Comment by stubybubs | Hacker News Reader

Comment by stubybubs | Hacker News Reader

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I'm like this. Got some labs from when I was 36:

  HDL: 1.96 normal range 0.90-1.60 ("good" cholesterol, above high normal)

  LDL: 2.19 normal range 2.00-3.40

  Triglycerides: 0.54 normal range 0.60-2.30 (below low normal, lower is better)

  HbA1c: 4.9% normal range 4.5-6.5% (measure of average blood sugar over about 3 months)

I had these results while I was in med school (late bloomer) and having seen a lot of lipids/HbA1c I have to say I have never seen results this good in anybody else. Yes, I am pretty proud of myself!

At one point I ran a half marathon, but that was 4-5 years previous to this. By this point I was on 20 minutes intense cardio 3x week, and heavy weights. By heavy I mean heavy for me, as in I didn't show up at the gym expect to do 3 set of 10 no matter what. If I could do 3x10 of a certain weight, it was time to up the weight for constant improvement.

I ate balanced protein and carbs with some fat, a habit I picked up from Body for Life a long time ago. I ate a lot of chicken, plenty of beef, also fish. I also love candy, and will eat a lot of it while coding or studying. Never skimped on things like popcorn, triple butter please. Love eggs. Love eating out, rich meals and dessert. I have never been vegan or vegetarian. When I really wanted to build muscle, I ate lots of meat.

For a genetic background, I have a sibling who ended up with NAFLD in their early 30s. Aunt and grandfather with T2DM. Mother is on statins now in her late 60s. Generally my family is average build, maybe a big chubbier. I would say my health is 90% effort.

I think the key is, you have to use absolutely everything you put in your body. If you are not building a stronger body with it, it's going to waste.

> Yes, I am pretty proud of myself!

Congratulate your parents as well for the good genes.

> I also love candy, and will eat a lot of it while coding or studying. Never skimped on things like popcorn, triple butter please.

> I think the key is, you have to use absolutely everything you put in your body. If you are not building a stronger body with it, it's going to waste.

I mean I’m totally in the indulge in moderation crowd if only to enjoy life, but I am still at a loss how your two statements above are connected. How are you building a stronger body with the triple butter?

I added some genetic background. That definitely isn't it. Nobody else in my family has put in the effort that I have.

> How are you building a stronger body with the triple butter?

The point is that I used it all. I burned all of the calories I put into my body. Even if the calories were "crap" I burned them instead of consuming the quality protein I ingested for basic metabolic needs. My weight crept slowly upward from 155 to 165 over the course of 10 years and it was muscle, not fat.

> I added some genetic background. That definitely isn't it.

It isn’t “it”, but you sure as hell know that lipid metabolism has a considerable genetic component.

> Mother is on statins now in her late 60s.

Even with your lipid levels posted if you have even a touch of hypertension you will have an indication for statin in your late 60s based of CV risk.

Seriously I am happy that you’re physically fit and doing well not trying to diminish that - but I could not help but be amused that you’re flexing off of results seen in medical training. Granted some of us train in relatively healthy areas - but I trained and work with a patient panel with A1c often in the teens - so just the thought of gauging my own progress off that comes off somewhat sadly as ludicrously funny.

My somewhat tech related story was we recently had a transfer patient with an A1c of 127. The limit on these assays is typically around 20% - but apparently the lab interface in this case stores A1c as a signed 8 bit integer and a maxed out value as +max - after mentioning this the endocrinologist gave me a blank stare and walked away.

Well, I'm obviously discounting results that you could classify as "unhealthy" right off the bat, and I was relating it to screening lipids on healthy patients. I'm not going to flex vs a 12% a1c from a diabetic, and the point is that I have not seen better numbers in any patient. Of course these are just numbers and my health could turn bad any day, but as far as numbers go, mine are great.

My mother is on statins based on her lipids. I suppose my situation could be the result of some favorable de novo mutations, but if you look at an extended family photo I am definitely the odd one out, something that only emerged with hard work starting late in my teens. Nothing with my fitness has been a gift. I could barely run 500m in my early 20s. It was far harder for me to gain muscle than most other people at the gym. That can be discouraging, but I stuck with it all became a form of meditation and a constant in my life when other things were changing.

>> and having seen a lot of lipids/HbA1c I have to say I have never seen results this good in anybody else.

> point is that I have not seen better numbers in any patient.

Well that’s a biased or too small sample size. 2.19 is a great number for most adults (barring those with very high risk ASCVD where these days we want to squash it down much lower) - and if you were my patient I would be congratulating you but alas you are just a rando on an Internet forum where we can discuss data dispassionately and.. https://www.ahajournals.org/doi/10.1161/circ.106.25.3237 If I see only 20 patients in clinic or realistically a cohort of clinics that is representative of the American population I expect 1 or 2 to pop better numbers.

It’s better than average but not rare or uncommon by even American standards (and don’t look at the Dutch numbers if you want to feel good about yourself).

This has become quite a bizarre conversation. You seem utterly unwilling to believe that you can meet a healthy person on the internet, and even if you did, you assume it's purely genetic.

You've sent me the distribution of lipids across all age groups, done for research purposes. In clinic you rarely test anyone in those younger age groups for lipids as screening starts at 40 for men and 50 for women. So, you know, you don't see results for 20 year olds in clinic, and if you do see those results for younger people it's because they have some pretty extreme risk factors like morbid obesity. Are you ordering lipids on healthy 20 year olds?

Interesting to see that even against the youngest age group, my triglycerides are low enough to be in the 5th percentile, HDL is above 95%, and LDL below 10th percentile. Total cholesterol was 4.40 so my ratio is 2.2, which is far below average for risk. My HDL was better than 95% of Dutch teenagers and my triglycerides were better than 90% of 20-somethings.

> You seem utterly unwilling to believe that you can meet a healthy person on the internet, and even if you did, you assume it's purely genetic.

You seem to have some deep insecurities. I already acknowledged multiple times that your stats are overall consistent with good health. I lightly pointed out, pretty uncontroversially, that some of those results have a genetic component - so thank your parents even if just a little. "you assume it's purely genetic" is pure hyperbole.

> You've sent me the distribution of lipids across all age groups, done for research purposes.

Yeah, exactly, why would that not be relevant? These are the distribution of lipid profiles in the NHANES dataset that is used to guide clinical care throughout the Western world. Modern medicine care is based on research.

> In clinic you rarely test anyone in those younger age groups for lipids as screening starts at 40 for men and 50 for women.

In the US it starts a bit younger. And again, rare is a hyperbole. We routinely screen pediatric patients in the US - that is standard of care. So....

> Are you ordering lipids on healthy 20 year olds?

Yes, of course - not that rarely.

If a healthy 20 year old has no record of being screened in childhood I will screen to rule out FH, obvi.

"healthy" is a nebulous concept - I consider it appropriate to order lipids on what I deem a healthy 20 something with risk factors (family history, certain childhood illnesses, HIV, diabetes - not all young folks with diabetes are unhealthy even if they are not as amazing as you, etc).

> ... My HDL was better than 95% of Dutch teenagers and my triglycerides were better than 90% of 20-somethings.... blah blah blah

Exactly. So, very good, as I already stated, even excellent. But not something that is super rare - 95%tile is 1 in 20, that is not rare.

You were that one that made this about an appeal to authority: "and having seen a lot of lipids/HbA1c I have to say I have never seen results this good in anybody else."

I quoted the literature to not make this some anonymous dick sizing contest - and also because the data is interesting. I admit lipid management is a personal interest - now you can look into why ordering lipids on 20 year olds is sometimes appropriate. You seem to be hung up on being butthurt that the entire conversation is not unconditional praise on your personal accomplishments.

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