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    Orthodoc's Avatar
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    LDL Particle Size

    Primal Fuel
    Hi All,
    Did a search an did not see any results for this. Have recently had a physical, and the total cholesterol number is fine, the ldl particle number is way to high, meaning I have lots of small dense ldl particles. Dr. says to try diet for 3-4 months to improve, and then statins if no success. I know I don't want to go on statins. Has anyone had success with diet reducing the small ldl particles?

    Thanks in advance!

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    Orthodoc, are you sure that you have the correct LDL breakdown? You mentioned the particle number, but is it type A (which, I believe, is the large, fluffy type) or type B (small and dense)? How is your HDL?

    I've read that particle size can be determined by your triglycerides - anything lower than 60 tends to lean toward the fluffy LDL particles, and higher than 150 tends to lean toward the small, dense LDL particles. An excellent way to lower your triglycerides is to stop eating refined/processed carbohydrates -- which is a cornerstone of the primal/paleo lifestyle.

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    Quote Originally Posted by JackieKessler View Post
    Orthodoc, are you sure that you have the correct LDL breakdown? You mentioned the particle number, but is it type A (which, I believe, is the large, fluffy type) or type B (small and dense)? How is your HDL?

    I've read that particle size can be determined by your triglycerides - anything lower than 60 tends to lean toward the fluffy LDL particles, and higher than 150 tends to lean toward the small, dense LDL particles. An excellent way to lower your triglycerides is to stop eating refined/processed carbohydrates -- which is a cornerstone of the primal/paleo lifestyle.
    Triglycerides are 63, HDL was 51. The test was the NMR test by Liposcience, and they are the type B small particles that are too high- 1786.

    Since I posted this, I found a book called "The Great Cholesterol Myth" which seems to be covering the subject in great detail.

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    Orthodoc-
    As I understand it the main function of the NMR Lipoprofile is to measure LDL-P, which is the number of LDL Particles, not their size. There are some leading edge cardiologists (Thomas Dayspring and Tara Dall, for example) who think LDL-P is a more accurate measure of future CAD events than all other tests. You can hear a great lecture by Tara Dall on this subject on LecturePad (free). When I had the NMR done it also included LDL-C, HDL-C, trigs, TC HDL-P, small LDL-P, LDL size and a LP-IR score. This is distinct from a VAP which will provide you with the large fluffy vs small sticky A/B LDL types. According to Dall and Dayspring that is irrelevant and only the # of LDL particles is significant. Dall has had great success using Metformin to reduce particle count in her patients. In fact, I'm testing it out myself.

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    It would be helpful to know a few things: What does your diet look like now, and how long have you been doing that? Are you currently in the process of loosing (fat) weight? Also, do you have any past tests to compare these numbers to?

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    Quote Originally Posted by janie View Post
    Orthodoc-
    Dall has had great success using Metformin to reduce particle count in her patients. In fact, I'm testing it out myself.
    Particle count does correlate with heart health. This in no way means that a drug that reduces particle count will benefit a person. Having a low count for genetic and/or dietary reasons and having a low count that was induced by exogenous biochemical agents are completely different things. I think you are playing with (very slow burning) fire here.

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    As I said, according to the cardiologists I mentioned, a high LDL-P is most predictive of CAD. Thus they recommend lowering LDL-P, and Metformin is a medication that they have had great success with and they find it is much more effective (and way less dangerous)than statins. In fact, Metformin has no significant negative history, is taken daily by many diabetics, and is now also being considered as a possible cancer treatment. My doctor -- and leading cardiologists -- find it much less dangerous than a high LDL-P. What information do you have that they don't that would have you think I'm playing with fire?

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    Quote Originally Posted by janie View Post
    As I said, according to the cardiologists I mentioned, a high LDL-P is most predictive of CAD. Thus they recommend lowering LDL-P, and Metformin is a medication that they have had great success with and they find it is much more effective (and way less dangerous)than statins. In fact, Metformin has no significant negative history, is taken daily by many diabetics, and is now also being considered as a possible cancer treatment. My doctor -- and leading cardiologists -- find it much less dangerous than a high LDL-P. What information do you have that they don't that would have you think I'm playing with fire?
    I believe Chris Masterjohn understands cholesterol and atherosclerosis better than anyone on the planet. Here is an excellent video. Mercola is a lightweight and has trouble formulating his questions but it doesn't detract from Masterjohn's expertise. LDL-P may be a decent marker; but, as The Scientist already said and Masterjohn explains, reducing LDL-P does not necessarily reduce risk. Also, it isn't at all clear that LDL particle size and count are additive to the standard risk cholesterol ratios which have been used for many years. I have listened to and read rather extensively Dall, Dayspring, Masterjohn, Attia and others. None inspire confidence in me as well as Masterjohn.


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    Last edited by Artbuc; 01-01-2013 at 03:37 PM.

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    Thanks for the Masterjohn link.

    My doc has made the Metformin recommendation to me based on Dayspring and Dall's success in treating patients who are high CAD risk. In my case there is a strong family history. I've been eating primal for some time, lost 70 pounds, maintained a normal weight for 3 years, have trigs of 35, HDL-C of 73....and yet my LDP-C and LDL-P have continued to rise and rise. An ox-LDL was very high, even though my diet is very low in PUFA/omega6. We are trying the Metformin for 3 months and then repeating the NMR as neither my doc or I are want statins. I'll check out the Masterjohn link to see why I'm "playing with fire" but it is hard for me to believe that there isn't some risk to such high LDL#s..

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    janie's Avatar
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    PrimalCon New York
    All due respect but I didn't read anything to convince me that high LDL-P and LDL-C are benign. While I'm familiar w/Masterjohn through WPF, I also feel that while theory is great, as a PhD he does not successfully treat patients w/CAD or off the chart values as Dall & Dayspring do. And I could find nothing that questions the wisdom of the Metformin experiment.

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