Factors that might skew a cholesterol test? - High Cholesterol Message Board

Wintergarden · 05-30-2005, 02:39 AM

The preliminary stuff: for the past 3 months, I've been suffering severe upper G.I. symptoms and after many tests and opinions from two gastroenterologists, I've been diagnosed with esophageal spasms, possibly aggravated by reflux. I seem to be improving since I began taking the antispasmodic drug Levsin.

Because I noticed skipped heartbeats and my symptoms were exacerbated by exertion, I took it upon myself to hook up with a cardiologist, just to make sure none of this could be heart related. For starters, I had my first cholesterol test ever, with these results:

Total cholesterol: 142
LDL: low 90's (can't remember exact number)
HDL: 36
Triglycerides: can't remember exact number, but Dr. commented it was great (well below 100)

I should mention I'm a 44 yr. old woman with no other risk factors for heart disease (or so says my cardiologist). I'm quite concerned about that low HDL number. As I understand it, it should be at least 50 in women, and I've also read that HDL may be the most significant factor in your cholesterol score, and that it's even a marker for longevity. Combine that with the studies correlating low TC to early death from other cause and, well, I'm pretty bummed out.

I was suprised to get this score because people in my family tend to have high HDL, and I have been exercising vigorously almost every day for the last 10 years (until recently getting sick with the upper G.I. symptoms)

I do eat a very low fat, vegetarian diet, but since my stomach troubles began, my diet has been even more restricted. I just haven't been able to eat much at all and have definitely been losing weight. Do you think that scenario would be likely to skew the test?

Furthermore, after finding out the results of my test, I opted to have the full VAP testing done, with homocysteine and CRP testing as well. Unfortunately I have to wait 2 weeks for the results that one. I just hope that will be accurate, given my recent abnormal diet. If I'd stopped to think it over calmly, maybe it would have been better to wait? In any event, I'm nervous as a cat about getting the results. As an anxious person by nature, I know I will obsess over the results if they're not good.

My cardiologist was concerned about the low HDL and said if it were one point lower, she'd be sending me home on medication, but she said lets see what happens once you resume regular exercise and run the panel again in 3 months. She said I could also take OTC niacin, which I have just begun doing, but the side effects are a b****. I also plan to add walnuts and flaxseed oil to my diet (not really thrilled about this either, since high fat foods have always been hard for me to digest, but whatever it takes...)

On the other hand, I asked my primary care physician about my results and she said they were fine because my TC and TGs were so low. I guess there's no consensus on this.

Any opinions would be much appreciated - thanks!

HubbleRules · 05-30-2005, 04:54 AM

Wintergarden,

I have an issue with low HDL myself, which has been very difficult to budge over the years, even when I was much more active than today and used to jog 25 miles/week...

I just recently started a variant of Niacin called Inositol Hexanicotinate (try to say THAT 3 times fast) - it is a Non-Flush brand. I buy it under the label of 'No-Flush Niacin', by Source Naturals.

The first night I took 1/2 of a 500mg pill, and I got a flushing reaction after 30 minutes - mostly my lips tingled - and I felt a slight constriction in my throat. The throat symptom did not recur on subsequent doses, and the lip tingling is now much less noticeable.

Now into the supplement about 12 days, I am taking 500mg/day with a meal, and don't notice much reaction at all. I want to get to 750mg/day (gradually), and see if it has any positive effect on my HDL - my next blood test is 6/24.

You might give this type of Niacin a shot - especially if you were trying the immediate-release type before and had problems with it.

The literature says that IH is just as effective at increasing HDL as the immediate release brand, but I can't say (yet) that it has done so for me.

You might also try Omega-3 Fish Oil - it is supposed to increase HDL...

HubbleRules

Lenin · 05-30-2005, 07:15 AM

Wintergarden,

Low HDL...true, over 40 or 50 would be excellent but 36 is not bad in a matrix of LDL's in the 90's and a total of 142.
It's REMARBABLE thay you get numbers that low but it seems about 10% of the population do. Undoubtedly your genes and your vegetarian diet (with ZERO dietary cholesterol) are responsible.
The risk seems to be for increases anxiety and depression (suicide risk) and MAYBE a small increase in hemhorragic stroke...probably because high cholesterol people have all their arteries too gunked up to LEAK.

) Anyway, if the constant esophageal nagging isn't depressing you, then I'd stop worrying, you are among the BLESSED.

The hyosciamine doesn't seem likely to be in the cholesterol picture at all.

I think any medication that might raise your HDL might also further drop your TC and thus might not be what you want.

Does that remarkable cholesterol picture run in your family?

Is Zantac or Prilosec contraindicated with the anti spasmodic? Might be a good idea...often it's the REFLUX that triggers the SPASM...cure the first and you;ve got the second taken care of.

Not to try to outguess your doctor, but vegetarians, especially low fat vegetarians almost always have trouble with gall bladder inflammation or frank gallstones. It's because the large bile releases never occurs since it's caused by a high fat meal. Without the pulsations, bile precipitates its cholesterol as STONES. To test this diagnosis, go off your diet and have a breakfast with eggs and a HALF POUND BACON...uncrisp. If it's a clogged bladder you will get waves of upper right quadrant pains to beat the band. This test NEVER fails to diagnose a wonky gallbladder. Maybe a cup of olive oil will work as well...yecch!

Uff-Da! · 05-30-2005, 08:59 AM

I also take niacin for my cholesterol, but I take Enduracin, a sustained-release type. The sustained release, as well as the Inositol Hexanicotinate produce very little flushing. I had minor flushing the first week but none thereafter. I started with 250 mg and built up to 750 mg. With a TC and LDL as low as yours, I don't think you'd want or need even that much. My suggestion if you are having trouble with flushing: start with a low dosage and build up. Lenin used as little as 50 mg to start of the immediate release. If you haven't been doing so, take the niacin with a meal. That helps reduce flushing, too. Taking an aspirin 30 minutes before the niacin also helps, but with your other problems, you probably wouldn't want to do that.

Are you a strict vegetarian or an octo-lacto vegetarian? If the latter, eat a few more eggs a week. Eggs raise both LDL and HDL, for many people in about the same proportion. With as low an LDL as you have, it wouldn't hurt to raise it a few points in order to get the HDL.

Wintergarden · 05-30-2005, 05:55 PM

Thank you all for your very helpful responses!

Hubble, I'll look into getting some of the No-Flush Niacin you mentioned. That is indeed the side effect I'm experiencing. I took my first dose (Trader Joe's "controlled release" 500mg) and 10 minutes later I looked like a tomato! (I have very pale skin, so I can acheive some impressive shades of fire engine red) The effect on me lasts about an hour, and it's pretty uncomfortable. Since then I've found that taking the pill with food blunts the effect and limits the flushing to my hands and arms (I look like I've slipped on some full length red gloves), and it's getting less dramatic as the days go by, but it would great to avoid this side effect altogether!

So you were a runner too? So much for that stuff about exercise boosting HDL....hmmph. Lately I feel like a poster child for that popular expression "exercise, eat right, die anyway"

I'll be watching for your results around the end of June, if you don't mind posting them. Hope you get a nice big increase in your HDL number - fingers crossed!

Lenin, thanks for pointing out the positives - I appreciate it! I see you are familiar with Levsin? (hyociamine) That has plenty of side effects too (dry mouth, dry eyes, dry everything) It may have bumped up my BP a little bit, but it's still running around or below 120/80. So far, it's the only thing that's helped me get back to a somewhat normal life. Double doses of Nexium, Prevacid and Prilosec (I've been through all 3) did nothing but take away the lump-in-the-throat sensation I had. It was only Levsin that finally gave me some real relief. (I'm still taking Prilosec though)

Regarding the gallbladder, you're on the same wavelength as my primary care doc, since that's the first thing she checked for. I was sure she was right too, and was very surprised to hear that abdominal ultrasound showed a normal GB with no stones. I was always a heavy coffee drinker...I wonder if that saved my GB (you've probably heard about the studies suggesting a protective effect)

I can tell you this cholesterol pattern definitely does NOT run in my family. They all tend to run slightly high in TC, with nice big HDL scores to keep it from being a big concern. Guess I'm the mutant of the litter. What you say about low TC and anxiety/depression has a ring of truth - certainly in my case. That has always been a struggle for me.

Uff-da, I was pretty much a vegan, but I may take your advice and have a couple of omelets per week. At least that's something I can eat and enjoy. Too bad I loathe red wine!

I remember reading somewhere that your weight should be stable for at least 2 weeks prior to a cholesterol test, and that malnutrition could effect it also (at least I think that's what I read) Since both those factors applied to me in the 2 month period prior to my test, I'll definitely be looking to get retested somewhere down the line.

I'm trying to stay active but I've been told not to over-exert myself till I have my stress echo on June 20. (sheesh, they make you wait so long for these tests, I should be really good and deconditioned by then...::grumble) My echocardiogram was normal and my treadmill test was normal (except for a small number of isolated PACs), but my cardiologist tells me she's "uncomfortable" with the fact that my upper G.I. symptoms get worse with exercise, and she thinks we need to test further to rule out CAD. Suddenly I'm feeling like a heart patient and wondering where it will all end. Anyway, thanks for listening and all the helpful comments