Bloodwork issues due to carbs?

Bloodwork is one thing but when a doctor says “lower my fat and cholesterol intake” might want to do the research yourself or see a new doc. Not all fat is bad and eating cholesterol doesn’t raise your cholesterol. This is all outdated info. But please do the research on this.

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Agree. I am not thrilled with the response. Hard to find a good PCP. I have been researching myself on both accounts (triglycerides and liver results)). I am actively reducing significantly refined sugar intake as well as reducing intake of carbs in general. Appreciate the response.

Cutting back on dietary cholesterol is still a reasonable recommendation in people with high cholesterol. You are correct in that saturated fat and whatnot plays a larger role.

However, there are still some patients who either eat an insane amount of cholesterol for some reason, or whose LDL values are more sensitive to dietary cholesterol for some reason. Hence, decreasing dietary cholesterol is still a very reasonable recommendation to make in people with high cholesterol as it’s easy, and does make a difference in a minority of people (whom you can’t predict beforehand).

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I ride more than you and do 90+ grams per hour, unless it’s a super easy recovery ride. 47yo, 170ish pounds. I just had my bloodwork done and everything was in the normal range.

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I hear on that (finding good PCP). I had a great relationship with a Dr for 15 years. He moved on to other areas and retired from PCP. I’ve been looking for one that fits since he left 5 years ago. I just ended up finding a decent one to do the basics and make sure I educate myself and go from there.

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I was listening to a Robert Lustig video the other day and he said something that reminded me of this topic. He basically said that fructose gets metabolized by the liver and turned into triglycerides. A web search reveals similar info:

Metabolism of fructose occurs primarily in the liver and high fructose flux leads to enhanced hepatic triglyceride accumulation (hepatic steatosis). This results in impaired glucose and lipid metabolism and increased proinflammatory cytokine expression.

My thought was that maybe the solution for someone with high triglycerides was to cut out the fructose (in sugar, gatorade, soda, candy, etc). One could still fuel with glucose variants (dextrose, maltodextrose, etc).

Sadly, I bet that this level of nuance is beyond most regular doctors. You’d need a sports endocrinologist.

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This is fantastic info. I generally only take in maltodextrin with honey but I can nix the honey altogether. I am going to clamp down on off the bike fructose input as well.

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Here is that video in case anyone is interested:

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Given the state of his belly either he doesn’t follow his own advice, or his advice is wrong

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We know nothing of Lustig’s triglyceride levels. Or, maybe that was a cheap ad-hominin for laughs? Also, false-dichotomy is false.

What’s your point?

That @ArthurV should reconsider his comment.

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Gotcha. I didn’t realize you replying to ArthurV.

Genetics? Does this run in your family? Coronary Calcium test may be warranted. Don’t know your age.

Not sure. I’m 41 will be 42 in April. My father has had issues with high triglycerides however his diet is pretty terrible. I don’t know of anybody with liver issues in my family. I will look into coronary calcium. That’s not something I’ve ever heard of; thank you

I dont’ know if this is relevant but my last but one blood test in November last year showed elevated triglycerides. The protocol however at least for our practice has gone from fasted to non fasted. Immediately prior to the test I’d done a 4 hr ride taking plenty of carbs on board and a carb heavy meal immediately after it, Hardly a surprise that they were elevated. A fasted test showed them to be OK a week later. They have improved (ie gone lower ) at my last one a couple of weeks ago. I just feel that at least in the UK the NHS seems obsessed with getting as many people on Statins as possible. (I’m off to have my annual argument with the practice nurse about them in a couple of hours). I suspect the recommendations to not have the tests now fasted comes basically from the pharmaceutical industry.

I mean, you always need to worry about industry influence…

But the reason why we are moving away from fasted measurements is that fasting is annoying, and non-fasted levels actually provide significant information about degree of cardiovascular risk (the whole reason for checking lipids in the first place)… probably more so than non-fasting levels did.

Here’s a nice recent review that explains the science behind why non-fasting levels are being used more now:

Despite the advantages of fasting triglycerides as a screening tool, they are less predictive of disease, and appear to be less sensitive than non-fasting and postprandial triglycerides for detecting CVD risk.

Non-fasting triglycerides include triglyceride measurements taken within 8 h of eating and are also easily measured with one blood draw. Non-fasting triglyceride measurement has not traditionally been the first choice of measurement in most countries, but several bodies including the American Heart Association, European Atherosclerosis Society, Danish Society for Clinical Chemistry, among others, now recommend non-fasting lipid panels be performed.

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Thanks I’ll have a look at that

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Yes!! Yes!! I had this! Highest levels (ALT/AST) while trying to stuff 90 g of carbs per hour down my gullet. My lipid panel was higher than is should be (or higher than I think it should be) based on diet etc., but I don’t qualify for statins. I have had a low carb existence since the 90’s I think I shocked the liver. My levels went down to nearly normal when I cut back the carbs and backed off the training. Also my A1C was “healthy” but I don’t think 110 is okay either(maybe my body wasn’t using all the carbs I gave it). I had an ultra sound of my liver and everything was ok, gallbladder ok, pancreas ok. I had a kidney stone in October and my ALT/AST elevated again. How was you ALP? (alkaline phosphatase) mine was elevated as well.
I am thinking in the direction of my liver having issues with glucose dysregulation.

PS. Medical Docs treat disease, and healthy people with weird bloodwork are an anomaly… Next blood test I am going to stop supplements be well hydrated and not go after a workout…

I should add… 53 y/o female 5"4 133 lbs., no meds… ( you know the standard issue ones for "people my age). I don’t drink, I don’t eat out. I gladly eat junk at aid stations and Coca Cola while I no longer partake in the leaded version day to day is hands down the elixir to deliver you from a bonk.

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Hi there. ALP was 95. I finally kicked whatever virus I was dealing with and I started training again. This time limiting myself to only taking in a recovery drink after. Nothing during training other than a nuun tablet or two depending on the workout intensity. Tried to see if I could get another quick test in to see if it was an anomaly. As it stands right now I have not heard back from my doctor and they want me to go back in February to see where things are at. Unlike you I do eat out however I’m not talking about junk food like McDonald’s. I’m talking about pretty healthy restaurant quality takeout.

I really appreciate you getting back to me in this post. I don’t mind cutting back on the carbs but I certainly don’t want to cut back on my training or riding. It’s pretty much the only thing that keeps me sane at this point. Need to start lifting again too!

One other thing I’m wondering about is maltodextrin since it’s heavily processed and how much that may be impacting this. I looked at my notes and I had actually been taking in closer to 60 g of carbs with 20 of those being honey and the other 40 maltodextrin.