Test Results Are Back

Last modified on November 26th, 2008

A few weeks ago I went into the doctor’s office to get a pile of tests done on myself. For those of you that remember, last year I came down with a clostridium difficile infection, which is a superbug that typically only affects people who end up in hospitals on broad spectrum antibiotics. When I was in the hospital last year with pneumonia, I ended up getting it, and it was a very nasty experience that took three rounds of antibiotics to get rid of.

That being said, my stomach has never really been the same, and I frequently have an upset stomach or cramps still. Since C. Diff. has about a 30% recurrence rate (that is, in 30% of people who are cured, it usually comes back), I wanted to get another round of tests to make sure it hadn’t returned. Also, since C. Diff typically only affects older people, the specialist who I was talking to wanted to do an HIV test just to rule that out (I’m definitely in the low risk category there, but he just wanted to cover all the bases). Also, because heart disease runs in my family, he wanted to do a full cholesterol work up, which I typically do once a year anyways.

First I’ll say that getting an HIV test, even when you’re basically sure it’s impossible for you to have, is a rather scary experience. HIV isn’t entirely the death sentence it once was (you can basically hold it at bay nowadays with antiretroviral medication), but it’s obviously something that nobody wants to live with or be diagnosed with. Surprisingly I felt more anxiety about getting the test than I did in the doctor’s office waiting for the result. The good news is, as expected, I’m negative on that regards, but it’s not really a pleasant thing to have tested.

Another thing I’ve always kept my eye on is basically how diabetic I am. I write routinely on my blog about a symptom called insulin resistance, which is something I basically suffer from (also called metabolic syndrome, usually involves several risk factors: high blood pressure, high blood insulin levels, high cholesterol, and difficulty losing weight). If it progresses, it sometimes ends up in type II diabetes, since the muscle tissues in the body essentially become desensitized to insulin, and the pancreas can no longer keep up. The solution to this problem is undoubtedly the next nobel prize winning idea in medicine, as it affects millions of people world wide.

My fasting blood glucose is well within normal range, which basically means that I’m nowhere near diabetic (nor do I plan to ever be). But at least for me, having a fairly accurate snapsnot of what’s going on in my body is comforting at some level.

Lastly, I got my cholesterol numbers back. I’ve basically had high blood pressure and high cholesterol my whole life, even when I was basically rail thin and going to the gym all the time. So unfortunately for me there’s a large genetic component here. I used to be on a diuretic for high blood pressure, but it made me feel weak and I gained weight rather quickly, so I stopped taking them years ago (it actually turns out that diuretics amplify the problems associated with insulin resistance, and can actually make blood pressure and weight worse in people) . Since then I generally control by blood pressure using diet and exercise.

As I expected, my cholesterol is higher than average, as it has been most of my life. That being said, there is a gross misunderstanding of the role cholesterol plays in the human body by the general public, and by many doctors as well. Most people don’t know that the body manufactures over 80% of the cholesterol in the body, irrespective of the cholesterol that comes in from the diet. To a large extent the actual composition of the foods (types of fat, types of sugars) we eat has a higher impact on blood cholesterol than the actual “cholesterol” component of the food. Thankfully the doctor I had today understands all of this too, and wasn’t worried in the least.

Most people know that LDL is the “bad” cholesterol, and that it should be as low as possible. That’s not really correct, as there are about 7 variants of LDL cholesterol, most of which are relatively harmless. That being said, when triglycerides are low, the LDL cholesterol is mostly of a type that’s large and fluffy, and relatively harmless when it comes to causing damage to arteries. When triglycerides are high, the LDL forms small, dense versions that cause heart and arterial damage. The most useful predictor of heart disease is the ratio of triglycerides to HDL cholesterol. LDL cholesterol on its own is basically only minimally correlated with heart disease (which is why the general public’s rather unfortunate obsession with calling it the “bad” cholesterol hasn’t done anyone any good over the years).

So the good news is that my triglycerides are basically right smack in the middle of the normal range. I’m actually surprised they are even that high, as triglycerides basically form as a result of carbohydrate consumption, and I typically limit the carbs I eat each day. My total cholesterol is elevated, but surprisingly it’s not that large either. Of note is that my HDL cholesterol (the “good” stuff) is well above normal, sitting around 1.5 mmol/L (0.9 mm/L is normal). HDL goes up with exercise, and with the consumption of mono and polyunsaturated fats (the “good” fats). Previously the highest mine has even been is around 1.4, so it’s a good sign that it’s going up.

So my triglycerides are 1.32 mmol/L, and my HDL cholesterol is 1.5 mmol/L. That puts my trig/HDL ratio at 0.88. Here is where they should be:

  • 2 or less is considered ideal
  • 4 – high, increases risk for heart disease
  • 6 – much too high, serious risk of heart diseases

As you can see, my ratio is fine, and I’m actually in the “at decreased risk for heart disease” category. So I don’t really have anything to worry about there yet.

But anyways, for the most part, all good news. The only remaining item is to go to a sleep specialist. I have an appointment on December 19th, so that’ll be good.