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Hack my latest blood work - is the LDL a cause for concern?

by (614)
Updated about 23 hours ago
Created October 19, 2012 at 5:48 PM

Collected 10/5/12 - Shiel Medical Lab - day 14 (before Testosterone injection) - I'm on TRT - get an injection every 2 weeks

HA1C - 5.6 Fasting Glucose - 100mg/dL Ref Range 65-99 mg/dL Estimated Average Glucose - 114.5 mg/dL

LDL-P 1430 nmol/L Small LDL-P 132 nmol/L

HDL-C 69mg/dL Triglycerides 31 mg/dL Trig/HDH ratio - .45

LDL-C (Calculated) 199 mg/dL LDL-C (Iranian Formula) 146 mg/dL

TC - 274 mg/dL

Estradiol, LC/MS/MS - 4 pg/mL S/B <= 29 pg/mL Enhanced Estradiol - 22.7 pg/mL Ref Range <39.8 pg/mL SHBG - 39 nmol/L Ref Range 11 - 80 nmol/L

Thyroid Panel Thyroxine (T4) - 10.9 ug/dL Ref Range 4.5 - 10.9 ug/dL T3-Uptake - 34.0% Ref Range 22.5 - 37% TSH - 3rd Generation Ultra - 1.47 uIU/mL Ref Range 0.40 - 4.50 uIU/mL Reverse T3, LC/MS/MS - 34ng/dL Ref Range 9 - 28 ng/dL T3, Total 81 ng/dL - Ref Range 60 - 181 ng/dL T4, Free 1.43 ng/d/L - Ref Range 0.80 - 1.80 ng/dL

Vitamin D (25 hydroxy) - 74 ng/dL Ref Range 30 - 100 ng/dL Cardiac Homocysteine - 10.0 umol/L Ref Range <11.4 umol/L PSA - 0.42 ng/d/L Ref Range <4.00 ng/dL

Quest Diagnostics - collected 10/8/12 (3 days AFTER the testosterone shot) Just to show how different labs get different results

Berkley Heart Labs Test

LDL PAttern Size A (Large) Triglycerides - 41 mg/dL HDL-C 76 mg/dL Trig/HDL ratio .54

Apolipoprotein B - 104 mg/dL Ref Range <115 mg/dL

One thing that does not make sense Oxidized LDL - 62 U/L Ref Range 9-44 U/L

Low Risk <45 Moderate Risk 45-59 High Risk 60-79 Very High Risk >79

HOWEVER - Shiel didn't run their HDL test as part of the Triple Marker test so I didn't get the Oxidized LDL/HDL ratio so I'll wait 6 months and run it again.

lipid subfractions

Total LDL-C 158 mg/dL (Berkeley Heart Lab LP Plus3 Test) HDL-C 79 mg/dL Triglycerides 41 mg/dL

Per the Iranian Formula the LDL - 118 mg/dL - MUCH BETTER

HOWEVER - the LDL subclasses are what's interesting

LDL IVb - 1.8% Ref Range 1.7% - 9.8% LDL IVb goal - <= 5% SO - This represents very low cardivascular risk

LDL IIIa + IIIb - 17.9 mg/dL Ref Range 12.0 - 32.1 mg/dL Again - low risk

LDL IVb - 1.0 mg/dL Ref Range 1.5 - 11.2 mg/dL Again - VERY LOW risk

So - total LDL-C doesn't mean much - BUT - they base giving statins on that number

D33a8d5f095a8532ddf7a0d6c27bfe63
578 · January 18, 2013 at 2:52 AM

Your T3 is kind of low, you notice that. And probably your Ft3 also. If your LDL wasn't this high before, it could be due to the T3-LDL receptor link. LDL piles up in your serum due to low T3. You can clarify if this is true or not by looking at prior numbers.

56bc750affa41124e1142a6e8e239e3d
145 · January 03, 2013 at 8:54 PM

Agree with what Jake wrote. I also get testosterone injections (do them myself per the prescription). You might want to get the dose halved and get them twice as often. There will be less of a hormonal swing from high to low this way, which could be causing some of your hormonal oddities. That said, I have crazy high LDL (mostly large) but other good numbers like you. I'm not worried since I really depend upon the trig/HDL ratio as a better indicator if I know I've been eating right.

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2 Answers

9c07f0980f9b2540ddebd2b4215612b4
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10 · June 02, 2013 at 6:40 AM

Did you ever find a cause for your high ox-LDL?

I know of one genetic haplotype that is associated with high oxidized-LDL, among other problems. There may be others.

Do you have genetic data (from 23andme, FTDNA, etc.)? The gs224 haplotype is a group of three mutations on the GCH1 gene that appear to reduce BH4 levels, and cause high oxidized LDL; if you run SNPedia's Promethease program, it will tell you if you have this particular set of mutations.

About 2% of the population carries gs224.

Here's a study with the gs224 GCH1 haplotype correlated with ox-LDL: http://circ.ahajournals.org/cgi/content/meeting_abstract/118/18_MeetingAbstracts/S_552-d "... The X haplotype was also associated with higher plasma ox-LDL (51.0??2.2 in XX+XO vs 44.2??1.4 U/L in OO p<0.05) and lower BH4:total biopterins ratio (43.1??3.2 in XX+XO vs 51.7??2.1% in OO, p<0.05)."

Yahoo group for the gs224 haplotype: http://health.groups.yahoo.com/group/GCH1discussions

~judi

00cd3b6f51530a6832fcda1712edbec3
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2353 · October 19, 2012 at 11:23 PM

Your LDL-P number is probably in the 70th percentile and is a cause for some concern. If you weren't eating a lower-carb/paleo diet, I'd say get on one. However, that measurement is discordant with your apoB number (good), trigs and HDL numbers (amazingly good), so I don't know what to make of it. I'm not an expert on the effects of testosterone injections, and can't say whether that should or shouldn't be affecting your LDL-P results.

LDL particle size and plasma concentration are, according to Dr. Tom Dayspring, irrelevant.

TC is slightly above the sweet spot (220-240).

Your thyroid panel is missing an important measure: Free T3. It's only the free T3 that's available to do it's job. But your high RT3 suggests that your FT3 might be low.

56bc750affa41124e1142a6e8e239e3d
145 · January 03, 2013 at 8:54 PM

Agree with what Jake wrote. I also get testosterone injections (do them myself per the prescription). You might want to get the dose halved and get them twice as often. There will be less of a hormonal swing from high to low this way, which could be causing some of your hormonal oddities. That said, I have crazy high LDL (mostly large) but other good numbers like you. I'm not worried since I really depend upon the trig/HDL ratio as a better indicator if I know I've been eating right.

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