81181cab058dd652659e4bb2e6f25843
0

lipoprotien(a), blood tests, and statins... facepalm

by (538)
Updated October 28, 2014 at 3:44 AM
Created September 06, 2012 at 3:28 PM

To be thorough, some background.

  • 25 yr old male
  • 5'9"
  • 173 lbs
  • Athletic, very active
  • <= 10% bodyfat (by caliper, for whatever it's worth)
  • Low carb high fat/ paleo/ primal (ish) for about 3 months now
  • Very high (>100 mg/dl) lipoprotien(a) levels run in the family (had a substantial blood clot in left arm following labrum repair (2006), requiring hospitalization and blood thinner lovenox for ~7 months)

wikipedia article on lipoprotien(a)

another pretty extensive article


I had a battery of blood tests done at a local Labcorp recently after a 12 hr fast and when the results were sent to my doctor I recieved a call from the receptionist saying that everything looked good except my lipoprotien(a) (which I figured), and my lipids (which caught me as odd). My doctor also took it upon herself to order a perscription statin (crestor I believe) which I have no intention of taking. Being befuddled by the news I immediately went to pick up my results to have a looksee.

Here are the results with listed norms:

  • Cholesterol (total) 193 mg/dl , >24 yrs, 100-199 mg/dl
  • HDL-C 65 mg/dl , >39 mg/dl
  • LDL-C (calc) 113 mg/dl , >24 yrs, 0-99 mg/dl (just turned 25 in July) for 20-24 yrs the norm range is 0-119 mg/dl
  • VLDL (calc) 15 mg/dl , 5-40 mg/dl
  • Triglycerides 76 mg/dl , >24 yrs, 0-149 mg/dl
  • lipoprotien(a) 52 mg/dl , 0-30 mg/dl
  • CRP 0.13 mg/L , 0.00-3.00 mg/L

Total/HDL ratio is 2.97:1

Previous levels of lipoprotien(a) have been in the 125-155 mg/dl range so I was PuMpEd to see in cut in about 1/3.

Based on this info I am VERY confused at the rec of a statin (which doesnt even effect lipoprotien(a)) and the notion that my lipids are bad.

My questions are: Is anyone else out there with some info or experience with lipoprotien(a) levels? What do you guys think about my results? What other, more indicitive tests can/ should I get?

81181cab058dd652659e4bb2e6f25843
538 · September 07, 2012 at 2:06 PM

man, I think I may just need to get a VAP test or something. that should show whether Im type A or B and be a good measure of LDL-P correct? Also, I read that the mass test (mg/dl) for lipoprotien(a) is a bad indicator of actual levels, has anyone else read this and have a suggestion for a better test?

E9a668f7e80156b0df5df3c3751618ed
110 · September 06, 2012 at 8:51 PM

Ah, cool. I didn't know that :) But, do they actually do this? When I used the other formula, I got ~105 mg/dl. Well, that value will probably more accurate than 113. That's a difference of almost 8%. I think this inaccuracy of these values very well represents the treatment of chronic diseases in our modern world. (value - not in the 'normal range' - give 'em drugs)

782d92f4127823bdfb2ddfcbcf961d0e
5201 · September 06, 2012 at 8:41 PM

There are two different formulas for determining LDL, the Friedewald equation and the Iranian equation. You are correct that the LDL value can be meaningless using the Friedewald if triglycerides are < 100mg/dl or > 400mg/dl. Then the Iranian equation is better (LDL = TC/1.19 + TG/1.9 – HDL/1.1 – 38 mg/dl). Better but not perfect from what I've read.

782d92f4127823bdfb2ddfcbcf961d0e
5201 · September 06, 2012 at 5:54 PM

Ratio should be less than 2. Yours is 1.16. I found this link helpful: http://www.lowcarbfriends.com/bbs/cholesterol-heart-health/661890-cholesterol-primer.html

81181cab058dd652659e4bb2e6f25843
538 · September 06, 2012 at 5:22 PM

thanks for the other ratio info... I never knew tri/hdl meant much. do you have any reading on how it suggests large puffy ldl?

Total Views
1.1K

Recent Activity
E9a668f7e80156b0df5df3c3751618ed

Last Activity
71D AGO

Followers
0

Get Free Paleo Recipes Instantly

2 Answers

best answer

E9a668f7e80156b0df5df3c3751618ed
1
110 · September 06, 2012 at 8:25 PM

They calculate the LDL with a formula:

LDL = TC - HDL - 0.2*TC 113 = 193 - 65 - 0.2*76 = 111,8 (not exact because the values of the test are not exact)

While the triglyceride and total cholesterol values are exact, the HDL value is an estimation. The formula above can be HIGHLY inaccurate, especially with low triglyerides. That means: People with a low or moderate carb intake get an LDL value that is worthless (it can easily be 50% higher than it actually is). Furthermore, there is LDL Type A and B. The test does not differentiate.

81181cab058dd652659e4bb2e6f25843
538 · September 07, 2012 at 2:06 PM

man, I think I may just need to get a VAP test or something. that should show whether Im type A or B and be a good measure of LDL-P correct? Also, I read that the mass test (mg/dl) for lipoprotien(a) is a bad indicator of actual levels, has anyone else read this and have a suggestion for a better test?

782d92f4127823bdfb2ddfcbcf961d0e
5201 · September 06, 2012 at 8:41 PM

There are two different formulas for determining LDL, the Friedewald equation and the Iranian equation. You are correct that the LDL value can be meaningless using the Friedewald if triglycerides are < 100mg/dl or > 400mg/dl. Then the Iranian equation is better (LDL = TC/1.19 + TG/1.9 – HDL/1.1 – 38 mg/dl). Better but not perfect from what I've read.

E9a668f7e80156b0df5df3c3751618ed
110 · September 06, 2012 at 8:51 PM

Ah, cool. I didn't know that :) But, do they actually do this? When I used the other formula, I got ~105 mg/dl. Well, that value will probably more accurate than 113. That's a difference of almost 8%. I think this inaccuracy of these values very well represents the treatment of chronic diseases in our modern world. (value - not in the 'normal range' - give 'em drugs)

782d92f4127823bdfb2ddfcbcf961d0e
1
5201 · September 06, 2012 at 4:27 PM

I don't know if I have an answer, but I also have a familial history of elevated Lp(a). When mine was tested years ago it was 33. Father's and sister's is much higher. Fortunately I have an excellent lipid profile (TC 233, HDL 136, LDL 92, Trig 27) so this isn't much of a concern. You also have an excellent profile. Your Trig/HDL ratio suggests large puffy LDL. I definately would not take a statin. Congradulations and keep up the good work.

81181cab058dd652659e4bb2e6f25843
538 · September 06, 2012 at 5:22 PM

thanks for the other ratio info... I never knew tri/hdl meant much. do you have any reading on how it suggests large puffy ldl?

782d92f4127823bdfb2ddfcbcf961d0e
5201 · September 06, 2012 at 5:54 PM

Ratio should be less than 2. Yours is 1.16. I found this link helpful: http://www.lowcarbfriends.com/bbs/cholesterol-heart-health/661890-cholesterol-primer.html

Answer Question

Login to Your PaleoHacks Account

Get Free Paleo Recipes