MEDICAL MOMENT: FASTING & BLOOD WORK

14 Dec MEDICAL MOMENT: FASTING & BLOOD WORK

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Dr. Kent Gaylord, Board Certified in Family Practice

Dr. Kent Gaylord answers this week’s question,

HOW IMPORTANT IS FASTING BEFORE A CHOLESTEROL TEST?

So: You show up for your yearly physical and blood work and Oops! You’ve forgotten to fast for your cholesterol test! Does this mean you have to come back on another day for your blood work?

A new study recently published in the Archives of Internal Medicine suggests the current guideline recommending an 8 hour fasting state to check cholesterol levels is not needed for most people. This study looked at nearly 210,000 people, and found levels of total cholesterol and HDL (the good cholesterol) changed only minimally in response to food intake.

LDL cholesterol levels showed slightly greater variations of up to 10% among groups of patients, and triglyceride levels showed variations up to 20%, but these two lipid results are not absolutely needed to determine a course of action for poor cholesterol levels. Doctors can use the Framingham risk score calculation, based on age, blood pressure, gender, total cholesterol and HDL (both of which varied little in this study) to determine a person’s 10 year heart disease risk.

Another reason to consider to obtain nonfasting cholesterol testing is these values may be more representative of usual metabolic conditions. Humans are usually in a nonfasting state and measuring your blood in this condition may give us a better look at your usual metabolic state.

Measurement of nonfasting lipid profiles may also be better able to reveal individual metabolic abnormalities in lipid clearance, which may ultimately better predict cardiovascular disease risks.

So, have the current fasting guidelines changed because of this study?  No, not yet.  If you remember to fast this is still currently the recommendation, however, I do think it is very reasonable to go ahead and draw a cholesterol screen if you have forgotten to fast. We can get a lot of meaningful information from a nonfasting cholesterol, and this can save you having to come back for a blood draw on another day.

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