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Cholesterol Physio Question

Discussion in 'Medical Students - MD' started by watto, Mar 12, 2002.

  1. watto

    watto Sleek White Pantsuit 10+ Year Member

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    Oct 19, 2000
    CA
    Okay, so I go in for a routine cholesterol test last week, three days after running a 26.2 mile marathon. But I'm feeling good, even though the 10 hour fast was especially difficult. So today I go pick up the results, and my numbers are really high. Over 200 on everything. Usually, I am on the lower end of the normal range.

    My question is this: would dehydration, and therefore increased blood concentration, be the culprit? Or does muscle breakdown have anything to do with this? There's no genetic predisposition for high chol in the family, so I am at a loss here. Thanks in advance.
     
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  3. squeek

    squeek Senior Member 7+ Year Member

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    Jan 21, 2002
    Is the total cholesterol broken down for you? I doubt that dehydration is the culprit, but a high triglyceride level may be. Triglycerides may actually be elevated in a fasting state, and your body may have released some of its fat stores during and after the marathon.
     
  4. watto

    watto Sleek White Pantsuit 10+ Year Member

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    CA
    Here are the outliers in my lab report:
    AST (SGOT) - 73 - range is 1-45 - makes sense if muscle breakdown
    LDH - 262 - range is 89-215
    CHOLESTEROL - 241
    TRIGLYCERIDES - 101 (this one not an outlier, range is 30-110)
    LDL CHOLESTEROL - 147 (should be under 130)
     
  5. neutropeniaboy

    neutropeniaboy Blasted ENT Attending 10+ Year Member

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    Feb 10, 2002
    USA
    My inclination is to say that it wouldn't affect it in the way yours went. Acute exercise actually lowers triglycerides by increasing catabolic states, and increased insulin sensitivity decreases VLDL production.

    Of course, you could always go back and check it again in 3 months.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by watto:
    <strong>Okay, so I go in for a routine cholesterol test last week, three days after running a 26.2 mile marathon. But I'm feeling good, even though the 10 hour fast was especially difficult. So today I go pick up the results, and my numbers are really high. Over 200 on everything. Usually, I am on the lower end of the normal range.

    My question is this: would dehydration, and therefore increased blood concentration, be the culprit? Or does muscle breakdown have anything to do with this? There's no genetic predisposition for high chol in the family, so I am at a loss here. Thanks in advance.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">
     
  6. watto

    watto Sleek White Pantsuit 10+ Year Member

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    Oct 19, 2000
    CA
    Thanks you guys. Yup, it looks like I'm doing it again in a few months. I have no idea what could have pushed it up so much, though--I don't eat red meat, it's usually normal, etc. Bizarro World.
     
  7. ckent

    ckent Banned Banned

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    Jul 31, 2000
    Smallville/Metropolis
    Did someone calculate your HDL level for you? I am calculating it to be in the 70s with a formula we learned in class. If you have HDL in the 70s, you will probably be fine with slightly elevated LDL levels (low risk for CAD).
     
  8. watto

    watto Sleek White Pantsuit 10+ Year Member

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    Winner! Winner! Clark guesses correct. The HDL was 74. Give that man a giant stuffed carrot.
     
  9. neutropeniaboy

    neutropeniaboy Blasted ENT Attending 10+ Year Member

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    Feb 10, 2002
    USA
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by watto:
    <strong>Winner! Winner! Clark guesses correct. The HDL was 74. Give that man a giant stuffed carrot.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Cool.

    Well, here's the way I look at it. If your HDL is 74, that subtracts 1 point from your total risk factor profile. I don't know if you have a family history, if you have high blood pressure, or if you smoke (I'm assuming you don't have HTN and that you don't smoke). So, in the absence of any significant CV problems, you have 0 risk factors. Therefore, your target LDL should be less than 160, and it is. Alternately, if you want to do the 10-year risk profile, you're less than 1% risk.

    If the values reported are true to what your cholesterol profile is, you risk is going to significantly increase as you age, and you'll have to consider dietary or drug therapy.

    So, you should follow the recommendations and get it checked every 5 years.
     
  10. docab

    docab Member 10+ Year Member

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    Oct 9, 2001
    As Neutropeniaboy states, without any cardiovascular risk factors, your target LDL is 160 according to the NCEP guidelines (which is considered the standard of care by the vast majority of physicians, although some advocate being even more aggressive with high-risk patients).

    I you've been following your cholesterol regularly and noticed a big change, then think about secondary causes for hyperlipidemia. Most likely you have none of them if you're feeling completely healthy but things like smoking, hypothyroidism and numerous drugs,including steroids (which I'm not at all meaning to imply with you, just a good thing to think about for future patients who are young & athletic).

    There are certain stressors (acute MI, surgery, infection) that do effect lipid profiles because of acute phase lipoprotein changes, but usually in the opposite direction (downwards). Tissue injury generates acute phase proteins that impair hepatic lipoprotein production and metabolism that can reduce total cholesterol, HDL & LDL but increase TGL. This, of course, is all short-term and should return to baseline within a few months. Probably more than you cared to know, but....

    By the way, were you fasting before the test?!
     
  11. watto

    watto Sleek White Pantsuit 10+ Year Member

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    Yep, fasted somewhere between 8-10 hours, just like they told me to. Metabolism was kicked into high gear, so it wasn't fun. This is all good info. Funny how much easier it is to absorb this type of information when it is a real-life matter.
     
  12. neutropeniaboy

    neutropeniaboy Blasted ENT Attending 10+ Year Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by watto:
    <strong>Yep, fasted somewhere between 8-10 hours, just like they told me to.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Wait...somebody help me out here. I seem to remember something about what the fasting actually affects in the lipid profile. I thought fasting altered only the triglycerides and the HDL level. Something like that, right?
     

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