Help with my wife's VAP results

Answered on August 19, 2014
Created March 07, 2012 at 2:09 AM

This is my first time asking a question and i'm looking for some help with cholesterol numbers. My wife has been dealing with high cholesterol her whole life. Doctors keep saying that she is going to have to go on meds. We are both fairly new to paleo/primal eating. We have pretty much cut out all grain and sugar except for the couple cheat days like pizza with the kids. She has cut back sugar to one teaspoon in her morning coffee.. Her numbers in May 2011 prior to starting paleo were

Total 220 triglycerides 164 HDL 50 LDL 137

In February 2012 about 1.5 months after eating paleo her numbers were

Total 255 Trig 89 HDL 72 LDL 165.2

The increase in her total and LDL scared the crap out of her.. And as you would guess her Dr. wanted to start her on meds. We decided to ask for a VAP test which she got about a week after her last test. Here are her results.

Tot LDl-Chol Direct 156 Tot HDL-Chol 70 Tot VLDL-Chol 19 Sum Total Chol 246 Triglycerides 78 Tot. NonHDL Chol (LDL+VLDL) 176 Total apoB100 - calc. 108 LP (a) Cholest 7.0 IDL Cholest 12 Real LDL-Chol 137 Real-LDL Size Pattern A Remnant Lipoprot (IDL+VLDL3) 24 Constellation of Lipid Risk No HDL-2 22 HDL-3 48 VLDL-3 12 LDL-4 5.7 LDL-3 51.3 LDL-2 61.8 LDL-1 18.3

From what we have read we believe her numbers are heading in the right direction. Like I said we are fairly new and we go in to see her Dr. next Thursday. What are some things she could do to lower her LDL. Any help will be appreciated.

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on March 08, 2012
at 10:17 PM

How much butter/cream does she eat?

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6 Answers


on March 07, 2012
at 07:42 AM

Okay, 3 things.

1) Statins are of no statistically significant benefit to women. Period. http://www.fathead-movie.com/index.php/2010/06/03/a-few-reasons-to-avoid-statins/

2) Some people NATURALLY have "high" cholesterol. I mention this because you say she's had high numbers her "whole life." That a red flag that we're very possibly dealing with her natural BIOLOGY, not PATHOLOGY. How are the numbers for others in her family?

3) However, if her numbers are high and this is abnormal for her family and/or you sure it's a sign of some underlying issue, remember it isn't about just getting those numbers down (which may or may not actually mean anything anyway), but about making sure her level of inflammation in her body is low; thereby, allowing the cholesterol to come down.

So . . . no sugar, no refined junk foods (we all know what these things are), NO industrially processed seed/veg oils (read labels!!!!). Be vigilant. Get sunshine, Vitamin D, laugh, hug, take walks, eat high fat & nutrient dense.


on March 07, 2012
at 02:20 AM

This may be helpful to you: http://chriskresser.com/chris-masterjohn-on-cholesterol-and-heart-disease-part-3

I recommend the entire series.


on March 09, 2012
at 12:36 AM

Calculate her Framingham risk score (http://hp2010.nhlbihin.net/atpiii/calculator.asp). If it is very low use that as evidence that she is ok. A reasonable doc should be ok with that. I would like to see the hdl over 75 in females. It will probably get there with more time. If she is really worried about the ldl, weight loss (if overweight) and high intensity exercise sometimes helps. She is definitely heading in the right direction.

If less than 60 yo, non-smoker and systolic bp of less than 130, 10 year risk is 2% or less. Unless there is a nasty family history, she has minimal short term risk. Guidelines recommend starting statin therapy only if the Framingham Risk Index is over 10% for an acute event in 10 years.


on March 08, 2012
at 10:01 PM

I had similar results (High HDL, High LDL, low Triglycerides) but didn't know about the VAP test at that time....I initially panicked but tons of research later concluded that the subclass of LDL has greater bearing on cardiovascular disease, than just total LDL. Linked to my recent reddit post below: http://www.reddit.com/r/Paleo/comments/qbyna/blood_test_results_after_lubing_my_arteries_with/c3yxkku



on March 07, 2012
at 04:16 AM

I second the Chris Kresser recommendation, he breaks this cholesterol stuff down really well. In particular, he discusses how often cholesterol numbers may have something to do with the thyroid.

But I have to say, when you said your wife's cholesterol has always been high, I was expecting some higher numbers than that. My total cholesterol (at the time of that particular test) was 263, with really high HDL. In the absence of any real medical issues, I ain't worrying about it.



on March 07, 2012
at 02:24 AM

Hi Chris,

I'm no expert, but from what I can see her trigs are down significantly (good), her HDL is up (good) and her LDL went up, but her size pattern is A (good), and there might not be a worthwhile argument for trying to lower it. I'm sure you will get some more informative answers, but please see the below link for an exhaustive explanation about cholesterol:


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