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07-31-2016, 07:08 PM | #1 | |||
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Grand Magnate
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Janieg, I think that mrsD and madisongrrl have provided great comments and links.
I don't know how much background you know but this might help you when you see your doctor: Lipoproteins are particles which differ in their density - eg, LDL is Low Density Lipoprotein and HDL is High Density Lipoprotein. Each class and subclass of lipoproteins contains different proteins and different proportions of lipids, including cholesterol. There is reasonable evidence that the amount of cholesterol in LDL ("Ldl-c" in your results) is a risk factor for cardiovascular disease. However, it has become clear that the number of LDL particles ("Ldl-p" in your results) is also important. This is something which Dr J D Otvos and his colleagues have worked on. They developed a clever NMR method to calculate the number of LDL particles. Dr Otvos is a respected scientist with 134 papers in PubMed. He and his colleagues looked at subjects in the Framingham Offspring Study, which is a long-term (it started in 1971) study looking at risk factors for cardiovascular disease. They found that the probability of survival was highest in people with low LDL-P and low LDL-C and lowest in people with high LDL-P. The paper is here LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study - Implications for LDL Management. - PubMed - NCBI - the PDF version of it is easiest to read. Your LDL-P and LDL-C levels look high to me. My approach to this (my LDL-C levels are fine so this is prophylactic) is to try to eat in a healthy way - lots of fresh vegetables, fish, eggs, meat in moderation, etc and minimal intake of food/drink with added sugar and foods with highly processed carbohydrates. Your doctor should be able to advise you about this and I think that it is highly likely that mrsD and madisongrrl can be helpful as well.
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"Thanks for this!" says: | janieg (07-31-2016) |
07-31-2016, 07:26 PM | #2 | |||
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Member
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The diet you described is the diet I changed to in 2014. I eat tons of fresh vegetables, next to no processed food or grains, lean protein, salmon once a week, no added sugar, etc, etc... And still, you can see my Ldl. The only thing I feel I can improve on is exercise. I used to get a ton when I didn't work...now, not so much except on weekends. I need to work on this. Also despite this diet and despite my blood sugar being under 90 the vast majority of the day, my A1c is creeping up. My test results seem to give me more questions than answers. |
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"Thanks for this!" says: | mrsD (08-01-2016) |
07-31-2016, 07:40 PM | #3 | |||
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You have a tightrope to walk with your insulin issues. And high insulin can drive that your particle count up as well. I was thinking maybe you had some genetics at play, but you are not an ApoE4. I'm stumped....
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"Thanks for this!" says: | mrsD (08-01-2016) |
07-31-2016, 07:58 PM | #4 | ||
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N/A
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Here is one more to ponder or not. All I can say in my folks life, none of these tests were done, they lived into 90's. Cholesterol wasn't a word.
Why Your Cholesterol Test Can Lie | Dr. Stephen Sinatra |
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"Thanks for this!" says: | mrsD (08-01-2016) |
07-31-2016, 08:00 PM | #5 | |||
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Thanks. I found this article by Chris Kesser which discusses possible causes of increased LDL. You pretty much nailed it.
What Causes Elevated LDL Particle Number? A tightrope is definitely what I'm walking with my insulin issues. When I get home from work, my blood sugar is often in the low 70s and sometimes high 60s (which I can usually feel). I'm going to have to start snacking more. I've seen my new primary care once for a new patient visit, but didn't come away with a great feeling. I'm thinking about asking for a referral to an endocrinologist to see if they might spot something. I'm also 35 minutes from Johns Hopkins if I could just figure out what kind of doctor to try to see! Quote:
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"Thanks for this!" says: | mrsD (08-01-2016) |
08-01-2016, 07:14 AM | #6 | ||
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Magnate
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--from a clinical perspective, I still don't think the researchers really have a handle on exactly what drives cardiovascular risk when it comes to particle size and number.
Certainly, the correlational studies don't provide a lot of strong absolute evidence for any particular size or number of particles resulting in greater infarction risk without other factors being taken into account, such as blood sugar, blood pressure, triglycerides (yours are impressively low), and measures of inflammation such as C-Reactive protein levels. There are plenty of people who go around with pretty high levels of "harmful" particles who because of healthy measures on some or all of these other levels are at relatively low risk for cardiac incidents--and a goodly number who have been found to have "good" cholesterol profiles as currently defined who are at high risk for events due to high blood sugar readings, high blood pressure, high inflammatory levels, and the like. More reserach is certainly needed, but these situations are complex and multifactorial, and a lot of it is driven by heredity as well as lifestyle--although at least lifestyle is alterable. What makes me wary is how the "acceptable" lab levels have been driven down over time--Total cholesterol normal has gone from less than 240 to less than 200 over the last twenty years, and now many want to set it at 170--without REALLY good solid evidence that these have significant salutary effects. (We do need a certain amount of cholesterol available for our brains and other tissues--hypocholeterolemia is not good for body functioning, either.) I often wonder how often these decisions are driven by the lobbying of big pharma wanting to sell new product rather than by good research into actual health outcomes. Last edited by glenntaj; 08-02-2016 at 06:11 AM. |
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"Thanks for this!" says: | echoes long ago (08-01-2016), janieg (08-01-2016), kiwi33 (08-01-2016), mrsD (08-01-2016), pinkynose (08-04-2016) |
08-01-2016, 07:12 PM | #7 | |||
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Member
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Thanks much for the input, glenntaj. You're concisely stating the feeling I've been getting reading all the conflicting opinions. I just don't think they really have a grasp on things yet.
Your comments on the acceptable levels being set lower and lower is also enlightening. I didn't know that, but am not surprised. It'll be interesting the stance my new doctor takes on this. She's part of a medical conglomerate here, and I'm sure there are Standards of Care she's supposed to adhere to. Quote:
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