Triglycerides

[tex]

Hi All,

This it totally off topic, but I find it very interesting, especially since it may well be a major factor in my long-term survival prospects.

From a newsletter by Dr. Briffa, dated 03/04/2011:

There are two main forms of stroke, and the most common is cause by blocking off of arteries that supply blood to the brain. You can think of these so-called 'ischaemic strokes' as 'heart attacks of the brain'. You'd expect that if cholesterol causes heart attacks, it should cause ischaemic strokes too. However, in my blog yesterday I share the results of research which found practically no relationship between cholesterol levels and risk of ischaemic stroke. On the other hand, there were strong links between this condition and levels of blood fats known as triglycerides that, by the way, are formed in response to eating carbohydrate.

And from his blog:

The study in question was published earlier this month in the journal Annals of Neurology [3]. In this study, about 14,000 men and women were followed for more than 30 years. The relationship between cholesterol levels and risk of stroke was analysed. The analysis was confined to ischaemic stroke only (so no chance of haemorrhagic strokes diluting the results here).

The results showed:

1. no relationship at all in women
2. no increased risk of stroke in men unless cholesterol levels were extremely raised (9.0 mmol/l or more – equivalent to 348 mg/dl or more) b

In other words, overall, there was little or no relationship between cholesterol levels and risk of ischaemic stroke. These findings suggest that cholesterol has little or no causative role to play in the development of ischaemic stroke.

This study also analysed the relationship between levels of blood fats known as triglycerides and stroke risk. The result? The higher the triglyceride levels, the higher the risk of stroke. In other words, risk of stroke was much more closely linked with triglycerides levels than cholesterol levels.

From a so-called ‘epidemiological’ study of this nature we cannot know if triglycerides cause ischaemic stroke, or are merely associated with an increase risk of this condition. However, it is worth bearing in mind that previous evidence has linked triglycerides with enhanced risk of heart disease and stroke [4].

So, what are triglycerides and where do they come from? Triglyceride is a form of fat used to transport fats around the bloodstream. Triglycerides are also the form of fat used to store fat in our fat tissue as well as elsewhere. Triglycerides in the bloodstream are made in the liver. The major stimulus for their manufacturing the liver is not fat, but carbohydrate (sugar and starch).

It’s well known that if individuals adjust their diet to contain less fat and more carbohydrate (as they’re often encouraged to do), triglyceride levels go up. In short, it seems conventional nutritional advice induces changes in the blood stream associated with enhanced risk of stroke.

http://www.drbriffa.com/2011/03/03/high ... ate-might/

OK, here's why it matters to me:

When I went to the ER with my first suspected TIA, (07/19/2009), no CBC was done. When I had the second, (late at night on 05/04/2010), they decided to keep me and run some tests, so the next morning, (05/05/10), they did a (fasting) CBC. On 04/13/10, (22 days prior), my triglyceride level was 80 mg/dL. On 06/01/10, (27 days after the TIA-like event), my triglyceride level was 94 mg/dL. On the morning of 05/04/10, roughly 8 hours after the beginning of the TIA-like event, my triglyceride level was 263 mg/dL, which is high, obviously. Other than that isolated test result, I've never had a triglyceride reading over 100. I'm guessing, of course, that if they had bothered to do a CBC with the first TIA-like event, it would have shown a high triglyceride reading then, as well.

Also, I noticed that at 1:58 am, (roughly 2 and a half hours after the event began), my white blood cell count was 11.3 x10e9/L, (which is high), while the CBC taken about 5 and a half hours later, (at 7:36 am), showed a WBC of 9.9 x10e9/L, (back in the normal range). Hmmmmmm.

I had initially chalked the TIA-like events up to a possible connection with hemiplegic migraines, (which would make them a benign issue), but after seeing the triglyceride connection with ischemic strokes, this changes the complexion of the issue, (unless, of course, hemiplegic migraines have the potential to affect triglyceride levels). IOW, it appears that I may indeed have an elevated stroke risk, after all.

Any thoughts on whether my interpretation is right or wrong?

Tex

[Polly]

Interesting, Tex.

My first thought is that the one time high reading was an error. Especially since your triglycerides have always been low. Remind me again - when was the blood transfusion? (Just checking to make sure the high trigly. wasn't someone elses's - LOL).

Have you had any other ones done since then?

Of course, another reason for artificially high blood test results (WBC or anything) is dehydration.

Love,

Polly

[tex]

Hi Polly,

The transfusions were on 02/02/10, about 90 days prior to the TIA event. As you probably recall, when I left the hospital after the surgery, my CBC was pretty decent, (except for being low on RBC, Homoglobin, and Hematocrit, of course. About a week later, when my GP checked a sample, my platelet count was at a panic high value, (643). It slowly receded, though, and it was back in the normal range long before the TIA event, (and so were my RBC, Homoglobin, and Hematocrit levels).

My WBC count came down by over 12% in about 5 and a half hours, immediately following the TIA event, and if I recall correctly, they never gave me any more than a small sip of water, the whole time I was there, (and I had to practically beg for that, LOL), (and they gave me no infusions). I had dry mouth, of course, when I arrived, (presumably a side effect of temporarily-elevated BP), but I never noticed any dehydration symptoms, before the TIA symptoms began.

I notice that they never checked my platelet count for either of the two blood draws on that day, either. One would think that they would have checked my platelet count if they suspected a TIA event. (Could platelet count be irrelevant in such a situation?) The resident doc didn't hesitate to prescribe plavix, though, even though they never checked my platelet count.

Have you had any other ones done since then?

Not that I'm aware of. The corner of my lips has always retained a slight degree of numbness, ever since the first TIA event, and sometimes it seems to be more noticeable than usual, but I certainly haven't noticed any more pronounced symptoms, other than during those two discrete events.

So apparently, the mystery continues.

Many thanks, your insight is always greatly appreciated.

Love,
Tex