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Hack my latest blood work - is the LDL a cause for concern?

Answered on September 12, 2014
Created October 19, 2012 at 5:48 PM

Collected 10/5/12 - Shiel Medical Lab - day 14 (before Testosterone injection) - I'm on TRT - get an injection every 2 weeks

HA1C - 5.6 Fasting Glucose - 100mg/dL Ref Range 65-99 mg/dL Estimated Average Glucose - 114.5 mg/dL

LDL-P 1430 nmol/L Small LDL-P 132 nmol/L

HDL-C 69mg/dL Triglycerides 31 mg/dL Trig/HDH ratio - .45

LDL-C (Calculated) 199 mg/dL LDL-C (Iranian Formula) 146 mg/dL

TC - 274 mg/dL

Estradiol, LC/MS/MS - 4 pg/mL S/B <= 29 pg/mL Enhanced Estradiol - 22.7 pg/mL Ref Range <39.8 pg/mL SHBG - 39 nmol/L Ref Range 11 - 80 nmol/L

Thyroid Panel Thyroxine (T4) - 10.9 ug/dL Ref Range 4.5 - 10.9 ug/dL T3-Uptake - 34.0% Ref Range 22.5 - 37% TSH - 3rd Generation Ultra - 1.47 uIU/mL Ref Range 0.40 - 4.50 uIU/mL Reverse T3, LC/MS/MS - 34ng/dL Ref Range 9 - 28 ng/dL T3, Total 81 ng/dL - Ref Range 60 - 181 ng/dL T4, Free 1.43 ng/d/L - Ref Range 0.80 - 1.80 ng/dL

Vitamin D (25 hydroxy) - 74 ng/dL Ref Range 30 - 100 ng/dL Cardiac Homocysteine - 10.0 umol/L Ref Range <11.4 umol/L PSA - 0.42 ng/d/L Ref Range <4.00 ng/dL

Quest Diagnostics - collected 10/8/12 (3 days AFTER the testosterone shot) Just to show how different labs get different results

Berkley Heart Labs Test

LDL PAttern Size A (Large) Triglycerides - 41 mg/dL HDL-C 76 mg/dL Trig/HDL ratio .54

Apolipoprotein B - 104 mg/dL Ref Range <115 mg/dL

One thing that does not make sense Oxidized LDL - 62 U/L Ref Range 9-44 U/L

Low Risk <45 Moderate Risk 45-59 High Risk 60-79 Very High Risk >79

HOWEVER - Shiel didn't run their HDL test as part of the Triple Marker test so I didn't get the Oxidized LDL/HDL ratio so I'll wait 6 months and run it again.

lipid subfractions

Total LDL-C 158 mg/dL (Berkeley Heart Lab LP Plus3 Test) HDL-C 79 mg/dL Triglycerides 41 mg/dL

Per the Iranian Formula the LDL - 118 mg/dL - MUCH BETTER

HOWEVER - the LDL subclasses are what's interesting

LDL IVb - 1.8% Ref Range 1.7% - 9.8% LDL IVb goal - <= 5% SO - This represents very low cardivascular risk

LDL IIIa + IIIb - 17.9 mg/dL Ref Range 12.0 - 32.1 mg/dL Again - low risk

LDL IVb - 1.0 mg/dL Ref Range 1.5 - 11.2 mg/dL Again - VERY LOW risk

So - total LDL-C doesn't mean much - BUT - they base giving statins on that number

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on January 18, 2013
at 02:52 AM

Your T3 is kind of low, you notice that. And probably your Ft3 also. If your LDL wasn't this high before, it could be due to the T3-LDL receptor link. LDL piles up in your serum due to low T3. You can clarify if this is true or not by looking at prior numbers.

56bc750affa41124e1142a6e8e239e3d

(145)

on January 03, 2013
at 08:54 PM

Agree with what Jake wrote. I also get testosterone injections (do them myself per the prescription). You might want to get the dose halved and get them twice as often. There will be less of a hormonal swing from high to low this way, which could be causing some of your hormonal oddities. That said, I have crazy high LDL (mostly large) but other good numbers like you. I'm not worried since I really depend upon the trig/HDL ratio as a better indicator if I know I've been eating right.

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2 Answers

1
9c07f0980f9b2540ddebd2b4215612b4

on June 02, 2013
at 06:40 AM

Did you ever find a cause for your high ox-LDL?

I know of one genetic haplotype that is associated with high oxidized-LDL, among other problems. There may be others.

Do you have genetic data (from 23andme, FTDNA, etc.)? The gs224 haplotype is a group of three mutations on the GCH1 gene that appear to reduce BH4 levels, and cause high oxidized LDL; if you run SNPedia's Promethease program, it will tell you if you have this particular set of mutations.

About 2% of the population carries gs224.

Here's a study with the gs224 GCH1 haplotype correlated with ox-LDL: http://circ.ahajournals.org/cgi/content/meeting_abstract/118/18_MeetingAbstracts/S_552-d "... The X haplotype was also associated with higher plasma ox-LDL (51.0??2.2 in XX+XO vs 44.2??1.4 U/L in OO p<0.05) and lower BH4:total biopterins ratio (43.1??3.2 in XX+XO vs 51.7??2.1% in OO, p<0.05)."

Yahoo group for the gs224 haplotype: http://health.groups.yahoo.com/group/GCH1discussions

~judi

0
00cd3b6f51530a6832fcda1712edbec3

(2411)

on October 19, 2012
at 11:23 PM

Your LDL-P number is probably in the 70th percentile and is a cause for some concern. If you weren't eating a lower-carb/paleo diet, I'd say get on one. However, that measurement is discordant with your apoB number (good), trigs and HDL numbers (amazingly good), so I don't know what to make of it. I'm not an expert on the effects of testosterone injections, and can't say whether that should or shouldn't be affecting your LDL-P results.

LDL particle size and plasma concentration are, according to Dr. Tom Dayspring, irrelevant.

TC is slightly above the sweet spot (220-240).

Your thyroid panel is missing an important measure: Free T3. It's only the free T3 that's available to do it's job. But your high RT3 suggests that your FT3 might be low.

56bc750affa41124e1142a6e8e239e3d

(145)

on January 03, 2013
at 08:54 PM

Agree with what Jake wrote. I also get testosterone injections (do them myself per the prescription). You might want to get the dose halved and get them twice as often. There will be less of a hormonal swing from high to low this way, which could be causing some of your hormonal oddities. That said, I have crazy high LDL (mostly large) but other good numbers like you. I'm not worried since I really depend upon the trig/HDL ratio as a better indicator if I know I've been eating right.

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