Cholesterol Gurus Needed! (Long post-sorry!)
eneild
Posts: 198 Member
Just had my biometric screening done this week in order to have money added to our new HSA. First, a bit of my background. Have been Keto (10g carbs or less/day) for 2 years now. I (50 y/o small framed 5'4" F) was 230+ pounds when I started. By last March I had lost 110 pounds and reached my first goal. I have been working over this past year to-very slowly!-loose 15 more pounds. As of this morning, I am 0.8 pounds away from my 105 pound goal weight. I don't have any known medical conditions. As far as exercise, I walk or slow run at least 12,000 steps or 5 miles/day. I last had blood work done 5 years ago which I never followed up on as I was so embarrassed with my weight.
2012 results. 2017 results
Total cholesterol. 228. 293
HDL. 41. 73
LDL. 161. 207
Triglycerides. 139. 66
Chol/HDL ratio. 5.6. 4.0
Trig/HDL ratio 3.4. 0.9
FBS. 86. 87
HbA1C. 5.3%
I am really pleased with my HDL, Trigs, and ratio improvements. But, due to my LDL, I "failed" this part of the screening and in order to earn back the HSA deposit I either need to have a discussion with a counselor about my diet or participate in a 9 weekly online "weight loss program" (haven't had time to investigate these 2 options fully yet).
Based on my readings, I would expect a LDL particle test to show more of the fluffier particles. I am looking into having this test done through healthcheckusa.com along with the hsCRP in order to hopefully bolster my argument if I go the counselor option. Any other advice/recommendations?
Thanks!
2012 results. 2017 results
Total cholesterol. 228. 293
HDL. 41. 73
LDL. 161. 207
Triglycerides. 139. 66
Chol/HDL ratio. 5.6. 4.0
Trig/HDL ratio 3.4. 0.9
FBS. 86. 87
HbA1C. 5.3%
I am really pleased with my HDL, Trigs, and ratio improvements. But, due to my LDL, I "failed" this part of the screening and in order to earn back the HSA deposit I either need to have a discussion with a counselor about my diet or participate in a 9 weekly online "weight loss program" (haven't had time to investigate these 2 options fully yet).
Based on my readings, I would expect a LDL particle test to show more of the fluffier particles. I am looking into having this test done through healthcheckusa.com along with the hsCRP in order to hopefully bolster my argument if I go the counselor option. Any other advice/recommendations?
Thanks!
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Replies
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It sounds like you fully understand the actual important cholesterol factors. The real job now is advocating for yourself. That's where the real work is.
I don't know what to say really. You seem knowledgeable on the subject... somehow you need to appease them while doing what you feel is right at the same time. It's a pickle!
Mmmmm pickles!2 -
Sunny_Bunny_ wrote: »It sounds like you fully understand the actual important cholesterol factors. The real job now is advocating for yourself. That's where the real work is.
I don't know what to say really. You seem knowledgeable on the subject... somehow you need to appease them while doing what you feel is right at the same time. It's a pickle!
Mmmmm pickles!
Thanks @Sunny_Bunny_ ! Love me some pickles as well!3 -
Oy!
You could see about Apo-A1 and ApoB tests, which approximate LDL subparticles (and are usually covered by insurance).
And perhaps a coronary artery calcium (CAC) scan, a CT imaging study you can often get at a hospital off the street for $100 (before your consult).
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Oy!
You could see about Apo-A1 and ApoB tests, which approximate LDL subparticles (and are usually covered by insurance).
And perhaps a coronary artery calcium (CAC) scan, a CT imaging study you can often get at a hospital off the street for $100 (before your consult).
Thank you @RalfLott I'll investigate these as well. I think this will be a weekend of getting into the weeds!
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Oy!
You could see about Apo-A1 and ApoB tests, which approximate LDL subparticles (and are usually covered by insurance).
And perhaps a coronary artery calcium (CAC) scan, a CT imaging study you can often get at a hospital off the street for $100 (before your consult).
Thank you @RalfLott I'll investigate these as well. I think this will be a weekend of getting into the weeds!
When life is messy, wear boots!
Good luck.1 -
I'm not a cholesterol guru just chiming in to wonder out loud. I'll be real curious as to what is in this "9 week weight loss program" for a slim 5'4" female of 110 pounds. I suppose it will be geared more towards what to eat versus how much? Encouraging whole grains and low fat options? Dear me.
Shaking my head. I too will be getting a lipid panel this year after a year on keto so I follow these threads with interest. Me: 5'6", F, 140-145, 63 yo, gets some intentional exercise regularly cuz otherwise I'm on my butt all day. <--posts only to say we're in a similar situation.
Congratulaions on your weightloss and thank you for posting for discussion.2 -
I'm not a cholesterol guru just chiming in to wonder out loud. I'll be real curious as to what is in this "9 week weight loss program" for a slim 5'4" female of 110 pounds. I suppose it will be geared more towards what to eat versus how much? Encouraging whole grains and low fat options? Dear me.
Shaking my head. I too will be getting a lipid panel this year after a year on keto so I follow these threads with interest. Me: 5'6", F, 140-145, 63 yo, gets some intentional exercise regularly cuz otherwise I'm on my butt all day. <--posts only to say we're in a similar situation.
Congratulaions on your weightloss and thank you for posting for discussion.
@kpk54 yes, I am curious about the 9 week program as well. I plan to dig into it this weekend and I'll report back with what I find.
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Following.
At 52, I have a similar cholesterol profile to yours--HDL is great, trigs are great, all the ratios are great--but everything except triglycerides has risen quite a bit since I hit menopause a few years ago. In my 30s and 40s, my TC stayed between 180 and 200; now it's more like 300.1 -
If you're worried about high TC, standing alone, here's some food for thought.
https://youtu.be/wHFbMUU0Oag 1 -
No cholesterol help but congrats on the awesome loss. It was good to see. I too am 5 42
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If you're worried about high TC, standing alone, here's some food for thought.https://youtu.be/wHFbMUU0Oag
Thanks for this @RalfLott! Lots of good information and many notes taken. I have to say, Mike has fabulous posture (and hair!)!!
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No cholesterol help but congrats on the awesome loss. It was good to see. I too am 5 4
I appreciate your kind words @tekwriter. It sure has been quite a journey!0 -
The calcium score @RalfLott mentioned is the biggest thing IMO. Everything else is just a marker for potential disease. The calcium score shows actual. If actual = 0, then why give a rip about a marker showing potential?
Other than that, an NMR which does measure partial size along with hsCRP which are much more accurate markers would be second best option.4 -
If you're worried about high TC, standing alone, here's some food for thought.https://youtu.be/wHFbMUU0Oag
Thanks for this @RalfLott! Lots of good information and many notes taken. I have to say, Mike has fabulous posture (and hair!)!!
Yes, he does. He has an especially good selection of topics and guests. For example, the segments on the perils of mouth breathing were jaw dropping.0 -
cstehansen wrote: »The calcium score @RalfLott mentioned is the biggest thing IMO. Everything else is just a marker for potential disease. The calcium score shows actual. If actual = 0, then why give a rip about a marker showing potential?
Other than that, an NMR which does measure partial size along with hsCRP which are much more accurate markers would be second best option.
FYI...
Micheal Eades suggests looking at the volume:density ratio, an increase in volume over time being a bad omen; an increase in (protective) density, a good one.
Calcium Density of Coronary Artery Plaque and Risk of Incident Cardiovascular Events
https://www.ncbi.nlm.nih.gov/pubmed/24247483
https://youtu.be/itUoG2IfJp8
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Just had my biometric screening done this week in order to have money added to our new HSA. First, a bit of my background. Have been Keto (10g carbs or less/day) for 2 years now. I (50 y/o small framed 5'4" F) was 230+ pounds when I started. By last March I had lost 110 pounds and reached my first goal. I have been working over this past year to-very slowly!-loose 15 more pounds. As of this morning, I am 0.8 pounds away from my 105 pound goal weight. I don't have any known medical conditions. As far as exercise, I walk or slow run at least 12,000 steps or 5 miles/day. I last had blood work done 5 years ago which I never followed up on as I was so embarrassed with my weight.
2012 results. 2017 results
Total cholesterol. 228. 293
HDL. 41. 73
LDL. 161. 207
Triglycerides. 139. 66
Chol/HDL ratio. 5.6. 4.0
Trig/HDL ratio 3.4. 0.9
FBS. 86. 87
HbA1C. 5.3%
I am really pleased with my HDL, Trigs, and ratio improvements. But, due to my LDL, I "failed" this part of the screening and in order to earn back the HSA deposit I either need to have a discussion with a counselor about my diet or participate in a 9 weekly online "weight loss program" (haven't had time to investigate these 2 options fully yet).
Based on my readings, I would expect a LDL particle test to show more of the fluffier particles. I am looking into having this test done through healthcheckusa.com along with the hsCRP in order to hopefully bolster my argument if I go the counselor option. Any other advice/recommendations?
Thanks!
Congrats on your weight loss and you do seem to be doing the right things. As the total number and LDLs are the only things that would concern anyone. There is a lot of info about how total numbers can go up after losing a lot of weight which you did. So logically, your number might be higher than desireable.
I think you are on the right path, all the best. Probably a consultation would be the simple solution. You can talk about anything the only thing that matters is what you actually do.1 -
One last thing - I think it was Dr Phinney who said keto athletes will have higher LDL than a keto couch potato (paraphrasing here). The logic being higher energy needs of the athletes and LDL being the pre-cursor to ketones- or something along those lines.
I am very active (3200-3500 kcals a day to maintain 185 lbs) and was thinking about doing an n=1 experiment where I scale back activity level for about 3 months before my next set of labs to see what difference it makes. My ratios are great, but LDLc is high by traditional standards. Fortunately I have found a doc who is LCHF friendly and ran the more extensive tests showing I really am in good shape.3 -
cstehansen wrote: »One last thing - I think it was Dr Phinney who said keto athletes will have higher LDL than a keto couch potato (paraphrasing here). The logic being higher energy needs of the athletes and LDL being the pre-cursor to ketones- or something along those lines.
I am very active (3200-3500 kcals a day to maintain 185 lbs) and was thinking about doing an n=1 experiment where I scale back activity level for about 3 months before my next set of labs to see what difference it makes. My ratios are great, but LDLc is high by traditional standards. Fortunately I have found a doc who is LCHF friendly and ran the more extensive tests showing I really am in good shape.
I had hoped you would chime in @cstehansen. This is why I had posted my daily "exercise." I, by no means, consider myself an athlete, but my daily walking/jogging routine probably has some impact on my numbers. Thanks for another avenue (aka deep rabbit hole) to follow up on.
Also, through my readings today there was something about low TG overestimating LDL-C and using an alternative formula (the "Iranian Equation") in determining LDL-C. So based on this formula (TC/1.19+TG/1.9-HDL-C/1.1-38), my LDL-C is 177 which is not ideal, but at least better.
Thanks to everyone for their feedback!
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I had forgotten about the Iranian equation.0
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Here's an article supporting the use of the ApoB/Apo-A1 ratio in place of the standard lipid panels:
https://www.ncbi.nlm.nih.gov/pubmed/18277343
"CONCLUSION:
The results indicate that a high ApoB/ApoA1 ratio is associated not only with early atherosclerosis but also with hypoechoic (BPB) and by inference unstable plaques."
@cstehansen @eneild
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Update: I phoned the "Healthcare advisor" today. A very nice RN. I had my whole spiel ready to go. Mentioned my weight loss, improvements in HDL/TG, thoughts about the particle makeup of my LDL's, and was ready to get into the research and finer points with her, but she didn't seem that interested. She agreed the 9 week online weight management course (my other option in order to receive the HSA deposit) was probably overkill given a BMI of around 18.9% and asked if I wanted to speak to a "wellness coach" about my diet or any stress I might have (I assume excluding the stress this whole biometric/HSA mess was causing me). I said I wasn't interested and she said fine and she would put it into the system that we talked and to have the full HSA incentive added to our account. So, a pretty easy win! And, as a bonus, my stress level has dropped!
Much thanks to all of you who had responded and your advice. My yearly physical is coming up and I am in a much stronger place knowledge-wise to discuss further testing, etc. This community is amazing!13 -
Keep us posted! 1 -
Update: I phoned the "Healthcare advisor" today. A very nice RN. I had my whole spiel ready to go. Mentioned my weight loss, improvements in HDL/TG, thoughts about the particle makeup of my LDL's, and was ready to get into the research and finer points with her, but she didn't seem that interested. She agreed the 9 week online weight management course (my other option in order to receive the HSA deposit) was probably overkill given a BMI of around 18.9% and asked if I wanted to speak to a "wellness coach" about my diet or any stress I might have (I assume excluding the stress this whole biometric/HSA mess was causing me). I said I wasn't interested and she said fine and she would put it into the system that we talked and to have the full HSA incentive added to our account. So, a pretty easy win! And, as a bonus, my stress level has dropped!
Much thanks to all of you who had responded and your advice. My yearly physical is coming up and I am in a much stronger place knowledge-wise to discuss further testing, etc. This community is amazing!
Great result with that phone call. After all the RN gets paid the same if you get your incentive or not. Glad you found someone who just did the right thing.3 -
That's great! Thanks for the update! This stuff is really helpful for everyone.2
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Your welcome. I thought it was interesting that after my first LCHF attempt my cholesterol was 343 and my triglycerides were 506. This sounds crazy but it was much higher before. The ratio was 1.484. This article says if you are less than 2 it's good. I'm hoping to be 30 pounds lighter than I was in the previous test when I get bloodwork done in a month.
Good luck!2 -
Your welcome. I thought it was interesting that after my first LCHF attempt my cholesterol was 343 and my triglycerides were 506. This sounds crazy but it was much higher before. The ratio was 1.484. This article says if you are less than 2 it's good. I'm hoping to be 30 pounds lighter than I was in the previous test when I get bloodwork done in a month.
Good luck!
The ratio is triglycerides to HDL, not total cholesterol. I am guessing your HDL was well under 100. Generally you won't see high HDL with triglycerides that high. LCHF will almost always raise HDL and lower triglycerides but HDL over 80 is very unusual.4 -
Chol/HDL Ratio (None) 6.6 Ratio No Flag
Cholesterol (140-200) 343 mg/dL H
Direct HDL (30-75) 52 mg/dL No Flag
LDL-Direct (0-130) 177 H
Triglycerides (35-160) 506 mg/dL H
I guess you're right. I'm not freaked out by it. I know when I lose another 50 pounds the doctor will be looking at the numbers thinking something is broken with his tester. ha ha This looks horrible but it's much better than it was and I'm still obese.
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@cstehansen I'm still a newbie when it comes to all of this-why would an HDL level over 80 be very unusual?2
This discussion has been closed.