Anxiety, depression, laziness...Can the nameless wonder change? page 8

[namelesswonder]

Can someone help me make sense of my Cholesterol test results? I looked at the Primer, but I don't have my triglycerides results, nor the LDL. Assuming that the numbers to the right are a range, then I think everything else is "good"

Tests: (1) CMP (2030)
Glucose 96.0 mg/dL 70.0-99.0
BUN 15.0 mg/dL 7.0-25.0
Creatinine 0.8 mg/dL 0.6-1.3
! Glomerular Filtration Rate
94.5
Reference Range eGFR is greater than or equal to 60 ml/min/1.73

*If a patient is African-American, multiply result by 1.210
Sodium 138.0 mEq/L 136.0-145.0
Potassium 4.2 mEq/L 3.5-5.1
Chloride 106.0 mEq/L 98.0-107.0
Bicarbonate 26.0 mEq/L 21.0-31.0
Anion Gap 10.2 mEq/L 10.0-20.0
Calcium 9.2 mg/dL 8.6-10.2
Total Protein 6.8 g/dL 6.4-8.9
Albumin 4.3 g/dL 3.5-5.7
! Globulin 2.5 g/dL 2.1-3.9
! Albumin/Globulin Ratio
1.7 1.0-2.1
Alkaline Phosphatase 71.0 U/L 34.0-104.0
ALT 21.0 U/L 7.0-52.0
AST 22.0 U/L 13.0-39.0
Total Bilirubin 0.3 mg/dL 0.3-1.0
Direct Bilirubin 0.20 mg/dL 0.03-0.20
<

Tests: (2) Cholesterol (2260)
Cholesterol [H] 255 mg/dL <200

Tests: (3) HDL-cholesterol (2280)
HDL-Cholesterol 69 mg/dL >40

[girlarchitect]

my morning BM did not thank me, but the "bloating" I had last night disappeared.

If the bloating disappeared overnight then your intestines were doing their work ... and fortunately your boyfriend was sleeping too (hey, he's doing it too - girls just don't admit it in public). If the bloating passed after your BM, then the constipation was holding it all in. It's a bit weird to write about this stuff (but probably more comfortable that talking about it in person) but I think we all really want that end of things to work and work well so we don't have to think about it.
My plumbing is still figuring it out too - around week two, I thought I had it mastered and, well, ha ha. Anyway, two things to read that I found interesting -- first this article from MDA and later this site which seems to fit within the primal diet approach. I found the discussion on constipation and on gut floral very interesting . Anyway - a bit awkward to discuss even in this format - but maybe it will be helpful.

[girlarchitect]

I'm curious, what does your doctor think? He/she should be providing some analysis of the numbers for you.
I think traditionally, the 255 number is considered high for total cholestrol - although honestly, I don't know if that's the case today anymore.

I do think it's great that you did this in your first month. It will be very interesting to see your blood work after a period of time - say one year. You, unlike may of us, will have measurable data of the effects of the diet on you blood chemistry.

Can someone help me make sense of my Cholesterol test results? I looked at the Primer, but I don't have my triglycerides results, nor the LDL. Assuming that the numbers to the right are a range, then I think everything else is "good"

Tests: (1) CMP (2030)
Glucose 96.0 mg/dL 70.0-99.0
BUN 15.0 mg/dL 7.0-25.0
Creatinine 0.8 mg/dL 0.6-1.3
! Glomerular Filtration Rate
94.5
Reference Range eGFR is greater than or equal to 60 ml/min/1.73

*If a patient is African-American, multiply result by 1.210
Sodium 138.0 mEq/L 136.0-145.0
Potassium 4.2 mEq/L 3.5-5.1
Chloride 106.0 mEq/L 98.0-107.0
Bicarbonate 26.0 mEq/L 21.0-31.0
Anion Gap 10.2 mEq/L 10.0-20.0
Calcium 9.2 mg/dL 8.6-10.2
Total Protein 6.8 g/dL 6.4-8.9
Albumin 4.3 g/dL 3.5-5.7
! Globulin 2.5 g/dL 2.1-3.9
! Albumin/Globulin Ratio
1.7 1.0-2.1
Alkaline Phosphatase 71.0 U/L 34.0-104.0
ALT 21.0 U/L 7.0-52.0
AST 22.0 U/L 13.0-39.0
Total Bilirubin 0.3 mg/dL 0.3-1.0
Direct Bilirubin 0.20 mg/dL 0.03-0.20
<

Tests: (2) Cholesterol (2260)
Cholesterol [H] 255 mg/dL <200

Tests: (3) HDL-cholesterol (2280)
HDL-Cholesterol 69 mg/dL >40

[namelesswonder]

^She only said "it's a bit high". The rest is gibberish to me, but like I said, based on the ranges, I think I'm in good shape. From a paleo perspective, it looks like my HDL is good? So I'm not too concerned about overall cholesterol, even with the missing numbers. This blood test is from week 1 or 2 of primal eating.

I haven't been feeling like eating much lately (and the brownies we made last night are not helping me stay on track with food), but my sleep schedule has been very off due to my gamer boyfriend as well. Since we share a room and that's all the space we have right now, if he uses his headset I'm awake. If I'm having a bad night and he's on the computer, the light from his monitor keeps me up too. Top that off with early morning calls from his parents to get rides places... we are so ready to move out, but his credit is poor (a bill his parents put in his name that they haven't paid off caused it) and our income is not ideal for landlords. Housing is very tight in the Boston area, sadly.

I am going on a business trip for training during the second week of August. I'll have internet access the whole time, fortunately, but I imagine I'll be pretty busy. The hotel I'll be staying at has a pool (I AM GOING TO SWIM EVERYDAY NO MATTER WHAT) and I'll probably walk to and from the office, since it's very close. I'm really looking forward to it! I just hope I can find some reasonable places to eat that fit within my allotted budget and are fairly primal (looks like it's going to be a lot of salads).

[Finnegans Wake]

I'm not a physician... But I stayed in a Holiday Inn once...

I would say that the lipid data you have there are incomplete. Total cholesterol numbers are usually not important unless extremely high or extremely low: yours is sort of a gray area. This chart is a little difficult to read, but it really illustrates that all-cause mortality correlates much more strongly to low total cholesterol, but that it also begins to climb again >230 mg/dL (though not as strongly correlated).

Further relevant data would be triglycerides (TG) and low-density lipids (LDL), which can be further broken out as LDL(a) and LDL(b). Usually when you get your lipid panel done, they measure TGs and calculate LDLs using this formula:

LDL Cholesterol = Total Cholesterol - HDL - (TG / 5)

(For example, if your TGs =100, then based on your other data, your calculated LDL would be 166.) It's really important to see that TG number, because just as HDL correlates to improved health, TGs correlate to bad. LDL is a trickier subject.

It's often reported that LDL is the "bad fat," in the metaphor where arteries get clogged with softer LDLs that stick to arterial walls and form plaques, as opposed to the HDL which roll through the arteries and knock those LDLs out of the way. The problem is that LDLs themselves are of several sorts, with LDL(a) being described as "big and fluffy" and LDL(b) as "small and dense." The LDL(b) is more often associated with coronary issues, so a high LDL(a):LDL(b) ratio is perfectly acceptable; it's impossible to tell from either overall cholesterol levels or from calculated LDL levels what that ratio is, however. Most insurance companies do not cover an actual testing for LDL(a) and (b), so it's a few hundred dollars out of pocket.

One should be wary of any news article that demonizes dietary fat (especially saturated fat) as "artery-clogging": it's a red-flag phrase. While it is true that cholesterol plaques can result in heart attacks, our model of cause and effect seems to be backwards. Given that dietary fats (saturated fats included) are necessary for the complete and diverse nature of bodily functioning, and that dietary fat is not causative of serum cholesterol, we have to ask what the role of cholesterol in the bloodstream actually is. Cholesterol is necessary for cellular development, but it also helps the body repair arterial walls.

Think of the various lipids as plumber's tools and the cardio vessels as pipes. A diet poor in nutritive value (especially antioxidants, as one would expect of the SAD) results in inflexibility of arterial walls. Switching metaphors, think of a garden hose left out in all weather conditions, hottest summer and freezing winters. After a few years, the hose becomes brittle and prone to holes and breaks, as opposed to one stored in the garage. So an individual eating a poor diet, exposed to carcinogens (tobacco smoke, the plethora of chemicals in household products), contacting natural attackers (bacteria, viruses), and the usual array of free radicals will be less able to repair cardiovascular damage.

When an arterial wall is damaged, the body begins to heal itself, just as it does when you cut your finger or a blister forms to protect against irritation. Inflammation, which is bad if the body is in a state of chronic inflammation response, is part of the process: swelling helps to close up the damage. At the same time, those "bad" LDLs, the soft ones, act as plumber's putty to patch the hole or lesion temporarily. The LDL putty the hole, and the HDL come along and smooth out the patch and ensure there is no blockage. Then the body heals the area, and plaque does not build up -- unless you are chronically exposed to the bad things listed above (diet, carcinogens, and so on). To switch metaphors yet again, if you blow a tire and use a fix-a-flat, you take the car to the shop right away; if you just keep driving until you're on three tires with fix-a-flat patches and one that's a doughnut, it's not destined to end well.

The bottom line is that cholesterol is not per se bad, and it does have a defined role in cardiovascular health. Artificially low cholesterol levels may compromise the body's ability to heal. But digging further into the numbers will yield some useful indicators. One of the best is the ratio of TG:HDL. A ratio of 2:1 or lower is good, whereas 4:1 or higher is bad, and values in between are acceptable. In general, higher TG numbers are a concern, and 150-199 is a level of concern, with >200 being potentially dangerous. Diets high in refined carbs show a highly causative effect with TGs.

Most physicians will point to high LDL as being unhealthful, but keep in mind that the LDL levels are usually calculated rather than directly measured, so there is room for some error, and further the LDL(a) and (b) levels are far more important than overall LDL. So I would take LDL that is not broken down with some grain of salt, and focus more on overall TGs and the TG:HDL number. If you're eating good dietary fats in sufficient quantity, your HDL level should be well over the 40 mg/DL cutoff.

Even if you don't buy and read these books, just scanning through Amazon Search Inside This Book! can offer some fascinating info. Uffe Ravnskov has been at the fore of cholesterol skeptics for the past 20 years with books such as
Fat and Cholesterol are Good for You. Also check out the cholesterol skeptics site. Malcolm Kendrick's
The Great Cholesterol Con covers much of the same ground, with an emphasis of warning against statins. Anthony Colpo also has a book titled The Great Cholesterol Con, confusingly enough, but it's also good source material. Finally, people would be well-advised to eschew warnings against dietary fat and concentrate on getting their complete B-6, B-12, and folic acid by eating vegetables along with their meat, as The Homocysteine Revolution by Kilmer McCulley shows that the homocysteine meatbolization cycle is responsible for more arterial damage and heart attacks than cholesterol.

[namelesswonder]

^[[whistles in amazement]] I will sort through that stuff when I can. Thank you for the info. I don't know if my doctor has any more information than what I posted (a direct copy of the report she sent me), but I'll ask.

No swimming today. The pool was full of old people (not during their class time so I was confused/not expecting it) and then I forgot my locker combination and had to have them cut it open with a bolt-cutter. Embarrassing, to say the least. I went to Shaws and found that they have a small selection of gluten-free frozen foods. Almost picked up a pizza, but still not feeling very hungry. Got almond butter, Lara Bar (which was okay but had a cigarette-like aftertaste, ew), and more unsweetened Almond milk. The "original" version is growing on me, but I'm too scared to try coconut water.

I found some coconut water bottles at Shaws too! But look at the nutrition facts: http://vitacoco.com/wp-content/theme...-nutrition.pdf. That doesn't look right to me. Isn't coconut supposed to have fat?

[girlarchitect]

I went to Shaws and found that they have a small selection of gluten-free frozen foods. Almost picked up a pizza, but still not feeling very hungry.

I'm really leery of the gluten-free products - cookies without gluten in a box sounds like franken-food. As I don't have a wheat allergen that would kill me or put me in the hospital for eating a piece, I think I'd rather just splurge once in a while on a good piece of real pizza and call it 20%.

[namelesswonder]

Haha true, and probably a good call. I'm reading labels lots (though got lazy and the almond butter may contain trace amounts of peanuts and soy, but that's not the end of the world) and getting better at it, but it sure is a hassle. I think the worst part is because I'm not overweight and don't *look* out of shape, people think I'm anorexic or crazy when I'm reading labels (except that I want to find fat haha). I was actually accused of being anorexic by a teacher in middle school, or that was a rumor going around anyway. Not something I like, considering my sister's history.

I had a couple spoonfuls of almond butter, the Lara Bar, and a cup of almond milk. I think the fatigue is keeping my appetite suppressed. I keep dreaming of that apartment we saw...I have hope and it's going to suck if we don't get it.

[NoSaladWithoutMeat]

Yeah, I'd stay away from gluten-free especially if you wanna lose weight. None of those things ever taste right... If you want something snacky eat some full fat whipping cream and berries, or make something with almond flour!

[Finnegans Wake]

I found some coconut water bottles at Shaws too! But look at the nutrition facts: http://vitacoco.com/wp-content/theme...-nutrition.pdf. That doesn't look right to me. Isn't coconut supposed to have fat?

Yeah, tried some coconut water at Costco, didn't care for it. I also thought it should have more fat, but the water is what's inside the coconut, and coconut milk uses the meat of the coconut, where the fat is.

So, coconut water? Pass.