whether the natural sterols in coconut oil were the reason for the drop in overall cholesterol.

I am very happy with the results overall - I expected cholesterol to have gone up further and LDL has come down but that HDL is a real mystery.

I know that the judgement on saturated fats are that they are healthy but I was wondering whether if I lowered them in favour of monounsaturates that I would get my HDL back up.

One of the main differences now to what I used to do is saturated fat. I used to eat butter but otherwise pretty much exclusively EVOO. Now I am eating a lot of butter, cream and more cheese. I wonder if I cut these down a bit whether I could get the balance back - previously my HDL was high so I wonder if this is significant.

Are there specific oils or fats that are relevant to HDL production?

I am not taking any statins or significant medication. My liver tests last month were amazing - they all normalised precipitously - the doctor couldnt quite believe it so lo-carbing has done this I am sure. I think your explanation that one of the enzymes maybe meanders around the normal range is probably correct.

We do have absolutely wonderful food all year round and although I very much want to lose weight and keep my BG low, I really dont feel its healthy to eat so few vegetables each day especially as I will be doing it for an extended period.

I think I will go back to the 28C I was on but add the extra carbs back in the form of vege soups and vegetable dishes. This was pretty much what I was doing before but my slow weight loss stalled so I upped the calories and the fat and decreased the carbs. I think I'll go to a mid level calorie intake now and still aim to keep fats reasonably high but reduce the fats from dairy.

Thanks Jenny for your advice.

[CarolynC]

Blood Results from 3 months ago, 2 weeks into Lo-Carbing.

A1C 7.8 (My usual lower than expected a1c result)
Chol. 7.0
HDL 5.1
LDL 4.8
TRIG 1.8
Total Cholesterol should approximately equal HDL + LDL + (TRIG/5). The values you gave above would yield a total cholesterol of about 10.3. Maybe the HDL value that you have listed is wrong. HDL doesn't change very fast, so it seems odd that it could go from 5.1 to 1.4 in only 3 months.

Blood Results this week

A1C 5.7 (higher than I expected)
Chol. 5.5
HDL 1.4
LDL 3.6
TRIG 1.1
Here, HDL+LDL+(TRIG/5) comes out to 5.3. So these numbers look OK for yielding your stated total cholsterol of 5.5.

[VictoriaGB]

Sorry if I missed it, can I just ask how you obtained these blood test results, I assume the blood tests were done at the request of your GP?

[KiaKaha]

Yes I did and the nurse read them out to me both times so maybe she made a mistake (I might ring again and check) or if what you say about HDL and LDL equalling total cholesterol (makes sense) then maybe its an erroneous result.

If thats the case the overall picture is a big improvement all round (you eat 83% fat and your cholesterol goes down - that really makes me smile) but I still wonder, what can you eat to get HDL up? I presume my cholesterol wont go down that much more so this means HDL would need to come up a bit.

[VictoriaGB]

Glad to hear it :)

There's nothing to be concerned about in there. If there was, I'm sure you'd know about it.

I'm also sure you know that there are good and bad fats. Maybe you're eating more 'good' fats and less 'bad' fats and hence the overall drop?
However that HDL value is quite a drop and looks wrong. I'm not sure how much cholesterol readings can fluctuate, but that looks a bit much for a fluctuation. The 5.1 in the first readings I'd expect to be around 2, which would fit in with your overall drop in cholesterol.

Anyway, it's looking good there at the moment so carry on how you are and see what the next tests say! Or if you really are concerned about the difference in the HDL, speak to your GP about it. It may just be an inaccurate reading, I'm sure it happens :thup:

[Rosebud]

Total Cholesterol should approximately equal HDL + LDL + (TRIG/5). The values you gave above would yield a total cholesterol of about 10.3. Maybe the HDL value that you have listed is wrong. HDL doesn't change very fast, so it seems odd that it could go from 5.1 to 1.4 in only 3 months.

Here, HDL+LDL+(TRIG/5) comes out to 5.3. So these numbers look OK for yielding your stated total cholsterol of 5.5.

Yes, there is something wrong with the first set of numbers.
Just to keep the record straight though, KiaKaha's results are in mmol/L, so the Friedewald equation is LDL = total cholesterol - HDH - trigs/2.2
The first set (I know, I'm working backwards cf your figures, but we are both pointed in the same direction ;)) would give LDL = 7 - 5.1 - 0.81
That comes to 1.1, nowhere near 4.8. So something is definitely off about those figures. I also guess that it was the HDL that was inaccurate, going by the fact that it is so much lower now.

The second set, however are completely accurate.
5.5 (total chol) - 1.4 (HDL) - 0.5 (trigs/2.2) = 3.6

KiaKaha, that is great news about your glucose and liver function tests.
But vis a vis the cholesterol, if I were you, I would ask the nurse to please ring the lab and ask them to double check the numbers of the first set, because they cannot be accurate.

How to raise your HDL: How much exercise do you get? I believe regular aerobic exercise helps raise levels of HDL.
Eating plenty of fish is also alleged to help.
I would be inclined to increase your monounsaturates, too, and see what happens.
You can also try googling something like "how to raise HDL" and see what other ideas are out there.

Cheers,

Roz:rose:

[CarolynC]

Yes, there is something wrong with the first set of numbers.
Just to keep the record straight though, KiaKaha's results are in mmol/L, so the Friedewald equation is LDL = total cholesterol - HDH - trigs/2.2

Oh, you're right! Thanks for catching that, Roz.