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My doctor had no idea what LDL Particle Size is... how do I get this tested?

Answered on September 12, 2014
Created September 06, 2012 at 7:43 PM

Today, I just had my first blood test since going Paleo 11 months ago. Of course, I asked the doctor to add in a few things other than the standard lipid panel, namely CRP, A1c, and LDL Particle Size. He had no clue about LDL Particle Size. He said that they would just get an LDL number as part of the lipid panel, and then if it's too high, I'd have to go on medication. I laughed at him and said there was no way I'd ever take medication.

So, even after I explained LDL particle size to him, he still had no idea how to actually order this test. So I got my blood work done without it.

Has this happened to anyone else? Is there some technical description of this test that I would need to ask for?

Thanks for any feedback!

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on September 06, 2012
at 09:27 PM

Likewise with the recommendation not to eat refined sucrose/fructose. Surely IMO one should focus just as hard on inflammation and other lifestyle factors. But as I said, regardless, very good article.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on September 06, 2012
at 09:25 PM

Very interesting article. Thanks for posting. Interesting to note that glucose seems less harmful than sucrose or HFCS, and an explaination of why small particle size, and triglycerides might pose a risk. I am however, dumbfounded by the lack of focus on inflammation in heart disease generally. Its well established that it plays a role, that stress thusly is a strong factor, and yet while mainstream doctors are warning people not to eat fats, they never tell you to eat more fish, or stop stressing out. Its a bit odd that people are fixated on one part of the mechanism (LDL), to me.

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13 Answers

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3
7953637a2b9df25a5473a4a086e730f0

(145)

on September 06, 2012
at 08:04 PM

I'm not an expert, but I remember Chris Kresser talking about this one.

I went to his site and found an article about it. At the bottom he has two links for LDL tests, but also says testing is probably unnecessary:

http://chriskresser.com/the-most-important-thing-you-probably-dont-know-about-cholesterol

The testing part:

If you want to get more specific, there are two tests I recommend for small LDL that use slightly different methodology:

LDL-S3 GGE Test. Proteins from your blood are spread across a gel palette. As the molecules move from one end to the other, the gel becomes progressively denser. Large particles of LDL cholesterol can???t travel as far as the small, dense particles can, Dr. Ziajka says. After staining the gel, scientists determine the average size of your LDL cholesterol particles. Berkeley Heart Lab. About $15 with insurance.

The VAP Test. Your sample is mixed into a solution designed to separate lipoproteins by density. Small, dense particles sink, and large, fluffy particles stay at the top. The liquid is stained and then analyzed to reveal 21 different lipoprotein subfractions, including dominant LDL size. The Vap Test. Direct cost is $40.

Link to the VAP test: http://thevaptest.com/

14
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on September 06, 2012
at 08:23 PM

Yes, the correct panel is the VAP. But before you do that, PLEASE GET A NEW DOCTOR

5
20bff9cbbddf521bac87b434981502c3

on September 06, 2012
at 08:30 PM

A recent post from Dr Peter Attia on Mark's Daily Apple discusses that it is not size that matters but rather LDL particle count (LDL-P).

The Straight Dope on Cholesterol, Part 2

Two ways to measure LDL particle count that I am aware of:

  • NMR LipoProfile test directly measures LDL-P
  • VAP measures ApoB which apparently can be used as a good substitute / indicator of LDL-P

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on September 06, 2012
at 09:27 PM

Likewise with the recommendation not to eat refined sucrose/fructose. Surely IMO one should focus just as hard on inflammation and other lifestyle factors. But as I said, regardless, very good article.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on September 06, 2012
at 09:25 PM

Very interesting article. Thanks for posting. Interesting to note that glucose seems less harmful than sucrose or HFCS, and an explaination of why small particle size, and triglycerides might pose a risk. I am however, dumbfounded by the lack of focus on inflammation in heart disease generally. Its well established that it plays a role, that stress thusly is a strong factor, and yet while mainstream doctors are warning people not to eat fats, they never tell you to eat more fish, or stop stressing out. Its a bit odd that people are fixated on one part of the mechanism (LDL), to me.

4
782d92f4127823bdfb2ddfcbcf961d0e

on September 06, 2012
at 07:59 PM

You want the VAP cholesterol test. There is only one lab that does it, Atherotech Diagnostics Lab.

3
Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on September 07, 2012
at 01:08 AM

Very simple......go to LEF.org become a member and order your own NMR profile under their blood testing portion of their site. Post the results here and at other sites. If you post it at my site you will get many comments. We are teaching people how to re engineer their bodies using labs and evolutionary medicine to solve the problems in modern medicine's blind spot.

Good Luck to you, and never settle for less.

2
68294383ced9a0eafc16133aa80d1905

(5795)

on September 07, 2012
at 01:13 AM

Definitely get it tested at a new Doctor's office...

2
Bd142c32b4055224d3191461f1f57520

on September 06, 2012
at 08:01 PM

Mine was called a Vertical Auto Profile (VAP). It was done through Atherotech.

0
A4e6473c7791ca1ddeedf5c5db5fbe14

on May 01, 2013
at 09:56 AM

Ooh I just read this part in the Perfect Health Diet. Jaminet mentions something about this in the chapter about ketogenic diets: "Tests for whether LDL is in the small, dense or large, buoyant form are expensive. However, a good proxy is the triglyceride-to-HDL ratio. When this is high, LDL particles are mostly in the small, dense form; when it is low, LDL particles are in the healthful, large, buoyant form."(p145)

So I guess it's not 100% accurate, but it should give you a clue.

0
8f81ab73fd238096db10725b9a446eb2

on May 01, 2013
at 08:56 AM

Also called "Neclear Magnetic Resonance." You can go to a place where they do blood testing. The in my area is called, "SEPA" There are many others with different names. Good Luck.

0
Edade67cd9c1af4e1ac9fe58a926c721

on March 14, 2013
at 09:21 PM

thank you all, I guess I will be looking for a new doctor also. Mine questioned why I wanted this test. ?????

0
230c22e1665ebf2226746c48045bb104

on March 14, 2013
at 07:56 PM

I listened to Coast to Coast two nights ago. Here in Vancouver we dial into CKNW. Check out their audio vault for March 12, 2013 at 2:00 am. It talks about the great cholesterol myth and doing a Berkley particle test. I have not been able to find anyone here in Vancouver who can do this test but it breaks down your LDL into its five component parts.....only one of which could be harmful. Standard cholesterol tests are not accurate and are not telling the whole story. You may not even need to be on Statins.

Check out the show and if you know how zI can get this test done here in Vancouver....let me know.

Roland

0
90f66d30d977b07694403b469b3f85c5

on September 07, 2012
at 03:22 AM

Great, thanks for the feedback everyone!

Yeah I decided during my conversation with this doc today that I'd never be back!

I am reminded of a George Carlin quote:

"Somewhere in the world is the world's worst doctor. And what's truly terrifying is that someone has an appointment with him tomorrow morning."

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