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How am I doing? My blood work 2 months into Paleo eating (from Vegetarian).

Answered on September 12, 2014
Created September 28, 2012 at 10:16 PM

How does my blood work look? 38 yo female, 5'7" 122 lbs, 13% body fat, HIIT 5x / week. Gets at least 8 hours of sleep.

Should I worry about LDL being small and dense? Dr says 'no' - it's such a new test and no one completely knows how to interpret and it must be considered with other risk factors.

How does one change the quality of LDL particles anyway???

Thank You!

Last year's numbers are in ( )

TC: 240 (190) LDL: 168 (125) HDL: 57 (49)

Small, dense LDL Small LDL particle size 693 (ref range is less than 117)

C-Reactive Protein 0.3 (ref range <1.0 low risk)

Tri 76 (84) Glucose 82 (84)

Vit D 65 (32) B12 477 (ref range 211-911) Alk Phos 30 (ref range 35-104)

TSH 0.899

00cd3b6f51530a6832fcda1712edbec3

(2411)

on October 13, 2012
at 10:55 PM

Also, I don't dispute that any of the other factors you mention are equally important as LDL-P or any plasma concentration measure, but I made the assumption that the OP would have mentioned these risk factors had they been relevant.

00cd3b6f51530a6832fcda1712edbec3

(2411)

on October 13, 2012
at 10:53 PM

I don't think that enough methodologically-sound research has been performed to definitively state that HDL, or the HDL/TC ratio is the most valid clinical predictor of heart attacks, atherosclerosis or atherothrombotic events. Do any of the health consultants you pay attention to assert this, or has your own literature review led you to this conclusion? I'm aware that Chris Masterjohn is in this camp, but I give as much, if not more weight to Dr.s Tom Dayspring and Tara Dall, who've been in the field longer.

5e92edc5a180787a60a252a8232006e9

(345)

on October 13, 2012
at 03:28 AM

You got parts of things wrong. The most valid measurement is HDL, how much HDL accounts for TC. The TC/HDL ratio in fact mimics the LDL-P. And the particle size isn't totally invalid: up to trigs of about 125, particle size is fairly accurate. I mean, you don't need a particle size if your trigs are around 60. What overrides everything though are independent risk factors: LP(a), blood pressure, blood stickiness, uncontrolled diabetes, smoking. You can have great LDL-P but it can be overridden by things that don't show up on your NMR, VAP or any other alphabet soup exam.

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3 Answers

1
00cd3b6f51530a6832fcda1712edbec3

(2411)

on October 13, 2012
at 12:10 AM

Plasma cholesterol concentrations, measured by the standard lipid panel, are nearly irrelevant, according to Dr. Tom Dayspring. 70% of the total atherothrombotic events in the U.S. (those resulting from clogged blood vessels) still happen, regardless of patients??? cholesterol levels. For an example, an epidemiological study in 2009, commissioned by the American Heart Association, called ???Get With the Guidelines,??? set out to prove that lower LDL cholesterol levels would reduce heart disease. The study looked at 136,000 admissions to the hospital for atherosclerotic heart disease, and found that

  • 55% had an LDL cholesterol level of 100 mg/dL or less.
  • 18% had an LDL level under 70 mg/dL, like a 10-year-old???s.
  • 45% had perfect HDL levels.

For a single case study, consider newsman Tim Russert, who died of heart disease but with an LDL cholesterol level of 66, considered spectacular.

As a lipidologist and nationally known lecturer on this topic, Dayspring cites recent research indicating that LDL-P and Apo(B) counts are the most accurate predictors of atherosclerosis. There's only one test (the NMR LipoAnalysis) and one lab in the country that does the LDL-P test: LipoScience Lab. All the other labs "offering" this test (e.g., LabCorp), ship your blood there for the test. The VAP (Vertical Assessment Profile) is not a count of lipoprotein particles; it???s just a different way of measuring the amount of cholesterol. The fact that this cholesterol comes in different-sized LDL and HDL packages isn???t relevant to the risk of atherosclerosis or atherothrombotic events. This test is of interest for academics only. It has no role in day-to-day measurement or (clinical) guidance of people, according to the research that Dayspring relies on. As further proof, There are seven guidelines in the world regarding measurement of cholesterol, five in the U.S., that advocate either Apo-B or NMR testing. None of them mention the standard lipid profiles by themselves or the VAP at all.

The only useful information from the standard lipid panel is the triglyerides/HDL ratio. Your triglycerides/HDL ratio should be low: under 3.0, and ideally, 1.4:1 or lower. Your ratio is terrific and hints that your LDL-P test will show healthy results (particle count of 1030 particles/dl or less).

TSH is an unreliable measure of thyroid health. I don't know enough of the details to explain them well, but there's an entire website, Stop the Thyroid Madness, dedicated to helping people get relevant tests, information, and advice to restore their thyroid health. The recommended thryoid tests for women are these:

  • Free T4
  • Free T3
  • Reverse T3
  • TPO antibodies

00cd3b6f51530a6832fcda1712edbec3

(2411)

on October 13, 2012
at 10:55 PM

Also, I don't dispute that any of the other factors you mention are equally important as LDL-P or any plasma concentration measure, but I made the assumption that the OP would have mentioned these risk factors had they been relevant.

5e92edc5a180787a60a252a8232006e9

(345)

on October 13, 2012
at 03:28 AM

You got parts of things wrong. The most valid measurement is HDL, how much HDL accounts for TC. The TC/HDL ratio in fact mimics the LDL-P. And the particle size isn't totally invalid: up to trigs of about 125, particle size is fairly accurate. I mean, you don't need a particle size if your trigs are around 60. What overrides everything though are independent risk factors: LP(a), blood pressure, blood stickiness, uncontrolled diabetes, smoking. You can have great LDL-P but it can be overridden by things that don't show up on your NMR, VAP or any other alphabet soup exam.

00cd3b6f51530a6832fcda1712edbec3

(2411)

on October 13, 2012
at 10:53 PM

I don't think that enough methodologically-sound research has been performed to definitively state that HDL, or the HDL/TC ratio is the most valid clinical predictor of heart attacks, atherosclerosis or atherothrombotic events. Do any of the health consultants you pay attention to assert this, or has your own literature review led you to this conclusion? I'm aware that Chris Masterjohn is in this camp, but I give as much, if not more weight to Dr.s Tom Dayspring and Tara Dall, who've been in the field longer.

1
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on October 12, 2012
at 11:33 PM

Looks good to me, lowest all mortality range www.zoeharcombe.com/2012/06/why-hasnt-my-healthy-diet-cut-my-cholesterol/

0
14a848cf0160c3fbde630361b95deeba

on September 28, 2012
at 11:20 PM

Both cranberry and pomegranate seem to be helpful with the oxidization of LDL, not an expert on cholesterol or the size of the particles so I don't know how useful this is to you.

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