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

by 549 · September 06, 2012 at 08:25 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?

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110 · September 06, 2012 at 08:25 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.

5179 · September 06, 2012 at 04:27 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.

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