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Just got my first set bloodwork done and need some advice!

Low TG but LDLs on the high side (didn't get to do VAP). What shocked me was my high A1C score - it screams pre-diabetics, doesn't it?

BTW I'm 24, asian female, and have been on paleo for about 3 months, doing moderate fat and moderate carb, and grain/dairy/legume-free.

TC: 211

HDL: 91

LDL: 112

LDL (Iranian): 78

TG: 41

Fasting blood glucose: 82

HBA1C: 6.2

C-reactive protein: 0.1

Will appreciate advice and help with analysis :)

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 I know others have answered... I was diagnosed diabetic with an OGTT - my HbA1c at that point was 6.1 & that was eating high carb/SWD (standard western diet). For me, that is higher than my diabetic diagnosis, so certainly worth keeping an eye on. – Efaitch Sep 16 2011 at 9:11

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neelie,

Congratulations on staying paleo for 3 months! Your numbers look good, which makes me suspect a lab error on the HBA1C result.

Some sources say a normal A1C can go up to 6.0%, instead of the more commonly reported 5.7%. Your result of 6.2% is close enough to the normal limit that it may be due to a measurement variation rather than being truly abnormal. It would be reasonable to repeat the A1C test in a few months.

I agree with Travis except for a minor quibble--hemoglobin A1C will usually come down in 3 months, because your body replaces most of its red blood cells within 3 months.

If your HBA1C test continues to be elevated when repeated, we know that it's not from inflammation/cortisol, because your CRP is close to zero. We also know that you're not consuming too much carbohydrate, because your triglycerides are low. Consider getting screened for hyperthyroidism at that point. Also, if you're taking high doses of iodine, stop.

Keep us updated if there are new developments.

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1 
 Thanks Ed. Curious about the link you made with hyperthyroidism - I feel more of the symptoms of hypothyroidism than those of hyper. Then of course, that's only my gut feel. – neelie Sep 16 2011 at 9:57
@neelie, your "gut feel" is probably right. Hypothyroidism is much more common, especially in asian women, than hyperthyroidism. I was merely noting that hyperglycemia can be a sign of hyperthyroidism in some cases. Thank you for accepting my answer :) – Ed♦ Sep 16 2011 at 13:44
That's a good point, Ed, but it may come down to how much of that "moderate carb" is comprised of high-fructose fruit as well. – Travis Culp♦ Sep 16 2011 at 15:54
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Eveything looks great; you ought to keep doing what you're doing. The HbA1c takes time to come down since it's a reflection of glycation over a long period.

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Thanks Travis. Was reading your previous question on the link between high LDL and paleo - upvoted that! – neelie Sep 16 2011 at 4:12
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Check this post out from Cris Kresser for why your A1C is most likely high.

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Interesting stuff. – David Moss Sep 16 2011 at 12:03
Thanks for the link, Jim! – neelie Sep 16 2011 at 14:57
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You may also have long lived RBCs. But its probably just short time in low carb.

Ed: Low CRP doesn't rule out inflammation or stress.

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Plus one maj and excellent points. Post prandial glucose and insulin levels are very accurate – The Quilt Sep 16 2011 at 12:31
Yes, I think this is the most important thing I got from Dr Davis. I don't get usefulness of fasting glucose levels, since if those are screwed chronically, you have diabetes already. I measure -1, 1, 2 hours on meal. – majkinetor Sep 16 2011 at 12:46
@majkinetor, true that low CRP does not rule out inflammation or stress, but inflammation or stress SEVERE ENOUGH TO CAUSE CHRONIC HYPERGLYCEMIA would almost certainly cause a blip in CRP. – Ed♦ Sep 16 2011 at 13:31

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