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  #46   ^
Old Sun, Jan-17-10, 11:10
BradC BradC is offline
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Posts: 34
 
Plan: LC - hi fat
Stats: 191/160/155 Male 70 inches
BF:
Progress:
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Hey Melisbsmile,

Below are my VAP results taken on 12/31 2009. I too was very concerned. I've lost 32 pounds and feel great on the LC-hifat way of life. Trying to improve my HDL and tryglicerides of course. Feeling a bit better after doing some research on the whole cholesteral/ldl hype. Doc didn't have much to say other than change diet and start meds (which I'm not doing). Been to Jimmy Moore's website and exchanged some info. His numbers too were rather high (TC and LDL). Everything I'm reading is making me feel better...trygliceride/hdl ratio, cholesteral myth and even some info about higher cholesteral levels being better as you get older. Oh well, sticking to this and still learing as I go. Good luck

Nancy gave me some info on vitamin D3 level which I am going to investigate also. Good info on thyroid in your posts also. Maybe I have a 'thyroid' issue going on also. I also am looking into reasons why my TC and LDL are so high. However, I have noticed thru the past 3/4 years, the stricter I got on LC-hiFAT the higher my LDL and TC went up, my HDL went higher and my triglyceriders dropped (along with my weight.. ). The past year I have been very strict. Very interesting.

TC=417
LDL=333
HDL=60
Tri=86
LDL pattern type = Pattern A (about the middle of Pattern A) (Great!)

Last edited by BradC : Sun, Jan-17-10 at 11:22. Reason: spelling
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  #47   ^
Old Wed, Jan-20-10, 22:27
cbcb's Avatar
cbcb cbcb is offline
Senior Member
Posts: 791
 
Plan: South Beach-esque
Stats: 194/159/140 Female 5'3"
BF:34% / 28% / 20%
Progress: 65%
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What's the name of a fancy cholesterol test package... is it the Princeton heart panel or something vaguely like that?
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  #48   ^
Old Thu, Jan-21-10, 10:38
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 45,187
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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There's the NMR and the VAP cholesterol test. They both directly count particle size and I think both will tell you if you have Pattern A (good) or Pattern B (bad) cholesterol.
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  #49   ^
Old Thu, Jan-21-10, 10:58
melibsmile's Avatar
melibsmile melibsmile is offline
Absurdtive
Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
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Quote:
Originally Posted by Nancy LC
There's the NMR and the VAP cholesterol test. They both directly count particle size and I think both will tell you if you have Pattern A (good) or Pattern B (bad) cholesterol.

Nancy what do you think of my results?

--Melissa
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  #50   ^
Old Thu, Jan-21-10, 11:47
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 45,187
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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Oops, missed this.

HDL is great. Trigs not. Any idea why those are so high? Are you taking any supplements? Are you raising your carbs? It could indicate diabetes too. You were fasting right? You really want to be as close to 100% pattern A as possible.

Fish oil should help with the Trigs, I think. Check out Dr. Davis's blog. I suspect if you solve the Trig problem your pattern will shift more towards A. How the Vit. D3 status? Thyroid?

Some of the tests I'm not sure of. Maybe plug them into the search box on Dr. Davis's site and/or http://www.labtestsonline.org/ for a good description. Sometimes the labs themselves have a web site with really good explanations.

You've also got high VLDL too. All in all, I wouldn't feel comfortable with the results of this test.

Just googling on the test names should turn stuff up too, like this:
Quote:
APOB100 is found in lipoproteins originating from the liver (VLDL, IDL, LDL). Importantly, there is one APOB100 molecule per hepatic-derived lipoprotein. Hence, using that fact, one can quantify the number of lipoprotein particles by noting the total APOB100 concentration in the circulation. Since there is one and only one APOB100 per particle, the number of particles is reflected by the APOB100 concentration. The same technique can be applied to individual lipoprotein classes (e.g. LDL) and thereby enable one to count them as well.

It is well established that APOB100 levels are associated with coronary heart disease, and are even a better predictor of it than is LDL level. A naive way of explaining this observation is to use the idea that APOB100 reflects lipoprotein particle number (independent of their cholesterol content). In this way, one can infer that the number of APOB100-containing lipoprotein particles is a determinant of atherosclerosis and heart disease.


Given your high trigs and high APOB100 and the weakness in your pattern A... I'd probably be joining the Track your Plaque program Dr. Davis has, to work on those things. It's a non-profit thing and I think there are a lot of expert members that can help explain these tests and guide you in improving things. Ralph, from the diabetes sub-forum, is really happy with that program. I'm not a member but would join in a heart beat (sic) if I had some questionable test results from a good test like the one you got.

Quote:
Originally Posted by melibsmile
Hi Lisa and Nancy. I got the full results of my VAP test today. The results are as follows, with the listed reference ranges if the results were out of range:

LDL 299 (<130)
HDL 71
VLDL 24
TC 394
Tris 132
Non HDL Cholesterol 323 (<160)
apoB100-calc 195 (<109)
LDL-R (Real) -C 257 (<100)
Lp(a) 12.0 (<10)
IDL 30 (<20)
Remnant Lipo (IDL+VLDL3) 45 (<30)
HDL-2 19
HDL-3 52
VLDL-3 (small remnant) 15 (<10)
LDL Density Pattern A

So I was pattern A as expected, which was nice to see. I was about a third of the over into pattern A from pattern A/B, so there is probably still room for improvement. Do you know what any of these other numbers mean? I'm not sure what to make of the Lp(a), VLDL-3, etc. Not sure if the apoB100 number is useful or not since it seems to be calculated.

A few other tests were run. My Free T4 was 1.16, with a range of 0.82-1.77. My TSH was 2.41, Total T3 was 107 (range 83-200). Vitamin D3 was 58, which has definitely improved thanks to my 5000 IU daily. My Vitamin B12 was 712.

I feel like there is definitely something else going on here. My LC diet does not explain why my LDL has doubled in the last year, even as all of my other indicators have improved. I think I need to find a doctor who is willing to do all of the testing that I need. Any thoughts or interpretations are appreciated.

--Melissa


It's hard to know what's going on with the thyroid. 2.41 is kind of a marginal TSH number. Lisa, who can't post here any longer, would tell you you might have a reverse T3 problem, but that takes another test and it's tough to get doctors to test for it. You can however order these tests yourself if your doctor is unwilling. Just post in my journal if you want more info on testing.

There may be something to low carb making us kick out a lot of RT3. I know having lots of estrogen will do that too, so can being on birth control pills.

RT3 is what the body produces when it wants the metabolism to slow down, like if you were starving. It is an inactive form of T3 and binds to the same receptors as T3 does. T3 is the only active form of thyroid (pretty sure). T4 is like a battery, it doesn't do anything until an iodine molecule is striped off and it becomes T3. Not sure what T1-T2, T5-T7 do but they're there!

Last edited by Nancy LC : Thu, Jan-21-10 at 12:05.
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  #51   ^
Old Thu, Jan-21-10, 12:16
melibsmile's Avatar
melibsmile melibsmile is offline
Absurdtive
Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
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Quote:
Originally Posted by Nancy LC
Oops, missed this.

HDL is great. Trigs not. Any idea why those are so high? Are you taking any supplements? Are you raising your carbs? It could indicate diabetes too. You were fasting right? You really want to be as close to 100% pattern A as possible.

Fish oil should help with the Trigs, I think. Check out Dr. Davis's blog. I suspect if you solve the Trig problem your pattern will shift more towards A. How the Vit. D3 status? Thyroid?

I was fasting, yes. I am not sure why my trigs are still high. They have come down since starting LC but should be farther down by now. I take a ton of supplements, including fish oil. My vitamin D3 status was good--58. I have not raised my carbs, I am eating roughly 25-30 g net per day. I think I am going to investigate the thryoid angle as that seems to be linked. My current doctor does not seem willing to do the needed testing to determine if there is an issue, so I may need to go to a doctor who specializes in thyroid and pay out of pocket.

--Melissa
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  #52   ^
Old Thu, Jan-21-10, 12:31
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,187
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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Yeah, Scarlet can point you to a good doctor. Just send her a PM. You're in the bay area so there should be loads up there. Not just any endo, most of them just follow the text book on thyroid, you need someone more into looking at things like free T3, RT3 and so on. In fact, I do too! I'm going to get a bunch of things tested like fasting insulin, leptin and RT3. Once I get that done I'll start figuring out where to go next.
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  #53   ^
Old Thu, Jan-21-10, 12:41
melibsmile's Avatar
melibsmile melibsmile is offline
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Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
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Quote:
Originally Posted by Nancy LC
Yeah, Scarlet can point you to a good doctor. Just send her a PM. You're in the bay area so there should be loads up there. Not just any endo, most of them just follow the text book on thyroid, you need someone more into looking at things like free T3, RT3 and so on. In fact, I do too! I'm going to get a bunch of things tested like fasting insulin, leptin and RT3. Once I get that done I'll start figuring out where to go next.

Scarlet thinks that I am hypo and she already sent me a PM with some info, I have a list of three potential doctors. I would be interested in them doing the insulin and leptin testing also, but if I have to pay out of pocket for the labwork then that may not happen.

I do take BCP, though that's been the case for a long time now (approx 7 years or so). It seems strange that it suddenly could be affecting me now, although I suppose it's possible. I think it's mostly a progesterone pill though.

--Melissa
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  #54   ^
Old Thu, Jan-21-10, 13:33
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,187
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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Lisa is working on a deal with some company for getting a lot of those labs at a good price. So if you can't get them done with a doctor, send me a PM and perhaps they'll be available by then.
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  #55   ^
Old Thu, Jan-21-10, 13:35
melibsmile's Avatar
melibsmile melibsmile is offline
Absurdtive
Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
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Quote:
Originally Posted by Nancy LC
Lisa is working on a deal with some company for getting a lot of those labs at a good price. So if you can't get them done with a doctor, send me a PM and perhaps they'll be available by then.

Thanks for the info. I will definitely look into that if I can't get the health insurance to at least cover the labwork and meds if needed; I am not optimistic about getting reimbursed for the doctors visits.

--Melissa
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  #56   ^
Old Tue, Feb-02-10, 18:58
gwynne2's Avatar
gwynne2 gwynne2 is offline
Senior Member
Posts: 1,698
 
Plan: Lowcarb/IF
Stats: 215/144.6/150 Female 5.5"
BF:
Progress: 108%
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Purely anecdotal info: my Mom (and I) have typically scary lowcarb numbers (high total, high LDL, low trigs) that freaked out our doctors and almost had my Mom scared into lipitor. Due to other factors she recently had to have full heart diagnostics done, and everything came up fine including no signs of arteriosclerotic disease. (She's 62.)
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  #57   ^
Old Fri, Mar-26-10, 10:02
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,187
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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Here's a super-nifty article about why LDL is not necessarily scary. Only the small LDL but the test your doctor gives you, doesn't show you!

The misguided war on fat
Quote:
Well, no. With this extrapolation, scientists and policymakers made a grave miscalculation: They assumed that all LDL cholesterol is the same and that all of it is bad. A spate of recent research is now overturning this fallacy and raising major questions about the wisdom of avoiding fat, especially considering that the food Americans have been replacing fat with—processed carbohydrates—could be far worse for heart health.
...
Last year, Ronald Krauss, director of atherosclerosis research at the Children's Hospital Oakland Research Institute, teamed up with researchers in Sweden to tease out some of the more nuanced characteristics of LDL cholesterol and its role in heart health. The term "LDL cholesterol" refers to the cholesterol housed in low-density lipoprotein particles, and these particles come in a range of sizes. Krauss and his colleagues analyzed the LDL particles they found in blood samples taken a dozen years earlier from 4,600 Swedish men and women and discovered that concentrations of the small- and medium-sized LDL particles best predicted whether the subjects later developed heart disease. Larger LDL particles, they noted in their study, which was published in Arteriosclerosis, Thrombosis, and Vascular Biology, were essentially neutral with regard to the subjects' heart health.
...
This finding is particularly interesting in light of what Krauss had uncovered years earlier: Men who switch from a low-saturated-fat diet to one high in saturated fat experience an increase in total blood LDL cholesterol, as expected. But the change is mostly the result of a spike in the concentration of large LDL particles, not small. In other words, saturated fat consumption typically boosts the number of particles that Krauss has shown to be harmless.


Recently Dr. Davis, Heart Scan blog doctor/cardiologist, wrote this:

Cut the carbohydrates in your diet and what sorts of results can you expect?
Quote:
Decreased triglycerides--Like reduction of small LDL, the effect is substantial. Triglyceride reductions of several hundred milligrams are not at all uncommon. In people with familial hypertriglyceridemia with triglyceride levels in the thousands of milligrams per deciliter, triglyceride levels will plummet with carbohydrate restriction. (Ironically, conventional treatment for familial hypertriglyceridemia is fat restriction, a practice that can reduce triglycerides modestly in these people, but not anywhere near as effectively as carbohydrate restriction.) Triglyceride reduction is crucial, because triglycerides are required by the process to make small LDL--less triglycerides, less small LDL.


Less small LDL... why is that important? Because that's the stuff that causes heart disease, the big LDL does not.
Quote:
Reduced small LDL--This effect is profound. Carbohydrates increase small LDL; reduction of carbohydrates reduce small LDL. People are often confused by this because the effect will not be evident in the crude, calculated (Friedewald) LDL that your doctor provides.

If doctors were truly practicing Evidence based Medicine they'd use evidence that actually meant something, not the crappy Friedwald test that shows nothing of use (except triglycerides).
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  #58   ^
Old Sun, Jun-06-10, 10:58
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Posts: 45,187
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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More on why the cholesterol calculation is such a poor marker for heart disease: http://nephropal.blogspot.com/2010/...fluence-of.html

Depending on your genotype (genes) the calculation can be very wrong.

Quote:
Influence of apolipoprotein E genotype on the reliability of the Friedewald formula in the estimation of low-density lipoprotein cholesterol concentrations.

Tremblay AJ, Bergeron J, Gagné JM, Gagné C, Couture P.
Metabolism. 2005 Aug;54(8):1014-9.
Lipid Research Center, CHUL Research Center, Quebec, Qc, Canada G1V 4G2.

Abstract

Lipoprotein data and apolipoprotein (apo) E genotype from 1302 participants, covering a wide range of total plasma cholesterol levels, were used to examine the impact of apo E genotype on the estimation of low-density lipoprotein cholesterol (LDL-C0 concentrations by the Friedewald formula using high-density lipoprotein cholesterol and triglyceride (TG) concentrations as compared with the beta -quantification reference procedure. The results showed that participants with apo E2/E2 genotype had significantly higher very low-density lipoprotein cholesterol (VLDL-C) concentrations and VLDL-C/TG ratio as well as lower LDL-C concentrations than participants with other apo E genotypes. Heterozygous carriers of the epsilon 2 allele had significantly higher VLDL-C than participants with apo E3/E3 and E4/E3 genotypes. The mean absolute error and the mean percentage of bias in calculated LDL-C according to all apo E genotypes, except E2/E2 genotype, were less than 0.16 mmol/L and 4.4%, respectively. Indeed, the mean error and the mean percentage of bias associated with the LDL-C calculated by the Friedewald formula in the apo E2/E2 group were 0.93 mmol/L and 40.6%, respectively. However, participants with the apo E2/E2 genotype and a type III phenotype showed a mean error and a mean percentage of bias reaching 1.53 mmol/L and 63.5%, respectively, whereas E2/E2 participants with a non-type III phenotype had a mean error and a mean percentage of bias of 0.18 mmol/L and 11.0%, respectively. Moreover, 41.9% to 57.1% of the participants had an absolute bias higher than 5% according to the apo E genotype, except for the apo E2/E2 genotypic group where 88.6% of the participants had an absolute bias higher than 5%. Stepwise multiple linear regression analyses revealed that the apo E genotype contributed to 39.0% of the VLDL-C/TG ratio variance, whereas sex, age, and high-density lipoprotein cholesterol explained between 0.5% and 3.2% of the variance. These results indicate that the apo E genotype exerts a significant influence on the estimation of LDL-C concentrations by the Friedewald formula as compared with the beta-quantification.
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  #59   ^
Old Thu, Oct-21-10, 07:43
Beez in BR's Avatar
Beez in BR Beez in BR is offline
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Posts: 954
 
Plan: Very low carb
Stats: 192.2/160/160 Female 5'6"
BF:
Progress: 100%
Location: Baton Rouge, Louisiana
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I just got back from the dr. She wanted to put me on statins. I said no. She's giving me four more months to lower my numbers. (My blood pressure is fine, 114/66.)

Total Cholesterol 248 HIGH (0 - 199)
Triglycerides 63 (0 - 149)
HDL 60 (40-59)
LDL Calculcated 175 HIGH (30-99)

Glucose 72 (70 - 100)
Insulin <2 (<17)
C-Peptide 1.4 (0.8-3.1)

Vitamin D 54 (30 -100)

Celiac Panel - NEGATIVE

AST 12 LOW (15 - 37)
ALT 27 LOW (30 -65)

TSH 0.066 LOW (0.300 - 2.500)
Free T4 1.76 (0.89 - 1.76)
Free T3 3.14 (2.30 - 4.20)

So she started in on the very high LDL right away. Wanted me on statins. I said, "No. I'm a low carber. I would expect my numbers to be high, but my HDL is great." She admitted that HDL was great, but wasn't comfortable leaving me with LDL at 175. (So I'm supposed to take a statin that will also lower the HDL?!?) I told her that I'd been low carbing for four months and I wanted more time. I had JUST gotten my thyroid levels better and just started losing weight three weeks ago. She said I could have four months and then a re-check.

She said that insurance won't pay for a VAP test. (But they would pay for me to be on statins the rest of my life?!?)

I went out last night and bought flush-free niacin and odorless garlic capsules. I already take cod liver oil. I'm thinking about adding psyllium fiber pills too.

My thyroid was not controlled well until JUST three weeks ago (it's only taken three years to feel better!!) I just started feeling better and exercising because I finally have the energy to. I wasn't losing on LC after the initial first week of 8 lbs, I hadn't lost anything since June. In the past three weeks I've dropped 5 lbs. (no change in the way I LC, which is CLEAN and no processed foods or cheats), so I expect to continue to lose weight now and be active -- AND continue low carbing.

I've been working on getting my D3 up for three years. I started out at 16, then after a year of supplementing I was at 33, now after taking 6,000 mcg/daily I'm up to 54 but my goal is 80.

What do you think about my numbers? Any other advice?

Last edited by Beez in BR : Thu, Oct-21-10 at 07:52.
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  #60   ^
Old Thu, Oct-21-10, 09:19
melibsmile's Avatar
melibsmile melibsmile is offline
Absurdtive
Posts: 11,313
 
Plan: Atkins
Stats: 272.5/174.4/165 Female 5'4
BF:44?/32.6/20
Progress: 91%
Location: SF Bay Area
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Do not under any circumstances take the statins. If she won't leave you alone, find a new doctor. (Sorry if that sounds harsh, but I'm really sick of "professionals" trying to force women to take drugs that have significant side effects and no proven effectiveness in women. She's just trying to cover her ass I'm guessing, and you don't need to indulge her.)

--Melissa
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