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Blood tests show HDL fallen despite eating niacin, dieting and improved cholesterol. Exercise affects?

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General & Family Physician
Practicing since : 2009
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Hello, I was consulting with Dr. XXXXXXX and wanted to ask him now why my blood test shows my HDL has fallen from 41 to 35 despite my taking 1000 mg of niacin, dieting and improved overall cholesterol and triglycerides. My cholesterol has gone down in 3 months from 207 to 193, LDL has fallen from 141 to 137, and triglycerides from 114 to 106. Does exercise affect HDL since I have been doing less the last month or two? Also the range for serum creatinine is 0.9 to 1.3 and mine is 0.8. Does this mean anything significant? Thank you.
Posted Wed, 2 May 2012 in General Health
Answered by Dr. Yogesh D 2 hours later

Thank you for the query.

All the values related to cholesterol seem to have reduced. But that is not unexpected.

Yes, exercise does cause HDL levels to fluctuate. If you stop exercising regularly, HDL levels will drop down and if you regularly exercise, the HDL levels will increase.

And your creatinine is within normal limits, nothing to worry.

Your labs are within normal limits, there is no significant finding.

Hope I have answered your query. Please write back if you have any more queries.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Blood tests show HDL fallen despite eating niacin, dieting and improved cholesterol. Exercise affects? 25 minutes later
Thanks again. Now what is the physiological effect of physical exertion in improving HDL specifically as compared with takiing up to 2000mg of niacin?
Does it have something to do with a large production of nitric oxide as in isometric exercise? I use an isometric hand squeeze device that has helped bring down my blood pressure. But I don't see it related to the HDL issue.
Follow-up: Blood tests show HDL fallen despite eating niacin, dieting and improved cholesterol. Exercise affects? 3 minutes later
One more thing, why is it that different labs have different ranges for various blood test components? Why is there no general standard? I am finding that with my local labs here in the States the ranges are more conservative than what I find online where there seem to be more flexible ranges. One lab considers a number to be LOW or HIGH, while another lab considers the number to be in a normal range. Doesn't that discrepancy affect the ability of doctors to treat patients since they may show a problem where none exists, or vice versa?
Answered by Dr. Yogesh D 41 minutes later
Hello again Mr. XXXXXXX

Thank you again for the follow-up.

Niacin does have a great role to play if taken continuously. Niacin a Vitamin-B complex part is well known to cause a very significant decrease in the total cholesterol levels, triglyceride levels and LDL levels and also increase the good cholesterol that is HDL levels.

You can read more about its actions here:
Physical exertion is in no way inferior to using Niacin alone. Both work very well together.

Exercise is definitely has a very major role in reducing all the bad cholesterols as well increasing the good cholesterol(HDL).

But in your case, a decrease of HDL levels from 41 to 35 is somewhat confusing. But this can happen in the initial days, but over a period of say 6 months to one year, your HDL levels will improve.

Regarding the production of Nitric oxide and its metabolites during exercise and its relation to HDL levels, the available literature suggests that NO does have positive effects on lipid levels.

Different labs have different values because, each lab generates its own database and draw an average based on these databases. They need to do this because certain local and environmental variables cause minor but consistent changes in the observed values. standardizing these errors by taking an average for that particular area makes the tests results to be interpreted appropriately.

The general standard is always there, it is mandated by the WHO, you can visit the WHO site and search for the table with normal values. Or you can open a medical text book where you will find the exact standard values given.

I am not very sure about your local labs being generally conservative as I do not have exposure to United States laboratories. The reason for this could be the regulations imposed by the FDA and the NHS.

This discrepancy wouldn't affect the the ability of doctors to treat patients, because doctors co-relate all the findings with the clinical picture and they would know the actual ranges as mentioned in the text books.

Hope I have answered all your queries.

Please accept my answer if you no further questions. You are welcome to post any follow-up queries if you have.

Wishing you all the best.


Above answer was peer-reviewed by
Follow-up: Blood tests show HDL fallen despite eating niacin, dieting and improved cholesterol. Exercise affects? 10 minutes later
I will accept the answer from you when I can click the blue button if you send a brief reply, and thank you for all your great and helpful information. I only wish my local doctors were as helpful with this type of information as you are Dr. XXXXXXX on Healthcare Magic!!
Answered by Dr. Yogesh D 17 minutes later

Thank you for your appreciation.

I am glad that I could be some help to you.

Please continue with your diet plan and do exercise regularly.

Wishing you a happy and trouble free life ahead.

Thank you again for your kind words.

Above answer was peer-reviewed by
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