So last week I went to the doc to get a prescription refilled. He decided to do blood work. I told him I wasn’t expecting that and thus hadn’t fasted. The nurse supposedly made a note of that.
Well the nurse called today and said my triglycerides were over 400 and I needed to make dietary changes. I told her I hadn’t fasted and had a normal breakfast and lunch. She said even still the tri levels shouldn’t be that high. I am not overweight. I weigh 180 and am 6-2. I get at least 10 hours of high impact cardio a week. My cholesterol levels have always been fine.
A few years back the same thing happened with another doctor. I forgot to fast before a physical and had a particularly bad lunch of a burger, fries, and Coke. My levels were again 400+. When I came back 2 months later and did a fasting test my levels were around 120.
Any thoughts about what is going on or why my nonfasting levels are so high? This particular day I had two cups of coffee and bagel and cream cheese for breakfast. Then I had a turkey sandwich and baked chips and diet coke for lunch. That was all I had eaten.
I was just at the doctor today for my annual medication check which includes cholesterol as I’m on a cholesterol medication due to very high triglyceride levels among other things and she asked if I had been fasting, which I had been. I told her I was washing some cherries this morning but didn’t eat any. She said that would have been OK as they weren’t carbs. So apparently carbs seem to be the issue.
I know that non-fasting lipid profiles are becoming more accepted (in fact, I think they’re regularly used in Europe), but it seems to me that just throws too much of a variable into the results. High-carb, and especially high-fat, meals eaten within 12 hours of the test can significantly skew the results.
I’ve been on cholesterol meds for about 25 years. My issue is primarily hereditary (thanks Mom!), but diet can definitely play a part. My lipid panels are always done in a fasting state; I schedule my appointment for early in the morning, and try to eat lightly the night before (and not at all for 12 hours prior to the blood draw).
If possible, I’d schedule another blood draw, this time fasting. Particularly given the fact you’ve experienced this before, and that your cholesterol levels have always been good, I’d avoid making any changes (either dietary or medication-wise) until you have more information.
A spike to 400 seems a little odd, but again, if your cholesterol range is normally low, I wouldn’t worry overmuch about it barring other issues.
Down to 158 as of yesterday!! WooHoo! That’s after a long road of medications and diet and exercise changes but finally some success. Overall cholesterol is still a little high at 248 but I’ll take it.
Your doctor doesn’t know a lot about food composition. While cherries aren’t 100% carbs, they do contain sugars (carbs are the family of chemical compounds of which sugars are just the smallest members). I can’t give a number since the values I find on a quick search are all over the map.
With regard to a lipid panel (of which triglycerides is one of the tests), carbs are not the issue. *Fats *are the issue (if you have recently consumed a fatty meal the result may be elevated).
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My pleasure. Standard disclaimers abound: I’m not a doctor, I’m not YOUR doctor, this ain’t professional medical advice, etc.
Two notes, though:
I’d do some research on my own and question the doc the next time I saw him about your triglyceride spike. I think your doctor (or maybe just the nurse) is probably jumping the gun on recommending dietary changes based on this one result, but why your levels jump so significantly after eating might be worth exploring.
While good overall physical health plays a factor in your lipid levels, and your diet is important, the biggest issue is genetic. Just because you’re in good shape and eat properly doesn’t mean your lipid levels are okay. Keep a check on your levels regularly (which it sounds like you do) and take medication if needed.
Sauron, one thing I read last night was that extreme exercise before a lipid test can cause a spike. Have you heard this? My appointment was last Wednesday and the night before I played a nearly 3 hour tennis match in 90 degree heat with 80% humidity. I was dehydrated and near cramping by the end. Do you think that could be part of it?
Both my parents have normal cholesterol levels. The one time before it spiked, I literally ate a huge fast meal 2 hours before the test.
Exercise shortly before the lipid panel can affect the results, yes. In general, regular exercise can help lower triglyceride levels, but strenuous exercise and dehydration may cause a temporary increase in LDL and triglyceride levels. Actually, it can create wonky results across the board, depending on your physiology.
A quick anecdote, which isn’t triglyceride-related, but it is blood-test-related:
About 20 years ago, I gave blood at a Red Cross drive, and shortly afterward I got a letter from them saying I’d tested positive for hepatitis C. I was sufficiently freaked out, because I had no clue how I could have contracted the disease.
Went to my doctor, who rolled his eyes and said he’d bet his pension I didn’t have hep-c, but scheduled a full blood analysis anyway. Result: I was completely clean.
Here’s the point of the story: My doc said that people who were losing weight sometimes twigged as false positives for hep-c. Something about an enzyme or some such the body created during weight loss, which could trick the test. At this time, I’d just lost about 25 pounds, so we figured that was the cause of the false positive. I’ve had blood tests every year since then as part of my annual physical, and I’ve never had another positive hep-c result.
The downside is, I can’t donate blood any longer. Well, I CAN, but the collecting agency will just destroy it, because I once tested positive for hep-c, and that’s noted somewhere in the Big Book o’ Blood Donors.
I think my result might be result of the extreme exercise I had the night before, then. It just doesn’t make sense that it would spike that high when nothing in my life has changed. If anything my diet and fitness level are better.
I appreciate the info and anecdotes you’ve posted. I’m a bit of a hypochondriac so it’s helped.