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BANGKOK 19 February 2019 11:16
jvs

Very high LDL

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No energy for at least a year so decided to get a check up.

Sometimes feeling a little dizzy so i tought maybe low bloodsugar around 5 pm.

I have a history of tinnitus and vertigo,this is getting worse.

Went to the hospital this morning and had a few tests done.

My BMI is 22 so not overweight.

My bloodsugar was 106 this morning and my doctor said it was not really too

bad for now,no real indication of diabetes yet.

blood pressure 143/89.

Now the bad news,HDL 86,LDL 291,this is really high!

I was giving Bestatin 20 mg.,Zoloft 25mg.

Appointment for next check-up in 3 months.

I do not smoke or drink and already avoid sugar.

Next no meat?No fried foods and no salt?(salt already very low)

Am i a walking timebomb?Should i get other tests done?

My grandfather died of a heart attack at sixty and my brother had bypass surgery

at 50(last year)

Any advice please?

When they took my blood sample this morning i nearly passed out

They gave me some ammoniak to sniff and after i ate something it got better.

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30 minutes ago, jvs said:

My bloodsugar was 106 this morning and my doctor said it was not really too

bad for now,no real indication of diabetes yet.

If 106 is a result for fasting blood sugar then you're already in the prediabetic range (100-125 mg/dL). You need to get back under 100. Change of diet, exercise will do it. I was 113 a few years ago, 93 currently.

 

38 minutes ago, jvs said:

blood pressure 143/89.

A bit on the high side but mine is similar if they test me soon after I've walked ten minutes and up a flight of stairs to go see a doctor. It comes down to 124/68 when they hook me up and do a resting BP before a stress test. Get yourself a BP home monitor kit to test yourself at different times of the day. May come down a bit if you're more relaxed.

 

37 minutes ago, jvs said:

Now the bad news,HDL 86,LDL 291,this is really high!

That is a very high LDL (are sure it's not your total cholesterol number?).

 

For HDL 40-60 is normal and good. Only person I know with 80+ HDL takes four fish oil caps a day.

 

So you're not a drinker or smoker and your BMI is similar to mine. Any thyroid problems? What was your Total Cholesterol and your Triglyceride figure?

 

 

49 minutes ago, jvs said:

My grandfather died of a heart attack at sixty and my brother had bypass surgery

at 50(last year)

What happened to Your brother would worry me most. I was reading about David Letterman (US TV show host) the other day, and the story behind his quintuple bypass. Very high cholesterol level, a famous cigar smoker, but fit (a runner). Immediate family history was considered to be highly important. Letterman had been tested regularly because of this and it's what saved his life. He had been for a run the day before his emergency operation.

 

 

 

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2 minutes ago, kkerry said:

If 106 is a result for fasting blood sugar then you're already in the prediabetic range (100-125 mg/dL). You need to get back under 100. Change of diet, exercise will do it. I was 113 a few years ago, 93 currently.

 

A bit on the high side but mine is similar if they test me soon after I've walked ten minutes and up a flight of stairs to go see a doctor. It comes down to 124/68 when they hook me up and do a resting BP before a stress test. Get yourself a BP home monitor kit to test yourself at different times of the day. May come down a bit if you're more relaxed.

 

That is a very high LDL (are sure it's not your total cholesterol number?).

 

 

For HDL 40-60 is normal and good. Only person I know with 80+ HDL takes four fish oil caps a day.

 

So you're not a drinker or smoker and your BMI is similar to mine. Any thyroid problems? What was your Total Cholesterol and your Triglyceride figure?

 

 

What happened to Your brother would worry me most. I was reading about David Letterman (US TV show host) the other day, and the story behind his quintuple bypass. Very high cholesterol level, a famous cigar smoker, but fit (a runner). Immediate family history was considered to be highly important. Letterman had been tested regularly because of this and it's what saved his life. He had been for a run the day before his emergency operation.

 

 

 

I am not sure about those numbers,forgot to take the paper with me.I will try to change my diet but to be honest i am not sure what i can do about that.Ok no more french fries i guess and no more butter.We eat mostly at home and eat veggies and fruit from our own garden.

I do a fair bit of walking everyday because i have to take care of many animals,I feel tired most of the time but that is also due to not a lot of quality sleep.(PTSD and Tinnitus)

Hence the question,am i a walking timebomb?

I have to go back in two weeks and i will make sure i take home all of those numbers then.

Thanks for your response.

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What was your triglyceride?

 

I ask because if the triglycerides are low, indirect measures of LDL (which is what Thai hospitals usually do) are inaccurate and you need direct measure. Also as other poster said an HDL of 86 would be most unusual.

 

Please post the exact numbers: total cholesterol, LDL, HDL and tirgylcerides. If you can, take a photo without the identifying info and post it.

 

Re the blood sugar, next time get Hb1Ac as the stress of being at hteh ospital can cause a rise in your fasting glucose whcih is not indicative of your ordinary tate. Hb1AC shows what your blood sugar had been doing over a period of time so unaffected by temporary stresses. This way we'll know if you are genuinely pre-diabetic or not. (Even if you are, doctor is right that this has nothing to do with the dizziness you feel. But it is important to know anyhow).

 

Also a good idea as suggested to get a thyroid panel done since you are feeling run down and tired and I would suggest testosterone level as well.

 

What s your age? What medications are you on? And where in Thailand do you live? (I might be able to suggest a lab where you can get the additional lab work done inexpensively).

 

 

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37 minutes ago, jvs said:

I am not sure about those numbers,forgot to take the paper with me

If the hospital is not far away, drop by and if you ask nicely I'm sure they will print up another copy for you on the spot, rather than wait another couple of weeks. Always keep your test results and scan them so if you go to a different hospital you can show them a history from your phone

 

40 minutes ago, jvs said:

Ok no more french fries i guess and no more butter.

If the figures you quoted are correct then there maybe more to it than that... if they are correct, from what you're saying, not obese, non smoker, don't drink, eat lots of fruit and vegetables, physically active, then it sounds like diet may not be the only issue. Do you drink lots of fruit juice or soft drink (high in sugar)? You said low in salt.. in a hot climate you don't want to cut back too much as we all need some salt to function.

 

2 hours ago, jvs said:

When they took my blood sample this morning i nearly passed out

I absolutely used to be that person. Needed to have my blood taken while lying down as I always felt like I was going to keel over otherwise, white as a sheet afterwards I've been told, feeling cold, clammy, light headed, doctor coming over to see what was wrong one time. Now, no problem, I no longer dread blood testing. What changed? I drink a lot more water so better hydrated. Means the vein is easier to find and the needle barely hurts. If you had a fasting blood sugar test (did you???) it means Nil By Mouth for 8-12 hrs before in most Thai hospitals. If you were already a bit dehydrated before that, it could help explain you nearly passing out.

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47 minutes ago, Sheryl said:

What was your triglyceride?

 

I ask because if the triglycerides are low, indirect measures of LDL (which is what Thai hospitals usually do) are inaccurate and you need direct measure. Also as other poster said an HDL of 86 would be most unusual.

 

Please post the exact numbers: total cholesterol, LDL, HDL and tirgylcerides. If you can, take a photo without the identifying info and post it.

 

Re the blood sugar, next time get Hb1Ac as the stress of being at hteh ospital can cause a rise in your fasting glucose whcih is not indicative of your ordinary tate. Hb1AC shows what your blood sugar had been doing over a period of time so unaffected by temporary stresses. This way we'll know if you are genuinely pre-diabetic or not. (Even if you are, doctor is right that this has nothing to do with the dizziness you feel. But it is important to know anyhow).

 

Also a good idea as suggested to get a thyroid panel done since you are feeling run down and tired and I would suggest testosterone level as well.

 

What s your age? What medications are you on? And where in Thailand do you live? (I might be able to suggest a lab where you can get the additional lab work done inexpensively).

 

 

Thank you Sheryl,

I will try to get the numbers later today and post them.Kind of stupid to forget.

I went to Phetcharaat hospital,i am located near Cha-am.

My age is 61.Before i was giving the meds today i was not taken anything.

The doctor asked me if i wanted to try to adjust my diet first or start with medicin,her advice was to start taken the medicine.

I just had a conversation with Ann about our diet and we concluded we are pretty well eating healthy but of course some adjustments can be made.

My brother had a triple bypass last year at 50 but he had a long history of very high blood pressure and he also was 25 kg.overweight.He was also a diabetic for some years already.

The dissiness can be vertigo the doctor said but the person who i was seeing before concerning Tinnitus was not here but i will see him in two weeks.

Yes i think it will be a good idea to get some additional tests,the suggested a total body check but i did not see the need of that.It included dental and other stuff.

Thanks again Sheryl,i really appreciate your expert help.

 

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9 minutes ago, kkerry said:

I absolutely used to be that person. Needed to have my blood taken while lying down as I always felt like I was going to keel over otherwise, white as a sheet afterwards I've been told, feeling cold, clammy, light headed, doctor coming over to see what was wrong one time. Now, no problem, I no longer dread blood testing. What changed? I drink a lot more water so better hydrated. Means the vein is easier to find and the needle barely hurts. If you had a fasting blood sugar test (did you???) it means Nil By Mouth for 8-12 hrs before in most Thai hospitals. If you were already a bit dehydrated before that, it could help explain you nearly passing out.

Had blood taken many times before but never had any problems with it,only today.Yes i had a fasting blood sugar test.

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20 minutes ago, jvs said:

Thank you Sheryl,

I will try to get the numbers later today and post them.Kind of stupid to forget.

I went to Phetcharaat hospital,i am located near Cha-am.

My age is 61.Before i was giving the meds today i was not taken anything.

The doctor asked me if i wanted to try to adjust my diet first or start with medicin,her advice was to start taken the medicine.

I just had a conversation with Ann about our diet and we concluded we are pretty well eating healthy but of course some adjustments can be made.

My brother had a triple bypass last year at 50 but he had a long history of very high blood pressure and he also was 25 kg.overweight.He was also a diabetic for some years already.

The dissiness can be vertigo the doctor said but the person who i was seeing before concerning Tinnitus was not here but i will see him in two weeks.

Yes i think it will be a good idea to get some additional tests,the suggested a total body check but i did not see the need of that.It included dental and other stuff.

Thanks again Sheryl,i really appreciate your expert help.

 

Do post the exact numbers. Can't be sure at this point there is even a problem.

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LDL is made up of small/dense particles and large/fluffy particles. The large particles form a  useful function, it is the small particles that oxidise and contribute to heart disease.

These is a test (NMR) which will analyse your LDL into particle types but I have yet to find it available in Thailand. However, there is a strong correlation between particle size and HDL/Trigs levels (see images). The lower your Trigs, and the higher your HDL, the larger your LDL particle size. So if you have a high HDL and low Trigs, your LDL score is not something of concern.
For reference, my Trigs are 58, my HDL is 94 and my LDL is 206. Very happy with that. 

 

There is increasing evidence that total LDL is not marker for heart disease, e.g.: https://www.sciencedirect.com/science/article/pii/S0167527318347417?fbclid=IwAR2gqPyu-3WminbhjyIYhIJZkwEQtsbpL2vKGqRbX--ApQMB7x1VelQg3j4

And indeed there is evidence that higher levels of cholesterol are more protective as you get older.

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Here are the numbers,

 

IMG_20190121_165449.jpg

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Ok, those make more sense and yes, there is a problem, with both your trigylcerides and your LDL being too high.

 

You may or may not be pre-diabetic but given the high triglycerides and LDL my guess is yes, and you may have what is known as "metabolic syndrome".

 

https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916

 

Given that the triglycerides are also high it is very unlikely your elevated LDL is due to too many of the "good" type.

 

In addition to diet (which from the sounds of it is already not too bad) the main thing that will help you is exercise but that will be difficult for you to do much of when you are feeling run down and suffering from vertigo. It is not clear to me that the cause of the run down feeling and vertigo has been adequately explored. The  doctor gave you an antidepressent, presumably on the assumption that depression is the cause.  Perhaos it is but that can also sometimes be a knee-jerk assumotion on the part of doctors.

 

I suggest at a minimum that you get a thyroid panel (TSH, T3/T4) done and also your testosterone levels checked.

 

If a complete blood count was not already done, have that as well to exclude anemia. No need if it was already done and normal. 

 

In terms of diet the most important things are:

 

  • avoid processed carbohydrates (white rice/bread/pastas, sugar) and processed foods in general;
  • consume a lot of fiber (oatmeal is good);
  • cook with healthy oils (no palm oil which is what Thais usually use and what anything bought fried from the market will have been cooked in) - contrary to what  people often assume it is not necessary or advisable to completely avoid anything fried, but it should be with a healthy oil;
  • no or only small quantities of red meat
  • lost of fresh fruits and veggies

The first 2 of these are especially important.

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Happy to see the actual results are not quite as dramatic as you remembered 😌

 

What I keep seeing lately about predictors for heart disease, is the importance of your triglyceride/HDL ratio. Optimal is less than 2, above 4 is too high. Your ratio is 3.83. With your family history you want to improve on that. Exercise is one way to help. After you have looked into the things Sheryl has suggested, ask about having a stress test. Cost will be somewhere around 3-4k. It will give you an insight as to what level of fitness you are now and how safe it is to proceed with further exercise that gets your heart pumping more than walking can. Exercise will also help lower your sugar levels.

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P.S,  Regarding blood tests I neglected to mention there are some labs in Hua Hin where you can get them done quickly without needing to see a doctor first (of course, bring the results with you when you next see your doctor).

 

Hua Hin Central Labs seems to be the one most people use

34/23 Phet Kasem Rd

Hua Hin

It's on Google maps

tel  084 055 8328

 

 
 
   
   
   
   
   
   
   
 
 
 
Phone: 084 055 8328

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18 hours ago, jvs said:

No energy for at least a year ........

I feel tired most of the time ........

My age is 61 ....

I'm similar. I put it down to being old.

 

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THank you for the responses so far.I took a sleeping pil lastnight early and another one about 2 hours later.finally fell asleep and woke up not long ago.

Iwill do the same thing tonight because i am just too tired.

I was always very active,long distance running and owned a fitness gym for years.Now i realise how difficult it can be to motivate oneself,i never had that before.

Yesterday installed an app to measure how much i walk each day,it will not make a difference but just to see how much exercise i am getting.

I think at my age i should be a lot more active but find it very hard to do so.

Also depression can play a part,that seems to come and go without any warning.

What kind of test should i have done9(exact name please)

i will go there and have it all done.Do i need to be sober to take these?

I have an appointment in two weeks to see what can be done about the constant sounds in my head.That is a story in itself,listening to music is fine but too much seems to activate

the tinnitus.

I also seem to have to correct a lot of splelling mistakes lately.

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