Crazy high HDL...questions?

[Julie G]

I know a few others here have super high HDL. Me too. My latest round of standard lipids was my highest HDL yet, at 100 (TC- 220, LDL- 110, TG- 45.) I want to believe that's a good thing. My lipidologist says it's VERY good, but I'm questioning it just to be safe... Has anyone else gotten their HDL subfractions? OR, pinpointed which gene or gene combos (if any) was responsible for your high HDL?

I recall reading that some genetically high HDL was found NOT to be cardio-protective, while some is. I'm trying to discern if mine is the "good" type or the " bad" type Has anyone else been able to extract this information? If so, how?

Here's a great paper outlining all of the genes involved in high and low HDL:
http://www.jlr.org/content/51/8/2032.full

Here's another paper discussing HDL subfractions:
http://www.karger.com/Article/FullText/346463

Both papers are chock-full of great information; whether your HDL runs high or low. (Including excellent tips on how to raise levels.) High non-functioning HDL is no better than low HDL. Function appears to be most important. Apparently, bigger HDL particles are better than small. Small HDL is associated with dyslipidemia and metabolic syndrome even if the level is high.

I had one detailed NMR that showed my HDL-P total-28.1, large HDL-P-2.7, HDL size- 8.7- all off the LipoScience chart- good. IF my understanding is accurate, that seems to indicate that my HDL is the "good"/functioning variety. I'd appreciate any further elucidation. Thanks in advance!

[KatieS]

Julie, yesterday my HDL is now up to 106 (TC-198, LDL-82,TG-48), so I'll need to read the articles again carefully. It does seem like with low TG, this HDL is not likely to be liver dysfunction which could be the case for me (ALT-81). I think alcohol increases the less beneficial fraction. The gene rs5882AA (I have) is related to "increased dementia and less HDL".

Since your last A1c was higher that you expected, did you repeat this test? I was disappointed that my A1c increased from 5.5 to 5.6, but this is from two different labs, so perhaps, it is a meaningless increase. Still cutting these carbs, I would think the A1c would be lower. Now onto fasting 12 hours before I eat for the next few months, and see how this helps.

[Julie G]

Whoa...highest HDL I've ever seen, Kit. And, your ratios are amazing. I LOVE that you exemplify how we can raise above our genes Have you ever had an NMR? I'd be really curious to know your LDL-P. Forgive my MANY questions, but how would you describe your diet.

I'm giving up on the A1c. My lipidologist surmises that it simply isn't accurate for me; may not be for you too. My fasting glucose at this physical was 67. I've been testing regularly and have never even caught a PP over 95. I think an A1c of 5.3 indicates an average BG of 110- impossible

Keep up the great work. You inspire me!

[KatieS]

Yes, I was told by an endocrinologist that the A1c is "just not reliable for me" and she could not even theorize a reason why, such as longer RBC lifespans, since even though the fructamine test was borderline high as well.

No, I have never had a NMR. My mother, the 96 y/o E3/4, still runs a high HDL (76). This HDL of 106, seems odd since during my competitive running years (80% complex CHO diet, low fat), the HDL was only in the 60s. However, I printed out the Mediterranean Diet that you listed, and have been strictly following, increasing berries & legumes. Could it be all those walnuts, almonds and EVOO with less carbs?

[SusanJ]

Kit, it might be the nuts and EVOO. My last HDL (82) is not as high as yours, but it definitely showed an increase after going lower carb and adding more nuts and EVOO in my diet. Trigs some dropped, too, but they've always been low for me.

Poked around a little and found this research on A1c.

Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c

In conclusion, our studies show that (1) reticulocyte HbA1c glycation is closely related to the whole blood HbA1c in diabetes but is too small a fraction of total HbA1c to cause discordance in clinical results; (2) in vivo HbA1c synthesis is linear with time and correlates with whole blood HbA1c; and (3) RBC survival varies sufficiently among hematologically normal people to cause clinically important differences in HbA1c.

http://bloodjournal.hematologylibrary.o ... -checked=1

HbA1c measured in stored erythrocytes and mortality rate among middle-aged and older women.

Among women with HbA1c <5.60%, the risk of mortality in age-adjusted analyses was 44% higher when comparing women in the highest quintile of HbA1c with those in the lowest (RR=1.44, 95% CI 1.11–1.88, p value for linear trend=0.02; Table 2). Adjustment for strenuous exercise, postmenopausal hormone use, multivitamins, smoking and BMI attenuated the association, though the risk was still significantly elevated in the highest quintile (RR=1.31, 95% CI 1.00–1.72, p value for linear trend= 0.10). After further adjustment for blood lipids, hypertension and hsCRP, the association no longer reached statistical significance (RR=1.28 comparing extreme quintiles, 95% CI 0.98–1.69, p value for linear trend=0.14).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757266/

Low Hemoglobin A1c and Risk of All-Cause Mortality Among US Adults Without Diabetes
(Too low isn't good for all cause mortality - gives their thoughts on why.)
http://circoutcomes.ahajournals.org/con ... 6/661.long

Just this quick look suggests something we talk often about - that its the combination of markers that matter, not just one.

[Julie G]

Great detective work, Susan on the A1c. (I know we've discussed it before.) I'm not going to bother with it anymore. Instead, I'll keep an eye on real BGs and fasting insulin. Congrats on bumping up the HDL Yay EVOO & nuts!

Kit, when you refer to the Mediterranean Diet that I listed, do you mean the PREDIMED (and it's off-shoots)? I'm asking as you have the best standard lipid profile that I've ever seen. I want to learn from you. How would you describe your macronutrient ratios? Are you bumping up legumes and berries (easy to do this time of year ) to keep LDL down? How much & what type of exercise are you doing now? FWIW, I would encourage you to do at least a one-time NMR through your physician to get both an LDL-P and to check on your HDL count/sizes, etc. I suspect you'll get great news. The detailed HDL info is not available in the $75 test; hence my suggestion for the real deal. I'm looking forward to more info on your diet- thanks!

[KatieS]

Thanks, Susan for the A1c articles.

Julie, yes the PREDIMED diet, trying to get 4 TBS EVOO (not always), more than their ounce of nuts and always an apple & carrots for snacks. I have a bad daily habit of half-cup of chocolate soy milk, mixed in with quart of non-fat (now 2%) milk, probably 30g/CHO. My rye or whole grain sourdough bread intake has decreased to 4-5 slices/day, another big source of CHO. But I never eat processed foods and only sample sweets or alcohol if served in social settings. I have my book clubs serving berries & nuts now!

Exercise: 3 spin classes/wk (HR 160 15-20x), 1 hilly mountain bike (2hr) every week or so, 3 swims (over a mile)/wk & 3-4 walks (2hr) in the forest.

As to the LDL-P, I will have to search out what labs can do this testing, especially for my husband's behalf.

[SpunkyPup]

standard lipids was my highest HDL yet,"

standard tests are useless did I say that how many times before...
well there is something called non-functional Hdl and that is likely going up. so high means nada nada nothing.
you even showed other info but did not check it with proper test to see what is really happening and want to believe!!!
"My lipidologist says it's VERY good"
no good lip.... ist danger ahead...
just like LDL is a calculated number in the standard test.. did I say useless....sometime ago.. yep..
why u ask do they keep doing this to me???
it is cheap and they don't know better and you accept it...
me I tell them don't bother me with those silly tests if you won't give me good ones I'm firing you and going elsewhere.

"PREDIMED diet, trying to get 4 TBS EVOO (not always), more than their ounce of nuts and always an apple & carrots for snacks. I have a bad daily habit of half-cup of chocolate soy milk, mixed in with quart of non-fat (now 2%) milk, probably 30g/CHO. My rye or whole grain sourdough bread intake has decreased to 4-5 slices/day, another big source of CHO. But I never eat processed foods and only sample sweets or alcohol if served in social settings."

Sounds horrible I'd never do that... what natural living civilization ate like that? none I ever heard of, its a real stretch to the Med diet imho but I have traveled to PREDIMED land so I will wait for the casualty reports or doctored studies.

nothing personal here just my opinion...with the best nmr I've seen here.

[Julie G]

Thanks for sharing, Kit. Same here with the EVOO and nuts. I'm surprised about the bread, but it's yielded great results for you. Do you eat any meat, poultry, fish? How about eggs? I love to see the variety in your exercise. I think all labs have their own variation of the NMR now. LipoScience is the original, but my local lab had a generic that tested all of the same categories.

Spunky, that's exactly what I'm trying to discern...whether or not my HDL is functional. From all I've read, large HDL is the functional kind as it removes the most cholesterol; small HDL is the non-functional. So if my NMR indicates my HDL-P, large HDL-P, and HDL-P size exceed the 99-100%ile, it seems like I could assume I have the functional type, right? Or, should I not rely on the NMR?

[KatieS]

Spunky, you state "would never eat like that…? I eat bread from a local baker who soaks the wheat overnight and bakes on the premises. I verified that my BG doesn't get the PP spike like I consistently have with the "whole wheat" store bread. Since I consume over 2400 kcal/day, just what is so HORRIBLE about this diet??? What do you recommend I eat?

Yes, I eat eggs now sautéed in EVOO, like those tasty food pictures that Julie posted a few months ago. Actually I have increased the amounts of poultry and fish, while decreasing the CHO part of my diet. Since seeing cows slaughtered in childhood, I have never been a red meat eater.

I agree that these lab tests can be completely erroneous, but since making these dietary changes that I have seen on this forum, my brain and knees seem to feel better. This has been the same lab for 34 years, so I can report an almost doubling of the HDL. This trend, with the same exercise and weight, seems attributed to the dietary or supplement (DHA, Curcumin, citocholine & no alcohol) changes.