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Blood Tests Results = My Doctor Is A Dumbass v. 2.0

by 30 · April 24, 2014 at 4:10 PM

I have had blood work done and got the following. I was really surprised at my LDL number. I had a finger prick cholesterol test at work and got Total cholesterol of 4.6. The following day I got bloods done at a medical centre to validate this and for records.

Cholesterol (mmol/l) /// (mg/dL) - http://www.onlineconversion.com/cholesterol.htm

Total - 9.5 /// 367.36

HDL - 2.43 /// 93.96

LDL - 6.6 /// 255.22

Tri - 1.02 /// 90.34

I can't remember what I ate the night before; could being mostly in ketosis throw up my LDL # like this and thus freakout my doctor?

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15 · March 25, 2014 at 1:21 AM

You have lots of preconceptions about cholesterol and conventional medicine. First, your doc is not a dumbass. Throw away that finger-prick trinket. Focus on the serum results delivered by the lab. You try to save money by buying a piece of junk that's off by 50%. How will that suit you when you need to take NMR, VAP or even 23&me tests for your gene map to really assess your coronary risk.

Your problem is FH. Your LDL skyrockets when you go fat-heavy. It's a familiar and familial phenomenon. It's related to your genes (ApoE4): one of your alleles are E4, so you react to fat, especially saturated fat, just like 25% of the population do. If you always tested like this, your doc would have pointed this out. Your FH is specifically related to the diet that you're on, which might not be ideal given your genotype.

Your TC is damn near 400 and at that level, your HDL has to climb above 110 for your magic ratio to fall below 3.5x. Do you think HDL that high is really beneficial? When your LDL starts climbing above 200, this increases the probability of atherogenesis despite your low trigs and high HDL. God helps you if your HS CRP, homocysteine, Lp(a), ferritin, BP, fibrinogen, and other markers are high. Already, one of your liver enzymes are high: you are probably recovering from fatty liver and it's taking you a while to rid of that liver fat. The reason why Jimmy Moore is kicking with ~450 TC is because his non-lipid markers are stellar and all of his other risk factors happen to line up in a way to avoid atherosclerosis. But everything short of that is happening in his coronaries; the particles are just not "sticking" to the artery wall. But not everyone can do that, especially if you are not as lucky as Jimmy and have other risk factors.

You have neutropenia already when you haven't been ketoing for that long. Eventually, you will end up with leukopenia and your globulin is probably going down along with your hormones, causing immune and hormonal dysfunction. Add some carbs, if you wanna see your LDL plummet. One of the low-carb "health gurus" that had a genetic coronary risk (pulmonary hypertension) and claimed that "carbohydrates can kill" passed away recently: RIP, Robert Su, M.D. Carbohydrates didn't kill him; hypertension did. Low-carbing, especially the hare-brained ketogenic/VLC variety, is not ideal when you already have a preexisting coronoary risk factor. It's your health. If you're on a budget and crimping on medical tests at this stage, perhaps you should not be so dismissive of familal hypercholesterolemia, which does increase the risk of CVD in those who're vulnerable. You listen to these cheerleaders for Team Fat and you would think a total cholesterol of 500 is perfectly safe. Think again, it's your health.

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30 · April 24, 2014 at 9:33 AM

@thyroiditis thanks for your information packed reply. I wanted to wait for the retest before commenting but truly am grateful for the effort and time you put into your reply. You are a legend.

Retest Results: (~3 weeks after 1st test)

Cholesterol (mmol/l) /// (mg/dL)

Total - 8.3 /// 320.96

HDL - 2.07 /// 80.05

LDL - 5.8 /// 224.28 ['Iranian' LDL - 5.22 /// 200.89]

Tri - 0.9 /// 79.71

B12 still high - 1561 ng/l (range 211-760) but lower than before.

Blood calcium became 'normal' - 2.47 mmol/l (range 2.18-2.60)

'ALT' on liver profile back to 'normal' - 33 I.U./l (range 11-58)

Neutrophils back to 'normal' - 2.14 x10^9/L (range 2.0-7.5)

Platelets low - 149 x10^9/L (range 150-400)

  • The post title is a soft poke at misinformed Doctors rather than a hard insult at my doctor.
  • The finger prick test was just something they did at work I don't own one.
  • It might be ApoE4 and my genetics; looking back at a past test it was the following (2012):

Cholesterol (mmol/l)

Total - 6.46

HDL - 2.29

LDL - 3.68 ['Iranian' LDL - 3.69]

Tri - 1.07

  • I am still a member of Team Fat as I perform and feel great living this way. I probably do need to be more loving towards carbohydrates but love ketosis too much for its protective factors for cancer, cognition & liver protection.
  • There is tremendous nutrient density in animal fat.
  • There is quite a few more bases to be covered to prevent CVD such as Vitamin K2, antioxidant consumption, exercise, plant consumption.

My doctor was amazed I could reduce my TC so much in ~3 weeks. Nothing changed that much, maybe 3 workout sessions between then, trip to the other side of the world for 2 weeks during holiday, more sun. He did say typically for a 32 year old with 'such a high cholesterol' he would put them on statins (no way in my mind would I take) but since I have such a 'remarkable' reduction I'll retest in 2 months and hopefully reduce things even more (I would like to get a LP(pla)2 test then)

Some other gems from our conversation:

Thanks for all the comments and answers guy. Big props to @thyroiditis for his content.

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10077 · March 24, 2014 at 10:54 AM

http://www.employees.org/~alokem/cholesterol.html

Multiplying your numbers by 40 to get US typical units,

380 TC - 97 HDL - 264 LDL - 40 TG

Why do a retest? Your TC is high, but the HDL is part of the reason for that and it's spectacularly good, as are your TG's. The 264 LDL is high-ish....does your dr have statins in mind for you....hmmmm

I'd save the time and money and buy some fresh seafood instead of getting another test.

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30 · March 24, 2014 at 10:18 AM

I'll be getting a retest.

I don't pay much value on the "lab on a stick" meter but I have no idea what would have made my LDL so high. I probably did eat a lot for dinner and might have played with my livers lipid production.

Other unusual things from the blood tests were sky high B12 - 1938 ng/l (range 211-760) probably from my liver consumption and occasional strong multi.

Slightly elevated blood calcium - 2.63 mmol/l (range 2.18-2.60)

High 'ALT' on liver profile - 136 I.U./l (range 11-58)

Low Neutrophils -1.75 x10^9/L (range 2.0-7.5)

I actually wanted a mildly comprehensive blood test done:

Standard panel:
  • Bone Profile
  • Cortisol
  • Fbc + Plc + Diff
  • Glucose Test
  • Liver Function Test
  • Renal Function Test
  • Testosterone
  • Thyroid Function Test
Plus:
  • Testosterone, Free, serum (RIA)
  • Oestradiol
  • Sex Hormone Binding Globulin (SHBG)
  • Free Triiodothyronine (FT3)

He skipped Testosterone, cortisol and all my 'Plus' requests.

I will update when I get the retest done in a couple weeks.

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20 · March 21, 2014 at 2:25 PM

My first suspicion with results like these would be the accuracy of the finger-prick test. Laboratory tests are far more accurate and have higher precision than can be obtained with a "lab on a stick" meter. Of course, the blood sample is also different (capillary versus venous blood) which could feasibly yield different values (it certainly does for glucose, but I'm not sure about lipids - just a suggestion), and the values may relating to different blood components (plasma, serum or whole blood), which by simple dilution can drastically alter the reported reading.

I wouldn't have thought that a ketogenic meal would have had such a big impact on total cholesterol (TC) levels as recent research suggests that TC values differ only minimally whether one is fasted or not and LDL-C varies by approx 10%. This, of course, relies on extrapolation from a ketonaemia arising from fasting state to a carbohydrate restricted state. I would be interested to hear what others think.

Overall, I think the most prudent action would be to have repeat blood tests and, if possible, have measurements made by both methods for direct comparison. It is possible, after all, that the lab were wrong and the meter reading was correct!

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26354 · March 21, 2014 at 2:06 PM

were both tests fasted?

Cholesterol is a point estimate, and fluctuations occur -- but doubling in a day? never seen anything like that. I would try to get another test -- soon.

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