I just had my annual physical and my numbers suck again. I'm 40, 6'1" and 203lbs. I would say I'm in great shape but my cholesterol says otherwise. According to the internet, I'm going to die or something. I have a dairy allergy so I don't eat fast food, cook 95% of meals at home, and eat pretty healthy. I don't drink much at all and cut out a lot of excess sugar.

I did not fast before the blood draw. Had a coffee, egg, and toast with butter and honey for breakfast and pork BBQ and macaroni salad for lunch before my appointment.

Cholesterol = 197
Triglycerides = 589
HDL = 31
VLDL = 93
LDL = 73
Non-hdl = 166

Anybody been through a similar situation?

Retest with fasting as ordered.

Yep there a reason they tell you to fast before metabolic blood work. If you eat it'll skew the numbers. It sucks, but you've gotta do it if you want meaningful results.

Yep, retest fasted then review the results.

Also just know a standard Lipid Panel like that does not give the full or really a good picture despite any numbers.

Request a Lipid Panel with NMR, Fasting Insulin and HbA1c test.
.02

I concur that this should definitely be performed after 12+ hours of fasting. I'm surprised they didn't specifically instruct you to do that. All the stuff you're reading online about normal ranges are based off fasting test results, which yours aren't.

As someone whose fasting test results hover around the top end of the normal range, I get my cholesterol/triglycerides/etc. tested every 6 months. I typically schedule it first thing in the morning (8:00ish), so you can just basically eat dinner as usual, go to bed, then get up and go straight to your blood test. No significant disruption to your normal eating routine.

If your cholesterol is still concerning after the fasting test, your doctor might talk about putting you on a statin prescription, but there are are things you can discuss trying short of jumping straight to a statin.

Increased exercise, diet change (lower carb and 8/16 intermittent fasting), and dietary supplements like krill oil and niacin have been enough to lower my levels and keep me off statin drugs.

As pointed out, fasting before blood draw is very important. May want to ask for dietary guidelines. Lowering numbers for me meant giving up or limiting a number of foods. I eat mostly chicken and fish (and occasionally pasta or lean hamburger) which I cook myself using olive or avocado oil. Numbers have come down significantly, but doctor wants them even lower.

My father's family had high triglycerides as do I. most lived into their mid 90's. The VA no longer requires fasting & when I asked my doctor she said that fasting does not significantly affect the numbers.

I would cut out the rest of the sugar, as much as possible. Forget the honey/jam, etc. except perhaps 1x/week. Try to eat more like a cave man, lots of protein, steak, bacon, etc. 203 lbs. is not light. If you have six pack abs it would probably be okay, though.

Fast
Retest
Calculate ASCHD for a better risk assessment.

https://tools.acc.org/ascvd-ri.../calculate/estimate/

not sure if this is germane or not

My triglycerides have been in good numbers for years

Then for my last test, it jumped to 350

The only change in diet was that I was drinking a lot of diet soda

I measure blood sugar every morning and in late 2022 / early 2023 the numbers were high (150 to 180)

To get the numbers down, I stopped drinking coke and started drinking a lot of diet pepsi (like 3 to 5 cans each day)

After about 6 months of this heavy diet soda, the test for triglycerides was 350

I read where consuming large amounts of diet soda can increase triglycerides.

So I cut way back on diet soda. In the next week or so, I will have another blood test to see if the triglyceride number is better.

My HDL number has always been low (31 - 35)

quote:

Originally posted by SIG4EVA:
I just had my annual physical and my numbers suck again. I'm 40, 6'1" and 203lbs. I would say I'm in great shape but my cholesterol says otherwise.

So also says your BMI: You're at the low end of overweight.

Yeah, yeah: I know "BMI is bullshit." Except, for the vast majority of people who aren't lifting heavy, and thus have a lot of muscle mass: It isn't. It's a fairly decent predictor of how much body fat you're carrying. Excess body fat is a killer. Literally.

E.g.: Before I started working out and got myself back on a relatively decent diet last fall my BMI was 25, which is at the high end of "normal." My BIA (Body Impedance Analyzer) body fat measurement device pegged me at 23% body fat.

My BMI is now 23, middle of "normal" range, and my body fat's down to 16%, which is "athletic" territory. "Waitaminute!", I can see coming. "Your body fat dropped 7% but your BMI dropped only 2 points. Doesn't that rather prove BMI is bullshit?" No, because see "lifting heavy," above. I do lift heavy, and have the muscle definition I did not have ten months ago to show for it--literally.

Most, not all, but, most of the people who complain "BMI is bullshit" are people that are overweight.

quote:

Originally posted by SIG4EVA:
I ... eat pretty healthy. I don't drink much at all and cut out a lot of excess sugar.

It isn't just excess sugar that hurts you. It's all simple and refined carbs, and too many carbs of any kind relative to protein and fat, overall.

Also: Define "excess sugar?" (Hint: Nearly all added sugar is excess.)

quote:

Originally posted by SIG4EVA:
I did not fast before the blood draw. Had a coffee, egg, and toast with butter and honey for breakfast and pork BBQ and macaroni salad for lunch before my appointment.

Then you wasted time and money on the cholesterol and triglycerides lab tests. They're worthless.

ETA: While you could certainly do worse, and many people do, what you describe above is arguably not "eating healthy." Toast and honey: Carbs. Pork BBQ: If it's the BBQ most think of as BBQ: Loaded with sugar. Macaroni salad: Carbs again. (ETA2: Oh yeah: And, if you ate that BBQ in a typical off-the-shelf supermarket brand bun: More sugar.)

This message has been edited. Last edited by: ensigmatic,

Toast=sugar
Macaroni=sugar

Waiting on my doctor's response. I told him in the appointment I had eaten which obviously would affect the results. FYI, I am somewhat still muscular, I lifted weights for almost 20 years, so I'm not a fat 203lbs.

My doctor did say he may have me back, fasted, to redo if the results were way off.

quote:

Originally posted by SIG4EVA:
FYI, I am somewhat still muscular, I lifted weights for almost 20 years, so I'm not a fat 203lbs.

"Lifted?" Past tense?

Never has "Use it or lose it" been more true than with lifting. You begin to lose muscle mass in as little as two-three weeks after you stop lifting. You continue to lose it as you continue to remain sedentary. Plus muscle atrophy accelerates as we age.

E.g.: In 2016, when I changed gyms and a year before I retired, I weighed between 192 and 195 lbs. and measured-out with 15% BF on two different BIA devices. (Also, a buddy of mine who'd competed in body building estimated me at about 15% just from looking at me.)

Here I am, seven years later, having at least twice skipped several months at the gym and the better part of two years due to Covid-19 restrictions, down to 180 lbs. and nearly back down to 15% BF.

That means that in seven years I lost somewhere around 10-13 lbs. of lean body mass. (There are no indicators of osteoporosis.)

I'm not being critical or trying to give you a hard time. Just trying to inject a note of reality. Many, perhaps most people aren't as healthy and fit as they believe themselves to be. Reason being is they're comparing themselves to those around them and, as we know, many (most?) Americans aren't even remotely fit or healthy.

quote:

Originally posted by ZSMICHAEL:
Retest with fasting as ordered.

This. My doc's office always stresses fasting before my blood draw. (They don't even want me to have coffee.). Otherwise, it spikes your levels.

I always schedule my blood draw first thing in the morning (8am), so fasting isn't an issue.

Fast before blood draw and exercise regularly...30-60 minutes per day on a treadmill at a reasonable clip is sufficient.

quote:

Originally posted by erj_pilot:
... exercise regularly...30-60 minutes per day on a treadmill at a reasonable clip is sufficient.

Sufficient for cardio-vascular health, maybe, but, it won't help you:

• Offset age-related muscular atrophy,
  
• much less make you stronger,
  
• do anything to fight age-related bone density loss, or
  
• do much to promote fat loss

For those you need weight/resistance training--the heavier the better.

quote:

Sufficient for cardio-vascular health, maybe, but, it won't help you:
*Offset age-related muscular atrophy,
*much less make you stronger,
*do anything to fight age-related bone density loss, or
*do much to promote fat loss

For those you need weight/resistance training--the heavier the better.

There is some truth but those points are they definitely not absolute.
Plenty of other variables to consider as well.

You want to really burn fat then train your body to use that as the primary fuel ~ not carbs/glycogen.

The real key is diet.

quote:

Originally posted by smschulz:

quote:

Sufficient for cardio-vascular health, maybe, but, it won't help you:
*Offset age-related muscular atrophy,
*much less make you stronger,
*do anything to fight age-related bone density loss, or
*do much to promote fat loss

For those you need weight/resistance training--the heavier the better.

There is some truth but those points are they definitely not absolute.

Which ones do you believe to be non-absolute and why?

There've been multiple studies done in recent years that have yielded those results.

Exception: Cardio to promote fat loss. HIIT/SIT cardio has been shown to be effective, but, erj_pilot had written "at a reasonable clip." Few people would regard even HIIT, much less SIT, a "reasonable clip" MICT has also been shown to be moderately effective in conjunction with a diet regimen, but, not in isolation.

Diet was not much of a factor for me.

My doctor said my numbers were most likely hereditary.

My numbers are reasonable now, I am on generic Vytoran.

Had to fight like hell to get it.

It is more expensive even generic but it was the only statin that did not give me aches and pains.

Your doctor will know what is best for your condition.