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Cholesterol - A Primer (Attempt 2)

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  • Hi everybody,

    Here are my numbers, as of today (male, 41 years old)

    Total: 222
    Trigs: 152
    HDL: 42
    LDL: 150 (lab calculated)

    Ratios:
    Total/HDL: 5.28
    Trig/HDL: 3.62
    LDL/HDL: 3.57

    The trigs are a high due to me sometimes falling from the bandwagon. But the LDL/HDL is good. Does this alters the interpretation of trig/HDL, in the sense that, given good results in LDL/HDL, Trig/HDL while being off, is not that bad?

    Or, to put it more specifically, what is the interrelation between the ratios, if any? Is there any synergy to be aware of?

    Many thanks!

    PS: Also, by Iranian, LDL is 190! If trigs are relatively high, supposedly iranian is no better than the other equation (don't remember the name, begins with f). Or the iranian eq. is always more accurate than the lab one?

    Nomade
    Last edited by Nomade; 07-14-2011, 10:18 AM. Reason: adding PS

    Comment


    • Is this why my doctors have never been worried about my total cholesterol level? It's always been a little high, but even though my bad cholesterol level is high, my good cholesterol level has always been very high. I have routinely been told it all balances out because of the latter. I just started the primal program and I've been a bit worried that my levels would go haywire. I shouldn't worry, right?

      Comment


      • @Nomade - what really matters is the pattern of LDL. Higher trigs indicate some pattern B LDL, which is to be avoided. BTW, you can't use the Iranian eq when trigs are above 100. Friedewald provides a better approximation when your trigs are between 100-400. Forget any approximation when trigs are over 400

        @Dee68 - yes, high HDL balances LDL so there is no worry
        Four years Primal with influences from Jaminet & Shanahan and a focus on being anti-inflammatory. Using Primal to treat CVD and prevent stents from blocking free of drugs.

        Eat creatures nose-to-tail (animal, fowl, fish, crustacea, molluscs), a large variety of vegetables (raw, cooked and fermented, including safe starches), dairy (cheese & yoghurt), occasional fruit, cocoa, turmeric & red wine

        Comment


        • Nomade, both the Friedewald and the Iranian formulas are rough estimates. However, when triglycerides are below 100, the Iranian is a better rough estimate of LDL than the Friedewald. Of course, neither tells you the particle size of the LDLs, which is more important than the LDL number. For that, you need a VAP test, where they measure LDL particles directly.

          Your HDLs are low, along with the triglycerides being kind of high. Your TG/HDL ratio is okay, but not great. If you stick with the plan better, and get exercise, these numbers should improve.

          Comment


          • peril, Labhraín, thanks for your comments. Definitely going to stick to the PB more strictly. Curiously, according to the ranges included in the tests for reference, all my numbers are practically in the middle of the "healthy" range. According to them, I'm the Embodied Average. Ha! It only shows how low expectations are. I'll go stricter and do another exam in 30 days. Let's see then.

            Nomade

            Comment


            • Heart attack on the way (according to my GP)

              Hi

              I am 30 yrs old and have been Primal for approx 10 months (lots of eggs, Beef, fish, chicken, coconut milk/oil/flour, nut butters, vegies, almond meal etc). I recently had a cholesterol test and have been informed by my doctor that I am a very high candidate for a Heart attack.... I am very physically active and have been for entire life (weight training 1 hr every day as well as some functional core training and walking to keep lean). This is the first time I have had a cholesterol test and it was quite disturbing to hear the doctor say I needed to start medication to control my high LDL cholesterol.

              The results of my test are as follows:
              Cholesterol = 9.56 mmol/l or 369.60 mg/dl
              Triglyceride = 0.88 mmol/l or 34.029 mg/dl
              HDL = 2.64 mmol/l or 102.088 mg/dl
              Chol/HDL ratio 3.6 mmol/l
              LDL = 6.5 mmol/l or 251.35 mg/dl (prob according to friedewald) or 5.74 according to Iranian

              I have done a fair bit of research on this site and others which state the ratios are what to look out for and I think my ratios are good. According to "Medical detective":
              My ratio of HDL to Total cholesterol is 0.276 which is optimal.
              My ratio of Triglyceride's to HDL is 0.33 which again is optimal
              My ratio of LDL to HDL is 2.46 which I think is optimal as well.

              How is it then that my doctor thinks I need to go on Medication to correct my LDL and total cholesterol?
              Confused?????

              I was wondering if you could have a quick look at my stats and let me know if I am actually at risk of this impending heart condition or if my doc has no idea???

              Thanks
              Josh

              Comment


              • Cardiac evaluation advice

                Here are my stats:
                I am 5'0", female, 38years old. My cholesterol has always been stupidly
                high and I have consistenly refused medication.

                2009 - 123 lbs, not primal
                Total 293
                HDL 44
                Triglicerides 65
                LDL 236 (Freidewald)
                LDL 202 (Iranian)

                Total/HDL 6.66
                Trig/HDL 1.47
                LDL/HDL 5.4 (Freidewald)
                LDL/HDL 4.6 (Iranian)


                2011 - 115 lbs, realistically 85/15 primal since Nov 2010
                Total 320
                HDL 59
                Triglicerides 66
                LDL 248 (Freidewald)
                LDL 212 (Iranian)

                Total/HDL 5.4 (ideal is <4.4, therefore not great)
                Trig/HDL 1.12 (ideal is <2, therefore good)
                LDL/HDL 4.2 (Freidewald) (ideal is <4.3, so ok)
                LDL/HDL 3.6 (Iranian) (ideal is <4.3, so better measured this way)

                However, according to my lab results they state that all my ratios are too
                high because they only look at Total/HDL and LDL/HDL (which they claim must
                be less than 3.2, not 4.3)

                So they want me to have a cardiac evaluation, ok fine I suppose I can humor them
                My question is what questions should I arm myself with for the cardiologist?
                And what tests should I specifically ask for?

                Thanks!
                Sasha

                Comment


                • Originally posted by josh_mc View Post
                  Hi

                  I am 30 yrs old and have been Primal for approx 10 months (lots of eggs, Beef, fish, chicken, coconut milk/oil/flour, nut butters, vegies, almond meal etc). I recently had a cholesterol test and have been informed by my doctor that I am a very high candidate for a Heart attack.... I am very physically active and have been for entire life (weight training 1 hr every day as well as some functional core training and walking to keep lean). This is the first time I have had a cholesterol test and it was quite disturbing to hear the doctor say I needed to start medication to control my high LDL cholesterol.

                  The results of my test are as follows:
                  Cholesterol = 9.56 mmol/l or 369.60 mg/dl
                  Triglyceride = 0.88 mmol/l or 34.029 mg/dl
                  HDL = 2.64 mmol/l or 102.088 mg/dl
                  Chol/HDL ratio 3.6 mmol/l
                  LDL = 6.5 mmol/l or 251.35 mg/dl (prob according to friedewald) or 5.74 according to Iranian

                  I have done a fair bit of research on this site and others which state the ratios are what to look out for and I think my ratios are good. According to "Medical detective":
                  My ratio of HDL to Total cholesterol is 0.276 which is optimal.
                  My ratio of Triglyceride's to HDL is 0.33 which again is optimal
                  My ratio of LDL to HDL is 2.46 which I think is optimal as well.

                  How is it then that my doctor thinks I need to go on Medication to correct my LDL and total cholesterol?
                  Confused?????

                  I was wondering if you could have a quick look at my stats and let me know if I am actually at risk of this impending heart condition or if my doc has no idea???

                  Thanks
                  Josh
                  I would ignore your doctor or request a direct measure (VAP cholesterol test) of LDL to determine pattern size (which undoubtedly would show you are pattern A and fine). You also request a screening of your arteries which would show no plaques/hardening and tell your doctor to shove off, he has no idea what he is talking about. Or better yet give him some education on what you have researched so he can stop prescribing medication and giving bad advice to healthy people.

                  Comment


                  • Originally posted by sforsyth View Post
                    Here are my stats:
                    I am 5'0", female, 38years old. My cholesterol has always been stupidly
                    high and I have consistenly refused medication.

                    2009 - 123 lbs, not primal
                    Total 293
                    HDL 44
                    Triglicerides 65
                    LDL 236 (Freidewald)
                    LDL 202 (Iranian)

                    Total/HDL 6.66
                    Trig/HDL 1.47
                    LDL/HDL 5.4 (Freidewald)
                    LDL/HDL 4.6 (Iranian)


                    2011 - 115 lbs, realistically 85/15 primal since Nov 2010
                    Total 320
                    HDL 59
                    Triglicerides 66
                    LDL 248 (Freidewald)
                    LDL 212 (Iranian)

                    Total/HDL 5.4 (ideal is <4.4, therefore not great)
                    Trig/HDL 1.12 (ideal is <2, therefore good)
                    LDL/HDL 4.2 (Freidewald) (ideal is <4.3, so ok)
                    LDL/HDL 3.6 (Iranian) (ideal is <4.3, so better measured this way)

                    However, according to my lab results they state that all my ratios are too
                    high because they only look at Total/HDL and LDL/HDL (which they claim must
                    be less than 3.2, not 4.3)

                    So they want me to have a cardiac evaluation, ok fine I suppose I can humor them
                    My question is what questions should I arm myself with for the cardiologist?
                    And what tests should I specifically ask for?

                    Thanks!
                    Sasha
                    The test you can request is a VAP cholesterol test which will give a direct measure of LDL and tell you what the pattern size is.

                    Comment


                    • I've been primal for about 2 months. At 31 years old, I feel and look as good as I ever have. However, my recent VAP results are really stressing me out.

                      Pre-primal (low-fat, high-grain), non-VAP results, April 2011 -
                      Total: 266
                      LDL: 210
                      HDL: 45
                      Tri: 55

                      This is typical of many tests I've had in the last 4 years.

                      Primal VAP results, July 2011 -
                      Total: 422
                      LDL: 340
                      HDL: 64
                      Tri: 61
                      apoB100-calc: 209
                      Pattern A

                      On my VAP results, all of my numbers look great, except for LDL and apoB. I'm wondering if my high sat fat diet is not right for me. I do plan on getting another VAP in a few months again to see the trend. I'm afraid that I'm going to worry myself into heart problems just stressing out about these numbers.

                      Comment


                      • I had bloodwork done for a new job back in February. It was just a health screening for my employer, so my doctor hasn't seen the numbers and I don't know how she will interpret them. I've been on/off with my low-carb/primal eating, so the numbers definitely aren't as good as they could be. I'm going for a physical later this month and I'm excited to see how I'm doing. I'm definitely going to ask for a VAP test and a complete panel with my vitamin data and all that good stuff.

                        Here are my results from February. LDL was calculated using the Friedewald equation, so I've calculated it with the Iranian just for comparisons. Although the total is slightly high (for CW standards), the numbers look great:

                        Total: 223
                        HDL: 89 (ideal >46)
                        Trig: 36 (ideal <150)
                        LDL: 127 (Friedewald) or 87 (Iranian) (ideal <130)
                        Total/HDL: 2.5 (ideal <4.4)
                        Trig/HDL: 0.4 (ideal <2.0)
                        LDL/HDL: 1.4(Friedewald) or 1.0 (Iranian) (ideal <4.3)

                        I'm loving these numbers!!! Thanks so much Griff for putting this together

                        Comment


                        • So glad to have read this, another big thanks for the post and all the time you put into it.

                          I went primal Jan 2010 and over the course of that year my cholesterol actually dropped by 40 points. My test last week shows it back up 60 points. I'm not bothered by the numbers, but am curious as to the radical changes.

                          My LDL was calculated with the Friedewald calc and the lab refused to do the VAP. So frustrating. Either way, my ratios are awesome! I didn't bother arguing with the nurse about the low fat, high fiber diet she recommended. I will be getting the VAP though regardless and never considered statins. I am thankful to have this info to give my family so they can stop worrying. My mom has high cholesterol and has had a heart attack so anytime anyone has high cholesterol they freak a bit.

                          Comment


                          • my total 420 HDL is 92, LDL is 316, triglycerides are 62, am I ok?

                            Comment


                            • Calculator / Excel

                              I made a spreadsheet that will calculate LDL and the ratios for you, if anyone is interested.



                              Download here (can't attach Excel file in forum apparently): http://befitby40.com/wp-content/uplo...and-Ratios.xls

                              Note: It was made in Google docs, so opening in Excel, openoffice, etc may not look right. See screenshot above to adjust

                              Comment


                              • Hi Griff.......thanks for the wonderful info...I do have a question, I was reading somewhere that the total cholesterol is not that important but the hdl and ldl ratios are the important thing.I'm starting to eat 3 tablespoons of coconut oil/day. My question is this.......will it raise my total cholesterol? It is supposed to raise hdl and lower the ldl......Your thoughts please
                                Michael

                                Comment

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