Does anyone know how to spike HDL for a cholesterol blood test?

[EasyEJL]

I have to take my annual blood test this week, and due to certain short term supplementation, I'm fairly certain my HDL is low again. It was 15 last year (as I stupidly did the same thing that time last year) and my doctor was concerned but let it slide. I know it bounces back to normal inbetween, but don't want her giving me a prescription or other grief for HDL coming back that low again when I get tested this week.

Any ideas?

 

[Engineer MD]

ah man that sucks. you can be certain that whatever you are doing now will put it right back to where it was.

I don't know how much you can jack up your HDL in a short timeframe, but the only thing I can think of is a mega dose of niacin.

We just learned recently in pharmacology that this is generally the BEST drug prescribed for low HDL. It is generally prescribed at 1000mg / day. The best part for you is that it is OTC. Pharmacist preparations are time release, though. Buy it on the shelf from a reputable brand. Try taking 2000mg - 3000mg split in two or three even doses each day.

This is important: Take half a 325mg aspirin beforehand or you will get massive erythema on your face and probably a lot of itching on the body. It's a normal reaction to high doses of niacin.

FYI... you are really screwing around with your heart by using whatever you're using. high LDL is a problem, but apparently we're starting to think that HDL <40 is an even bigger problem. Yours is around 15... that's a BIG TIME risk factor for atherosclerosis especially at your age. Don't expect a miracle from the niacin... you'll be lucky if you can get it past 40 in a period of a few days. Plan on telling your doctor the truth.

 

[Engineer MD]

I forgot - take the aspirin 45min before the niacin or it won't do anything

 

[goonstopher]

Just be warned that niacin is not great for the liver so dosing should be done 1xday when you are not in a panic/hurry.

On a longer term basis, psyllium husk should help lower LDL. Metamucil actually tastes pretty good as long as you drink it before it starts to get thicker (just drink it right down)

 

[goonstopher]

I forgot - take the aspirin 45min before the niacin or it won't do anything

I wonder your take on the asprin thing because that isn't a long term solution either. a baby aprin a day might be fine, would that be enough for the nightly dosing (after this catch up phase)?

Also I wonder if anyone has questioned if the asprin hurts the actions of niacin, flush free niacin does not work so could the flush be needed?

Finally, niacin and 160-170mg (2 baby asprin) each night might get hard on the liver over time

 

[Engineer MD]

no. I don't think you understood what the point of this is. he has about a week to try to straighten out his levels. the only reason to take the aspirin is to prevent the skin reactions to a large dose over 1000mg. as you know, aspirin works by inhibiting COX1 which makes prostaglandins from PGG and PGH. that is what causes the vasodilation and the skin itching from the prescription level dose of Niacin. Aspirin does nothing to raise HDL

Regardless this is his short term attempt at eluding his doctor's blood test, so take 1000mg at noon and another 1000mg at midnight. If you keep your diet fat and cholesterol free you may be able to raise the HDL to about 30.

Either way, this is how we prescribe this. Usually niacin should only be at 1000mg a day but he's really trying to jack up his levels here. The aspirin is optional but it will prevent the itching and erythema.

And since his HDL is still going to be on the low side, all of what I just said is probably what his doctor is going to say to him anyway after the blood test. (Or she might prescribe a fibrate to go with the niacin). Anyway, I'm only a second year med student so feel free to double check on my suggestions.

 

[EasyEJL]

I know from prior experience it will bounce back to 40s within a month or so of me stopping taking methylated orals, since I take enough fish oil and eat other healthy fats. So yeah, its just about the short term so i don't end up getting put on lipitor or some other horror. My ldl only comes in anywhere from 120-150 even at the bad times.

 

[JayV]

Easy, you can try to consume as much EVOO as you can tolerate. I don't know how fast it will jack up your numbers, but it definitely raises your HDL. Mine usually runs in the 30's but with daily shots of olive oil I had mine up in the 60's.

 

[EasyEJL]

I was thinking of perhaps rather than going in fasted i'd take a little fish oil or evoo before the blood draw

 

[nattydisaster]

Time released niacin, but like goony said it has sides too sooo...

Lots of fiber

 

[criticalbench]

I would not falsify blood results; if your hdl is low, its low regardless of its cause. It's not acceptable for it to be low just because you cycled unless it is only a minor fall out of range. An hdl level of 15 would have any cardiologist on my unit seriously concerned and that would be taken very seriously. I would let your true hdl show, and go from there. Get rechecked 4 weeks later, insurance should cover that then. If all is good, all is good, if its not, something needs to be done.

Just my opinion tho

 

[Engineer MD]

Don't take oils or anything while fasting because you'll really screw up the test and probably just raise TGs with that. If your LDL is really around 120 while using the supplement then she's going to prescribe you Niacin or Fenofibrate or Gemfibrozil or a combination of those. Statins are only prescribed when LDL is wack and HDL is normal.
That's the scenario if you remain silent.

You would much rather have a breakdown of 60HDL and 180LDL than
120LDL and 15HDL.... The latter has about a 6 fold increase in the rate of atherosclerosis. That being said, he's right. When she asks if you're on any medications, tell her you're using a supplement which distorts your lipid profile. This way she won't think it's an ongoing metabolic problem and end up prescribing you a drug that you don't need.

Doctors aren't stupid. If she's doing a full blood panel and not just lipids, she's going to see other values out of whack. If she's smart she might be able to put two and two together - especially if you have a decent physique at your age. Could be an embarrassing situation if you try to sneak by.