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Old 03-25-2013, 02:28 PM   #1
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Please educate me about Hemoglobin A1c

I had my HA1c tested just a few months into my low-carb diet, and it was 4.8%. I had it tested again in February, almost two years into my low-carb diet, and was expecting that if anything, the number would have gone down. It went up to 5.1%.

What is the margin of error on these tests? Are those two results essentially the same?

Is 5.1% high for someone who eats no more than 40 (usually 30) grams of carbohydrate per day? I know it's considered normal by doctors. But as someone who eats low-carb, should I expect to have a lower-than-average number or is this still normal?

Everything else looks fine. Fasting glucose was 84, and that's the lowest it's ever been (has been 90-98 in the past). HDL and triglycerides were good at 94 and 77 respectively. LDL was tagged as too high at 150, but I'm not worried about that.

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Old 03-25-2013, 03:37 PM   #2
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Greta-
Because I'm hypothyroid and taking supplemental thyroid hormones, I have blood tests every 4 months--which include A1c. Your numbers are essentially the same, and nothing to worry about. The key is to be below 6.0

I eat very low carb (no sugar), and my A1c varies from 5.2 - 5.4. I think it should be lower because of the way I eat, but my endo says that it's just fine. We can't entirely change our body chemistry with diet. What's significant is keeping the A1c fairly consistent and below 6.0.

Ignore that LDL number because with high HDL and low trigs, your LDL is most likely all the 'large, fluffy' kind (Pattern A). When mine was tested (VAP test), my LDL was 100% that Pattern A, and my endo commented at the time that he's noticed that patients with high HDL and low trigs will have Pattern A LDL.
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Old 03-25-2013, 03:58 PM   #3
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your A1c is not going to be lower, because your body is secreting insulin based on how many carbs you eat. it puts out just enough to keep your blood sugars optimal. the point of low carbing is to keep your INSULIN low, and that is happening just fine.

your results are just about optimal. and yeah, I don't think the diff between the old and new readings is significant.
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Old 03-25-2013, 04:26 PM   #4
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Thank you both so very much. I appreciate the clarification!
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Old 04-09-2013, 07:20 PM   #5
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May I ask how much protein you consume on a daily basis? Alot of people don't know is that protein can be converted to glucose when there is an excess thus increasing blood sugar.
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Old 04-10-2013, 06:30 PM   #6
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Good point, noirbeau. I eat moderate protein and lots of fat. 90-110 grams per day of protein. Not enough to keep my blood glucose high after a meal (I do check. Not after every meal, but from time to time.).

I listened to a podcast the day before yesterday which I think explains things in my particular case. In this podcast, Dr. Keith Berkowitz was discussing reactive hypoglycemia, which is something that I've struggled with for many years. He said that A1c levels of 5% are normal, and that levels below that could be an indication of hypoglycemia. The first time I had mine tested (when it was 4.8) I had only recently gone low-carb, and I was still struggling to get the hypoglycemia fully under control. Now that I've been on the diet longer, my blood sugar is much more steady, and I haven't had any hypo episodes in quite some time now. So maybe that's why it rose a bit.

Last edited by Gretalyn; 04-10-2013 at 06:31 PM..
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