OP’s tour is over. Pre-diabitus

[Heisman2]

For those confused about adult onset diabetes that isn't classic type 2:
- https://www.mayoclinic.org/diseases-...s/faq-20057880
- https://www.health.harvard.edu/a_to_...ng-mody-a-to-z

You can google for further information if curious.

With a fasting glucose of 108 that's slightly high but not terribly worrisome. Do you know if you actually got a hemoglobin A1c checked? 5.7-6.4 is considered prediabetes.

[boo99]

Your LDL is high. What did your doc say about that?

How much saturated fat and cholesterol are you consuming per day? How's your fiber intake?

I was told by my MD that that the ratio is prioritized and scrutinized the most

@Heisman, is this the way it is?

I trust you more than my own MD

[Mrpb]

I was told by my MD that that the ratio is prioritized and scrutinized the most

I guess he received his education quite a while ago?

LDL independent of HDL is a pretty good indicator for CVD risk from what I've seen. Lower LDL is better. Increasing HDL on its own has no effect.

[boo99]

I guess he received his education quite a while ago?

LDL independent of HDL is a pretty good indicator for CVD risk from what I've seen. Lower LDL is better. Increasing HDL on its own has no effect.

Probably

Most MDs here aren't so progressive


Except Heisman



"Have you heard of NCBI Doc?"

I show them new research sometimes and they kinda sneer at me, glance at the paper for a second, then toss it aside

But the ratios are what they tell their patients, unfortunately

More than one of my MDs have said that

[rtpmarine]

I have literally ZERO idea what ANY of this means. All I was told is that cholesterol and glucose were a bit high.

Here are the cliff notes. Mrpb and Heisman2, keep me honest if I mess anything up.

Triglyceride result 70 mg/dL (reference range 10-149)

Triglycerides are lipids that store energy in fat tissue. They are called triglycerides because they contain three fatty acids that are linked together by glycerine. When your body is low on energy, it will draw triglycerides out of fat cells and break them down for use. The three fatty acids can be used by almost all tissues in the body (except for the brain). If energy is very low, then the glycerine link can be converted to glucose. Your triglycerides number is pretty much perfect considering your diet at the time.

Cholesterol 229 mg/dL (reference range 10-199)
HDL Cholesterol 49 (reference range >=40)
LDL Cholesterol (calculated) 166
Total Cholesterol/HDL ratio 4.7 (reference range 3.4-9.6)

Cholesterol is also a lipid, but whereas triglyceride is for storing energy, cholesterol is actually used by the cell for constructive purposes. LDL has traditionally been thought of as "bad" cholesterol, and HDL as "good" cholesterol. This understanding is currently changing, however, as we learn their nuances. One thing that seems fairly certain is that HDL and LDL need to remain in balance and if one gets too out of whack relative to the other then bad things happen. This is why your test results show the Total/HDL ratio. In your case, your HDL looks good but your LDL is a bit high. The entire lipid profile actually looks exactly like someone who is predisposed to storing visceral fat more than subcutaneous fat.

Testosterone 665.0 ng/dL (Flag reference range 249.0-836.0)

Hopefully testosterone speaks for itself--you're good to go there. This number probably has more effect on your libido than anything else, so your experiences may just reflect the ups and downs of your testosterone. Totally normal fluctuations regardless of diet. I'll get wildly horny from a heavy squat or deadlift session.

Thyroid Stimulating Hormone, Serum w/FT4 Reflex 2.12 ulu/ml (flag reference range 0.27-4.20)

TSH is somewhat tricky. The thyroid hormones that actually affect metabolism are T3 and T4. These two have a complicated relationship that is kinda confusing, but just understand that these are the hormones most responsible for regulating cellular metabolism throughout the body. TSH is the hormone that tells the thyroid to make T3 and T4. A TSH of 2.12 is interesting, but doesn't really tell you anything without also knowing T4.

• If T4 is normal or slightly high, then your TSH measurement can be interpreted as being normal. This is because we expect the TSH to signal the production of T3/T4. So a moderate TSH value should match with a moderate T4 level.
• If your T4 is low, however, then that implies that the body wants more T3/T4, is therefore sending the TSH signal to the thyroid to make what it wants, but the thyroid isn't able to get the job done. This is hypothyroidism.

Most doctors won't request T4 tests unless you are exhibiting signs of being hypothyroid. They assume that feeling normal = normal T3/T4 levels. It's up to you if you want to go the extra mile to get those numbers for added clarity. I'd expect you to be in the normal range.

Glucose 108 (reference range 70-99)

The idea behind this test is that fasting overnight and then measuring your blood glucose before eating any breakfast gives an indication of how well your body is maintaining blood glucose, in particular with respect to the top of the reference range. Assuming that you stayed fasted prior to taking this blood test, the result of 108 indicates that your body never got blood glucose levels down from the night before. Since insulin's primary job in life is to bring down blood glucose, the implication is that you are either A) not producing enough insulin or B) your body is becoming resistant to the effects of insulin or C) both A and B. There are more advanced tests that can measure both A and B, but as I mentioned previously the Triglycerides/HDL ratio tends to be a really good indicator of insulin resistance. Your TG/HDL does not throw up any red flags in this regard, so if you are indeed insulin resistant, then it is likely genetic rather than an adaptive response to undue carbohydrate intake. Just me making a wild ass guess.

[Mrpb]

Probably

Most MDs here aren't so progressive


Except Heisman



"Have you heard of NCBI Doc?"

I show them new research sometimes and they kinda sneer at me, glance at the paper for a second, then toss it aside

But the ratios are what they tell their patients, unfortunately

More than one of my MDs have said that

In many situations it can make sense. HDL goes up when people lose weight, exercise, stop smoking, eat healthy etc. So MDs will like it when the ratio improves.

In Kusoks case his HDL looks fine. His LDL doesn't. I suspect those MDs would say that too, but who knows.

[kusok]

Would you guys say it’s reasonable to try the lower carb for a couple of months, then re-test, and see how I feel, (so far feel fine) and I can always run another experiment and for a few months bring carbs back in but reduce sat fat and increase fiber? And then test again and see how that feels like.

[Mrpb]

Would you guys say it’s reasonable to try the lower carb for a couple of months, then re-test, and see how I feel, (so far feel fine)

Why wouldn't it be? Serious question.

You've been raving about low carb diets for a long time, I'm surprised you keep wanting to go back to carbs.

I'll give you a suggestion based on your posts and blood test: try eating a lower carb diet with lots of vegetables, seeds, nuts, fish, poultry, some dairy and EVOO. Given your LDL level I would suggest to restrict red meat and eggs. Choose unsaturated fats instead of saturated fats if possible. A case could be made to include some oil high in PUFA too, but consume it cold.

When I say 'lower carb' I don't mean getting anal about avoiding carbs like some keto enthusiasts are doing. Unless it makes you feel bad I wouldn't even avoid fruits. I suspect you'll feel fine after eating an apple. If so, don't avoid it because it has carbs.

[kusok]

Why wouldn't it be? Serious question.

You've been raving about low carb diets for a long time, I'm surprised you keep wanting to go back to carbs.

I'll give you a suggestion based on your posts and blood test: try eating a lower carb diet with lots of vegetables, seeds, nuts, fish, poultry, some dairy and EVOO. Given your LDL level I would suggest to restrict red meat and eggs. Choose unsaturated fats instead of saturated fats if possible. A case could be made to include some oil high in PUFA too, but consume it cold.

When I say 'lower carb' I don't mean getting anal about avoiding carbs like some keto enthusiasts are doing. Unless it makes you feel bad I wouldn't even avoid fruits. I suspect you'll feel fine after eating an apple. If so, don't avoid it because it has carbs.

Thanks.

I’m always reluctant to not eat any carbs, or even to have a long term low carb diet, since I read that carbs make one more anabolic... And there is all this talk about lower test and thyroid on Keto and even on just lowered carb diet.

When you say restrict eggs and streak, so like a couple of times per week steak and maybe 2 eggs daily limit? Something like that?

[Mrpb]

Thanks.

I’m always reluctant to not eat any carbs, or even to have a long term low carb diet, since I read that carbs make one more anabolic...

No good evidence supporting that, and it's even more questionable in people with poor insulin sensitivity (although we don't know if that applies to you).

And there is all this talk about lower test and thyroid on Keto and even on just lowered carb diet.

Keto actually increases testosterone (https://www.ncbi.nlm.nih.gov/pubmed/28399015). I think I've already told you that previously but it seems like you don't take the answers seriously and just keep believing what you already believe. That's fine and your good right of course, but then why keep asking the same question?

When you say restrict eggs and streak, so like a couple of times per week steak and maybe 2 eggs daily limit? Something like that?

I don't know how serious you are about reducing your LDL/risk for CVD. If as much as possible I'd say 2 yolks per week and only lean red meat, 2-3 times per week. Even less would be even better when it comes to reducing LDL.

[kusok]

No good evidence supporting that, and it's even more questionable in people with poor insulin sensitivity (although we don't know if that applies to you).


Keto actually increases testosterone (https://www.ncbi.nlm.nih.gov/pubmed/28399015). I think I've already told you that previously but it seems like you don't take the answers seriously and just keep believing what you already believe. That's fine and your good right of course, but then why keep asking the same question?


I don't know how serious you are about reducing your LDL/risk for CVD. If as much as possible I'd say 2 yolks per week and only lean red meat, 2-3 times per week. Even less would be even better when it comes to reducing LDL.

Awesome, thanks for advice. Makes sense.