Just got some bloodwork back and would love to get some feedback. Really happy to see my small LDL dropping back to where it was when I went off a statin but my LDL total is still high but not sure I should be concerned. Any advice on next steps? I am supplmenting with 1g fish oil, calcium and magnesium.
2/14/12 5/21/12 10/1/12
Cholestreol 198 282 297
HDL 54 59 61
Triglycerides 58 44 72
LDL-C 132 214 222
Ratio (Total/HDL) 3.7 4.8 4.9
LDL-P 1550 2779 2202
HDL-P 33 31 34
Small LDL-P 550 1290 526
% Small LDL-P 35% 46% 24%
LDL Size 21.3 21.1 21.8
LP-IR (insuilin resistance) 25 36 15
asked byBriterian (65)
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on November 03, 2012
at 02:21 PM
The best test predictor of atherosclerosis risk is your small LDL particle count. That's because atherosclerosis is really caused by the collision of Apolipoprotein B (Apo B) molecules with blood vessel walls and the cascade of inflammatory responses thereafter. Small LDL particles are much more likely to collide with the walls and get stuck, while big LDL particles may actually be protective against atherosclerosis. In short, you shouldn't be worried about big, fluffy LDL.
Overall cholesterol levels mean very little. LDL concentration doesn't tell you much about LDL particle count. High triglycerides can also mask high Apo B counts, but your trigs weren't high enough for that to be true.
I'm concerned about two things: your Total/HDL ratio is increasing and your trigs are increasing. The change is small, but if the trend continues, you may want to take some steps to change it.
You still need to tell us more about your dietary habits along this timeline.
on November 17, 2012
at 05:51 PM
First what statin were you on? Was it a strong one like Crestor or Lipitor? Dosage? Or a less toxic one like Pravastatin? If you go off a strong statin, everything else being equal, your LDL will increase. Ergo, your TC will increase. More often, your TG would increase, too.
Assuming you made no dietary change before and after, the reasonable explanation is that you're probably ApoE4. About 25% of the population is either hetero/homozygously E4. You're genetically predisposed to higher LDL and TC when eating saturated fat like dairy, eggs, beef. Assuming: You're not undergoing any weight loss. You have no thyroid issues nor pronounced micronutrient deficiency.
That increase in LDL-P from 1500 to 22-2800 is an issue. That's pretty significant and TC of around 300 is getting up there. Perhaps not FH but probably E4-induced. I'd lay off saturated fat from dairy, eggs, try eating lean beef an fish, poultry. Then retest. To confirm, you can sign up with 23andme and get your rs7412 & rs429358 genes figured out.
Why is this happening? Polymorphism. That is, SNP: Single Nucleotide Polymorphism. People react differently to diets. There is no one size fits all diet. High fat Paleo may not be ideal for you. If you wanna lay off statin, might try high carb, safe starch Paleo. But I'd focus on getting your LDL=P down below 1200.