First I wanted to thank Dr. Jossart for taking time to answer questions. You have no idea how thankful people will be.

I had VSG through single incision on 8/26/09. I am on full solids. Due to a strange sequence of events I have not seen a bariactric doctor since the day I left the hospital. I have been seeing a nurse. She didn't seem know what my lab results meant. I admit I don't take my vitamins daily. I miss doses. My life is kind of hectic right now. I workout 1 hour 4-5 times per week now.

My questions is: Does rapid weight loss cause cholesterol levels to rise after surgery? My 3 month labs showed a rise in my cholesterol from 119 to 172.

Here are my specific cholesterol results. Ranges are in parenthesis.

11/10/09
Total: 172 (<200)
Tri: 91 (<200)
HDL: 38 (35-85)
VLDL: 18 (8-32)
LDL: 116 (65-130)

Before Surgery 6/17/09 (no special diet but was being careful about what I ate)

Total: 119
Tri: 110 (40-150)
HDL: 44 (35-85)
VLDL: 22 (8-32)
LDL: 63 Low (65-130)

I can never remember having cholesterol above 140. My cholesterol has always been low and hovered in the 120 range. I eat more meat now. I used to eat more on the vegatarian side but obviously need more dense protein afer surgery. I do also rely on cheese as a protein source more than maybe I should.

Below I have included my full 3 month labs in case you need them. Thank you so much for your time! I really appreciate it.

Full labs 11/10/09:
Thiamine: Lost in transit. No results
Protein: Lost in transit. No results
Iron: 57 (37-145)
IBC Transferrin: 206 (200-360)
TIBC preformed on COBAS: 288 (261-478)
WBC: 5.5 (4.0-10.5)
RBC CNT: 5.03 High (3.9-5.0)
HGB: 13.5 (12.0-15.3)
HCT: 42.1 (36-46)
MCV: 83.7 (82-99)
MCH: 26.8 Low (28-33)
MCHC: 32.1 (32-36)
RDW: 15.0 High (11.5-14.0)
Platelets: 232 (150-450)
PMV: 8.2 (6.4-10.3)
All specific WBC were normal except:
Mono %: 2.3 Low (2.0-7.0)
Mono #: .01 Low (0.2-0.9)
Na+: 138 (136-145)
K: 3.6 (3.5-5.1)
Cl-: 103 (98-107)
CO2: 23 (22-32)
Anion Gap: 12 (3-20)
Creat: 0.6 (.4-1.0)
BUN: 11 (6-20)
CA: 8.9 (8.9-10.4)
Phos: 3.5 (2.7-4.5)
Mg: 2.30 (1.7-2.55)
GFR: >60 (must be >60 for caucasion female)
Fasting glucose: 82

Day after surgery 8/27/09:
WBC: 9.9 (4.0-10.5)
RBC CNT: 4.55 (3.9-5.0)
HGB: 12.3 (12.0-15.3)
HCT: 36.4 (36-46)
MCV: 79.8 Low (85-99)
MCH: 27.0 Low (28-33)
MCHC: 33.8 (32-36)
RDW: 14.6 High (11.5-14.0)
Platelets: 253 (150-450)
PMV: 7.8 (6.4-10.3)
Fasting glucose: 96

Pre Surgery 6/17/09:
WBC: 6.4 (4.0-10.5)
RBC CNT: 4.87 (3.9-5.0)
HGB: 13.3 (12.0-15.3)
HCT: 38.9 (36-46)
MCV: 79.8 Low (82-99)
MCH: 27.4 Low (28-33)
MCHC: 34.3 (32-36)
RDW: 14.5 High (11.5-14.0)
Platelets: 270 (150-450)
PMV: 8.0 (6.4-10.3)
All WBC normal
H pylori negative
HGB A1C: 5.5 (4.8-5.9)
Est Glucose: 97
Fasting Glucose: 82
Total Protein: 6.5 Low (6.6-8.7)

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VSG Surgery: 8/26/09
Balboa Naval Hospital, San Diego, California






223/202/204/125
Highest/Pre-Op/Surgery/Goal

Whilst our bodies need protein and whilst higher levels does have definite advantages with weight loss, if you suddenly start eating more red meat, cheese, eggs, dairy and other cholesterol laden foods, it is entirely possible to be skinnier with worse blood chemistry. It doesnt happen for everyone and lots of people swear that a high protein low carb diet had quite the opposite effect for them.

But you wouldnt think that after VSG surgery you'd be eating very large amounts of animal foods, so I agree, its very puzzling. But (and this is just a layman's guess) its probably more due to a reduction in the good, cholesterol lowering elements of your diet.

You should maybe think about getting more of your protein from plant sources, including appropriate amounts of good fats like fish oil and avocadoes, getting plenty of fibre (which reduces cholesterol), including foods like oats (real oats, not packaged processed rubbish). shakes of course give you protein without a lot of the nasties. You also need lots of fresh fruit and vegies. None of this is easy to achieve with such small stomach space of course.

what happens of course is that everone is told "protein first" (and this is a curiously US phenomenon, we're not told that in Australia) and focus on it, as they're told to do and with our tiny stomachs, out go the grains, the fruits, the vegies. The diet suddenly becomes very low calorie but very much animal based with very high proportion of saturated fat.

Vigorous exercise like running will also have great effects on your cholesterol, particularly increasing the good levels of HDL in your blood.

SoCal,
I'm just over 4 months out and my cholesterol (LDL) has also risen, it is 130. My PCP, who ordered the labs and called to go over them, was not too concerned, and my surgeon two weeks ago at a follow-up appointment made mention of it and after questioning me told me to reduce my cheese and nut intake. I have a family history of high cholesterol even amongst my normal weight relatives...my grandfather was never overweight and jogged everyday and they still couldn't get his levels normal without medication. I just found it interesting that before surgery my levels were fine and I know I ate so much more fatty foods. Good luck!

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Sleeve Date-8/4/2009






16 pounds lost pre-op

I am curious about this too, can we hear from Dr. Jossart?
Thanks Linda

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Start weight 223
Sleeved Dec. 4, 09/ Dr. Aceves
Current weight 166

I'm having my 6-7 month follow up in mid-January. I couldn't go for my true 6 month follow up because of the clot in my leg a couple of weeks ago. But, my surgeon wants to run a full lipid panel ( I don't know what all that entails), but I'm curious to see how my cholesterol looks. I never had high cholesterol pre-op, but I worry about it as well.

I plan on adding flax seed oil or crush flax seed into my vitamin regimen. I would like to lace my husband's food with crushed flax seed because I worry about his cholesterol all the time ! ! !

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If you don't want the truth, don't ask me. If you want something sugarcoated, go eat a donut.
LapBand 10/01/08
Band OUT, Sleeve done 06/03/09
Dr. Michael Michel M.D.
I'm not around much, but if you have questions, shoot me a message ! ! ! I'm out living life, but check in regularly. . .

The rapid weight loss and starvation process after all weight loss operations will trigger changes in many labs. Liver enzymes may go up, cholesterol can go up or down, white blood count may go up or down. The trend of labs over the first 2-3 years is the best indicator of whether you are cured or not. Most likely, the cholesterol will improve by the one year mark, given adequate weight loss and a healthy diet.

Thanks Dr Jossart...that's about what I suspected.

After a pretty intense pre-op diet for 3 weeks, and losing 17 lbs, my pre-op labs the day of surgery showed an LDH of 237, and a cholesterol of 206 (it's always been about 160). Uric acid was 7.20 and BUN was 20, so I was a bit dehydrated but had been NPO for over 12 hours so that was not surprising.

Monday I'll get results of my 3 month post op labs and hope to see some more "normal" numbers since I'm hydrated better. But I suppose we can't expect things to really normalize totally until about a year or more out when we are eating a more balanced diet.

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CAJUN
Highest Weight: 288 lbs
Sleeved 9/23/09 at 273 lbs
Dr. Alberto Aceves FACS
Mexicali, Mexico