Cholesterol numbers - Should I be concerned?
First time I've ever had it checked - pretty primal for the past 6+ months (on and off for 2+ years), 5'9 160lbs, very active (running, p90x, etc.), 35 years old.
Total - 343
Tri - 77
HDL - 54
Chol/HDL Ratio - 6.35
LDL - 274
I've heard total means mostly nothing, but that LDL and ratio is a little disconcerting. Thoughts?
Some people in the primal community might say not to be concerned, but your LDL is very high relative to your HDL, and that should be something of concern. This seems to be a common question around here, but have you had a full thyroid panel? T3 is necessary to activate the LDL receptor, and if someone is hypothyroid then you can see high cholesterol just from this alone. Other reasons can be leptin resistance (which I doubt you have because you are primal and have pretty low triglycerides), a genetic condition called familial hypercholesteremia, or inflammation and active infections. I think inflammation is the biggest reasons for high LDL for a lot of people, as LDL transports cholesterol to cells in the body for repair and growth. You may even be too active and constantly inflaming yourself (see mark's whole 'chronic cardio' articles). I would recommend getting a hemoglobin A1C test, a C-Reactive Protein test (measure inflammation in the body - very important), and a full thyroid panel. Make sure you do not have any infections either. Also, make sure you oils are high quality primal sources and that you are not consuming too much fructose/alcohol/anything else inflammatory.
Yeah something is out of whack there for sure. What exactly is your training program? How much running? How many days of P90X a week? what else are you doing? As the above poster said, you may be in a constant state of inflammation. Being "active" is good to a certain point. It can very easily be taken to extremes though. There is a real misconception out there that the more fit one becomes, the healthier they become as well. This is not entirely true. Yes if one is unfit and they become more fit, their health will most definitely improve as a result of their better fitness. This however is only true up until a certain point. At that point fitness can still be improved but health benefits level off. Carried on to the extreme, health can deteriorate. So one could be very active and be able run miles and appear very fit and at the same time have dwindling health. A good example of this would be professional athletes. The extreme training and frequent extreme exertion while making them very fit for their particular sport, takes its toll on their bodies and health suffers. These athletes often live with crippling pain, various illnesses such as heart disease at a much younger age than the average person and often die much younger as well.
It's generally agreed that there's good LDL & bad LDL. You need a different test to find out how much of each you've got, but in the absence of that, there is a strong association with triglycerides; low trigs = good LDL & vice versa. The good news is your trigs are very low.
Trigs / HDL is thought to be a very good indicator of risk of heart disease; the lower the better, with less than 2 being excellent. If that's true, you've got no worries with a score of 1.4 (unlike me with a score of 7.3...).
That being said, the LDL is high, regardless of whether it's the bad stuff or not. As others have said, that's likely due to inflammation/damage that needs repairing.
All - thanks for your input, very informative.
Re: exercise - I train quite a bit. Rarely a day goes by where I'm not pushing myself pretty hard - whether it be P90x, heavy weights, distance running, sprints, etc. I'm training for several distance runs and obstacle courses (Tough Mudder, Half Marathons, etc.). One thing I noticed: my first time going 12+ miles in my life (followed up a couple days later with a competitive 7k), was only a week or so before my blood work, so the inflammation angle definitely makes me think. I'll look into a hemoglobin A1C test for sure.
Also on the Doctor's note, he mentioned familial hypercholesteremia, but I'm not sure if they know that or are just looking at the numbers and making a call.
Regardless, I'll certainly increase up my rest days and decrease my intense training sessions to a few times a week. Can I ask what other steps to take to reduce inflammation? Certain supplements/foods?