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  #31   ^
Old Thu, Oct-06-16, 22:05
doreen T's Avatar
doreen T doreen T is offline
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Posts: 35,294
 
Plan: DANDR '92
Stats: 236/184/140 Female 165 cm
BF:
Progress: 54%
Location: Eastern ON, Canada
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Quote:
Originally Posted by Nancy LC
>>Hours After Meal 7 Hours

I thought you're supposed to do it after fasting for 12 hours. Anyway, that will raise some of your numbers.

I'm in Ontario, Canada ... same as the OP, jude. Non-fasting lipid panel testing is the new norm here for routine work up, and probably soon will be the norm worldwide.

more info .. http://www.medpagetoday.com/cardiology/prevention/46739

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  #32   ^
Old Fri, Oct-07-16, 03:53
JEY100's Avatar
JEY100 JEY100 is online now
To Good Health!
Posts: 9,491
 
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
BF:45%/25.3%/24%
Progress: 96%
Location: NC
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Fasting for only 8 hours is an "unnecessary burden"? After following Dr Fung a while, this comment is pretty funny. Note industry conflicts, one author would not want to miss a potential statin user [” Bangalore said abandoning the fasting requirement could speed up the process of identifying and treating patients who need to be on statin therapy.”] and the other would not want a patient to skip a return visit to the Quest lab for a blood draw.

In the US a regular annual exam, the cholesterol draw is often one test along with others including a fasting blood glucose, which must be done fasted. So I'll just have to drag my famished body to the lab anyway

But serious question, if Canada Health decided fasting makes no difference, then why add this line to her test results: "LDL-C calculation is decreased if fasting < or = 10 hours. Consider the Non HDL-C value as an alternate lipid target if monitoring treatment in intermediate or high risk patients."

Does this mean her doctor should decrease the 5.10 mmlo LDL result or is it already somehow lower than it should be had she fasted longer, And by how much? The LDL is only a few points away from what is now considered a good level in the US, so this is a minor point ignored before, but interesting in light of the study Doreen posted.

Last edited by JEY100 : Fri, Oct-07-16 at 07:09.
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  #33   ^
Old Fri, Oct-07-16, 07:58
DelaneyLC's Avatar
DelaneyLC DelaneyLC is offline
Posts: 1,994
 
Plan: Atkins '72
Stats: 188/143/144 Female 5'4"
BF:
Progress: 102%
Location: NV
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Not having to fast must be the new "thing". My last blood test I was told there was no need to fast. I fasted anyway.
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  #34   ^
Old Fri, Oct-07-16, 08:23
doreen T's Avatar
doreen T doreen T is offline
Forum Founder
Posts: 35,294
 
Plan: DANDR '92
Stats: 236/184/140 Female 165 cm
BF:
Progress: 54%
Location: Eastern ON, Canada
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Quote:
Originally Posted by JEY100
Fasting for only 8 hours is an "unnecessary burden"? After following Dr Fung a while, this comment is pretty funny. Note industry conflicts, one author would not want to miss a potential statin user [” Bangalore said abandoning the fasting requirement could speed up the process of identifying and treating patients who need to be on statin therapy.”] and the other would not want a patient to skip a return visit to the Quest lab for a blood draw.

In the US a regular annual exam, the cholesterol draw is often one test along with others including a fasting blood glucose, which must be done fasted. So I'll just have to drag my famished body to the lab anyway

But serious question, if Canada Health decided fasting makes no difference, then why add this line to her test results: "LDL-C calculation is decreased if fasting < or = 10 hours. Consider the Non HDL-C value as an alternate lipid target if monitoring treatment in intermediate or high risk patients."

Does this mean her doctor should decrease the 5.10 mmlo LDL result or is it already somehow lower than it should be had she fasted longer, And by how much? The LDL is only a few points away from what is now considered a good level in the US, so this is a minor point ignored before, but interesting in light of the study Doreen posted.

Janet, I had the same questions and misgivings when I had my bloodwork done last winter. As it was explained to me, non-fasting is the norm now for routine or screening lipid panel. If the patient has a history of abnormal results, or if the non-fasting test comes back out of whack, then the dr. may order a follow-up fasting panel.

I also noticed I had no fasting glucose ordered, just HbA1c. I'm assuming this too is the new norm for routine screening as long as the patient's history is normal. Guess I should be happy I'm considered "normal"

The "LDL-C calculation is decreased if fasting < or = 10 hours .. etc" blurb that's printed with jude's results is exactly the same on mine. I suspect it's cookie-cutter info that's provided with everyone's results, and is not an indicator of anything untoward.

Here are the official guidelines for medical labs in Ontario, current as of November 2013 .. http://oaml.com/wp-content/uploads/...ngFinal2013.pdf. (Note that each province/territory in Canada has its own guidelines which may vary from these ... I'm posting Ontario-specific info for jude's benefit ).
Quote:
3. Option to Use Non-Fasting Samples for the Measurement of Lipid Levels

Traditionally, fasting samples have been used for the assessment of dyslipidemia. However, the CCS’s 2012 Dyslipidemia Guidelines introduced the use of non-fasting specimens for lipid assessment with the introduction of non-HDL-C and apo-B as alternate lipid assessment targets. Neither non-HDL-C nor apo-B are affected by the patient’s fasting status.

In addition, Sidhu and Naugler’s 2012 community-based population study, published in 2012 in the Archives of Internal Medicine, with lipid data from 209,180 patients, also suggests fasting for routine lipid levels is largely unnecessary, as non-fasting lipid profiles change minimally in response to food intake. This study illustrated that the change in measured TC, or HDL-C for fasting compared to non-fasting specimens was less than 2%. Average differences between fasting and non-fasting measurements were less than 10% for LDL-C and less than 20% for TG.

Clinically, fasting carries some risks for patients as noted on the previous page. Therefore, alternative effective markers which do not require fasting have been sought and found. These include non-HDL-C and apo-B. Both may be determined on non-fasting specimens and both are equally effective, if not superior, for determining whether therapeutic targets have been met.

< snip >
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  #35   ^
Old Fri, Oct-07-16, 08:25
doreen T's Avatar
doreen T doreen T is offline
Forum Founder
Posts: 35,294
 
Plan: DANDR '92
Stats: 236/184/140 Female 165 cm
BF:
Progress: 54%
Location: Eastern ON, Canada
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Quote:
Originally Posted by jude
So I went and had blood tests yesterday (call me a wuz). As expected, I have no idea what the numbers mean. I'd really appreciate it if you guys could give me a heads up before I go to see the doctor. (His office has already called to get me to make an appointment.)

Just tossing out some thoughts, in case

re - "7 hours after last meal" .. Did you have anything to drink other than water in those 7 hours? Some folks think a meal means solid food, and forget that their morning coffee or tea counts as a meal. Caffeine can skew the results.

Do you smoke, or live with a smoker? Smoking/second-hand smoke can also skew the results. I'm always amazed to see a huddle of people outside the lab, having a "last drag" before they go in to get their blood drawn. If only they knew that smoking before the test will screw up so many test results, not just lipids.


Without having the previous results, it's impossible to know if this latest panel is better or worse. I honestly don't see anything that requires an immediate prescription for statins, though. If the dr. suggests statins, you do have the right to ask for an opportunity to try making lifestyle changes first and then recheck the bloodwork in a few months


Wishing you the best,

Doreen
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  #36   ^
Old Fri, Oct-07-16, 08:39
jude's Avatar
jude jude is offline
Senior Member
Posts: 941
 
Plan: Atkins
Stats: 182/149/145 Female 65"
BF:
Progress: 89%
Location: Innisfil, Ontario
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Thank you Janet, MickiSue and Nancy....you've taken a load off my mind. Bottom line...no statins. I never had any intention of agreeing to statins, but its nice to know I don't have to worry about "What if?" I trust this way of eating. The numbers converted to mg make more sense to me, Janet.
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  #37   ^
Old Fri, Oct-07-16, 08:46
jude's Avatar
jude jude is offline
Senior Member
Posts: 941
 
Plan: Atkins
Stats: 182/149/145 Female 65"
BF:
Progress: 89%
Location: Innisfil, Ontario
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Hi Doreen.....II didn't realise I should fast, but I didn't drink anything during the 7 hours either, because I was running around shopping, etc that day.

btw, I still remember you introducing me to avocados back in 2002.
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  #38   ^
Old Fri, Oct-07-16, 09:10
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 45,206
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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I guess you get to write more scripts for statins if you test without fasting because, no surprise, your numbers will be much higher. Your triglycerides should be off the charts.
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  #39   ^
Old Fri, Oct-07-16, 09:47
MickiSue MickiSue is offline
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Posts: 8,006
 
Plan: Atkins
Stats: 189/148.6/145 Female 5' 5"
BF:36%/28%/25%
Progress: 92%
Location: Twin Cities, MN
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Hey, if you get someone who had a glass of wine with their lunch, and the draw is about an hour later, BONUS! The TC will be off the charts!
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  #40   ^
Old Sat, Oct-08-16, 04:54
JEY100's Avatar
JEY100 JEY100 is online now
To Good Health!
Posts: 9,491
 
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
BF:45%/25.3%/24%
Progress: 96%
Location: NC
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Doreen, Thank you for all the additional info on non-fasting blood work! New to me, but I will continue to fast even if not requested. agree with Nancy and MickiSue, not fasting seems a great way to get higher Trigs and more patients on meds.
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  #41   ^
Old Sat, Oct-08-16, 06:15
inflammabl's Avatar
inflammabl inflammabl is offline
Senior Member
Posts: 1,825
 
Plan: Atkins
Stats: 296/220/205 Male 71 inches
BF:25%?
Progress: 84%
Location: Upstate South Carolina
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Quote:
Originally Posted by Nancy LC
I guess you get to write more scripts for statins if you test without fasting because, no surprise, your numbers will be much higher. Your triglycerides should be off the charts.


You guess? Any sort of substantiation for this accusation? Some kind of link or study or something?
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