This may sound dumb, but what the heck. I’ve been advised to take nothing by mouth except water, tea or coffee after midnight the night before my physical.
OK, my doc’s got me taking Inderal once a day, and I normally take it about 6:30 AM. Should I skip it? Take it before midnight?
In most cases, the NPO (nothing by mouth) order is really a fasting order, to enable one to provide a fasting blood sample in the morning, to check for diabetes and see how high ones triglycerides are. In that case, the prohibition is really generally for no food or drink with calories in it.
But if one is going in for a surgical procedure, or other procedure which requires anesthesia, then its really necessary to take nothing by mouth.
I always told my patients with your situation who were coming in for a routine physical to take an important medicine (like inderal) at the usual time with a small amount of water.
I don’t know if you doc has other plans for you or not.
Hope that helps.
QtM, MD
Thanks Qad, I was hopin’ you’d see this thread (before midnight). It is a routine physical.
I exist but to serve. Not.
On call 
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At least one study has tried to demonstrate that over-zealous adherence to the “nothing by mouth rule” could affect cholesterol measurements.
So KarlGauss, what do you think is an adequate fast to get reliable triglyceride readings? You are more wise in the myriad ways of the pancreas than I.
(Thanks for the lovely email note, BTW. Once I get my life organized, I will return the favor. Say about 2007!)
Am I correct in assuming that not fasting will result in higher triglyceride levels? In other words, if, say, a cholesterol test is conducted while you are not fasting but yields results in the normal range, is it safe to say that your “real” cholesterol level is also within the normal range?
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Qadgop
I haven’t seen a thread on your adventures lately. Have you done one recently and I just missed it or do you owe us another installment?
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For most people, a fast of eight to ten hours should suffice to get an accurate triglyceride level. Of course, there will be the occasional person, starting off with massively elevated levels, who may take much longer to get the TG’s down.
As the paper cited above suggests, though, there may be some misleading readings obtained after a prolonged fast if it included strict salt and water restriction. Simply put, if you dry out during a fast, your lipids become more concentrated.
Truth Seeker - Yes, not fasting will lead to higher triglyceride levels. And, yes, you would be generally right to say that if a non-fasting cholesterol is normal, the fasting cholesterol level will also be normal.
The reason I say you are only “generally right” about nonfasting cholesterol tests has to do with HDL and LDL. Here is an article and here is another that show that generally there’s not much difference for cholesterol measured in the non-fasting state (unlike that for triglycerides) but there can sometimes be some significant differences (and in directions you might not expect).