Well, after doing my homework by studying up on this board, I went to my Doc and requested an NMR test and full thyroid (Free 3&4) tests after having my LDL and cholesterol skyrocket after losing 40 pounds on low carb diet and moderate exercise, cutting out all caffeine and no drinking at all. I've not been this healthy in years.

So here's the bad news:

LDL-P 2141

HDL 42

Cholesterol, Total 255

Triglycerides 92

LDL Cholesterol 195

SMALL LDL PARTICLE NUMBER 702

HDL PARTICLE NUMBER 31.7

LDL SIZE 21.7

LP-IR SCORE 40

All thyroid tests were in the normal range.

Based on my amateur interpretation, I have small LDL particles and lots of them, qualifying me for heart problems. Does this mean I'm automatically due for statins?

I'm 6'2", 240 pounds, with another 30 pounds to lose. I have not cheated at all in 4 months of dieting. I do not have a history of heart disease in the family. Prior to dieting, I was 284 with poor eating habits, virtually no exercise, and my general lipid panel numbers were almost perfect! LDL was only at 140.

I understand this says nothing about particle size, but should I interpret all of this as: I went from a terrible lifestyle and very good numbers to an excellent lifestyle with over 40 pounds lost and terrible heart disease profile?

Firstly welcome to the forum! and well done on the weight loss which I rate at 10lb a month and hopefully ongoing.

Second, the biggest problem with your figures is you've not enough detail of previous results to establish trends.
You can't say yet if your small LDL is increasing or decreasing without a previous benchmark.
Also your figure of 140 for previous total LDL may have been an indirect measurement, as distinct from the latest direct measure.

What has happened your waist to height ratio? I presume it's way better. Improving this ratio is a much more positive marker for cardio health than a guess at small LDL number trend.
Also useful would be trend in the FT4 and FT3 numbers. Again you need to measure the trend so that will mean more than one measure over a period.

How low-carb have you gone? Are you less than .5g per kilo? You may be affected by low T3 from difficulty adapting to very low carb. This can lead to a rise in reported LDL. Hopefully not an issue as you report thyroid was "in the normal range".

Lastly your question
"I have small LDL particles and lots of them, qualifying me for heart problems. Does this mean I'm automatically due for statins?"

Most conventional docs will be reaching for the statins on those numbers based on total cholesterol or LDL numbers rather than small LDL.
However my Total Chol and (indirect) LDL are both higher than yours and I don't take statins.

If it was me I'd keep with the program. When weight loss slows or stops check if small LDL has gone down. Also check your FT3 again.

Post the numbers and ranges for the thyroid tests, please.

Some people DO create a lot of small LDL by heredity. I think that Dr. Davis (Track-Your-Plaque, Wheat Belly, Cardiologist) recommends staying low carb because that helps some.

He also reports a lot of successes with D3 supplementation. You might want to join Track-Your-Plaque to get more info.

FT4 1.3
FT3 2.5
ANTI THYROPEROXIDASE 20.6
TSH 2.6

Yes, amergin, there is no baseline of quality data prior to the weight loss, as the LDL numbers are indirect off of a standard lipid panel, at which time total cholesterol was 200 and my diet of terrible food made me look like a model heart health citizen.

Also, I've lost at least 6 inches off my waist; all the weight is coming off my midsection.

I am very low carb, targeting as close to zero as possible. I would estimate less than 10 grams per day. I have every intention of continuing this rate until I lose another 20 at least, preferably another 30 pounds, before leveling off.

I'm tempted to seek out a cardiologist in town who will sit down with me and evaluate these numbers without immediately grabbing his prescription pad. But I'm 34 years old and 4 months in to dieting, and perhaps another couple months to lose the weight and establish a better baseline of data is the better course of action before exposing myself to the deluge of "you must go on statins right now" crowd.

Sounds like a good plan.
As Nancy says some people are genetically pre-disposed to high small LDL.
Also there is an opinion frequently quoted here that higher lipids can be a transient feature during weight loss.

Either way if you give it another few months and re-test you'll be in a better place to judge.

Also be aware if you're going near docs that an Oral Glucose Tolerance Test (OGTT) will not be reliable if you're low carb. A false positive on this may have a negative impact if an individual has obligations to disclose health info for whatever reason.

Join the club. I had a terrible NMR profile earlier this year. (I have a thread below) Really high small LDL count. But it also said particle size was Pattern A. I don't know how that makes sense. No one, including the LC gurus/scientists, seem to know why or if it is dangerous for LC'ers. I just keep the faith in my low trigs and good ratios.

I'm not sure that there is enough research that has been done to really know the significance of all the data that is presented from the NMR test. I had one done in October and also had higher than expected particle counts. The size though fell into the Large (Pattern A) bucket.

Here, for comparison, were my results:

LDL-P 1588

HDL 54

Cholesterol, Total 204

Triglycerides 51

LDL Cholesterol 140

SMALL LDL PARTICLE NUMBER 572

HDL PARTICLE NUMBER 32.8

LDL SIZE 21.3

LP-IR SCORE 17

My doctor put me on statins, which I took for 3 days before I came to my senses. I do have a family history of heart problems, but they have always been associated with diabetes. Low-carbing has removed me from the 'borderline diabetic' category to the 'don't worry about it' category.

Can you post the ranges?

A TSH of 2.6 is a tad high. Some think the cut-off should be 2.5, but the important numbers are the FT's.

Nancy, sure:

FT4 - 0.7 - 1.5 range. Tested value 1.3
FT3 - 1.7 - 3.7 range. Tested value 2.5
TSH - 0.35 - 4.94 range. Tested value 2.26

Interestingly, I signed up for the track your plaque website to begin to do some more detailed research on this. When I entered my scores in their tracking platform, they give you ranges.

Point being, the site shows preferred FT3 scores at 3.5-4.2, much higher than the lab averages. Obviously this would suggest I'm much lower than what Dr. Davis suggests.

I've not done enough research yet to uncover where an FT3 level really should be.

It isn't uncommon for FT3 to be lower when you're dieting. It's part of the body's way of keeping your weight stable. Over-exercising will do it too.

I've had my FT3 be a tick below range and I feel pretty good at the lowest end of the FT3 range. I seem to be VERY sensitive to T3.

Do you know what your D3 levels are? Do you supplement?

I don't know my D3 Levels, but I recently started supplementing with 5000 units per day.

I'm actively looking for docs who prescribe Armour, to discuss my symptoms on the T3 issue. The Track Your Plaque folks seem to think my range numbers are extremely low, and the scale may be so far off that what looks "in range" is actually considerably lower than most labs' ranges.

It all makes sense when taken in concert with my long term symptoms.