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HDL up, LDL down, TG down, TC up??

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  • HDL up, LDL down, TG down, TC up??

    I just had another test result back and it was looking good with HDL up and both LDL and TG down until I noticed that the Total Cholesterol (TC) was up. What's up with that?

    Test name Abbr. 20150503(US) 20190509(US) 20190719(US) 20190829(US) 20191129(US)
    LDL/HDL 5.1 3.3 - 3.0 2.3
    TG/HDL <1 good 1-2 Ok >2 Bad 4.1 1.5 - 2.2 1.0
    TC/HDL <3.5 good 3.5-5 OK 5> Bad 6.5 4.6 - 4.2 3.7
    Glucose GLU 92 97 0 100 87
    Triglyceride TG 124.0 69.1 0.0 96.5 56.7
    Total cholesterol TCHO 198.0 207.7 213.5 188.7 208.4
    High-density lipoprotein cholesterol HDL-C 30.5 45.2 0.0 44.5 55.7
    Low density lipoprotein cholesterol LDL-C 154.3 148.1 0.0 131.9 130.7

  • #2
    I wouldn't worry about the relatively small ups and downs as the lab results for these kinds of tests appear to make those ups and downs seem more significant than those really are as far as health indicators goes. When the deltas go up/down more 20% over time, then you probably have a trend vs. a "biologic" variation which isn't meaningful.

    Comment


    • Tom
      Tom commented
      Editing a comment
      One other comment is that you want your lab results to reflect your diet/lifestyle, and so you should not make significant changes to your diet/lifestyle just before getting the lab tests done. Some people, for whatever reason, make significant changes and the results muddle their health markers. For instance, if you significantly change your carb intake in the days before a lab test, it will likely be reflected in your triglyceride levels but not in your HDL-C levels. For many people a long-term higher level of triglycerides will reduce their HDL-C. If a person is on a LCHF diet long-term, then they do need to transition to burning some carbs before taking an OGTT. However, their problem is typically not high triglycerides reducing their HDL-C level. Once you have a lab test result, then make significant long-term changes which hopefully will be reflected in the next lab test. For me after several rounds of lab tests and changing my diet/lifestyle, I can almost tell what my numbers are going to be to the extent that those matter for health.

    • sthubbar
      sthubbar commented
      Editing a comment
      Tom, points well taken. Thank you.

  • #3
    This is a case where total cholesterol is misleading.
    • Your HDL is a little low. Optimal is 60 and higher.
    • Your triglycerides are great, but the formula for total cholesterol only uses triglycerides/5 when calculating total cholesterol. That's why even though your triglycerides were significantly lower, your total cholesterol went up.
    • You have to decide if you believe your ldl is good where it is or if it should be lower. Low LDL advocates say 50-100 with the sweet spot around 70. Others believe it should be much higher. I think it comes down to what does your level of ldl mean?
    Total cholesterol = LDL + HDL + triglycerides/5 (this will be close to what lab reports)
    198 = 130.7 + 55.7 + 56.7/5

    Comment


    • sthubbar
      sthubbar commented
      Editing a comment
      rich, thank you. I appreciate the advice. I had never heard this TC calculation, I always thought TC = HDL + LDL + all the other cholesterol. I never had any idea that "all the other cholesterol" = TG/5. Something more to research.

    • Tom
      Tom commented
      Editing a comment
      The TG/5 estimation for VLDL particles is a rough estimation that becomes less accurate when a person's triglyceride level is over 200 mg/dL. I know that we have these formulas that people like to use, but the accuracy is not nearly as good as the numbers indicate.
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