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Uff Da

HDL 101 and other lab results

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Uff Da

I had my lab work done yesterday and just got the results.  The most surprising was an HDL of 101, up from 82 in May and the highest I've ever had.  I attribute the increase to taking krill oil, which I started prior to my previous lab tests, but this is the first full period covered while I was taking it.  I intended to take those pills every day, but miss a lot, since I can't put them in my weekly pill box.  It appears that I've averaged about one pill every two days.  (Serving size is supposed to be 2 per day according to the label.)

 

Total cholesterol was 237, up from 236 in May.  My doctor will be unhappy with this regardless of such a high HDL.

 

LDL was 121, down from 136 in May.  Unfortunately my doctor wants it under 70. 

 

Triglycerides were 77, down from 91 in May.

 

Cholesterol/HDL ratio 2.4, down from 2.9 in May.

 

A1c was 5.9, up from 5.6 in May.  I'm okay with it, though.  I've reduced my hypos and have been making a concerted effort to run my numbers higher to get my hypo awareness back to a better level.  I've only had eight mild hypos since September 1, six in the 60s, two in the 50s.  Prior to that I was having hypos almost every day or at least every two days for a while.  I have twice the sensitivity to carbs as the average diabetic, so my endo doesn't get too excited about my hypos.  I've never had a hypo that I couldn't handle myself, though I've gone as low as 31.

 

All other tests, liver enzymes, kidney enzymes, and the like were all within normal range. Not bad for an old timer.

 

I see my endo next Tuesday and my PCP the following week, so we'll see what they have to say about all this.

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GrammaBear

Of course I am not a doctor, but personally I think your numbers are pretty awesome!  I don't think I've ever seen an HDL that high either.  Do you think it is the krill oil that did that?  What brand do you use?

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NoraWI

Congrats! I, too, had very high HDL and a good ratio. To keep the doctors from harping on me about taking a statin for a total lipid of 215, I simply refused to do any more lipid tests. My endo wrote that into my file and no one has suggested it since. Your A1c is awesome as is your cholesterol ratio. So, congrats, fellow old timer!

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Ela

Great results!  Congratulations! 

 

On my test in February I also had HDL 100, but my LDL was 165, Trigs 78 with 281 total.  'My' doctor didn't harp and didn't prescribe statins.  She said that I have excellent ratios (and so do  you!!!) and my Trigs are normal, so she is not concerned.  So different doctors - different standards, but we have only one body.

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naesatt

I had my lab work done yesterday and just got the results.  The most surprising was an HDL of 101, up from 82 in May and the highest I've ever had.  I attribute the increase to taking krill oil, which I started prior to my previous lab tests, but this is the first full period covered while I was taking it.  I intended to take those pills every day, but miss a lot, since I can't put them in my weekly pill box.  It appears that I've averaged about one pill every two days.  (Serving size is supposed to be 2 per day according to the label.)

 

Total cholesterol was 237, up from 236 in May.  My doctor will be unhappy with this regardless of such a high HDL.

 

LDL was 121, down from 136 in May.  Unfortunately my doctor wants it under 70. 

 

Triglycerides were 77, down from 91 in May.

 

Cholesterol/HDL ratio 2.4, down from 2.9 in May.

 

A1c was 5.9, up from 5.6 in May.  I'm okay with it, though.  I've reduced my hypos and have been making a concerted effort to run my numbers higher to get my hypo awareness back to a better level.  I've only had eight mild hypos since September 1, six in the 60s, two in the 50s.  Prior to that I was having hypos almost every day or at least every two days for a while.  I have twice the sensitivity to carbs as the average diabetic, so my endo doesn't get too excited about my hypos.  I've never had a hypo that I couldn't handle myself, though I've gone as low as 31.

 

All other tests, liver enzymes, kidney enzymes, and the like were all within normal range. Not bad for an old timer.

 

I see my endo next Tuesday and my PCP the following week, so we'll see what they have to say about all this.

I'm sure your cholesterol (LDL) is a bit higher due to running you bg's a bit higher...you will probably see an improvement after you dial it back a bit...congrats though, and I sure don't understand your doctor not being happy w/your triglycerides!?!

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jwags

My HDL has always been in the high range, close to 100. That increases my total cholesterol so it always comes in higher than what my doctor wants. They keep pushing statins but I keep resisting. With a high HDL the chances are your cholesterol is the light fluffy kind.

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Uff Da

Of course I am not a doctor, but personally I think your numbers are pretty awesome!  I don't think I've ever seen an HDL that high either.  Do you think it is the krill oil that did that?  What brand do you use?

 

I suspect the primary cause of the increased HDL was the krill oil, which according to the research I've seen tends to increase HDL and lower LDL.  I have to wonder what would have happened if I'd taken two a day as directed.  I think I'll continue with averaging about one every other day as I did during this four-month period.  The brand I take is Viva Labs. They do give me a bit of fishy burps, though.

 

Another thing that might have added a point or two to my HDL was taking niacin the last couple of weeks before my blood test. I'd taken this particular niacin for several years before my doctor put me on statins five or six years ago.  During the period I was taking niacin back then, it definitely did help increase HDL and decrease LDL and total. The niacin I take is Enduracin, an extended release version, so it doesn't give the flush if one builds up the dose.  This is not the same thing as a no-flush niacin, which I understand is not particularly effective for cholesterol.  The one I take is the same brand as was used in some of the original research that showed niacin to be effective in reducing cholesterol.

 

I don't know if I'm going to continue taking the niacin or not.  I hate having to take so many pills.  I'm still taking a statin three days a week.  It was very effective in getting my cholesterol down in the numbers my doctors were pleased with while I was taking 20 mg each day, but I'm still suspicious that it contributes to the major leg cramps I was having, which is why I dropped it to three times a week.  Maybe if I take the simvastatin three days a week and niacin four days, I'll minimize the side effects.  Or who knows, maybe I'll just have some kind of side effects from both of them.  LOL.  Hard to know what to do.  I think the doctors overplay the importance of cholesterol.  I'm certainly not going to try to get it as low as the doctors want, but think it might be a good thing to moderate the high levels I used to get before I took anything for it.  I had a total cholesterol as high as 275 back then.

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Seagal

I had exceptional results with niacin/fish oil therapy.  After much research, I used the B-3 (flush type) as it seemed to be the most effective.  I worked my way up to 2000mg. per day and believe me, this must be done slowly, I did it 500mg. at a time over a period of months.  When I had my MI, my ldl was 95, hdl 106 and trigs 55 (or thereabouts), I doubt cholesterol had anything to do with what the cardiologist called "apparent" heart attack.  Prior to starting the niacin my ldl was 130, so I was  pleased to see it under 100.   I don't want to start the build up to 2000mg. again and I think it may have (niacin) had a bearing on my kidney numbers, they are better now that I'm not high dosing.

 

If you are taking a statin three days a week, why bother with the niacin?  Taking 10mg. lipitor 3x week kept my numbers in line.  Last test, the dr. said "it is obvious you aren't taking your medication".  I have not had any ill effects from the low dose and have resumed the 3x weekly until December's test.  I am taking 1000mg. Krill per day along with 4400mg. fish oil - neither of which causes fishy burps :)  My total was 194, HDL 57, LDL 117 and trigs 102.  Hoping the krill will aid the hdl and a better exercise program now that my new knee is working well.

 

The Krill I take is by Sports Research-Antarctic Krill Oil, with astaxanthan 1000mg.

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Seagal

Some may want to take a look at Linus Pauling & Rath's Unified Theory of Cardiovascular disease.  I forgot to mention after my MI, I started taking Lysine, Proline  & C.

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Uff Da

If you are taking a statin three days a week, why bother with the niacin?  

 

Because my total cholesterol the last three times, since I reduced the statin to 20 mg three times a week, have been 211, 236 and 237.  (While on a statin seven times a week it was under 200.) My doctor wants it under 200. My doctor wants my LDL under 70, and I'm a long way from that.  While I frankly don't think cholesterol itself is of that much importance for my health directly, my systolic blood pressure goes over 200 when I have to have these discussions with my doctor, and trimming a few more points off my numbers may help to get her off my back a little.

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Seagal

Looks like your kidney & liver functions are doing great, so adding the niacin would be another arrow in your quiver.  My doc wants my ldl in the 50's and was real happy when it was 48 after the MI & statin therapy.  That is when I stopped taking it daily.  I am prescribed 40mg. lipitor, with doc's ok, I cut it into quarters, could you cut the 20mg. and take 10 each day?  Of course, if it is extended release you wouldn't do this.  I always took a baby aspirin before my flush niacin in order to negate the flush, but you probably don't have that problem.

 

Hope you post after your appointment on Tuesday with good news!  Sorry about the bp...I know how that goes.

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Uff Da

Had a pleasant appointment with my endo today.  He was extremely pleased with how I was doing.  He thought my A1c was okay, though he'd have liked to see it a little higher, as long as it stayed under 6.5.  He wasn't the least bit worried about all the hypos I've been having, but was pleased that I've managed to reduce them by decreasing the basal and generally running my numbers a little higher.  He said my I:C ratios and all were pretty typical of a type 1.  He thinks my diabetes is stable enough that seeing me every six months is adequate.

 

Oh, my systolic BP was over 170 when he measured it.  He asked if it was usually that high.  I laughed and said, "No, but I've been talking."  I explained that I'm a loner and whenever I start talking with anyone (not just white coats), my BP goes up.  After 20-some years my PCP has learned that she has to have the nurse leave me sitting quietly in a room by myself for five minutes before she comes back to take my BP if she wants anywhere near a normal reading.  Even then my readings are usually much lower at home.

 

My endo didn't even mention the cholesterol. It is my PCP and my cardiologist that get excited about that. I'll see my PCP next week and the cardiologist sometime in the next two months. 

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Uff Da

Saw my PCP yesterday.  As expected, she was not happy with my cholesterol.  She did acknowledge that the ratios were good, but she is a firm believer in keeping total cholesterol under 200 and LDL under 70 for a diabetic.  I reluctantly agreed to increase my 20 mg simvastatin to 4 times a week instead of 3, but we'll see if I actually do that for long.  Since I don't have another blood test for six months, I might just forget about taking it altogether until about two months before my next blood test.  Seriously, I don't really think it is going to make a bit of difference for my health.  I've read enough of the research about cholesterol for women and the elderly and personally don't think cholesterol makes much difference in risk unless one already has heart disease.

 

I'll be seeing my cardiologist sometime in the next two months.  I'm sure he will try to get me back on the statin seven days a week.

 

Even though the nurse let me sit quietly for a few minutes before she took my blood pressure, it was still 144 over something. Guess she needed to give me more time to calm down after talking to the doctor.  My BP had been 112/56 at home before I left for the appointment! 

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Caravaggio

Is there any reason or basis for the LDL being under 70 for a diabetic? I suppose it's the associated higher risk of having heart issues if one is also diabetic. But did your PCP give any specific reason?

 

I've just had my quarterly blood tests. My copy of the test results indicate that acceptable LDL range is between 70 and 130. My endo just wants me to be within that range. My total cholesterol has always been higher than the accepted threshold so my doctor is not that worried but he wants to see my LDL go lower. He has mentioned statin or niacin only once (years ago) but has not raised this matter since then because he happy with my A1c and other numbers. His parting words yesterday were to remind me to watch food intake because "autumn is the season when appetite starts to increase", and because of the coming holiday party season.

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jwags

I think there may be a higher rate of heart disease with diabetics. But does it come from normal cholesterol levels or higher HbA1 c's. Since many doctors and CDE's still prescribe high carb diets and 180's after meal, that may be the reason. Carbs are inflammatory in our bodies and cholesterol is made when our body tries to fix the Inflammation.

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Orlando

I suspect the primary cause of the increased HDL was the krill oil, which according to the research I've seen tends to increase HDL and lower LDL.  I have to wonder what would have happened if I'd taken two a day as directed.  I think I'll continue with averaging about one every other day as I did during this four-month period.  The brand I take is Viva Labs. They do give me a bit of fishy burps, though.

 

Another thing that might have added a point or two to my HDL was taking niacin the last couple of weeks before my blood test. I'd taken this particular niacin for several years before my doctor put me on statins five or six years ago.  During the period I was taking niacin back then, it definitely did help increase HDL and decrease LDL and total. The niacin I take is Enduracin, an extended release version, so it doesn't give the flush if one builds up the dose.  This is not the same thing as a no-flush niacin, which I understand is not particularly effective for cholesterol.  The one I take is the same brand as was used in some of the original research that showed niacin to be effective in reducing cholesterol.

 

I don't know if I'm going to continue taking the niacin or not.  I hate having to take so many pills.  I'm still taking a statin three days a week.  It was very effective in getting my cholesterol down in the numbers my doctors were pleased with while I was taking 20 mg each day, but I'm still suspicious that it contributes to the major leg cramps I was having, which is why I dropped it to three times a week.  Maybe if I take the simvastatin three days a week and niacin four days, I'll minimize the side effects.  Or who knows, maybe I'll just have some kind of side effects from both of them.  LOL.  Hard to know what to do.  I think the doctors overplay the importance of cholesterol.  I'm certainly not going to try to get it as low as the doctors want, but think it might be a good thing to moderate the high levels I used to get before I took anything for it.  I had a total cholesterol as high as 275 back then.

Have you considered reducing the amount of carbohydrates you consume. I take 10 mg of Simvastatin per day and eat only 20 grams of carbohydrates. My total cholesterol is 131 LDL 51.2 triglycerides 59 . FBG 96 [not so great ] Maybe a modest reduction in carbs is worth a try if you dont want to take more statins. By the way I have had heart disease for over 25 years .

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Seagal

I think there may be a higher rate of heart disease with diabetics. But does it come from normal cholesterol levels or higher HbA1 c's. Since many doctors and CDE's still prescribe high carb diets and 180's after meal, that may be the reason. Carbs are inflammatory in our bodies and cholesterol is made when our body tries to fix the Inflammation.

When I had my MI, my a1c was 5.7 and my cholesterol was (if I remember correctly) hdl 101, trigs 54 and ldl 95, so although the theory sounds good, maybe it is another one of those YMMV?

 

There is no doubt that cardiologists believe ldl should be under 70 for diabetics and you are right Jeanne, we are at higher risk :(

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Uff Da

Have you considered reducing the amount of carbohydrates you consume. I take 10 mg of Simvastatin per day and eat only 20 grams of carbohydrates. My total cholesterol is 131 LDL 51.2 triglycerides 59 . FBG 96 [not so great ] Maybe a modest reduction in carbs is worth a try if you dont want to take more statins. By the way I have had heart disease for over 25 years .

 

I really have no desire to reduce my carbohydrates further.  I've been averaging around 140 grams carb per day over the past few months, which is only about 30% of my total calories.  That's low enough for me.  Unlike many people, I have a hard time keeping my weight up if I cut carbs too much. 

 

And I really don't worry too much about the cholesterol, either.  As I see it, the research is really mixed.  Many of the doctors want us to keep cholesterol low, but many are going by the ADP-4 guidelines issued last November, where half the committee had financial ties to the pharmaceutical companies.  Those doctors who haven't caught up are still going by the ADP-3 guidelines, where the number of committee members with ties to pharmaceutical companies was even worse.  That's the committee, I believe, that originally came up with the 70 for diabetics guideline.  To what extent should we accept such advice?  How about the studies that seem to indicate that women don't fit that picture or that the elderly with the highest levels of cholesterol had the lowest all-cause mortality?  Were those considered at all? Or were the committee members biased?

 

So my thinking at this point is that I'll split the difference and aim for a moderate level of cholesterol, which is where I'm at right now.  I have no intention of trying to get it down to the level my PCP or cardiologist want at this point, though I can see again trying to shave a few points off the total by changing what I do shortly before my blood tests to fool my doctors into thinking my cholesterol isn't quite as "bad" as they think it is.  Now secondary prevention, I believe, has stronger validity in the research.  For people who have already had one heart attack, I think the research is a lot stronger that cholesterol may make a difference.  So if I do have a first heart attack and survive it, I'll probably change my ways.  But as I see it, I'm already age 73.  What do old people typically die from, whether their cholesterol is high or low?  Heart attacks and strokes.  Actually, not a bad way to go in my opinion. 

 

I'll continue to read some of the literature on cholesterol.  And who knows, maybe by next year I'll change my mind. 

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fjordscape

The PCP was an old fogey. After a career spent opposing cholesterol, they can't make the switch. 

 

You noted ATP IV. Here's a clinical practice standard from ATP III some PCP's missed out on: there were three regimes of LDL target. ATP III was not one size fits all. The LDL targets were <100, <130, and <160, depending on the combined weight of the patient's other indicators. Depending on big picture -- common sense! ATP III can be found online. But, under ATP IV LDL targets have been officially abandoned. 

 

I looked up HDL, There's actually a bad subtype of it. 

 

Last month, I unintentionally jacked up HDL from 72 to 97 by eating 1 to 2 eggs a day for 3 weeks. 

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