LDL high but HDL ok, Triglycerides low, VLDL low, should I be concerned?

[Bubbs]

My LDL is 180ish , HDL 55, VLDL 10 and tris under 70 consistently

I'm on a modified keto diet with carbs pre workouts so I'd expect it to affect the cholesterol a bit, should I be concerned about the LDL if the other numbers are relatively good? My older PCP wants me on a statin and insisted LDL is bad end of story

 

[mcs]

My LDL is 180ish , HDL 55, VLDL 10 and tris under 70 consistently

I'm on a modified keto diet with carbs pre workouts so I'd expect it to affect the cholesterol a bit, should I be concerned about the LDL if the other numbers are relatively good? My older PCP wants me on a statin and insisted LDL is bad end of story

Your PCP is completely ignorant when it comes to current lipidology, sticking to obsolete cookie-cutter medicine. Get a doc that can order an advanced lipid panel and THEN and only then assess your results. Standard lipid panels are worthless other than for trigs. There are subfractions of LDL that need to be taken into account and it is not true that just because LDL is elevated, it's pathogenic. It all depends on the particle size, type and pattern which only an advanced panel will determine.

 

[goolapsh]

My LDL is 180ish , HDL 55, VLDL 10 and tris under 70 consistently

I'm on a modified keto diet with carbs pre workouts so I'd expect it to affect the cholesterol a bit, should I be concerned about the LDL if the other numbers are relatively good? My older PCP wants me on a statin and insisted LDL is bad end of story

You can incorporate more plant based protein and less meat consumption.

 

[Bubbs]

Your PCP is completely ignorant when it comes to current lipidology, sticking to obsolete cookie-cutter medicine. Get a doc that can order an advanced lipid panel and THEN and only then assess your results. Standard lipid panels are worthless other than for trigs. There are subfractions of LDL that need to be taken into account and it is not true that just because LDL is elevated, it's pathogenic. It all depends on the particle size, type and pattern which only an advanced panel will determine.

He won't order anything but the basics

Cardio IQ Advanced Lipid Profile Blood Test | Walk-In Lab

Order a Cardio IQ Advanced Lipid Profile Blood Test for a specialized blood test designed to assess cardiovascular disease risk and monitor treatment.

www.walkinlab.com

Is this ok?

 

[MarcoFL]

How old are you? Family history? I just went on a statin at 59, but also have family history.

 

[Bubbs]

45, Zero history, my grandparents all lived to their 90s

It's weird because pre keto my LDL was 130 so jumping to 180 must be related to diet (and from what I understand not necessarily bad)

I'm ordering the cardio IQ + crp HS asap since my Dr refuses to "waste money" on them

I guess I need to do that 23andme I ordered to test my polymorphisms

 

[Vince]

45, Zero history, my grandparents all lived to their 90s

It's weird because pre keto my LDL was 130 so jumping to 180 must be related to diet (and from what I understand not necessarily bad)

I'm ordering the cardio IQ + crp HS asap since my Dr refuses to "waste money" on them

I guess I need to do that 23andme I ordered to test my polymorphisms

Have you ever considered getting a complete cholesterol panel? To find out what kind of LDL cholesterol you have?

 

[Guided_by_Voices]

45, Zero history, my grandparents all lived to their 90s

It's weird because pre keto my LDL was 130 so jumping to 180 must be related to diet (and from what I understand not necessarily bad)

I'm ordering the cardio IQ + crp HS asap since my Dr refuses to "waste money" on them

I guess I need to do that 23andme I ordered to test my polymorphisms

The same thing happened to me after I went lower-carb. The doctors who specialize in Low carb such as Dr. Davis generally say that HDL, Trigs, and LDL-type all improve on low- carb but total LDL is unpredictable and can go any direction. Before you over-focus on LDL and under-focus on the things that really make a big difference, I would read Dr. Kendrick's (book length) series on What Causes Heart Disease, and also check out the list linked here...

20 Heart-Healthy Actions With Better Risk/Reward Than Statins - Excel Male Health Forum

Here at Excelmale there are frequent posts discussing the pros and cons of statins, and one in particular several weeks ago where a position paper was cited where the assumption was that statins are not only a viable option but should be the first line of defense against heart disease. As I have...

www.excelmale.com

 

[Bubbs]

Have you ever considered getting a complete cholesterol panel? To find out what kind of LDL cholesterol you have?

I'm getting

Cardio IQ® Cholesterol, Total; Cardio IQ® HDL Cholesterol; Cardio IQ® Triglycerides; Cardio IQ® Non-HDL and Calculated Components; Cardio IQ® Lipoprotein Fractionation, Ion Mobility; Cardio IQ® Apolipoprotein B; Cardio IQ® Lipoprotein (a); Cardio IQ® hs-CRP; Cardio IQ® Lp-PLA2 Activity

tested on Friday, my cardiologist agreed to sign off on them when my PCP wouldn't

 

[MarcoFL]

I'm getting

Cardio IQ® Cholesterol, Total; Cardio IQ® HDL Cholesterol; Cardio IQ® Triglycerides; Cardio IQ® Non-HDL and Calculated Components; Cardio IQ® Lipoprotein Fractionation, Ion Mobility; Cardio IQ® Apolipoprotein B; Cardio IQ® Lipoprotein (a); Cardio IQ® hs-CRP; Cardio IQ® Lp-PLA2 Activity

tested on Friday, my cardiologist agreed to sign off on them when my PCP wouldn't

Ask him for the Boston Heart labs to be run. I had them two months ago and was only $150 and give you a lot of information!

 

[Bubbs]

I'm curious about the minimum effective dose for statins, from my reading it looks like just 10mg of Crestor a week would get me down a lot but my Dr wants me on 10mg a day as a "starting point"

The low dose studies show that LDL was reduced @30% on VLD crestor vs @50% on much higher doses that came with side effects

I wonder if it's worth a low dose experiment at maybe 2.5mg a day to see if it actually does anything, or 5mg EOD or E3D as EOD dosing with 50% of the prescribed dose was shown to be almost as effective in studies as the full ED dose

Efficacy and Tolerability of non-daily Statin Administration: A Systematic Review of Literature

Purpose. Current issues regarding biosimilar drug use are reviewed in a two-part article from the perspective of pharmacy practice.Background. Statins are known to be safe, but some patients discontinue the therapy due to adverse effects. Given the clinical benefits of statin therapy, it is...

meridian.allenpress.com

Efficacy of rosuvastatin (5 mg and 10 mg) twice a week in patients intolerant to daily statins - PubMed

The aim of this study was to evaluate the efficacy of rosuvastatin twice weekly in 40 patients intolerant to daily statins. Rosuvastatin twice weekly alone or added to other lipid-lowering medications decreased total cholesterol by 19%, low-density lipoprotein cholesterol by 26%, and...

pubmed.ncbi.nlm.nih.gov

Once-a-week rosuvastatin (2.5 to 20 mg) in patients with a previous statin intolerance - PubMed

The purpose of this study was to determine the efficacy of rosuvastatin dosed once a week in patients with a previous statin adverse event. Rosuvastatin once a week was tolerated by 37 (74%) of the 50 study participants, with doses ranging from 2.5 mg to 20 mg a week (mean 10 +/- 4 mg). Patients...

pubmed.ncbi.nlm.nih.gov

 

[xcpatr922]

Your PCP is completely ignorant when it comes to current lipidology, sticking to obsolete cookie-cutter medicine. Get a doc that can order an advanced lipid panel and THEN and only then assess your results. Standard lipid panels are worthless other than for trigs. There are subfractions of LDL that need to be taken into account and it is not true that just because LDL is elevated, it's pathogenic. It all depends on the particle size, type and pattern which only an advanced panel will determine.

The standard is not worthless.

All these more detailed/advanced blood test result is usually parallel with the standard test, thing like ApoB is fraction of LDL.

What's more important I believe is the ratio between HDL-C and LDL-C. Statin target is to bring down those LDL-C to be below 100 or lower than HDL if at all possible. Even lets say you have lpa issue, the treatment anyway is still the same.

Doc will give you statin, but func. medicine may give you even more meds, from Niacin to folic acid to reduce homocyesteine.

However folks have wrong idea just because you had statin you have reduced event which is not the same, statin is only for very long term prevention. It's blood thinner agent that reduce the actual event (from omega3 to Heparin)

 

[Bubbs]

No way my LDL is going lower than my HDL, my mid 50s HDL is as good as I'm going to get on TRT (TRT dropped it 10 points)

Going below 100 would be ideal but Id settle for around 100 if the infrequent low dose Crestor (5mg e3d) delivers what the studies show

I'll increase my niacin too, 3g ED seems the ideal for aggressively lowing ldl

Pre keto I was around 120 LDL so I'm sure that's a big factor in it jumping 60 points in 4 months. It's ironic as I assumed keto would lower ldl

I'm also taking 4g ED of fish oil for the EPAs which may influence it?

 

[xcpatr922]

My result as it's pretty consistent
Rosuva 10mg makes me LDL-C 75-80
Rosuva+Ezetimibe LDL-C drops to 35-40
After losing weight and regular training HDL is 51-53.
So making HDL>LDL is possible in my case.

I dont have side effect of statin, the TRT or beta blocker side effect is much more where I need to manage more; I also on low carb, looking at your TG your # is fine after keto. Your LDL-C is standard.

 

[Bubbs]

Thank you for sharing your experience! My Crp HS was 0.3 last time I had it taken I think so I'm not overly worried about inflammatory LDL plaque but I am trying to get my cardiologist to follow the Dr Ford Brewer advice on the tests for soft plaque since he thinks a treadmill stress test is sufficient and apparently it's not, not at all:/

 

[mcs]

He won't order anything but the basics

Cardio IQ Advanced Lipid Profile Blood Test | Walk-In Lab

Order a Cardio IQ Advanced Lipid Profile Blood Test for a specialized blood test designed to assess cardiovascular disease risk and monitor treatment.

www.walkinlab.com

Is this ok?

That appears to be the correct one.

 

[mcs]

I'm getting

Cardio IQ® Cholesterol, Total; Cardio IQ® HDL Cholesterol; Cardio IQ® Triglycerides; Cardio IQ® Non-HDL and Calculated Components; Cardio IQ® Lipoprotein Fractionation, Ion Mobility; Cardio IQ® Apolipoprotein B; Cardio IQ® Lipoprotein (a); Cardio IQ® hs-CRP; Cardio IQ® Lp-PLA2 Activity

tested on Friday, my cardiologist agreed to sign off on them when my PCP wouldn't

Not surprised. PCPs are not trained in lipidology.

 

[xcpatr922]

Thank you for sharing your experience! My Crp HS was 0.3 last time I had it taken I think so I'm not overly worried about inflammatory LDL plaque but I am trying to get my cardiologist to follow the Dr Ford Brewer advice on the tests for soft plaque since he thinks a treadmill stress test is sufficient and apparently it's not, not at all:/

The problem with the cardiologist (in the USA) is they can't perform catheterization without a symptom first, so if the first symptom is an MI that's an issue. They can only do that if they see abnormality first in threadmill / ultrasound Also they can't prescribe stronger antiplatelet/anti coag agent just because one is having a large CAC score but no symtom.

Sometime I want to visit cardiologist outside USA that's more 'creative'.

 

[xcpatr922]

The way the procedure in US is being done is they ask too many questions but they do very little intervention procedure to prevent an event, they follow the guidelines strictly. In other places, the doctor doesn't ask too many questions and right away does intervention for prevention.

Same as covid in this country. So many questions. Other country has so many drugs for covid treatment, here in the hospital they don't give any meds until one already pretty much suffering due to covid.

 

[xcpatr922]

Not surprised. PCPs are not trained in lipidology.

even the best cardiologist in bay area ordered the standard test.