38F 3/4 Worried Re:Bloodwork. Input much appreciated.

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
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DistinguishedHeathen
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38F 3/4 Worried Re:Bloodwork. Input much appreciated.

Post by DistinguishedHeathen »

Well, I just got my annual physical and it's a mix of good news/bad news.

The good? Fasting glucose is 76 and my A1C is 4.9% (down from 5.6% in 2016). Also, my homocysteine is 6.6%, and while I could stand to raise my vitamin D from 36 (on it), it's not terrible.

The bad? My cholesterol scares me. In 2016, my HDL was 49, LDL 131, and trigs 66. Now? My HDL is a less good 46 (despite no processed foods, constant working out, and 1g phospholipid omega 3/day), my LDL is 152 and my trigs are 152 as well.

Given that, in the year since my mom was diagnosed with Alzheimer's, I dramatically cut sugar, cut all processed foods, and took up HIIT and powerlifting 5 days/week, I kind of want to cry. I'm assuming that the trigs and LDL went up because I started consuming A LOT of animal protein to build muscle (lean protein, but still, at 130 grams/day, you're going to get a lot of saturated fat).

So, I'm going to start swapping half my protein for veggie sources like tempeh, lentils, and hemp. I'm also making sure I get 40 grams of fiber/day (up from 20, not so great) and keeping saturated fat to under 15 grams.

How does this sound as a plan? For those who don't really eat processed or fast foods, did you ever have LDL and triglycerides this high? If so, how did you bring them down?
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38F 3/4 Worried Re:Bloodwork. Input much appreciated.

Post by grommet »

Hey there. :-) The good news is you can absolutely get your total and LDL cholesterol down to perfect numbers. I too was on a paleo diet with an emphasis on supposedly “good” saturated fats like grass fed beef, pastured butter, coconut oil, etc and my numbers were actually higher than yours. Total was like 254 and LDL was around 165. My doctor wanted to put me on a statin…I was like helllllll no.

I switched to a whole foods, plant based diet (with some fish so I guess that’s Mediterranean) which obviously is naturally low in saturated fat. And after TWO months with no exercise my LDL plunged to ~ 80. I was so stoked.

So hang in there - you can absolutely do the same thing. When you get retested make sure to also check LDL-P or Apo B which measures LDL particle count since that’s a better measure of relative risk. And since you have family risk you might also want to check Apo(a) which is also an independent risk factor.

Sorry to hear about your mother - I can’t imagine how hard that must be on you and your family.


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38F 3/4 Worried Re:Bloodwork. Input much appreciated.

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BTW, your glucose and homocysteine numbers are something to be proud of! I have to take 5000iu Vitamin D (with K) a day just to maintain 50 ng/dl. Been doing that for years and I’ve never been able to break 50. Don’t be afraid to supplement at those levels - everyone is different.

And your protein intake seems super high. Many longevity experts say we only need .36 g per lb to maintain perfect health, at least for younger people under 65. Not saying you have to go that low, but perhaps something close. I’m 165 lbs and only eat 60 g / day…but I don’t lift weights as much as I used to.


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Re: 38F 3/4 Worried Re:Bloodwork. Input much appreciated.

Post by DistinguishedHeathen »

grommet wrote:BTW, your glucose and homocysteine numbers are something to be proud of! I have to take 5000iu Vitamin D (with K) a day just to maintain 50 ng/dl. Been doing that for years and I’ve never been able to break 50. Don’t be afraid to supplement at those levels - everyone is different.

And your protein intake seems super high. Many longevity experts say we only need .36 g per lb to maintain perfect health, at least for younger people under 65. Not saying you have to go that low, but perhaps something close. I’m 165 lbs and only eat 60 g / day…but I don’t lift weights as much as I used to.


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Thank you for the input! I was actually already taking 5,000 ID D3/day (with K2), but had only been doing so for two months -- can't imagine how deficient I was. I'm going ahead and lowering my protein and implementing the dietary changes (guess steak will have to become a rare cheat for me -- oh the pain!). Hoping that will help!

That said, my doctor called me back today to flag my thyroid levels -- evidently the lab ordered a TSH reflex test because my values indicated I am slightly hypothyroid (would explain a few things like why I'm often tired despite my lifestyle and why I'm still 20 lbs above what I weighed in my 20s and early 30s despite being far more active/eating cleaner than I ever have). He mentioned that some folks w/hypothyroid also present with high trigs, so off to the endocrinologist I go next week!

But thank you for the kudos on my A1C/glucose -- as someone who used to live off candy and eat half loaves of white bread in her 20s, it's been a helluva journey to break my sugar addiction. Seeing it pay off like that feels amazing.
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Re: 38F 3/4 Worried Re:Bloodwork. Input much appreciated.

Post by giftsplash »

Your HDL, LDL and Trigs are nothing to worry about.

I measure my lipids every 2 weeks and Trigs swing wildly depending how much I ate carbs last few days.

The LDL is also nothing to worry about. 100 to 140 is ideal LDL for longevity you are very close to that.
https://michaellustgarten.com/2020/12/ ... longevity/

You can also get your lipids tested for under $40. However you might have to go to Connecticut to have it done since NY does not let you self test.
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Re: 38F 3/4 Worried Re:Bloodwork. Input much appreciated.

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DistinguishedHeathen wrote:Well, I just got my annual physical and it's a mix of good news/bad news.

The good? Fasting glucose is 76 and my A1C is 4.9% (down from 5.6% in 2016). Also, my homocysteine is 6.6%, and while I could stand to raise my vitamin D from 36 (on it), it's not terrible.

The bad? My cholesterol scares me. In 2016, my HDL was 49, LDL 131, and trigs 66. Now? My HDL is a less good 46 (despite no processed foods, constant working out, and 1g phospholipid omega 3/day), my LDL is 152 and my trigs are 152 as well.

Given that, in the year since my mom was diagnosed with Alzheimer's, I dramatically cut sugar, cut all processed foods, and took up HIIT and powerlifting 5 days/week, I kind of want to cry. I'm assuming that the trigs and LDL went up because I started consuming A LOT of animal protein to build muscle (lean protein, but still, at 130 grams/day, you're going to get a lot of saturated fat).

So, I'm going to start swapping half my protein for veggie sources like tempeh, lentils, and hemp. I'm also making sure I get 40 grams of fiber/day (up from 20, not so great) and keeping saturated fat to under 15 grams.

How does this sound as a plan? For those who don't really eat processed or fast foods, did you ever have LDL and triglycerides this high? If so, how did you bring them down?

Hi there, I recommend watching the documentary "Game Changers." You don't need meat.
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38F 3/4 Worried Re:Bloodwork. Input much appreciated.

Post by grommet »

giftsplash wrote:Your HDL, LDL and Trigs are nothing to worry about.

I measure my lipids every 2 weeks and Trigs swing wildly depending how much I ate carbs last few days.

The LDL is also nothing to worry about. 100 to 140 is ideal LDL for longevity you are very close to that.
https://michaellustgarten.com/2020/12/ ... longevity/
CVD risk goes up with higher LDL particle counts (ApoB). Particle count correlates pretty strongly with LDL-C and a LDL-C of 140 is objectively not great.

I didn’t fully understand the study Dr. Lustgarten was referring to but it did mention that it’s possible there’s reverse causation b/w non-CVD disease (e.g. cancer) and low LDL levels. Interesting read regardless.


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Re: 38F 3/4 Worried Re:Bloodwork. Input much appreciated.

Post by Quantifier »

I agree with grommet, the current view is shifting from traditional lipid markers to ApoB as the best predictor of lipid status for cardiovascular health (See here ).

There was some work about lifestyle and blood markers among the Hadza hunter gatherers - the abstract is here. I was able to get the full paper via sci-hub and I'm quoting from it the following:
Blood markers of cardiovascular disease (cholesterol levels and CRP) also do not show any strong evidence of cardiovascular risk. Because the CardioChek system does not
provide values of total cholesterol below 100, we provide
descriptive data from our small sample (Table 6). From these
data, none of our subjects display total cholesterol values
that are in a high cardiovascular risk group (i.e., >200 mg/
dl) and only a single subject possessed LDL levels that were
over the threshold for optimal scores (<100 mg/dl). Over
half of our subjects have HDL cholesterol values in a highrisk category (<40 mg/dl); however, combined with low
LDL levels, low HDL levels are not considered high risk
(Ridker et al., 2010). Serum-equivalent CRP values were
low in this sample of Hadza individuals, with 74% of participants falling below the high-risk threshold of 3 mg/L
(Table 6).
Looking at Table 6, they have 9 people with *total* cholesterol under 100 mg/dl, 13 with levels 100-172 mg/dl, 1 no measurement. HDL levels range from under 15 to 59 mg/dl (of course with the ApoB centered view HDL is irrelevant for risk), the highest LDL level calculated is 115 mg/dl. CRP levels are all over the place (probably not surprising for people living that lifestyle). Just for perspective for us westerners.
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