I think this guy is a doctor.

Does LDL-P Matter?

He was alarmed when his LDL-P (particles) went up to 3000, which I think correlates to an LDL of 300.

Maybe, maybe not. The discordance between LDL-P and LDL-C seems to be fairly high, so it does not seem very accurate to try to determine one from the other.

I've long given up on anything meaningful being determined from "cholesterol numbers" when it comes to heart disease. Until they actually start checking for existence of ACTUAL disease (no, "high cholesterol" is not a disease, though it might be a symptom of some other issue such as thyroid concerns) then we'll be medicating people needlessly with statins, and making people who may very well have good cardiovascular health think they have "heart disease." This has a lot of ramifications, including social policy and insurance issues.

Hmm, interesting read. Yesterday I listened to a Jimmy Moore podcast with Dr. Dayspring who specializes in lipidology. After listening to the podcast I figured I had better pick out my burial place and order my tombstone. He went on at great length about LDL-C (LDL count) and LDL-P (number of particles) as well as HDL-C (HDL count) and HDL-P (number of particles).

He basically said that the people with one foot in the grave and the other on a banana peel were those with high LDL-P and/or low HDL-P. That the particle size of your LDL particles didn't matter a whit, and "pattern A" or "pattern B" were meaningless numbers, and it was only the total number that mattered, and if your number is high you're a walking dead person. Ditto if your HDL-P is low. You're also a walking dead person regardless of your HDL-C number which can we high up in the "good" range. He kept talking about Tim Russert as a guy who had "perfect" cholesterol numbers but still dropped dead of a heart attack - because he actually had high LDL-P. He kept going on and on about the graveyards being full of people with great cholesterol numbers - but who actually had high LDL-P and/or low HDL-P.

So back in 2010, when I was first battling my hypothyroid problem, I did persuade the endo to do an NMR test (which Dayspring says is really the only test worth running, and a VAP test is useless). And my LDL-P particle count was 2018! Considered "way high". It was 90% "pattern A" - the large fluffy sort, but Dayspring says that means nothing. And while my HDL-C was 62 my HDL-P was 30.5 , considered "low" because the "normal" value is anything ABOVE 30.5. So I had a double whammy right there.

Dayspring indicated a low carb diet was a good way to correct the situation - but at the time of that test I'd been low-carbing for over 4 years. He claimed that if low carb didn't improve your numbers the only other option was statins. Eeek. I so have NO interest in that.

OTOH he also said if you didn't have the means to do an NMR test a "quick and dirty" check was to divide your triglycerides by your HDL-C, and this number should be less than 3, and ideally 1. And in my case the tri was 62 and the HDL-C was 62, so a perfect 1 there.

So I had two factors that said I should be dead any day now, and one factor that said I'm at low risk for heart disease.

Of course this was also before I was able to get on Armour thyroid, and my total cholesterol was 290. I have not had an NMR done since on Armour, but after 6 weeks, when my total cholesterol dropped to 196, my estimated LDL-C dropped also from 216 to 117. Though Dayspring says that is meaningless as far as LDL-P does, but I have to think there would have been an improvement there - but I'm just guessing. Also my Triglycerides went up slightly to 79 and my HDL-C dropped a bit, so my ratio there went from a perfect 1 to 1.88.

So now I just don't know anything.

I think maybe he doesn't know what he's talking about. The ultimate proof is a coronary scan and the guy with 3000 LDL-P had squeaky clean arteries even though he had issues with an earlier scan.

After many years on LC my HDL is 85 now. My triglycerides are super low too.