My doctors know pretty much nothing. Help understanding my blood results?

tests
(Jake Liddell) #1

Hi all.

I’ve started a low-carb, fat replacement diet about 4 weeks ago.

I have no idea whether I have reached ketosis - I have had pretty much none of the symptoms, apart from a general feeling of not being hungry, which is great.

I have been skipping breakfast every day (no cheating). I have had none of the big carbs - beer, rice, pasta, bread, sugar, etc.

From my home scales my starting numbers were:
99.3 kg weight
33.2 BMI
36.3 Fat %
29.6 Muscle %
17 (no idea what scale) visceral fat
1989 resting calorific burn.

I’m 46, male, 5-9 or 174cm height, and I would have thought I was pretty much in the risk category when it comes to pre-diabetes.

I went to the doctor a day or so before the start to discuss my plan to try keto. I was told that her, and the UK National Health Service’s remit was not to provide this sort of advice.

I asked, what, not to provide advice on weight loss? She said that she could provide advice on weight loss, but not specific diets. (I suspect she had no idea what I was talking about.)

I asked for her advice on weight loss. She said (and I’m not abbreviating) “Monitor intake, monitor output, do more exercise.”

Hmm.

I complained via letter to the practice head and made an appointment to see him. He was a lot more understanding. He said that if I was to undertake a period of weight loss then it was always good to take some blood tests before and after, to monitor how things are working. So we did this. (He also went on about calories though… clearly no better informed, but at least looking at the numbers.)

Now about 4 weeks on I have the following numbers from my scale:
93.6kg
31.3 BMI
35.6 Body fat %
29.7 Muscle %
15 Visceral fat
1907 resting cals

And my blood tests are back. Blood was taken about 3 weeks into the change of eating.

Interesting ones are:

HbA1c: IFCC standardised is 35, which is 5.4 DCCT%
I think this means I am not showing signs of being pre-diabetic?

Liver ALT level 115 iu/L
It says I’m high on this

Gamma GT level 90 - again, high

Ferritin 531 ug/L - again high.

Apparently according to the NHS these three show signs of some sort of liver problem?

Cholesterol 6.2 mmol/L
HDL cholesterol 1.21 mmol/L
LDL 4.49 mmol/L
Cholesterol:HDL ratio 5.1
Non-HDL cholesterol 5 mmol/L

This is a dangerous level according to the results.

Can anyone shed any light on the above? Which, if any, are likely to change if I keep this eating up? Should I be alarmed regarding the liver results?

The second doctor is going to do another blood test just before the end of December, so I will have some numbers to compare soon.

Thanks for your help and inspiration.

Jake.

#2

Others will be on here with some specific advice, but I can tell you that 1) lipids (your LDL, etc) are going to be significantly out of whack while you’re losing fat and 2) I think that scales are not great for accurate bf% so you might want to track measurements (especially your waist) as well.

Congrats on your results so far, and welcome!

#3

Those liver panel & ferritin results are suggestive of fatty liver disease (insert I am not a doctor disclaimer here) but the good news is that keto is fabulous for resolving that. Were the cholesterol tests taken when you were fasted? Did they give you any triglyceride results?

(Jake Liddell) #4

Thanks Madeleine.

I did take measurements too! But I’ve lost where I put them. :smile:

But by week two I was able to wear a pair of shorts that by chance I tried just before starting!

(Jake Liddell) #5

Triglycerides was 1.1 mmol/L - not sure what that means?

No, I wasn’t fasting - apart from the not having breakfast. I would have had stuff through until about 10pm, then nothing through to 11am when the blood was taken.

Thanks Safi.

#6

For the purposes of a blood test fasting just means 10 - 12 hours without food so technically you were fasted (just an FYI).

Your triglycerides are pretty good & your triglyceride to HDL ratio is normal so I wouldn’t worry about the LDL while you’re in weight loss mode. FWIW my LDL went down, my triglycerides went down & my HDL went up eating keto so hopefully you’ll see a similar pattern on your next test - many do.

(You've tried everything else; why not try bacon?) #7

An HbA1C of 5.4 is just under the limit for pre-diabetes, I believe, so that’s good, and your ratio of triglycerides to HDL is spot on 0.9, which is the top of the range for low risk of heart disease.

For someone who has just started a ketogenic diet, those are really good results. You should see even better results once you’ve been eating this way for around six months. That’s usually how long it takes the numbers to stabilize. So basically you are already healthy, and you should expect some improvement in these numbers over the next five months.

You might consider postponing the tests for a month, since December is just a bit soon for solid results, although you should certainly see improvements. I understand from people who have dealt with these things, that fasting for 12-14 hours before the test gives you the best cholesterol results (wish I’d known that before my last physical, lol!), so when you schedule your next blood draw, time your last meal accordingly. If your doctors are still stuck in the cholesterol paradigm, this will reassure them no end. (Mine, fortunately, was not fazed by my highish triglycerides and lowish HDL, but I was disappointed.)

(Jake Liddell) #8

Thanks PaulL. Any thoughts on the liver results?

(You've tried everything else; why not try bacon?) #9

It’s not time to worry about your liver numbers yet. Next time, if they haven’t improved, then start to worry. But they are bound to improve. Those numbers are signs of fat in the liver, which clears out fairly quickly on a ketogenic diet. Think of what they must have been five weeks ago, before you started eating this way!

(Garry (Canada)) #10

A1c is excellent.
Increase your saturated fat intake to elevate HDL levels. (Butter, butter, butter everything). This will get your lipids more balanced. Currently they are whacked.
Can’t help with liver concerns.
Good luck.

(Nimitta) #11

Hi Madeleine,

Do lipids change/normalize when a person stabilizes around a healthy target weight?

#12

Generally yes - and then there are sometimes things to look at and/or tweak, but basically when you’re mobilizing stored fat for energy (while losing weight, while fasting), I think there’s just much more in circulation so it throws off your lipid numbers.

(Jake Liddell) #13

Well, just been away for a week on holiday, and instead of putting on weight I’ve continued to lose it. My scales say I’m 14 for visceral fat - a new all-time low for me. A number my scales have never said before! :slight_smile: