# Blood levels down - Cholesterol Up !!!



## Jackiejh (Dec 8, 2021)

Hi all, after another test last week, my results have now come down from 93 at diagnosis, then down to 55, now yesterday got the results that they had come down to 37!!!  Very pleased.  Only downside is that my cholesterol has gone up and is now 6.3???  I had been sort of following the keto style diet and have lost 2 stone - but may have overdone the cream and cheese part!!  Nurse said to cut down on these and will check levels again in 12 months.  Any advice or tips would be helpful!!


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## travellor (Dec 8, 2021)

Saturated fats push my LDL through the ceiling.

Have a read of the advice here for up to date guidance.



			https://forum.diabetes.org.uk/boards/threads/nhs-england-lipid-management-guidelines.97005/


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## Jackiejh (Dec 8, 2021)

travellor said:


> Saturated fats push my LDL through the ceiling.
> 
> Have a read of the advice here for up to date guidance.
> 
> ...


Thank you, will have a read!


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## rebrascora (Dec 8, 2021)

I have been eating significantly increased amounts of cream and cheese and fatty meat since diagnosis nearly 3 years ago and cholesterol is still slowly decreasing. Last result was 4.5 from 5.2 at diagnosis. No statins. Don't follow keto but I am low carb....I average about 70g carbs a day. What was your cholesterol when you were diagnosed. Just wondering how much it has gone up and do you know the break down of the lipids? ie HDL, Trigs and LDL and how that has changed? 

Oh!..... and many congratulations on your *sensational* HbA1c reduction and weight loss!


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## travellor (Dec 8, 2021)

Jackiejh said:


> Hi all, after another test last week, my results have now come down from 93 at diagnosis, then down to 55, now yesterday got the results that they had come down to 37!!!  Very pleased.  Only downside is that my cholesterol has gone up and is now 6.3???  I had been sort of following the keto style diet and have lost 2 stone - but may have overdone the cream and cheese part!!  Nurse said to cut down on these and will check levels again in 12 months.  Any advice or tips would be helpful!!



12 months is a bit of a long time to leave it.
I always reckoned any change to anything took at least 2 weeks to make a difference to any blood test results, but my surgery was happy to test after three months when I told them what I was doing, such as eating low GI. or the Newcastle diet, or cutting out fats.
That way we knew if it was working or not, and didn't go in the wrong direction for nine months.

Congratulations on you hba1c, I sure with a bit of tweaking your cholesterol will get back into line!


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## Drummer (Dec 8, 2021)

My cholesterol went down after I stopped the 'cholesterol lowering' high carb diet and ate low carb, 50 gm of carbs max each day.


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## travellor (Dec 8, 2021)

Drummer said:


> My cholesterol went down after I stopped the 'cholesterol lowering' high carb diet and ate low carb, 50 gm of carbs max each day.



Can't comment on that, there does seem to be a few it happens to that way, no doubt a few more can say the same, but as it has risen for the op on a keto diet, we need to concentrate on that?
Obviously down from 93 hba1c to 37 has smashed the prediabetic barrier, and a two stone weight loss means it's a great result apart from the final tweak.


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## Jackiejh (Dec 8, 2021)

rebrascora said:


> I have been eating significantly increased amounts of cream and cheese and fatty meat since diagnosis nearly 3 years ago and cholesterol is still slowly decreasing. Last result was 4.5 from 5.2 at diagnosis. No statins. Don't follow keto but I am low carb....I average about 70g carbs a day. What was your cholesterol when you were diagnosed. Just wondering how much it has gone up and do you know the break down of the lipids? ie HDL, Trigs and LDL and how that has changed?
> 
> Oh!..... and many congratulations on your *sensational* HbA1c reduction and weight loss!





rebrascora said:


> I have been eating significantly increased amounts of cream and cheese and fatty meat since diagnosis nearly 3 years ago and cholesterol is still slowly decreasing. Last result was 4.5 from 5.2 at diagnosis. No statins. Don't follow keto but I am low carb....I average about 70g carbs a day. What was your cholesterol when you were diagnosed. Just wondering how much it has gone up and do you know the break down of the lipids? ie HDL, Trigs and LDL and how that has changed?
> 
> Oh!..... and many congratulations on your *sensational* HbA1c reduction and weight loss!


It was 6 on diagnosis!!  Will post breakdown when I get home from work! And thank you!!


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## Drummer (Dec 8, 2021)

Cholesterol is what carries fat around the bloodstream when it is moved out of cells and taken to be broken down, so the weightloss might be why there is more cholesterol in the blood.


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## Jackiejh (Dec 8, 2021)

Drummer said:


> My cholesterol went down after I stopped the 'cholesterol lowering' high carb diet and ate low carb, 50 gm of carbs max each day.


I think my carb intake is probably only around 40 - 50 g per day - until weekends!!  Still rarely have takeaways or anything like that, probably eat less on a weekend.


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## Jackiejh (Dec 8, 2021)

travellor said:


> 12 months is a bit of a long time to leave it.
> I always reckoned any change to anything took at least 2 weeks to make a difference to any blood test results, but my surgery was happy to test after three months when I told them what I was doing, such as eating low GI. or the Newcastle diet, or cutting out fats.
> That way we knew if it was working or not, and didn't go in the wrong direction for nine months.
> 
> Congratulations on you hba1c, I sure with a bit of tweaking your cholesterol will get back into line!


Have to see the diabetic nurse next week as I have only seen them once since diagnosis (end April)!  Will try the low fat route again as I can maybe up my carbs without too much disruption (around 50 per day at moment!).  She may ask for a test sooner than the 12 months.  Mind you the nurse yesterday did say I wasn't probably due a heart attack just yet!!  Thanks!!!


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## travellor (Dec 8, 2021)

Drummer said:


> Cholesterol is what carries fat around the bloodstream when it is moved out of cells and taken to be broken down, so the weightloss might be why there is more cholesterol in the blood.



But you have said in many posts you are still losing weight as well aren't you?
And even so, it's still better to address it now, than simply hope it will decrease by itself again one day.


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## ianf0ster (Dec 8, 2021)

Without at least knowing the breakdown of the HDL level , the LDL level and the Triglyceride level it's impossible to know whether your Cholesterol is overall a little bit 'worse' or a little bit 'better'! LDL often goes up temporarily when in the weight loss phase so if it's just a 0.3 change then it's hardly a concern because you improvement in your diabetic status and your weight loss would more than compensate for a 0.3 rise in LDL (if indeed you actually have a rise in LDL).


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## rebrascora (Dec 8, 2021)

Jackiejh said:


> Have to see the diabetic nurse next week as I have only seen them once since diagnosis (end April)!  Will try the low fat route again as I can maybe up my carbs without too much disruption (around 50 per day at moment!).  She may ask for a test sooner than the 12 months.  Mind you the nurse yesterday did say I wasn't probably due a heart attack just yet!!  Thanks!!!


Lucky you! My nurse has just told me that I have a risk factor of 14% in the next 10 years. The worst of it is that the main risk factor is my diabetes which is well controlled and I am fitter and slimmer (now normal BMI) and healthier and my cholesterol is lower than it was 3 years ago pre diagnosis. I can't change my diagnosis or push it into remission because I am Type 1, my other risk factors are my age and being female apparently. Never smoked and no genetic factors. Can't do anything about my age or sex! My cholesterol is 4.5 which would be considered a healthy level for a non diabetic, so the diabetes diagnosis which has caused me to get my act together and become fitter and healthier, allegedly makes me at higher risk than before. I am not convinced by this sort of generalized logic. I suspect that the vast number of diabetics who don't lose weight or moderate their diet or manage their diabetes effectively, cause that heavy risk weighting to impact all diabetics risk score.


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## Drummer (Dec 8, 2021)

travellor said:


> But you have said in many posts you are still losing weight as well aren't you?
> And even so, it's still better to address it now, than simply hope it will decrease by itself again one day.


Losing volume, and most likely from reducing fat - but it is at a very gentle trickle - and obviously not affecting me much as I only really notice it after setting clothes aside for 6 months.


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## nonethewiser (Dec 8, 2021)

Jackiejh said:


> Have to see the diabetic nurse next week as I have only seen them once since diagnosis (end April)!  Will try the low fat route again as I can maybe up my carbs without too much disruption (around 50 per day at moment!).  She may ask for a test sooner than the 12 months.  Mind you the nurse yesterday did say I wasn't probably due a heart attack just yet!!  Thanks!!!



Sure they can request repeat test sooner than 12 months, especially has cholesterol is high. Failing that you can get it done privately, look online for postal service companies.

Personally dont avoid fat but dont look for it either, like cheese full fat yogurt but cut fat of most meat where it is in excess. Eat fairly normal diet with healthy carbs & dont have high cholesterol, last result & times before are between 4.1 to 4.5, so take things with a pinch of salt when some say that carbs raise cholesterol levels, its complete nonsense mate.


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## harbottle (Dec 30, 2021)

Same happened to me with my test results on Christmas eve!

My LDL was 3.2 when diagnosed, and has gone up to 5.0
HDL was .8 and is now 1.2 which is OK
Trig was 2.0 and is now 1.3  which is also OK

Weight dropped from 13 to 11 stone. I'd been eating 5% fat Greek yogurt, no red meat, and making a few recipes (Maybe once a week) with double cream in them (Maybe a tablespoon per person.). Use olive oil to cook (And occasionally a knob of butter) and have eggs occasionally. A Daal we make has coconut milk in it, though. Have the odd teaspoon of peanut butter in pancakes or with yoghurt... I did start putting a teaspoon or two in a coffee once or twice a week but stopped doing that.

This triggered a call from the GP and an 'offer' of statins but it was my decision. We decided to have another blood test in 3 months and see what happens.


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## Leadinglights (Dec 30, 2021)

harbottle said:


> Same happened to me with my test results on Christmas eve!
> 
> My LDL was 3.2 when diagnosed, and has gone up to 5.0
> HDL was .8 and is now 1.2 which is OK
> ...


This link may help explain your results.


			https://www.heartuk.org.uk/cholesterol/understanding-your-cholesterol-test-results


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## Felinia (Dec 30, 2021)

I had a similar result to you 20 years ago.  I lost four and a half stone on a low fat diet, but my cholesterol shot up to 7.8.  I don't know if it was true, but I was told it was because most cholesterol is a function of the liver, not so much from the food.  Because I had lost so much weight the cholesterol pumped out was supposedly more concentrated in the bloodstream.  Like I said - I don't know the medical facts - but I have never got my cholesterol below 5.2.  But as my ratio is good the GP is happy.


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## rebrascora (Dec 30, 2021)

Just my opinion but I think the weight loss process may change the ratios and levels of the lipid profile. After all your body it burning it's own fat during this phase, so it may be that your levels will sort themselves out when you reach a weight maintenance phase. 
The current thinking is that the cholesterol from the food we eat is not transferred into the blood stream but is manufactured by the body/liver. I currently eat a high proportion of saturated fats and there is no indication of that being a problem for my cholesterol levels, which have been slowly decreasing since diagnosis and low carb high fat way of eating. They are still slightly higher than the NICE guidelines for diabetics at 4.5 but if I wasn't diabetic that level would be considered fine and my diabetes is well controlled, so I am not taking statins purely because I am "diabetic". I am fit and a healthy weight which I think goes a long way to helping with these things.


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## Perfect10 (Jan 3, 2022)

I can’t get my cholesterol to lower enough but GP says ratios are ok and so won’t prescribe statins. It’s currently 6.4 but that is the lowest it has been. I do eat more fats now as have a low carb diet but would be hungry otherwise, really hard to find the right balance.


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## ianf0ster (Jan 4, 2022)

Perfect10 said:


> I can’t get my cholesterol to lower enough but GP says ratios are ok and so won’t prescribe statins. It’s currently 6.4 but that is the lowest it has been. I do eat more fats now as have a low carb diet but would be hungry otherwise, really hard to find the right balance.


What are your lipid profile figures? Surely if your ratios are OK, then who cares about total cholesterol?
My total was 7.7 at prior reading (awaiting news of test just before Xmas) and my ratios were good with low Triglycerides and high HDL.


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## ianf0ster (Jan 4, 2022)

@Perfect10 I have just read this in vol 153 of Preventative Medicine (December 2021):

Highlights​
•
The number of Americans dying of heart disease has been steadily climbing while the number with high cholesterol has been gradually falling.
•
Current guidelines recommend aggressive reduction of LDL-C to prevent coronary heart disease, but new research suggests that other factors may be far more important in the pathogenesis of coronary heart disease.
•
Despite the widespread utilization of cholesterol-lowering statins in Europe, there has been no accompanying decline in coronary heart disease deaths.
•
The totality of new evidence compels us to question why our current approach to heart disease prevention through targeted reductions of LDL-C is not working.

Later it says this:

The cholesterol hypothesis, which posits that lowering serum cholesterol reduces the risk of cardiovascular disease, is the foundation of current guidelines for the prevention of atherosclerotic cardiovascular disease (Grundy et al., 2019). The Framingham Heart Study is often cited for identifying high blood cholesterol, specifically low-density lipoprotein cholesterol (LDL-C), as a risk factor for coronary heart disease (CHD), the principal cause of heart deaths. *Yet in the original 1996 report, Framingham director Dr. William Castelli concluded, “…. unless LDL levels are very high (300 mg/dl (7.8 mmol/l) or higher), they have no value, in isolation, in predicting those individuals at risk of CHD.” (Castelli, 1996)* Despite this conclusion, modestly elevated levels of LDL-C are commonly viewed as a causal factor for CHD and the aggressive reduction of LDL-C is routinely recommended for both primary (moderate and high-risk individuals) and secondary prevention (Grundy et al., 2019). However, some recent studies are challenging whether LDL-C should be regarded as a primary risk factor. *The Women's Health Study of 28,014 women, for example, found that lipoprotein insulin resistance was the strongest biochemical marker for premature CHD (6.40 adjusted HR) compared to LDL-C (1.38 adjusted HR) (Dugani et al., 2021). The study concluded, “In this cohort study, diabetes and insulin resistance, in addition to hypertension, obesity, and smoking, appeared to be the strongest risk factors for premature onset of CHD.” (Dugani et al., 2021) Similarly, the PREDIMED study of 6901 participants concluded that, “remnant cholesterol, not LDL-C, is associated with incident cardiovascular disease.” (Castañer et al., 2020) *LDL-C is also conspicuously absent from the Pooled Cohort Equations currently recommended for estimating atherosclerotic cardiovascular risk in the most recent American Heart Association/American College of Cardiology cholesterol guidelines (Grundy et al., 2019).

I attempt to post the link to the article here: https://www.sciencedirect.com/science/article/pii/S0091743521003601


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## travellor (Jan 4, 2022)

Or then again, for those of us that don't simply want to shoot for the moon with cholesterol figures.
Get the numbers right, the ratio takes care of itself.

Posted by @Eddy Edson the official NHS guidelines.



			https://forum.diabetes.org.uk/boards/threads/nhs-england-lipid-management-guidelines.97005/
		


Up to date and summarised in a helpful chart: https://www.england.nhs.uk/aac/wp-c...2020/04/lipid-management-pathway-guidance.pdf


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## Perfect10 (Jan 4, 2022)

although my total cholesterol is 6.4 the serum cholesterol/HDL ratio is 3.56 which I think is ok?
Find it all really complicated to understand


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## ianf0ster (Jan 4, 2022)

Perfect10 said:


> although my total cholesterol is 6.4 the serum cholesterol/HDL ratio is 3.56 which I think is ok?
> Find it all really complicated to understand


That happens to be the same as mine. However since both HDL and LDL are so easy to manipulate by adjusting the amount of carbs and fat eaten - which causes a trade-off against Type 2 diabetes in my case-  (or by using the Dave Feldman protocol), plus all the drugs which raised HDL in an attempt to prevent heart attacks failed (didn't prevent heart attacks), I pay much more attention to the triglycerides.


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## Pandora71 (Jan 4, 2022)

Jackiejh said:


> Hi all, after another test last week, my results have now come down from 93 at diagnosis, then down to 55, now yesterday got the results that they had come down to 37!!!  Very pleased.  Only downside is that my cholesterol has gone up and is now 6.3???  I had been sort of following the keto style diet and have lost 2 stone - but may have overdone the cream and cheese part!!  Nurse said to cut down on these and will check levels again in 12 months.  Any advice or tips would be helpful!!


What you do depends on your view of whether higher LDL is bad for your heart. The QI risk calculator asks about HDL not LDL for example and plenty of cardiologists believe that having a low trig/high hdl ratio (these will be on your lipid profile for comparison to earlier readings) along with good blood glucose control is more important than LDL as a risk predictor.   However since the trig/hld ratio is altered by good luck and a lower carb diet, doctors reach for a pill rather than give lifestyle advice and are incentivised to do so.
Anyway if your blood sugar is better because you've enjoyed meat, cheese and cream rather than carbs, I'd say carry on because having a high blood glucose and high insulin  levels (t2) is what does the damage to your arteries.
There is NO EVIDENCE that reducing saturated fat will either reduce your ldl levels or improve your  risk of heart disease so I'd advise sticking to a diet you can live with rather than trying  to go low fat!


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## Drummer (Jan 4, 2022)

I read on Twitter - so not the most reliable of sources - someone claiming to work at a cardiology clinic where over half the patients had below average cholesterol, but that it could not be mentioned for fear of the consequences.


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## travellor (Jan 4, 2022)

I guess we all believe what we want to.

Is cholesterol a massive worldwide conspiracy theory with no evidence, and the NHS and the rest of the world health authorities are simply playing us all for reasons unknown?
Do they fix your heart attack, then recommend drugs and diets specifically to get you back in with another one?
If your total cholesterol is 20, and your HDL is 5.5, is that an excellent result, as your ratio is good?
Is Twitter a reliable source of information, and the place to expose worldwide conspiracies?

In the end all make our own choices, and see where we end up.

My personal choice is to believe the NHS, eat a healthy diet, keep all my blood results in range, BG, Hba1c, trigs, LDL, HDL, liver, kidneys, thyroid, and a host of other things, and only reading Twitter before Trump was banned. (It was better than Private Eye for entertainment)


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## Maz2 (Jan 7, 2022)

I have had the same problem. I was pre-diabetic but managed to get my levels two years running to normal levels.  HBA1c not checked less frequently. However, my cholesterol had gone up to 5.8 total unstarved.  GP asked me to try to reduce it and would check again in a year which has not been done yet due to all the problems with the Covid virus and the fact that our surgery was a vaccination hub and is now one again.   GP did explain that the cholesterol levels have now been brought down so that you have to reach a lower level before you are classed as "normal". She did say to try to reduce it but not to worry myself sick about it. Not put on statins. 

The article mentioned above is very interesting and I will  have a read at it. 

When I mentioned to the surgeon I used to work for about the Covid virus as we were unable to have our normal meet ups he seemed more concerned about whether I was still pre-diabetic than with my cholesterol so it seems he thought the former was a bigger risk factor.   If I am honest I would rather have higher cholesterol than diabetes although would, of course, prefer to avoid both.


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## Maz2 (Jan 7, 2022)

Sorry should read "hba1c now checked less frequently."


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