Concerned About Lipids

Training Over 35 Lifter
1

Substantiated comments welcome.

I’ve been concerned about my lipids situation for a while. I’ve been on TRT a couple years, and still don’t have the energy I think I should, and with Arimidex I’ve been chasing Estradiol all over the place. I will have Estradiol retested soon.

Anyway, recently I had these tests done. Doctor says that with the exception of low HDL and high fasting glucose, I’m ok.

I am not taking any medications for cholesterol or HDL. He has referred me to an endocrinologist who I will see on Monday.

In the meantime, if any of you guys know about this stuff from your own experience or education, I’d appreciate any clues.

Thanks.
BD

TSH 2.10 0.20-4.50 uIU/ML
THYROXINE, FREE 1.1 0.8-1.8
FREE T3 3.3 2.3-4.2 pg/ml
CHOL 128 < 200 MG/DL
TRIGLYCERIDES 63 00-149
CHOLSTEROL/HDL RATIO 4.6 No normal range
HDL 28 l 40-60 MG/DL
LDL 87 0-130 MG/DL
GLUCOSE 102 h 60-100 G/DL

2

I’ll jump in since no one is responding. The problem with HDL and testosterone is that the research is conflicting. Some studies say it lowers HDL and some say it has no effect. I’ve also seen some studies that say higher levels of estrogens lower HDL.

This is further complicated by the fact that diet and exercise have an effect on HDL so isolating testosterone (or estradiol) as the causative agent in HDL studies is difficult.

Do you take fish oil supps?

3

[quote]bigdawg011 wrote:
Substantiated comments welcome.

I’ve been concerned about my lipids situation for a while. I’ve been on TRT a couple years, and still don’t have the energy I think I should, and with Arimidex I’ve been chasing Estradiol all over the place. I will have Estradiol retested soon.

Anyway, recently I had these tests done. Doctor says that with the exception of low HDL and high fasting glucose, I’m ok.

I am not taking any medications for cholesterol or HDL. He has referred me to an endocrinologist who I will see on Monday.

In the meantime, if any of you guys know about this stuff from your own experience or education, I’d appreciate any clues.

Thanks.
BD

TSH 2.10 0.20-4.50 uIU/ML
THYROXINE, FREE 1.1 0.8-1.8
FREE T3 3.3 2.3-4.2 pg/ml
CHOL 128 < 200 MG/DL
TRIGLYCERIDES 63 00-149
CHOLSTEROL/HDL RATIO 4.6 No normal range
HDL 28 l 40-60 MG/DL
LDL 87 0-130 MG/DL
GLUCOSE 102 h 60-100 G/DL[/quote]

Can you post TT, FT, DHEA or DHEAs with lab ranges?

I think that your cholesterol is too low.

If you are not on hCG, your prenenolone will be low and preg is used to produce DHEA.

Hormone imbalances can cause cholesterol levels, but that is low now.

Niacin, Biotin and some other things can increase HDL.

Are you taking statin drugs?
Are you eating an extreme diet, low fat etc?

Low levels of cholesterol are associated with increased mortality.

4

[quote]happydog48 wrote:
I’ll jump in since no one is responding. The problem with HDL and testosterone is that the research is conflicting. Some studies say it lowers HDL and some say it has no effect. I’ve also seen some studies that say higher levels of estrogens lower HDL.

This is further complicated by the fact that diet and exercise have an effect on HDL so isolating testosterone (or estradiol) as the causative agent in HDL studies is difficult.

Do you take fish oil supps?[/quote]

Some recent studies I have read: Chocolate raises HDLs; Pomegranate lowers cholesterol levels; niacin-bound chromium raises HDls and lowers LDLs. I mix pure cocoa powder with my morning coffee and take 1 Tblspoon pomegranate juice concentrate every day.

5

[quote]happydog48 wrote:
…

Do you take fish oil supps?[/quote]

happydog48, thanks for the response.

I do take fish oil supps. About 10g per day.

6

Thanks very much for the response, KSman.

[quote]KSman wrote:
…
Can you post TT, FT, DHEA or DHEAs with lab ranges?

I think that your cholesterol is too low.

If you are not on hCG, your prenenolone will be low and preg is used to produce DHEA.

Hormone imbalances can cause cholesterol levels, but that is low now.

[/quote]
“can cause cholesterol levels” to do what?

I take hcg 250 iu every other day, and a 10% pregnenolone cream daily, rotating sites, and oral DHEA 25mg twice daily.

The closest hormone labs to that cholesterol labs had

TT 1541 (270-1734)
FT 534 (400-600)
E2 49.6 (0-56)
SHBG 17 (13-71)
DHT was high 80s, almost at top of range (sorry, I don’t have the range handy)

DHEA was not measured, but usually my DHEA-S is just a little above the top of the range.

I have started Arimidex since those labs, and am still tuning the right amount and am getting Estradiol tested next week to see how that is doing.

I take 500mg Niacin (flushing kind) over 4 split doses daily. Didn’t know about Biotin.

I am not any statin or any cholesterol meds. I do Precision Nutrition, which is definitely not low fat.

Thanks again.

7

[quote]middleageguy wrote:
Some recent studies I have read: Chocolate raises HDLs; Pomegranate lowers cholesterol levels; niacin-bound chromium raises HDls and lowers LDLs. I mix pure cocoa powder with my morning coffee and take 1 Tblspoon pomegranate juice concentrate every day.
[/quote]

How much pure cocoa? Where are you getting the niacin bound chromium?

Thanks for the input, middleageguy

8

[quote]bigdawg011 wrote:
middleageguy wrote:
Some recent studies I have read: Chocolate raises HDLs; Pomegranate lowers cholesterol levels; niacin-bound chromium raises HDls and lowers LDLs. I mix pure cocoa powder with my morning coffee and take 1 Tblspoon pomegranate juice concentrate every day.

How much pure cocoa? Where are you getting the niacin bound chromium?

Thanks for the input, middleageguy

[/quote]

Cocoa Reduces LDL Oxidative Susceptibility and Increases HDL-Cholesterol

Twenty-five normocholesterolemic and mildly hypercholesterolemic Japanese men with a mean age of 38 ± 1 years participated in a 12-week study of cocoa powder ingestion.1 The participants received either 12 g of sugar per day (controls) or 26 g of cocoa powder plus 12 g of sugar per day (experimental group). The results showed that, after 12 weeks, the cocoa-consuming group had a 9% prolongation from baseline levels in the time it takes for LDL to be oxidized (lag time). This was a significantly greater prolongation than the reduction (decreased prolongation) measured in the control group (�??13%). HDL-cholesterol was significantly increased (24% increase) as compared to the controls (5% increase).

An earlier study cited by the authors reported that HDL-cholesterol increased by 11% and 14% after a 3-week intake of dark chocolate or dark chocolate enriched with cocoa polyphenols, respectively. The daily consumption of catechin monomers and proanthocyanidins was reported to be 270 mg from the dark chocolate and 420 mg from the dark chocolate with added cocoa polyphenols. As the authors note,1 �??These results indicated that the increase in plasma HDL-cholesterol concentration caused by polyphenols was dose-related. Our study also showed that cocoa powder enhanced plasma HDL-cholesterol concentrations and that there was a nonsignificant trend toward a positive correlation between the excretion of urinary catechin and plasma HDL-cholesterol. Intake of flavonoids other than catechins, such as isoflavones, flavanones (naringenin and hesperetin), and polyphenols in red wine, have also been shown to increase HDL concentrations in both human and animal studies.�??

The results also showed that the cocoa powder ameliorated some of the deleterious effects of the sugar intake by reducing the excretion (a 24% reduction from baseline) of urinary dityrosine, which was significantly greater than in the control group (�??1%), and there was also a trend of lower production of Maillard reaction products (chemical reactions between sugar and protein) as measured by Nε-(hexanoyl)lysine excretion.

Reference

  1. Baba et al. Continuous intake of polyphenolic compounds containing [sic] cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans. Am J Clin Nutr 85:709-17 (2007).

I love chocolate, I put 3 heaping teaspoons and sweeten it with stevia. Source Naturals Chromate GTF Chromium is a niacin-bound chromium, I order it from iherb.com, check out their great prices…

9

Thank you very much m.a.g.!

10

You want your total cholesterol/HDL below 4.5. Many focus on this ratio now.

The whole cholesterol thing is very complex and is not as simple as a number. It would be nice if it was that simple. Some people die young with low cholesterol and a heart attack, and others live an extremely long life with no side affects from incredibly high cholesterol. Oversimplified high cholesterol, or for some unfortunate souls practically any cholesterol in those with the genetic predisposition hardens arteries, and in those without the genetic predisposition it may not harden much even with high cholesterol. Thus doctors know family history is of great importance.

In general for most of us it is probably best to keep our LDL low, but not too low and our HDL high. If you have heart disease or a family history of heart disease the doctors will want very strict control. Once over 65 with no heart disease it is better to have your cholesterol a little high as opposed to too low. I am not an expert in this field. The current cholesterol drugs in development are testing different combination medication with statins and niacin.

The bottom line is regardless of the individual doctors understating of the issue their treatments are fairly universal because they are based on well known treatment protocols in the profession that are the result of large studies. I have a close friend that is young and lives an incredibly healthy lifestyle and has cholesterol so high it is beyond the reference range, with no family history of high cholesterol. He has low HDL too. Part of him wishes he never had it tested. The doctors tell him they have no way of really knowing his personal risk of heart disease, because they treat based on the studies which do not include many people like himself. He struggled to decide if he should take medications. He decided to. The doctors are used to dealing with the obese and noncompliant diabetic whose risk factors of heart attack or stroke they know they can lower a little with medications.

Diet and exercise help, but the main influence on the production of cholesterol is in the liver which is genetic.

Flush free niacin unfortunately is no good for raising HDL, but regular niacin or slo-niacin or niamax raise HDL and lower LDL. Estrogen is very effective at raising HDL, but what man cares? Many other things show some promise. I think curcumin and resveratrol could be a consideration and have numerous other health benefits. Resveratrol also seems to improve insulin sensitivity and lower estrogen. Statins are very good at lowering LDL.

Fish oil is great, but mainly lowers triglycerides. Its LDL and HDL effects are exaggerated. Regardless it seems to lower the risk of heart disease.

Stressing too much about this stuff may do more damage to our bodies than the cholesterol. Your numbers are not bad why the concern?

11

icecold:
The low HDL is a concern, according about 5 doctors that have seen me. I am going to see an endocrinologist about this next week.

From what I’ve read, the TSH is not optimal. According to LEF optimal is between 0.2 and 2.0, the higher the TSH means the more the brain is being told “I need more thyroid output!”

12 hour fasted glucose was also high.

I was diagnosed with metabolic syndrome, dyslipidemia and insulin resistance a few years ago.

Thanks for the response and mention of resveratrol and curcumin.

12

Your 28 HDL is the concern. Are you a smoker btw? Just curious.

Your diet is really important for HDL. Fish oil supplements are good, but are you augmenting your diet with foods like…

  • almonds/walnuts
  • raw onions
  • oatmeal
  • citrus foods

My bloodwork was similar to yours a while ago…think my HDL was the same and I had to take 800mg Niaspan to get it up. But I was a smoker at the time and I didn’t incorporate things into my diet to specifically work on my cholesterol.

13

Bama42: I am not a smoker.

I should eat more of what you listed, my diet is low in those things.

How did you like the Niaspan?

Thanks for the response.

14

Niaspan isn’t bad IF YOU EAT IT ON A FULL STOMACH.

Me, being the idiot I am, took the shit with my pre-bed stuff (multivitamin, fish oil, aspirin/statin). If I was doing it on an empty stomach, the Niacin flush was painful…burning, pin prick sensation over your entire body. After a couple nights of that (again, my own fault) I decided to fix my diet and threw that Niaspan shit out.

But it did raise my HDL up over 20 points.

15

I just got back from the endocrinologist. Since I look good in the labs, she recommended nothing other than to gradually double the 500mg niacin per day (split dose) to 1000mg per day over the next month, and eat more avocados.

And get checked for sleep disorders, which actually might not be a bad avenue to follow.

She did say that exogenous T can lower HDL, but because my ration of total to HDL was 4.6, she was happy with that.

Oh yeah, I should cut out the weights and do all cardio.

16

[quote]bigdawg011 wrote:
I just got back from the endocrinologist. Since I look good in the labs, she recommended nothing other than to gradually double the 500mg niacin per day (split dose) to 1000mg per day over the next month, and eat more avocados.

And get checked for sleep disorders, which actually might not be a bad avenue to follow.

She did say that exogenous T can lower HDL, but because my ration of total to HDL was 4.6, she was happy with that.

Oh yeah, I should cut out the weights and do all cardio.[/quote]

Niacin and exercise are the best for HDL. You HDL is low but Niacin is about all the doctors have and will increase your dose to tolerance and monitor your liver. 500mg is more of a preventive dose and does not require monitoring. True treatment is usually 1,000mg to 5,000mg. Everything else in one study it has a significant affect and in another study has a very slight affect on HDL.

For over all health Dr. Oz is correct you really want no or very little abdominal fat. Even someone who looks skinny and has just a couple pounds isolated fat there has tremendous inflammation in their body. Take lots of fish oil. The last things to do is relax and realize you have done what you can. Curcumin and resveratrol may or may not affect your HDL significantly but all the studies show they have numerous health benefits.

17

[quote]bigdawg011 wrote:

She did say that exogenous T can lower HDL, but because my ration of total to HDL was 4.6, she was happy with that.

[/quote]

I don’t know why she would say that. TRT often lowers total cholesterol while leaving HDL unchanged. So she should have said that it was possible, but uncommon.

18

KSman, I honestly think she really didn’t know much about TRT. Seems she is usually dealing with diabetics or people with high cholesterol.

The ironic thing is her front office staff are fat as all get out. Meanwhile, the doctor is a puny vietnamese lady.

Anyway, I’m gonna just leave it all alone and not worry about it. Just keep eating well.

19

The low HDL and slightly impaired fasting glucose are concerning. I agree with the exogenous T probably lowering the HDL, but it’s hard to say. The biggest thing I would be concerned about in you is metabolic syndrome. You already meet 2 out of at least 3 criteria needed:

I agree with the poster noting you definitely want to keep down your abdominal fat as much as possible. Whats your waist circumference and blood pressure?

20

paulMD, my pulse at the office visit yesterday was 67bpm, bp 128/72. Those are consistent have been ever since I can remember.

Thank you for the link. I wish I had a doctor here that knew as much about metabolic syndrome as the one in my home state that diagnosed it.

My waist (at navel) was 39-40" for a long time, now it is 37" as I have been working really hard to get the weight down.

The thing is it’s really hard to do, harder than I think it should be, especially since I am on TRT.

Thanks for your input.