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Old 03-07-2003, 06:12 PM   #1
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Question 50 point increase!

I'm a 51 year old male who never gave much thought to cholesterol diet-wise, because for decades no matter what I ate, every time I ever got it checked it was safely in the 150 - 165 range.

I was a very active person --> a long distance runner. That changed last December when I was struck down by a ruptured aneurism of the splenic artery. I nearly bled to death. I had emergency surgery to clamp off the bleeding artery and remove my spleen. The recovery has been slow, and I'm only just now getting capable of a little light jogging - about 4 or 5 miles per week I have been walking a mile or two every day since early January.

After getting over the surgery, I had been eating the same diet I did before. So you can imagine my shock when a routine cholesterol test showed that it had shot up to 209. I had never seen 170 before, much less over 200.

So now I'm obsessing about cholesterol - adding soy and oat bran to my diet and cutting out eggs and cutting down on meat. I'd like to avoid drugs if I can.

My question is does anyone know what could cause a 50 point increase in only a few months time? The main changes in my life were the surgery and big blood loss, removal of my spleen, and big reduction in the amount of running I do.

I thought that exercise might be keeping my cholesterol in check over the years, but I was under the impression the direct cholesterol benefit from exercise was very modest. I'm hoping exercise is the answer, because I can look forward to low cholesterol again as my ability to run comes back. But I have a hard time believing that this is the whole story.

Has anyone else had similar experiences with starting or stopping a vigorous exercise program? Does anyone see anything else here that could explain a sudden 40 or 50 point increase?

Thanks for any help you can offer.

 
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Old 03-07-2003, 06:47 PM   #2
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The first thing I'd do in your shoes is have the test redone. Lab error is always a possibility with a change that big that fast.
Beyond that, I can't comment.
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Old 03-07-2003, 08:38 PM   #3
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Only 209? I wouldn't worry about it.
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Old 03-08-2003, 08:59 AM   #4
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I am with midwest. That much of an increase may very well be an error. However, it still is not that high. More importantly, you do not offer your other related cholesterol numbers wich would be your ldl, your HDL, and your Trigs. The total number is not generally considered to be that important.

What are your other numbers. If you don't know them, inisist on getting them.

 
Old 03-10-2003, 09:05 AM   #5
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Thanks for the replies. My other numbers are:

HDL = 43
LDL = 144
Trig = 108
Chol/HDL = 4.9

I recognize that a cholesterol of 209 is is only moderately elevated, but what alarms me more than the level is the sharp rate of increase. If I can't find any explanation for a 50 point increase and respond accordingly, there is nothing to say that it won't keep right on increasing for another 50 points or so.

Thanks for all you help.

 
Old 03-10-2003, 12:00 PM   #6
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Quote:
Originally posted by Coureur:
My question is does anyone know what could cause a 50 point increase in only a few months time? The main changes in my life were the surgery and big blood loss, removal of my spleen, and big reduction in the amount of running I do.

I thought that exercise might be keeping my cholesterol in check over the years, but I was under the impression the direct cholesterol benefit from exercise was very modest. I'm hoping exercise is the answer, because I can look forward to low cholesterol again as my ability to run comes back. But I have a hard time believing that this is the whole story.

Has anyone else had similar experiences with starting or stopping a vigorous exercise program? Does anyone see anything else here that could explain a sudden 40 or 50 point increase?

Thanks for any help you can offer.

Your question had me curious as to whether any exact data could be found for the impact of exercise on our lipid profiles. I know that I do my running to increase my HDL above 40. Until I ran, I was never able to achieve an HDL of 40 plus. However, I am not able to discriminate between what weight loss and exercise contribute to my LDL and Triglycerides, since I did both concurrently. I do know that in total, I took my Triglycerides down from 400 plus to 34 at the last measurement, and my LDL from where it was once above 100 to a paltry 51 (these are mg/dL).

As far as meds, I don't think you need any at this time; but I am not a physician either. I am willing to be that as you continue adding exercise back in, your total will drop and HDL would stay about the same, if not perhaps increase slightly.

Anyway, I searched for any publication on this subject and came up with the following:
[url="http://atvb.ahajournals.org/cgi/content/full/21/7/1097"]http://atvb.ahajournals.org/cgi/content/full/21/7/1097[/url]

Exercise contributed ~15% reduction in triglycerides for both low and high triglyceride groups. Assuming you had average results, yours would drop from 108 mg/dL to 92 mg/dL, for a net drop in total cholesterol of 3 mg/dL. (Not much there...)

In this study, the data indicate that exercise would not benefit greatly those with low TG/low HDL, but has a significant impact (well 5%) for people like me with high TG/low HDL.

Of course there should be a disclaimer that what one group considers heavy exercise may not match everyone else's definition. If I run 10 minute miles, and you run 7 minute miles, and we both run the same amount of time or even distance, you are getting a higher workout in METS than I am and quite possibly that will have a larger impact on positive results with your lipid profile than my routine will with my profile.

I didn't run across any applicable journal papers for the LDL/exercise relation; however, I ran across plenty of descriptive information stating a) that LDL is impacted greatly by diet and b) LDL is impacted even moreso when both diet is modified and exercise is combined.

So, its quite possible that with your high workload of exercise, you were able to benefit your lipid profile greatly. Diet alone may help reduce LDL and TGs (i.e. via low-fat, low carb) but that also tends to drop HDL. We counter that by adding in exercise which tends to increase HDL and decrease your TGs.


 
Old 03-10-2003, 01:41 PM   #7
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Coureur--I was just curious if you had ever asked your doctor if the surgery to remove your spleen may have somehow had an impact on your cholesterol, even if it should be a temporary elevation.
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Old 03-10-2003, 02:02 PM   #8
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Quote:
Originally posted by ARIZONA73:
Coureur--I was just curious if you had ever asked your doctor if the surgery to remove your spleen may have somehow had an impact on your cholesterol, even if it should be a temporary elevation.
I have not asked my doctor that question. But I'd be astonished if it did have any impact (but I'm open to any possibility). The spleen is a lymphoid organ - a part of the immune system. To the best of my knowledge (I am by profession an immunologist) it plays no role in lipid metabolism.

The main thing losing my spleen has done for me is to put me at risk from sudden death due to overwhelming infections from certain encapsulated gram negative bacteria that I can no longer effectively fight. Developing sharply rising cholesterol on top of that was not something I needed right now.

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Old 03-11-2003, 07:34 AM   #9
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your numbers don't sound too bad; I think obsessing over your cholesterol probably is worse than the actual risk you have of a cardiovascular "event", considering your levels. remember, cholestrol is a secondary indicator of possible trouble. what does the doc say?

 
Old 03-11-2003, 02:12 PM   #10
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My doctor hasn't said anything. His office just FAXed me the numbers. The notation on the report said that anything over 200 was bad. I'm not scheduled for a follow-up visit until June.

 
Old 03-11-2003, 02:22 PM   #11
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Somewhere along the way I was told cholesterol is needed in the constuction of new cells. After the surgical spleen removal and loss of blood you are surely needing new massive cell structure.......probably needing all of that 50 point increase.
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Old 03-11-2003, 08:58 PM   #12
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Good point. But this increase in cholesterol demand to make new cells would argue that my cholesterol should have DROPPED 50 points instead of risen. In fact I've read that surgery commonly does cause cholesterol to temporarily drop significantly. Which worries me all the more, since the 50 point increase may actually be much larger, but part of it is being masked by the post-surgery drop.

 
Old 03-12-2003, 10:54 PM   #13
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I believe our bodies may make up for problems and may produce extra cholesterol when the body calls for it. Maybe?
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Old 03-14-2003, 10:49 AM   #14
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my numbers are worse than yours:

TC 230
HDL 43
TRIGS 149
LDL 157

and still my doctor only advises a low carbohydrate diet, with more veggies and fruit, to see if the numbers improve. later, if the diet doesn't work, we may consider meds but in any case, he tells me that it's nothing that I should be overly worried about.

 
Old 03-14-2003, 11:35 AM   #15
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My numbers are all bad. I starting Zocor today. Doctor says that diet can only lower the numbers by 10%. The target numbers are total cholesterol <200, hdl >45 for men, >55 for women, ldl <130, triglycerides < 200. Your numbers aren't bad at all.

 
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