Disappointing blood panels

Hey!

I am 31 years old, in the normal weight range. BMI is a bit higher than normal, but body fat has not increased. Work life is pretty stressful at times. I tend to do 3 two to three hour sessions of resistance training each week.

I’ve had a pretty thourough blood screening done every two years as a part of my work. Two years ago everything was great, but this time my LDL-cholesterol was over 6 and HDL lower than it should be. Because my dad had a heart attack at a relatively young age and because my grandmother died from a stroke, I took the tests again with also lipoprotein-a. My lipoprotein a was 134, so it was above the norm.

I also had low vitamin d levels, even though 2 years ago they were absolutely fine.

Nothing has changed in my diet or otherwise. During lockdowns I had maybe some months lasting breaks from excersise but that’s it. The only thing that was different, was that during this time I had started taking duloxetine and propranolol for generalized anxiety and chronic pain and I turned 30.

I understand the lipoprotein a is mostly like it is from childhood already, and is strongly determined by genetics. Could it be that these medications pushed the cholesterol levels beyond the normal range? Checking the side effects list, it seems like both can have an effect.

Another question I would like to ask is about vitamin d. It was 55 nnmol per liter. It was already low in the summmer, despite having spent the summer mostly outside. Is there anything that can be done about it? Does it actually even matter that much? I read that low vitamin D levels can be explained by inflammatory bowel issues. I don’t have an inflammatory disease, but I do have pretty serious case of IBS, which makes diet regulation extremely hard at times.

You are correct that Lp(a) is primarily genetically mediated.

Duloxetine would not cause these changes. Propranolol can have some effects on blood lipid metabolism, but would also not be expected to induce major elevations in blood lipids either, particularly if you have not experienced any weight gain. I will say that propranolol is generally not a great medication for generalized anxiety disorder.

I would recommend checking out the most recent cholesterol article series on the website, particularly Part 1 and 2, for more actionable advice in your situation.

We did a whole podcast on Vitamin D, episode 152, that I’d suggest checking out on that front. It’s hard to give individualized advice on that particular topic through this forum, unfortunately.