Tuesday, September 25, 2012

Does LDL-P Matter?


(Note: Please consult with your healthcare provider for any personal health issues)

Now that I have your attention, the question above is certainly rhetorical and one could easily substitute ApoB or Non-HDL cholesterol, so I am not singling out LDL-P (or picking on NMR technology). 

It has been a several weeks since AHS 2012 occurred and unfortunately I was unable to attend. From the twittersphere, I read about some good presentations including Peter Attia’s discussion on cholesterol (if you have not checked out The Eating Academy, you really should).

I fell down the low carb rabbit hole several years ago and have never felt better, both physically and mentally. As that rabbit hole goes deeper (read: greater carb restriction), there have been some inherent “problems”. There are numerous reports of low carbers having their cholesterol go thru the roof when they restrict their carbs (for definition let’s say less than 50 grams a day). Food quality is good, exercise is good, they feel good, but their lipids look horrible.

I would like to share my story, my n=1 case. I started a lower carb Paleolithic diet over 2 years ago after I had read Steven Gundry’s Diet Evolution (also see books by Cordain, DeVany, Wolf, Taubes, among others). I have progressed in my personal views and have progressed to where currently I eat a form of a cyclic ketogenic diet (CarbNiteSolution (CNS) by Kiefer). There are many reasons, but I am a fat kid at heart and it allows me some flexibility with my “re-feeds”.

Last fall I had a NMR LipoProfile done which showed a LDL-P of 2700 (less than 1000 is optimal). For a physician who focuses on heart attack prevention, this was quite horrifying. What should I do? My initial thought was to slug down 20 mg of Crestor daily. The only thing was that I was losing weight (more precisely, fat via body composition testing) and I felt better than ever. My energy was amazing. So I continued and eventually started Kiefer’s protocol described in CNS earlier this year. There was one problem, my LDL-P was not changing and as of this writing the last value was over 3000.

Well, as I do with my patients, I always want to know if a patient has disease or not. That really is the question, not how high is the cholesterol. I know from my practice that risk factor assessment means very little without actually knowing if disease exists.  Using standard risk assessment tools can miss people who really are at risk (3). By looking at risk assessment models  (like Framingham Risk Score) we can over- or under-estimate risk greatly. My workhorse disease detection is Carotid Intima Media Thickness (CIMT). This test simply put, measures the “lining” of the carotid artery via ultrasound. The thicker the lining is, the greater the risk. It is also a way to assess for plaque (atherosclerosis) of the artery. Having plaque means you have atherosclerosis. I believe it is a significantly better way of looking at risk because we are looking for the actual pathology (1,2).

I had my CIMT done in 2006 on the Standard American “heart healthy diet” eating low fat, higher carb. You know those espoused by the ADA and AHA. My lipids were “normal” at this time. My thickness was 0.6 mm (about the 50th percentile). I also had two small “road bumps “ (minimal plaques) at my left carotid bulb both measuring 1.2 mm. I was not happy. I also had similar findings on a study in 1/2010.

Flash-forward to June 2012, about 4 months into CNS, my CIMT showed a thickness of 0.445 mm (13th percentile) and I had the vascular age of a 16 year old! And oh by the way, the “road bumps” were gone. All the while carrying an LDL-P of over 2500 consistently for over a year. I have also had a CT Coronary Calcium score that was zero.


Epidemiology tells us that high LDL-P is associated with greater CVD risk (4,5). Where is mine?

Lets address the high LDL-P issue on low carb diets first. Unfortunately, I do not have the complete answer. The literature does not reveal much. The work of Paul Jaminet/Chris Masterjohn proves interesting (6). To sum, high cholesterol on a low carb diet could be due to:

            1. Thyroid dysfunction (my TSH, T4, T3, rT3 were normal)
            2. Micronutrient deficiency (none noted via testing)
            3. Toxin/Infectious exposure (no periodontal disease or other sources of infection)
            4. Active weight loss (check, but does not explain why others with active weight loss have better/normal lipids)

Let’s take a 50000 ft. view. My hypothesis is that insulin signaling is playing a huge role. We know that the root cause of atherosclerosis in 80% of people is due to insulin resistance (7).  Insulin is an anabolic hormone (ask bodybuilders). Unfortunately it is not very discriminatory. Meaning: subcutaneous areas, the liver and the arteries can be storage depots for fat in the setting of insulin resistance. I see insulin resistance as “loading the gun” for initial heart attack risk/event.

Inflammation is the second part. If insulin resistance loads the gun, then inflammation pulls the trigger. Inflammation has a role in the development and progression of atherosclerosis AND in the rupture/destabilization of plaques (8). In addition, to complicate matters, the majority of plaque rupture/erosions do not cause events.

So what does one due to mitigate all of this disease? Well, that would be to minimize the effects of insulin. That can be done by a carbohydrate-restricted diet. In the largest extreme that would be a ketogenic diet.

What does a ketogenic diet do? Well simply put, it minimizes the effect of insulin from the dietary component. This mitigation can be a reason for fat efflux (ala LPL and HSL activity).  Could one also hypothesize that fat is being effluxed not only from the subcutaneous tissue, but also the liver, hence a potential treatment of nonalcoholic hepatitis (NASH)? By this same thought process, could this be a mechanism to efflux “fat” out of arteries, which may be one mechanism of action which may account for disease in patients with high HDL-C cholesterol in the presence of insulin resistance?

Although not widely studied, Ketogenic diets (which remove agents of Neolithic disease) can minimize inflammation. I have seen this clinically in my practice and in myself. My hs-CRP is not detectable (all my other markers of inflammation are normal as well, Lp-PLA2 and Myeloperoxidase). Inflammation IS the key component to events (ie plaque rupture) as stated above.

So if LDL-P is high but inflammation is very low and there is no insulin resistance, does it matter? This, of course, does not preclude the possibility of atherosclerosis to progress in the setting of insulin resistance and no/low inflammation (think the 78 yr old that needs a stent but never had the event).  So if one is eating low carb, one would think these metabolic issues should take care of themselves.

I definitely think in the Standard American Diet (SAD), high LDL-P is a huge problem. Primarily due to the significant insulin resistance associated with the discordance of LDL-C to LDL-P in the setting of inflammation. It is a recipe for disaster. It also represents nearly 80% of patients coming thru my door.  Yes, 80%, it is that high! (9,10)

I propose diet DOES matter (shocking, I know). In particular, those that minimize carbohydrate exposure and thus insulin signaling; will have difficulty developing atherosclerosis, inflammation and thus events and potentially reverse it. What are the diets that do this? A ketogenic diet,  low carb/LC Paleo diet AND as much as it pains me to say, the plant based diet.

This is a very complex issue and one that warrants further investigation and for now most of my answers are “it depends”. But we must always remember to treat the patient/disease and not the number.

References:
2.     http://ht.ly/dQAo9


62 comments:

  1. Hi Doc. Thanks for the excellent post. Having a "case study" like this is very helpful for putting these things into perspective.

    ReplyDelete
    Replies
    1. If you had to guess...

      Which of these points do you press
      to relieve a your migraine?

      Or to lower cholesterol?

      To reduce pain from arthritis?

      Or to reduce high blood pressure?

      Find out here: How To lower cholesterol?

      Best rgs

      Delete
  2. OUTSTANDING!!! I'll be addressing this issue further with Dr. Thomas Dayspring on my http://www.askthelowcarbexperts.com podcast on Thursday, October 4, 2012 with the topic "Cholesterol Testing: What Matters Most?"

    ReplyDelete
  3. Really great post and case study. I wish I could say we "knew" the answer to this question, but clearly we need more work to evaluate the clinical meaning of elevated LDL-P or apoB in the context of a radically different diet (and hormonal milieu) than originally studied. I look forward to incorporating this work into my subsequent work.

    ReplyDelete
    Replies
    1. Peter - in the 4 years since this post, have you followed through with incorporating this work into yours? I would anxiously await your results

      Delete
  4. Thanks Peter, Yes the "answer" is the million dollar question.

    ReplyDelete
  5. Excellent post. What were the changes in your "standard" lipid panel after your diet change? I'm guessing LDLc skyrocketted while everything else "improved".

    ReplyDelete
    Replies
    1. LDL-C was in the low 100's, currently my most recent LDL-C is 289 and LDL-P is 3234

      Delete
    2. Thanks Rakesh. Do you know what your LDL-p was when your LDL-C was in the low 100's?
      I have read plenty of blogs that quote the results from studies where people are put on LC diets and the average LDL-C remains about the same or slightly elevates. My mate and I both had large increases, more so my mate. He also discovered he had very high ferritin levels (doesn't have hemochromatosis). I wonder if there is a connection? I exercise too much (reducing it now) & wonder if that is my issue.
      Your n=1 is certainly encouraging, it would certainly seem to throw a spanner in the works wrt the whole LDL-p argument.

      Delete
    3. Rakesh.
      What was your small LDL particles, with a total LDL particle of 3234?
      Dr. Davis, at tract your plaque blog, thinks the small LDL, is the only relevant, particle, that causes atherosclerosis, regardless of the the total LDL particle.
      Thanks,
      kasing12

      Delete
    4. I don't have an ldl-p from back then, but based on my non-hdl, it was probably 1400-1500 (based on Framingham Offspring Study cut points)

      Delete
    5. @kasing12 The epidemiology suggests otherwise. But having high small LDL-P is just another sign that you have insulin resistance and are overconsuming carbohydrates. I believe my last small LDL-P was around 450, i think it was in the 30-40th percentile

      Delete
  6. This comment has been removed by the author.

    ReplyDelete
  7. Hi Rakesh et al,
    I love it when doctors experiment on themselves!
    In Dr. Peter Attia’s Straight Dope Peter's says CAD can only be delayed, which, for me, translated to "whatever you have now can't get better, you can only slow down the progression".
    But my take away from your post was when you switched from a SAD diet to a Low-Carb diet, your Lipid Numbers got worse but your actual artery thickness number (CIMT) got smaller and your CT score is now 0... Besides the fact that this is super cool, I didn't think one's coronary artery disease could "improve".
    Do you see my confusion? Can one “heal" CDA with a low-carb diet and how does that translate to "but you're going to get it anyway eventually"?
    Thanks for any response!
    Diana

    ReplyDelete
    Replies
    1. That is what really needs to be studied, But i firmly believe one can regress or at the very least stabilize atherosclerosis

      Delete
  8. I had an NMR blood test done on 5/10/12 - so I'll be getting another one in a few weeks

    LDL-P 1500
    Small LDL-P 127
    LDL Size 21.1

    Triglycerides 36
    HDL-C 59
    HDL-P 28.5

    LDL - per the Iranian Formula - 141
    Total Cholesterol 254

    I'm currently switching over to a VLC Ketogenic diet



    ReplyDelete
    Replies
    1. Interesting, changing to keto should help your low HDL-P as well

      Delete
  9. CIMT does not always correlate with what is going on in the coronary arteries. I have a .5 CIMT, zero plaque there; but in coronary arteries i have plaque as evidenced by a positive calcium score. Age 61

    ReplyDelete
    Replies
    1. Yes when looking at vascular beds, one must exhaust looking at all beds until you can show no disease

      Delete
  10. Really like this website, this really helps and very useful.Thank You.

    Regards,
    Yan Katsnelson

    ReplyDelete
  11. Dr. Patel,
    Thanks for this post. My lipids and diet are like yours. Having put a lot of time into investigating this, my conclusions are also basically the same as yours.
    It appears that the "atherogenic lipid profile" in the context of chronically elevated insulin (for probably most of the US population) generates the study statistics that many then over-interpret and apply universally. It is likely the insulin that is the primary problem.
    My fasting insulin is below the minimum measurable by commercial lab equipment. My calcium score is zero too.

    ReplyDelete
    Replies
    1. an oxLDL test should be commercially availble soon, so it will be interesting to see how this looks in a low carb setting

      Delete
    2. Shiel Labs has an oxidized LDL test available - I will have the results next Friday

      http://www.shiel.com/oxldl.htm

      http://www.shiel.com/PDF/OxLDLTMTBrochure.pdf

      The role of the oxLDL/HDL ratio test in the pathophysiology of atherosclerosis and coronary artery disease is easy to comprehend. It is widely believed that LDL is the "bad lipoprotein" and HDL is the "good lipoprotein"; however, oxidized LDL (oxLDL) now appears to be the "worst lipoprotein", since experimental studies have shown that LDL must first be converted to oxLDL in order for LDL to participate and be directly involved in the atherosclerotic disease process. Thus, the ratio of oxLDL to HDL is essentially the ratio of the "worst lipoprotein" to the "best lipoprotein", or the ratio of proatherogenic to antiatherogenic disease activity.

      Delete
    3. I just had my oxLDL tested as my LDL was very high 228, unfortunately my ox LDL is extremely high, My husband on the other hand with an LDL of 171, has a very low oxLDL. We both have low TG and high HDL. 95% of our LDL is large type I'm post menopausal - I also have a female client with a similar profile also post menopause. I'd love to see some more people with high LDL on low carb diets get their oxLDL done. I'd like to know too, how much of a risk this is in our context. In the meantime, I'm making dieatary changes - less SFA and more root veg and berry carbs to see what happens.

      Delete
    4. Does one have to go to NYC to have the oxLDL test from Shiel done, or are any other clinics/providers offering it? Thanks in advance.

      Delete
  12. Dr. Patel,

    Dr. Attia linked me to this blog post because I eat a low carb diet and got an NMR resulting in LDL-P of 2192 (my HDL is 55 and TG: 22). The one thing that stood out was your mention of Periodontal Disease/Infection. I had a root canal when I was very young that failed once resulting in Apico Surgery and the tooth never really came around. About 7 or 8 months a go an Endodontist told me the tooth cannot be salvaged and would have to be pulled. I still havent gotten it pulled yet for money reasons and it hasn't given me too much problem but it's definitely not a healthy tooth. Is this what you meant by Periodontal Disease/Infection and can this be contributing to my high LDL-P count despite my normal HDL and exceptional TG? And if it does effect the LDL-P count is it just making the number inaccurate (skewing the results) or does the Periodontal disease actually increase the number of particles (therefore being a problem)?

    Anything you can tell me or link me to would be greatly appreciated. Thank you!

    Brian

    ReplyDelete
    Replies
    1. I have read online on how infection can effect cholesterol, but have not seen good citations in the literature, so not so sure on. But what we do know is that active periodontal infection increases inflammation. Make sure to get a pathogen test. I recommend www.oraldna.com. They have a test call MyPerioPath (http://www.oraldna.com/periodontal-testing.html)

      Delete
  13. Hello Dr Patel,

    Add my n=1 to the list of similar experiences. 3 months into LCHF my LDL-C shot to 10.4mmol/L (400). My ApoB (can't access NMR for LDL-P) went from 0.93g/L in '07 to 2.71 in June '12. I don't know what that converts into for US numbers but a 300% increase seemed significant. HDL and Trigs improved.

    I discovered at the same time that I am Apo E4/E4. Do you know what your ApoE profile is and do you have any comment on its significance? I have since started supplementing with iodine, magnesium, K2 and cod liver oil while diet has remained constant. Will test again in a few months to see if there is any difference, but I'm starting to get used to the idea that I'm going to continue to freak out doctors with high LDL/ApoB. My health and well being is otherwise great. Treating a number seems wrong.

    E4 is obviously studied a lot due to the AD and CVD links but there is so much that is still unknown.

    ReplyDelete
    Replies
    1. I am 3/3. I take APOE status with a grain of salt. If you have a 4 AND family history of AD, then the risk is associated. If no family history of AD, then no correlation

      Delete
  14. I live in Phoenix, Arizona what I would like to know is does anyone know where I can find a real holistic doctor that is willing to take me on as a patient? I know that it will come out of my own pocket but I have a issue that I want to get taken care of that I frankly would like for the holistic doctor to get me exempt from if possible.

    Thanks

    regards,
    hvac schools AZ

    ReplyDelete
  15. This comment has been removed by a blog administrator.

    ReplyDelete
  16. Dr. Patel,

    You should know that these people who commented here with a link in their comment just do so in order to get that link from your blog. It is a shabby way of pushing the linked website in Google's search results (Search Engine Optimization) ...

    ReplyDelete
  17. Are you able to provide the primary research link / article title or other applicable reference(s) for the source of those four points above from Paul Jaminet/Chris Masterjohn?

    I'm in a similar boat with dramatically increased LDL's post-paleo (six months in) and really would like to figure out if this is a crisis or what.

    Thanks in advance!

    ReplyDelete
    Replies
    1. Here is a link to copper def. that Stephan Guyenet wrote about, all sources are referenced in his blog post: http://wholehealthsource.blogspot.com/2010/04/copper-and-cardiovascular-disease.html

      I will try to dig up the others

      Delete
    2. Thanks so much! Very appreciated.

      Delete
  18. I've asked myself the LDL-P question for months. Switched to a pretty LC paleo a year ago and doubled LDL-P. I am a sterol hyperabsorber with normal synthesis. Family dr, cardiologist, & Dayspring consult all suggested dual therapy statin/Zetia. I love your idea of treating heart disease and not treating markers but I thought Zetia a potential low risk treatment. It doesn't seem to cause a ton of downstream side effects. Getting tested next week to see if I have been able to impact absorption markers and LDL-P without goofing synthesis markers with this 3mth Zetia experiment. Also hoping my one inflammation marker Lp-PLA2 has finally calmed down. Your thoughts on Zetia in general?

    Also, about 10 years ago I got CIMT after Dr noticed high LPa. I decided on calcium cardiac scan over CIMT last year and ended up in 90% risk range (for 42yo female). That was a sucker punch to the gut, took a bit to rally from that. You did CIMT, curious why you chose that over calcium cardiac score. I plan on repeating one (or the other) yearly to mark reversal of disease.

    Thanks for all you do. Your perspective has helped validate where I've been heading this last roller coaster year.

    ReplyDelete
  19. I am a hyper absorber as well. The last time i checked my sterol markers, my liver markers for production were low(lathosterol was less than 0). This was on a low carb diet. I do not have my markers on a SAD. Looking back, when i did try medication, I seem to always respond better when Zetia was in the mix.

    I did have a calcium score and it was zero.

    ReplyDelete
  20. Dr. Patel, great post! I'm a hyper-absorber as well and have a similar lipid profile to you and others who are eating paleo/low carb. Until the LDL-P question is sorted out, isn't it possible to eat a ketogenic, low-carb diet (as Dr. Dayspring might suggest) and reap all the benefits while keeping LDL and LDL-P in a more reasonable range? Wouldn't this be the prudent thing to do?

    ReplyDelete
    Replies
    1. Well the questions to ask are several. Does it really matter? Is there something from a genetic standpoint causing the high particle count, or could it be an environmental factor like sub-clinical infection? Until we have some studies looking at lipids in low carb eating populations we will not know

      Delete
  21. I was pleased to find this discussion as I recently discovered my very high ldl-p with a very high hdl-p and well controlled insulin resistance. It is good to know this is a topic of conversation as I am sure my doctor will not know what to do with this information.

    Any further research suggestions would be helpful.

    Story: obese most of my adult life; low carb 2.5 years; in first 18 months lost 25 pounds with work; discovered the T2D 1 year ago; added metformin and lost another 10 pounds; weight and BG stuck both still somewhat high; high FBG. In mild ketosis much of the time, with periodic breaks with added carbs.

    The data:
    * unexpected results

    A1C 5.8
    Insulin 6 uIU/ml
    LP(a) 137*
    B12 331
    D 64

    LDL-P 2341*
    LDL-C 149
    Small LDL-P 724
    LDL size 21

    HDL-P 49.2
    HDL-C 88

    IR Numbers:
    Large VLDL-P < .7
    Small LDL-P 724
    Large HDL-P 11.4
    VLDL Size - not enough to measure
    LDL Size 21
    HDL Size 9.4

    LP-IR Score 15th percentile (good)

    ReplyDelete
    Replies
    1. I would suggest some evaluation of your arteries to determine if you have subclinical atherosclerosis. You have 3 big risk factors: 1. DM2 2. High Lp(a) 3. hi LDL-P

      These issues are of significant concern and you should work with your healthcare provider

      Delete
  22. This comment has been removed by a blog administrator.

    ReplyDelete
  23. Rakesh,
    This is a great post. I stumbled upon it when looking for material to understand my recent NMR profile results. There is very little material online that explains what the various numbers mean especially in conjunctions with each other.
    My results have me worried especially as I have a strong family history of heart disease (Father died of his first attack at 50, other family members have also had CVD).

    LDL-C: 84 (this is much better from 176 from three months ago)
    HDL-C: 43 (improved from 38 from three months ago)
    Triglycerides: 252 ( 300 three months ago)
    Total: 177 (250 three months ago)

    These numbers all look good and have improved significantly since I quit my high stress job and started exercising. However, the detailed profile numbers are shockingly bad:

    LDL-P: 2115 (really bad)
    HDL-P: 25.6 (again bad)
    LDL size: 21.2 (seems to be good but from what I have heard doesn't matter much)
    Small LDL-P: 960 (again very bad and 80th percentile)

    My calculated Insulin score is 77 putting me in the 90th percentile.

    I am 35, 5-10, 160 and relatively healthy with 14-18% body fat (also Indian origin). My coronary calcium scan done a year and half ago had a score of 0 (no plaque seen)..

    My glucose tests have all been fine (last one was five months ago).

    My TSH levels have been fluctuating between 4 and 9(unmedicated).

    Not sure what to make of these latest results. They put me in a very high CVD and insulin resistance risk category, yet other results seem to be normal.

    Any thoughts that you might have would be very helpful. Thanks once again for this awesome blog.



    ReplyDelete
    Replies
    1. As you state your numbers reflect significant insulin resistance. Your cursory numbers may look fine (which they are not; high TG, low HDL, and hi LDL-P), but if you were to work with your health care provider, i am sure you would find markers that reflect your disease. An oral glucose tolerance test might be a place to start (it should include a 1 and 2 hour post prandial test). In addition your thyroid dysfunction could be a driver of your abnormal lipids.

      Definitely circle back with your physician to address these issues.

      Delete
  24. You said above that, "I propose diet DOES matter (shocking, I know). In particular, those that minimize carbohydrate exposure and thus insulin signaling; will have difficulty developing atherosclerosis, inflammation and thus events and potentially reverse it. What are the diets that do this? A ketogenic diet, low carb/LC Paleo diet AND as much as it pains me to say, the plant based diet."

    Can you please comment on which plant-based diet you are talking about and what evidence you have that supports your conclusion that it works?

    ReplyDelete
    Replies
    1. This comes from anecdotal evidence from Caldwell Esselstyn at the Clevelnad Clinic: http://www.youtube.com/watch?v=SlIBGG8V8P4

      Delete
  25. Hi,

    I just had the sonography instructor at the community college where I work measure my Carotid Intima and she said they were both .6mm. I'm 42 and have been eating 80/20 paleo framework for about the last two years My last metabolic s were good: 185 total, HDL 68, LDL 102, Tri 58.
    Should the relatively high thickness concern me or should I have a second opinion, wait it out, relax, do it again in a year...

    Thanks,
    Really appreciate your work!

    ReplyDelete
    Replies
    1. Hard to comment without a full CIMT with plaque assessment. If that accurately reflected your mean far wall IMT of your CCA, then it puts you somewhere above the 75th percentile from the european cohort AXA study. Numbers look good but IMT potentially gives you higher CV risk

      Delete
  26. This comment has been removed by the author.

    ReplyDelete
  27. I've been doing keto as well, similarly high cholesterol numbers. However, my CIMT is 75%, which I immediately followed up with a calcium score. Calcium score is 0. How do I dig deeper into this contradiction?

    ReplyDelete
    Replies
    1. the ctcs can be reassuring, but does not completely rule out soft, noncalcified plaque. The elevated IMT is a concern, but with no plaque, conveys about a 8% risk of event if left "untreated" over the next 10 years. See Cafe-Caves trial referenced. Elevated IMT can be seen associated with periodontal disease, as well (http://www.ncbi.nlm.nih.gov/pubmed/18052701).

      Delete
  28. Thanks! I do have a tendency to build up calcification on my teeth if I don't keep on it with the OralB. Is there any kind of blood test which can reflect/indicate the bacteria involved? Or is this something where I need to see the dentist?

    ReplyDelete
  29. Are there any tests which focus on measuring soft plaque? Perhaps something with an MRI?

    ReplyDelete
  30. Excellent article and very pertinent to my situation. I've been eating keto since thanksgiving 2013, so about 7.5 months. I've lost about 45 lbs and feel great. I had my yearly checkup and asked for the NMR type blood cholesterol test. The results are scary:

    Glucose level: 88
    NMR total cholesterol: 324
    HDL: 54 (up from 42 last year)
    HDL-P: 28.6
    LDL: 253 (up from 158 last year)
    LDL Size: 21.2
    Small LDL-P: 1152
    LDL Particle Count: 3256
    Triglyceride: 87 (down from 190)
    Consider Insulin Resist/Metabolic Syndrome: 45

    LDL particle count number is most concerning. I am currently losin weight and feel good. My doctor is talking about statins but I do not want to go that route if I do not need to. Should I be concerned? Is there anything I can do diet wise to improve my numbers?

    --Matt

    ReplyDelete
  31. Sorry for asking another question after reading all these Q&As but i cant understand those medical terms. So that I needed to ask this.Thank u for this unique article abt this particular subject. am 29 yrs old and 5 ft 10 inches tall and weighing 100 kgs before 2 weeks. I tested my blood and I started ketogenic diet for 2 weeks. then I tested my blood again . I lost 7 kgs in 13 days and mostly used coconut oil and butter (no olive oil), but ate 2 avacadoes. Readings are,


    Total cholesterol 159 to 305
    Triglycrrides 110 to 224
    HDL 46 to 42
    LDL 91 to 219
    VLDL 22 to 44
    Cholesterol/HDL ratio 3.46 to 7.26

    I am afraid of continuing this . But I need to continue coz of other benefits . Can u suggest me any tests to convince myself and others to believe wat am doing is not dangerous coz my family worries much.Thanks again.

    ReplyDelete
  32. Guys, please watch the documentary "the CEREAL Killers", and follow the links - all this has been researched very well and documented, but BIG Sugar and Breakfast Cereals prevent the publishing of these articles in most medical journals. You cannot outrun or out-medicate a bad diet ...

    ReplyDelete
  33. Great article – Impressive: We think you might be interested to know more about our company. Techno Data Group helps you get your hands on world’s best class customized B2B Contact List, which can make your sales and marketing campaigns cost effective. Achieve Your Marketing Goals and Grow Your Business.
    Family Medicine Email List

    ReplyDelete