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Cholesterol Test
I had an heart attack 8 years ago, when I go to the cardiologist he requests the cholesterol test be done after fasting. When I go to the internist he insists it be done w/o fasting, any time during the day. I would like to know what others are experiencing.
You are correct, Eskimo. However, may I suggest that when you return to him with the new knowledge in your head, then he will respect you and will be more forthcoming in the future. Doctors see so many patients, and most I bet do not want to learn anything.
By the way, if you are in Alaska with little sun, you might want to do some reading about how lack of vitamin D may increase Heart Disease risk. Have a nice weekend. Signing off.
By the way, if you are in Alaska with little sun, you might want to do some reading about how lack of vitamin D may increase Heart Disease risk. Have a nice weekend. Signing off.
Thank you for this very informative answer to my question, which was is there something new about fasting or non-fasting cholesterol tests. The conflict was between what my cardiologist stated and what the internist was stating. Apparently there is some validity to having the non-fasting test and all of this confusion could have been avoided if he would just have taken a moment and said he was trying something new. His sarcastic remark about seeing an older doctor if I did want a fasting test was totally uncalled for. "Blind faith" only belongs in churches.
Dear Eskimo:
On the left of this page it says, "Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health!"
I'm sure that ericjon means well, but you are getting unknowledgeable advice. Would you rather have advice that possibly saves your life, or have nice sociability?
Does ericjohn think that your doctor is making up studies in his head? I myself am researching disease prevention, so looked and found this about two studies that say that non-fasting is valuable ***precisely*** for triglycerides. For example (Nordestgaard and colleagues): "The researchers found that the fasting triglycerides values followed the same patterns as fasting cholesterol and added no new information to that already identified by the HDL and LDL cholesterol values. The nonfasting test, however, identified risk that was not predicted by the fasting test. Therefore a nonfasting test might identify a person who is at risk when a standard fasting lipid profile would not show that risk. The nonfasting test was found to be most valuable when the sample was taken two to four hours after a meal."
You can read the whole article (especially about number of hours after eating), or track down the studies on medline. There are always pros and cons.
I don't doubt that your doctor is perturbed over having to constantly defend his decisions to patients who received unknowledgeable advices from amateurs on the internet. The warnings on the left of this page are there for a reason. Doctors might be sometimes wrong, but before disputing them one should at least take a look around.
Pilgrim has it right, though, about calculated versus measured LDL.
Good luck on your health.
On the left of this page it says, "Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health!"
I'm sure that ericjon means well, but you are getting unknowledgeable advice. Would you rather have advice that possibly saves your life, or have nice sociability?
Does ericjohn think that your doctor is making up studies in his head? I myself am researching disease prevention, so looked and found this about two studies that say that non-fasting is valuable ***precisely*** for triglycerides. For example (Nordestgaard and colleagues): "The researchers found that the fasting triglycerides values followed the same patterns as fasting cholesterol and added no new information to that already identified by the HDL and LDL cholesterol values. The nonfasting test, however, identified risk that was not predicted by the fasting test. Therefore a nonfasting test might identify a person who is at risk when a standard fasting lipid profile would not show that risk. The nonfasting test was found to be most valuable when the sample was taken two to four hours after a meal."
You can read the whole article (especially about number of hours after eating), or track down the studies on medline. There are always pros and cons.
I don't doubt that your doctor is perturbed over having to constantly defend his decisions to patients who received unknowledgeable advices from amateurs on the internet. The warnings on the left of this page are there for a reason. Doctors might be sometimes wrong, but before disputing them one should at least take a look around.
Pilgrim has it right, though, about calculated versus measured LDL.
Good luck on your health.
Well so far I haven't heard from anyone that non-fasting is the new thing for cholesterol tests. I wish I lived in an area where there were more doctors to choose from, but that's not the case.
Thanks for your input, I do appreciate it.
Thanks for your input, I do appreciate it.
COMMUNITY LEADER
Wow, I would not let my doctor speak to me like that. That was totally unprofessional. As a patient, you have every right to ask a question like that. Having said that, I have found the fasting lipids to be the most accurate, especially if you're looking for you Tri's. I'm sure your cardiologist would order the test for you, that's where I would start.
Jon
Jon
Thanks so much for your response. I apparently have an ego-maniac for a doctor because when I questioned him about the not fasting his response was " I keep up todate with the latest information but if you want to fast maybe you need an older doctor." At the clinic where the blood is drawn they said he is the only doctor who requests a non-fasting cholesterol test. I thought maybe there is something new out there but I can't seem to find it. My cardiologist is mostly interested in the triglycerides so there's my dilemna.
When I have my cholesterol tested, I have to fast. The bad cholesterol (LDL) cannot be measured directly(for the most part); the LDL is determined by subtracting out the HDL and triglycerides from the total cholesterol. One has to fast for the triglyceride number to be accurate. If one doesn't fast, the LDL won't be as accurate. I don't know how much the error will be.
However, some labs can measure the LDL directly so fasting is not required to determine it. However, the triglycerides would be off, in my opinion.
Have you ask the internist why fasting is not required? Perhaps he/she is just interested in the Total and HDL amounts?
However, some labs can measure the LDL directly so fasting is not required to determine it. However, the triglycerides would be off, in my opinion.
Have you ask the internist why fasting is not required? Perhaps he/she is just interested in the Total and HDL amounts?
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