Cholesterol Levels While Nursing
heart rate / cardiovascular | metabolism
Whitney Erin Boesel
After giving birth, Whitney Erin Boesel learned that her cholesterol was very high. Given her family history, it seemed that an intervention was in order. But what if she did nothing and simply made observations?
Cholesterol Levels While Nursing
Hi, my name is Whitney Erin Boesel and my talk is called, Cholesterols Levels While Nursing.
I will start by being honest with you and telling you that I never used to care much about my cholesterol at all. But at QS17 in Amsterdam two summers ago I ran into Azure, Erica and a cardio check machine hanging out at a table. Ad since I do actually care very about capillary blood diagnostics, I got gleefully got in line to volunteer some of my blood for what was clearly going to be super important.
When the cardio checked the results, I was taken aback. My total cholesterol wasn’t what one would call abysmal, but it was higher remembered it being which due to my feelings about phlebotomy had kind of been a while.
The thing is, high cholesterol runs on one side of my family but not on the other, and since I’m still in my 30s I don’t yet know which end of the gene pool I’m swimming in. As you can see in this dramatization. Some people in my family need medication to control their cholesterol. Others eat a red meat diet without a problem at all, and I really do have a sibling whose total cholesterol is 70, thanks to a specialized vegan diet.
Dietarily I fall somewhere in the middle. I don’t eat land creatures, but I do eat a ton of eggs and full fat dairy, and I didn’t want to change that if I could get away with it. I was therefore particularly eager to participate in Blood Testers, a QS Labs project which 21 of us used cardio checks to check their own cholesterol at home.
I also started using wearable temperature sensors called iButtons, to get a better picture of what was going on with my hormonal cycling. iButtons are just little temperature sensors, I use one taped to my pectoral region, and one to my ankle which I’m not going to try to show you. And I have them configured to record my skin temperature every three minutes.
So, armed with a cardio check and two iButtons, I decided to check an unusual hypothesis. My experiment for Blood Testers was, if I do absolutely nothing my cholesterol will improve all by itself. That sounds like some crazy path medical thinking, but I did have two variables in play that had by hypothesis a little bit more reasonable than you might think.
The first variable is that five and a half months before that first cardio check screen, I had given birth to my daughter. I knew from my experiences on a drug called spironolactone, that is there a relationship between sex hormones and cholesterol levels. So, it seemed reasonable that my lactational laminaria could be affecting my cholesterol.
None of us could find much in the literature on PubMed about how cholesterol varies over a person’s menstrual cycle, but I did find it to be an established fact on Mummy Blog, that cholesterol is higher during the second and third time after pregnancy and during the postpartum period.
Given what I knew at the time, I expected that my cholesterol levels would drop when my cycle returned and re-established itself. And speaking of lactational, my second variable that I was and still am breastfeeding my child Since that only 10% of cholesterol is produced in human milk is produced within the breast, that means that 90% of cholesterol in my milk has to travel through my blood, and human breast milk is pretty high in cholesterol.
So, as my child continues to approach weaning, and as I slowly stop cholesterolating for two, I would expect that my cholesterol would down.
My menstrual cycles had actually returned by the time Blood Testers started, but I was able to track my daily fasting cholesterol over one, 16-day anovulatory cycle, the 28-day cycle immediately following it. And then, in February 2018, my fifth regular length postpartum cycle. In the meantime, I made no changes at all to either my diet or exercise habits.
By February, my menstrual cycle was stabilized. They were back to being regular and had started showing a post of ovulatory thermal shift. These are heat maps made from my iButton data, and you can actually see the thermal shift is up there like in the upper right-hand corner of the last one.
My child was also 14 months old by February, and she had started to get the majority of her calories from solid food rather than from my milk. And my cardio check results showed that sure enough, my cholesterol had gone down and all by itself.
As I discussed my results with Azure, I learned that my February cholesterol levels also showed the same pattern reported in one of the only published studies on this topic. Although the protocol in that study involved taking eight samples over the volunteer’s menstrual cycle, whereas I actually took 28 over mine. It may be the case that my work with the Blood Testers project is the first high-resolution study of its kind to look at cholesterol variants over the menstrual cycle.
Now, when I talked about this project at the QS Public Health Emposium in April, I closed by saying, quote, I obviously have no way of teasing out how much causality tributes to each of my two variables or to any additional variables, but my hypothesis does stand. I made no changes to diet or exercise, and my cholesterol still improved. For me at least, it seems that mildly elevated cholesterol was simply a natural part of my postpartum journey.
And that was true, right up until it wasn’t.
Fast forward to the summer of 2018 when I thought, my, wouldn’t it be fun to track my cholesterol for another cycle so that I have fresh data for QS18. So I did that, and it was discomfited to find that my results were looking a bit different.
My August cholesterol pattern didn’t resemble the curve in the published study, and mostly that my cholesterol was significantly higher than it had been on the same cycle day back in February.
This is the graph of the total change in my cholesterol, and you can see it got as much as 70 points higher. What happened?
The easiest answer here is stress. My kid got sick and had to potty train early and I will tell you that while having a potty-trained toddler is awesome. Getting to that point was initially much less awesome.
There were four or five days at the beginning of my cycle when pretty much everything in my house got peed on, and everyone was crying. And I was pretty much losing my crap, no pun intended.
There was also a quick cross-country trip followed by another quick cross-country trip, followed by an incident that I had started calling potty gate, in which my childhood actually got kicked out of a daycare for being potty trained. You can’t make this stuff up.
As you might imagine none of this was any good for my stress levels, and we do know that stress can increase cholesterol levels in the blood.
Additionally, a late thermal shift in my iButton data suggest that I was still stressed out that I ovulated late, and that hormonal disruption probably affected my cholesterol as well.
The update and moral of my story is that although my 20 month old toddler is still siphoning off a little extra cholesterol each morning and night, at this point nursing can no longer explain what is going on with my cholesterol levels.
And while my cholesterol levels may have dropped by itself ones, I’m pretty sure that my stress level is not going to drop all by itself, especially as my child approaches the second birthday, and as I approach starting a job search. It looks like I’m going to have to make some changes after all.
Stress may be here to stay, but let’s be real so was cheese. So, I bought a toddler seat for my bike and I joined a gym. Over the last the years, I have learned that my body can do some pretty amazing things, including making an entire human. But I’m not done learning about myself and my cholesterol. Now, I’m curious to see what happens as I increase physical activity, as my child completes her journey towards weaning and as I just keep getting older.
I want to close by saying thank you to QS Labs and to the Blood Testers project, and in particular to Azure Grant, without whom none of this would have been possible and thanks to all of you for listening.