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Liver, LDL, and Apo B question

Commented on October 16, 2014
Created November 17, 2012 at 1:45 PM

Hey guys,

My wife just got her Wellness FX results back. She is 27, 5'1 and 115 lbs and a former pro athlete.

Here are her numbers and I wanted to get your thoughts:

Total Cholesterol: 348 LDL-C: 229 HDL-C:108 Triglycerides: 55 vLDL-C: 11 LP(a): 1 Apo B: 170

Alanine aminotransferase: 80 (Supposed to be under 40) Aspartate aminotransferase: 43 (Supposed to be under 32) BUN/Creatinine Ratio: 26 (Supposed to be under 26) Dehydration??

Any thoughts would be appreciated! I love her HDL, Triglycerides, and vLDL, but the the Apo B and total LDL concern me.

Bb3c4a525c6ba36c6117100cc3ae8135

(15)

on November 28, 2012
at 06:05 PM

Any thoughts on Hypothyroidism? I see that it can be linked to high LDL, elevated liver enzymes, and possible fibromyalgia. She has chronic back pain that has shifted to shoulder pain, wrist, and knee pain. She also describes feeling tired after climbing a flight of stairs. Her TSH test came back at 2.59 which is in the normal range. She also finds her ring finger swollen some mornings to where she cant remove her ring.

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4 Answers

2
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on November 17, 2012
at 06:49 PM

Those test results have some issues.

There's something wrong with her liver enzymes. ALT way high over AST: usually indicates non-alcohol related fatty liver but she's not obese. Did she lose weight recently or have chronic muscle injury like polymyositis? Those levels indicate significant inflammation. I'd follow up with your PCP and test her for CRP, ESR and other inflammation markers. Her HDL might be related to that also.

High Bun/CR could be due to high BUN, which may result from excess proteins and/or dehydration. Your Cr is probably normal and under <1. It's best to retest and if similar result, restrict protein. If she were a bodybuilder, she may hae had this before.

TC ~350 and LDL ~230 is an issue, no matter her low trigs and "high" HDL. I'd guess ApoE4-related SNP. How were her numbers before? Before her change in diet? I'd recommend laying off dairy, eggs and eating lean meats, poultry and fish, and increasing safe starch proportions to 30-50%.

1
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on November 17, 2012
at 09:05 PM

Then it's not due to fatty liver. They're pretty high for someone eating Paleo and in shape. I'd go see a gastroenterologist or hepatologist for further analysis.

The low creatinine tells you that her BUN isn't so much of an issue. The ratio is high due to her low Cr, which is related to muscle-type of issue or other reasons (like preganancy). Has she been losing muscle mass? Only an issue if confirmed low on multiple tests.

And her high TC and LDL seem to be due to ApoE4. I'd decrease Saturated Fat by skimping on dairy, eggs, fatty beef slices; do lean meats, poultry and fish. Incorporate some safe starches. Then test. If both TC and LDL decrease significantly, then you know how your genes are reacting.

Bb3c4a525c6ba36c6117100cc3ae8135

(15)

on November 28, 2012
at 06:05 PM

Any thoughts on Hypothyroidism? I see that it can be linked to high LDL, elevated liver enzymes, and possible fibromyalgia. She has chronic back pain that has shifted to shoulder pain, wrist, and knee pain. She also describes feeling tired after climbing a flight of stairs. Her TSH test came back at 2.59 which is in the normal range. She also finds her ring finger swollen some mornings to where she cant remove her ring.

1
Bb3c4a525c6ba36c6117100cc3ae8135

on November 17, 2012
at 06:58 PM

She hasn't lost much weight, less that 5-10 pounds. Her hs-CRP was .46. Creatine was .61.

She has always had high TC. 6 months ago while just low-carb and not on the bulletproof diet, her TC was 326, HDL - 76, TRIG- 68, LDL 236.

Her bun/creatine ratio used to be 36.

Before going low-carb her TC was around 260, but HDL was around 40 and Trigs were close to 100.

0
A1d8631c2b4605b00aa4fa35f77c392d

on October 16, 2014
at 05:28 PM

 

Did you ever figure this out? I've been primal/paleo for a couple years and my lipid panal looks similar to your wife's (none of the ALT/BUN stuff though) which led me to this post. I was surprised to see the mention of back and joint pain. RA a possibility? Inflamatory illness can impact lipid levels. She might try hydrolyzed collagen (unflavored gelatin) - was miraculous for my back pain (didn't improve the lipid panel though!)

 

Bb3c4a525c6ba36c6117100cc3ae8135

(15)

on October 16, 2014
at 06:42 PM

Shen retested a month later and the liver enzymes returned to normal. She found out that Her TC is elevated because her body hyper absorb plant sterols and she was eating a lot of nuts and avocados. 

 

What really helped was the supplementation of 1000mg of Tyrosine per day.

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