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Pathology/High Cholesterol and Triglycerides

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QUESTION: HI,

I recently had some blood work done. To cut a long story short, my Doctor has advised I have VERY high cholesterol and triglycerides. Scary high... I am hoping to give some natural supplements a try before I take on statin drugs etc. I am a bodybuilder, so I look after myself with exercise and diet already. Bewilders me what is wrong with me...

Anyway, these are the results that I received...

Chemistry (serum)

Sodium   -   140 mmol/L  ( Reference range - 135 - 145 )
Potassium   -   4.7 mmol/L  ( Reference range - 3.5 - 5.5 )
Chloride   -   103 mmol/L  ( Reference range - 135 - 145 )
Bicarbonate   -   26 mmol/L  ( Reference range - 20 - 32 )
Anion Gap   -   11 mmol/L  ( Reference range - 5 - 15 )

Ca (corr)   -   2.46 mmol/L  ( Reference range - 2.10 - 2.55 )
Phosphate   -   1.2 mmol/L  ( Reference range - 0.8 - 1.5 )

Urea   -   7.2 mmol/L  ( Reference range - 3.0 - 8.0 )
Urate   -   0.37 mmol/L  ( Reference range - 0.20 - 0.50 )
Creatinine   -   81 umol/L  ( Reference range - 60 - 110 )
eGFR   -   >90    ( Reference Range - >59 )

Fast Glucose   -   5.2 mmol/L  ( Reference range - 3.6 - 6.0 )

Total Protein   -   79 g/L    ( Reference Range - 66 - 83 )
Albumin   -   51 gL    ( Reference Range - 39 - 50 )
Globulin   -   28 g/L   ( Reference Range - 20 - 39 )
T Bilirubin   -   11 umol/L  ( Reference range - 4 - 20 )
ALP   -   78 U/L   ( Reference Range - 35 - 110 )
AST   -   33 U/L   ( Reference Range - 10 - 40 )
ALT   -   55 U/L   ( Reference Range - 5 - 40 )
GGT   -   39 U/L   ( Reference Range - 5 - 40 )
LDH  -   203 U/L   ( Reference Range - 120 - 250 )

Cholesterol   -   8.8 mmol/L  ( Reference range - 3.9 - 5.5 )
Triglyceride   -   7.8 mmol/L  ( Reference range - 0.6 - 2.0 )
HDL   -   1.07 mmol/L  ( Reference range - 0.90 - 1.50 )
LDL   -          ( Reference range - 0. 0 - 4.0 )
Cholesterol/HDL Ratio   -   8.2   ( Reference range - 0. 0 - 4.5 )

Haemolysis Index   -   15   ( Reference Range - 0 - 40 )

Comments on Lab   -   Suggested optimal treatment targets for patients are:
LDL Cholesterol   -  <2.0 mmol/L
HDL Cholesterol   -   >1.00 mmol/L
Triglycerides   -   <1.5 mmol/L

Triglycerides exceed 4.5 mmol/L. This prevents calculation of the LDL cholesterol level.

Measured LDL Cholesterol

Measured LDL Cholesterol   -   3.6 mmol/L  ( Reference range - 0 - 4.0 )

Comments on Lab   -   This LDL has been measured directly. A calculated LDL level using the Friedewald equation was not valid for this sample as the triglyceride level was >4.5 mmol/L

Androgens

Testosterone   -   7.6 nmol/L   ( Reference Range - 11.0 - 40.0 )

Anaemia Profile

Iron   -   22 umol/L   ( Reference Range - 5 - 30 )
TIBC   -   62 umol/L   ( Reference Range - 45 - 72 )
Saturation   -   35%   ( Reference Range - 20 - 55 )
Ferritin   -   242 ug/L   ( Reference Range - 25 - 220 )

Comments on Lab   -   Mildly elevated ferritin. This may be seen in any acute illness, early iron overload, treated haemochromatosis, chronic disease states, eclampsia and hepatic disease.
In iron overload serum iron increases and TIBC falls. Both iron and TIBC may fall in chronic diseases states.

Are you seeing anything glaringly obvious? Is there anything in this that may show what it could be that is causing me issues?

Thanks!

ANSWER: Hello Steve:

Most of all your blood tests are within normal range. The lipid profile is really elevated.

One thing I would like to clarify. Did you fast at least 12 hours prior to getting the test done. Ideally you should have your normal routine diet for a week or so and the night before the test, after dinner do not eat anything till the blood is drawn for the test. Your diet has a significant effect on lipid profile. Cholesterol and triglycerides will be high if you have been having fatty food, fried food, lots of nuts etc.

If your diet is normal, do you have a family history of high cholesterol. Familial hypercholesterolemia is a known condition.

Other reason could be that with all the exercise and body building you are having a high calorie diet, maybe more than needed and that is seen as raised cholesterol and triglycerides.

A high calorie diet or family history could explain these elevated results. If both are not there, I would say get the test repeated and if they are still raised, your doctor has to look into other diseases which may be causing this. It is highly unlikely that an error was made in testing or there was a mixup of the blood sample, but is rarely possible. A repat test again would help.




---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your reply!

With the blood testing that was done, I fasted about 12-13 hours before blood was taken.

There is a family history with my dad having high cholesterol. He ended up getting on to statins (I think) to lower his levels. I am hoping to address any diet issues and look into natural supplements before I have to go the same route.

My Doctor wants me to be re-tested in 6 weeks time.

Diet wise, I really watch what I eat. I try and keep fat, sugar and calories low. With my daily caloric intake, I aim for about 2600 - 2900 calories a day. I am 5'-11" and weigh about 205lbs. I am quite muscular.

My testosterone is low also.

Any other thoughts?

Thanks again...

Answer
Hello Steve:

I apologize for the delay in responding to your question. I am travel and sometimes it's hard to keep track of my mail.

Since you have family history of high cholesterol, it is possible you have inherited the condition. There are studies which point at relationship between low testosterone and high cholesterol, which can lead to cardiovascular disease. However, it's not well established how this happens.

I think the best approach is to continue with a healthy diet and lifestyle with adequate exercise and have the test repeated. If still found to be elevated your physician will recommend an action plan.

Pathology

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Neha Dahiya MD

Expertise

Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.

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I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory in India.

Organizations
Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

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MD (pathology) MBA

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