Help me interpret my lab results
October 22, 2010 9:20 AM Subscribe
I need help with deciding what steps to take to lower my cholesterol..
I have recently gotten a full workup done at the doctor.
I scheduled an appointment with a doctor because my employee sponsored "screening" indicated that I have high cholesterol. I have family history of heart disease so I thought it would be a good idea to get everything under control asap.
My labs results are hard to interpret-and my doctor's explanation was very medical and a little hard to grasp.
My labs results showed (unfortunately, as expected)
High LDL levels and high TOTAL cholesterol.
The tests also showed High T3 and Thyroxine Binding Globulin.
The doctor wants me to meet with a special dietician and try to get the cholesterol down with a diet alone. She does not want to give me any medication (although: she is sending me to do the thyroid test again, to confirm the results are the same)
My question: According to my Google search (and the doctor)-the high t3 and TBG indicate that something is up with my thyroid.
Since the thyroid monitors the metabolism-I'm wondering if it's going to be "worth" going on the special diet.
As an extra note: I'm female, 25 and 5'3. My current weight is a little over 150 and I should note: it's VERY hard for me to lose weight. I can do it..but it's very very slow process. In general one a day to day: I do monitor myself and I eat healthy. I also do at least 3 hours of cardio a week (usually, more).
Does anyone have experience with this? Is my thyroid the reason my cholesterol is high? vice versa? Should I start the diet? Should I insist on meds for the thyroid before I start?
I have recently gotten a full workup done at the doctor.
I scheduled an appointment with a doctor because my employee sponsored "screening" indicated that I have high cholesterol. I have family history of heart disease so I thought it would be a good idea to get everything under control asap.
My labs results are hard to interpret-and my doctor's explanation was very medical and a little hard to grasp.
My labs results showed (unfortunately, as expected)
High LDL levels and high TOTAL cholesterol.
The tests also showed High T3 and Thyroxine Binding Globulin.
The doctor wants me to meet with a special dietician and try to get the cholesterol down with a diet alone. She does not want to give me any medication (although: she is sending me to do the thyroid test again, to confirm the results are the same)
My question: According to my Google search (and the doctor)-the high t3 and TBG indicate that something is up with my thyroid.
Since the thyroid monitors the metabolism-I'm wondering if it's going to be "worth" going on the special diet.
As an extra note: I'm female, 25 and 5'3. My current weight is a little over 150 and I should note: it's VERY hard for me to lose weight. I can do it..but it's very very slow process. In general one a day to day: I do monitor myself and I eat healthy. I also do at least 3 hours of cardio a week (usually, more).
Does anyone have experience with this? Is my thyroid the reason my cholesterol is high? vice versa? Should I start the diet? Should I insist on meds for the thyroid before I start?
Your Doctor is a health professional.
Google is not.
posted by Biru at 10:04 AM on October 22, 2010 [2 favorites]
Google is not.
posted by Biru at 10:04 AM on October 22, 2010 [2 favorites]
The thyroid issue and the cholesterol issue are two different things.
Regarding the thyroid, the answer is easy - get the tests repeated, confirm if the results are correct, and be treated for your thyroid issue if they are. You do not need meds for thyroid before you start to address your cholesterol problem.
For cholesterol, you definitely want to try the diet. The fact that your doctor recommended diet changes first and not medication immediately means that your numbers were high, but not beyond-repair-sky-high. You should also continue your regimen of moderate exercise, maybe step it up to 5 days a week. I also take fish oil because it seems like we are always finding out new benefits from fish oil, and you say you have a family history of heart disease - fish oil is known to help prevent heart attacks, and it brings down your triglycerides. I recommend taking a high quality brand right before you go to bed so you don't get fishy reflux.
It sounds like a little background reading on what it means to have high cholesterol would be helpful for you. You can try this Mayo Clinic site.
Remember, addressing high cholesterol is not the same as addressing being overweight. But weight loss can result by eating right and exercising, two things that will also help your cholesterol!
posted by treehorn+bunny at 10:12 AM on October 22, 2010
Regarding the thyroid, the answer is easy - get the tests repeated, confirm if the results are correct, and be treated for your thyroid issue if they are. You do not need meds for thyroid before you start to address your cholesterol problem.
For cholesterol, you definitely want to try the diet. The fact that your doctor recommended diet changes first and not medication immediately means that your numbers were high, but not beyond-repair-sky-high. You should also continue your regimen of moderate exercise, maybe step it up to 5 days a week. I also take fish oil because it seems like we are always finding out new benefits from fish oil, and you say you have a family history of heart disease - fish oil is known to help prevent heart attacks, and it brings down your triglycerides. I recommend taking a high quality brand right before you go to bed so you don't get fishy reflux.
It sounds like a little background reading on what it means to have high cholesterol would be helpful for you. You can try this Mayo Clinic site.
Remember, addressing high cholesterol is not the same as addressing being overweight. But weight loss can result by eating right and exercising, two things that will also help your cholesterol!
posted by treehorn+bunny at 10:12 AM on October 22, 2010
Response by poster: treehorn-thanks for the response. I'm wondering if I would see more results from the diet-if the thyroid problem was fixed first. I want to specify-I do not eat badly-I've examined my diet, I write down all the food I eat..I'm very careful. I don't think the dieticians are going to make huge changes to my current routine. This is not going to be a switch from fast food and carbs to a clean, healthy diet. I'm already doing everything "right". (Obviously, I'm not a dietician or a doctor-but I have a pretty good grip on the nutrition aspect).
However, I've honestly had a really really hard time losing weight. I excercise, I write down my food, I count calories. In the past, I've actually thought that it feels like my body is just not listening and it working differently than others. I should be at an optimal weight based on my calories intake and excercise level.
I'm afraid that I will get discouraged with the lack of results - IF the cause for me not losing weight is due to this thyroid problem. If that's not the cause-I'm back at square one.
posted by duddes02 at 10:24 AM on October 22, 2010
However, I've honestly had a really really hard time losing weight. I excercise, I write down my food, I count calories. In the past, I've actually thought that it feels like my body is just not listening and it working differently than others. I should be at an optimal weight based on my calories intake and excercise level.
I'm afraid that I will get discouraged with the lack of results - IF the cause for me not losing weight is due to this thyroid problem. If that's not the cause-I'm back at square one.
posted by duddes02 at 10:24 AM on October 22, 2010
Another vote for fish oil. In the year since I've been taking it, and with no other changes to my diet, exercise, caffeine, or nicotine habits, I dropped from a total cholesterol of 175 with an HDL of 31 to a total cholesterol of 161 with an HDL of 71.
Do you smoke? I'm assuming not, since you have a family history of heart disease. What about eating a lot of simple carbs? Research is showing that eating fat doesn't raise your cholesterol, carbohydrates do.
High cholesterol runs in my family. I eat a preposterously high fat diet. I still consume nicotine. But I take fish oil and I don't eat a lot of simple carbs. Works for me. Might not work for you.
posted by elsietheeel at 10:26 AM on October 22, 2010
Do you smoke? I'm assuming not, since you have a family history of heart disease. What about eating a lot of simple carbs? Research is showing that eating fat doesn't raise your cholesterol, carbohydrates do.
High cholesterol runs in my family. I eat a preposterously high fat diet. I still consume nicotine. But I take fish oil and I don't eat a lot of simple carbs. Works for me. Might not work for you.
posted by elsietheeel at 10:26 AM on October 22, 2010
Response by poster: I don't smoke and I don't eat a whole lot of simple carbs.
I'm liking the fish oil suggestion! I'll def look into that.
posted by duddes02 at 10:28 AM on October 22, 2010
I'm liking the fish oil suggestion! I'll def look into that.
posted by duddes02 at 10:28 AM on October 22, 2010
When my cholesterol was high I was advised to keep an eye on saturated fat - take care on dairy, red meat, cakes and pastries. It's not necessarily about weight - a colleague is a lean runner and is having a similar issue.
posted by mippy at 10:56 AM on October 22, 2010
posted by mippy at 10:56 AM on October 22, 2010
Eating soluble fiber is another way to lower LDL cholesterol. Oatmeal, beans, and some fruits and vegetables contain soluble fiber.
I was able to lower my LDL with no dietary changes just by exercise, but it sounds like you are already on top of that.
Coffee, oddly, has been shown to increase cholesterol. Using filters removes the compounds that raise cholesterol. So I had to cut down on espresso drinks and switch to making filtered at home.
posted by Knowyournuts at 11:32 AM on October 22, 2010
I was able to lower my LDL with no dietary changes just by exercise, but it sounds like you are already on top of that.
Coffee, oddly, has been shown to increase cholesterol. Using filters removes the compounds that raise cholesterol. So I had to cut down on espresso drinks and switch to making filtered at home.
posted by Knowyournuts at 11:32 AM on October 22, 2010
Unfortunately, for some people, eating a pretty healthy diet isn't enough--they have to be really scrupulous about the cheese, meat, etc., that they eat. My mother had a healthy diet and high cholesterol; she had to really be careful with her eating to lower her cholesterol at all. There's lots of info out there, but generally what you want to do is increase your healthy fat (olive oil, tree nuts, avocados) and decrease saturated fat (butter, cheese, etc.). Eat your veggies, oatmeal, and beans.
I don't know if this applies to you, but I've noticed that a lot of people tell little lies to themselves about how healthy they eat. Things like, "cheese is okay because it has calcium," "it's okay because it's a salad," "butter is okay because it's natural" and "I can eat this because I worked out." You have to be really honest with yourself, and look at the details closely, because the dressing and the toppings (croutons, cheese, bacon bits) can make a healthy salad into a diet disaster.
All that being said, my honey lowered his cholesterol by working out a lot, even though his diet is still pretty unhealthy.
posted by WorkingMyWayHome at 1:05 PM on October 22, 2010 [1 favorite]
I don't know if this applies to you, but I've noticed that a lot of people tell little lies to themselves about how healthy they eat. Things like, "cheese is okay because it has calcium," "it's okay because it's a salad," "butter is okay because it's natural" and "I can eat this because I worked out." You have to be really honest with yourself, and look at the details closely, because the dressing and the toppings (croutons, cheese, bacon bits) can make a healthy salad into a diet disaster.
All that being said, my honey lowered his cholesterol by working out a lot, even though his diet is still pretty unhealthy.
posted by WorkingMyWayHome at 1:05 PM on October 22, 2010 [1 favorite]
You need to do strength training as well. Strong muscles burn calories just sitting there. [too much] cardio alone actually works against weight loss because it increases the body's desire for fat reserves.
posted by gjc at 2:41 PM on October 22, 2010
posted by gjc at 2:41 PM on October 22, 2010
[I'm an internist who's been in practice for 15 years.]
Thyroid evaluation begins with TSH (thyroid-stimulating hormone). Other thyroid tests are impossible to interpret except in light of the TSH value. If you are hypothyroid with a TSH over 8 or so, it will be difficult-to-impossible to get your cholesterol down without treating the thyroid issue first. Hypothyroidism would also explain an inability to lose weight.
Cholesterol is the least important risk factor for cardiovascular disease. Smoking is by far the most important, followed closely by diabetes. High blood pressure is important.
For people with high HDL, using the ratio of total cholesterol to HDL (TC/HDL) is a useful measure; the average is 4.3 with lower being better.
People with high cholesterol fall into two camps: those whose diet affects it and those whose diet doesn't affect it.
If your cholesterol levels are consistently borderline, a test of C-reactive protein may help decide whether you should take a statin.
Exercise has little impact on cholesterol, but is still essential and the more the better.
posted by neuron at 3:40 PM on October 22, 2010 [2 favorites]
Thyroid evaluation begins with TSH (thyroid-stimulating hormone). Other thyroid tests are impossible to interpret except in light of the TSH value. If you are hypothyroid with a TSH over 8 or so, it will be difficult-to-impossible to get your cholesterol down without treating the thyroid issue first. Hypothyroidism would also explain an inability to lose weight.
Cholesterol is the least important risk factor for cardiovascular disease. Smoking is by far the most important, followed closely by diabetes. High blood pressure is important.
For people with high HDL, using the ratio of total cholesterol to HDL (TC/HDL) is a useful measure; the average is 4.3 with lower being better.
People with high cholesterol fall into two camps: those whose diet affects it and those whose diet doesn't affect it.
If your cholesterol levels are consistently borderline, a test of C-reactive protein may help decide whether you should take a statin.
Exercise has little impact on cholesterol, but is still essential and the more the better.
posted by neuron at 3:40 PM on October 22, 2010 [2 favorites]
OP, you probably would see more results if the thyroid problem was fixed first, but I still think it's never too early to avoid high-cholesterol foods.
Agreed with neuron that you need a TSH to help with interpretation. Am surprised that they ran the other tests without running a TSH.
Just remember, some medical problems like cholesterol and blood pressure don't cause much in the way of changes you can see or feel, so it's hard to motivate yourself based on how you look or feel - but if you can get those numbers down it does make a difference for your health long term. I used to have high cholesterol myself, and I made a few dietary changes (cut out my alfredo sauce habit, became vegetarian, the fish oil). I haven't lost any weight, in fact I've probably gained 10 pounds, but my cholesterol's significantly improved, in the normal range now.
posted by treehorn+bunny at 8:12 PM on October 22, 2010
Agreed with neuron that you need a TSH to help with interpretation. Am surprised that they ran the other tests without running a TSH.
Just remember, some medical problems like cholesterol and blood pressure don't cause much in the way of changes you can see or feel, so it's hard to motivate yourself based on how you look or feel - but if you can get those numbers down it does make a difference for your health long term. I used to have high cholesterol myself, and I made a few dietary changes (cut out my alfredo sauce habit, became vegetarian, the fish oil). I haven't lost any weight, in fact I've probably gained 10 pounds, but my cholesterol's significantly improved, in the normal range now.
posted by treehorn+bunny at 8:12 PM on October 22, 2010
You should also be aware of the arguments/facts presented in Good Calories, Bad Calories. Long story short, carbs - especially refined carbs - become bad LDL and VLDL cholesterol. The actual book is a substantial chunk of forest (or electrons) but a summary is also available.
After reading that book, I have started a Paleo diet which jibes very much with that research, and have been feeling excellent.
posted by Earl the Polliwog at 9:06 PM on October 22, 2010 [1 favorite]
After reading that book, I have started a Paleo diet which jibes very much with that research, and have been feeling excellent.
posted by Earl the Polliwog at 9:06 PM on October 22, 2010 [1 favorite]
You might also consider reducing your wheat consumption.
It has been linked to higher bad cholesterol. The data from the famous China Study actually implicates wheat as the most highly correlated variable with both heart disease and high BMI.
This is also consistent with evolutionary/paleo nutrition.
posted by Earl the Polliwog at 1:30 AM on October 23, 2010
It has been linked to higher bad cholesterol. The data from the famous China Study actually implicates wheat as the most highly correlated variable with both heart disease and high BMI.
This is also consistent with evolutionary/paleo nutrition.
posted by Earl the Polliwog at 1:30 AM on October 23, 2010
but I still think it's never too early to avoid high-cholesterol foods.
http://en.wikipedia.org/wiki/Cholesterol#Dietary_sources
Total fat intake, especially saturated fat and trans fat,[14] plays a larger role in blood cholesterol than intake of cholesterol itself
posted by gjc at 4:02 AM on October 23, 2010
http://en.wikipedia.org/wiki/Cholesterol#Dietary_sources
Total fat intake, especially saturated fat and trans fat,[14] plays a larger role in blood cholesterol than intake of cholesterol itself
posted by gjc at 4:02 AM on October 23, 2010
Response by poster: Thanks for all the answers.
As an additional note: (I should have added this in my initial question)-I eat a very limited selection of food (including very little dairy) For example:no butter, cheese, creamy dressings, creamy soups, red meat..etc. My diet is mostly low fat protein, healthy oils, whole wheat/whole grain carbs, vegetables, and fruits.
I'm going to be retake the thyroid tests as well as meeting the dietician. Hopefully, I can fix both problems at the same time.
posted by duddes02 at 8:47 PM on October 24, 2010
As an additional note: (I should have added this in my initial question)-I eat a very limited selection of food (including very little dairy) For example:no butter, cheese, creamy dressings, creamy soups, red meat..etc. My diet is mostly low fat protein, healthy oils, whole wheat/whole grain carbs, vegetables, and fruits.
I'm going to be retake the thyroid tests as well as meeting the dietician. Hopefully, I can fix both problems at the same time.
posted by duddes02 at 8:47 PM on October 24, 2010
This thread is closed to new comments.
I know it's a giant time commitment; if he'd not built it into his commute, I don't think he could have done it. But man alive it was effective.
posted by KathrynT at 9:48 AM on October 22, 2010