Paleo Diet and Paleolithic Diet Questions & Answers

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I posted some blood work numbers under another question, but at the time only had calculated LDL numbers. Turns out my Dr. did do a full VAP test, but only gave me basic totals over the phone. Since I'm generally new to Paleo (about 8 months) and not well-versed in the whole cholesterol testing numbers thing, I thought I would post some of the numbers I got to see what everyone thinks — my total numbers were kind of high so want to make sure I'm not overlooking things I should be concerned with.

First, I am a 57 year old male, 5ft 7in, 145 lbs. Was on statins before going Paleo. Stopped when I started. Lost about 20lbs since on the diet. Eat mostly grass-fed meats/chicken, good amount of fish, egss, some dairy (mostly cream) and cook alot with coconut oil and coconut milk. Eat some fruit (mostly blueberries and strawberries) and indulge in dark chocolate a few days/week. Oh and take some vitamin D (~4,000 iu) and exercise about 3-5 days/wk.

So here are the numbers, as best as I can interpret them or what I think are important ones:

General #'s: Total Cholesterol: 277 mg/dL HDL: 72 mg/dL Cholesterol/HDL Ratio: 3.8 LDL (calculated): 196 mg/dL Triglycerides: 43 mg/dL

More Detailed Total LDL-C Direct: 214 mg/dL Total HDL-C Direct: 65 mg/dL Total VLDL-C Direct: 16 mg/dL Triglycerides-Direct: 53 mg/dL

Total Non-HDL-C (LDL+VDL): 230 mg/dl Total APOB 100-Calc: 141 mg/dl

LP(a) Cholesterol: 14.0 mg/dl IDL-C: 16 mg/dl REAL-LDL-C: 185 mg/dl SUM Total LDL-C: 214 mg/dl

Not exactly sure how to read the Pattern A/B section, as there is just a bracketed area with A and B about the same size and under the bracket section is the following:

REMNANT LIPO (IDL+VLDL3): 25 mg/dl

HDL-2 (Large buoyant): 18 mg/dl HDL-3 (small dense): 47 mg/dl VLDL-3 (Remnant LIPO): 9 mg/DL

And also on the test results: Glucose 90 mg/dL Vitamin D, 25-OH total: 41 ng/mL

My Dr. thinks I should go on statins (Crestor)

So worries? not so bad? just ignore. any comments appreciated.

Jeff

flag	asked Mar 2 2011 at 20:09 jstern 142●9

	Not sure what APOB means. Does list is as [H] which I assume means high and shows the ideal range as <109 – jstern Mar 2 2011 at 21:05
	APOB is ApoB -- Apolipoprotein B, the one in LDL and VLDL particles. – Lumifer Mar 25 at 20:39

Travis Culp · Answer 1 · 2011-03-02 20:16:53Z UTC

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High HDL, low TGs. (which is good) APOB is high but will lower over time with this diet, as will LP(a)

VLDL is within range as well.

Don't they put a mark on the scale of pattern A or B so you can see how close you are to one or the other?

And of course if your doctor sees those results and wants you on a statin, you should either ignore him or get a new doctor.

answered Mar 2 2011 at 20:16

Travis Culp♦
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There is an asterisk within the bracket for Pattern A -- about 1/3 from left bracket. What is APOB anyway? – jstern Mar 2 2011 at 21:01

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I don't think a doctor who does not mention statins would be the licensed kind if cholesterol > 250. Wouldn't their license get revoked eventually? – Turnkey Mar 31 2011 at 5:11

Stabby · Answer 2 · 2011-03-31 04:31:38Z UTC

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Your LDL is emphatically NOT putting you at risk for atheroclerosis by its own virtues. However sometimes we run into nutrient deficiencies if we're not paying attention. Paul Jaminet at perfecthealthdiet.com says that a copper insufficiency causes damage to the arteries and elevated production of LDL http://perfecthealthdiet.com/?p=2547

You might also not be getting enough potassium and magnesium. Just putting that out there.

But really, you are healthy in your blood fats and sugars. Keep it up! Wahoo!

answered Mar 31 2011 at 4:31

Stabby
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	Thanks for info. Did meet with a new Dr. who is a crossfitter and mostly Paleo. She did suggest getting a Coronary Calcium CT scan test (only $100) so I am going to have one to see what that shows. On another note, have been have some muscle joint pains. My wife is now complaining of some similar pains. Tracked my intake on fitday last week and Potassium and Magnesium fluctuate from about 45% to 80% of RDA. I have taken some magnesium (natural calm), not my wife, and may have helped but not enormously (also can't take too many days in a row as tends to cause the runs). – jstern Mar 31 2011 at 11:27
	Diet is pretty balanced with lots of grassfed meats, veggies (salads, carrots, cukes, spinach, chard, broccoli, etc.), eggs, some dairy (cream mostly), minimal cheats (mostly when eat at friends homes on weekends). – jstern Mar 31 2011 at 11:29

Mike Gruber · Answer 3 · 2011-03-03 03:41:27Z UTC

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Typically (in my experience) a VAP test will also give LDL subfractions ... LDL1, LDL2, LDL3, LDL4. These are the numbers that they derive the A/B pattern from, I think. You want to drive LDL3 and LDL4 (the dense subfractions) lower. Do your results say anything about these?

I found it interesting and useful to compare my pre-paleo numbers to what I got after changing diets.

answered Mar 3 2011 at 3:41

Mike Gruber
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	I've seen people list those values but don't see anything on my test results -- under the pattern section just a graph with the asterisk into the Pattern A section by about 1/3 and then HDL-2, HDL-3 and VLDL-3 results. – jstern Mar 3 2011 at 15:36
	When my labwork was done by Paclab, I used to get LDL1->4 broken out. Now my Dr. uses Quest, and they don't do that unless you specifically ask for it. These are the 2 labs in the Seattle area. – Mike Gruber Sep 15 2011 at 22:28

Rhubarb · Answer 4 · 2011-04-14 07:45:39Z UTC

Your numbers look good to me (but I am just some random dude on the interwebs..).

Two things about the statins, no way I would be going on them, particularly with your lipid panel, and if your doctor is unable to give you an incredible reason to go on them, apart from the fact he thinks your total cholesterol is to high because he subscribes to the lipid hypothesis, I'd be looking for a new doc.

Namby Pamby · Answer 5 · 2011-04-28 14:52:26Z UTC

I would track other markers of CVD. Have your doc check your (1) inflammaiton levels (CRP, Sed Rate, Ferritin, WBC, etc.), (2) insulin resistance (A1c, Fasting BG, GTT, Fructosamine), and (3) homocysteine (along with B12, B5 and Folic Acid).

Along with the lipid profile, you should look at these results, which are in many ways better indicators taken together as a whole than the lipid profile.

If those results come out normal, I would opt out of the statin track. Get tested again in about 2-3 months, recheck your lipid profile and these markers. If you're doing Paleo correctly, your results should improve.

goodwill · Answer 6 · 2011-10-28 01:23:57Z UTC

I know a lot of good research is posted on this site but people please be careful of medical advice coming from non-medical people. Physicians are trained for many many years. As much as we all like to think we're experts reading a dozen articles or so it cannot replace 4 years of medical school and another ~4-8 years of residency, possible fellowship, and years of clinical experience. As for Statins, they do have a bad name and have significant risks but they also save lives. I don't want to start a Statin debate because i'm well aware of both side. Obviously, any good doctor should be telling you to (and how to) approach diet + exercise first. Perhaps find a doc who is paleo as well. There are actually plenty of them.

Gary Mullennix · Answer 7 · 2013-01-26 22:46:34Z UTC

My numbers are similar and I've been Paleo for 15 months, losing 45 lbs. my numbers and ratios are very nice although my ferritin level of 172 caused mr to donate blood which I shall do until I get to 90. However, in running down all the details to be clear about my cardio health, I had a Coronary Calcium scan and in one artery I had a value of 329. My blood pressure is low, my HDL is 91 and my risk of a MIZ IN THE NEXT 10 years is 9%. So, all the blood markers now don't tell about then...before paleo. The calcium scan takes about 10 minutes and unlike the lipid panels is not a proxy. It is in fact real evidence of plaque. That plaque is composed of 3% cholesterol and 50% calcium. Your goal is to get sugars out of your system and stop the inflammation. That inflammation is caused by the small LDL4 and 3 particles. Eat grains, starches and sugary juices and watch them go up and up. My Ldl1/2 totaled 111 and my 3/4 totaled 47 with 4 ay 12mg/dl

elduderino · Answer 8 · 2013-01-27 01:38:35Z UTC

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Your numbers do not look that bad IMHO. Some gut feeling tells me that you should get a thyroid panel. Your lab does look a little bit hypothyroid-y to me, I just can't explain why.

answered Jan 27 at 1:38

elduderino
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Diane Carter · Answer 9 · 2013-03-25 20:21:38Z UTC

I can't believe the responses saying the numbers are not bad. Without getting into all of the VAP reference. I am also shocked the ordering physician/provdider did not provide you with an interpretation. VAP test is patented and only performed by Atherotech lab. Their website http://www.atherotech.com/content/thevaptest/pdfs/vapbrochure.pdf discusses normal and desirable result ranges. LDL should be less than 139 per Atherotech. Your LDL is 214. However, if you have risk factors such as family history, a physician will want you to go below 100 mg/dl or even below 80 if you have any symptoms of CVD. Your cholesterol of 277 is extremely high.
The National Cholesterol Education Program (NCEP) has set the following guidelines for lipids (total cholesterol, triglycerides, high density lipoprotein [HDL], and low density lipoprotein [LDL] cholesterol) in adults ages 18 and up: TOTAL CHOLESTEROL Desirable: <200 mg/dL Borderline high: 200-239 mg/dL High: > or =240 mg/dL The National Cholesterol Education Program (NCEP) and National Health and Nutrition Examination Survey (NHANES) has set the following guidelines for lipids (total cholesterol, triglycerides, HDL, and LDL cholesterol) in children ages 2-17: TOTAL CHOLESTEROL Desirable: <170 mg/dL Borderline high: 170 -199 mg/dL High: > or =200 mg/dL

Also see age and sex adjusted reference values in Total Cholesterol-Percentile Ranking in Lipids and Lipoproteins in Blood Plasma (Serum) in Special Instructions. Interpretation The National Cholesterol Education Program (NCEP) has set the following guidelines for total cholesterol:

Desirable: <200 mg/dL Borderline high: 200 mg/dL to 239 mg/dL High: > or = 240 mg/dL

Help Interpreting My VAP test

9 Answers