Page 1 of 2 12 LastLast
Results 1 to 10 of 13

Thread: YALP (Yet Another Lipid Panel) with NMR but a bit weird one page

  1. #1
    Lumifer's Avatar
    Lumifer is offline Senior Member
    Join Date
    Mar 2013
    Location
    Earth
    Posts
    116

    YALP (Yet Another Lipid Panel) with NMR but a bit weird one

    Shop Now
    Recently I had a bunch of blood tests done including an NMR lipid panel. Everything is great except for one number. The problem is that some people say that's the only number that matters.

    The number is LDL-P, the number of LDL particles, which is 1905. That's officially considered to be "a lot" and puts me somewhere above the 95% percentile. I am aware that there are other people (like Jimmy Moore of the Livin' La Vida Low Carb fame) in the same situation with even worse numbers.

    Other things are good: TG 51, HDL-C 80, LDL pattern A, small LDL-P is only 149, HDL-P is 37.1.

    LDL-C is 160 which actually seems lowish for the particle number of 1900. My ApoB is 120 which also seems lowish for that LDL-P since each LDL particle has exactly one ApoB molecule. TC is 250.

    I am eating nonspecific paleo-style, low-carb (but not VLC, I'm not usually in ketosis). My thyroid panel is normal, TSH is 1.2, free T3 is 3.3. My inflammation markers are low, CRP is 0.47. I don't have glucose problems, HbA1C is 4.9% and the NMR panel gave me the insulin resistance score of 6. I'm not actively losing weight. I doubt I'm copper-deficient as my Ceruloplasmin is 18 which is well within normal range.

    So all in all I'm not terribly worried, but I still don't like that LDL particle number. Recent studies like MESA point to the LDL-P being a better predictor of CVD to the extent that once you account for it, other common predictors (like LDL cholesterol, LDL-C, or particle size) become insignificant.

    Any comments, ideas, advice?

  2. #2
    Lumifer's Avatar
    Lumifer is offline Senior Member
    Join Date
    Mar 2013
    Location
    Earth
    Posts
    116
    OK, I did a re-test recently. It's interesting partially because I had lipid panels done at two different places from the same blood sample (well, different vials but drawn at the same time). This way we have three different sets of numbers. The numbers tagged NMR-Jan are from the first test discussed in the OP. The numbers tagged NMR-Jun are from a recent re-test, same lab (Liposcience). And the numbers tagged BHL-Jun are from the same re-test, but coming from the Berkeley Heart Lab.

    Code:
    Tot-C: 250 (NMR-Jan), 205 (NMR-Jun), 227 (BHL-Jun).
    LDL-C: 160 (NMR-Jan), 124 (NMR-Jun), 144 (BHL-Jun).
    HDL-C:  80 (NMR-Jan),  69 (NMR-Jun),  68 (BHL-Jun).
    Trigs:  51 (NMR-Jan),  60 (NMR-Jun),  73 (BHL-Jun).
    
    LDL-P: 1905 (NMR-Jan), 1611 (NMR-Jun).
    HDL-P: 37.1 (NMR-Jan), 31.7 (NMR-Jun).
    Small LDL-P: 149 (NMR-Jan), 608 (NMR-Jun).
    
    ApoB: 120 (Jan),  107 (Jun), 94 (BHL-Jun).
    
    In both cases pronounced LDL pattern A (large & fluffy).
    What changed besides time? My diet changed a bit (not hugely), in the direction of less saturated fat and more MUFA and more carbs. A fair chunk of that additional carbs was fruits, so fructose.

    The direction of lipid changes is a bit of a trade-off. Certainly LDL went down a noticeable amount. But HDL went down as well and trigs went up. Not up into worrisome territory, but still up.

    The spike in small LDL-P is puzzling. It may be an error as the LDL size profile from Berkeley Heart Labs says that only 11% of my LDL particles are small and dense. Yes, I know that the definitions of what's "small" do not match -- I'll look into it further.

    Still haven't done ApoE testing, but at the moment it does seem that my LDL is sensitive to the amount of saturated fat in my diet. N=1, of course.

  3. #3
    janie's Avatar
    janie is offline Senior Member
    Join Date
    Nov 2010
    Location
    Maryland
    Posts
    649
    I just finished reading a article by Dr. Thomas Dayspring on Lecturerpad. It was in response to a query from a woman whose LDL-P and LDL-C rose significantly on a low carb primal diet, even though she lost 20 lbs. You may need to register first (it is free) and the article can be accessed here:

    Lipidaholics Anonymous Case 291: Can losing weight worsen lipids? - Lecturepad.org

    I have a high LDL-P and LDL-C even though the rest of my panel is perfect (i.e. high HDL, low trigs, low Cr-P, pattern A, etc.) which is why I was interested the science he presents and his recommendations.
    Starting Weight: 197.5
    Current Weight: 123
    Lost 75# eating low carb (20-40 g) and then MDA primal low carb. Tried many other options but only LC helped me lose weight and improve health. Now at a good weight, I find my body can tolerate a few more carbs but rarely go over 100 g.

  4. #4
    Lumifer's Avatar
    Lumifer is offline Senior Member
    Join Date
    Mar 2013
    Location
    Earth
    Posts
    116
    Quote Originally Posted by janie View Post
    I just finished reading a article by Dr. Thomas Dayspring on Lecturerpad.
    The lipidaholics series can be accessed completely free here: Index of /pdf/lipidaholics

    I've read a bunch of these cases. Dr. Dayspring is clearly a serious guy, though he strongly prefers LDL-P to all and any other measures. Oh, and I think he considers that all humans are born with a statin deficiency which needs to be compensated ASAP :-)

  5. #5
    janie's Avatar
    janie is offline Senior Member
    Join Date
    Nov 2010
    Location
    Maryland
    Posts
    649
    To the complete frustration of my internist, I have refused a statin both pre and current primal. I would, however, consider the dietary approach by curtailing some sat fat (I am usually quite lavish with it, esp. butter) and up the safe MUFAs and PUFAs. Also thinking of losing the dairy as the patient he spoke with did and add some chia and perhaps oatmeal. I'm an ongoing n-1.
    Starting Weight: 197.5
    Current Weight: 123
    Lost 75# eating low carb (20-40 g) and then MDA primal low carb. Tried many other options but only LC helped me lose weight and improve health. Now at a good weight, I find my body can tolerate a few more carbs but rarely go over 100 g.

  6. #6
    janie's Avatar
    janie is offline Senior Member
    Join Date
    Nov 2010
    Location
    Maryland
    Posts
    649
    I forgot to say "thanks for the link". My LDL-P was 1493 in 6/12, and 2013 in 4/13 with no appreciable change in diet or lifestyle. They are rather outrageous #s, which is why I'm considering the dietary approach the female patient took. More and more docs seem to be taking the position that LDL-P matters the most.
    Starting Weight: 197.5
    Current Weight: 123
    Lost 75# eating low carb (20-40 g) and then MDA primal low carb. Tried many other options but only LC helped me lose weight and improve health. Now at a good weight, I find my body can tolerate a few more carbs but rarely go over 100 g.

  7. #7
    TheyCallMeLazarus's Avatar
    TheyCallMeLazarus is offline Senior Member
    Join Date
    Jul 2011
    Location
    Northeast Kingdom, Vermont
    Posts
    994
    Ugh....I have to say this again....

    I am a physician and deal with blood panels all day. What I am about to say I have never had a strong rebuttal to, from anyone of any degree of expertise, from dude on the street to an endocrinologist.

    Here goes, again: There is ONLY ONE truly valuable question that a LP, blood glucose, trigly panel answers: Do you have metabolic syndrome markers, and how severe are they?

    That's it. That's all. The rest is fun to track, mostly genetics, and doesn't have a bearing on your health. I am of the opinion, and I have seen a lot of research that backs this up, that all of the studies done on LP's and heart disease were not measuring LP's alone; they were measuring metabolic syndrome.

    This accounts for why singular variables, like LP's and heart disease in high trigly vs normal show up, why the data on LP's is so contradictory. In your case, with an Hba1c that low and trigly numbers like that, you are looking awesome on the big indicators of metabolic syndrome. That is what kills you, not LP numbers.

    I think that in ten years, the entire medical community will agree on the above. The numbers that do are growing by the day.

  8. #8
    janie's Avatar
    janie is offline Senior Member
    Join Date
    Nov 2010
    Location
    Maryland
    Posts
    649
    Thank you for your comments, Lazarus. It has always boggled my mind how persons like Lumifer and myself can have such ideal measures on a large part of the profile and then another value that is hugely contradictory. It doesn't seem logical, especially since our lifestyles are good and we have no indication of metabolic syndrome.
    Starting Weight: 197.5
    Current Weight: 123
    Lost 75# eating low carb (20-40 g) and then MDA primal low carb. Tried many other options but only LC helped me lose weight and improve health. Now at a good weight, I find my body can tolerate a few more carbs but rarely go over 100 g.

  9. #9
    TheyCallMeLazarus's Avatar
    TheyCallMeLazarus is offline Senior Member
    Join Date
    Jul 2011
    Location
    Northeast Kingdom, Vermont
    Posts
    994
    I understand Janie....

    I think it is MORE unusual to see a patient without some outliers in their panels....for example, in my panel I have VERY high total cholesterol. My LDL is often around 250 (guideline would say too high), but my HDL around 95 (through the roof high).

    When I break it down further, the Pattern A vs B ratios are great, trigly are always low, HbA1c around 4%....and the little tidbit that my numbers have ALWAYS looked that way, and my father's are much the same. About 80% of your numbers is not dietary, but instead largely hereditary. That is important to remember.

    Most people have a few numbers that look wonky. The overall picture is ALL that matters. Individual numbers are meaningless, but patients aren't correctly informed about these facts. They are told "keep LDL low", with nothing else. That is idiotic beyond belief to me....

  10. #10
    janie's Avatar
    janie is offline Senior Member
    Join Date
    Nov 2010
    Location
    Maryland
    Posts
    649
    LOL. They wanted to put my Mom on a statin but I said absolutely not. I figured there was more risk to the medication than to the cholesterol. She'll be 99 in September and aside from arthritis and reduced hearing, is perfectly healthy.

    I appreciate your comments; it is actually a great relief to understand that an "off" value is nothing to panic over.
    Starting Weight: 197.5
    Current Weight: 123
    Lost 75# eating low carb (20-40 g) and then MDA primal low carb. Tried many other options but only LC helped me lose weight and improve health. Now at a good weight, I find my body can tolerate a few more carbs but rarely go over 100 g.

Page 1 of 2 12 LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •